Annual research review: Categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders - Implications of recent empirical study

TY - JOUR

T1 - Annual research review

T2 - Categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders - Implications of recent empirical study

AU - Coghill, D.

AU - Sonuga-Barke, E.J.S.

N1 - Copyright 2012 Elsevier B.V., All rights reserved.

PY - 2012/5/1

Y1 - 2012/5/1

N2 - The question of whether child and adolescent mental disorders are best classified using dimensional or categorical approaches is a contentious one that has equally profound implications for clinical practice and scientific enquiry. Here, we explore this issue in the context of the forth coming publication of the DSM-5 and ICD-11 approaches to classification and diagnosis and in the light of recent empirical studies. First, we provide an overview of current category-based systems and dimensional alternatives. Second, we distinguish the various strands of meaning and levels of analysis implied when we talk about categories and dimensions of mental disorder - distinguishing practical clinical necessity, formal diagnostic systems, meta-theoretical beliefs and empirical reality. Third, we introduce the different statistical techniques developed to identify disorder dimensions and categories in childhood populations and to test between categorical and dimensional models. Fourth, we summarise the empirical evidence from recent taxometric studies in favour of the 'taxonomic hypothesis' that mental disorder categories reflect discrete entities with putative specific causes. Finally, we explore the implications of these findings for clinical practice and science.

AB - The question of whether child and adolescent mental disorders are best classified using dimensional or categorical approaches is a contentious one that has equally profound implications for clinical practice and scientific enquiry. Here, we explore this issue in the context of the forth coming publication of the DSM-5 and ICD-11 approaches to classification and diagnosis and in the light of recent empirical studies. First, we provide an overview of current category-based systems and dimensional alternatives. Second, we distinguish the various strands of meaning and levels of analysis implied when we talk about categories and dimensions of mental disorder - distinguishing practical clinical necessity, formal diagnostic systems, meta-theoretical beliefs and empirical reality. Third, we introduce the different statistical techniques developed to identify disorder dimensions and categories in childhood populations and to test between categorical and dimensional models. Fourth, we summarise the empirical evidence from recent taxometric studies in favour of the 'taxonomic hypothesis' that mental disorder categories reflect discrete entities with putative specific causes. Finally, we explore the implications of these findings for clinical practice and science.

UR - https://www.scopus.com/pages/publications/84859733766

U2 - 10.1111/j.1469-7610.2011.02511.x

DO - 10.1111/j.1469-7610.2011.02511.x

M3 - Article

AN - SCOPUS:84859733766

SN - 0021-9630

VL - 53

SP - 469

EP - 489

JO - Journal of Child Psychology and Psychiatry

JF - Journal of Child Psychology and Psychiatry

IS - 5

ER -