Categorical Approach vs. Dimensional Approach: A review of the current state of the DSM
Dakshin De Silva
663160
Word Count:2250
The primary aim of psychiatric diagnosis is to provide information about the conditions from which psychological problems emerge. A formal diagnostic system like DSM–V provides concepts that can be diagnosed by applying a specific set of diagnostic rules (Kamphuis, J. H. & Noordhof, A.(2009). In our present stage of knowledge we are not able to classify psychotic disorders by their nature and we must rely on their describable manifestations (Peralta, V. & Cuesta, M. J. (2007). In this manner the format of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, American Psychiatric …show more content…
In particular a categorical model can be easier to use than a dimensional model (Widiger, T. A. (1991). It’s much easier to categorise a few disorders than assess the degree to which each of the disorders is present. Further there is no middle ground when using the categorical model, such that an individual will either have the disorder or not. In the clinical setting as well since the categorical approach has being well established it has a sense of familiarity among clinicians. A rapid change from the system would represent a major shift in clinical practice (Frances, 1990). The categorical approach is also consistent with the neo-Kraepelinian emphasis on identifying homogeneous, distinct syndromes (Robins & Helzer, 1986). In this way the categorical diagnoses are consistent with clinical decisions. Since treatment must be defined to a certain disorder the categorical model allows for this compared to the dimensional model. Though in the clinical setting the categorical approach may seem the most feasible it is not without its disadvantages. The high level of coexisting DSM disorders is a major challenge to research paradigms (Klein & Riso, 1993; Krueger, 1999; Maser & Cloninger, 1990). In particular one must remember that causal relation between diagnoses and actual psychopathology cannot be observed, so diagnoses can be regarded as hypothetical constructs (Cronbach & Meehl, 1955). These hypothetical constructs are defined in the DSM IV by “a categorical approach to classification works best when all members of a diagnostic class are homogenous, when there are clear boundaries between classes, and when the different classes are mutually exclusive”( (American Psychiatric Association, 1994). However it can be seen that in several mental illness such as personality disorders and Schizophrenia this is
Dakshin De Silva
663160
Word Count:2250
The primary aim of psychiatric diagnosis is to provide information about the conditions from which psychological problems emerge. A formal diagnostic system like DSM–V provides concepts that can be diagnosed by applying a specific set of diagnostic rules (Kamphuis, J. H. & Noordhof, A.(2009). In our present stage of knowledge we are not able to classify psychotic disorders by their nature and we must rely on their describable manifestations (Peralta, V. & Cuesta, M. J. (2007). In this manner the format of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, American Psychiatric …show more content…
In particular a categorical model can be easier to use than a dimensional model (Widiger, T. A. (1991). It’s much easier to categorise a few disorders than assess the degree to which each of the disorders is present. Further there is no middle ground when using the categorical model, such that an individual will either have the disorder or not. In the clinical setting as well since the categorical approach has being well established it has a sense of familiarity among clinicians. A rapid change from the system would represent a major shift in clinical practice (Frances, 1990). The categorical approach is also consistent with the neo-Kraepelinian emphasis on identifying homogeneous, distinct syndromes (Robins & Helzer, 1986). In this way the categorical diagnoses are consistent with clinical decisions. Since treatment must be defined to a certain disorder the categorical model allows for this compared to the dimensional model. Though in the clinical setting the categorical approach may seem the most feasible it is not without its disadvantages. The high level of coexisting DSM disorders is a major challenge to research paradigms (Klein & Riso, 1993; Krueger, 1999; Maser & Cloninger, 1990). In particular one must remember that causal relation between diagnoses and actual psychopathology cannot be observed, so diagnoses can be regarded as hypothetical constructs (Cronbach & Meehl, 1955). These hypothetical constructs are defined in the DSM IV by “a categorical approach to classification works best when all members of a diagnostic class are homogenous, when there are clear boundaries between classes, and when the different classes are mutually exclusive”( (American Psychiatric Association, 1994). However it can be seen that in several mental illness such as personality disorders and Schizophrenia this is