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Annual Research Review: Categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders – implications of recent empirical study
Author(s) -
Coghill David,
SonugaBarke Edmund J.S.
Publication year - 2012
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/j.1469-7610.2011.02511.x
Subject(s) - categorical variable , psychology , context (archaeology) , empirical research , meaning (existential) , categorization , developmental psychology , nosology , cognitive psychology , clinical psychology , psychiatry , psychotherapist , epistemology , paleontology , philosophy , machine learning , computer science , biology
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.