Dimensionality of childhood psychopathology and the challenge of integration into clinical practice

Excerpt

For decades, the debate on whether psychopathology is best conceptualized as a dimension or as a category has occupied a central role in our field. Several articles and reviews were published on this theme [1‐3]. In the past years, a growing body of evidence has suggested that dimensionality would be a more ‘natural’ approach to mental disorders, at least for some of them [3, 4]. Thus, when the DSM-5 was initially planned, a dimensional component was supposed to be incorporated into the new classification system, in a way that patients could benefit from the understanding that the complexity of psychopathology is not entirely captured by diagnostic categories [5]. Unfortunately, this task was too ambitious for the moment and was not fully achieved, resulting in a final document that is fundamentally unchanged from the previous version. The DSM-5, as DSM-IV, is founded on categories and clinical decisions are still based on answers to dichotomous questions, with little impact of a dimensional component. …