Psychopathology does not fit with a traditional medical disease model, and as such the line defining clinical disorders is often blurred. The DSM-5’s categorical diagnostic system provides an inadequate method for describing psychopathology. There is mounting evidence that psychopathology is better described using a dimensional, continuous approach. Several pieces of evidence support a dimensional view over the current categorical structure: High rates of comorbidity among current DSM diagnoses, heterogeneity within diagnostic categories, and the lack of discontinuity separating sub-threshold symptoms from diagnosable disorders. Specifically, the structure of psychopathology may be best described using several broad spectra (i.e., internalizing, …show more content…
Empirical research has not found a gap between sub-threshold and diagnosis-level symptoms, as would be expected from a categorical perspective. For example, the DSM-5 criteria for Generalized Anxiety Disorder actually identify a continuous distribution of severity among self-identified worriers, and do not indicate any clinically-significant ‘break’ in symptoms as would be expected from a categorical perspective (Hobbs, Anderson, Slade, & Andrews, 2014). Another study examined the occurrence of prolonged grief reactions among children who had experienced the death of a parent, and found that a dimensional approach to diagnosis was a better longitudinal predictor than was the proposed DSM-5 categorical approach (Melham, Porta, Payne, & Brent, …show more content…
Critically, a categorical approach entails assigning diagnostic labels based on an arbitrary set of criterion, whereas a dimensional approach might assign a diagnostic profile based on a dimensional analysis of symptoms. Brown and Barlow (2009) suggest such an approach, and they indicate that doing so may begin to address the issue of comorbidity. Kamphuis and Noordhof (2009) also support the notion of combining a dimensional structure with categorical labels, and go on to discuss how to statistically determine cutoffs to fit with the medical model of ‘having’ or ‘not having’ a