Do We Need a Novel Framework for Classifying Psychopathology? A Discussion Paper

Winfried Rief; Stefan G Hofmann; Max Berg; Miriam K Forbes; Diego A Pizzagalli; Johannes Zimmermann; Eiko Fried; Geoffrey M Reed

doi:10.32872/cpe.11699

Do We Need a Novel Framework for Classifying Psychopathology? A Discussion Paper

Clin Psychol Eur. 2023 Dec 22;5(4):e11699. doi: 10.32872/cpe.11699. eCollection 2023 Dec.

Authors

Winfried Rief¹, Stefan G Hofmann², Max Berg¹, Miriam K Forbes³, Diego A Pizzagalli⁴, Johannes Zimmermann⁵, Eiko Fried⁶, Geoffrey M Reed⁷

Affiliations

¹ Clinical Psychology and Psychotherapy Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany.
² Translational Clinical Psychology Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany.
³ School of Psychological Sciences, Australian Hearing Hub, Macquarie University Sydney, Sydney, Australia.
⁴ Department of Psychiatry, Center for Depression, Anxiety and Stress Research & McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA.
⁵ Department of Psychology, University of Kassel, Kassel, Germany.
⁶ Clinical Psychology Group, Department of Psychology, Leiden University, Leiden, The Netherlands.
⁷ Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.

Abstract

Introduction: The ICD-11 and DSM-5 are the leading systems for the classification of mental disorders, and their relevance for clinical work and research, as well as their impact for policy making and legal questions, has increased considerably. In recent years, other frameworks have been proposed to supplement or even replace the ICD and the DSM, raising many questions regarding clinical utility, scientific relevance, and, at the core, how best to conceptualize mental disorders.

Method: As examples of the new approaches that have emerged, here we introduce the Hierarchical Taxonomy of Psychopathology (HiTOP), the Research Domain Criteria (RDoC), systems and network approaches, process-based approaches, as well as a new approach to the classification of personality disorders.

Results and discussion: We highlight main distinctions between these classification frameworks, largely related to different priorities and goals, and discuss areas of overlap and potential compatibility. Synergies among these systems may provide promising new avenues for research and clinical practice.

Keywords: DSM-5; Hierarchical Taxonomy of Psychopathology HiTOP; ICD-11; Research Domain Criteria RDoC; network theory; personality disorders; process-based therapy PBT.

Publication types

Review

Grants and funding

Rief: Winfried Rief declares to have received speaker’s honorarium from Boehringer Ingelheim. His research is support by several unconditional public grants from the German Research Foundation DFG and the Hessian Ministry of Science and Art. He also receives shares from publishing scientific and clinical books. All views expressed are solely those of the author. Berg: Max Berg’s post-doc position is funded by the Hessian Ministry of Arts and Science. No funding from this entity was used to support the current work, and all views expressed are solely those of the author. Forbes: Miriam K. Forbes is funded by the Australian National Health and Medical Research Council, receives consulting fees from the Environmental Protection Authority Victoria, and receives honoraria from the American Psychological Association for editorial work. No funding from these entities was used to support the current work, and all views expressed are solely those of the author. Fried: Eiko I. Fried is supported by funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme, grant no. 949059. No funding from these entities was used to support the current work, and all views expressed are solely those of the author. Hofmann: During the last 3 years, Stefan G. Hofmann has received financial support by the Alexander von Humboldt Foundation (as part of the Alexander von Humboldt Professur), the Hessische Ministerium für Wissenschaft und Kunst (as part of the LOEWE Spitzenprofessur), NIH/NIMH R01MH128377, NIH/NIMHU01MH108168, Broderick Foundation/MIT, and the James S. McDonnell Foundation 21st Century Science Initiative in Understanding Human Cognition – Special Initiative. No funding from these entities was used to support the current work, and all views expressed are solely those of the author. Pizzagalli: Over the past 3 years, Dr. Pizzagalli has received consulting fees from Albright Stonebridge Group, Boehringer Ingelheim, Compass Pathways, Engrail Therapeutics, Neumora Therapeutics (formerly BlackThorn Therapeutics), Neurocrine Biosciences, Neuroscience Software, Otsuka, Sunovion, and Takeda; he has received honoraria from the Psychonomic Society and the American Psychological Association (for editorial work) and from Alkermes; he has received research funding from the Brain and Behavior Research Foundation, the Dana Foundation, Millennium Pharmaceuticals, NIMH, and Wellcome Leap; he has received stock options from Compass Pathways, Engrail Therapeutics, Neumora Therapeutics, and Neuroscience Software. No funding from these entities was used to support the current work, and all views expressed are solely those of the author. Reed: Geoffrey M. Reed has received support from the World Health Organization and the National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico. He has received honoraria for the direction and teaching of courses on the ICD-11 from the World Psychiatric Association, and a speaker’s honorarium from the California Psychological Association. No funding from these entities was used to support the current work, and all views expressed are solely those of the author. Zimmermann: Johannes Zimmermann received honoraria from the Society for Personality Assessment for editorial work. No funding from this entity was used to support the current work, and all views expressed are solely those of the author.