Salud Mental

Transdiagnostic Specifiers: Challenges in Children and Adolescents Psychiatry Classification

##plugins.themes.bootstrap3.article.main##

Francisco R. de la Peña
Gabriela Cortés-Meda
Emmanuel Isaías Sarmiento Hernández

Abstract

The last twenty years have been one of debate and controversy around changes in the classification of mental disorders in general but particularly in children and adolescents (de la Peña & Feria, 2021). The original proposals for diagnostic validity mentioned by Robins & Guze (1970) and Feigher et al. (1972) are far away from new classification approaches. The clinical descriptions of the current classifications diagnoses are complex and involve symptoms in affects, cognition, behaviors and social interactions that are present among the different categories, this condition generates shared clinical manifestations. This situation impedes an adequate categorical delimitation. Current detailed brain imaging and function approaches, genetic or neuropsychological studies are still not of complete diagnostic utility for clinical work in children and adolescents psychiatry. Follow-up studies and long-term treatments have only partially helped to understand some aspects of the pathophysiology of disorders and their evolution over time.

References

Achenbach, T. M. (1966). The classification of children’s psychiatric symptoms: A factor-analytic study. Psychological Monographs: General and Applied, 80(7), 1-37. doi: 10.1037/h0093906

Achenbach, T. M. (2021). Hierarchical dimensional models of psychopathology: Yes, but… World Psychiatry, 20(1), 64-65. doi: 10.1002/wps.20810

Achenbach, T. M., Ivanova, M. Y., Rescorla, L. A., Turner, L. V., & Althoff, R. R. (2016). Internalizing/externalizing problems: Review and recommendations for clinical and research applications. Journal of the American Academy of Child & Adolescent Psychiatry, 55(8), 647-656. doi: 10.1016/j.jaac.2016.05.012

American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders - DSM-5 (5th Ed.). Arlington, VA: American Psychiatric Publishing.

Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., Meier, M. H., Ramrakha, S., Shalev, I., Poulton, R., & Moffitt, T. E. (2014). The p Factor:one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2(2), 119-137. doi: 10.1177/2167702613497473

de la Peña, F. R., & Feria, M. (2021). Diagnostic dimensionality and transdiagnostic clinical manifestations. Salud Mental, 44(3), 103-105. doi: 10.17711/SM.0185-3325.2021.014

Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26(1), 57-63. doi: 10.1001/archpsyc.1972.01750190059011

Frick, P. J., Cornell, A. H., Bodin, S. D., Dane, H. E., Barry, C. T., & Loney, B. R. (2003). Callous-unemotional traits and developmental pathways to severe conduct problems. Developmental Psychology, 39(2), 246-260. doi: 10.1037/0012-1649.39.2.246

Hooley, J. M., Fox, K. R., & Boccagno, C. (2020). Nonsuicidal self-injury: diagnostic challenges and current perspectives. Neuropsychiatric Disease and Treatment, 16, 101-112. doi: 10.2147/NDT.S198806

Lochman, J. E., Evans, S. C., Burke, J. D., Roberts, M. C., Fite, P. J., Reed, G. M., de la Peña. F. R., Matthys, W., Ezpeleta, L., Siddiqui, S., Garralda, M. E. (2015). An empirically based alternative to DSM-5’s disruptive mood dysregulation disorder for ICD-11. World Psychiatry, 14(1), 30-33. doi: 10.1002/wps.20176

Mullins-Sweatt, S. N., Bornovalova, M. A., Carragher, N., Clark, L. A., Corona Espinosa, A., Jonas, K., Keyes, K. M., Lynam, D. R., Michelini, G., Miller, J. D., Min, J., Rodriguez-Seijas, C., Samuel, D. B., Tackett, J. L., & Watts, A. L. (2022). HiTOP assessment of externalizing antagonism and disinhibition. Assessment, 29(1), 34-45. doi: 10.1177/10731911211033900

Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. American Journal of Psychiatry, 126(7), 983-987. doi: 10.1176/ajp.126.7.983

Watson, D., Levin‐Aspenson, H. F., Waszczuk, M. A., Conway, C. C., Dalgleish, T., Dretsch, M. N., Eaton, N. R., Forbes, M. K., Forbush, K. T., Hobbs, K. A., Michelini, G., Nelson, B. D., Sellbom, M., Slade, T., South, S. C., Sunderland, M., Waldman, I., Witthöft, M., Wright, A. G., ... Krueger, R. F. (2022). Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum. World Psychiatry, 21(1), 26-54. doi: 10.1002/wps.20943

World Health Organization [WHO], (2024). Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (CDDR). Available at https://www.who.int/publications/i/item/9789240077263