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Defining Psychopathology in the 21st Century

DSM-V™ and Beyond

Edited by John E. Helzer, M.D., and James J. Hudziak, M.D.
American Psychopathological Association

  • ISBN 978-1-58562-063-0
  • Item #62063

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Among today's astounding research discoveries, perhaps the most fascinating is the mapping of the human genome and its implications for a vastly improved understanding of how genes affect our physiology and behavior. With that understanding comes a critical need to establish a diagnostic taxonomy for psychiatric illness that is more precise but still clinically relevant.

This volume responds to that need. It highlights the shortcomings of current categorical diagnoses, such as those used in DSM-IV, for future research needs in behavioral disorders in general and psychiatric genetics in particular.

With a chapter by each distinguished neuroscientist who presented at the 2000 American Psychopathological Association (APPA) meeting, this volume is divided into four sections: Definitional Tensions, which discusses the difficulties with the current categorical diagnostic system; Imaging Psychopathology, which presents research demonstrating how imaging technologies can tremendously improve our illness definitions; Longitudinal Studies, which details what we can learn from epidemiological and other longitudinal studies; and Exploring Alternatives, which discusses the application of dimensional classification systems in genetics research in psychopathology, with a fascinating chapter on using new methodologies for treating subsyndromal or pre-schizophrenia, a taxonomic condition defined herein as schizotaxia.

This unique collection represents a significant step in developing approaches to classification that will lead to more accurate diagnoses and treatments for patients and a broader range of taxonomic options for researchers. As such, it will also be welcomed by psychiatric clinicians and educators, as well as by anyone interested in genetics and how it governs human behavior.


  • Contributors
  • Preface
  • Part I: Definitional Tensions
  • Chapter 1. Five Criteria for an Improved Taxonomy of Mental Disorders
  • Chapter 2. Defining Clinically Significant Psychopathology With Epidemiologic Data
  • Chapter 3. Why Requiring Clinical Significance Does Not Solve Epidemiology's and DSM's Validity Problem: Response to Regier and Narrow
  • Chapter 4. Psychometric Perspectives on Comorbidity
  • Part II: Imaging Psychopathology
  • Chapter 5. Toward a Neuroanatomical Understanding of Psychiatric Illness: The Role of Functional Imaging
  • Chapter 6. Neuroimaging Studies of Mood Disorders
  • Chapter 7. Genetic Neuroimaging: Helping to Define Phenotypes in Affective Disorders
  • Part III: Longitudinal Studies
  • Chapter 8. Psychopathology and the Life Course
  • Chapter 9. Detecting Longitudinal Patterns of Alcohol Use
  • Chapter 10. Empirically Based Assessment and Taxonomy Across the Life Span
  • Chapter 11. ADHD Comorbidity Findings From the MTA Study: New Diagnostic Subtypes and Their Optimal Treatments
  • Part IV: Exploring Alternatives
  • Chapter 12. Implications of Genetic Epidemiology for Classification
  • Chapter 13. Importance of Phenotype Definition in Genetic Studies of Child Psychopathology
  • Chapter 14. Defining Genetically Meaningful Classes of Psychopathology
  • Chapter 15. Schizotaxia and the Prevention of Schizophrenia
  • Index

About the Authors

John E. Helzer, M.D., is Professor of Psychiatry at the Health Behavior Research Center of the University of Vermont School of Medicine in Burlington, Vermont.

James J. Hudziak, M.D., is Associate Professor of Psychiatry and Medicine (Division of Human and Medical Genetics) and Director of Child Psychiatry at the University of Vermont School of Medicine in Burlington, Vermont.

The 21st century will see the rise of molecular medicine. For psychiatry to participate in this ongoing revolution, we need a diagnostic system that is biologically and genetically meaningful. The chapters in this volume offer a wide-ranging blueprint to establish a diagnostic system that is relevant to both treatment and research.—Richard D. Todd, Ph.D., M.D., Departments of Psychiatry and Genetics, Washington University School of Medicine, St. Louis, Missouri

Defining Psychopathology in the 21st Century is a fascinating collection of papers, and represents some of the best research being done in current psychiatry.—Metapsychology Online, 8/1/2003

[Helzer and Hudziac] have produced a fine text that is both scholarly in content and exciting to read.—British Journal of Psychiatry, 8/1/2003

I would recommend Defining Psychopathology in the 21st Century to anyone interested in psychiatric research as well as to those who are concerned about and interested in the future of psychiatry. I believe that this book gave me a glimpse of where the field of psychiatry is headed, and I find this exciting.—Benjamin O'Brien, M.D., Psychiatric Services, 8/1/2003

This book is an informative and provocative update for a clinician or student who cannot read all the journals all the time and might be wondering, 'How are scientific findings distilled into facts that produced the early DSM versions, and what will be the theoretical basis for the next DSM?'.—Ronald M. Solomon, M.D., Journal of Clinical Psychiatry, 8/1/2003

[R]eaders wanting an exciting 'state of the art' collection about the sorts of studies and thinking likely to shape future editions of the DSM will find this volume to be extremely worthwhile.—Joel Yager, M.D., Bulletin of the Menninger Clinic, 8/1/2003

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