Externalizing psychopathology in adulthood: a dimensional-spectrum conceptualization and its implications for DSM-V

Area of Science:

• Psychiatry
• Behavioral Science
• Genetics

Background:

• Mental disorders like antisocial behavior and substance use often co-occur and share genetic links.
• These conditions appear to exist on a spectrum rather than as distinct categories.

Purpose of the Study:

• To propose a dimensional, hierarchical "externalizing spectrum" model for psychopathology.
• To empirically investigate comorbidity patterns among externalizing disorders using a quantitative approach.

Main Methods:

• A model-based quantitative approach was used to compare categorical and continuous models of psychopathology.
• Comorbidity data for externalizing disorders, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), were analyzed.

Main Results:

• Evidence supports a continuous, normally distributed spectrum of risk for multiple externalizing disorders.
• Comorbidity among these disorders is best explained by this underlying continuum.

Conclusions:

• The externalizing spectrum conceptualization offers a more accurate framework for understanding these linked disorders.
• This model has significant implications for the classification of mental disorders in the DSM-5.