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Beyond comorbidity: Toward a dimensional and hierarchal approach to understanding psychopathology across the lifespan

机译:超越合并症:寻求一种维度和层次的方法来理解整个生命周期的精神病理学

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摘要

In this review, we propose a novel developmentally informed framework to push research beyond a focus on comorbidity between discrete diagnostic categories, and to move towards research based on the well-validated dimensional and hierarchical structure of psychopathology. For example, a large body of research speaks to the validity and utility of the Internalizing and Externalizing (IE) spectra as organizing constructs for research on common forms of psychopathology. The IE spectra act as powerful explanatory variables that channel the psychopathological effects of genetic and environmental risk factors, predict adaptive functioning, and account for the likelihood of disorder-level manifestations of psychopathology. As such, our proposed theoretical framework uses the IE spectra as central constructs to guide future psychopathology research across the lifespan. The framework is particularly flexible, as any of the facets or factors from the dimensional and hierarchical structure of psychopathology can form the focus of research. We describe the utility and strengths of this framework for developmental psychopathology in particular, and explore avenues for future research.
机译:在这篇综述中,我们提出了一个新颖的,具有发展知性的框架,以推动研究超越对离散诊断类别之间的合并症的关注,并朝着基于经过充分验证的心理病理学的维度和层次结构进行研究的方向。例如,大量的研究表明内在化和外在化(IE)光谱作为组织结构来研究常见形式的心理病理学的有效性和实用性。 IE光谱是强有力的解释变量,可引导遗传和环境风险因素的心理病理学作用,预测适应性功能并解释心理病理学在疾病水平表现的可能性。因此,我们提出的理论框架使用IE光谱作为中心结构来指导整个生命周期内的未来心理病理学研究。该框架特别灵活,因为心理病理学的维度和层次结构中的任何方面或因素都可以成为研究的重点。我们特别描述了该框架对发展性精神病理学的实用性和优势,并探索了未来研究的途径。

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