Rethinking the Mood and Anxiety Disorders: A Quantitative Hierarchical Model for DSM-V

David Watson, University of Iowa

Article comments

Published in Journal of Abnormal Psychology, 114:4 (2005) pp. 522-536. DOI: 10.1037/0021-843X.114.4.522 Copyright © 2005 American Psychological Association. Used by permission. http://www.apa.org/journals/abn/

This article may not exactly replicate the final version published in the journal. It is not the copy of record.

Abstract

DSM-IV (American Psychiatric Association, 1994) groups disorders into diagnostic classes based on the subjective criterion of “shared phenomenological features”. We now have sufficient data to eliminate this rational system and replace it with an empirically-based structure that reflects the actual similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together in an overarching class of emotional disorders, which can be decomposed into three subclasses: the bipolar disorders (bipolar I, bipolar II, cyclothymia), the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder) and the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia). The optimal placement of other syndromes (e.g., obsessive-compulsive disorder) needs to be clarified in future research.