Contemporary Directions in Psychopathology PDF
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The present book is similar in concept to a well-received volume that one of us (Theodore Millon) edited with Gerald L. Klerman of Harvard University in 1986; it is, however, an almost entirely new book, with only one chapter carried over from the earlier work. Gerry and I were colleagues at the Stanley Cobb Psychiatric Laboratories of Massachusetts General Hospital, as well as active participants in the development of DSM-III. Our aim in the earlier volume was to describe substantive and innovative advances since the publication of DSM-III in 1980, and to emphasize themes we believed should be considered in the forthcoming DSMIV. We, the present editors, intend to do the same in this volume for DSM-IV(-TR) and for the forthcoming DSM-V and ICD-11.
Numerous changes in the character of psychopathology have begun taking place in the past several decades. Slow though progress has been, there are inexorable signs that the study of mental disorders has advanced beyond its earlier history as an oracular craft. No longer dependent on the intuitive artistry of brilliant clinicians and theoreticians who formulated dazzling but often unfalsifiable insights, psychopathology has acquired a solid footing in the empirical methodologies and quantitative techniques that characterize mature sciences. Although the term “psychopathology” was used in the past as synonymous with “descriptive symptomatology,” it can now be justly employed to represent “the science of abnormal behavior and mental disorders.” Its methods of study comfortably encompass both clinical and experimental procedures.
Among the many indices of continuing progress is the construction of psychometrically sound diagnostic tools that wed the quantitative and statistical precision typifying rigorous empirical disciplines with the salient and dynamic qualities characterizing the concerns of a clinical profession. Contributing to this precision is the introduction of comprehensive and comparable diagnostic criteria for each mental disorder—an advance that not only enhances the clarity of clinical communication, but strengthens the reliability of research, contributing thereby to the collection of reciprocal and cumulative data. Similarly, sophisticated multivariate statistical methods now provide quantitative grounds for analyzing symptom patterns and constructing an orderly taxonomy.
Theoretical formulations have also begun to take on a more logical and orderly structure. Whereas earlier propositions were often presented in haphazard form, with circular derivations and ambiguous or conflicting empirical consequences, contemporary theorists began to specify explicit criteria for their concepts, as well as to spell out objective procedures and methods for testing their hypotheses. Moreover, theorists have become less doctrinaire in their positions than formerly; that is, they no longer act and write as religious disciples of “theological purity.” A true “ecumenism” has emerged—an open-mindedness and sharing of views that are much more characteristic of disciplines with secure foundations. Thus erstwhile analysts have shed their former dogmatisms and have begun to incorporate findings such as those in the neurosciences and social psychology; similarly, once-diehard behaviorists have jettisoned their earlier biases and have integrated cognitive processes into their principles. On many levels and from several perspectives, the signs indicate consistently that psychopathology is becoming a full-fledged science.
It is our intent in this book to draw attention to innovations that constitute continuations of these directions. The volume is not intended to be a comprehensive textbook, but many of its chapters provide thoughtful pedagogic reviews and heuristic recommendations that may prove useful to the forthcoming DSM-V and ICD-11. In this latter regard, we very much favor current efforts to construct further rapprochements between the American Psychiatric Association’s DSM and the World Health Organization’s ICD. Work on the new editions of both manuals is well underway, and we believe that a successful accommodation will come from the combination of careful theoretical and conceptual analyses, and the parallel acquisition of empirical data from well-designed research. This work not only reflects the current state of psychopathology as a science, but should help identify the issues and methods that can foster this important reconciliation.
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