Dr. Miri Forbes: Symptom Overlap & Repetition in the DSM-5 Framework

Diagnostic frameworks like the DSM are often regarded as definitive, having an almost canonical-like quality.  On the other hand, there are many in the field who have become increasingly critical of the DSM and its shortcomings.  That said, the DSM has been quite helpful in a lot of ways with respect to organizing our thinking around mental illness as well as facilitating research.  Professor Dr. Miri Forbes joins us for a discussion of some of her research examining symptom overlap and repetition among DSM diagnoses.  In this discussion we cover:     

• Dr. Forbes' long-standing interest in symptom level structure of psychopathology
• general thoughts on the nature of mental illness vs. normal and expected reactions to psychosocial stress
• the major concerns that have coalesced around the DSM model of psychopathology 
• a description of HiTOP - a alternative diagnostic framework
• the phenomenon of diagnostic inflation
• a review of key questions addressed in recent research by Dr. Forbes and colleagues including:  1) How many distinct symptoms comprise the hundreds of diagnoses defined in DSM-5?  2) What proportion of these symptoms repeat across multiple diagnoses and/or chapters?  3) What patterns are evident in the symptom overlap among diagnoses within and between different chapters? 4) Are some chapters of psychopathology more prone to symptom repetition than others? 5) which symptoms show the greatest non-specificity as indicators of varied manifestations of psychopathology? 
• Conundrums around the search for biomarkers relative to our diagnostic systems and circular reasoning inherent in this
• the primacy of the DSM framework relative to other systems available
• the need for more continuum based perspectives to be integrated into existing  and emergent diagnostic frameworks 

Miri Forbes is an Associate Professor in the Centre for Emotional Health and School of Psychological Sciences at Macquarie University in Sydney, Australia. Dr Forbes was awarded her PhD in Psychology in 2014, and went on to do postdoctoral fellowships at the University of Minnesota and Macquarie University, before receiving back-to-back fellowships to fund her own program of research. She is a member of the Executive Board of the international Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium and a member of the Executive Committee of the Centre for Emotional Health. Dr Forbes' current research focuses on improving our understanding of the empirical structure of psychopathology based on the specific patterns in which symptoms of mental disorders tend to co-occur.

https://miriamkforbes.academ