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Letters to the Editor |

The Structure of the DSM

Robert F. Krueger, PhD
Arch Gen Psychiatry. 2002;59(6):570-571. doi:.
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It has been very gratifying to see so much interest in my recent work on comorbidity among common mental disorders,1 as evidenced by the letter from Borsboom and the recent replication and extension by Vollebergh et al.2 I will offer a few brief remarks on some of the points raised in Borsboom's letter.

Borsboom suggests that the factor structure of common DSM mental disorders1,2 could be attributed to overlapping criteria among the disorders. The majority (33 of 45) of the correlations among the mental disorders I studied were unaffected by shared criteria (see Borsboom's table). In fact, all the correlations bearing on the question of whether the National Comorbidity Survey data support a coherent externalizing factor that is distinct from the internalizing factor were unaffected by shared criteria. The issue of overlapping criteria is relevant only to the mood and anxiety disorders (ie, only correlations among these disorders have criterion overlap values greater than 0 in Borsboom's table). Can correlations among these disorders be understood by proposing a broad and coherent factor linking them, as opposed to attributing the relationships solely to criterion overlap? Consider the following 5 points.


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