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September 1988, Vol 45, No. 9 >
Article | September 1988

Having a Dream: Title and subTitle BreakA Research Strategy for DSM-IV

Robert L. Spitzer, MD; Janet B. W. Williams, DSW
[+] Author Affiliations

Accepted for publication April 1, 1988.

Reprint requests to New York State Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr Spitzer).


Arch Gen Psychiatry. 1988;45(9):871-874. doi:10.1001/archpsyc.1988.01800330105013
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• Psychiatric research has had a major impact on both DSM-III and its revision (DSM-III-R). We propose a strategy to maximize the impact of psychiatric research on DSM-IV. This strategy is an elaboration of a study design that was particularly helpful in developing criteria for several of the problematic diagnostic categories of DSM-III-R. The strategy, called a "multiplex study design," employs (1) multiple collaborating centers, (2) multiple experts in the diagnoses being studied at each site, and (3) multiple diagnostic criteria sets so that alternative definitions of disorders can be compared in terms of (4) multiple external validity criteria, such as familial aggregation, course, and differential response to treatment. This strategy is a particularly efficient method for providing an empiric base for further revisions in our official classification of mental disorders.

REFERENCES

1 +
Spitzer RL, Williams JBW:  Research couple finds novel use for Archives . Arch Gen Psychiatry 1984;;41:632.
2 +
Feighner JP, Robins E, Guze SB, Woodruff RA, Winokur G, Munoz R:  Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 1972;;26:57-63.
3 +
Spitzer RL, Endicott J, Robins E:  Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry 1978;;35:773-789.
4 +
Williams JBW:  The multiaxial system of DSM-III: Where did it come from and where should it go? I. Its origins and critiques . Arch Gen Psychiatry 1985;;42:175-180.
5 +
Cooper JE, Kendell RE, Gurland BJ, Sharpe L, Copeland JRM, Simon R: Psychiatric Diagnosis in New York and London: A Comparative Study of Mental Hospital Admissions . London, Oxford University Press, 1972;.
6 +
Spitzer RL, Andreasen NC, Endicott J:  Schizophrenia and other psychotic disorders in DSM-III . Schizophr Bull 1978;;4:489-511.
7 +
Weissman MM:  The myth of involutional melancholia . JAMA 1979;;242:742-744.
8 +
Klein DF, Zitrin CM, Woerner M:  Antidepressants, anxiety, panic and phobia , in Lipton MA, DiMascio A, Killman K (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978;, pp 1401-1410.
9 +
Marks I. Fears and Phobias . Orlando, Fla, Academic Press Inc, 1969;.
10 +
Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, Davenport Y, Mueller PS, Newsome DA, Wehr TA:  Seasonal affective disorder: A description of the syndrome and preliminary findings with light therapy . Arch Gen Psychiatry 1984;;41:72-80.
11 +
Terman M:  On the question of a mechanism in the phototherapy for seasonal affective disorder: Considerations of clinical efficacy and epidemiology . J Biol Rhythms , in press.
12 +
Halbreich U, Endicott J, Nee J:  The diversity of premenstrual changes as reflected in the premenstrual evaluation form . Acta Psychiatr Scand 1982;;65:46-65.
13 +
Rubinow DR, Roy-Byrne P, Hoban MC:  Prospective assessment of menstrually related mood disorders . Am J Psychiatry 1984;;141:684-686.
14 +
Spitzer RL:  Psychiatric diagnosis: Are clinicians still necessary? Compr Psychiatry 1983;;24:399-411.
15 +
Berlin FS:  Interviews with five rapists . Am J Forensic Psychiatry 1986;;7:11-41.
16 +
American Psychiatric Association: Draft: DSM-III-R in Development—10/5/85 . Washington, DC, American Psychiatric Association, 1985;.
17 +
Liebowitz MR, Quitkin FM, Stewart JW, McGrath PJ, Harrison WM, Markowitz JS, Rabkin JG, Tricamo E, Goetz DM, Klein DF:  Antidepressant specificity in atypical depression . Arch Gen Psychiatry 1988;;45:129-137.
18 +
Ochberg F (ed). Post-traumatic Therapy and Victims of Violence . New York, Brunner-Mazel, 1988;.
19 +
Kocsis JH, Frances AJ:  A critical discussion of DSM-III dysthymic disorder . Am J Psychiatry 1987;;144:1534-1542.
20 +
Akiskal HS:  Dysthymic disorder: Psychopathology of proposed chronic depressive subtypes . Am J Psychiatry 1983;;140:11-20.
21 +
Gershon ES, Weissman MM, Guroff JJ, Prusoff BA, Leckman JF:  Validation of criteria for major depression through controlled family study . J Affective Disord 1986;;11:125-131.

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1 +
Spitzer RL, Williams JBW:  Research couple finds novel use for Archives . Arch Gen Psychiatry 1984;;41:632.
2 +
Feighner JP, Robins E, Guze SB, Woodruff RA, Winokur G, Munoz R:  Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 1972;;26:57-63.
3 +
Spitzer RL, Endicott J, Robins E:  Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry 1978;;35:773-789.
4 +
Williams JBW:  The multiaxial system of DSM-III: Where did it come from and where should it go? I. Its origins and critiques . Arch Gen Psychiatry 1985;;42:175-180.
5 +
Cooper JE, Kendell RE, Gurland BJ, Sharpe L, Copeland JRM, Simon R: Psychiatric Diagnosis in New York and London: A Comparative Study of Mental Hospital Admissions . London, Oxford University Press, 1972;.
6 +
Spitzer RL, Andreasen NC, Endicott J:  Schizophrenia and other psychotic disorders in DSM-III . Schizophr Bull 1978;;4:489-511.
7 +
Weissman MM:  The myth of involutional melancholia . JAMA 1979;;242:742-744.
8 +
Klein DF, Zitrin CM, Woerner M:  Antidepressants, anxiety, panic and phobia , in Lipton MA, DiMascio A, Killman K (eds): Psychopharmacology: A Generation of Progress . New York, Raven Press, 1978;, pp 1401-1410.
9 +
Marks I. Fears and Phobias . Orlando, Fla, Academic Press Inc, 1969;.
10 +
Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, Davenport Y, Mueller PS, Newsome DA, Wehr TA:  Seasonal affective disorder: A description of the syndrome and preliminary findings with light therapy . Arch Gen Psychiatry 1984;;41:72-80.
11 +
Terman M:  On the question of a mechanism in the phototherapy for seasonal affective disorder: Considerations of clinical efficacy and epidemiology . J Biol Rhythms , in press.
12 +
Halbreich U, Endicott J, Nee J:  The diversity of premenstrual changes as reflected in the premenstrual evaluation form . Acta Psychiatr Scand 1982;;65:46-65.
13 +
Rubinow DR, Roy-Byrne P, Hoban MC:  Prospective assessment of menstrually related mood disorders . Am J Psychiatry 1984;;141:684-686.
14 +
Spitzer RL:  Psychiatric diagnosis: Are clinicians still necessary? Compr Psychiatry 1983;;24:399-411.
15 +
Berlin FS:  Interviews with five rapists . Am J Forensic Psychiatry 1986;;7:11-41.
16 +
American Psychiatric Association: Draft: DSM-III-R in Development—10/5/85 . Washington, DC, American Psychiatric Association, 1985;.
17 +
Liebowitz MR, Quitkin FM, Stewart JW, McGrath PJ, Harrison WM, Markowitz JS, Rabkin JG, Tricamo E, Goetz DM, Klein DF:  Antidepressant specificity in atypical depression . Arch Gen Psychiatry 1988;;45:129-137.
18 +
Ochberg F (ed). Post-traumatic Therapy and Victims of Violence . New York, Brunner-Mazel, 1988;.
19 +
Kocsis JH, Frances AJ:  A critical discussion of DSM-III dysthymic disorder . Am J Psychiatry 1987;;144:1534-1542.
20 +
Akiskal HS:  Dysthymic disorder: Psychopathology of proposed chronic depressive subtypes . Am J Psychiatry 1983;;140:11-20.
21 +
Gershon ES, Weissman MM, Guroff JJ, Prusoff BA, Leckman JF:  Validation of criteria for major depression through controlled family study . J Affective Disord 1986;;11:125-131.

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