Beyond DSM and ICD: a comprehensive look at alternative approaches to understanding PTSD

Abstract

Psychopathology, diagnosis, and classification of mental disorders have traditionally been based on a biomedical perspective. With the aim of defining and classifying mental disorders, the American Psychiatric Association (APA) and the World Health Organization (WHO) developed two systems that are widely used in the mental health field: the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases and Related Health Problems (ICD). However, the limitations of DSM and ICD have led to the development of alternative models, such as the Research Domain Criteria (RDoC), Network Theory (NT), the Power Threat Meaning Framework (PTMF), the Hierarchical Taxonomy of Psychopathology (HiTOP), and the Psychodynamic Diagnostic Manual (PDM- 2). This manuscript describes these models using posttraumatic stress disorder (PTSD) for exemplification, as it is one of the most challenging and controversial disorders, briefly expounding their strengths and limitations. Although none of the models have proposed a widely accepted conceptualization of posttraumatic stress, their combined use from an integrative approach could provide an accurate definition of this phenomenon. The aim of this paper is to disseminate these models among practitioners and academics and to foster a debate concerning the potential benefits of assuming an integrative approach instead of assuming models ascribed to specific theoretical frameworks that limit our understanding of psychiatric conditions