DSM-V Research Planning Activities

Background

The preparation of DSM-IV placed a comprehensive review of empirical data at the center of the revision process. The first stage of the process consisted of a systematic review of the literature. Although many gaps were identified in the existing literature, there were only limited options available to the DSM-IV work groups for filling in these gaps. One such mechanism entailed reanalysis of existing data sets that were collected for other studies. Although useful in addressing some diagnostic questions (e.g., determining the minimum number of panic attacks required in order to justify a diagnosis of Panic Disorder), many of the data re-analyses were hampered by incompatibilities in the data sets and by the fact that the data necessary to answer many unanticipated diagnostic questions often had not been collected. The only empirical data collected specifically for DSM-IV were the fifteen NIMH-funded focused field trials. Because of the limited resources available and the short time line, the goals of these field trials were by necessity fairly modest (i.e., comparing different criteria sets in terms of reliability, user acceptability, and comparison to a clinical “gold standard”). An important lesson learned from the DSM-IV process is that it would be advantageous to enrich the empirical research base prior to the start of the formal revision process in order to increase the likelihood that the necessary data will be available to answer the diagnostic questions raised by the work groups.

DSM-V Research White Papers

The first phase of the DSM-V Research Planning Process was to commission a series of “white papers.” These white papers were an attempt to stimulate research and discussion in the field in preparation for the eventual start of the DSM-V revision process in 2007. They were produced under a partnership between the American Psychiatric Association and the National Institute of Mental Health with the goal of providing some direction and potential incentives for research that could provide an improved scientific basis for future classifications. Furthermore, limitations in the current diagnostic paradigm embodied in the current DSM-IV suggest that future research efforts that are exclusively focused on refining the DSM-defined syndromes may never be successful in uncovering their underlying etiologies. For that to happen, an as-yet-unknown paradigm shift may need to occur. Therefore, an important goal of these white papers was to encourage a research agenda that goes beyond our current ways of thinking in order to try to integrate information from a wide variety of sources and technologies. For this reason, the white papers did not focus on specific diagnostic areas but rather on cross-cutting issues. Thus, six white papers covered the following topic areas: 1) Basic Nomenclature Issues; 2) Neuroscience; 3) Developmental Science; 4) Personality Disorders and Relational Disorders; 5) Mental Disorders and Disability; and 6) Culture and Psychiatric Diagnosis. For a summary of the six white papers, click here.

The initial six white papers were published by American Psychiatric Publishing, Inc. in 2002 in a monograph entitled A Research Agenda for DSM-V. Three additional white papers are currently being developed, one focusing on gender issues, one focusing on diagnostic issues in the geriatric population, and one focusing on mental disorders in infants and young children. Publication of these white papers is planned for 2004.

APA/NIH Conference Series: "The Future of Psychiatric Diagnosis: Refining the Research Agenda"

The second phase of the DSM-V Research Planning Process consists of reviewing the literature reviews and data generated as part of the 10 research planning conferences (plus a methods conference) to be convened over 2004-2007 under the title "The Future of Psychiatric Diagnosis: Refining the Research Agenda". These conferences are being organized with the assistance and support of the World Health Organization and are co-funded by the NIMH, NIAAA, and NIDA. Unlike the white papers in the first phase which focused on general cross-cutting issues, these conferences for the most part will focus on specific diagnostic topics. The primary goals of these conferences are to stimulate the empirical research necessary to allow informed decision making regarding crucial diagnostic deficiencies identified in DSM-IV and ICD-10 and to promote international collaboration in order to increase the likelihood of developing a future unified DSM/ICD. Each of the conferences will have three general objectives: 1) to present reviews of current data relevant to the specific diagnostic question(s) that will be the focus of the conference; 2) to develop a research agenda for the design of studies that may significantly enhance the empirical data base necessary for resolving these diagnostic issues; and 3) to develop strategies to facilitate the collection and analysis of the relevant empirical data. Summaries of the research reviews, research agendas, and any proposed research criteria will be disseminated through published monographs, presentations at conferences, and on this web site.

Conference topics were selected after consultation with US and international experts. Finite resources necessitated that the number of APA-NIH sponsored conferences be limited to a total of ten; thus a number of potentially important topics could not be included. We encourage researchers to conduct additional research planning conferences to cover additional topics areas. Please contact us if you are planning to hold such a conference; we can provide both suggestions as well as establish a liaison connection to insure that the any research coming from the conference is integrated into the DSM-V process.

A Steering Committee headed by Dr. Darrel Regier, Executive Director of the American Psychiatric Institute for Research and Education (APIRE) is orchestrating the series of research planning conferences.  Members of the Steering Committee include representatives of the three NIH funding institutes (Dr. Bruce Cuthbert, NIMH; Dr.Wilson Compton, NIDA; and Dr. Bridget Grant, NIAAA), Dr. Michael B. First, Associate Professor of Psychiatry, Columbia University and consultant to APA on DSM activities and Dr. Norman Sartorius representing Dr. Benedetto Saraceno of the World Health Organization (WHO).  For each of the scheduled conferences, the Steering Committee has recruited a pair of co-chairs--in virtually every case these leadership positions are shared by a leading U.S. expert in a given diagnostic area and a distinguished investigator in the same field from a country other than the U.S. In turn, the co-chairs have collaborated with members of the Steering Committee in identifying and recruiting a Core Working Group for each conference.  Each Core Working Group will assume lead responsibility for planning detailed conference programs, recruiting the approximately 20 presenters and discussants who will participate in each conference, generating resources such as literature reviews, ensuring timely production of a “proceedings” for each session, monitoring relevant research results that become available over the next four years, and then providing a summary of such research that will be made available to the DSM-V Workgroups once they are convened in 2007.

The following conferences are planned. In order to maximize the productivity at each conference, attendance will be limited to 25 researchers who are attending by invitation only. As more information about each conference becomes available, additional pages for each conference will be added to this site. If you are interested in being informed by e-mail about the ongoing progress and results from each conference, please register here.

Research Planning Launch/Methods Conference (February 18-20, 2004)

Personality Disorders Conference (December 1-3, 2004)


Substance-Related Disorders Conference (February 14-17, 2005)

Stress-Induced and Fear Circuitry Disorders Conference (June 23-24, 2005)

Dementia Conference (September 15-17, 2005)

Deconstructing Psychosis (February 15-17, 2006)

Obsessive Compulsive Spectrum Disorders Conference (June 20-22, 2006)

Dimensional Conference (July 26-28, 2006)

Somatic Presentations (September 6-8, 2006)

Externalizing Disorders of Childhood Conference (February 14-16, 2007)

Depression and Generalized Anxiety Disorder Research Planning Conference (June 20-22, 2007)

Public Health Implications of Changes in Psychiatric Classification (September 25-26, 2007)

Autism Spectrum Disorders Conference