| Relationship problems and the DSM:needed improvements and suggested solutions. | |
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MedLine Citation:
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PMID: 19293949 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Relational problems are clinically significant behavioral or psychological syndromes or patterns that occur between or among individuals and that are associated with present distress or disability or with a significant increased risk of suffering death, pain, disability, or an important loss of freedom. Relational problems (e.g., partner relational problems, partner abuse, child maltreatment) are included as Axis I disorders in the DSM-IV as V-codes (i.e., "Other conditions that may be a focus of clinical attention"). However, there are no criteria provided in the DSM-IV for these codes. In this article, we briefly review literature that incontrovertibly documents both relational problems' syndromes/patterns and their serious sequelae. We then review a series of studies that provide evidence of content validity and inter-rater agreement for criteria to determine presence versus absence of relational problems. The most studied subset of relational problem criteria, those for partner and child maltreatment, have been shown to have remarkably high levels of reliability when disseminated broadly in the field (kappa = .66-.89), at agreement levels never reached by DSM diagnoses for individuals. We conclude by arguing that science, service, families, individuals, and the DSM itself, would be well served to include diagnostic criteria for relational problems and to consider the various options for placement of relational problems/processes in the DSM-V. |
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Authors:
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Richard E Heyman; Amy M Smith Slep; Steven R H Beach; Marianne Z Wamboldt; Nadine J Kaslow; David Reiss |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World psychiatry : official journal of the World Psychiatric Association (WPA) Volume: 8 ISSN: 1723-8617 ISO Abbreviation: World Psychiatry Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-03-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101189643 Medline TA: World Psychiatry Country: Italy |
Other Details:
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Languages: eng Pagination: 7-14 Citation Subset: - |
Affiliation:
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Family Translational Research Group, Department of Psychology, Stony Brook University, State University of New York, Stony Brook, NY 11794-2500, USA. |
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