Diagnostic systems as an avenue for change in youth mental health care

Thank you to Division 37 member Spencer Evans, PhD, for cultivating these resources.

• Diagnostic systems, particularly ICD and DSM, guide how mental health conditions are defined and diagnosed throughout the world.
• Diagnostic systems matter because they can lead to different services (e.g., therapy vs. medication) depending on what diagnosis is given (e.g., behavioral vs. mood disorder).
• Transdiagnostic symptoms like irritability and aggression can pose a challenge for DSM/ICD diagnosis given that they are part of the criteria for many different disorders affecting youth.
• Over half of youth therapy cases identify irritability as top problem, and 79% of adolescents report having experienced clinical irritability symptoms.
• Research on irritability and aggression shows that changing the ICD and DSM to better match clinical needs and evidence has the potential to impact youth mental health services at a broad level.

Evans, S. C., Corteselli, K. A., Edelman, A., Scott, H., & Weisz. J. R. (2023). Is irritability a top problem in youth mental health care? A multi-informant, multi-method investigation. Child Psychiatry & Human Development, 54, 1027-1041. https://doi.org/10.1007/s10578-021-01301-8opens in new window

Evans, S. C., Roberts, M. C., Keeley, J. W., Rebello, T. J., de la Peña, F., Lochman, J. E., Burke, J. D., Fite, P. J., Ezpeleta, L., Matthys, W., Youngstrom, E. A., Matsumoto, C., Andrews, H. F., Medina-Mora, M. E., Ayuso-Mateos, J. L., Khoury, B., Kulygina, M., Robles, R., Sharan, P., Zhao, M., & Reed, G. M. (2021a). Diagnostic classification of irritability and oppositionality in youth: A global field study comparing ICD-11 with ICD-10 and DSM-5. Journal of Child Psychology and Psychiatry, 62(3), 303–312. https://doi.org/10.1111/jcpp.13244opens in new window

Karlovich, A. R., Shaughnessy, S., Simmons, K. & Evans, S. C. (in press, 2023). Toward greater specificity in the nonspecific: Estimating the prevalence of DSM-defined irritability and sleep symptoms in adolescents. Journal of Psychopathology and Clinical Science.

Stepanova, E., Youngstrom, E. A., Langfus, J. A., Evans, S. C., Stoddard, J., Young, A. S., Van Eck, K., & Findling, R. L. (2023). Finding a needed diagnostic home for children with impulsive aggression. Clinical Child and Family Psychology Review, 26, 259–271. https://doi.org/10.1007/s10567-022-00422-3opens in new window