From categories to dimensions: Some considerations, waiting for a new paradigm

This contribution offers a brief overview about the development of the nosology of the mental diseases proposed by the DSM system, taking into consideration the epistemological background of such evolution. The aim of this overview is to understand whether a change in the scientific paradigm is actually taking place, as Antonietti, Borgatti and Giorgetti's (2022) paper suggests. RDoC (2009) and Human Connectome (2011) projects, supported by NHI, are proposing alternative ways to carry out a diagnostic process in the case of mental diseases and, in particular, in the case of neurodevelopmental disorders. However, the thesis of this contribution is that, so far, these new perspectives cannot be considered valid substitutions of the DSM/ICD systems yet. Hence, for the moment, it seems wise to keep teaching and using diagnostic categories listed in manuals, as they play a relevant role in the communication of the diagnosis and provide normative means to support the person with special needs and his/her family. The awareness of the drawbacks of such categories, though, currently suggests applying and promoting an assessment procedure aimed to get the representation of the whole functioning profile of the person according to a transdiagnostic and multidimensional perspective. Such integration of categories and dimensions is expected to offer the best way to plan interventions to support adaptive behavior and wellbeing in people with special needs.