Symptom Descriptions in Psychopathology: How Well Are They Working for Us?

Abstract

In this article, we examine how symptoms are conceptualized in theories of psychopathology. We identify five questions that need to be asked about symptoms, including what kind of constructs they are, how we should describe them, and what causal explanations they support. We then examine how three different theoretical frameworks address these questions: the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the symptom-network-modeling approach, and the Cambridge model of symptom formation. We show that the assumptions these frameworks make affect the kinds of theoretical models they support and the research approaches they advocate. When symptoms are viewed as empirical observations, the focus of inquiry is directed elsewhere. However, when symptoms are understood as complex constructs in their own right, that are themselves built on certain theoretical assumptions, then understanding them becomes crucial to theoretical progress. We conclude by calling for greater focus on research that unpacks the constructs underlying symptoms.