{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:38:36Z","timestamp":1792643916862,"version":"4.5.0"},"reference-count":26,"publisher":"American Psychiatric Association Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PS"],"DOI":"10.1176\/appi.ps.20260333","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:00:13Z","timestamp":1792641613000},"source":"Crossref","is-referenced-by-count":0,"title":["The Need for a Validity-Based Diagnostic Hierarchy in\n                    <i>DSM-6<\/i>"],"prefix":"10.1176","author":[{"given":"Mark L.","family":"Ruffalo","sequence":"first","affiliation":[{"name":"University of Central Florida College of Medicine, Orlando."},{"name":"Department of Psychiatry, Tufts University School of Medicine, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald W.","family":"Pies","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Tufts University School of Medicine, Boston."},{"name":"Department of Psychiatry, State University of New York Upstate Medical University, Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"230","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_3_2_2_2","article-title":"The conundrum of psychiatric comorbidity","author":"Tew J","year":"2007","unstructured":"Tew J, Pincus HA: The conundrum of psychiatric comorbidity. Psychiatric Times, Dec 1, 2007. https:\/\/www.psychiatrictimes.com\/view\/conundrum-psychiatric-comorbidity","journal-title":"Psychiatric Times"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(70)90054-8"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20082"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20563"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20287"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-022-00267-3"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.126.7.983"},{"key":"e_1_3_2_9_2","article-title":"The bind of the binary: psychiatry\u2019s critics and the law of the excluded middle","author":"Pies RW","year":"2026","unstructured":"Pies RW: The bind of the binary: psychiatry\u2019s critics and the law of the excluded middle. Psychiatric Times, Jan 6, 2026. https:\/\/www.psychiatrictimes.com\/view\/the-bind-of-the-binary-psychiatrys-critics-and-the-law-of-the-excluded-middle","journal-title":"Psychiatric Times"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.136.6.815"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1994.03950010008002"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.1062484"},{"key":"e_1_3_2_13_2","volume-title":"The Making of DSM-III: A Diagnostic Manual\u2019s Conquest of American Psychiatry","author":"Decker HS","year":"2013","unstructured":"Decker HS: The Making of DSM-III: A Diagnostic Manual\u2019s Conquest of American Psychiatry. New York, Oxford University Press, 2013"},{"key":"e_1_3_2_14_2","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"1968","unstructured":"Diagnostic and Statistical Manual of Mental Disorders, 2nd ed. Washington, DC, American Psychiatric Association, 1968","edition":"2"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000086093"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.3.504"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2014.00268"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2020.45"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(99)90001-9"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbu169"},{"key":"e_1_3_2_21_2","first-page":"34","article-title":"Schizophrenia with obsessive compulsive features","volume":"3","author":"Hwang MY","year":"2006","unstructured":"Hwang MY, Yum SY, Losonczy MF, et al: Schizophrenia with obsessive compulsive features. Psychiatry 2006; 3:34\u201341","journal-title":"Psychiatry"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.186.3.182"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.3109\/10673229.2012.677358"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjb.2025.10206"},{"key":"e_1_3_2_25_2","article-title":"High hopes for the diagnostic model HiTOP: a promising new approach for diagnosing psychological disorders","author":"Shpancer N","year":"2022","unstructured":"Shpancer N: High hopes for the diagnostic model HiTOP: a promising new approach for diagnosing psychological disorders. Psychology Today, March 1, 2022. https:\/\/www.psychologytoday.com\/us\/blog\/insight-therapy\/202203\/high-hopes-for-the-diagnostic-model-hitop","journal-title":"Psychology Today"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-126"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.15252\/embr.201643041"}],"container-title":["Psychiatric Services"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:00:30Z","timestamp":1792641630000},"score":1,"resource":{"primary":{"URL":"https:\/\/psychiatryonline.org\/doi\/10.1176\/appi.ps.20260333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":26,"alternative-id":["10.1176\/appi.ps.20260333"],"URL":"https:\/\/doi.org\/10.1176\/appi.ps.20260333","relation":{},"ISSN":["1075-2730","1557-9700"],"issn-type":[{"value":"1075-2730","type":"print"},{"value":"1557-9700","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]},"article-number":"appi.ps.20260333"}}