Dimensional Diagnosis

Practical and Conceptual Issues in the Integration of Personality and Psychopathology

Edited by Christopher J. Hopwood and Carla Sharp

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April 3, 2026
ISBN 9781462562381
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341 Pages
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Despite a general consensus that the mental health field is shifting from categorical toward dimensional diagnosis, important questions remain about exactly how this transition should occur—both practically and conceptually. This book brings together leading scholars to discuss how personality is related to psychopathology, how this changes our understanding of mental disorders, how dimensional models can be applied in varied clinical settings, and implications for training and research. The volume is uniquely structured to address 15 core challenges identified by the editors. Within each chapter, two author teams weigh in with different perspectives on the questions posed, offering a window into critical debates at the cutting edge of clinical science and practice.

This title is part of The Guilford Series in Personality and Psychopathology, edited by Christopher J. Hopwood.


“This scholarly yet very accessible book is a 'must read' for anyone involved in assessment and treatment in mental health. While it is now widely accepted that mental health problems fall along continuous dimensions rather than fitting into discrete categories, clinical implementation of this new understanding of psychopathology remains challenging. Bringing together dozens of experts with varying perspectives, this groundbreaking book launches a much-needed discussion of dimensional diagnosis. Topics include not only assessment, diagnosis, and treatment, but also epidemiology, clinical training, genetics, neurobiology, stigma, overlap and distinctions between personality and psychopathology, and incorporating more diverse and underrepresented populations into work in this area.”

—Lee Anna Clark, PhD, William J. and Dorothy K. O’Neill Professor Emerita, Department of Psychology, University of Notre Dame


“Dimensional diagnosis sounds good, in principle. Finally, here is a volume that helps make it practical. This book is a go-to resource for all. It addresses everything from the conceptual basis of dimensional diagnoses to measurement considerations to clinical implications—and even how to train the next generation of scientists and practitioners.”

—Avshalom Caspi, PhD, Edward M. Arnett Distinguished Professor of Psychology and Neuroscience, Duke University; Professor of Personality Development, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, United Kingdom


“The move from categorical to dimensional models of psychopathology is perhaps the most significant change in psychiatric nosology in the past quarter century. This outstanding volume is the first to explore the implications of this shift with such clarity, realism, and depth. The editors—two of the field's most innovative scientist-clinicians—have brought together leading international experts to address the urgent clinical questions arising from the DSM and ICD revisions. The volume combines conceptual sophistication with remarkable pragmatism. It offers realistic, implementable guidance for clinicians, while at the same time illuminating the broader intellectual significance of the dimensional approach. This is a rare achievement—a book that is both indispensable for daily practice and transformative in its influence. Destined to become a classic.”

—Peter Fonagy, CBE, FMedSci, FBA, FAcSS, Head, Division of Psychology and Language Sciences, University College London, United Kingdom

Table of Contents

1. Introduction, Christopher J. Hopwood, Carla Sharp, & Robert F. Krueger

2. What does dimensional diagnosis mean for clinical assessment?

•Part I. Dimensional diagnosis and clinical assessment, Leslie C. Morey

•Part II. Implementation of dimensional factor-based models of psychopathology in clinical practice, Leonard J. Simms & Tyra Jones

3. What does dimensional diagnosis mean for conceptualizing psychotherapy processes?

•Part I. Rethinking psychotherapy processes in a dimensional framework, Jennifer L. Callahan

•Part II. What does dimensional diagnosis mean for conceptualizing psychotherapy processes?, Christoph Flückiger

4. What does dimensional diagnosis mean for conceptualizing psychotherapy technique?

•Part I. Targeting higher order dimensions of personality: A potent, parsimonious, and personalizable approach to addressing psychopathology, Shannon Sauer-Zavala, Madeline L. Kushner, Alexandra Hines, & Sarah E. Cecil

•Part II. Addressing basic dimensions of personality functioning: A classic yet contemporary conceptualization of personality pathology, Susanne Hörz-Sagstetter &Leonie Kampe

5. What does dimensional diagnosis mean for clinical psychological training?

•Part I. Dimensional diagnosis will enhance clinical psychological training, Camilo J. Ruggero & Jennifer L. Callahan

•Part II. Barriers to integrating dimensional diagnosis into clinical psychology, Sharon M. Nelson, Sierra A. Iwanicki, & Theresa L. Welles

6. Can dimensional diagnosis of psychopathology help reduce mental health stigma?

•Part I. Can dimensional approach to psychological problems help reduce stigma?, Benjamin B. Lahey

•Part II. Decreasing stigma with dimensional diagnoses: Does it matter?, Patrick W. Corrigan &Vardha Kharbanda

7. What is the intersection between dimensional diagnosis and diversity, equity, and inclusion?

•Part I. Integrating dimensions of context within dimensional diagnosis, Shayan Asadi, Sienna Nielsen, & Craig Rodriguez-Seijas

•Part II. Possibilities and challenges for enhancing equity and inclusivity through dimensional models of psychopathology, Sarah L. Pedersen, Frances Wang, Rachel A. Vaughn-Coaxum, Paula Marie Powe, & Cassandra L. Boness

8. How does dimensional diagnosis change psychopathology research?

•Part I. Dimensional diagnosis can improve theory building and testing in psychopathology research, Christopher C. Conway

•Part II. Exploring the strengths and weaknesses of different models used in psychopathology classification, Arielle Baskin-Sommers, Brendan Lam, & Samuel Paskewitz

9. How can developmental processes help us understand the similarities and differences between personality and psychopathology?

•Part I. A developmental perspective on personality and psychological problems, Benjamin B. Lahey

•Part II. Developmental personality–psychopathology spectrum approaches: Are traits enough?, Charlotte S. Zell and Carla Sharp

10. How does genetic research help us understand similarities and differences between personality and psychopathology?

•Part I. Genetic evidence for personality in a hierarchical model of psychopathology, Monika A. Waszczuk

•Part 2. Exploring the shared genetic architecture between psychopathology and personality, Holly E. Poore & Irwin D. Waldman

11. How does dimensional diagnosis change how we should think about psychiatric epidemiology?

•Part I. Philosophy of psychiatric epidemiology: A conceptual framework, Dan J. Stein & Anna Hartford

•Part II. Diagnoses as metrics in continuous approaches to psychopathology, Kristian E. Markon

12. How does dimensional diagnosis change how we should think about psychotherapy research?

•Part I. How dimensional diagnosis transforms psychotherapy research, André Kerber, Thomas Munder, & Johannes C. Ehrenthal

•Part II. The application of complexity science and methods to psychotherapy research on dimensional diagnosis, Trevor Sanchez Stevens, Adele M. Hayes, Merlijn Olthof, & Anna Lichtwarck-Aschoff

13. What is the difference between personality traits and psychopathology symptoms/functioning?

•Part I. Psychopathology, personality, and cybernetics: Dimensional diagnosis should prioritize dysfunction over symptoms, Colin G. DeYoung & Robert F. Krueger

•Part II. What is the difference between personality traits and personality disorder symptoms/functioning?, Sabine C. Herpertz

14. If psychopathology is dimensional, what are personality disorders?

•Part I.Personality disorders are distinguished by precociousness, pervasiveness, and persistence, but distinctions are blurry and fraught, Joshua D. Miller, Nathaniel L. Phillips, Thomas A. Widiger, & Donald R. Lynam

•Part II. The personality disorders as disorders of self and social functioning, Aidan G. C. Wright & Janan Mostajabi

15. What can we learn about psychopathology from personality change interventions in nonclinical populations?

•Part I. Personality psychology meets clinical practice: Insights from personality change interventions, Isabel Thielmann & Nicole Casali

•Part II. Insights from personality dynamics highlight opportunities and challenges of volitional personality change interventions to promote mental health, Eranda Jayawickreme, Stephen M. Schueller, Rowan Kemmerly, & Juliette L. Ratchford

16. Where do cognitive and neurodevelopmental disorders fit in dimensional models of psychopathology?

•Part I. Incorporating neurodevelopmental and neurocognitive conditions in transdiagnostic dimensional models of psychopathology, Sylia Wilson & Giorgia Michelini

•Part II. Where do cognitive and neurodevelopmental disorders fit in dimensional models of psychopathology?, Miriam K. Forbes

Author Index

Subject Index


About the Editors

Christopher J. Hopwood, PhD, is Professor of Personality Psychology at the University of Zurich, Switzerland. Dr. Hopwood is Associate Editor of the Journal of Personality Assessment and the Journal of Psychopathology and Clinical Science, and Editor-in-Chief of the journal Psychology of Human–Animal Intergroup Relations. He is the 2018 recipient of the Theodore Millon Grant in Personality Psychology from the American Psychological Foundation, among other honors. Dr. Hopwood's research interests include personality assessment and development, interpersonal processes, psychopathology, and human–animal relations.

Carla Sharp, PhD, is John and Rebecca Moores Professor of Clinical Psychology and Associate Dean for Faculty and Research at the University of Houston, where she is also Director of the Adolescent Diagnosis Assessment Prevention and Treatment (ADAPT) Center and the Developmental Psychopathology Lab. Dr. Sharp holds adjunct positions at University College London in the United Kingdom and the University of the Free State in South Africa. Her work has significantly advanced scientific understanding of personality pathology in youth. She is a recipient of the Mid-Career Investigator Award from the North American Society for the Study of Personality Disorders and the Award for Achievement in the Field of Severe Personality Disorders from the Borderline Personality Disorder Resource Center.

Audience

Practitioners, researchers, and graduate students in clinical psychology, psychiatry, clinical social work, counseling, and psychiatric nursing.

Course Use

May serve as a supplemental text in graduate-level courses.