Integrating dimensional assessment and categorical diagnosis in DSM-5: The benefits and challenges of the paradigm shift for the anxiety disorders

With DSM-5, the American Psychiatric Association (APA) strongly encourages clinicians and researchers to supplement traditional categorical diagnoses with dimensional ratings of severity. To that end, several scales have been created for or adopted by the APA that are brief, psychometrically sound, and easily accessible. Despite these scales’ inclusion in the text and online, awareness of them remains low one year after DSM-5’s publication. In the present paper, we review the APA’s guidelines for dimensional assessment and examine several issues relevant to dimensional assessment including: persuading clinicians of the utility of dimensional assessment, raising awareness of the scales, establishing guidelines for interpretation, incorporating data from multiple informants, assessment across diverse groups, and the risks and benefits of scales accessible to the general public. These issues will be illustrated through the example of the anxiety disorders, due to the fact that this diagnostic category has made significant progress with regard to dimensional classification.