Neurodevelopmental disorders: The limits of categorical diagnosis and the search for basic constructs of functioning

Abstract

This contribution, in response to the questions of the target article by Antonietti, Borgatti and Giorgetti (2022), analyzes in detail the problems raised by the diagnosis as indicated by international diagnostic manuals and proposes an integrated approach which refers to the search for dissociations/associations between symptoms within specific dimensions of functioning. Hence, it is necessary the need not to limit oneself to the observation of phenotypic features of the disorder, but to identify the basic developmental constructs, the underlying dimensions, and how these influence each other throughout development. The study of dimensions thus sees in the definition of the endophenotype the measurable and highly specific aspects of behavior located in the intermediate position between symptoms and neurobiological mechanisms within different disorders. Thus, to prepare for an effective intervention, the clinician’s attention must shift from the phenotypic features of the disorder to the description of functioning and to the developmental diagnosis.