Since the publication of DSM-III in 1980, the scientist-practitioner gap in clinical psychology has expanded, as almost all outcome research in clinical psychology has been on diagnosed mental disorders within a medical model using drug trial methodologies, whereas most practising clinicians undertake functional analyses and case formulations of clinical psychological problems (CPPs) and then apply tailored interventions within an ongoing hypothesis-testing methodology. But comparatively reliable assessment and generalizable conclusions in psychotherapy outcome research require a comprehensive theory-derived conception or operational definition of ‘CPPs’, standardized functional analyses, and a taxonomy of CPPs comparable to DSM's listings of mental disorders. An alternative conception and taxonomy of CPPs have recently been proposed, offering improvements in the reliability and generalizability of case formulation-based psychotherapy outcome research. It conceives of CPPs as instances of the formation and operation of self-sustaining problem-maintaining circles (PMCs) of psychological-level causal elements—that is, at the level of cognitions, behaviours, emotions, and events or situations (stimuli). The paper describes this new conception of CPPs, a subsequent nascent taxonomy of evidence-based PMCs which standardizes the underlying mechanisms that maintain CPPs, and ensuing benefits to research (as well as to practice) in clinical psychology. These benefits include being able to encompass all treatment-worthy CPPs, not just diagnosable mental disorders; to assess theory-derived intervention strategies, not just arbitrary therapy bundles; and to directly feed back into psychological theories, not just expand an atheoretical list of patented “evidence supported therapies.”

中文翻译：

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心理治疗结果研究：新临床分类的意义

自 1980 年 DSM-III 发布以来，临床心理学中的科学家与实践者之间的差距扩大了，因为临床心理学中几乎所有的结果研究都是使用药物试验方法在医学模型中诊断出的精神障碍，而大多数实践临床医生承担功能分析和临床心理问题 (CPP) 的案例表述，然后在正在进行的假设检验方法中应用量身定制的干预措施。但心理治疗结果研究中相对可靠的评估和可概括的结论需要对“CPPs”的全面的理论衍生概念或操作定义、标准化的功能分析以及与 DSM 的精神障碍列表相当的 CPPs 分类。最近提出了另一种 CPP 的概念和分类，提高了基于案例制定的心理治疗结果研究的可靠性和普遍性。它将 CPP 视为心理层面因果要素的自我维持问题维持循环 (PMC) 形成和运作的实例，即在认知、行为、情绪和事件或情况（刺激）层面。该论文描述了 CPPs 的这一新概念，这是一种基于证据的 PMCs 的新兴分类法，它标准化了维持 CPPs 的基本机制，并为临床心理学的研究（以及实践）带来了好处。这些好处包括能够涵盖所有值得治疗的 CPP，而不仅仅是可诊断的精神障碍；评估理论衍生的干预策略，而不仅仅是任意的治疗包；