A taxonomy of the objects of study, theory, assessment, and intervention is critical to the development of all clinical sciences. Clinical psychology has been conceptually and administratively dominated by the taxonomy of an adjacent discipline – psychiatry’s Diagnostic and statistical manual of mental disorders (DSM). Many have called for a ‘paradigm shift’ away from a medical nosology of diseases toward clinical psychology’s own taxonomy of clinical psychological problems (CPPs), without being able to specify what is to be listed and classified. An examination of DSM’s problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists actually do, leads to the proposal that: The critical psychological-level phenomenon underlying CPPs is the occurrence of ‘problem-maintaining circles’ (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. This concept provides an empirically-derived, theory-based, treatment-relevant, categorical, essentialist, parsimonious, and nonstigmatizing definition of CPPs. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to ‘counseling’, clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be ‘cured’ by PMC-breaking alone. A subsequent classification and coding system of PMCs is proposed, and expected benefits to research, communication, and the quality of case formulation in clinical psychology are described, reliant upon a development effort of some meaningful fraction of that which has been devoted to the DSM.

中文翻译：

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临床心理问题的新概念和后续分类

研究、理论、评估和干预对象的分类对所有临床科学的发展至关重要。临床心理学在概念上和管理上一直由相邻学科的分类法——精神病学的精神障碍诊断和统计手册（DSM）主导。许多人呼吁“范式转变”，从疾病的医学分类学转向临床心理学自己的临床心理问题分类法（CPPs），但无法具体说明要列出和分类的内容。对 DSM 的临床心理学问题进行检查，尤其是缺乏临床实用性，并在临床心理学家实际所做的工作中寻找 CPP 的本质，得出以下建议：CPP 背后的关键心理层面现象是因果相关的认知、情绪、行为和/或刺激的“问题维持圈”（PMC）的发生。这个概念提供了一个基于经验的、基于理论的、与治疗相关的、分类的、本质主义的、简约的和非污名化的 CPP 定义。它区分了 PMC 尚未（尚未？）形成并且可能对“咨询”有反应的心理问题，活动性 PMC 需要临床干预的临床心理问题，以及不太可能通过 PMC 破坏“治愈”的精神病理学问题独自的。提出了 PMCs 的后续分类和编码系统，并描述了临床心理学研究、交流和案例制定质量的预期益处，