The rowboat moves across the bay in the early light, oarlocks clicking their steady rhythm as I pull toward open water. The surface this morning carries a dozen different patterns—wind chop near the headland, long swells from yesterday’s storm, wavelets catching the slant sun and scattering it into fragments of brightness. A wake from some passing vessel crosses the swells at an angle, creating interference patterns that rise and subside without warning. All of them waves, technically. All of them water responding to force and friction, gravity and wind. But no single description captures what the ocean actually does.
I have been rowing this bay for years, long enough to recognize certain patterns. The steep chop that builds when westerlies push against an outgoing tide. The glassy swell that precedes a weather change. The confused sea that follows multiple storm systems passing through in sequence. I know these patterns the way I know the people who sit across from me in my clinical practice—not because I can categorize them neatly, but because I have learned to read what the water is actually doing, not what the chart says it should do.
Chapman’s Piloting and Seamanship contains precise definitions: a wave is a swell if its wavelength exceeds seven times its height; a sea is wind-generated; a swell is a sea that has traveled beyond its generating area. A rogue wave is defined by specific mathematical criteria. The manual offers categories, thresholds, diagnostic criteria for the ocean’s behavior. And like all such manuals, it is both useful and deeply inadequate. The wave rolling toward me now—a long swell with wind chop riding its back, steepening as it passes over the shoal—fits no single category. It is what it is: water doing what water does when shaped by forces too complex to reduce.
Psychology and Psychiatry have been subject to the same impulse that created that boating manual: the desire to categorize the continuous, to draw boundaries around what is fluid, to mistake our organizational convenience for the territory itself. At professional conferences I hear much about neurological studies, brain imaging, genetics, and the illusion that precise measurement will solve the fundamental problem of human suffering. Some of these approaches may eventually help people in a variety of ways. But human beings are not mechanisms. We are complex adaptive systems embedded in environments we cannot fully predict, shaped by forces—developmental, relational, traumatic—that resist the neat categories we invent to contain them.
At the center of this reductionism sits the Diagnostic and Statistical Manual of Mental Disorders—the DSM—which has become the lingua franca of psychiatry and clinical psychology. Like Chapman’s manual for the ocean, it offers utility: a common language for communication, standardized codes for billing, shared frameworks for training. But like all such manuals, it embodies a fundamentally flawed approach to understanding what it purports to describe. It reduces the irreducible, categorizes the continuous, and mistakes adaptation for pathology.
The Categorical Trap
The DSM organizes mental health challenges into discrete categories, the way Chapman’s distinguishes swells from seas, wind waves from ground swells. You either have Major Depressive Disorder or you don’t. Social Anxiety Disorder is present or absent. Generalized Anxiety Disorder meets criteria or fails to meet criteria. This categorical approach creates the illusion of clarity—neat boxes into which we can sort human suffering, precise thresholds that tell us when a pattern crosses from normal to disordered.
But human experience doesn’t organize itself this way, any more than the ocean arranges itself into the categories sailors invented to navigate it.
I have watched this categorical approach fail across more than three decades of clinical practice. A person sits across from me meeting criteria for Major Depressive Disorder, Generalized Anxiety Disorder, and Post-Traumatic Stress Disorder simultaneously—three discrete diagnoses for what appears to be a single coherent response to developmental trauma. The DSM treats these as comorbidities, separate conditions occurring together by chance or mutual influence. But the person’s experience is not three separate illnesses. It is one system responding to impossible conditions the way systems do: by adapting.
Research has consistently revealed what clinicians observe daily: the categorical approach cannot robustly describe the architecture of mental health challenges (Monaghan & Bizumic, 2023). Considerable attempts have been unable to reproduce the factor structure of the DSM’s categorical model. Issues with factorial replication are exacerbated by the substantial symptom overlap between disorders—the same symptoms appearing across multiple diagnoses, facilitating their excessive co-occurrence. As a result, individuals are substantially more likely to be diagnosed with several disorders than a singular one, weakening the argument that categories provide neat constellations of inter-related symptoms.
Estimates of patients who do not fit neatly into current DSM categories range from 21 to 49%, accordingly given the catch-all diagnosis of “Not Otherwise Specified” (Monaghan & Bizumic, 2023). This isn’t a minor problem at the edges of the system. It’s evidence that the fundamental organizing principle is wrong. When half your patients don’t fit your categories, perhaps the problem isn’t the patients but the categories themselves. The DSM approach forces clinicians to decide whether a patient meets diagnostic criteria and then diagnose the disorder as present or absent—the way a navigator might declare a wave officially a “swell” once it crosses the mathematical threshold. This categorical approach to the diagnostic threshold constricts the range of clinical information that may be of high importance to treatment planning, prognosis, and monitoring treatment outcomes (Helzer et al., 2008). I lose the person’s developmental history, the particular shape their adaptation has taken, the environmental constraints that maintain the pattern. I gain a billable code.
Moreover, DSM/ICD-based diagnoses impede the development of efficacious treatments and clinical tests, hinder understanding of etiology, and prevent reliable prediction of illness course (Marquand et al., 2017). The categories obscure more than they reveal.
But the problems with the DSM run deeper than just practical limitations. The categorical approach embodies a fundamentally mechanistic and reductionistic view of human nature—one that is ill-suited to understanding behavior. Human nature is not a mechanism, and does not lend itself to complete explanations involving chemistry, genetics, and cellular biology alone. We are not broken machines requiring repair. We are complex adaptive systems doing what such systems do: organizing ourselves around the constraints and affordances our environments provide.
What the DSM Misses: Adaptation, Not Disorder
The ocean teaches what diagnostic manuals miss: what appears irregular is often adaptation to actual conditions. The steep, confused chop I’m rowing through this morning isn’t disordered water. It’s water responding precisely as it should to wind pushing against tide, to yesterday’s swell still rolling through, to the shoal beneath creating turbulence. The water is doing exactly what water does when shaped by multiple forces simultaneously.
Here’s what the DSM—and the entire medical model it represents—fundamentally misunderstands: what looks like disordered behavior is often adaptive in exactly this way. A person responds to unmanageable stress by developing behaviors that help manage the stress, even if these behaviors sometimes increase suffering over time due to a mismatch between the body’s own evolutionary survival strategies and the particular circumstances of the modern world. Consider depression. The DSM defines Major Depressive Disorder as a discrete illness characterized by a checklist of symptoms: depressed mood, loss of interest, sleep disturbance, fatigue, feelings of worthlessness, difficulty concentrating. Five symptoms for two weeks equals a diagnosis. But from an evolutionary and developmental perspective—from the perspective of someone who has sat with hundreds of people carrying this diagnosis—these symptoms may represent functioning adaptations operating exactly as designed by natural selection, not brain malfunction (Durisko et al., 2015; Hollon et al., 2021). Research from evolutionary psychiatry suggests that depressive symptoms may serve multiple adaptive functions: biasing cognition to avoid losses, conserving energy, disengaging from unobtainable goals, signaling submission, soliciting resources, and promoting analytical thinking (Durisko et al., 2015). I recognize these functions in the people I work with—not because I stand above the pattern analyzing from a distance, but because I have traced its outline in my own life, in the lives of dozens of others.
When an infant’s needs go chronically unmet—through parental depression, substance use, absence, or chaos—the developing system cannot flee or fight. It can only freeze: shut down, stop asking, wait passively. This freeze response, initially adaptive in an impossible situation, becomes the foundation for all later patterns. The infant learns, at a somatic and pre-verbal level, that needs are futile, that reaching out doesn’t work, that satisfaction is impossible or unreliable. The symptoms we call depression are not random malfunctions. They are the nervous system’s elegant solution to an impossible developmental dilemma—the way steep chop is the ocean’s elegant solution to wind opposing tide. The system learned that freezing was safety, that shutting down preserved the organism when no other options existed. When stress arises later in life, particularly stress that activates feelings of profound unmet need, this early learning reasserts itself. The person becomes depressed—not because their brain chemistry is broken, but because their system is doing exactly what it learned to do to survive.
The same pattern holds for anxiety, trauma responses, and addiction. These aren’t disorders in any simple sense. They are the system self-organizing around solutions that worked, at least initially, to preserve the organism. I have worked with veterans whose hypervigilance kept them alive in combat zones. That constant scanning for threat was safety—not paranoia, but accurate threat assessment in an environment where threats were real and constant. The problem isn’t that the system learned poorly. The problem is that the system learned well, and the learning persists beyond the environment that demanded it.
But not always—because we’re talking about complex systems, and complexity resists universal explanations. Not all mental health challenges fit neatly into this developmental adaptation model. Schizophrenia, bipolar disorder, and other conditions with stronger genetic and neurobiological components involve forces beyond developmental trauma alone. For these presentations, biological factors may constrain the system in ways that require pharmacological intervention as a primary rather than adjunct treatment. The dynamical systems framework still applies—even biologically driven patterns represent the system organizing itself around the constraints available—but the emphasis shifts. Some conditions require us to work with biology more directly, acknowledging that medication is not correcting a simple imbalance but providing essential stabilization that creates the possibility for life to continue. The framework I’m offering here applies most clearly to patterns that emerge primarily from developmental disruption and trauma response, while acknowledging that all mental health challenges involve complex interactions of biology, development, environment, and meaning-making.
In dynamical systems terms, these patterns are what we call attractor states—stable configurations the system returns to repeatedly, the way water in this bay returns to certain patterns depending on wind, tide, and swell direction. The psychological system has organized itself around a particular configuration, and multiple constraints—internal and environmental—guide the person back to this state repeatedly. The trauma created initial conditions that favored this response. The person’s neurobiology, developmental history, current circumstances, and learned patterns all combine to create a stable configuration that resists change not because the person lacks willpower or insight, but because the entire system is organized to maintain it.
Enter Dynamical Systems Theory
The ocean is a complex adaptive system. So are tropical rainforests, climate systems, and human beings. Recent developments in psychiatry are beginning to recognize what ecological psychologists and systems theorists have long understood: we are not mechanisms with discrete disorders that break and require repair. We are complex adaptive systems whose patterns may shift across our lifetimes, suggesting the need for a paradigm shift in diagnosis and treatment (Scheffer et al., 2024a). Dynamical systems theory—used widely to explain tipping points, cycles, and chaos in complex systems ranging from climate to ecosystems to oceans—offers a radically different way of understanding mental health challenges. In the dynamical systems view, the healthy state has a basin of attraction representing its resilience, while what we call “disorders” are alternative attractors in which the system can become trapped (Scheffer et al., 2024a). Think of it this way: the ocean has multiple stable states. It can be calm, choppy, or storm-tossed. Each state is stable under certain conditions, and the system resists transition between states until conditions change sufficiently.
Resilience in this approach is a dynamical property—an emergent characteristic of how the entire system responds to perturbation. This explains why the same person can move in and out of mental health challenges across their lifespan, why recovery is possible but not linear, and why individual responses to treatment are so variable. We’re working with systems that can reorganize along multiple possible trajectories, the way water can shift from one stable pattern to another when conditions align. This perspective has profound implications. To understand mental health challenges, we need to think ecologically and dynamically—the way a navigator thinks about the ocean: a system embedded in larger systems, responding to multiple forces simultaneously.
Human beings are complex adaptive systems embedded in environments that constrain and afford different possibilities for action. When we experience trauma, our system learns to seek particular survival strategies. This isn’t a moral failing or a choice in any simple sense. It’s the system self-organizing around a solution that worked, at least initially, to preserve the organism.
I have observed a particular pathway across years of clinical work—from early developmental disruption through trauma response to mental health adaptation to addictive behaviors. When an infant experiences the world as fundamentally unsafe—through parental violence, neglect, unpredictability—the nervous system learns that escape is safety. This flight response, when repeatedly activated, becomes internalized as dissociation. The person develops the capacity to “leave” their immediate experience—to separate consciousness from the body, to observe from a distance, to split awareness from overwhelming sensation or emotion. Dissociation is initially adaptive; it allows survival in conditions that would otherwise be psychologically devastating. Over time, substances and behaviors that facilitate departure become compelling. But here’s the crucial insight: the addiction isn’t merely caused by trauma or even just a symptom of it. The addiction participates in maintaining the entire system in a state of perpetual flight. It’s a feedback loop, a self-reinforcing pattern that becomes increasingly stable over time. The addiction facilitates the continuance of the trauma response itself. This is what dynamical systems theory helps us see: multiple elements of the system—developmental vulnerability, trauma response, mental health adaptation, substance use, current environment, relational patterns—all constrain and reinforce each other in ways that create stable configurations. The person isn’t choosing to maintain the pattern; the entire system is organized to do so.
Why Dynamical Systems Thinking Matters for Clinicians
Rowing teaches you to read actual conditions, not the forecast. The chart might predict calm water, but if the ocean is delivering confused seas, you respond to what’s actually there. Understanding mental health challenges through a dynamical systems lens changes everything about how we approach treatment in precisely this way.
If we’re working with categorical disorders caused by brain dysfunction, our job is to fix the broken mechanism—typically through medication that corrects neurotransmitter imbalances or cognitive techniques that correct faulty thinking patterns. We consult the manual, apply the protocol, expect predictable results.
But if we’re working with complex adaptive systems that have organized themselves around survival strategies that once made sense, our job is completely different. We’re participating in a process of system reorganization—creating conditions where new patterns can emerge, where the person can discover through experience that old survival strategies are no longer necessary. We’re reading the water.
This doesn’t mean medication has no role. For many people, psychiatric medications provide essential stabilization—calming the water enough that reorganization becomes possible. A person whose system is locked in severe depression or acute mania may need pharmacological support before any other intervention can reach them. Medication-assisted treatment for opioid use disorder remains the gold standard of care. The question is how to understand it: as one constraint among many that can shift the system’s dynamics, creating conditions where other changes become possible. Some people will need medication long-term or permanently, and this is clinically appropriate—the goal is not ideological purity but creating a life where the person can function, connect, and find meaning.
Recent work has demonstrated the universality of generic dynamical indicators of resilience that are now employed globally to monitor the risks of collapse of complex systems—tropical rainforests, climate tipping points, ocean ecosystems (Scheffer et al., 2024a). The same tools may help monitor resilience in mental health. Emerging results suggest that time series of mood and behavior may be used to assess the stability of a person’s psychological system using the same generic dynamical indicators that are employed to assess stability in complex physical systems (Scheffer et al., 2024b).
Moreover, experiences in ecological restoration confirm the theoretical prediction that under some conditions, short interventions may invoke long-term success when they flip the system into an alternative basin of attraction (Scheffer et al., 2024a). I have watched this happen—not universally, not predictably, but often enough to recognize the pattern. A person attends a single intensive workshop and something shifts permanently. Another person enters treatment for the fifth time and this time it takes. A third tries medication they’ve tried before, under slightly different circumstances, and suddenly the pattern reorganizes. And others try everything—every medication, every therapy, every approach—and the pattern persists. The system reorganization I’m describing is real, but it is not guaranteed. Some people row through rough water their entire lives.
This explains something we see clinically but can’t explain within the medical model: why some people recover through treatment programs while others recover without them, why some need constraints and structure while others need freedom and exploration, why some require hitting “rock bottom” while others change before significant consequences—and why, despite our best efforts and their best efforts, some people don’t reorganize at all, at least not in ways we can measure or within timeframes we expect. The system can reorganize from multiple starting points through multiple pathways. What matters is not the specific intervention but whether the entire configuration of person-environment interactions reaches a critical transition point where reorganization becomes possible. All the constraints and affordances align, perhaps only briefly, in a configuration that permits reorganization. The person doesn’t develop willpower in that moment—the way water doesn’t decide to shift from one stable pattern to another. The entire system simply reaches a critical point where continuing the pattern becomes less stable than changing it.
This perspective has profound implications for how we work. We can’t manufacture readiness, but we can influence the constraints and affordances that shape the possibility space. We can remove obstacles to change, provide scaffolding for new patterns, and create conditions where reorganization becomes more likely. But we must hold our interventions lightly, recognizing that change happens through processes far more complex than our theories can capture. We are rowers learning to read the water, not engineers fixing broken machines.
The Path Forward: Embracing Complexity
Dynamical systems thinking doesn’t reject all aspects of the DSM or medical model. Categories can be useful for communication and organization, the way Chapman’s categories help sailors communicate about sea conditions. But we must understand them for what they are: convenient fictions, maps that should never be confused with territory, organizational structures that help us think and talk but that don’t represent actual discrete entities in nature. The chart shows swells and seas as separate phenomena. The ocean produces waves. The overwhelming majority of psychiatric conditions examined using taxometric methods appear to be dimensional in nature, not categorical (Haslam, 2003; Widiger & Samuel, 2005). This isn’t a minor technical point—it’s evidence that the fundamental organizing principle of the DSM is incorrect. Consequently, all categorizations become artificial and debatable. Even though DSM-5 took a modest step toward a more dimensional approach, its core remains categorical (Bornstein, 2015). We are still trying to force the ocean into neat boxes, still mistaking our organizational convenience for the territory itself.
What would psychiatry and clinical psychology look like if we truly embraced dynamical systems thinking? What would it mean to read the water rather than consult the chart?
We would: Attend to the entire system, not just the individual. We would recognize that mental health challenges emerge from the interaction of developmental history, current environment, relational patterns, physiological states, and meaning-making processes—the way wave patterns emerge from the interaction of wind, tide, swell, and bathymetry. We would work at multiple scales simultaneously: individual, relational, environmental, cultural.
View symptoms as adaptations, not pathologies. We would ask not “What’s wrong with this person?” but “What has this person’s system learned to do to survive?” We would recognize that the same pattern that once protected the person may now imprison them, and that healing requires honoring the adaptive function while creating conditions for new learning. Steep chop isn’t disordered water. It’s water doing what water does.
Expect non-linearity and emergence. We would stop looking for simple cause-and-effect relationships and linear treatment protocols. We would recognize that small interventions can sometimes produce large effects (and vice versa), that timing matters enormously, and that recovery involves emergent reorganization that cannot be fully predicted or controlled. Any rower knows this: a small shift in oar angle at the right moment can turn the boat. The same shift at the wrong moment does nothing.
Embrace uncertainty and complexity. We would hold our theories lightly, recognize the limits of our knowledge, and remain humble in the face of human complexity. We would resist the temptation to reduce suffering to mechanisms that can be simply fixed. We would accept that sometimes we participate in healing without understanding exactly how or why.
Honor degeneracy—the principle that multiple different pathways can lead to the same outcome. We would stop arguing about which treatment is “best” and recognize that different people need different things at different times. We would personalize our approach based on the unique configuration of each person’s system rather than applying standardized protocols. There are many ways to cross rough water. The right way depends on the boat, the rower, and the particular conditions that morning. The shift from categorical thinking to dynamical systems thinking represents more than a technical change in how we conceptualize mental health. It represents a fundamental reorientation toward human suffering—from viewing people as broken mechanisms requiring repair to recognizing them as complex adaptive systems whose current patterns, however painful, once made sense and whose future patterns remain open to possibility. It’s the difference between consulting the manual and reading the water.
This is not to say that suffering isn’t real or that all patterns are equally viable. Depression is devastating. Anxiety is torturous. Addiction destroys lives. But these experiences are not discrete illnesses that befall people randomly. They are patterns that emerge from the interaction of development, trauma, environment, and biology—patterns that make sense when we understand the conditions that gave rise to them, the way confused seas make sense when we understand the forces creating them.
A More Humane Approach to Wellbeing
Human beings are complex, creative, unpredictable systems embedded in equally complex environments. We adapt, we learn, we reorganize. Sometimes our adaptations serve us well; sometimes they don’t. But they are always adaptations—always the system doing its best with the constraints and affordances available, the way water always does what water does under the particular forces shaping it in that moment.
The DSM, with its categorical approach and focus on disorder, cannot capture this complexity. It reduces the irreducible and mistakes the map for the territory. Dynamical systems theory offers something better: a framework that honors complexity, recognizes adaptation, and creates space for the genuine unpredictability of healing.
To believe that approaches focused on brain structure, neurology, genetics, and biochemistry can, on their own, vanquish the varieties of human suffering—their breadth, depth, and turbulent wake across all human societies—is to believe that Chapman’s manual can teach you to row. People heal in a variety of surprising and encouraging ways: connection with communities and cultural traditions, physical activity and immersion in nature, music, craft, and art. These practices work because one kind of complexity slowly replaces another. There is no shortcut to this path. Healing is always a hard-won and human journey.
And yet, in spite of goodwill and best efforts, access to healing is not equally distributed. Therapy costs money. Treatment programs require time away from work and family. Geographic isolation, poverty, systemic racism, and inadequate insurance create barriers that no theoretical framework can overcome. Some people try everything available to them and find no relief. Some cannot access treatment at all. Dynamical systems thinking doesn’t solve these problems—it simply offers a more truthful framework for understanding what we’re working with when we can work at all. The promise of reorganization remains just that: a possibility, not a guarantee, and for many, not even an accessible option.
As we move forward in understanding mental health, we must be willing to abandon the comfortable illusion of categorical disorders and embrace the more challenging but ultimately more truthful view of human beings as complex adaptive systems. This doesn’t make our work easier—if anything, it makes it harder. But it makes it truer, more humane, and ultimately more helpful.
The future of psychiatry and clinical psychology lies in understanding the dynamic, ecological, developmental processes that give rise to suffering and in creating conditions where new patterns can emerge. This is the promise of dynamical systems thinking: to embrace complexity, to facilitate reorganization, to participate humbly in the mystery of healing.
I’ve turned the boat toward shore now, oarlocks maintaining their rhythm as I pull across water that has settled somewhat since morning. The wind has shifted, easing the chop. The swells still roll through from yesterday’s storm, but they are longer now, gentler, less steep. I cannot say the ocean has changed—it is always changing. But I have learned, across this morning and across years of mornings like it, to read what the water is actually doing rather than what the chart predicted it would do.
There is a person waiting for me in my office later today. The intake form lists three diagnoses, five medications, a history of treatments that helped briefly before the pattern reasserted itself. The paperwork reduces a human being to categories and criteria. But when we sit together, I will not be reading the paperwork; I will be reading the water—attending to the actual person across from me, the unique configuration of their system, the forces that have shaped them, the patterns they have learned in order to survive.
I try not to mistake the manual for the ocean, to confuse our organizational convenience with the territory itself. The water teaches what the manual cannot: that complexity resists reduction, that patterns emerge from forces too multiple to categorize, that the system will do what the system does when conditions align.
I ease the oars, letting the boat glide on its own momentum for a moment. The water beneath the hull shifts from cobalt to cerulean as the depth decreases, sunlight catching particles suspended in the shallows. All of it water. All of it responding to forces beyond simple description.
I pull again, steady and rhythmic, reading the water stroke by stroke.
The oarlocks click. The hull swishes through wavelets. The dock appears ahead, familiar and unchanged. I row toward it.
Sources
Bornstein, R. F.(2015). Personality assessment in the diagnostic manuals: On mindfulness, multiple methods, and test score discontinuities. Journal of Personality Assessment, 97(5), 446-455. https://doi.org/10.1080/00223891.2015.1027346
Durisko, Z., Mulsant, B. H., & Andrews, P. W.(2015). An adaptationist perspective on the etiology of depression. Journal of Affective Disorders, 172, 315-323. https://doi.org/10.1016/j.jad.2014.09.032
Haslam, N. (2003). Categorical versus dimensional models of mental disorder: The taxometric evidence. Australian and New Zealand Journal of Psychiatry, 37(6), 696-704. https://doi.org/10.1111/j.1440-1614.2003.01258.x
Helzer, J. E., Kraemer, H. C., & Krueger, R. F.(2008). Dimensional approaches to psychiatric diagnosis: Refining the research agenda for DSM-V. In J. E. Helzer, H. C. Kraemer, R. F. Krueger, H.-U. Wittchen, P. J. Sirovatka, & D. A. Regier (Eds.), Dimensional approaches in diagnostic classification: Refining the research agenda for DSM-V (pp. ix-xvi). American Psychiatric Association.
Hollon, S. D., Andrews, P. W., & Thomson, J. A., Jr. (2021). Cognitive behavior therapy for depression from an evolutionary perspective. Frontiers in Psychiatry, 12, 667592. https://doi.org/10.3389/fpsyt.2021.667592
Marquand, A. F., Wolfers, T., Mennes, M., Buitelaar, J., & Beckmann, C. F.(2017). Beyond lumping and splitting: A review of computational approaches for stratifying psychiatric disorders. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 1(5), 433-447. https://doi.org/10.1016/j.bpsc.2016.04.002
Monaghan, C., & Bizumic, B. (2023). Dimensional models of personality disorders: Challenges and opportunities. Frontiers in Psychiatry, 14, 1098452. https://doi.org/10.3389/fpsyt.2023.1098452
Scheffer, M., Bockting, C. L., Borsboom, D., Cools, R., Delecroix, C., Hartmann, J. A., Kendler, K. S., van de Leemput, I., van der Maas, H. L. J., van Nes, E., Mattson, M., McGorry, P. D., & Nelson, B. (2024a). A dynamical systems view of psychiatric disorders—Theory: A review. JAMA Psychiatry, 81(6), 618-623. https://doi.org/10.1001/jamapsychiatry.2024.0215
Scheffer, M., Bockting, C. L., Borsboom, D., Cools, R., Delecroix, C., Hartmann, J. A., Kendler, K. S., van de Leemput, I., van der Maas, H. L. J., van Nes, E., Mattson, M., McGorry, P. D., & Nelson, B. (2024b). A dynamical systems view of psychiatric disorders—Practical implications: A review. JAMA Psychiatry, 81(6), 624-630. https://doi.org/10.1001/jamapsychiatry.2024.0228
Widiger, T. A., & Samuel, D. B.(2005). Diagnostic categories or dimensions? A question for the Diagnostic and Statistical Manual of Mental Disorders—Fifth edition. Journal of Abnormal Psychology, 114(4), 494-504. https://doi.org/10.1037/0021-843X.114.4.494
