Psychiatric nosology and cognitive enhancement

Abstract There has been renewed interest in psychiatric classification, with the recent development of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the 11th edition of the International Classification of Disease (ICD-11), and the Research Domain Criteria (RDoC) framework. This chapter will consider issues relevant to cognitive enhancement, particularly interventions for individuals with subthreshold symptoms, from the perspective of debates in psychiatric classification. DSM-5, ICD-11, and RDoC each take a somewhat different approach to delineation of the normal from the pathological, and so to the conceptualization of individuals with subthreshold symptoms. For the foreseeable future, an integrative approach to the assessment and treatment of patients with subthreshold symptoms will emphasize the fuzziness of the boundary between enhancement and treatment, will incorporate DSM, ICD, RDoC and a range of other constructs, and will weigh up a broad range of relevant facts and values in clinical decision-making.