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The use of diagnoses in mental health disorders has been the subject of considerable discussion and controversy, not least because diagnostic systems are criticised by some as pathologising distress which might otherwise be considered part of the human condition (Kirschner, 2013). Researchers and clinicians have argued that mental health problems diagnosed by a symptom severity threshold being crossed, particular degree of dysfunction or chronicity of a problem would be better considered dimensionally, with symptoms occurring on one or more continua (Ayuso-Mateos et al., 2010). Specifically, for each group of symptoms used to diagnose mental health problems at present, someone might be considered to be at a certain point on a continuous dimension. This approach would be similar to common conceptualisations of personality where people score at various points on dimensions of extraversion, neuroticism, openness, etc. The pattern of points across various different dimensions might then demarcate the different mental health disorders being experienced.

Multidimensional diagnostic systems such as the Research Domain Criteria (RDoC; Insel et al., 2010) that classify mental disorders based on behavioural phenotypes and biomarkers therefore offer a different way to consider CMDs. By viewing mental disorders on continua, advocates of these systems suggest a more dynamic and flexible method of assessing mental disorders can be created (Insel et al., 2010). This approach may help address questions raised concerning the reliability and validity of diagnoses based on the current categorical diagnostic systems (e.g. Lieblich et al., 2015). Multidimensional approaches could help to resolve the issue of overlap between symptoms of different CMDs – for example, the experience of excessive worry or panic attacks common across many CMDs or the degree of co-morbidity between CMDs (Hirschfeld, 2001; Kessler et al., 2005). Furthermore, they may also help elucidate mechanisms of change and better explain why individuals with the same diagnosis that are given the same treatment can have substantially different treatment outcomes (Insel et al., 2010).