Can disorders of subjective time inform the differential diagnosis of psychiatric disorders? A transdiagnostic taxonomy of time.

Summary

Distortions in how time is experienced, perceived, and processed appear across many psychiatric disorders, including depression, mania, anxiety, autism, impulse-control, dissociative, and attention-deficit/hyperactivity disorders. A proposed Transdiagnostic Taxonomy of (disordered) Time (TTT) maps these temporal disturbances onto a 2 × 2 × 2 state space that combines psychological models of temporal processing with phenomenological models of subjective time experience. The taxonomy differentiates diagnoses primarily involving distorted macro-level phenomenal temporal experiences (anxiety, dissociation/PTSD, depression, mania) from those involving distorted micro-level temporal processing (psychotic, impulse-control, autistic, and attention-deficit/hyperactivity disorders). Temporal distortions may precede functional decline, suggesting potential for early detection and intervention in at-risk groups.

Study at a glance

Abstract

Time is a core aspect of psychopathology with potential for clinical use and early intervention. Temporal experience, perception, judgement and processing are distorted in various psychiatric disorders such as mood (depression and mania), anxiety, autistic, impulse-control, dissociative and attention-deficit/hyperactivity disorders. Can these disorders of time be used as early diagnostic or predictive markers? To answer this question, we develop a Transdiagnostic Taxonomy of (disordered) Time (TTT) that maps on to the symptomatological, phenomenal, perceptual and functional descriptions of each underlying disorder in a 2 × 2 × 2 state space. Temporal distortions may precede functional decline, and so assist efforts at early detection and intervention in at-risk groups. Firstly, this article integrates a psychological model of how time is processed with a subjective or phenomenological model of how time is experienced or perceived. Secondly, the integrated combined model of time is then used to heuristically map major psychiatric disorders on to the basic elements of temporal flow and integration. The TTT systematically describes the basic temporal nature of eight diagnostic categories of psychiatric illness. It differentiates between diagnoses primarily associated with distorted "macro-level" phenomenal temporal experiences (i.e. anxiety, dissociation/PTSD, depression, and mania) from those primarily related to distorted 'micro-level' temporal processing (i.e. psychotic, impulse-control, autistic and attention-deficit/hyperactivity disorders). The TTT allows differential diagnostic classification of various psychiatric disorders in terms of a possible underlying time disorder, making it useful for future diagnostic and predictive purposes using novel techniques of temporal processing, time perception, passage of time, and time perspective.