PRiSM Writing Contest: More On This New Diagnostic Tool from Mark Ruffalo, MSW, DPsa

Mark Ruffalo, MSW, DPsa, discusses a new diagnostic instrument and our Psychiatric Times writing opportunity surrounding this tool.

The Psychopathology Refracted into Seven Modalities (PRiSM) instrument is meant to bridge the divide between dimensional and categorical diagnoses, the creators explained.¹ The 7 PRiSM domains of psychopathology can be analogized to the dimensions of psychopathology now somewhat incorporated into the DSM-5. Using distribution of signs and symptoms among the 7 PRiSM domains, clinicians can identify a likely diagnosis more easily. The PRiSM instrument may then be able to point clinicians towards a particular DSM diagnosis.

With many patients receiving a multitude of diagnoses, which are often clinically redundant or lacking validity, patients can be confused and treatment plans can be harder to implement, Ruffalo noted. PRiSM intends to organize psychopathology into categories to capture how it manifests in clinical life. Clinicians can identify a central modality along with other contributing modalities, while still holding a clear diagnostic center. This tool does not intend to replace the DSM, Ruffalo pointed out, but to complement it by providing a more clinically intuitive format.

Ruffalo and Pies stated in their introduction of this tool, "we believe Psychiatric Times' readers are in the ideal situation to help “field test” PRiSM. Together with Psychiatric Times—"the voice of psychiatry”—we invite you to leverage the PRiSM instrument in your clinical practice or research, and to share your experiences, reflections, and results. Entries will be reviewed and scored, and the winning entry will be published in Psychiatric Times and receive a modest honorarium. The deadline for entries is January 31, 2026."¹

Dr Ruffalo is an assistant professor of psychiatry at the University of Central Florida College of Medicine in Orlando and adjunct assistant professor of psychiatry at Tufts University School of Medicine in Boston, Massachusetts.

References

1. Pies R, Ruffalo M. Bridging the categorical-dimensional divide: exploring the PRiSM diagnostic instrument. Psychiatric Times. November 6, 2025. https://www.psychiatrictimes.com/view/bridging-the-categorical-dimensional-divide-exploring-the-prism-diagnostic-instrument