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As we draw nearer to the publication of the fifth edition of DSM, greater attention is being focused on potential revisions which can enhance the clinical utility and scientific integrity of DSM-V. In addition to possible changes to disorder criteria, certain cross-cutting factors are being considered such as how to integrate dimensional and categorical classification approaches and how to operationalize “clinical significance” diagnostic threshold criteria with better measures of functional impairment and disability. The overarching goal of the 2009 APPA conference is to advance an understanding of the scientific basis for conceptualizing possible revisions to DSM-V as they relate to these cross-cutting factors. Presentations will address specific changes being considered in light of five general constructs: 1) validation of spectrum disorders that rearrange or cross present diagnostic boundaries, 2) dimensional-categorical classification options, 3) clinically feasible functional impairment measures, 4) gender and cultural expression variations, and 5) developmental variations across the lifespan.