scholarly journals Irritability through Research Domain Criteria: an opportunity for transdiagnostic conceptualisation

BJPsych Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Erica Bell ◽  
Richard A. Bryant ◽  
Philip Boyce ◽  
Richard J. Porter ◽  
Gin S. Malhi
Keyword(s):  
Children And Adolescents ◽  
Diagnostic Category ◽  
Research Domain Criteria ◽  
Diagnostic Categories ◽  
Underlying Mechanisms ◽  
The Many ◽  
Research Domain ◽  
Shed Light

Irritability is a transdiagnostic phenomenon that, despite its ubiquity and significant impact, is poorly conceptualised, defined and measured. As it lacks specificity, efforts to examine irritability in adults by using a diagnostic category perspective have been hamstrung. Therefore, using a Research Domain Criteria (RDoC) approach to examine irritability in adults, which spans many constructs and domains, may have a better chance of yielding underlying mechanisms that can then be mapped onto various diagnostic categories. Recently, a model has been proposed for irritability in children and adolescents that uses the RDoC framework; however, this model, which accounts for chronic, persistent irritability, may not necessarily transpose to adults. Therefore, use of the RDoC framework to examine irritability in adults is urgently needed, as it may shed light on this currently amorphous phenomenon and the many disorders within which it operates.

The Psychophysiology of Anxiety and Mood Disorders

2017 ◽  
Vol 225 (3) ◽  
pp. 175-188 ◽  
Author(s):  
Peter J. Lang ◽  
Lisa M. McTeague ◽  
Margaret M. Bradley
Keyword(s):  
Mental Health ◽  
Heart Rate ◽  
Brain Function ◽  
Physiological Reactivity ◽  
Research Domain Criteria ◽  
Diagnostic Systems ◽  
Psychophysiological Reactivity ◽  
Diagnostic Categories ◽  
New Research ◽  
Research Domain

Abstract. Several decades of research are reviewed, assessing patterns of psychophysiological reactivity in anxiety patients responding to a fear/threat imagery challenge. Findings show substantive differences in these measures within principal diagnostic categories, questioning the reliability and categorical specificity of current diagnostic systems. Following a new research framework (US National Institute of Mental Health [NIMH], Research Domain Criteria [RDoC]; Cuthbert & Insel, 2013 ), dimensional patterns of physiological reactivity are explored in a large sample of anxiety and mood disorder patients. Patients’ responses (e.g., startle reflex, heart rate) during fear/threat imagery varied significantly with higher questionnaire measured “negative affect,” stress history, and overall life dysfunction – bio-marking disorder groups, independent of Diagnostic and Statistical Manuals (DSM). The review concludes with a description of new research, currently underway, exploring brain function indices (structure activation, circuit connectivity) as potential biological classifiers (collectively with the reflex physiology) of anxiety and mood pathology.

scholarly journals Towards a contemporary approach for understanding personality pathology in developmental context: An integrative model

2021 ◽  
pp. 1-10
Author(s):  
Melody R. Altschuler ◽  
Robert F. Krueger
Keyword(s):  
Personality Disorders ◽  
Personality Pathology ◽  
Integrative Model ◽  
Research Domain Criteria ◽  
Developmental Context ◽  
Dimensional Classification ◽  
Developmental Theories ◽  
Underlying Mechanisms ◽  
Research Domain

Abstract Traditional categorical approaches to classifying personality disorders are limited in important ways, leading to a shift in the field to dimensional approaches to conceptualizing personality pathology. Different areas of psychology – personality, developmental, and psychopathology – can be leveraged to understand personality pathology by examining its structure, development, and underlying mechanisms. However, an integrative model that encompasses these distinct lines of inquiry has not yet been proposed. In order to address this gap, we review the latest evidence for dimensional classification of personality disorders based on structural models of maladaptive personality traits, provide an overview of developmental theories of pathological personality, and summarize the Research Domain Criteria (RDoC) initiative, which seeks to understand underlying mechanisms of psychopathology. We conclude by proposing an integrative model of personality pathology development that aims to elucidate the developmental pathways of personality pathology and its underlying mechanisms.

scholarly journals Kaleidoscope

2014 ◽  
Vol 205 (3) ◽  
pp. 254-255
Author(s):  
Derek K. Tracy ◽  
Dan W. Joyce ◽  
Sukhwinder S. Shergill
Keyword(s):  
Experimental Approach ◽  
Response Selection ◽  
Research Priorities ◽  
Borderline Personality ◽  
Research Domain Criteria ◽  
Case Processing ◽  
Negative Valence ◽  
Underlying Mechanisms ◽  
Golden Gate Bridge ◽  
Research Domain

June 27 this year was the day that funding was approved for San Francisco's Golden Gate Bridge physical suicide deterrent barrier (www.ggbsuicidebarrier.org). This follows over 1400 suicides since the bridge's opening in 1937: a morbid record 46 were in 2013 alone, possibly exacerbated by the global economic crisis. The barrier is in place to prevent the end-point of suicidal behaviour (physically preventing suicide) but how much effort is going into the examination of the external factors that drive such behaviour? Aleman & Denys argue that psychiatry has failed to tackle suicide as a disease entity in its own right, instead relegating the act of deliberately ending one's life to a symptom or consequence of an underlying psychiatric illness. They note that in DSM-5 suicidality is only mentioned as a symptom of borderline personality disorder and mood disorders, despite this presenting as the most prominent psychiatric emergency. They argue for a more experimental approach based on the National Institute of Mental Health's Research Domain Criteria (www.nimh.nih.gov/research-priorities/rdoc/index.shtml) that emphasises the study of psychiatric phenomena with reference to their underlying mechanisms: in this case, processing of negative valence, context and response selection, and mechanisms to regulate arousal.

scholarly journals The role of RDoC in future classification of mental disorders

2020 ◽  
Vol 22 (1) ◽  
pp. 81-85 ◽  
Keyword(s):  
Mental Health ◽  
Affective Behavior ◽  
Research Domain Criteria ◽  
Computational Approaches ◽  
Diagnostic Categories ◽  
Key Features ◽  
Study Designs ◽  
Research Domain

The Research Domain Criteria (RDoC) project constitutes a translational framework for psychopathology research, initiated by the National Institute of Mental Health in an attempt to provide new avenues for research to circumvent problems emerging from the use of symptom-based diagnostic categories in diagnosing disorders. The RDoC alternative is a focus on psychopathology based on dimensions simultaneously defined by observable behavior (including quantitative measures of cognitive or affective behavior) and neurobiological measures. Key features of the RDoC framework include an emphasis on functional dimensions that range from normal to abnormal, integration of multiple measures in study designs (which can foster computational approaches), and high priority on studies of neurodevelopment and environmental influences (and their interaction) that can contribute to advances in understanding the etiology of disorders throughout the lifespan. The paper highlights key implications for ways in which RDoC can contribute to future ideas about classification, as well as some of the considerations involved in translating basic behavioral and neuroscience data to psychopathology.

Positive Valence System Dysregulation in Psychosis

2019 ◽  
pp. 251-283
Author(s):  
Deanna M. Barch ◽  
David Pagliaccio ◽  
Katherine Luking
Keyword(s):  
Action Selection ◽  
Research Domain Criteria ◽  
Treatment Development ◽  
Diagnostic Categories ◽  
Reward Prediction ◽  
Hedonic Experience ◽  
Positive Valence ◽  
The Moment ◽  
Hedonic Processing ◽  
Research Domain

Motivational and hedonic impairments cut across diagnostic categories, are core aspects of psychopathology, and may be crucial for understanding pathways to development and maintenance of psychopathology. Given the pervasive nature of motivational and hedonic deficits across psychopathology forms, the Research Domain Criteria initiative includes a “positive valence” systems domain that outlines constructs critical for understanding motivational and hedonic impairments in psychopathology. These constructs include initial responsiveness to reward, reward anticipation or expectancy, incentive or reinforcement learning, effort valuation, and action selection. The chapter reviews behavioral and neuroimaging studies providing evidence for construct impairments in in individuals with psychosis versus individuals with depressive pathology. Evidence suggests there are meaningful differences in reward-related and hedonic deficits associated with psychosis versus depression. These differences have implications for understanding the differential etiology of these forms of psychopathology and the ways treatment development may need to proceed for each domain. The literature suggests that individuals with depressive pathology experience impairments of in-the-moment hedonics or “liking,” particularly among those who experience anhedonia. Given that hedonic experience is the basis in many ways for all other aspects of motivational function, such deficits may propagate forward and contribute to impairments in other constructs dependent on hedonic responses. In contrast, individuals with psychosis have relatively intact in-the-moment hedonic processing, instead experiencing impairments in process aspects that translate reward to action selection. More specifically, individuals with schizophrenia exhibit altered reward prediction and associated striatal and prefrontal activation, impaired reward learning, and impaired reward-modulated action selection.

Clinical Heterogeneity Arising from Categorical and Dimensional Features of the Neurobiology of Psychiatric Diagnoses

2016 ◽  
Author(s):  
John H. Krystal ◽  
Alan Anticevic ◽  
John D. Murray ◽  
David Glahn ◽  
Naomi Driesen ◽  
...  
Keyword(s):  
Computational Neuroscience ◽  
American Psychiatric Association ◽  
Psychiatric Diagnoses ◽  
Clinical Heterogeneity ◽  
Research Domain Criteria ◽  
Statistical Manual ◽  
Limited Ability ◽  
Diagnostic And Statistical Manual ◽  
Research Domain ◽  
Shed Light

Clinical heterogeneity presents important challenges to optimizing psychiatric diagnoses and treatments. Patients clustered within current diagnostic schema vary widely on many features of their illness, including their responses to treatments. As outlined by the American Psychiatric Association Diagnostic and Statistical Manual (DSM), psychiatric diagnoses have been refined since DSM was introduced in 1952. These diagnoses serve as the targets for current treatments and supported the emergence of psychiatric genomics. However, the Research Domain Criteria highlight DSM’s shortcomings, including its limited ability to encompass dimensional features linking patients across diagnoses. This chapter considers elements of the dimensional and categorical features of psychiatric diagnoses, with a particular focus on schizophrenia. It highlights ways that computational neuroscience approaches have shed light on both dimensional and categorical features of the biology of schizophrenia. It also considers opportunities and challenges associated with attempts to reduce clinical heterogeneity through categorical and dimensional approaches to clustering patients. Finally, discussion will consider ways that one might work with both approaches in parallel or sequentially, as well as diagnostic schema that might integrate both perspectives.

Problems of psychopathologic systematics: alternative approaches and clinical practice requests

2020 ◽  
Vol LII (2) ◽  
pp. 20-28
Author(s):  
Мikhail L. Zobin ◽  
Natalia V. Ustinova
Keyword(s):  
Clinical Practice ◽  
Mental Disorders ◽  
Conceptual Framework ◽  
Reliability And Validity ◽  
Research Domain Criteria ◽  
Advantages And Disadvantages ◽  
Diagnostic Categories ◽  
Clinical Instability ◽  
Alternative Approaches ◽  
Research Domain

The reliability and validity of traditional classifications give rise to justifiable criticism because of the conventionality of the boundaries between norm and pathology, fuzzy delimitation of disorders and their frequent co-occurrence, heterogeneity and clinical instability of symptoms within the diagnostic categories. There is little evidence that the majority of mental disorders are discrete entities. Discontent with the expert consensus classifications have led to attempts at a new quantitative and empirical systematization of psychopathology. Two alternative projects have been proposed: Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP). The aim of the paper is to clarify the conceptual framework of RDoC and HiTOP, discuss their advantages and disadvantages in terms of the prospects for use in clinical practice.

Research Domain Criteria

2017 ◽  
Author(s):  
Cara Bohon
Keyword(s):  
Eating Disorders ◽  
Psychiatric Symptoms ◽  
Relevant Literature ◽  
The United States ◽  
Research Domain Criteria ◽  
Eating Disorder Symptoms ◽  
Great Heterogeneity ◽  
Underlying Mechanisms ◽  
Improving Patient Care ◽  
Research Domain

A primary goal of the research domain criteria (RDoC) project from the National Institute of Mental Health in the United States is to better characterize and understand the pathology and etiology of mental illness by examining constructs with biological underpinnings and their effects on psychiatric symptoms. This endeavor shows promise in helping to better conceptualize dysfunction in the field of eating disorders, where there appears to be great heterogeneity within diagnostic groups. Treatments designed for a particular diagnosis may result in improved remission rates if they instead target underlying mechanisms of eating disorder symptoms. This system is not without challenge and limitations, however. This chapter includes a brief review of relevant literature on the proposed RDoC functional domains in eating disorders and discussion of the benefits and costs of this type of approach in improving patient care.

scholarly journals The Research Domain Criteria: moving the goalposts to change the game

2014 ◽  
Vol 204 (3) ◽  
pp. 171-173 ◽  
Author(s):  
Joanne L. Doherty ◽  
Michael J. Owen
Keyword(s):  
Mental Health ◽  
Diagnostic Criteria ◽  
Psychiatric Research ◽  
Research Domain Criteria ◽  
Diagnostic Categories ◽  
Research Domain

SummaryThere is increasing concern that a reliance on the descriptive, syndrome-based diagnostic criteria of ICD and DSM is impeding progress in research. The USA's major funder of psychiatric research, the National Institute of Mental Health (NIMH), have stated their intention to encourage more research across diagnostic categories using a novel framework based on findings in neuroscience.

scholarly journals Evolving Concepts of the Schizophrenia Spectrum: A Research Domain Criteria Perspective

2021 ◽  
Vol 12 ◽  
Author(s):  
Bruce N. Cuthbert ◽  
Sarah E. Morris
Keyword(s):  
Psychotic Disorders ◽  
Diagnostic System ◽  
Research Domain Criteria ◽  
Diagnostic Categories ◽  
The Past ◽  
Schizophrenia Spectrum ◽  
Response Systems ◽  
Translational Research Program ◽  
Symptoms And Signs ◽  
Research Domain

Several trends intersecting over the past two decades have generated increasing debate as to how the concepts of schizophrenia, the schizophrenia spectrum, and the psychotic disorders spectrum should be regarded. These trends are reflected in various areas of research such as genomics, neuroimaging, and data-driven computational studies of multiple response systems. Growing evidence suggests that schizophrenia represents a broad and heterogenous syndrome, rather than a specific disease entity, that is part of a multi-faceted psychosis spectrum. Progress in explicating these various developments has been hampered by the dependence upon sets of symptoms and signs for determining a diagnosis, and by the reliance on traditional diagnostic categories in reviewing clinical research grants. To address these concerns, the U.S. National Institute of Mental Health initiated the Research Domain Criteria (RDoC) project, a translational research program that calls for studies designed in terms of empirically-based functions (such as cognitive control or reward learning) rather than diagnostic groups. RDoC is a research framework rather than an alternative diagnostic system, intended to provide data that can inform future nosological manuals. This commentary includes a brief summary of RDoC as it pertains to schizophrenia and psychotic spectra, examples of recent data that highlight the utility of the approach, and conclusions regarding the implications for evolving conceptualizations of serious mental illness.

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