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.

Towards a new conceptual framework for psychopathology: Embodiment, enactivism, and embedment

2018 ◽  
Vol 28 (6) ◽  
pp. 800-822 ◽  
Author(s):  
Kristopher Nielsen ◽  
Tony Ward
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Conceptual Framework ◽  
Continuous Model ◽  
Research Domain Criteria ◽  
Eliminative Materialism ◽  
The Mind ◽  
Metaphysical Position ◽  
Research Domain

Psychopathology classification is at a conceptual crossroads. It is becoming increasingly accepted that the flaws of the DSM relate to its struggles to pick out “real” entities as opposed to clusters of symptoms. The Research Domain Criteria (RDoC) was formulated in response to this failure, and attempts to address the concerns confronting the DSM by shifting to a causal and continuous model of psychopathology. Noting key criticisms of neurocentricism and problems with conceptual validity leveled at the RDoC, we argue that they stem from its grounding in the metaphysical position of eliminative materialism, or at least material-reductionism. We propose that 3e cognition (viewing the mind as embodied, embedded, and enactive) offers a superior alternative to eliminative materialism. A 3e-informed framework of mental disorder is sketched out and its advantages as a basis for classifying and conceptualizing mental disorders are considered.

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 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.

scholarly journals A knowledge network for a dynamic taxonomy of psychiatric disease

2015 ◽  
Vol 17 (1) ◽  
pp. 79-87 ◽  
Keyword(s):  
Mental Disorders ◽  
Strategic Plan ◽  
Research Community ◽  
Mental Illnesses ◽  
Knowledge Network ◽  
Psychiatric Disease ◽  
The Novel ◽  
Research Domain Criteria ◽  
Novel Approach ◽  
Research Domain

The Research Domain Criteria (RDoC) project was initiated by the National Institute of Mental Health (NIMH) in early 2009 as the implementation of Goal 1.4 of its just-issued strategic plan. In keeping with the NIMH mission, to "transform the understanding and treatment of mental illnesses through basic and clinical research," RDoC was explicitly conceived as a research-related initiative. The statement of the relevant goal in the strategic plan reads: "Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures." Due to the novel approach that RDoC takes to conceptualizing and studying mental disorders, it has received widespread attention, well beyond the borders of the immediate research community. This review discusses the rationale for the experimental framework that RDoC has adopted, and its implications for the nosology of mental disorders in the future.

Research Domain Criteria and OCD

2017 ◽  
Author(s):  
Eyal Kalanthroff ◽  
Gideon E. Anholt ◽  
Helen Blair Simpson
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Disorders ◽  
The United States ◽  
Self Report ◽  
Research Domain Criteria ◽  
Diagnostic Systems ◽  
Behavioral Measures ◽  
Research Domain

This chapter discusses the Research Domain Criteria (RDoC) project, an initiative of the National Institutes of Mental Health (NIMH) of the United States to develop for research purposes new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures, and explores how the hallmark symptoms of OCD (obsessions, compulsions, and anxiety) can be mapped onto RDoC domains. Unlike current categorical diagnostic systems (e.g., DSM), RDoC seeks to integrate many levels of information (from genomics to self-report) to validate dimensions defined by neurobiology and behavioral measures that cut across current disorder categories. The chapter explores, for heuristic reasons, how the RDoC matrix might be used to elucidate the neurobehavioral domains of dysfunction that lead to the characteristic symptoms of OCD. It then selectively reviews the OCD literature from the perspective of the RDoC domains, aiming to guide future transdiagnostic studies to examine specific neurobehavioral domains across disorders.

Assessments of Upper Limb Ability following Stroke: A Review

2008 ◽  
Vol 71 (10) ◽  
pp. 427-437 ◽  
Author(s):  
Tennille J Rowland ◽  
Louise Gustafsson
Keyword(s):  
Clinical Practice ◽  
Psychometric Properties ◽  
Upper Limb ◽  
Clinical Utility ◽  
Reliability And Validity ◽  
Psychometric Testing ◽  
Inclusion Criteria ◽  
Test Items ◽  
Advantages And Disadvantages ◽  
Set Up

The aim of this paper was to review the psychometric properties and clinical utility of assessments of upper limb ability following stroke. Upper limb ability was defined as the use of the arm in meaningful activity. The database searches identified 13 assessments of upper limb ability. The inclusion criteria were (a) an evaluation of upper limb ability post-stroke, (b) a quantitative assessment yielding a numerical score, (c) able to be administered by an occupational therapist and (d) published information building on the results of a review in 2001. The assessments included were reviewed with respect to the ability measured, equipment required, evidence of reliability and validity, and advantages and disadvantages of use. Seven assessments satisfied the inclusion criteria. These assessments have undergone varying degrees of psychometric testing as outcome measures for upper limb recovery and all demonstrate at least adequate levels of reliability and validity. There is variation in the availability of instruction manuals and time commitments for test administration. All test items are generally available and inexpensive, enabling departments to set up the assessments with minimal financial outlay. The assessments described are regularly used in research and all demonstrate psychometric properties that suggest that they could be incorporated into clinical practice. Occupational therapists are encouraged to consider how they may include these assessments into their own clinical practice. An important step in this process may be further research into the clinical utility of these assessments.

scholarly journals Research Domain Criteria: cognitive systems, neural circuits, and dimensions of behavior

2012 ◽  
Vol 14 (1) ◽  
pp. 29-37 ◽  
Keyword(s):  
Mental Disorders ◽  
Neural Circuits ◽  
Integrative Approach ◽  
Research Domain Criteria ◽  
Diagnostic Systems ◽  
Research Perspective ◽  
Treatment And Prevention ◽  
Regulatory Systems ◽  
Positive Valence ◽  
Research Domain

Current diagnostic systems for mental disorders were established before the tools of neuroscience were available, and although they have improved the reliability of psychiatric classification, progress toward the discovery of disease etiologies and novel approaches to treatment and prevention may benefit from alternative conceptualizations of mental disorders. The Research Domain Criteria (RDoC) initiative is the centerpiece of NIMH's effort to achieve its strategic goal of developing new methods to classify mental disorders for research purposes. The RDoC matrix provides a research framework that encourages investigators to reorient their research perspective by taking a dimensional approach to the study of the genetic, neural, and behavioral features of mental disorders, RDoCs integrative approach includes cognition along with social processes, arousal/regulatory systems, and negative and positive valence systems as the major domains, because these neurobehavioral systems have all evolved to serve the motivational and adaptive needs of the organism. With its focus on neural circuits informed by the growing evidence of the neurodevelopmental nature of many disorders and its capacity to capture the patterns of co-occurrence of behaviors and symptoms, the RDoC approach holds promise to advance our understanding of the nature of mental disorders.

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.

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