The DSM5/RDoC debate on the future of mental health research: implication for studies on human stress and presentation of the signature bank.

In 2008, the National Institute of Mental Health (NIMH) announced that in the next few decades, it will be essential to study the various biological, psychological and social "signatures" of mental disorders. Along with this new "signature" approach to mental health disorders, modifications of DSM were introduced. One major modification consisted of incorporating a dimensional approach to mental disorders, which involved analyzing, using a transnosological approach, various factors that are commonly observed across different types of mental disorders. Although this new methodology led to interesting discussions of the DSM5 working groups, it has not been incorporated in the last version of the DSM5. Consequently, the NIMH launched the "Research Domain Criteria" (RDoC) framework in order to provide new ways of classifying mental illnesses based on dimensions of observable behavioral and neurobiological measures. The NIMH emphasizes that it is important to consider the benefits of dimensional measures from the perspective of psychopathology and environmental influences, and it is also important to build these dimensions on neurobiological data. The goal of this paper is to present the perspectives of DSM5 and RDoC to the science of mental health disorders and the impact of this debate on the future of human stress research. The second goal is to present the "Signature Bank" developed by the Institut Universitaire en Santé Mentale de Montréal (IUSMM) that has been developed in line with a dimensional and transnosological approach to mental illness.

[Can physicians efficaciously promote the purchase of bicycle helmets?]. / Les médecins, peuvent-ils efficacement promouvoir l'achat de casques de vélo?

OBJECTIVE: To evaluate the effectiveness of physician intervention in the purchase of bicycle helmets. DESIGN: Randomized single-blind controlled trial; randomization by clusters. SETTING: July 11, 1992, cycling path in Beauport, Quebec. PARTICIPANTS: Non-helmeted cyclists riding alone and groups of two to six cyclists in which at least one member was not wearing a helmet were invited to participate in the study; 274 individuals or groups of cyclists (total n = 485 cyclists) were randomized for the study. INTERVENTION: For the study group a physician handed out and explained the Canadian Medical Association's (CMA) pamphlet on bicycle helmets. This pamphlet includes a discount coupon for the purchase of a helmet. All of the participants in both the study group and the control group completed a questionnaire, including queries about sociodemographic characteristics, name, and telephone number. MAIN OUTCOME MEASURE: Proportion of previously non-helmeted cyclists purchasing a helmet within 2 to 3 weeks of the intervention. RESULTS: Telephone contact was made with 340 of the 416 non-helmeted cyclists (from 224 groups of cyclists). Of the 174 cyclists who had received a CMA pamphlet, 13.8% (n = 24) had purchased a helmet, compared to 3.0% (n = 5) of the 166 control group cyclists (RR = 4.6, 95% CL = 1.8-11.7). Similar results were achieved by cluster analysis of cyclists. CONCLUSION: Physician intervention using the CMA pamphlet could be effective in promoting the purchase of bicycle helmets.

Psychophysiological responses to subliminal auditory suggestions for activation.

The aim of this study was to characterize further the experimental procedure proposed by Borgeat and Goulet in 1983. Subliminal activation auditory suggestions were expected to increase heart rate and skin conductance in presence of a stressing task. 20 subjects were alternately exposed to activating or neutral (random numbers) 25-dB suggestions masked by a 40-dB white noise. Analyses of variance and covariance indicated an effect of the activating suggestions on heart rate but not on skin conductance. Partly confirming previous results, the data support the reliability of heart rate and the importance of a stressing factor to reveal the effects of preconscious or subliminal stimulations.