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4.
J Nerv Ment Dis ; 207(6): 419-420, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31157690

RESUMO

In 2010, the National Institute of Mental Health launched the Research Diagnostic Criteria (RDoC) as a research framework aimed at advancing research into the etiology of mental disorders, the development of clinically actionable biomarkers, and the eventual development of precision medications. The foundation of RDoC in that first phase rested in the assumption that mental disorders are brain disorders that originate in aberrant neural circuitry, and that therapeutic advances could flow from alterations in that circuitry. RDoC proposed a matrix of psychological constructs with seven levels of analysis ranging from the cell to self-report, but with neural circuitry at the center. In 2016, another model was proposed in which neural circuitry became equivalent to other units of analyses. With the advent of a new Director of the NIMH, the emphasis returned to neural circuitry as a priority, along with computational psychiatry. Have these shifts undermined the RDoC project?


Assuntos
Encefalopatias , Transtornos Mentais , Modelos Biológicos , Vias Neurais , Encefalopatias/classificação , Encefalopatias/diagnóstico , Encefalopatias/fisiopatologia , Humanos , Transtornos Mentais/classificação , Transtornos Mentais/diagnóstico , Transtornos Mentais/fisiopatologia , National Institute of Mental Health (U.S.) , Vias Neurais/fisiopatologia , Estados Unidos
5.
Psychiatry Res ; 277: 70-71, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31229308

RESUMO

The Genain Quadruplets, a genetically identical group of sisters, all developed schizophrenia by their early 20s. Beginning in the 1950s, under the direction of David Rosenthal, they have been studied extensively with a number of neurobiological, neuroradiological and neurobehavioral measures at the Intramural Program of the National Institute of Mental Health (NIMH). A major focus of research interest has been the fact that they varied greatly in the severity of their illness. The present report emphasizes the important role that Monte Buchsbaum had in their evaluation, especially with respect to neuroradiology, during their second period of study at NIMH in the 1980s. It is of special interest that Buchsbaum et al. (1984) concluded "No strong relationship is shown between these (radiological) measures and illness severity or drug responsivity." The inference, therefore, is that the differences in illness severity among the sisters were not readily attributable to differences in the amount of damaged brain, at least as could be determined by the imaging methods available in the 1980s. The current report also summarizes the results of the other studies performed on the sisters in the 1980s, to which Monte Buchsbaum contributed.


Assuntos
Quadrigêmeos/história , Esquizofrenia/história , Adulto , Feminino , História do Século XX , Humanos , National Institute of Mental Health (U.S.) , Psiquiatria/história , Quadrigêmeos/psicologia , Esquizofrenia/genética , Esquizofrenia/patologia , Estados Unidos
6.
Mol Psychiatry ; 24(11): 1576-1582, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31164699

RESUMO

The Genomics Workgroup of the National Advisory Mental Health Council (NAMHC) recently issued a set of recommendations for advancing the NIMH psychiatric genetics research program and prioritizing subsequent follow-up studies. The report emphasized the primacy of rigorous statistical support from properly designed, well-powered studies for pursuing genetic variants robustly associated with disease. Here we discuss the major points NIMH program staff consider when assessing research applications based on common and rare variants, as well as genetic syndromes, associated with psychiatric disorders. These are broad guiding principles for investigators to consider prior to submission of their applications. NIMH staff weigh these points in the context of reviewer comments, the existing literature, and current investments in related projects. Following the recommendations of the NAMHC, statistical strength and robustness of the underlying genetic discovery weighs heavily in our funding considerations as does the suitability of the proposed experimental approach. We specifically address our evaluation of applications motivated in whole, or in part, by an association between human DNA sequence variation and a disease or trait relevant to the mission of the NIMH.


Assuntos
Genômica/tendências , Transtornos Mentais/genética , Saúde Mental/tendências , Humanos , National Institute of Mental Health (U.S.) , Estados Unidos
7.
Psychiatr Serv ; 70(6): 514-517, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30966946

RESUMO

Coordinated specialty care (CSC) is a promising multielement treatment for the care of individuals experiencing the onset of schizophrenia. The community mental health block grant program has increased federal support for CSC programs. In order to maximize the number of sites capable of science-to-service or service-to-science translation, the National Institute of Mental Health funded a supplement to the PhenX toolkit consisting of measures for early psychosis. The early psychosis working group included translational research and clinical services panels. The clinical services panel was charged with identifying low-burden and psychometrically sound measures for use in routine clinical settings. The 19 new clinical measures complement existing measures already in the toolkit. Measures cover a range of domains, including symptoms, social and occupational functioning, well-being, medication adherence and side effects, physical activity, and shared decision making and person-centered care. Several challenges are also discussed. The review process underscored the challenges facing nonacademic sites in collecting even low-burden assessments.


Assuntos
Intervenção Médica Precoce/métodos , Esquizofrenia/terapia , Software , Intervenção Médica Precoce/economia , Humanos , National Institute of Mental Health (U.S.) , Desenvolvimento de Programas , Estados Unidos
8.
Curr Psychiatry Rep ; 21(6): 37, 2019 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-31030293

RESUMO

PURPOSE OF REVIEW: We discuss the implications of the Research Domain Criteria (RDoC) initiative for neuroscience research on personality disorder (PD). To organize our review, we construct a preliminary conceptual mapping of PD symptom criteria onto RDoC constructs. We then highlight recent neuroscience research, often built around concepts that correspond to RDoC elements, and discuss the findings in reference to the constructs we consider most pertinent to PD. RECENT FINDINGS: PD symptoms were strongly conceptually tied to RDoC constructs within the Social Processes domain, implicating brain systems involved in interpersonal rejection, facial emotion perception, and self-referential processes. Negative and Positive Valence Systems were conceptually associated with many PD symptoms, with particular relevance ascribed to the latter's Reward Valuation construct, which could reflect a more widespread disruption of computational processes involved in estimating the probability and benefits of a future outcome. Within the Cognitive Systems domain, the Cognitive Control construct mainly related to PD symptoms associated with impulse control, suggesting a connection to neural circuits that underlie goal selection and behavioral control. Arousal and Regulatory Systems could only be conceptually mapped onto PD symptoms through the Arousal construct, with different symptoms reflecting either a higher or lower biological sensitivity to internal and external stimuli. The RDoC framework has promise to advance neuroscience research on PD. The Social Processes domain is especially relevant to PD, although constructs falling within the other RDoC domains could also yield important insights into the neurobiology of PD and its connections with other forms of psychopathology. Identifying RDoC constructs (e.g., habit formation) that subserve more fundamental processes relevant to personality functioning warrants further investigation.


Assuntos
Transtornos da Personalidade , Psicopatologia , Encéfalo , Emoções , Humanos , National Institute of Mental Health (U.S.) , Estados Unidos
9.
Neuron ; 101(5): 779-782, 2019 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-30844398

RESUMO

The NIMH Research Domain Criteria (RDoC) can aid in the translation of integrative neuroscience. We argue that the RDoC framework, with its emphasis on integration across units of analysis, leveraged with computational approaches, can organize intermediary treatment targets and clinical outcomes, augmenting the translational stream.


Assuntos
Metodologias Computacionais , Transtornos Mentais/terapia , National Institute of Mental Health (U.S.) , Pesquisa Médica Translacional/métodos , Humanos , Neurociências/métodos , Medicina de Precisão/métodos , Pesquisa Médica Translacional/organização & administração , Estados Unidos
10.
Compr Psychiatry ; 90: 65-72, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30743139

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is characterized by heterogeneous behaviors and symptoms, developmental trajectories, and treatment response. Isolating intermediate phenotypes that are superior to current DSM-based nosology in order to explain such heterogeneity is integral to enhancing etiological theory, improving clinical assessment, predicting treatment response, and developing tailored treatments. To this end, this review provides an integrated developmental psychopathology and National Institute of Mental Health Research Domain Criteria (RDoC) approach to ADHD. In particular, associations between ADHD and RDoC domains of cognition (specifically working memory) and positive valence (reward anticipation/delay/receipt) are discussed. These domains are examined across behavioral and neurocircuitry levels of analysis and placed within a developmental context via examining associations among RDoC domains, relevant features of ADHD, and environmental correlates implicated across development. Limitations of the existing literature and proposed future directions are explored. Importantly, future work should focus on novel approaches that account for developmental shifts in functioning of relevant RDoC domains over time, as well as further examination of the interaction across RDoC domains and levels of analysis.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Encéfalo/diagnóstico por imagem , National Institute of Mental Health (U.S.)/tendências , Rede Nervosa/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Cognição/fisiologia , Humanos , Memória de Curto Prazo/fisiologia , Psicopatologia , Recompensa , Estados Unidos/epidemiologia
13.
Eur Psychiatry ; 57: 58-60, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30677549

RESUMO

In this article we aim at conceptual reconstruction of the historical background behind RDoC project. It incorporates some elements that have not heretofore been included in frameworks for psychopathology research. At the same time, however, RDoC - like any approach to mental illness - must grapple with longstanding challenges in addressing issues about the roles and relationships of mind, brain, and patients' reports in considering the nature of disorder. In this respect, the historical roots of psychopathology remain as relevant as ever.


Assuntos
Transtornos Mentais/classificação , Psiquiatria/normas , Psicopatologia/normas , Humanos , National Institute of Mental Health (U.S.) , Projetos de Pesquisa , Estados Unidos
14.
Arthritis Care Res (Hoboken) ; 71(12): 1630-1639, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30354017

RESUMO

OBJECTIVE: We examined psychometric performance of Patient-Reported Outcomes Measurement Information System (PROMIS) measures in a racially/ethnically and linguistically diverse cohort with systemic lupus erythematosus (SLE). METHODS: Data were from the California Lupus Epidemiology Study, a multiracial/multiethnic cohort of individuals with physician-confirmed SLE. The majority (n = 332) attended in-person research visits that included interviews conducted in English, Spanish, Cantonese, or Mandarin. Up to 12 PROMIS short forms were administered (depending on language availability). An additional 99 individuals completed the interview by phone only. Internal consistency was examined with Cronbach's alpha and item-total correlations. Correlations with the Short Form 36 subscales and both self-reported and physician-assessed disease activity assessed convergent validity. All analyses were repeated within each racial/ethnic group. Differences in scores by race/ethnicity were examined in bivariate analyses and by multiple regression analyses controlling for age, sex, disease duration, and disease damage and activity. RESULTS: The total sample was 30.0% white, 22.3% Hispanic, 10.9% African American, 33.7% Asian, and 3.0% other race/ethnicity. Seventy-seven percent of interviews were conducted in-person. Non-English interviews were conducted in 26.0% of the Hispanic subjects and 18.6% of the Asian subjects. Each scale demonstrated adequate reliability and validity overall and within racial/ethnic groups. Minimal floor effects were observed, but ceiling effects were noted. Missing item responses were minimal for most scales, except for items related to work. No differences were noted by mode of administration or by language of administration among Hispanics and Asians. After accounting for differences in disease status, age, and sex, few differences in mean scores between whites and other racial/ethnic groups were noted. CONCLUSION: PROMIS measures appear reliable and valid in persons with lupus across racial/ethnic groups.


Assuntos
Grupos de Populações Continentais , Grupos Étnicos , Lúpus Eritematoso Sistêmico/etnologia , National Institute of Mental Health (U.S.)/estatística & dados numéricos , Medidas de Resultados Relatados pelo Paciente , Psicometria/métodos , Adulto , Feminino , Seguimentos , Humanos , Lúpus Eritematoso Sistêmico/psicologia , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Estudos Retrospectivos , Estados Unidos/epidemiologia
15.
Psychol Med ; 49(1): 1-8, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30409236

RESUMO

Given the failure of psychiatry to develop clinically useful biomarkers for psychiatric disorders, and the concomitant failure to develop significant advances in diagnosis and treatment, the National Institute of Mental Health (NIMH) in 2010 launched the Research Domain Criteria (RDoC), a framework for research based on the assumption that mental disorders are disorders of identifiable brain neural circuits, with neural circuitry at the center of units of analysis ranging from genes, molecules, and cells to behavior, self-reports, and paradigms. These were to be integrated with five validated dimensional psychological constructs such as negative and positive valence systems. Four years later, the NIMH stated that the ultimate goal of RDoC is precision medicine for psychiatry, with the assumption that precision medications will normalize dysfunctional neural circuits. How this could be accomplished is not obvious, given that neural circuits are widely distributed, have unclear boundaries, and exhibit a significant degree of neuroplasticity, with multiple circuits present in any given disorder. Moreover, the early focus on neural circuitry has been criticized for its reductionism and neglect of the more recent RDoC emphasis on the integration and equivalence of biological and psychological phenomena. Yet this seems inconsistent with the priorities of the NIMH director, an advocate of the central role of neural circuitry and projects such as the Brain Initiative and the Human Connectome Project. Will such projects, at a cost of at least $10 billion, lead to precision medications for mental disorders, or further diminish funding for clinical care and research?


Assuntos
Transtornos Mentais , Rede Nervosa , Medicina de Precisão , Humanos , Transtornos Mentais/classificação , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , National Institute of Mental Health (U.S.) , Estados Unidos
16.
Am Psychol ; 74(4): 415-431, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30265019

RESUMO

The National Institute of Mental Health (NIMH) plays an enormous role in establishing the agenda for mental health research across the country (its 2016 appropriation was nearly $1.5 billion; NIMH, 2016a). As the primary funder of research that will lead to development of new assessments and interventions to identify and combat mental illness, the priorities set by NIMH have a major impact on the mental health of our nation and training of the next generation of clinical scientists. Joshua Gordon has recently begun his term as the new Director of NIMH and has been meeting with different organizations to understand how they can contribute to the grand challenge of reducing the burden of mental illness. As a group of clinical psychological scientists (most representing the Coalition for the Advancement and Application of Psychological Science), he asked what we saw as key gaps in our understanding of the burden of mental illnesses and psychological disorders that psychosocial research could help fill. In response, we first present data illustrating how funding trends have shifted toward biomedical research over the past 18 years and then consider the objectives NIMH has defined in its recent strategic plan (U.S. Department of Health and Human Services, National Institutes of Health, & National Institute of Mental Health, 2015). We then note ways that advances in psychosocial research can help achieve these objectives. Critically, this involves integrating psychosocial and biomedical approaches to efficiently relieve the suffering of millions of Americans who struggle with mental illnesses and psychological disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Efeitos Psicossociais da Doença , Transtornos Mentais/terapia , Saúde Mental , Pesquisa , Humanos , National Institute of Mental Health (U.S.) , Estados Unidos
17.
Psychol Med ; 49(2): 190-199, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30070191

RESUMO

The National Institute of Mental Health launched the Research Domain Criteria (RDoC) initiative to better understand dimensions of behavior and identify targets for treatment. Examining dimensions across psychiatric illnesses has proven challenging, as reliable behavioral paradigms that are known to engage specific neural circuits and translate across diagnostic populations are scarce. Delay discounting paradigms seem to be an exception: they are useful for understanding links between neural systems and behavior in healthy individuals, with potential for assessing how these mechanisms go awry in psychiatric illnesses. This article reviews relevant literature on delay discounting (or the rate at which the value of a reward decreases as the delay to receipt increases) in humans, including methods for examining it, its putative neural mechanisms, and its application in psychiatric research. There exist rigorous and reproducible paradigms to evaluate delay discounting, standard methods for calculating discount rate, and known neural systems probed by these paradigms. Abnormalities in discounting have been associated with psychopathology ranging from addiction (with steep discount rates indicating relative preference for immediate rewards) to anorexia nervosa (with shallow discount rates indicating preference for future rewards). The latest research suggests that delay discounting can be manipulated in the laboratory. Extensively studied in cognitive neuroscience, delay discounting assesses a dimension of behavior that is important for decision-making and is linked to neural substrates and to psychopathology. The question now is whether manipulating delay discounting can yield clinically significant changes in behavior that promote health. If so, then delay discounting could deliver on the RDoC promise.


Assuntos
Desvalorização pelo Atraso/fisiologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/fisiopatologia , National Institute of Mental Health (U.S.) , Humanos , Estados Unidos
18.
Psychol Med ; 49(2): 212-216, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30322416

RESUMO

Despite the clinical impact of motor symptoms such as agitation or retardation on the course of depression, these symptoms are poorly understood. Novel developments in the field of instrumentation and mobile devices allow for dimensional and continuous recording of motor behavior in various settings, particularly outside the laboratory. Likewise, the use of novel assessments enables to combine multimodal neuroimaging with behavioral measures in order to investigate the neural correlates of motor dysfunction in depression. The research domain criteria (RDoC) framework will soon include a motor domain that will provide a framework for studying motor dysfunction in mood disorders. In addition, new studies within this framework will allow investigators to study motor symptoms across different stages of depression as well as other psychiatric diagnoses. Finally, the introduction of the RDoC motor domain will help test how motor symptoms integrate with the original five RDoC domains (negative valence, positive valence, cognitive, social processes, and arousal/regulation).


Assuntos
Transtorno Depressivo/complicações , Hipocinesia/etiologia , Rede Nervosa/fisiopatologia , Agitação Psicomotora/etiologia , Transtorno Depressivo/diagnóstico , Humanos , Hipocinesia/diagnóstico , National Institute of Mental Health (U.S.) , Agitação Psicomotora/diagnóstico , Estados Unidos
20.
Wiley Interdiscip Rev Cogn Sci ; 10(3): e1491, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30585702

RESUMO

Neuroconstructivism can provide Research Domain Criteria (RDoC) with a developmental framework to understand mental disorders. Neuroconstructivism proposes that mental disorders are the outcome of a developmental trajectory. Based on this assumption, symptoms would reveal the system's adaptation to optimize functioning according to the system's experience of the physical and social contexts. RDoC adopts a translational research approach with the aim of detecting, curing, and preventing mental illness. More specifically this involves to: (a) identify early signs of mental disorders, (b) find the optimal patient-treatment fit, and (c) design efficient interventions to prevent the system's eventual pathological functioning. We propose that meeting RDoC's threefold objective necessarily involves predicting the system's developmental trajectory. Such endeavor requires counting with assessment tools that are sensitive to both the process of development and its different contexts; the measures provided by these tools will allow identifying the risk and protective factors that make the system vulnerable to depart from a typical developmental trajectory. Including vectors relative to time and contexts in a relevant part of the matrix will make of RDoC a truly integrative model, which considers the relationships between behavior and neural circuits throughout the developmental pathway. This article is categorized under: Psychology > Brain Function and Dysfunction Neuroscience > Clinical Neuroscience Neuroscience > Development.


Assuntos
Encéfalo/fisiopatologia , Transtornos Mentais/classificação , Transtornos Mentais/diagnóstico , Adaptação Fisiológica , Humanos , Transtornos Mentais/fisiopatologia , National Institute of Mental Health (U.S.) , Projetos de Pesquisa , Pesquisa Médica Translacional , Estados Unidos
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