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The integration of developmental processes is essential for a full understanding of psychopathology. The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) provide a scaffold on which to organize the components and processes of psychopathology and to detail behavioral and biological disruptions in developmental processes gone awry. This special section on Integrating Developmental Psychopathology With the RDoC Framework provides the opportunity to comment on five extraordinary developmental psychopathology articles that report results and theory integral to RDoC. An introductory overview provides context for RDoC's approach to developmental issues. This is followed by brief summaries of each article and points regarding its particularly salient aspects, and concludes with broader comments about the import of the articles as a set. Collectively, the work by these eminent translational scholars illustrates how to conduct significant research on developmental psychopathology using RDoC, and simultaneously raises important questions and future directions to integrate development and environment in RDoC-framed research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Trastornos Mentales , Humanos , Trastornos Mentales/diagnóstico , National Institute of Mental Health (U.S.) , Psicopatología , Estados UnidosRESUMEN
BACKGROUND: In 2013, a few years after the launch of the National Institute of Mental Health's Research Domain Criteria (RDoC) initiative, Cuthbert and Insel published a paper titled "Toward the future of psychiatric diagnosis: the seven pillars of RDoC." The RDoC project is a translational research effort to encourage new ways of studying psychopathology through a focus on disruptions in normal functions (such as reward learning or attention) that are defined jointly by observable behavior and neurobiological measures. The paper outlined the principles of the RDoC research framework, including emphases on research that acquires data from multiple measurement classes to foster integrative analyses, adopts dimensional approaches, and employs novel methods for ascertaining participants and identifying valid subgroups. DISCUSSION: To mark the first decade of the RDoC initiative, we revisit the seven pillars and highlight new research findings and updates to the framework that are related to each. This reappraisal emphasizes the flexible nature of the RDoC framework and its application in diverse areas of research, new findings related to the importance of developmental trajectories within and across neurobehavioral domains, and the value of computational approaches for clarifying complex multivariate relations among behavioral and neurobiological systems. CONCLUSION: The seven pillars of RDoC have provided a foundation that has helped to guide a surge of new studies that have examined neurobehavioral domains related to mental disorders, in the service of informing future psychiatric nosology. Building on this footing, future areas of emphasis for the RDoC project will include studying central-peripheral interactions, developing novel approaches to phenotyping for genomic studies, and identifying new targets for clinical trial research to facilitate progress in precision psychiatry.
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Trastornos Mentales , Psiquiatría , Genómica , Humanos , Trastornos Mentales/diagnóstico , Psiquiatría/métodos , Psicopatología , Investigación Biomédica TraslacionalRESUMEN
The National Institute of Mental Health (NIMH) addressed in its 2008 Strategic Plan an emerging concern that the current diagnostic system was hampering translational research, as accumulating data suggested that disorder categories constituted heterogeneous syndromes rather than specific diseases. However, established practices in peer review placed high priority on extant disorders in evaluating grant applications for mental illness. To provide guidelines for alternative study designs, NIMH included a goal to develop new ways of studying psychopathology based on dimensions of measurable behavior and related neurobiological measures. The Research Domain Criteria (RDoC) project is the result, intended to build a literature that informs new conceptions of mental illness and future revisions to diagnostic manuals. The framework calls for the study of empirically-derived fundamental dimensions as characterized by related behavioral/psychological and neurobiological data (e.g., reward valuation, working memory). RDoC also emphasizes full-range dimensional approaches (from typical to increasingly abnormal), neurodevelopment and environmental effects, and research designs that integrate data across behavioral, biological, and self-report measures. This commentary provides an overview of the project's first decade and its potential future directions. RDoC remains grounded in experimental psychopathology perspectives, and its progress is strongly linked to psychological measurement and integrative approaches to brain-behavior relationships.
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Posttraumatic stress disorder (PTSD) is marked by alterations in emotional functioning, physiological reactivity, and attention. Neural reactivity to acoustic startle stimuli can be used to understand brain functions related to these alterations. Investigations of startle reactivity in PTSD have yielded inconsistent findings, which may reflect the heterogeneity of the disorder. Furthermore, little is known of how the common co-occurrence of mild traumatic brain injury (mTBI; i.e., concussion) may influence neural reactivity. We examined the event-related potentials (ERPs) of combat veterans (n = 102) to acoustic startle probes delivered during viewing of pleasant, neutral, unpleasant, and combat-related pictures. Interview-based assessments yielded dimensional characterizations of PTSD and mTBI. The P3 ERP response to startle probes was reduced during all affective relative to neutral pictures but failed to be associated with a PTSD diagnosis. However, two separable domains of PTSD symptomatology were associated with startle ERPs regardless of the picture conditions. Maladaptive avoidance was associated with smaller N1, P2, and P3 amplitudes, while intrusive reexperiencing was associated with larger P2 amplitudes. There were no main effects of mTBI. Findings suggest that level of symptomatology rather than a formal diagnosis of PTSD better explains alterations in neural reactivity after traumatic events, while mild brain injuries have little impact. Avoidance symptoms of PTSD may dampen neural functions that facilitate reorientation to threat while intrusive reexperiencing of traumatic events appears to heighten sensory reactivity. Considering specific aspects of symptomatology provides insight into the neural basis of trauma-related psychopathology and may help guide individualization of clinical interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Conmoción Encefálica , Trastornos por Estrés Postraumático , Veteranos , Encéfalo , Potenciales Evocados , Humanos , Trastornos por Estrés Postraumático/diagnósticoRESUMEN
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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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.â©.
El proyecto Research Domain Criteria (Criterios de Dominio de Investigación, CDI) constituye un marco traslacional para la investigación en psicopatología y fue iniciado por el Instituto Nacional de Salud Mental en un intento por proporcionar nuevas alternativas de investigación para sortear los problemas que surgen del uso de categorías diagnósticas basadas en síntomas para el diagnóstico de los trastornos mentales. La propuesta CDI se centra en la psicopatología basada en dimensiones, las cuales se definen simultáneamente por el comportamiento observable (incluyendo las mediciones cuantitativas del comportamiento cognitivo o afectivo) y las mediciones neurobiológicas. Las características clave de los CDI incluyen un énfasis en las dimensiones funcionales que van de lo normal a lo anormal, la integración de múltiples mediciones en los diseños de estudio (que pueden fomentar enfoques computacionales) y una alta prioridad en los estudios del neurodesarrollo y de las influencias ambientales (y de su interacción), todo lo cual puede contribuir a los avances en la comprensión de la etiología de los trastornos a lo largo de la vida. Este artículo destaca las consecuencias clave de las formas en que los CDI pueden contribuir a futuras ideas acerca de la clasificación, así como a algunas de las consideraciones involucradas en la traducción de datos básicos del comportamiento y de la neurociencia para la psicopatología.
Le National Institute of Mental Health a créé le projet des Critères de domaines de recherche (RDoC, Research Domain Criteria) comme cadre de recherche en psychopathologie, dans le but d'ouvrir les champs de recherche en contournant les problèmes issus des catégories diagnostiques basées sur les symptômes des maladies. Le RDoC est centré sur la psychopathologie et s'appuie sur un comportement observable (y compris des données quantitatives de comportement cognitif ou affectif) comme sur des données neurobiologiques. Structuré autour de caractéristiques essentielles, le RDoC valorise les dimensions fonctionnelles (de normales à anormales), les études de conceptions différentes (pouvant favoriser les méthodes numériques), et prioritairement les études de neurodéveloppement, les influences environnementales et leurs interactions qui peuvent améliorer la compréhension de l'étiologie des maladies au cours de la vie. Cet article souligne les principaux messages concernant les apports du RDoC aux nouvelles méthodes de classification, ainsi que certaines observations en lien avec la traduction des données fondamentales neuroscientifiques et comportementales en psychopathologie.
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Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos Mentales/clasificación , National Institute of Mental Health (U.S.)/tendencias , Predicción , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Estados Unidos/epidemiologíaRESUMEN
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.
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Trastornos Mentales/clasificación , Psiquiatría/normas , Psicopatología/normas , Humanos , National Institute of Mental Health (U.S.) , Proyectos de Investigación , Estados UnidosRESUMEN
The PRISM (Psychiatric Ratings using Intermediate Stratified Markers) project was funded under the auspices of the European Union Innovative Medicine Initiative (EU-IMI) to explore quantitative approaches to the biological and behavioral aspects of neuropsychiatric disorders. PRISM focuses specifically on social withdrawal, although its principles are applicable to a wide range of disorders. This commentary explores some of the major aspects of the PRISM design from the perspective of the Research Domain Criteria (RDoC) project initiated by the National Institute of Mental Health. PRISM represents an apt exemplar of the principles developed in the RDoC framework, with the potential to contribute palpable advances in precision diagnosis and innovative approaches to treatment development.
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Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Aislamiento Social , Animales , Biología Computacional , Humanos , Relaciones Interpersonales , Trastornos Mentales/fisiopatología , Proyectos de InvestigaciónRESUMEN
Emotional dysfunction is evident in posttraumatic stress disorder (PTSD), yet it is unclear what aspects of the disorder most directly relate to aberrant emotional responding. Also, the frequent co-occurrence of blast-related mild traumatic brain injuries (mTBIs) among recently deployed U.S. military personnel complicates efforts to understand the basis for emotional disruption. We studied a cross-sectional sample (enriched for PTSD and mTBI) of 123 U.S. veterans of wars in Iraq and Afghanistan. We measured subjective affective evaluations and peripheral psychophysiological responses to images with pleasant, neutral, unpleasant, and combat-related aversive content. When compared with other postdeployment participants, those who had combat-related PTSD rated pleasant image content as less positive (ηp2 = .04) and less arousing (ηp2 = .06), and exhibited heightened physiological responsivity to combat image content (ηp2 = .07). Symptoms of PTSD were associated with elevated skin conductance responses (ß = .28), reduced heart rate deceleration (ß = .44 to .47), and increased corrugator facial muscle electromyography (ß = .47). No effects for blast-related mTBI were observed across any affective modulation measures. These findings point to a greater impact of PTSD symptomatology than blast-related mTBI on emotional functioning and highlight the utility of dimensional assessments of psychopathology for understanding the effects of combat-stress conditions on adjustment to civilian life.
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Síntomas Afectivos/etiología , Conmoción Encefálica/psicología , Emociones , Trastornos por Estrés Postraumático/psicología , Veteranos/psicología , Adulto , Traumatismos por Explosión/complicaciones , Conmoción Encefálica/etiología , Conmoción Encefálica/fisiopatología , Estudios Transversales , Músculos Faciales/fisiopatología , Femenino , Respuesta Galvánica de la Piel , Frecuencia Cardíaca , Humanos , Masculino , Trastornos por Estrés Postraumático/fisiopatología , Estados Unidos , Adulto JovenRESUMEN
This article describes the National Institute of Mental Health's Research Domain Criteria (RDoC) initiative. The description includes background, rationale, goals, and the way the initiative has been developed and organized. The central RDoC concepts are summarized and the current matrix of constructs that have been vetted by workshops of extramural scientists is depicted. A number of theoretical and methodological issues that can arise in connection with the nature of RDoC constructs are highlighted: subjectivism and heterophenomenology, desynchrony and theoretical neutrality among units of analysis, theoretical reductionism, endophenotypes, biomarkers, neural circuits, construct "grain size," and analytic challenges. The importance of linking RDoC constructs to psychiatric clinical problems is discussed. Some pragmatics of incorporating RDoC concepts into applications for NIMH research funding are considered, including sampling design.
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Trastornos Mentales/diagnóstico , National Institute of Mental Health (U.S.) , Psicopatología/métodos , Humanos , Trastornos Mentales/psicología , Estados UnidosRESUMEN
The current special issue, devoted to the Research Domain Criteria (RDoC) initiative of the US National Institute of Mental Health, showcases a variety of empirical and review articles that address issues related to this dimensional and multi-method approach to research on mental disorders. Here, we provide an integrative perspective on various aspects of these articles, focused around the primary principles of the RDoC approach and the practical and methodological issues related to conducting RDoC-informed research. The chief point we wish to highlight is that these articles demonstrate the ways in which the field of psychophysiology already thinks along the lines of RDoC in terms of using biobehavioral constructs, looking for convergence among constructs using various methodologies, and utilizing dimensional measurements in studies. In this sense, RDoC is not novel; however, by specifying a formal research platform it provides explicit encouragement and guidance for using such principles in understanding psychiatric phenomena, rather than continuing to focus research efforts on traditional diagnostic categories alone.
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Trastornos Mentales/fisiopatología , Psicofisiología , Humanos , National Institute of Mental Health (U.S.) , Estados UnidosRESUMEN
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.
A comienzos de 2009 el Instituto Nacional de Salud Mental (NIMH) lanzó el proyecto Criterios del Ámbito de la Investigación (RDoC) como parte de la implementación del Objetivo 1.4 de su recién publicado plan estratégico. En conformidad con la misión del NIMH, para "transformar la comprensión y el tratamiento de las en-fermedades mentales a través de la investigación básica y clínica" el RDoC fue concebido explícitamente como una iniciativa relacionada con la investigación. La declaración del objetivo pertinente en el plan estratégico señala: "Desarrollar, para propósitos de investigación nuevas vías de clasificación de los trastornos mentales en base a dimensiones observables de la conducta y mediciones neurobiológicas". Debido al novedoso enfoque que tiene el RDoC para conceptualizar y estudiar los trastornos mentales, ha recibido gran atención, mucho más allá de las fronteras de la comunidad de investigación inmediata. Esta revisión discute los fundamentos del marco experimental que ha adoptado el RDoC y sus repercusiones futuras para la nosología de los trastor-nos mentales.
Le NIMH (National Institute of Mental Health) a lancé le projet de « Critères de domaines de recherche ¼ (CDoR) début 2009, en tant qu'application de l'objectif 1.4 de son plan stratégique venant d'être publié. Les CDoR ont été conçus explicitement comme une initiative liée à la recherche, en phase avec la mission du NIMH pour « transformer la compréhension et le traitement des maladies mentales par la recherche fondamentale et clinique ¼. L'objectif exposé dans le plan stratégique est le suivant: « Développer, aux fins de recherche, de nouvelles façons de classifier des troubles mentaux selon des critères de comportements observables et des mesures neurobiologiques ¼. Cette nouvelle approche des CDoR pour concevoir et étudier les troubles mentaux a reçu une grande attention, bien au-delà des frontières des communautés de chercheurs. Cet article analyse le fondement du cadre expérimental adopté par les CDoR et ses implications dans l'avenir pour la nosologie des troubles mentaux.
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Investigación Biomédica , Trastornos Mentales/clasificación , Trastornos Mentales/diagnóstico , Psiquiatría/métodos , Psiquiatría/normas , HumanosRESUMEN
The Research Domain Criteria project (RDoC) was initiated by the National Institute of Mental Health in early 2009 to "develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures." RDoC provides a framework for psychopathology research intended to explicate specific aspects of functional impairment by studying relevant brain-behavior relationships, in contrast to the current heterogeneous categories of mental disorders defined by various groupings of symptoms. Endophenotypes fit naturally into the RDoC context since they are typically conceived to be closer to fundamental neural and psychological mechanisms than more abstracted disorder categories. Consequently, the genomic aspects of endophenotypes take on particular significance for understanding genetic risk architectures in such an approach to psychopathology.
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Encéfalo/fisiopatología , Trastornos Mentales/fisiopatología , Fenotipo , Humanos , National Institute of Mental Health (U.S.) , Estados UnidosRESUMEN
The article by Lillienfeld in this issue comprises a thoughtful critique of the Research Domain Criteria (RDoC) project initiated by the National Institute of Mental Health, and includes four specific theoretical and methodological challenges along with recommendations to address each one. In this commentary, I briefly consider each of the four challenges in turn, noting points of agreement and also clarifying selected points from the NIMH RDoC perspective. Overall, Lillienfeld's paper represents a valuable contribution to the RDoC literature as research conducted with the new framework continues to accelerate.
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Trastornos Mentales/clasificación , Trastornos Mentales/diagnóstico , Escalas de Valoración Psiquiátrica , HumanosRESUMEN
We explore how hallucinations might be studied within the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) framework, which asks investigators to step back from diagnoses based on symptoms and focus on basic dimensions of functioning. We start with a description of the objectives of the RDoC project and its domains and constructs. Because the RDoC initiative asks investigators to study phenomena across the wellness spectrum and different diagnoses, we address whether hallucinations experienced in nonclinical populations are the same as those experienced by people with psychotic diagnoses, and whether hallucinations studied in one clinical group can inform our understanding of the same phenomenon in another. We then discuss the phenomenology of hallucinations and how different RDoC domains might be relevant to their study. We end with a discussion of various challenges and potential next steps to advance the application of the RDoC approach to this area of research.