Psychiatric research is in crisis. We highlight efforts to overcome current challenges by focusing on the emerging field of computational psychiatry, which might enable the field to move from a symptom-based description of mental illness to descriptors based on objective computational multidimensional functional variables. We survey recent efforts toward this goal and describe a set of methods that together form a toolbox to aid this research program. We identify four levels in computational psychiatry: (a) behavioral tasks that index various psychological processes, (b) computational models that identify the generative psychological processes, (c) parameter-estimation methods concerned with quantitatively fitting these models to subject behavior by focusing on hierarchical Bayesian estimation as a rich framework with many desirable properties, and (d) machine-learning clustering methods that identify clinically significant conditions and subgroups of individuals. As a proof of principle, we apply these methods to two different data sets. Finally, we highlight challenges for future research.
We argue that dominant research approaches concerning mental illness, which are centered on traditional categories of psychiatric classification as codified in the DSM-IV, have serious empirical, conceptual, and foundational problems. These problems have led to a classification scheme and body of research findings that provide a very poor map of the domain of mental illness, a map that, in turn, undermines clinical and research pursuits. We discuss some current efforts to respond to these problems and argue that the DSM-5 revision process is not very promising, whereas the NIMH Research Domain Criteria initiative and some recent research in cognitive neuroscience fares better, although the latter remains potentially compromised by residual influences of the DSM-based approach. We conclude with some lessons and suggestions for the pursuit of alternative research pathways.
ome promising developments for people with severe and disabling mental illnesses occurred in the first decade of the 21st century. The keynote was sounded by a special national project, the President's New Freedom Commission on Mental Health. The Commission issued a scathing indictment of American mental health services, especially those for people with the most severe illnesses, and a corollary call for massive reform. The federal Substance Abuse and Mental Health Services Administration responded with an ambitious reform agenda featuring grants to transform state mental health service systems and projects to identify, package and disseminate proven treatment approaches. Operating one of the world's largest systems of health care, the Veterans Administration followed suit.In the 1990s, the Institute of Medicine issued a major position paper, arguing that practitioners are not as influenced by current scientific research as they should be. By 2000, this concern had spread to the mental health scientific and professional communities. The idea of evidence-based practice (also variously termed evidence-based medicine, science-based practice, research-validated treatment, etc.) quickly became associated with broader aspects of mental health service reform.
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