The role of RDoC in future classification of mentaldisorders

Abstract

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.

Mood disorders disrupt the functional dynamics, not spatial organization of brain resting state networks

“…Here, we extracted iCAPs from resting state fMRI in a group of mixed mood disorder patients in order to determine chages in both the temporal dynamics and spatial organization of spontaneous brain activity, relative to age-matched HP. Our transdiagnostic, dimensional approach is in line with current research models in psychiatry advising to target symptoms common to different pathologies ( Cuthbert, 2020 , Insel et al, 2010 ), rather than historically defined diagnoses. Accordingly, it is increasingly more frequent to target circuits across different diagnostic categories and relate them to clinical symptoms, rather than rely on fixed, historically-defined nosologic conditions.…”

“…On the other hand, we believe that this variability fruitfully reflects clinical reality as well as the variety of functional processes underlying mood disorders. Moreover, dimensional approaches such as ours allow for going beyond somewhat arbitrary, historically-defined boundaries between diagnostic categories ( Cuthbert, 2020 , Insel et al, 2010 ).…”

κ-Opioid receptor antagonism reverses heroin withdrawal-induced hyperalgesia in male and female rats

“…κ-Opioid receptor antagonists have been proposed as a treatment for mood disorders ( Carrol and Carlezon, 2013 ; Krystal et al, 2020 ), drug addiction ( Chakvin and Koob, 2016 ; Helal et al, 2017 ), stress-related pain disorders, and neuropathic pain ( Nation et al, 2018 ; Navratilova et al, 2019 ) by promoting resilience to stress. The reason for the failure of these compounds in clinical trials to date is unknown and may require testing hypotheses that involve specific behavioral symptoms rather than global disorder constructs ( Kwako et al, 2017 ; Cuthbert, 2020 ). The present results suggest that KORs remain a viable target for medication development for elements of stress-related psychiatric disorders, such as depression, chronic pain, and addiction ( Chavkin and Koob, 2016 ).…”

Avolition as the core negative symptom in schizophrenia: relevance to pharmacological treatment development

“…RDoC, the initiative of the US National Institute of Mental Health (NIMH), is such an approach of defining critical dimensions or domains of functioning that are smaller than syndromes, not necessarily pathological on their own, and definable with greater levels of specificity. It proposes to divide current DSM syndromes into simpler, more basic, observable manifestations for which measurable physiological correlates can be devised 79 . The assumption is that observable behaviors and emotions and their respective neurobiological measurable correlates span multiple DSM disorders 80 and may be combined with each other in order to produce the larger syndromes 74 .…”