What kind of science for psychiatry?

Abstract

Psychiatry has invested its hopes in neuroscience as a path to understanding mental disorders and developing more effective treatments and ultimately cures. Recently, the U.S. NIMH has elaborated this vision through a new framework for mental health research, the Research Domain Criteria (RDoC). This framework aims to orient mental health research toward the discovery of underlying neurobiological and biobehavioral mechanisms of mental disorders that will eventually lead to definitive treatments. In this article we consider the rationale of the RDoC and what it reveals about implicit models of mental disorders. As an overall framework for understanding mental disorders, RDoC is impoverished and conceptually flawed. These limitations are not accidental but stem from disciplinary commitments and interests that are at odds with the larger concerns of psychiatry. A multilevel, ecosocial approach to biobehavioral systems is needed both to guide relevant neuroscience research and insure the inclusion of social processes that may be fundamental contributors to psychopathology and recovery.

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

“…framework takes for granted that every human being will respond to a given environment with a similar biological response (Kirmayer & Crafa, 2014). However, many studies show that this is not the case and, as a function of cultural or personal factors, biological responses might greatly differ between individuals.…”

Deconstructing the mental health crisis: 5 uneasy pieces

“…16 This aside, an endophenotypic approach, including ambi tious undertakings, such as using the Research Domain Cri teria to assess mental illnesses, could have considerable prac tical and scientific ramifications 17 that could be further enhanced by considering psychosocial and cultural factors that contribute to the development of mental illness. 18 Such an approach might also point to individuals who would bene fit from other (or additional) modalities of treatment, including cognitive therapy, mindfulness and meditative approaches as well as yogabased practices, either alone or in combination with pharmacotherapy.…”

Global Mental Health and systems of diagnostic classification: clinical and cultural perspectives

“…Furthermore, the conceptual evolution of the field has seen the multiplication of terms, the accentuation of dichotomies and the inter-connection of areas of knowledge and research (2,3) that, ultimately, cannot avoid a political impact and the convergence of those avenues into the field of Public Health and its many branches. In turn, the international scenario of practice, enhanced by the multifaceted phenomenon we call Globalization(4-6) has contributed to the coinage of terms such as Global Health (GH), defined as the area of study, research and practice that places a priority on improving health services and achieving equity in health for all people worldwide (7).…”