Ch2: Promises And Chalenges With The Domaine Criteria Framework

Question 1

Research Domain Criteria: Description and Reasons for Development

Answer 1

-Relatively little progress in the development of more effective treatments and prevention strategies for mental illness over the past several decades, despite rapid advances in neuroscience
-One likely obstacle has been problems with the validity of the current mental illness classification systems (DSM, ICD)

Question 2

History of Diagnostic Classification

Answer 2

The DSM-I was published in 1952 and contained approximately 100 disorders; given names and very short descriptions to assist in communication
•The DSM-II was published in 1968 and expanded the classification of disorders from two to ten divisions; widely criticized as the diagnoses were shown to be unreliable
•The DSM-III introduced checklists of mostly behavioral features, which improved diagnostic reliability, but potentially at the expense of validity
•The checklist of symptoms was polythetic in that many listed symptoms were not required or essential to the diagnosis
•This polythetic checklist approach was maintained in the remaining DSM versions

Question 3

Research Domain Criteria (RDoC)

Answer 3

National Institute of Mental Health (NIMH) introduced a new Strategic Plan in 2008 for the development of new ways to classify mental illnesses based on “observable behavioral and neurobiological measures”
•NIMH introduced the Research Domain Criteria (RDoC) framework in 2009 to guide future research in a manner that addresses the aims of this plan and does not rely on a presumably flawed diagnostic system
•RDoC was modeled after a separate NIMH-

Question 4

RDoC Approach

Answer 4

The RDoC approach uses a bottom-up model that begins with empirical findings from studies that are agnostic to existing theoretical diagnoses, with intentions to use that knowledge to create a future classification system
•RDoC also represents a new dimensional approach to psychopathology that encourages examination of the entire range from normal to abnormal functioning on the constructs

Question 5

RDoC Advocates

Answer 5

RDoC advocates
–(a) the development and validation of dimensional constructs that
–(b) integrate elements of psychology and biology that
–(c) are theoretically linked to narrowly defined impairments of psychiatric clinical importance
• RDoC does not attempt to represent an alternative diagnostic system

Question 6

RDoC matrix

Answer 6

-The RDoC template consists of a matrix of units of analysis in relation to particular dimensional domains, constructs, and sub-constructs
•The units of analysis span a micro to macro level, starting with Genes, Molecules, and Cells
•Expanding to Circuits (as measured by functional neuroimaging and event-related potentials) and Physiology (biological indices that do not directly map on to circuits)
-Units of analyses are intended to be independent, with no unit viewed as more important or causally linked to another unit
•There is a separate column for Paradigms, which are well-validated means of measuring the respective construct, which may include more than one unit of analysis
•Units of analysis and paradigms are presented in the vertical columns of the grid, while the constructs comprise the rows
•The matrix is not a fixed framework
-RDoC explicitly seeks to better understand developmental trajectories across all phases of the lifespan
•In particular it seeks to better understand the trajectories that mark the transition from normal to abnormal behavior, with a goal of identifying pre-symptomatic dysfunction that could be targeted by prevention strategies
•The NIMH also recognizes that it is widely accepted that most mental illnesses result from the interaction of neuropathology with

Question 7

RDoC Domains

Answer 7

Currently there are five domains:
•Negative Valence Systems (e.g., Acute Threat, Loss)
•Positive Valence Systems (e.g., Approach Motivation, Reward Learning)
•Cognitive Systems (e.g., Attention, Working Memory)
•Social Processes (e.g., Affiliation and Attachment, Social Communication)
•Arousal and Regulatory Systems (e.g., Arousal)

Question 8

Two additional important aspects of the RDoC framework are not explicitly included in the matrix itself, as they represent additional dimensions that could not be represented on the two-dimensional matrix?

Answer 8

–neurodevelopmental trajectories
–interactions with the environment

Question 9

RDoC critiques

Answer 9

• As the RDoC framework is a radical departure from the long tradition of diagnoses based on the medical model (e.g., DSM), there have been many criticisms and concerns
  • A central concern raised by different investigators is that RDoC is reductionistic and places more emphasis on biology while underemphasizing the role of the environment
  -Lack of emphasis on self-report which captures the embodied experience
  •Problems with disparate and largely unknown levels of measurement error present in particular instruments/paradigms identified in the matrix
  •RDoC does not explicitly address how individuals vary in their characteristic developmental adaptations (i.e., behavioral expressions) of underlying basic tendencies/traits

Question 10

Five strategies for patient sampling (RDoC Methologies)

Answer 10

– 1) recruitment of a nonpsychiatric community sample to identify, using exploratory analyses, one or more psychiatric symptom severity scales that relate to a RDoC construct

–2) recruitment of participants to include two or more specified DSM disorders and explore symptoms that relate to a RDoC construct across the combined sample