Lecture 39: RDoC

Question 1

Name the domains of RDoC

Answer 1

• Negative valence
• Positive valence
• Cognitive systems
• Systems for social processes
• Arousal / modulatory systems

Question 2

Give some examples of the units of analysis in RDoC

Answer 2

• Genes
• Molecules
• Cells
• Circuits
• Physiology
• Behaviour
• Self-reports
• Paradigms

Question 3

How would a RDoC depression profile look like?

Answer 3

➜ Genes – serotonin transporter
➜ Molecules – upregulation of glucocorticoids
➜ Brain circuits – amygdala reactivity
➜ Physiology – neuroinflammation 
➜ Behaviour – Increased sleep
➜ Self-report – hopelessness

Question 4

How does RDoC propose solving the failure in categorical systems to account for different phenomenological symptoms in people with the same diagnosis?

Answer 4

• stratify according to severity

- focus on psychobiological (e.g. dysfunction of neurocircuitry)

Question 5

Outline some limitations of RDoC

Answer 5

Limitations:

➜ limited clinical utility: no biomarker yet have adequate specificity or sensitivity for diagnosis/prognosis/treatment

➜ overemphasis on biological dysfuntion / too much biological focus: everything is in the brain, but rdoc does not allow for nuances

➜ falsifiability: how can you prove that doesn’t doesn’t fit in? what would constitute a negative finding?

o there are markers that are not hypothetised and how do we know that they are not included?

➜ focus on intra-individual variables: they don’t take into account cultural differences

➜ doesn’t make distinction between trait and state markers

➜ not feasible to train people in biomedical, two systems should communicate a bit more

Question 6

How could DSM5 improve and be a better tool for clinicians?

Answer 6

• Addressing the diagnostic criteria (thresholds, subtypes, etc)

Question 7

Outline some criticism for RDoC - dimensional model

Answer 7

• limited clinical utility: no biomarker specific/sensitive enough for diagnosis, prognoses, or treatment
• overemphasis on biological over psychosocial
• need for objectivity in dx
• hypotheses stated beforehand and in a biased way
• doesn’t take cultural differences into account
• doesn’t make distinction between trait and state markers