Connecting psychopathology meta-structure and mechanisms.

Abstract

A persistent challenge for the field of psychopathology has been how to best explain mental disorders and organize clinical symptoms into diagnoses. Meta-structural approaches have clarified fundamental problems and made substantial gains by using covariance structures to organize the nature of clinical symptom patterns. A remaining task is how to specify the connections between these patterns across behavioral, cognitive, and neural mechanisms. Together, meta-structural approaches and the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) offer a means to parse out these connections. I comment on the included articles in this special section on psychopathology meta-structure and argue that core dimensions of psychopathology identified with meta-structural approaches can advance the RDoC initiative and that the RDoC framework, in turn, can strengthen structural approaches by providing an organizational scaffold to elucidate the relations of behavioral, cognitive, and neural mechanisms and to relate them to dimensions of human suffering and dysfunction. General Scientific SummaryThe Research Domain Criteria (RDoC) project was initiated by the National Institute of Mental Health to facilitate research on mental disorders by providing a new ways to understand connections of problems in the brain and body with clinical symptoms and distress. The aim is to improve the diagnosis of mental disorders, and facilitate the development of better treatments. In this commentary, ways that RDoC and statistical approaches to complement each other to better understand mental disorders complement are described.Keywords: RDoC, diagnosis, mechanisms, meta-structure, NIMH It is a pleasure to have the opportunity to comment on the articles included in this special section in Abnormal Psychology on the meta-structure of psychopathology. This is an important and timely topic. Structural approaches to psychopathology have been pivotal for moving clinical research forward, for helping to address the pervasive problem of comorbidity, and for moving the field toward dimensional conceptualizations of psychopathology. RDoC is of particular significance to this special section because findings from meta-structure studies of psychopathology were a cornerstone rationale for its development. In what follows, the theoretical perspective of the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) is offered in the context of commentary on the special section articles.Both RDoC and structural approaches are motivated by problems with descriptively derived diagnoses (e.g., diagnostic overlap, comorbidity, narrow constraints, arbitrary cut points, heterogeneity), but RDoC expressly grapples with the problem that mechanisms from integrative neuroscience (e.g., cognitive control, emotion regulation, reward processing) did not map neatly onto clinical syndromes. Metastructural research has clarified broad (e.g., internalizing) and specific (e.g., fear) dimensions of psychological and behavioral problems usef...

Characterising the latent structure and organisation of self-reported thoughts, feelings and behaviours in adolescents and young adults

“…Our objective was to create a data driven behavioural phenotype that could be more closely associated with the underlying intermediate neurocognitive systems than single measurement constructs. This approach resonates with the RDoC initiative to more closely align neuroscience, cognition and behavioural phenotypes [31]. Several lines of evidence support the prediction of a bifactor structure.…”

“…This is driven in part by the low validity inherent in the descriptive diagnostic system and the need to develop a greater understanding of the aetiologies and pathophysiologies of mental illnesses [30]. Redefining how we conceptualise the ‘surface’ characteristics of mental health in the population at large using both mental illness and mental wellness items may create a more accurate behavioural phenotype of mental states in the natural world [31]. This may in turn translate to greater precision in pinpointing the relevant genetic, neural and cognitive factors that could underlie mentally well together with ill states.…”

Social anxiety disorder: looking back and moving forward

“…Given the contrasting findings, it is difficult to draw conclusions as to whether SAD is best represented dimensionally or categorically, or indeed a combination of both. In spite of the lack of consistency across studies, it has been suggested that the dimensional approach may afford greater utility over categorical models for refining understanding of the mechanisms of disorders such as SAD (Sanislow, 2016).…”

The role of RDoC in future classification of mentaldisorders

“…Initiated by NIMH in 2009, RDoC constitutes a framework for translational research that shifts the focus away from traditional DSM/ICD disorder categories and toward research on functional dimensions of behavior or cognitive/affective processes (eg, reward learning or working memory) as studied across the entire range of functioning from normal to abnormal. 1 - 3 The paradigm emphasizes the inclusion in study designs of multiple measures (eg, behavioral/cognitive, phenomenological, physiological) for examining such psychological constructs, thus promoting an integrative rather than reductionistic approach. 4 High priority is placed upon the examination of neurodevelopmental processes and environmental influences (and their interaction) in research designs.…”