Organization:Research Domain Criteria

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Short description: Diagnostic framework in personalized psychiatry
RDoC
Research Domain Criteria
RDoC: Research Domain Criteria Initiative
Project typeResearch framework
SponsorsNational Institute of Mental Health
Project coordinatorBruce Cuthbert[1]
DurationJanuary 28, 2010 (2010-01-28)[2]
WebsiteNIMH.NIH.gov/Research-priorities/rdoc

The Research Domain Criteria (RDoC) project is an initiative of personalized medicine in psychiatry developed by US National Institute of Mental Health (NIMH). In contrast to the Diagnostic and Statistical Manual of Mental Disorders (DSM) maintained by the American Psychiatric Association (APA), RDoC aims to address the heterogeneity in the current nosology by providing a biologically-based, rather than symptom-based, framework for understanding mental disorders.[3] "RDoC is an attempt to create a new kind of taxonomy for mental disorders by bringing the power of modern research approaches in genetics, neuroscience, and behavioral science to the problem of mental illness."[4]

Call for creation

The National Institute of Mental Health oversees the RDoC initiative.

The 2008 NIMH Strategic Plan calls for NIMH to "Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures."[5] The strategic plan continues:

Currently, the diagnosis of mental disorders is based on clinical observation—identifying symptoms that tend to cluster together, determining when the symptoms appear, and determining whether the symptoms resolve, recur, or become chronic. However, the way that mental disorders are defined in the present diagnostic system does not incorporate current information from integrative neuroscience research, and thus is not optimal for making scientific gains through neuroscience approaches. It is difficult to deconstruct clusters of complex behaviors and attempt to link these to underlying neurobiological systems. Many mental disorders may be considered as falling along multiple dimensions (e.g., cognition, mood, social interactions), with traits that exist on a continuum ranging from normal to extreme. Co-occurrence of multiple mental disorders might reflect different patterns of symptoms that result from shared risk factors and perhaps the same underlying disease processes.

To clarify the underlying causes of mental disorders, it will be necessary to define, measure, and link basic biological and behavioral components of normal and abnormal functioning. This effort will require integration of genetic, neuroscience, imaging, behavioral, and clinical studies. By linking basic biological and behavioral components, it will become possible to construct valid, reliable phenotypes (measurable traits or characteristics) for mental disorders. This will help us elucidate the causes of the disorder, while clarifying the boundaries and overlap between mental disorders. In order to understand mental disorders in terms of dimensions and/or components of neurobiology and behaviors, it will be important to:

  • Initiate a process for bringing together experts in clinical and basic sciences to jointly identify the fundamental behavioral components that may span multiple disorders (e.g., executive functioning, affect regulation, person perception) and that are more amenable to neuroscience approaches.
  • Develop reliable and valid measures of these fundamental components of mental disorders for use in basic studies and in more clinical settings.
  • Determine the full range of variation, from normal to abnormal, among the fundamental components to improve understanding of what is typical versus pathological.
  • Integrate the fundamental genetic, neurobiological, behavioral, environmental, and experiential components that comprise these mental disorders.[5]

Contrast with DSM

On April 29, 2013, a few weeks before the publication of the DSM-5, NIMH director Thomas Insel published a blog post critical of the DSM methodology and highlighting the improvement offered by the RDoC project.[6]

Wrote Insel:

While DSM has been described as a 'Bible' for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.[6]

In that post, Insel wrote: "Patients with mental disorders deserve better."[6] He would later elaborate on this point, saying "I look at the data and I'm concerned. ... I don't see a reduction in the rate of suicide or prevalence of mental illness or any measure of morbidity. I see it in other areas of medicine and I don't see it for mental illness. That was the basis for my comment that people with mental illness deserve better."[7]

In their effort to resolve their issues with the new DSM, the NIMH launched the Research Domain Criteria Project (RDoC), based on four assumptions:

  • A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,
  • Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,
  • Each level of analysis needs to be understood across a dimension of function,
  • Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.[6]

Insel stressed that the RDoC is not designed as diagnostic criteria to replace the DSM, but rather as a research framework, for future development. His argument centers around the claim that, "symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment."[6] As a result of this position, the NIMH is no longer using the DSM as the criteria upon which they will evaluate funding of future clinic trials.[6]

DSM researcher Eric Hollander was quoted as saying "I do think it does represent a lack of interest and faith on behalf of NIMH for the DSM process and an investment in alternative diagnostic systems."[7]

A NIMH description of RDoC explained:

Currently, diagnosis in mental disorders is based on clinical observation and patients' phenomenological symptom reports ... However, in antedating contemporary neuroscience research, the current diagnostic system is not informed by recent breakthroughs in genetics; and molecular, cellular and systems neuroscience.[8]

RDoC matrix

The RDoC matrix is one way of organizing the concepts involved, with domains as tables, constructs as rows, sub-constructs as subrows and units of analysis often presented as columns.

Negative Valence Systems, as of January 2022[9]
Construct Genes Molecules Cells Circuits Physiology Behavior Self-reports Paradigms
Acute Threat (Fear) n/a
  • Fear survey schedule
  • SUDS
Potential Threat (Anxiety) n/a
  • BNST
n/a
  • Anxiety Sensitivity Index
  • BIS
  • Fear of Negative Evaluation Scale
  • Intolerance of Uncertainty Scale
  • LEDS
  • NPU Threat Task
Sustained Threat n/a
  • ACTH
  • CRF
  • HPA axis hormones
  • Dysregulated HPA axis
  • Error-related negativity
  • Childhood Trauma Questionnaire
  • LEDS
  • Risky Families
  • STRAIN
  • TESI
  • Youth Life Stress Interview
n/a
Loss n/a n/a
  • Sadness eliciting film clips
Frustrative Nonreward n/a n/a
n/a
  • Frustrative Nonreward Responsiveness Subscale
  • Questionnaire of Daily Frustrations
  • Lab-TAB
  • PSAP
Positive Valence Systems, as of January 2022[9]
Construct / Subconstruct Genes Molecules Cells Circuits Physiology Behavior Self-reports Paradigms
Reward Responsiveness Reward Anticipation n/a n/a n/a n/a n/a n/a n/a
  • Monetary incentive delay
Initial Response to Reward n/a
  • CREB
  • Endocannabinoids
  • FosB
  • Glutamate
  • Mu and delta opioid
  • Orexin
n/a
  • Anterior Ins
  • Dorsal ACC
  • LH
  • Medial OFC
  • Nucleus accumbens
  • Ventral pallidum
  • Ventromedial PFC
  • VTA
n/a
  • Taste reactivity
  • Consummatory subscale of TEPS
  • PANAS (state version)
  • Simple guessing task
Reward Satiation n/a n/a n/a n/a n/a n/a n/a
  • Fixed-ratio satiation schedule
Reward Learning Probabilistic and Reinforcement Learning n/a n/a n/a n/a n/a n/a n/a
Reward Prediction Error n/a n/a
  • Cortical slow waves
  • Heart rate change
  • Skin conductance
  • Goal tracking
  • Pavlovian approach
  • Reward-related speeding
  • Sign tracking
  • Affective forecasting
  • ASAM scale
  • Eating Expectancy Inventory
  • Generalized reward and punishment expectancy scale
  • Self-report of craving
  • TEPS anticipatory scale
  • Drifting Double Bandit
  • Rutledge Passive Lottery Task
Habit - PVS n/a
  • Dopaminergic neurons
  • medium spiny neurons
  • Substantia Nigra
  • dorsal striatum
  • Medial Prefrontal Cortex
  • SN/VTA
  • Ventral striatum
n/a
  • Compulsive behaviors
  • Repetitive behaviors
  • Stereotypic behaviors
  • Aberrant behaviors checklist
  • Measures of repetitive behaviors
  • Devaluation task
  • Habit Learning TaskHabit Task
Reward Valuation Reward (probability) n/a n/a n/a n/a n/a n/a n/a
  • Probability Choice Task
  • Willingness to Pay Task
Delay n/a n/a n/a n/a n/a n/a n/a
  • Delay discounting
Effort n/a n/a
  • Basolateral amygdala
  • dorsal ACC
  • Ventral pallidum
  • Ventral striatum (nACC)
  • VTA
n/a n/a
  • Drive subscale of the Behavioral Activation Scale
  • EEfRT task
Cognitive Systems, as of January 2022[9]
Construct / Subconstruct Genes Molecules Cells Circuits Physiology Behavior Self-reports Paradigms
Attention n/a
  • Implementation
    • GABA
    • Glutamate
  • Control
  • Balance between TPN vs DMN
  • Implementation
    • local circuit interactions
    • pulvinar
    • TRN
  • Control
    • Amg
    • Ascending / descending information pathways
  • Attentional systems
  • fMRI
    • Sensory areas from peripheral to central
  • Auditory ERP
    • N1
    • N2
    • Neural oscillations
    • P1
    • P300
    • Processing negativity
  • Visual ERP
    • N2pc
    • Negativity (SN)
    • Neural oscillations
    • P300
    • Selection modulations of sensory ERP components
    • Slow waves
  • Peripheral physiology
    • Heart rate deceleration
    • Pupil dilation
  • ANT task distractibility
  • Attentional lapses vs sustained attention
  • Distractibility
  • Object/feature attention
  • Psychophysics
  • Spatial attention
Perception Visual n/a
  • Subcortical
  • Cortical
  • Non-retinogeniculate
  • Local circuitry
    • Lateral interactions
    • Top-down interactions
  • Implicated in contextual and association fields (responsible for the influence of spatial context on target processing)
  • Perceptual anomalies of schizophrenia and depression
  • Scheme 1: Stages of Vision
    • Early Vision
      • Local computations
      • Retinotopic representations
    • Intermediate Vision
      • Nonlocal properties of images
      • Transformations beyond retinotopic representations
    • Late Vision
      • Representations of external objects
  • Scheme 2: Commonly Used Research Paradigms
    • Backward masking
    • Biological motion processing
    • Bistability
    • Coherent motion
    • Contour integration/interpolation
    • Contrast sensitivity
    • Cross modality paradigms
    • Emotion expression identification
    • Face identification
    • Figure ground
    • Lateral facilitation
    • Multistability
    • Object perception
    • Object recognition/perceptual closure/perceptual organization
    • Parallel/serial search
    • Reading
    • Vernier discrimination
    • Visual illusion susceptibility
  • Other Schemes
    • Action-Perception loops
    • Re-entrant processing
Auditory n/a
  • Cochlear hair cells
  • Cortical and limbic inhibitory interneurons
  • Ribbon synapses
  • Nodes in Circuit
    • A1
    • Anterior insula
    • Brainstem
    • Cochlea
    • Inferior colliculus
    • MGN
    • STG
  • Circuits
    • Corticofugal
    • Dorsal/ventral streams
  • Adaptation/ habituation
  • Auditory steady-state response (ASSR)
  • fMRI
  • Intracortical EEG
  • Metabolic changes
  • Mismatch negativity (MMN)
  • N1
  • Neural oscillations
  • P3a
  • P50
  • startle and PPI
  • Perceptual identification
  • Perceptual learning
  • Perceptual priming
  • Spatial localization
  • Stimulus detection
  • Action-Perception loops
  • Auditory masking
  • auditory scene perception (e.g., streaming)
  • Bistability
  • Categorization
  • Cross-modal interactions
  • Detection of speech in noise
  • Deviance detection
  • Gating
  • inhibitory control
  • Manipulation of ISI and/or intensity
  • McGurk (multisensory)
  • novelty/oddball detection
  • Object perception
  • Regularity and change detection
  • same-different tasks
  • self-monitoring
  • tone detection (e.g., JND tasks)
  • Tone matching
Olfactory / Somatosensory / Multimodal n/a n/a n/a n/a n/a n/a n/a
  • Manipulation of ISI and/or intensity
  • Smell identification
Declarative Memory n/a
  • Cholinergic
  • Glutamatergic
  • Noradrenergic
  • Opioid
  • Glia
  • Granule cells
  • Inhibitory and excitatory interneurons
  • Pyramidal cells
  • Extrinsic hippocampal circuitry
  • Intrinsic hippocampal circuitry
  • PFC and PPC interactions with multiple association cortices
  • AMPA-related synaptic plasticity
  • conjunction codes
  • frontal/temporal coordinated oscillations
  • LTP/LTD
  • NMDA-related synaptic plasticity
  • place cell activity
  • subsequent memory effect (fMRI, ERP)
  • up/down states
  • Discrimination
  • Familiarity
  • Learning
  • Recall
  • Recognition
  • Cognitive Assessment Interview
  • acquired equivalence
  • delayed recall
  • list and story learning
  • Paired associate learning
  • transitive inference
Language n/a n/a n/a
  • Inferior frontal cortex
  • Inferior Parietal Cortex
  • Inferior temporal cortex
  • Lateral superior and middle temporal cortices
  • Overlap with memory, motor, sensory, and emotional circuits
  • anterior negativities
  • N400
  • P600/late positivities
  • Coherent discourse
  • Coherent sentences
  • Production and comprehension of words
  • Cognitive Assessment Interview
  • Language Production
    • Linguistic corpus-based analyses of language output
    • Naming
  • Language Comprehension
    • Ability to answer questions about the content of sentences and discourse
    • Ability to distinguish between coherent and incoherent sentences and discourse
    • Detection and classification of semantic relationships between words
    • Listening and reading times to critical words and regions in linguistic input
    • Patterns of eye movements (in eye tracking paradigms) or motor movements (in mouse tracking paradigms) to critical words and regions in linguistic input
    • Patterns of eye movements to non-verbal visual stimuli during spoken language comprehension (the visual world paradigm)
  • Experimental Manipulations
    • Manipulations of different types of coherence and cohesion between clauses in discourse
    • Manipulations of different types of relationships between individual words in priming paradigms
    • Manipulations of predictability and acceptability, at different levels of representation, in a linguistic input
    • Manipulations of relationships between language and non-verbal behaviors
Cognitive Control 1 of 2: Goal Selection; Updating, Representation, and Maintenance n/a n/a n/a
  • Frontopolar/Anterior LPFC (BA10)
  • Inhibition of DMN
n/a n/a
  • BRIEF (Gioa)
  • Badre tasks
  • Koechlin paradigm
  • Task switching
2 of 2: Goal Selection; Updating, Representation, and Maintenance n/a
  • ACH
  • Dopamine
  • GABA
  • Glutamate
  • Norepinephrine
  • PV
  • Pyramidal cells
  • Dorsolateral Prefrontal Cortex
  • Posterior Parietal Cortex
  • Thalamocortical
  • Gamma synchrony
  • Pupilometry
  • Distractibility
  • Off-task behaviors
  • BRIEF (Gioa)
  • Cognitive Failures Questionnaire
  • SANS/SAPS/PANSS
  • AX paradigms
  • Cued stimulus-response reversal tasks
  • Task switching
  • Tower tasks
1 of 2: Response Selection; Inhibition / Suppression n/a
  • PV
  • Pyramidal cells
  • Gamma
  • Theta
  • Impulsive behaviors
  • BRIEF (Gioa)
  • SANS/SAPS/PANSS
  • Flanker
  • Simon
  • Stroop
2 of 2: Response Selection; Inhibition / Suppression n/a
  • Pyramidal cells
  • BA6/8 (FEF)
  • Posterior Parietal Cortex
  • Pre-Supplementary Motor Area
  • Ventrofronto-striatal
  • Alpha
  • Pupilometry
  • Short interval cortical inhibition (TMS)
  • Distractibility
  • Impulsive behaviors
  • Off-task behaviors
  • ADHD Rating Scale (Dupaul)
  • ATQ/CBQ Effortful Control
  • BRIEF (Gioa)
  • Conners impulsivity scale
  • Antisaccade
  • Conflicting and contralateral motor response task
  • Countermanding
  • Go/Nogo
  • Motor persistence paradigms (e.g. NEPSY statue task)
  • Stimulus-Resp Incompat
  • Stop-Signal Reaction Time
Performance Monitoring n/a n/a
  • ACC / pre-SMA Insula
  • ERN
  • N2
  • N450
  • Post-error or post-conflict adjustments in performance
  • YBOCS total score
  • Flanker
  • Simon
  • Stroop
Working Memory Active Maintenance n/a
  • D1
  • Dopamine
  • GABA
  • Glutamate
  • NMDA
  • Distinct types of inhibitory neurons
  • Pyramidal cells
  • Inferior Parietal Cortex
  • PFC-parietal-cingulate-dorsal thalamus-dorsal striatum
  • VLPFC
  • Delta
  • Gamma waves
  • Theta waves
n/a n/a
  • AX-CPT/DPX
  • Change detection tasks
  • Complex Span tasks
  • delayed match to non sample
  • delayed match to sample
  • keep track task
  • Letter memory/running memory
  • Letter Number Sequencing
  • N-back
  • Self-Ordered Pointing
  • sequence encoding and reproduction
  • Simple Span Tasks
  • Sternberg Item Recognition
Flexible Updating n/a
  • D2
  • Dopamine
  • GABA
  • Glutamate
  • Medium Spiny Neurons (basal ganglia)
  • dorsal striatum
  • Dorsolateral Prefrontal Cortex
  • MD
  • PFC-parietal-cingulate-dorsal thalamus-dorsal striatum
  • VA thalamus
  • Delta
  • Gamma waves
  • Theta waves
n/a n/a
  • AX-CPT/DPX
  • Complex Span tasks
  • keep track task
  • Letter memory/running memory
  • Letter Number Sequencing
  • N-back
  • Self-Ordered Pointing
  • Sternberg Item Recognition
Limited Capacity n/a
  • D1
  • D2
  • Dopamine
  • GABA
  • Glutamate
n/a
  • Dorsal Parietal
  • Dorsolateral Prefrontal Cortex
  • Inferior Parietal Cortex
  • MDPFC-parietal-cingulate-dorsal thalamus-dorsal striatum
  • VA thalamus
  • VLPFC
  • Delta
  • Gamma waves
  • Theta waves
n/a n/a
  • AX-CPT/DPX
  • Change detection tasks
  • Complex Span tasks
  • delayed match to non sample
  • delayed match to sample
  • keep track task
  • Letter memory/running memory
  • Letter Number Sequencing
  • N-back
  • Self-Ordered Pointing
  • sequence encoding and reproduction
  • Simple Span Tasks
  • Sternberg Item Recognition
Interference Control n/a
  • Calbindin
  • Calretinin
  • Distinct types of inhibitory neurons
  • Parvalbumin
  • DLPFC
  • PFC-parietal-cingulate-dorsal Th-dorsal striatum
n/a n/a
  • Complex Span tasks
  • Delayed match to non-sample
  • Delayed match to sample
  • Keep track task
  • Letter memory/running memory
  • Letter number sequencing
  • n-back
  • Self-Ordered Pointing
  • Simple Span Tasks
  • Sternberg Item Recognition
Social Processes, as of January 2022[9]
Construct / Subconstruct Genes Molecules Cells Circuits Physiology Behavior Self-reports Paradigms
Affiliation and Attachment n/a
  • Magnocellular OT
  • Amygdala
  • BNST
  • FF gyrus
  • NAcc
  • OFC
  • PVN
  • VMPFC
  • VTA- NAcc- VP-amygdala
  • activation of sympathetic activity
  • HPA axis activation
  • HPA down-regulation
  • Immune markers
  • immune responses (“sickness”)
  • Sex steroid changes
  • Vagal tone
  • vagal withdrawal
  • Attachment Formation
    • Maintaining proximity
    • Preference for individual
  • Attachment Maintenance
    • Distress upon separation
  • Adult Attachment Interview
  • Attachment Questionnaire for Children Scale
  • Attachment Style interview
  • Bartholomew and Shaver
  • Bereavement scales
  • Experience in Close Relationships Scale
  • Inventory of Parent and Peer Attachment Scale
  • Multidimensional Scale of Perceived Social Support
  • Parental Bonding Instrument
  • QSORT Parent Attachment interview
  • Social Anhedonia scale
  • Social subscales of depression
  • Cyberball
  • One-armed Bandit Task
Social Communication Reception of Facial Communication n/a
  • Dopamine
  • FMRP
  • GABA
  • Oxytocin
  • Serotonin
  • Testosterone
  • Vasopressin
  • Face selective neurons
  • Mirror neurons
  • amygdala-brainstem
  • IFG-INS-amygdala/VS
  • OFC-ACC-amygdala-striatum
  • Resting state networks
  • V1-FFA-STS-amygdala
  • V1-FFA-STS-VS
  • ECoG frontal brain asymmetry
  • Facial EMG
  • HR/BP/respiration
  • Local cerebral blood flow changes
  • N170
  • N250
  • Network dynamics
  • Pupil dilation
  • SCR
  • Startle reflex
  • Behavioral observation/coding systems
  • Eye gaze detection
  • Identification of emotion
  • Implicit mimicry
  • Scanning patterns
  • Arousal ratings
  • Face dimensional rating scales
  • Gaze Cuing
  • Penn Emotion Recognition (ER-40)
Production of Facial Communication n/a
  • AP
  • Contactin
n/a
  • Eye Movements
    • PPC-SC-SNc-SEF-FEF-CB
  • Facial Expression
    • Regions including PAG, AC
  • Facial EMG
  • HR variability
  • NIRS
  • Photoplethysmography (skin color measure of capillary dilation; temperature)
  • Pupil dilation
  • SC
  • Tear production
  • Behavioral observation/coding system
  • sEye gaze aversion/contact
  • Facial affect production
  • Head turning
  • Imitation of facial gestures
  • Joint attention
  • Reciprocal emotional expression
  • Reciprocal eye contact
  • Berkeley Expressivity Questionnaire
n/a
Reception of Non-Facial Communication n/a n/a
  • A1-RSTG
  • MPFC
  • Superior Temporal Sulcus
  • VLPFC
  • EEG features e.g., evoked gamma
  • Local cerebral blood flow changes
  • Network dynamics
  • Comprehension of emotional prosody
  • Comprehension of non-verbal gestures
  • Humor comprehension
  • Irony/sarcasm comprehension
  • Metaphor comprehension
  • Social Responsiveness Scale
  • Multimodal Social Paradigms
Production of Non-Facial Communication n/a n/a n/a
  • R-IFG-RSTG
  • Songbird circuits
n/a
  • Crying/laughing
  • Gestural/postural expressions
  • Interactive play
  • Response to distress/separation distress
  • Speech (affective) prosody
  • Vocalizations
  • Social Responsiveness Scale
  • Multimodal Social Paradigms
Perception and Understanding of Self Agency n/a n/a n/a
  • Right insula-right inferior frontal
  • Right parietal
  • SMA-somatosensory-premotor
  • Scalp Motor Potentials
  • Delusions of control
  • Evidence that one understands ownership of one’s own body parts or action (thoughts/behaviors)
  • Hallucinations
  • Stereotypic behaviors
  • Perceptual Aberration Scale
n/a
Self-Knowledge n/a n/a
  • Von Economo neurons
  • left inferior frontal cortex
  • MPFC
  • posterior cingulate/precuneus
  • ventral anterior cingulate (valence specific)
  • P300s to self-relevant stimuli
  • Developmentally appropriate perception of one’s competences, skills, abilities beliefs, intentions, desires, and/or emotional states
  • Levels of Emotional Awareness
  • Private Self-Consciousness
  • Self Components of Attributional Styles Questionnaire
  • Self-monitoring scale
  • Toronto Alexithymia scale
  • Self-Referential Memory Paradigm
Perception and Understanding of Others Animacy Perception n/a n/a n/a
  • extrastriate body area
  • fusiform face area
  • occipital face area
  • Superior Temporal Sulcus
  • MU Suppression
  • Ability to appropriately attribute animacy to other agents
n/a
  • Point Light Displays of Biological Motion
Action Perception n/a n/a
  • Inferior Parietal Cortex
  • Superior Temporal Sulcus
  • ventral/dorsal premotor
  • cortico-spinal facilitation (TMS)
  • MU Suppression
  • Ability to identify what actions an agent is executing
  • Gaze following
  • Imitation
  • Mimicry
  • Balanced Emotional Empathy Scale
  • Empathy Quotient
  • Perspective Taking and Empathic Concern subscales of the Interpersonal Reactivity Index
  • How/Why Task
Understanding Mental States n/a
  • Oxytocin
  • Vasopressin
n/a
  • MPFC
  • precuneus
  • Superior Temporal Sulcus
  • temporal pole
  • TPJ
n/a
  • Developmentally appropriate interpretations of other intentions, goals and beliefs
  • Balanced Emotional Empathy Scale
  • Empathy Quotient
  • Other components of Attributional Styles Questionnaires
  • Perspective Taking and Empathic Concern subscales of the Interpersonal Reactivity Index
  • Hinting Task
  • Reading the Mind in the Eyes
Arousal and Regulatory Systems, as of January 2022[9]
Construct Genes Molecules Cells Circuits Physiology Behavior Self-reports Paradigms
Arousal n/a
  • Basal nuclei to cortical circuits
  • Cholinergic & monoaminergic nuclei / projections
  • Circadian & sleep-related circuits modulate and are modulated by arousal
  • Cortical circuits
  • Hy to thalamic and cortical circuits
  • Reciprocal Hy
  • Reciprocal NTS-aCeN
  • ADACL
  • POMS arousal subscale
  • Self-assessment mannequin
Circadian Rhythms n/a
  • Input
    • Raphe to SCN projection
    • retinal cell
    • RHT
    • retinogeniculate tract
  • Output
    • BL / Hi
    • central extended Amg (aCeN/BNST)
    • HPA axis
    • neuroendocrine cell groups
    • Hy OX projections
    • PVN, DMH, subparaventricular zone, PVT
    • SCN / PVN / SCG / pineal
    • SNS / PNS
  • Intrinsic to SCN
  • Seasonal
  • Drive-regulated behavior
  • Locomotor activity
  • Masking
  • Neurobehavioral function
  • Sleep-rated and waking behavior
  • Sleep-wake
  • Diary-based measures of daily regularity/rhythmicity (e.g., Social Rhythm Metric)
  • Morningness–eveningness questionnaire
  • Munich Chronotype Questionnaire
  • Phase, diurnal preference, chronotype (e.g., Horne-Ostberg, CTQ)
  • Sleepiness, alertness, well-being, mood
Sleep-Wakefulness n/a
  • Brain metabolic activity
  • Capacity for wakefulness under low stimulation
  • EEG
  • EMG
  • EOG
  • NREM sleep and REM sleep
  • Physiologic measures of sleepiness, homeostatic sleep drive during waking
  • Sex-specific sleep physiology
  • Sleep hormones
  • Sleep latency
  • Temporal and topographic organization of...
    • homeostatic sleep drive during sleep
    • sleep dynamics
  • Wakefulness
  • Intermediate/admixed sleep-wake states
  • Rest-activity patterns
  • Sensory arousal threshold
  • Sleep
  • Sleep-dependent neurobehavioral functions
  • Wakefulness
  • Alertness
  • Dream report
  • Fatigue
  • Insomnia severity index
  • Sleep quality, restoration, quantity
  • Sleep timing
  • Sleep-modulated symptoms
  • Sleepiness
  • Specific sleep symptoms
  • Finger tapping motor sequence task
  • Latency to persistent sleep
  • Multiple sleep latency testing
  • Non-REM sleep EEG slow wave activity
  • Sleep spindle
  • Total sleep time
  • Wake time after sleep onset
Sensorimotor Systems, as of January 2022[9]
Construct / Subconstruct Genes Molecules Cells Circuits Physiology Behavior Self-reports Paradigms
Motor Action Action Planning and Selection n/a n/a n/a n/a
n/a
  • Go-before-you-know
Sensorimotor Dynamics n/a n/a
  • Short afferent inhibition
n/a
  • Sensory Motor Adaptation Tasks
Initiation n/a n/a n/a
n/a
  • Apathy
  • Catatonic stupor
  • Negative symptoms
  • Psychomotor retardation
  • Stuttering
  • Lille Apathy Rating Scale
  • Libet's Temporal Judgement
Execution n/a n/a
  • Efferent and afferent spinal and peripheral pathways
  • Motor cortex
n/a
  • Motor evoked potential latency
Inhibition and Termination n/a
  • Intracortical inhibitory interneurons
  • Striatal interneurons
n/a
  • Stop-signal reaction time
Agency and Ownership n/a n/a
n/a n/a
Habit - Sensorimotor n/a
n/a
  • PtA
  • Sensorimotor-BG
n/a
  • 2-step task
Innate Motor Patterns n/a n/a n/a
n/a n/a

The domains are tentative: "It is important to emphasize that these particular domains and constructs are simply starting points that are not definitive or set in concrete."[8] Also, subconstructs have been added to some constructs. For example, Visual Perception, Auditory Perception, and Olfactory/Somatosensory/Multimodal perception as subconstructs of the Perception construct.[9]

Methodology

The RDoC methodology distinguishes itself from traditional systems of diagnostic criteria.

Unlike conventional diagnostic systems (e.g. DSM) which use categorization, RDoC is a "dimensional system" — it relies on dimensions that "span the range from normal to abnormal."[8]

Whereas conventional diagnostic systems incrementally revise and build upon their pre-existing paradigms, "RDoC is agnostic about current disorder categories."[8] Official documents explain this feature, writing: "Rather than starting with an illness definition and seeking its neurobiological underpinnings, RDoC begins with current understandings of behavior-brain relationships and links them to clinical phenomena."[8]

Unlike conventional diagnostic systems, which typically rely on self-report and behavioral measures alone, the RDoC framework has the "explicit goal" of allowing investigators access to a wider range of data. In addition to self-report measures or measure of behavior, RDoC also incorporates units of analysis beyond those found in the DSM — allowing RDoC to be informed by insights into genes, molecules, cells, circuits, physiology, and large-scale paradigms.[8] Early data driven approaches to RDoC based continuous transdiagnostic psychiatric phenotypes predict clinical prognosis across diagnosis and have genetic correlates that in not only clinical populations.[10][11]

References

  1. "RDoC Unit and Work Group Members". https://www.nimh.nih.gov/research-priorities/rdoc/rdoc-unit-and-work-group-members.shtml. 
  2. Asher, Jules (28 January 2010). "Genes and Circuitry, Not Just Clinical Observation, to Guide Classification for Research". https://www.nimh.nih.gov/news/science-news/2010/genes-and-circuitry-not-just-clinical-observation-to-guide-classification-for-research.shtml. 
  3. Cuthbert, Bruce N; Insel, Thomas R (Dec 2013). "Toward the future of psychiatric diagnosis: the seven pillars of RDoC" (in en). BMC Medicine 11 (1): 126. doi:10.1186/1741-7015-11-126. ISSN 1741-7015. PMID 23672542. 
  4. Insel, Thomas R.; Lieberman, Jeffrey A. (13 May 2013). "DSM-5 and RDoC: Shared Interests" (Press release). National Institute of Mental Health.
  5. 5.0 5.1 "The National Institute of Mental Health Strategic Plan". 6 November 2008. Strategy 1.4. http://www.nimh.nih.gov/about/strategic-planning-reports/index.shtml. 
  6. 6.0 6.1 6.2 6.3 6.4 6.5 Insel, Thomas (29 April 2013). "Director's Blog: Transforming Diagnosis". http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml. 
  7. 7.0 7.1 Szalavitz, Maia (7 May 2013). "Mental Health Researchers Reject Psychiatry's New Diagnostic 'Bible'". TIME. http://healthland.time.com/2013/05/07/as-psychiatry-introduces-dsm-5-research-abandons-it. 
  8. 8.0 8.1 8.2 8.3 8.4 8.5 "Research Domain Criteria (RDoC)". 29 May 2013. http://www.nimh.nih.gov/research-priorities/rdoc/nimh-research-domain-criteria-rdoc.shtml. 
  9. 9.0 9.1 9.2 9.3 9.4 9.5 9.6 "RDoC Matrix". https://www.nimh.nih.gov/research-priorities/rdoc/constructs/rdoc-matrix.shtml. 
  10. McCoy, Thomas H.; Yu, Sheng; Hart, Kamber L.; Castro, Victor M.; Brown, Hannah E.; Rosenquist, James N.; Doyle, Alysa E.; Vuijk, Pieter J. et al. (2018-06-15). "High Throughput Phenotyping for Dimensional Psychopathology in Electronic Health Records". Biological Psychiatry 83 (12): 997–1004. doi:10.1016/j.biopsych.2018.01.011. ISSN 1873-2402. PMID 29496195. 
  11. McCoy, Thomas H.; Castro, Victor M.; Hart, Kamber L.; Pellegrini, Amelia M.; Yu, Sheng; Cai, Tianxi; Perlis, Roy H. (2018-06-15). "Genome-wide Association Study of Dimensional Psychopathology Using Electronic Health Records". Biological Psychiatry 83 (12): 1005–1011. doi:10.1016/j.biopsych.2017.12.004. ISSN 1873-2402. PMID 29496196. 

Further reading

External links