The Research Domani Criteria framework (RdoC) encourages research on specific impairments present across traditional nosological categories and suggests a list of biological and behavioral measures for assessing them. After a description of RdoC, in this article we focus on impairments of the ability of understanding others, specifically in Theory of Mind and empathy. We illustrate recent evidence on brain anomalies correlating with these deficits in Schizophrenia, Addiction Disorders and Mood Disorders populations. In the last section, we zoom out (...) and consider this kind of research vis-à-vis the objection of being reductionistic that is, in favoring mechanistic accounts of mental disorders. We argue that metaphysical reductionism and explanatory reductionism are not conceptually entailed by the RdoC framework. (shrink)

Recently there has been a trend of moving towards biological and neurocognitive based classifications of mental disorders that is motivated by a dissatisfaction with the syndrome-based classifications of mental disorders. The Research Domain Criteria (indicated with the acronym RDoC) represents a bold and systematic attempt to foster this advancement. However, RDoC faces theoretical and conceptual issues that need to be addressed. Some of these difficulties emerge when we reflect on the plausible reading of the slogan “mental disorders are (...) brain disorders”, that according to proponents of RDoC constitutes one of its main presuppositions. Some authors think that endorsing this idea commits RDoC to a form of biological reductionism. We offer empirical and theoretical considerations for concluding that the slogan above should not be read as a reductionist thesis. We argue, instead, that the slogan has a pragmatic function whose aim is to direct research in psychopathology. We show how this function might be captured in the framework of a Carnapian explication as a methodological tool for conceptual engineering. Thus, we argue that a charitable interpretation of the aims of the proponents of RDoC should be understood as an attempt at providing an explication of the concept of mental disorder in terms of brain disorder whose main goal is to provide a more precise and fruitful notion that is expected to have a beneficial impact on classification, research, and treatment of psychiatric conditions. (shrink)

The thesis of multiple realisation that Borsboom et al. are relying on should not be taken for granted. In dissolving the apparent multiple realisation, the reductionist research strategies in psychopathology research (the Research Domain Criteria [RDoC] framework, in particular) are bound to lead to eliminativism rather than reductionism. Therefore, Borsboom et al. seem to be aiming at a wrong target.

In this article, I explain why stabilizing constructs is important to the success of the Research Domain Criteria Project and identify one measure for facilitating such stability.

This paper is a response to a commentary by Walter Glannon (2016, Frontiers in Human Neuroscience) on my paper "Stabilizing Constructs Across Research Fields as a Way to Foster the Integrative Approach of the Research Domain Criteria Project".

In this important new book in the IPPP series, a group of leading thinkers in psychiatry, psychology, and philosophy offer alternative perspectives that address both the scientific and clinical aspects of psychiatric validation, emphasizing throughout their philosophical and historical considerations.

In this paper, I will argue that the NIMH’s new Research Domain of Criteria is a useful test of the philosophical hypothesis of eliminative materialism and demonstrates the superiority of a moderate eliminativism over integrationism, which is a rival philosophical framework for the cognitive sciences. I begin by going over the motivation for RDOC, which rests on the problems with the existing Diagnostic and Statistical Manual of Mental Disorders framework in psychiatry. Then, I introduce the main tenets of (...) class='Hi'>RDoC before discussing eliminativism and trying to show what a moderate eliminativism looks like through the example of addiction. I then contrast that approach with intregrationism to the latter’s detriment. I end by wondering whether the broadly political consequences of eliminativism give us non-scientific reasons for resisting it, as it threatens to rob ordinary people of important means of self-description. (shrink)

The field of mental health continues to struggle with the question of how best to structure its diagnostic systems. This issue is of considerable ethical importance, but the implications for public health approaches to mental health have yet to be explored in any detail. In this article I offer a preliminary treatment, drawing out several core issues while sounding a note of caution. A central strand of the debates over diagnosis has been the contrast between categorical and dimensional models, with (...) renewed attention due to recent publication of the DSM-5, launch of the RDoC, and ongoing work on the ICD-11. This dispute involves an interesting assortment of ethical and empirical considerations, many with direct relevance for public health. It has been proposed, for example, that dimensional diagnosis may be morally preferable because it can help reduce the stigma associated with mental disorder. This is a pressing concern, as preventive strategies are expanded in mental health, often operating under dimensional assumptions that target various risk factors. But this type of proposal relies upon an empirical claim and the scientific status of dimensionality remains unresolved, including its relation to stigma. I suggest, then, that the current state of the evidence does not yet warrant clear adjudication between competing frameworks, and thus any implications for public mental health remain highly provisional. More research is needed to help resolve these issues, including ethical analysis. (shrink)

In this paper, I will argue that the NIMH’s new Research Domain of Criteria is a useful test of the philosophical hypothesis of eliminative materialism and demonstrates the superiority of a moderate eliminativism over integrationism, which is a rival philosophical framework for the cognitive sciences. I begin by going over the motivation for RDOC, which rests on the problems with the existing Diagnostic and Statistical Manual of Mental Disorders framework in psychiatry. Then, I introduce the main tenets of (...) class='Hi'>RDoC before discussing eliminativism and trying to show what a moderate eliminativism looks like through the example of addiction. I then contrast that approach with intregrationism to the latter’s detriment. I end by wondering whether the broadly political consequences of eliminativism give us non-scientific reasons for resisting it, as it threatens to rob ordinary people of important means of self-description. (shrink)

This thesis investigates the nature of psychiatric disorders, and to what extent they can form a basis for classification, explanation, and treatment interventions. These questions are important in the light of the “crisis of validity” in psychiatry, according to which current diagnostic categories do not pick out real disorders. I address the questions by defending an account of psychiatric disorders that can better accommodate social aspects and non-epistemic values than the symptom-based model of the Diagnostic and Statistical Manual of Mental (...) Disorders (DSM) and the brain disease model of the biomedical approach, including the Research Domain Criteria (RDoC). I concentrate on three ways that psychiatric disorders can differ from prototypical natural kinds, such as biological species and chemical elements. First, the concept of psychiatric disorder or mental disorder is partly value-laden and cannot be defined based only on scientific facts. Second, the objects of psychiatric classifications are interactive human kinds because people with disorders respond to their classifications through looping effects. Third, sociocultural factors can shape disorders in complex ways, which is indicated by their cross-cultural variation. I argue that these challenges can be overcome with a pluralistic explanatory account that grants an explicit role to value-sensitive considerations and social scientific research. Based on this, I argue that particular disorders can in principle support inductive inferences. ------------------------------------------------------------------------------------------ My key argument is that although whether a condition is considered pathological is partly a value-laden question, this does not rule out a realist account of particular psychiatric disorders as homeostatic property cluster kinds (HPC). I assert that causal mechanisms responsible for psychiatric kinds can be understood non-metaphysically based on the contrastive-counterfactual and interventionist theories of explanation. An advantage of this account is that it can address the concern that psychiatric explanations require one to relate heterogeneous causal factors on different levels, such as genetic, neurological, psychological, and social. My novel argument is that mechanistic explanations of scientific kinds have applicability domains over which they account for specific aspects of kinds and warrant inductive inferences. That is, identifying the applicability domain of an explanation spells out the conditions under which the explanation is expected to be reliable and when it can break down. This helps to understand how different discipline approaches, including social and cultural ones, can be complementary and make an explanation of a psychiatric kind more reliable. On the other hand, the account also shows how the complex nature of psychiatric kinds can license re-classifications for different epistemic and non-epistemic purposes. Finally, in the light of the social implications of psychiatric classifications, I suggest a value-sensitive or ameliorative approach to engineering the concept of psychiatric disorder. In conclusion, my account shows that research on the social and cultural factors that shape psychiatric disorders, and weighing the non-epistemic values that influence classificatory practices, can and should inform classificatory choices as well as policy and treatment interventions. (shrink)

Abstract:Diagnostic classification systems in psychiatry have continued to rely on clinical phenomenology, despite limitations inherent in that approach. In view of these limitations and recent progress in neuroscience, the National Institute of Mental Health (NIMH) has initiated the Research Domain Criteria (RDoC) project to develop a more neuroscientifically based system of characterizing and classifying psychiatric disorders. The RDoC initiative aims to transform psychiatry into an integrative science of psychopathology in which mental illnesses will be defined as involving putative (...) dysfunctions in neural nodes and networks. However, conceptual, methodological, neuroethical, and social issues inherent in and/or derived from the use of RDoC need to be addressed before any attempt is made to implement their use in clinical psychiatry. This article describes current progress in RDoC; defines key technical, neuroethical, and social issues generated by RDoC adoption and use; and posits key questions that must be addressed and resolved if RDoC are to be employed for psychiatric diagnoses and therapeutics. Specifically, we posit that objectivization of complex mental phenomena may raise ethical questions about autonomy, the value of subjective experience, what constitutes normality, what constitutes a disorder, and what represents a treatment, enablement, and/or enhancement. Ethical issues may also arise from the (mis)use of biomarkers and phenotypes in predicting and treating mental disorders, and what such definitions, predictions, and interventions portend for concepts and views of sickness, criminality, professional competency, and social functioning. Given these issues, we offer that a preparatory neuroethical framework is required to define and guide the ways in which RDoC-oriented research can—and arguably should—be utilized in clinical psychiatry, and perhaps more broadly, in the social sphere. (shrink)

This chapter has two aims. The first aim is to compare and contrast three different conceptual-explanatory models for thinking about mental illness with an eye towards identifying the assumptions upon which each model is based, and exploring the model’s advantages and limitations in clinical contexts. Major Depressive Disorder is used as an example to illustrate these points. The second aim is to address the question of what conceptual-theoretical framework for thinking about mental illness is most likely to facilitate the discovery (...) of causes and treatments of mental illness in research contexts. To this end, the National Institute of Mental Health’s Research Domain Criteria (RDoC) Project is briefly considered. (shrink)

Effective and specifically targeted social and therapeutic responses for antisocial personality disorders and psychopathy are scarce. Some authors maintain that this scarcity should be overcome by revising current syndrome - based classifications of these conditions and devising better biocognitive classifications of antisocial individuals. The inspiration for the latter classifications has been embedded in the Research domain criteria approach (RDoC). RDoC - type approaches to psychiatric research aim at transforming diagnosis, provide valid measures of disorders, aid clinical practice, and (...) improve health outcomes by integrating the data on the genetic, neural, cognitive, and affective systems underlying psychiatric conditions. In the first part of the paper, we discuss the benefits of such approaches in comparison to the dominant syndrome-based ones and review recent attempts at building biocognitive classifications of antisocial individuals. Other researchers, how ever, have objected that biocognitive approaches in psychiatry are committed to an untenable form of explanatory. (shrink)

The aim of this article is to introduce the concept of Cognitive Fitness (CF), identify its key ingredients underpinning both real-time task performance and career longevity in high-risk occupations, and to canvas a holistic framework for their assessment, training, and augmentation. CF as a capacity to deploy neurocognitive resources, knowledge and skills to meet the demands of operational task performance, is likely to be multi-faceted and differentially malleable. A taxonomy of CF constructs derived from Cognitive Readiness (CR) and Mental fitness (...) (MF) literature maps into phases of operational cycles from foundational to advanced, mission-ready and recovery. Foundational cognitive attributes, such as attention, executive control and co-action, were hypothesized to be trainable at the initial Cognitive Gym phase. More advanced training targets at the CR phase included stress and arousal regulation, adaptability, teamwork, situation awareness (including detection, sense-making and prediction) and decision making (de-biasing and confidence calibration). The mission-ready training phase is focused on tolerances (to sleep loss, monotony, pain, frustration, uncertainty) and resistance (to distraction, deception or manipulation). Operational Augmentation phase relies on support tools such as decision aids and fatigue countermeasures, while the Recovery phase employs reflexive (e.g., mindfulness), and restorative practices (e.g., nutrition and sleep hygiene). The periodization of cognitive training in this cycle is hypothesized to optimize both real-time cognitive performance and the resilience that enables life-long thriving. One of the most promising avenues of validating this hypothesis is by developing an expert consensus on the key CF ingredients and their relative importance in high-performance settings. (shrink)

Although researchers in psychiatry have been trying for decades to elucidate the pathophysiology underlying mental disorders, relatively little progress has been made. One explanation for this failure is that diagnostic categories in psychiatry are unlikely to track underlying neurological mechanisms. Because of this, the US National Institutes of Mental Health has recently developed a novel ontology to guide research in biological psychiatry: the Research Domain Criteria. In this paper, I argue that while RDoC may lead to better neuroscientific explanations (...) for mental disorders, it is unlikely that this new knowledge will then lead to an improved diagnostic system. I therefore suggest that researchers in psychiatry should work toward the development of two new ontologies: one for research and one for clinical practice. (shrink)

Clinical fields of the “sciences of the mind” (psychotherapy, psychiatry, etc.) lack integrative conceptual frameworks that have explanatory power. Mainly descriptive-classificatory taxonomies like DSM dominate the field. New taxonomies such as Research Domain Criteria (RDoC) aim to collect scientific knowledge regarding “systems” for “processes” of the brain. These terms have a supradisciplinary” meaning if they are considered in context of Systems Science. This field emerges as a platform of theories like general systems theory, catastrophe theory, synergetics, chaos theory, etc. (...) It provides a lot of abstract concepts, constructs, methods and models. We assume that these tools also enable theoretical integration in the diversified field of clinical practice in the sciences of the mind. Additionally, systems thinking in clinical psychology improves conceptual links to currently network-oriented neurobiology. However, clear definitions of systemic terms are necessary to emerge from their mainly metaphorical use. Here we revise mainly terms like “structure”, “process” and “dynamics” as they are used already in psychology, psychoanalysis, psychopathology and psychiatry in an ill-defined way. For instance, affective-cognitive structures like “life space” or “object representations” can be seen as products of mental processing. These structures, in turn, modulate dynamics of mental processes. Additionally, we suggest a coupled network concept of emotions and motivations as the main subsystem that modulates mental dynamics that results in a qualitative systemic model of the mind. Finally, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental. ystem for mental dynamics. In this context, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental. (shrink)

Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and then grouped into a psychiatric category. I highlight this primarily through analysing research domain criteria. RDoC’s importance makes it worth scrutinizing, and this assessment also serves as a case study with relevance for other areas of psychiatry. RDoC takes inadequacies of existing psychiatric categories as holding back causal investigation. Consequently, RDoC aims to circumnavigate existing psychiatric categories by (...) directly investigating the causal basis of symptoms. The unique methodological approach of RDoC exploits the supposed lack of influence of psychiatric categories on symptom modelling, taking psychiatric symptoms as the same regardless of which psychiatric category is employed or if no psychiatric category is employed. But this supposition is not always true. I will show how psychiatric categories can influence symptom modelling, whereby identical behaviours can be considered as different symptoms based on an individual’s psychiatric diagnosis. If the modelling of symptoms is influenced by psychiatric categories, then psychiatric categories will still play a role, a situation which RDoC researchers explicitly aim to avoid. I discuss four ways RDoC could address this issue. This issue also has important implications for factor analysis, cluster analysis, modifying psychiatric categories, and symptom based approaches. (shrink)

Levels of Analysis in Psychopathology draws research from psychiatry, philosophy, and psychology to explore the variety of explanatory approaches for understanding the nature of psychiatric disorders both in practice and research. The fields of psychiatry and clinical psychology incorporates many useful explanatory approaches and this book integrates this range of perspectives and makes suggestions about how to advance etiologic theories, classification, and treatment. The editors have brought together leading thinkers who have been widely published and are well-respected in their area (...) of expertise, including several developers of the Diagnostic and Statistical Manual of Mental Disorders and authors of the US National Institute of Mental Health's Research Domain Criteria Project (RDoC). Each main chapter has a commentary provided by one of the other authors and an introduction written by one of the editors to create an accessible, interdisciplinary dialog. (shrink)

Heterogeneity within MDD has hampered identification of biological markers (e.g., intermediate phenotypes, IPs) that might increase risk for the disorder or reflect closer links to the genes underlying the disease process. The newer characterizations of dimensions of MDD within Research Domain Criteria (RDoC) domains may align well with the goal of defining IPs. We compare a sample of 25 individuals with MDD compared to 29 age and education matched controls in multimodal assessment. The multimodal RDoC assessment included the (...) primary IP biomarker, positron emission tomography (PET) with a selective radiotracer for 5-HT1A ([11C]WAY-100635), as well as event-related functional MRI with a Go/No-go task targeting the Cognitive Control network, neuropsychological assessment of affective perception, negative memory bias and Cognitive Control domains. There was also an exploratory genetic analysis with the serotonin transporter (5-HTTLPR) and monamine oxidase A (MAO-A) genes. In regression analyses, lower 5-HT1A binding potential (BP) in the MDD group was related to diminished engagement of the Cognitive Control network, slowed resolution of interfering cognitive stimuli, one element of Cognitive Control. In contrast, higher/normative levels of 5-HT1A BP in MDD (only) was related to a substantial memory bias toward negative information, but intact resolution of interfering cognitive stimuli and greater engagement of Cognitive Control circuitry. The serotonin transporter risk allele was associated with lower 1a BP and the corresponding imaging and cognitive IPs in MDD. Lowered 5HT 1a BP was present in half of the MDD group relative to the control group. Lowered 5HT 1a BP may represent a subtype including decreased engagement of Cognitive Control network and impaired resolution of interfering cognitive stimuli. Future investigations might link lowered 1a BP to neurobiological pathways and markers, as well as probing subtype-specific treatment targets. (shrink)

In the United States, the National Institute of Mental Health is seeking to encourage researchers to move away from diagnostic tools like the Diagnostic and Statistical Manual of Mental Disorders. A key mechanism for this is the “Research Domain Criteria” initiative, closely associated with former NIMH Director Thomas Insel. This article examines how key figures in US psychiatry construct the purpose, nature, and implications of the ambiguous RDoC project; that is, how its novelty is constituted through discourse. In this (...) paper, I explore and analyze these actors’ accounts of what is new, important, or desirable about RDoC, demonstrating how they are constituted through institutional context and personal affects. In my interviews with mental health opinion leaders, RDoC is presented as overly reliant on neurobiological epistemologies, distant from clinical imaginaries and imperatives, and introduced in a top-down manner inconsistent with the professional norms of scientific research. Ultimately, the article aims to add empirical depth to current understandings about the epistemological and ontological politics of contemporary psychiatry and to contribute to science and technology studies debates about “the new” in technoscience. Accordingly, I use discussions about RDoC as a case study in the sociology of novelty. (shrink)

The very idea of mental illness is contested. Given its differences from physical illnesses, is it right to count it, and particular mental illnesses, as genuinely medical as opposed to moral matters? One debate concerns its value-ladenness, which has been used by anti-psychiatrists to argue that it does not exist. Recent attempts to define mental illness divide both on the presence of values and on their consequences. Philosophers and psychiatrists have explored the nature of the general kinds that mental illnesses (...) might comprise, influenced by psychiatric taxonomies such as the Diagnostic and Statistical Manual and the International Classification of Diseases, and the rise of a rival biological ‘meta-taxonomy’: the Research Domain Criteria (RDoC). The assumption that the concept of mental illness has a culturally invariant core has also been questioned. This book serves as a guide to these contested debates. (shrink)

L'importance que les défenseurs du Research Domain Criteria (RDoC) accordent aux circuits du cerveau dans la compréhension des désordres mentaux a conduit certains chercheurs à suspecter qu'on avait affaire à un programme de recherche foncièrement réductionniste. Puisque le RDoC devrait éventuellement affecter la psychiatrie clinique, on a craint qu'elle ne se transforme en une science neuro-comportementale appliquée sans tenir compte de l'esprit (mindless). Cet article montre en quoi le projet du RDoC s'éloigne du réductionnisme classique et comment (...) il en évite les écueils. Pour cette raison, du moins en principe, le RDoC pourrait enrichir plutôt qu'appauvrir la psychiatrie clinique. Pour conclure, les effets néfastes produits par le réductionnisme de façade des défenseurs du RDoC seront soulignés. (shrink)

The core dimensions of cognitive fitness, such as attention and cognitive control, are emerging through a transdisciplinary expert consensus on what has been termed the Cognitive Fitness Framework. These dimensions represent key drivers of cognitive performance under pressure across many occupations, from first responders to sport, performing arts and the military. The constructs forming the building blocks of CF2 come from the RDoC framework, an initiative of the US National Institute of Mental Health aimed at identifying the cognitive processes (...) underlying normal and abnormal behavior. Similar to physical conditioning, cognitive fitness can be improved with deliberate practice. This paper reports the development of a prototype cognitive fitness training program for competitive athletes and the protocol for its evaluation. The program is focused on primary cognitive capacities and subtending skills for adjusting training rhythms and enhancing readiness for competition. The project is driven by the Australian Psychological Society’s College of Sport & Exercise Psychology and includes the development of a Cognitive Gym program for a smartphone app-enhanced implementation. Its key building blocks are training protocols connected by a periodized training plan. A website with background supporting resources has also been developed as part of the project. National-level training squads will participate in a three-week pilot evaluation protocol, assessing the program’s efficacy and usability through gamified cognitive assessment of participants’ training gains and coaching staff evaluations, respectively. Both near and far transfer of training effects will be examined. (shrink)

Contemporary psychiatry finds itself in the midst of a crisis of classification. The developments begun in the 1980s—with the third edition of the Diagnostic and Statistical Manual of Mental Disorders —successfully increased inter-rater reliability. However, these developments have done little to increase the predictive validity of our categories of disorder. A diagnosis based on DSM categories and criteria often fails to accurately anticipate course of illness or treatment response. In addition, there is little evidence that the DSM categories link up (...) with genetic findings, and even less evidence that they... (shrink)

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric (...) research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes. (shrink)

The failure of psychiatry to validate its diagnostic constructs is often attributed to the prioritizing of reliability over validity in the structure and content of the Diagnostic and Statistical Manual of Mental Disorders. Here I argue that in fact what has retarded biomedical approaches to psychopathology is unwarranted optimism about diagnostic discrimination: the assumption that our diagnostic tests group patients together in ways that allow for relevant facts about mental disorder to be discovered. I consider the Research Domain Criteria framework (...) as a new paradigm for classifying objects of psychiatric research that solves some of the challenges brought on by this assumption. (shrink)

Though pluralism is given a lot of lip service it is not the status quo in psychiatry. In this paper I argue that following the recent Research Domain Criteria project of the National Institute of Mental Health, we run the danger of promoting a reductionist agenda that current evidence and research suggests is not the right way of tackling mental disorders. I further argue that in order to better address the needs of the patients and maintain the ethical standards required (...) in the psychiatric profession we ought to maintain a pluralistic attitude in psychiatric research as well as practice. (shrink)