The Research Domain Criteria (RDoC): An analysis of methodological and conceptual challenges

doi:10.1016/j.brat.2014.07.019

Behaviour Research and Therapy

Volume 62, November 2014, Pages 129-139

https://doi.org/10.1016/j.brat.2014.07.019 Get rights and content

Highlights

•
I review shortcomings with the extant classification system that led to calls for change.
•
I lay out the assumptions of the competing Research Domain Criteria (RDoC) program.
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I examine four key conceptual and methodological challenges to RDoC's progress.
•
I present potential remedies for each of these challenges.

Abstract

In a bold effort to address the longstanding shortcomings of the Diagnostic and Statistical Manual (DSM) framework for the classification and diagnosis of psychopathology, the National Institute of Mental Health recently launched a research program – the Research Domain Criteria (RDoC) – in the hopes of developing an alternative taxonomic system rooted in dysfunctional brain circuitry. Although the RDoC endeavor has considerable promise, it faces several methodological and conceptual challenges, four of which I address here: (a) an overemphasis on biological units and measures, (b) neglect of measurement error, (c) biological and psychometric limitations of endophenotypes, and (d) the distinction between biological predispositions and their behavioral manifestations. Because none of these challenges is in principle insurmountable, I encourage investigators to consider potential remedies for them. RDoC is a calculated gamble that appears to be worth the risk, but its chances of success will be maximized by a thoughtful consideration of hard-won lessons learned – but frequently forgotten – over the past several decades of psychological and psychiatric research.

Section snippets

The Research Domain Criteria (RDoC): an analysis of conceptual and methodological challenges

It perhaps goes without saying that our current model of psychiatric classification has left many researchers and clinicians dissatisfied (Frances, 2013, Greenberg, 2013). In contrast to contemporary systems of classification in internal medicine, the Diagnostic and Statistical Manual of Mental Disorders (DSM), which first appeared in 1952, diagnoses individuals almost exclusively on the basis of their signs (overt manifestations) and symptoms (subjective reports) rather than on the basis of

The DSM and its discontents

Of course, these disagreements are hardly new. Deep-seated discontent regarding the prevailing DSM model has been a recurring theme in clinical psychology and psychiatry over the past several decades (e.g., Faust and Miner, 1986, Kirk and Kutchins, 1992, Widiger and Clark, 2000). Indeed, both apologists and critics of the DSM have apparently managed to achieve consensus on one point: The current system of classification and diagnosis is far from optimal. Even the most fervent defenders of the

The Research Domain Criteria (RDoC) proposal: mental disorders as dysfunctions of brain circuits

Against the backdrop of lingering discontent with the DSM and ICD, in 2009 the National Institute of Mental Health (NIMH) initiated a bold initiative to transform the current framework of psychiatric classification and diagnosis into an explicitly biological system (Cuthbert, 2014, Insel et al., 2010, Sanislow et al., 2010). Dubbed the Research Domain Criteria (RDoC), largely as an homage to the Research Diagnostic Criteria (RDC) that were precursors to the DSM-III criteria (Spitzer, Endicott,

Concluding thoughts

RDoC is a calculated gamble. Given that incremental efforts to improve the DSM by nibbling around its edges have not translated into measurable declines in the morbidity and mortality of most serious psychiatric disorders (Insel, 2009), NIMH's substantial investment of time and money in a rival paradigm would appear to be worth the risk. Even if RDoC is not an unqualified success, the knowledge yielded by the endeavor may contribute to valuable insights regarding the classification and etiology

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The Research Domain Criteria (RDoC): An analysis of methodological and conceptual challenges

Highlights

Abstract

Section snippets

The Research Domain Criteria (RDoC): an analysis of conceptual and methodological challenges

The DSM and its discontents

The Research Domain Criteria (RDoC) proposal: mental disorders as dysfunctions of brain circuits

Concluding thoughts

Journal of the American Academy of Child & Adolescent Psychiatry

Biological Psychiatry

Biological Psychology

Brain and Cognition

Clinical Psychology Review

Journal of Research in Personality

Clinical Psychology Review

Clinical Psychology Review

Clinical Psychology Review

Cognitive Psychology

Drug and Alcohol Dependence

Psychiatry Research

Psychodynamic diagnostic manual (PDM)

Diagnostic and statistical manual of mental disorders, third edition (DSM-III)

Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5)

The broken brain: The biological revolution in psychiatry

Psychology as the science of self-reports and finger movements: whatever happened to actual behavior?

Perspectives on Psychological Science

How reliable are the results from functional magnetic resonance imaging?

Annals of the New York Academy of Sciences

Classification and psychopathology research

Journal of Abnormal Psychology

The classification of psychopathology: Neo-Krraepelinian and quantitative approaches

Advancing the psychology of personality: paradigmatic shift or improving the quality of research?

Comorbidity of psychiatric disorders and posttraumatic stress disorder

Journal of Clinical Psychiatry

Power failure: why small sample size undermines the reliability of neuroscience

Nature Reviews Neuroscience

Understanding desisting and persisting forms of delinquency: the unique contributions of disruptive behavior disorders and interpersonal callousness

Journal of Child Psychology and Psychiatry

Endophenotypes in the genetic analyses of mental disorders

Annual Review of Clinical Psychology

From thought to behavior: “Having” and “doing” in the study of personality and cognition

American Psychologist

Twin studies of schizophrenia: from bow-and-arrow concordances to star wars Mx and functional genomics

American Journal of Medical Genetics

Scales for sphysical and social anhedonia

Journal of Abnormal Psychology

Equifinality and multifinality in developmental psychopathology

Development and Psychopathology

Multisite fMRI reproducibility of a motor task using identical MR systems

Journal of Magnetic Resonance Imaging

Comorbidity: a network perspective

Behavioral and Brain Sciences

The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology

World Psychiatry

Toward the future of psychiatric diagnosis: the seven pillars of RDoC

BMC Medicine

Constructing constructs for psychopathology: the NIMH research domain criteria

Journal of Abnormal Psychology

Neural systems involved in fear and anxiety measured with fear-potentiated startle

American Psychologist

Disease-associated epigenetic changes in monozygotic twins discordant for schizophrenia and bipolar disorder

Human Molecular Genetics

The stability of behavior: I. On predicting most of the people much of the time

Journal of Personality and Social Psychology

The stability of behavior: II. Implications for psychological research

American Psychologist

The stability of confusion: a reply to Mischel and Peake

Psychological Review

The seductive allure of “seductive allure.”

Perspectives on Psychological Science

The empiricist and his new clothes: DSM-III in perspective

American Journal of Psychiatry

Preserving the clinician-research interface in the age of RDoC

World Psychiatry

The endophenotype concept in psychiatric genetics

Psychological Medicine

Models of scientific progress and the role of theory in taxonomy development: a case study of the DSM

Journal of Consulting and Clinical Psychology

The DSM-III personality disorders section: a commentary

American Journal of Psychiatry