Presentation made by Dr. Bruce Cuthbert at the May 28 2014 Live Webinar hosted by the Schizophrenia Forum - Research Domain Criteria (RDoC) Applied to Verbal Hallucinationshttp://schizophreniaforum.org/for/live/detail.asp?liveID=92
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Cuthbert SRF Forum May 2014
1. Schizophrenia Research Forum
Webinar
May 28, 2014
Bruce N. Cuthbert, Ph.D.
Director, Division of Adult Translational Research
National Institute of Mental Health
Toward Precision Medicine for Mental Disorders:
NIMH Research Domain Criteria (RDoC)
2. Disclosures
• Dr. Cuthbert is a Title 42 federal employee
who is required to disclose all financial
holdings as public record, and has no outside
activities to disclose.
2
3. 3
Schizophrenia: A complex syndrome
• Highly heterogeneous
• Michael Owen: “There is no such thing as schizophrenia.”
• Psychosis, hallucinations in other disorders
• Research task: Study the individual differences to find more precise
diagnosis and intervention
4. Polygenic Risks for Mental Disorders
Cross-Disorder group of the PGC,
Lancet, 2013
6. 6
NIMH Strategic Plan: Goal 1.4
• “Develop, for research purposes, new ways of classifying
mental disorders based on dimensions of observable
behavior and neurobiological measures.”
7. [Symptoms]
• Elevated Stress
• Heightened threat reactivity
• Abnormalities in reward-related activity
• Substance abuse
• Hippocampus: encoding functions
• Perceptual aberrations
• Social withdrawal
• Need for social relationships
• Disruptions in network connectivity
• Dysfunctions in arousal/activation systems
8. 8
RDoC: Quick Summary
• A framework to study mechanisms that cut across traditional disorder
boundaries
• Dimensional approach – understand transitions from normal to mild,
moderate, severe dysfunction
• Will inform, not compete with, future versions of DSM and ICD
• Toward personalized medicine in psychiatry, consistent with other areas
of medicine
• http://www.nimh.nih.gov/research-priorities/rdoc/index.shtml
Hinweis der Redaktion
And so we are faced with a paradox:
We can’t move past these neuroscientifically uninformative heterogeneous categorical diagnoses until we have a body of knowledge organized along neuroscientific principles.
*******
RDoC was initiated to address this paradox.
RDoC focuses on the primary neural circuits and functions that the brain has evolved to function adaptively,
To characterize the range of intact to disordered functioning,
And develop a classification scheme based on what we know about how the brain and behavior are organized.
Craddock and Owen published a comprehensive schematic that has several important parallels to RDoC – dimensional view of psychopathology, multiple units of analysis.
If we want to get to this, actually being able to identify these neural modules, biological systems and genes, we need to change the way we’re asking questions.
And so we are faced with a paradox:
We can’t move past these neuroscientifically uninformative heterogeneous categorical diagnoses until we have a body of knowledge organized along neuroscientific principles.
*******
RDoC was initiated to address this paradox.
RDoC focuses on the primary neural circuits and functions that the brain has evolved to function adaptively,
To characterize the range of intact to disordered functioning,
And develop a classification scheme based on what we know about how the brain and behavior are organized.
And so we are faced with a paradox:
We can’t move past these neuroscientifically uninformative heterogeneous categorical diagnoses until we have a body of knowledge organized along neuroscientific principles.
*******
RDoC was initiated to address this paradox.
RDoC focuses on the primary neural circuits and functions that the brain has evolved to function adaptively,
To characterize the range of intact to disordered functioning,
And develop a classification scheme based on what we know about how the brain and behavior are organized.
