■最近的研究发现,自闭症谱系障碍等精神疾病的临床表现存在相当大的重叠,注意缺陷多动障碍和社交焦虑障碍。诊断方法收集症状以反映单个潜在的精神病理学过程。研究领域标准(RDoC)强调精神病理学是由核心基础结构的异常组合引起的,可以在许多分析水平上进行测量。从生物学到行为学。具有临床异质性的患者可能受益于跨诊断病例概念化,该概念化基于RDoC框架,跨多个功能领域的多个测量整合了详细的症状信息。
我们报告了一个案例,该案例被纳入一项研究,该研究的重点是将知识推向诊断,基于大脑的焦虑和抑郁模型。这位20岁的男性患者因注意力不集中而出现在社区精神健康诊所,情绪低落,睡眠问题和焦虑症状。患者还出现了负效价系统的主要问题(焦虑,回避,和对负面信息的偏见),认知系统(认知能力随时间波动,注意力和专注能力差),和社会处理系统(社会沟通技巧的缺陷)。通过诊断透镜对这种情况进行概念化,通过包括更综合的方法来增强患者的治疗计划。治疗包括社交技能培训,渐进式放松练习,以及情感表达和独立生活技能方面的基本心理教育。
■此案例说明了诊断方法的实用性,特别是当传统的诊断模型产生相互矛盾的证据和/或多种合并症时.RDoC提供了用于跨多个维度集成异常的框架。此外,它为未来将大脑行为关系整合到案例概念化和个性化治疗方法中奠定了基础。
UNASSIGNED: Recent research recognizes considerable overlap in the clinical presentation of psychiatric disorders such as Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder and Social Anxiety Disorder. The diagnostic approach collects symptoms to reflect a single underlying psychopathological process. The Research Domain Criteria (RDoC) emphasizes psychopathology as arising from combinations of abnormalities in core underlying constructs that can be measured at many levels of analysis, from biological to behavioral. Patients who present with clinical heterogeneity may benefit from transdiagnostic
case conceptualization that integrates detailed symptom information across multiple measurements spanning multiple domains of functioning based in the RDoC framework.
UNASSIGNED: We report on one
case that was included in a research study focused on advancing knowledge towards a transdiagnostic, brain-based model of anxiety and depression. The 20-year-old male patient presented at a community mental health clinic for inattention, low mood, sleep problems and anxious symptoms. The patient also presented with primary problems in negative valence systems (anxiety, avoidance, and bias towards negative information), cognitive systems (fluctuating cognitive ability over time, poor concentration and ability to focus), and social processing systems (deficits in social communication skills). Conceptualizing this
case through a transdiagnostic lens augmented the patient\'s treatment plan by including a more integrative approach. Treatment included social skills training, progressive relaxation exercises, and basic psychoeducation in emotional expression and independent living skills.
UNASSIGNED: This
case illustrates the utility of a transdiagnostic approach, particularly when a traditional diagnostic model generates conflicting evidence and/or multiple comorbidities. RDoC provides a framework for integrating abnormalities across multiple dimensions. Furthermore, it lays the foundation for future integration of brain-behavior relationships into
case conceptualization and personalized treatment approaches.