RDoC

RDoC
  • 文章类型: Journal Article
    需要对新的破坏性情绪失调障碍(DMDD)诊断的潜在机制进行系统概述。研究领域标准(RDoC)代表了人类功能的六个领域的系统,旨在构建对精神疾病性质的理解。通过RDoC框架,本系统评价的目的是综合同行评审论文中报道的18岁以下儿童和青少年患有DMDD的现有数据.
    使用Medline进行了由PRISMA指导的文献检索,PsychInfo,和Embase,而RDoC域被用来系统化研究结果。检查了纳入研究中的偏倚风险。
    我们确定了319项研究。经过研究选择,我们纳入了29项研究。其中21个发现与>1个RDoC域有关。偏倚风险评估在当前DMDD机制知识的研究基础上显示出局限性。
    审查自我报告,通过RDoC域的行为和神经回路发现,我们认为DMDD青年在社会过程和效价系统中有负面的解释偏见。在发生负面刺激解释时,可能会出现异常的认知过程。然而,当前对DMDD的知识受到缺乏样本多样性和开放科学实践的影响。
    我们发现六个RDoC域可用于构建DMDD潜在机制的当前证据。建议在该研究领域进行未来研究的重要机会。在临床实践中,这份关于DMDD机制的全面总结可用于心理教育和治疗计划.
    UNASSIGNED: A systematic overview of underlying mechanisms in the new disruptive mood dysregulation disorder (DMDD) diagnosis is needed. The Research Domain Criteria (RDoC) represent a system of six domains of human functioning, which aims to structure the understanding of the nature of mental illnesses. By means of the RDoC framework, the objective of this systematic review is to synthesize available data on children and youths <18 years suffering from DMDD as reported in peer reviewed papers.
    UNASSIGNED: A literature search guided by PRISMA was conducted using Medline, PsychInfo, and Embase, while the RDoC domains were employed to systematize research findings. Risk of bias in the included studies was examined.
    UNASSIGNED: We identified 319 studies. After study selection, we included 29 studies. Twenty-one of these had findings relating to >1 RDoC domain. The risk of bias assessment shows limitations in the research foundation of current knowledge on mechanisms of DMDD.
    UNASSIGNED: Reviewing self-report, behavior and neurocircuit findings by means of RDoC domains, we suggest that DMDD youths have a negative interpretation bias in social processes and valence systems. In occurrence of a negative stimuli interpretation, aberrant cognitive processing may arise. However, current knowledge of DMDD is influenced by lack of sample diversity and open science practices.
    UNASSIGNED: We found the six RDoC domains useful in structuring current evidence of the underlying mechanisms of DMDD. Important opportunities for future studies in this field of research are suggested. In clinical practice, this comprehensive summary on DMDD mechanisms can be used in psychoeducation and treatment plans.
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  • 文章类型: Systematic Review
    众所周知,成瘾通常与神经认知功能的独特模式有关,共识是自上而下的执行控制受损和异常的风险回报处理。尽管人们一致认为神经认知在表征和维持成瘾性障碍中起着重要作用,缺乏系统性,自下而上的定量证据表明神经认知可以预测成瘾行为,以及哪些神经认知结构具有最好的预测有效性。本系统综述旨在评估研究领域标准(RDoC)定义的认知控制和风险回报过程是否可以预测成瘾行为的发展和维持,消费,严重程度,和复发。这篇综述的发现揭示了大量缺乏神经认知预测成瘾结果的证据。然而,有证据表明,奖励相关的神经认知过程对于检测早期成瘾风险可能很重要,以及设计新颖的潜在可行目标,更有效的干预措施。
    It is well-established that addiction is typically associated with a distinct pattern of neurocognitive functioning with a consensus that it is typified by impaired top-down executive control and aberrant risk-reward processing. Despite a consensus that neurocognition plays an important role in characterizing and maintaining addictive disorders, there is a lack of systematic, bottom-up synthesis of quantitative evidence showing that neurocognition predicts addictive behaviors, and which neurocognitive constructs have the best predictive validity. This systematic review aimed to assess whether cognitive control and risk-reward processes as defined by the Research Domain Criteria (RDoC) predict the development and maintenance of addictive behaviors specifically, consumption, severity, and relapse. The findings from this review expose the substantial lack of evidence for neurocognition predicting addiction outcomes. However, there is evidence that suggests reward-related neurocognitive processes may be important for the detection of early risk for addiction, as well as a potentially viable target for designing novel, more effective interventions.
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  • 文章类型: Systematic Review
    Changes in reward processing are hypothesized to play a role in the onset and maintenance of binge eating (BE). However, despite an increasing number of studies investigating the neurobiological reward system in individuals who binge eat, no comprehensive systematic review exists on this topic. Therefore, this review has the following objectives: (1) identify structural and functional changes in the brain reward system, either during rest or while performing a task; and (2) formulate directions for future research.
    A search was conducted of articles published until March 31, 2022. Neuroimaging studies were eligible if they wanted to study the reward system and included a group of individuals who binge eat together with a comparator group. Their results were summarized in a narrative synthesis.
    A total of 58 articles were included. At rest, individuals who binge eat displayed a lower striatal dopamine release, a change in the volume of the striatum, frontal cortex, and insula, as well as a lower frontostriatal connectivity. While performing a task, there was a higher activity of the brain reward system when anticipating or receiving food, more model-free reinforcement learning, and more habitual behavior. Most studies only included one patient group, used general reward-related measures, and did not evaluate the impact of comorbidities, illness duration, race, or sex.
    Confirming previous hypotheses, this review finds structural and functional changes in the neurobiological reward system in BE. Future studies should compare disorders, use measures that are specific to BE, and investigate the impact of confounding factors.
    This systematic review finds that individuals who binge eat display structural and functional changes in the brain reward system. These changes could be related to a higher sensitivity to food, relying more on previous experiences when making decisions, and more habitual behavior. Future studies should use a task that is specific to binge eating, look across different patient groups, and investigate the impact of comorbidities, illness duration, race, and sex.
    Se plantea la hipótesis de que los cambios en el procesamiento de la recompensa desempeñan un papel en el inicio y mantenimiento de los atracones (BE). Sin embargo, a pesar de un número creciente de estudios que investigan el sistema de recompensa neurobiológica en individuos que comen en atracones, no existe una revisión sistemática exhaustiva sobre este tema. Por lo tanto, esta revisión tiene los siguientes objetivos: (1) identificar cambios estructurales y funcionales en el sistema de recompensa cerebral, ya sea en reposo o mientras se realiza una tarea; (2) formular direcciones para futuras investigaciones. MÉTODOS: Se realizó una búsqueda de artículos publicados hasta el 31 de marzo de 2022. Los estudios de neuroimagen eran elegibles si querían estudiar el sistema de recompensa e incluían a un grupo de individuos que comían en atracón junto con un grupo de comparación. Sus resultados se resumieron en una síntesis narrativa.
    Se incluyeron un total de 58 artículos. En reposo, los individuos que comen en atracón mostraron una menor liberación de dopamina estriatal, un cambio en el volumen del cuerpo estriado, la corteza frontal y la ínsula, así como una menor conectividad frontostriatal. Al realizar una tarea, hubo una mayor actividad del sistema de recompensa cerebral al anticipar o recibir alimentos, más aprendizaje de refuerzo sin modelos y un comportamiento más habitual. La mayoría de los estudios sólo incluyeron un grupo de pacientes, utilizaron medidas generales relacionadas con la recompensa y no evaluaron el impacto de las comorbilidades, la duración de la enfermedad, la raza o el sexo. DISCUSIÓN: Confirmando hipótesis anteriores, esta revisión encuentra cambios estructurales y funcionales del sistema de recompensa neurobiológica en BE. Los estudios futuros deben comparar los trastornos, utilizar medidas que sean específicas para el comer en atracones e investigar el impacto de los factores de confusión.
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  • 文章类型: Journal Article
    延迟贴现范例在临床研究中获得了广泛的普及。鉴于该领域的普遍性,研究人员对延迟折扣作为关键的诊断过程和“核心”过程的重要性设定了很高的期望。我们认为延迟折扣已经过早地重新定义为,本身,心理功能障碍的核心过程,尽管人们对折现率的结构有效性存在重大担忧。具体来说,高延迟折扣率仅与心理功能障碍的措施适度相关,因此不是这些更复杂的行为问题的“核心”。此外,折现率似乎与精神病理学的任何障碍或维度无关。这引起了人们对贴现效用的基本担忧,如果该措施仅与大多数形式的精神病理学松散相关。这与折扣可以作为特定疾病的“标记”的说法形成鲜明对比,尽管从未对我们所知道的任何疾病表现出足够的敏感性或特异性。最后,经验证据不支持折现率在实验室或现实世界中做出的其他决策的普遍性,因此,折现率不能也不应该作为个人决策模式的汇总指标。我们为改进未来的延迟贴现研究提供建议,但也强烈鼓励研究人员考虑经验证据是否支持该领域对折扣的过度关注。
    Delay discounting paradigms have gained widespread popularity across clinical research. Given the prevalence in the field, researchers have set lofty expectations for the importance of delay discounting as a key transdiagnostic process and a \'core\' process underlying specific domains of dysfunction (e.g. addiction). We believe delay discounting has been prematurely reified as, in and of itself, a core process underlying psychological dysfunction, despite significant concerns with the construct validity of discounting rates. Specifically, high delay discounting rates are only modestly related to measures of psychological dysfunction and therefore are not \'core\' to these more complex behavioral problems. Furthermore, discounting rates do not appear to be specifically related to any disorder(s) or dimension(s) of psychopathology. This raises fundamental concerns about the utility of discounting, if the measure is only loosely associated with most forms of psychopathology. This stands in striking contrast to claims that discounting can serve as a \'marker\' for specific disorders, despite never demonstrating adequate sensitivity or specificity for any disorder that we are aware of. Finally, empirical evidence does not support the generalizability of discounting rates to other decisions made either in the lab or in the real-world, and therefore discounting rates cannot and should not serve as a summary measure of an individual\'s decision-making patterns. We provide recommendations for improving future delay discounting research, but also strongly encourage researchers to consider whether the empirical evidence supports the field\'s hyper-focus on discounting.
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  • 文章类型: Journal Article
    Deficits in social processing (SP) have been proposed to underpin interpersonal dysfunction in both Borderline Personality Disorder (BPD) and Substance Use Disorders (SUD). This study aimed to explore potential transdiagnostic cognitive and behavioral phenotypes of these disorders utilizing the NIMH Research Domain Criteria \'Systems for Social Processes\'. A systematic review and meta-analysis of the published research was conducted on 134 studies identified through our database searches. Four meta-analyses were conducted, which revealed significant overlapping deficits in the ability to identify facial emotions and infer the mental states of others in both BPD and SUD. Further, people with BPD displayed a higher ostracism effect following perceived social exclusion. Systematically reviewed studies also revealed significant dysfunction amongst individuals with BPD and SUD across both self and other SP constructs, which were broadly similar in magnitude. Taken together, these results support the proposition that SP dysfunction may be considered a core transdiagnostic phenotype of BPD and SUD.
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  • 文章类型: Journal Article
    在撰写本文时,有一千多个以功能磁共振成像(fMRI)作为结局指标的试验已在clinicaltrials.gov中注册。然而,这些已注册的试验中有93%仍未完成已发表的结果,并且没有关于这些正在进行的以功能磁共振成像作为结局指标的试验的方法学维度的图片。
    我们于2018年10月13日在ClinicalTrials.gov注册表中收集了使用功能磁共振成像作为结果测量的试验,并审查了每个试验的记录条目。提取并总结合格试验的特征。
    总共,确定了1,386项临床试验,在其结果测量中报告了fMRI,其中33%的fMRI是唯一的主要结果。82%的fMRI试验是在2011年之后开始的。最常见的干预是药物(药物干预)(29%)。57%的试验采用平行分配设计,20%为交叉分配设计。对于基于任务的功能磁共振成像,基于研究领域标准(RDoC)的认知系统(46%)是最常见的任务领域。不到三分之一的试验(28%)注册了至少一个感兴趣的区域进行分析。食物线索反应性任务,疼痛感知任务,n-back任务,在超过25项注册试验中招募了货币激励延迟任务。
    具有任务和休息方案的fMRI试验(fMRI作为结果测量)的数量正在快速增长。我们的研究表明,在临床试验中对基于fMRI的结果进行预注册的方法和分析的协调和标准化清单的需求日益增加。
    More than one-thousand trials with functional magnetic resonance imaging (fMRI) as an outcome measure were registered in clinicaltrials.gov at the time of writing this article. However, 93% of these registered trials are still not completed with published results and there is no picture available about methodological dimensions of these ongoing trials with fMRI as an outcome measure.
    We collected trials that use fMRI as an outcome measure in the ClinicalTrials.gov registry on 13 October 2018 and reviewed each trial\'s record entry. Eligible trials\' characteristics were extracted and summarized.
    In total, 1,386 clinical trials were identified that reported fMRI in their outcome measures with fMRI as the only primary outcome in 33% of them. 82% of fMRI trials were started after 2011. The most frequent intervention was drug (pharmacological intervention) (29%). 57% of trials had parallel assignment design and 20% were designed for cross-over assignment. For task-based fMRI, cognitive systems (46%) based on Research Domain Criteria (RDoC) was the most frequent domain of tasks. Less than one-third of trials (28%) registered at least one region of interest for their analysis. Food cue reactivity task, pain perception task, n-back task, and monetary incentive delay task were recruited in more than 25 registered trials.
    The number of fMRI trials (fMRI as an outcome measure) with both task and rest protocols is growing rapidly. Our study suggests a growing need for harmonization and standardized checklists on both methods and analysis for preregistration of fMRI-based outcomes in clinical trials.
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  • 文章类型: Journal Article
    自杀行为的风险可能在整个月经周期中波动。这里,我们使用RDoC框架审查了该周期可能增加急性自杀风险的潜在机制.
    月经周期影响大多数与自杀风险相关的RDoC结构,尤其是对激素敏感的女性,如患有经前烦躁不安症或精神病的经前恶化者。尽管如此,没有发表的研究检查自杀意念,规划,或在整个周期中纵向的行为。需要更多的工作来了解激素敏感性如何与特质和状态自杀风险有关。建议通过特定的RDoC机制对周期性激素对自杀风险的影响进行深入的多水平调查。这是一个肥沃的研究领域,可能提供有关急性自杀风险机制的关键见解。
    Risk for suicidal behavior may fluctuate across the menstrual cycle. Here, we use the RDoC framework to review potential mechanisms by which the cycle may increase acute suicide risk.
    The menstrual cycle impacts the majority of RDoC constructs linked to suicide risk, particularly among hormone-sensitive women, such as those with premenstrual dysphoric disorder or premenstrual exacerbation of a psychiatric disorder. Despite this, there are no published studies examining suicidal ideation, planning, or behavior longitudinally across the cycle. More work is needed to understand how hormone sensitivity may relate to both trait and state suicide risk. Intensive multilevel investigations of cyclical hormone effects on suicide risk through specific RDoC mechanisms are suggested. This is a fertile research area and may provide key insights regarding the mechanisms of acute suicide risk.
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  • 文章类型: Review
    异质性是所有精神疾病的关键特征,表现在许多层面上,包括症状,病程,和生物基础。这些构成了理解疾病机制和发展有效的实质性障碍,个性化治疗。作为回应,许多研究旨在对精神疾病进行分层,旨在根据多种类型的数据找到更一致的子组。在最近的研究举措之后,这种方法重新受到关注,如国家心理健康研究所领域标准和欧洲心理健康研究路线图,两者都强调找到基于生物系统和跨越当前分类的分层。我们首先介绍对精神疾病进行分层的基本概念,然后对现有文献进行方法论导向和批判性审查。这表明,旨在将临床人群细分为更连贯的亚组的主要聚类方法做出了有用的贡献,但在很大程度上取决于所使用的数据类型;它产生了许多不同的方法来对我们所审查的疾病进行分组,但是对于大多数疾病来说,它并没有聚集在一组一致的亚组上。我们强调了当前方法尚未得到广泛认可的问题,并讨论了验证的重要性,以确保派生的亚组索引临床相关的变异。最后,我们回顾了新兴的技术,例如评估生物学和行为之间映射的规范模型的技术,这些技术提供了新的方法来解析潜在的异质性精神疾病,并评估所有方法以满足美国国家心理健康研究所领域标准和心理健康研究路线图等目标.
    Heterogeneity is a key feature of all psychiatric disorders that manifests on many levels, including symptoms, disease course, and biological underpinnings. These form a substantial barrier to understanding disease mechanisms and developing effective, personalized treatments. In response, many studies have aimed to stratify psychiatric disorders, aiming to find more consistent subgroups on the basis of many types of data. Such approaches have received renewed interest after recent research initiatives, such as the National Institute of Mental Health Research Domain Criteria and the European Roadmap for Mental Health Research, both of which emphasize finding stratifications that are based on biological systems and that cut across current classifications. We first introduce the basic concepts for stratifying psychiatric disorders and then provide a methodologically oriented and critical review of the existing literature. This shows that the predominant clustering approach that aims to subdivide clinical populations into more coherent subgroups has made a useful contribution but is heavily dependent on the type of data used; it has produced many different ways to subgroup the disorders we review, but for most disorders it has not converged on a consistent set of subgroups. We highlight problems with current approaches that are not widely recognized and discuss the importance of validation to ensure that the derived subgroups index clinically relevant variation. Finally, we review emerging techniques-such as those that estimate normative models for mappings between biology and behavior-that provide new ways to parse the heterogeneity underlying psychiatric disorders and evaluate all methods to meeting the objectives of such as the National Institute of Mental Health Research Domain Criteria and Roadmap for Mental Health Research.
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  • 文章类型: Journal Article
    Reduced capacity to cognitively regulate emotional responses is a common impairment across major neuropsychiatric disorders. Brain systems supporting one such strategy, cognitive reappraisal of emotion, have been investigated extensively in the healthy population, a research focus that has led to influential meta-analyses and literature reviews. However, the emerging literature on neural substrates underlying cognitive reappraisal in clinical populations is yet to be systematically reviewed. Therefore, the goal of the current review was to summarize the literature on cognitive reappraisal and highlight common and distinct neural correlates of impaired emotion regulation in clinical populations. We performed a two-stage systematic literature search, selecting 32 studies on cognitive reappraisal in individuals with mood disorders (n=12), anxiety disorders (n=14), addiction (n=2), schizophrenia (n=2), and personality disorders (n=5). Comparing findings across these disorders allowed us to determine underlying mechanisms that were either disorder-specific or common across disorders. Results showed that across clinical populations, individuals consistently demonstrated reduced recruitment of the ventrolateral prefrontal cortex (vlPFC) and dorsolateral prefrontal cortex (dlPFC) during downregulation of negative emotion, indicating that there may be a core deficit in selection, manipulation and inhibition during reappraisal. Further, in individuals with mood disorders, amygdala responses were enhanced during downregulation of emotion, suggesting hyperactive bottom-up responses or reduced modulatory capacity. In individuals with anxiety disorders, however, emotion regulation revealed reduced activity in the dorsal anterior cingulate cortex (dACC) and inferior/superior parietal cortex, possibly indicating a deficit in allocation of attention. The reviewed studies thus provide evidence for both disorder-specific and common deficits across clinical populations. These findings highlight the role of distinct neural substrates as targets for developing/assessing novel therapeutic approaches that are geared towards cognitive regulation of emotion, as well as the importance of transdiagnostic research to identify both disorder specific and core mechanisms.
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  • 文章类型: Journal Article
    In 2009, the U.S. National Institute of Mental Health (NIMH) proposed an approach toward the deconstruction of psychiatric nosology under the research domain criteria (RDoC) framework. The overarching goal of RDoC is to identify robust, objective measures of behavior, emotion, cognition, and other domains that are more closely related to neurobiology than are diagnoses. A preliminary framework has been constructed, which has connected molecules, genes, brain circuits, behaviors, and other elements to dimensional psychiatric constructs. Although the RDoC framework has salience in emerging studies, foundational literature that pre-dated this framework requires synthesis and translation to the evolving objectives and nomenclature of RDoC. Toward this end, we review the candidate-gene association, linkage, and genome-wide studies that have implicated a variety of loci and genetic polymorphisms in selected Positive Valence Systems (PVS) constructs. Our goal is to review supporting evidence to currently listed genes implicated in this domain and novel candidates. We systematically searched and reviewed literature based on keywords listed under the June, 2011, edition of the PVS matrix on the RDoC website (http://www.nimh.nih.gov/research-priorities/rdoc/positive-valence-systems-workshop-proceedings.shtml), which were supplemented with de novo keywords pertinent to the scope of our review. Several candidate genes linked to the PVS framework were identified from candidate-gene association studies. We also identified novel candidates with loose association to PVS traits from genome-wide studies. There is strong evidence suggesting that PVS constructs, as currently conceptualized under the RDoC initiative, index genetically influenced traits; however, future research, including genetic epidemiological, and psychometric analyses, must be performed.
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