RDoC

RDoC
  • 文章类型: Journal Article
    背景:精神疾病传统上属于诊断类别,但是这种方法有局限性。研究领域标准(RDoC)构成了基于跨越这些精神病学诊断的领域内的维度的精神疾病研究分类系统。RDoC的总体目标是更好地了解基础神经生物学和行为系统功能障碍方面的精神疾病,导致更好的诊断,预防和治疗。
    方法:独特的脑电图(EEG)特征,称为纺锤过度β(SEB),已经研究了与冲动控制和睡眠有关的问题,作为唤醒/调节系统RDoC域的一部分。这里,我们研究了脑电图额叶β活性作为一种潜在的诊断生物标志物,能够诊断和预测冲动控制和睡眠问题.
    结果:我们在第一个数据集(n=3279)中显示具有SEB的概率,由深度学习算法分类,与不良的睡眠维持和低的白天冲动控制有关。此外,另外两个,独立数据集(iSPOT-A,n=336;iSPOT-D,n=1008),我们揭示了传统的额中央β功率和/或SEB概率,被称为Brainmarker-III,与注意力缺陷多动障碍(ADHD)的诊断有关,以性别特异性方式缓解多动症儿童的哌醋甲酯,并以药物特异性方式缓解患有重度抑郁症的成年人的抗抑郁药物。
    结论:我们的结果证明了RDoC方法在精神病学研究中发现具有诊断和治疗预测能力的生物标志物的价值。
    BACKGROUND: Psychiatric disorders are traditionally classified within diagnostic categories, but this approach has limitations. Research Domain Criteria (RDoC) constitute a research classification system for psychiatric disorders based on dimensions within domains that cut across these psychiatric diagnoses. The overall aim of RDoC is to better understand mental illness in terms of dysfunction in fundamental neurobiological and behavioral systems, leading to better diagnosis, prevention and treatment.
    METHODS: A unique electroencephalographic (EEG) feature, referred to as spindling excessive beta (SEB), has been studied in relation to impulse control and sleep, as part of the arousal/regulatory systems RDoC domain. Here, we study EEG frontal beta activity as a potential transdiagnostic biomarker capable of diagnosing and predicting impulse control and sleep problems.
    RESULTS: We show in the first dataset (n=3279) that the probability of having SEB, classified by a deep learning algorithm, is associated with poor sleep maintenance and low daytime impulse control. Furthermore, in two additional, independent datasets (iSPOT-A, n=336; iSPOT-D, n=1008), we revealed that conventional frontocentral beta power and/or SEB probability, referred to as Brainmarker-III, is associated with a diagnosis of attention deficit hyperactivity disorder (ADHD), with remission to methylphenidate in children with ADHD in a sex-specific manner, and with remission to antidepressant medication in adults with a major depressive disorder in a drug-specific manner.
    CONCLUSIONS: Our results demonstrate the value of the RDoC approach in psychiatry research for the discovery of biomarkers with diagnostic and treatment prediction capacities.
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  • 文章类型: Journal Article
    目的:临床上焦虑的年轻人对情绪刺激过度警惕,难以将注意力从情绪刺激转移到非情绪刺激,提示认知控制对情绪的损害。然而,目前尚不清楚这种偏倚的神经底物是否在焦虑的临床与非临床范围内变化,还是因年龄而异.
    方法:7-17岁有临床焦虑(N=119)或没有焦虑诊断(N=41)的青少年在磁共振成像过程中与情绪面部干扰物匹配的情绪面部或匹配的形状,探测情绪处理和对情绪的认知控制,分别。从国家精神卫生研究所的研究领域标准框架构建,临床焦虑的年轻人被纳入诊断类别,在最小至亚临床严重程度范围内对未受临床影响的青少年进行采样.
    结果:在这两种情况下,与右下顶叶过度激活相关的焦虑严重程度,高度警惕的基质。大脑焦虑的关联也通过注意状态来区分;焦虑的严重程度与情绪处理(面部匹配)过程中左腹外侧前额叶皮层的更大激活以及在认知控制情绪(形状匹配)过程中左上颞沟和颞顶交界处的更大激活(以及较慢的反应)相关。年龄也调节了焦虑和对情绪的认知控制之间的关联,因此,对于年龄较小和平均年龄的儿童,焦虑与更大的右丘脑和双侧后扣带皮质激活相关,但不适合年长的年轻人。
    结论:大脑区域的异常功能与刺激驱动的对情绪分散者的注意力有关,可能会导致青少年焦虑。结果支持针对发育阶段量身定制的焦虑注意力调节干预措施的潜在效用。
    OBJECTIVE: Clinically anxious youth are hypervigilant to emotional stimuli and display difficulty shifting attention from emotional to nonemotional stimuli, suggesting impairments in cognitive control over emotion. However, it is unknown whether the neural substrates of such biases vary across the clinical-to-nonclinical range of anxiety or by age.
    METHODS: Youth aged 7 to 17 years with clinical anxiety (n = 119) or without an anxiety diagnosis (n = 41) matched emotional faces or matched shapes flanked by emotional face distractors during magnetic resonance imaging, probing emotion processing and cognitive control over emotion, respectively. Building from the National Institute of Mental Health Research Domain Criteria (RDoC) framework, clinically anxious youth were sampled across diagnostic categories, and non-clinically affected youth were sampled across minimal-to-subclinical severity.
    RESULTS: Across both conditions, anxiety severity was associated with hyperactivation in the right inferior parietal lobe, a substrate of hypervigilance. Brain-anxiety associations were also differentiated by attentional state; anxiety severity was associated with greater left ventrolateral prefrontal cortex activation during emotion processing (face matching) and greater activation in the left posterior superior temporal sulcus and temporoparietal junction (and slower responses) during cognitive control over emotion (shape matching). Age also moderated associations between anxiety and cognitive control over emotion, such that anxiety was associated with greater right thalamus and bilateral posterior cingulate cortex activation for children at younger and mean ages, but not for older youth.
    CONCLUSIONS: Aberrant function in brain regions implicated in stimulus-driven attention to emotional distractors may contribute to anxiety in youth. Results support the potential utility of attention modulation interventions for anxiety that are tailored to developmental stage.
    BACKGROUND: Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety; https://clinicaltrials.gov; NCT02810171.
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  • 文章类型: Journal Article
    压力源可以引发中枢和外周变化的级联反应,调节中皮质边缘多巴胺能回路,最终,对奖励的行为反应。由于缺乏关于这一主题的确凿证据和研究领域标准框架,采用随机效应荟萃分析来量化急性应激源对奖励反应的影响,估价,在啮齿动物和人类科目中学习。在啮齿动物中,急性压力降低了奖励反应性(g=-1.43)和估值(g=-0.32),同时放大奖励学习(g=1.17)。在人类中,急性应激对估值有边际效应(g=0.25),而不影响反应能力和学习。适度分析表明,急性压力对啮齿动物和人类的奖励处理都没有统一影响,并且压力源的持续时间和奖励体验的特异性(即,食物与药物)可能在质量和数量上产生不同的行为终点。亚组分析未能减少异质性,which,加上出版偏见的存在,对可以得出的结论持谨慎态度,并指出需要指导该领域未来研究的开展。
    Stressors can initiate a cascade of central and peripheral changes that modulate mesocorticolimbic dopaminergic circuits and, ultimately, behavioral response to rewards. Driven by the absence of conclusive evidence on this topic and the Research Domain Criteria framework, random-effects meta-analyses were adopted to quantify the effects of acute stressors on reward responsiveness, valuation, and learning in rodent and human subjects. In rodents, acute stress reduced reward responsiveness (g = -1.43) and valuation (g = -0.32), while amplifying reward learning (g = 1.17). In humans, acute stress had marginal effects on valuation (g = 0.25), without affecting responsiveness and learning. Moderation analyses suggest that acute stress neither has unitary effects on reward processing in rodents nor in humans and that the duration of the stressor and specificity of reward experience (i.e., food vs drugs) may produce qualitatively and quantitatively different behavioral endpoints. Subgroup analyses failed to reduce heterogeneity, which, together with the presence of publication bias, pose caution on the conclusions that can be drawn and point to the need of guidelines for the conduction of future studies in the field.
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  • 文章类型: Journal Article
    感知生物运动(BM)对于人类生存和社会交往至关重要。许多研究报道了自闭症谱系障碍的BM感知受损,其特点是社会互动不足。患有注意力缺陷多动障碍(ADHD)的儿童通常在社交互动中表现出类似的困难。然而,很少有研究调查患有ADHD的儿童的BM感知。这里,我们比较了处理局部运动学和全局构型线索的能力差异,BM感知的两个基本能力,在典型的发展和多动症儿童之间。我们进一步调查了使用社会反应量表测量的BM感知和社交互动技能之间的关系,并检查了潜在因素的贡献(例如性别,年龄,注意,和智力)到BM感知。结果显示,患有ADHD的儿童表现出非典型的BM感知。局部和全局BM处理显示出明显的特征。本地BM处理能力与社交互动技能有关,而全球BM加工能力随着年龄的增长而显著提高。严重的,ADHD儿童的一般BM感知(即局部和全局BM处理)可能受到持续注意能力的影响。这种关系主要是由推理智力介导的。这些发现阐明了ADHD中非典型的BM感知以及与BM感知相关的潜在因素。此外,这项研究提供了新的证据,表明BM感知是社会认知的标志,并促进了我们对局部和全局处理在BM感知和社会认知障碍中的潜在作用的理解.
    Perceiving biological motion (BM) is crucial for human survival and social interaction. Many studies have reported impaired BM perception in autism spectrum disorder, which is characterised by deficits in social interaction. Children with attention deficit hyperactivity disorder (ADHD) often exhibit similar difficulties in social interaction. However, few studies have investigated BM perception in children with ADHD. Here, we compared differences in the ability to process local kinematic and global configurational cues, two fundamental abilities of BM perception, between typically developing and ADHD children. We further investigated the relationship between BM perception and social interaction skills measured using the Social Responsiveness Scale and examined the contributions of latent factors (e.g. sex, age, attention, and intelligence) to BM perception. The results revealed that children with ADHD exhibited atypical BM perception. Local and global BM processing showed distinct features. Local BM processing ability was related to social interaction skills, whereas global BM processing ability significantly improved with age. Critically, general BM perception (i.e. both local and global BM processing) may be affected by sustained attentional ability in children with ADHD. This relationship was primarily mediated by reasoning intelligence. These findings elucidate atypical BM perception in ADHD and the latent factors related to BM perception. Moreover, this study provides new evidence that BM perception is a hallmark of social cognition and advances our understanding of the potential roles of local and global processing in BM perception and social cognitive disorders.
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  • 文章类型: Journal Article
    与没有NDC的个体的兄弟姐妹相比,患有神经发育疾病(NDC)的个体的兄弟姐妹经历了不同的挑战,并且具有独特的优势。本研究检查了有或没有神经发育疾病的个体的兄弟姐妹的属性和愿望,并分析了增长心态的定性反应和定量测量之间的关系,正价和负价,和心理健康诊断。采用了一种新颖的混合方法进行主题分析,以探索166个兄弟姐妹(75个NDC和91个对照,年龄在14-26岁之间,女性占66.27%)完成了一项在线调查,这是一项有关兄弟姐妹心理健康的大型研究的一部分。总体主题描述了自我实现和整合的过程,反映了兄弟姐妹在心理挑战中寻求了解自己和他人的旅程。它包含三个子主题:个人成长和身份形成;联系和归属;社会视角和全球意识。在研究领域标准(RDoC)框架内分析了定性响应,以及现象学和心理健康诊断之间的关联。NDC兄弟姐妹的反应中嵌入了较高的负价和较低的正价,和定量较低的自我报告的成长心态(即,关于个人成长能力的信念),与对照兄弟姐妹相比,这与自我报告的心理健康诊断相关。研究结果表明,临床实践可能专注于优化自我识别的优势,并为自我实现希望和抱负提供机会。同时为家庭提供支持,以减轻影响心理健康的生物生态因素。
    Siblings of individuals with neurodevelopmental conditions (NDCs) experience distinct challenges and have unique strengths compared to siblings of individuals without NDCs. The present study examined attributes and aspirations of siblings of individuals with and without neurodevelopmental conditions, and analyzed the association between qualitative responses and quantitative measures of growth mindset, positive and negative valence, and mental health diagnoses. A novel mixed methods thematic analysis was employed to explore the experiences of 166 siblings (75 NDC and 91 controls, aged 14-26, 66.27% female) completing an online survey as part of a larger study on sibling mental health. The overarching theme described The Process of Self-Actualization and Integration, reflecting the journey siblings undergo in seeking to understand themselves and others amidst psychological challenges. It encompassed three subthemes: Personal Growth and Identity Formation; Connection and Belonginess; and Societal Perspective and Global Consciousness. Qualitative responses were analyzed within a Research Domain Criteria (RDoC) framework, and associations between phenomenology and mental health diagnoses examined. NDC siblings had higher negative valence and lower positive valence embedded in their responses, and quantitatively lower self-reported growth mindset (i.e., beliefs about the capacity for personal growth), compared to control siblings, which correlated with self-reported mental health diagnoses. Findings suggest clinical practice may focus on optimizing self-identified strengths and offer opportunities for self-actualization of hopes and ambitions, while providing support for families to attenuate bioecological factors impacting mental health.
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  • 文章类型: Journal Article
    女性与压力相关的精神疾病如抑郁和焦虑的发生率增加了两倍,但是这种易感性增加的机制仍未完全了解。女性受试者在历史上被排除在临床前研究和临床试验之外。此外,在动物模型中用于研究精神病理学的慢性应激范式是为男性开发的。然而,NIH政策的最新变化鼓励女性受试者的纳入,近年来,已经进行了大量的工作来了解生物学上的性别差异,这些差异可能是与慢性压力相关的精神疾病易感性差异的基础。我们在这里回顾了使用NIH研究领域标准的框架作为一种跨诊断方法来研究慢性应激啮齿动物模型中的性别差异的效用以及当前的挑战,包括神经行为领域性别差异研究的最新进展。正价,认知,社会进程,唤醒,和社会进程。
    Women have a 2-fold increased rate of stress-associated psychiatric disorders such as depression and anxiety, but the mechanisms that underlie this increased susceptibility remain incompletely understood. Historically, female subjects were excluded from preclinical studies and clinical trials. Additionally, chronic stress paradigms used to study psychiatric pathology in animal models were developed for use in males. However, recent changes in National Institutes of Health policy encourage inclusion of female subjects, and considerable work has been performed in recent years to understand biological sex differences that may underlie differences in susceptibility to chronic stress-associated psychiatric conditions. Here, we review the utility as well as current challenges of using the framework of the National Institute of Mental Health\'s Research Domain Criteria as a transdiagnostic approach to study sex differences in rodent models of chronic stress including recent progress in the study of sex differences in the neurobehavioral domains of negative valence, positive valence, cognition, social processes, and arousal.
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  • 文章类型: Journal Article
    面部认知的包容性测试是否可以达到或超过突出的包容性较小测试的心理测量特性?在这里,我们规范并验证了有影响力的“在眼睛测试中阅读心灵”(RMET)的更新版本,一种临床上重要的神经精神病学范式,长期以来一直用于评估心理和社会认知理论。不像RMET,我们的多种族阅读眼睛测试(MRMET)包含种族包容性的刺激,非性别答案选择,地面真相引用的答案,和更容易理解的词汇。我们展示,通过一系列大型数据集,MRMET在主要心理测量指数中达到或超过RMET。此外,两个测试捕获的可靠信号在统计上无法区分,完全互换性的证据。因此,我们提出的MRMET作为一个高质量的,包容性,规范和验证的替代RMET,作为一个例子,面部认知的心理测量测试中的包容性是一个可以实现的目标。MRMET测试以及我们的规范和验证数据集可在osf.io/ahq6n的CC-BY-SA4.0许可下公开获得。
    Can an inclusive test of face cognition meet or exceed the psychometric properties of a prominent less inclusive test? Here, we norm and validate an updated version of the influential Reading the Mind in the Eyes Test (RMET), a clinically significant neuropsychiatric paradigm that has long been used to assess theory of mind and social cognition. Unlike the RMET, our Multiracial Reading the Mind in the Eyes Test (MRMET) incorporates racially inclusive stimuli, nongendered answer choices, ground-truth referenced answers, and more accessible vocabulary. We show, via a series of large datasets, that the MRMET meets or exceeds RMET across major psychometric indices. Moreover, the reliable signal captured by the two tests is statistically indistinguishable, evidence for full interchangeability. We thus present the MRMET as a high-quality, inclusive, normed and validated alternative to the RMET, and as a case in point that inclusivity in psychometric tests of face cognition is an achievable aim. The MRMET test and our normative and validation data sets are openly available under a CC-BY-SA 4.0 license at osf.io/ahq6n.
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  • 文章类型: Journal Article
    本文从Fowles(1980)的角度出发,重点研究了JeffreyGray的焦虑理论,他的作品在唤醒理论中的应用,心理生理学,以及精神病的病因.虽然影响很大,一般唤醒的概念在采用多种生理测量的个体间评估方面未能得到支持.格雷构建了一个调节焦虑的行为抑制系统(BIS),激励行为以接近奖励的行为方法或激活系统(BAS),和一个非特定的唤醒系统,激励行为捕捉唤醒的各个方面。Fowles(1980)提出BIS引发皮肤电活动以应对威胁,BAS增加心率以响应奖励激励线索,精神病与BIS弱有关。本文回顾了格雷对这些主题未来研究的影响,包括与国家精神卫生研究所研究领域标准相关的早期建议。最后,本文总结了自1980年以来精神病病因学理论的演变,并指出了格雷理论在精神病研究中仍然存在的方面。帕特里克的三方模型已经成为精神病的主要理论。Beauchaine的注意缺陷多动障碍的特质冲动理论也是相关的。
    This paper focuses on Jeffrey Gray\'s theory of anxiety from the perspective of Fowles\' (1980) application of his work to theories of arousal, psychophysiology, and the etiology of psychopathy. Although highly influential, the concept of general arousal failed to find support in terms of between-individuals assessment with multiple physiological measures. Gray\'s constructs of a behavioral inhibition system (BIS) that mediates anxiety, a behavioral approach or activation system (BAS) that energizes behavior to approach rewards, and a nonspecific arousal system that energizes behavior captured aspects of arousal. Fowles (1980) proposed that the BIS elicits electrodermal activity in response to threats, the BAS increases heart rate in response to reward incentive cues, and psychopathy is associated with a weak BIS. The paper reviews Gray\'s impact on future research on these topics, including early proposals relevant to the National Institute of Mental Health\'s Research Domain Criteria. Finally, the paper summarizes the evolution of theories of the etiology of psychopathy since 1980, noting ways in which aspects of Gray\'s theory are still seen in psychopathy research. Patrick\'s triarchic model has emerged as a major theory of psychopathy. Beauchaine\'s trait impulsivity theory of Attention Deficit Hyperactivity Disorder also is relevant.
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  • 文章类型: Journal Article
    越来越多的共识是,诊断标签不足以描述个别儿童的精神病概况,更不用说告知干预措施的精确组合,这些干预措施将在特定儿童的发育过程中最小化风险的影响和/或增强保护因素。此外,对与精神病理学相关的神经生物学和遗传机制的研究揭示了相当大的交叉诊断重叠,破坏了提出风险与精神疾病1:1关系的模型的有效性。因此,最近的出版物提倡利用基于特征的测量的神经发育模型,以及越来越重视生物和经验机制的整合。尽管越来越多的文献支持这种概念转变,实际影响尚不清楚。在本期特刊中,我们编写了一系列新颖的实证研究论文,并回顾了RDoC框架的跨诊断原则。
    There is growing consensus that diagnostic labels are insufficient to describe the individual child\'s psychiatric profile, much less inform the precise combination of interventions that will minimize the impact of risk and/or bolster protective factors over the course of a particular child\'s development. Moreover, investigations of neurobiological and genetic mechanisms associated with psychopathology have revealed considerable cross-diagnostic overlap, undermining the validity of models that propose a 1:1 relationship between risk and psychiatric disorder. Accordingly, recent publications have advocated for neurodevelopmental models that utilize trait-based measurement, as well as increased emphasis on integration of biological and experiential mechanisms. Despite an expanding body of literature supporting this conceptual shift, the practical implications remain unclear. In this special issue, we compile a collection of novel empirical research papers and reviews that build on the trans-diagnostic principles of the RDoC framework.
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  • 文章类型: English Abstract
    The routine in-depth characterization of patients with methods of clinical and scale-based examination, neuropsychology, based on biomaterials, and sensor-based information opens up transformative possibilities on the way to personalized diagnostics, treatment and prevention in psychiatry, psychotherapy, and psychosomatics. Effective integration of the additional temporal and logistical effort into everyday care as well as the acceptance by patients are critical to the success of such an approach but there is little evidence on this to date. We report here on the establishment of the Diagnosis and Admission Center (DAZ) at the Central Institute of Mental Health (ZI) in Mannheim. The DAZ is an outpatient unit upstream of other care structures for clinical and scientific phenotyping across diagnoses as a starting point for data-driven, individualized pathways to further treatment, diagnostics or research. We describe the functions, goals, and implementation of the newly created clinical scientific translational structure, provide an overview of the patient populations it has reached, and provide data on its acceptance. In this context, the close integration with downstream clinical processes enables a better coordinated and demand-oriented allocation. In addition, DAZ enables a faster start of disorder-specific diagnostics and treatment. Since its launch in April 2021 up to the end of 2022, 1021 patients underwent psychiatric evaluation at DAZ during a pilot phase. The patient sample corresponded to a representative sample from standard care and the newly established processes were regarded as helpful by patients. In summary, the DAZ uniquely combines the interests and needs of patient with the collection of scientifically relevant data.
    UNASSIGNED: Die routinemäßige, tiefgreifende Charakterisierung von Patienten mit Methoden der klinischen und skalenbasierten Untersuchung, der Neuropsychologie, anhand von Biomaterialien und sensorbasierten Informationen verspricht transformative Möglichkeiten auf dem Weg zu einer personalisierten Diagnostik, Therapie und Prävention in der Psychiatrie, Psychotherapie und Psychosomatik. Die effektive Integration des zusätzlichen zeitlichen und logistischen Aufwands in den Versorgungsalltag sowie die Akzeptanz bei Patienten sind entscheidend für den Erfolg eines solchen Ansatzes, hierzu liegen jedoch bisher kaum Daten vor. Wir berichten hier über die Etablierung eines Diagnose- und Aufnahmezentrums (DAZ) am Zentralinstitut für Seelische Gesundheit (ZI) in Mannheim. Beim DAZ handelt es sich um eine den anderen Versorgungstrukturen vorgeschaltete ambulante Einheit zur klinischen und wissenschaftlichen diagnoseübergreifenden Phänotypisierung als Ausgangsbasis für eine datenunterstützte, individuelle Bahnung der weiteren Behandlungs‑, Diagnostik- oder Studienpfade. Wir beschreiben die Funktionen, Ziele und Implementierung der neu geschaffenen klinisch-wissenschaftlich translationalen Struktur, geben einen Überblick über die damit erreichten Patientenpopulationen und liefern Daten zur Akzeptanz. Die enge Verzahnung mit den nachgelagerten klinischen Prozessen ermöglicht dabei eine besser abgestimmte und bedarfsorientierte Zuweisung und einen schnelleren Beginn der störungsspezifischen Diagnostik und Therapie. Seit dem Start im April 2021 bis Ende 2022 wurden in einer Pilotphase 1021 Patienten im DAZ psychiatrisch untersucht. Die Patientenklientel entsprach dabei einer repräsentativen Stichprobe aus der Regelversorgung und die neu etablierten Prozesse wurden von Patienten als hilfreich erlebt. Zusammenfassend verknüpft das DAZ somit in hohem Maße Interessen und Bedürfnisse der Patienten mit der Erhebung wissenschaftlich relevanter Daten.
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