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RDoC 框架:促进从 ICD/DSM 向整合神经科学和精神病理学的维度方法的转变。

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

机构信息

National Institute of Mental Health, 6001 Executive Blvd., Bethesda, MD, 20892-9632, USA.

出版信息

World Psychiatry. 2014 Feb;13(1):28-35. doi: 10.1002/wps.20087.

Abstract

In 2008, the National Institute of Mental Health (NIMH) included in its new Strategic Plan the following aim: "Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures". The implementation of this aim was named the Research Domain Criteria project, or RDoC. RDoC is a programmatic initiative that will fund grants, contracts, early-phase trials, and similar activities for the purpose of generating studies to build a research literature that can inform future versions of psychiatric nosologies based upon neuroscience and behavioral science rather than descriptive phenomenology. RDoC departs markedly from the DSM and ICD processes, in which extensive workgroup meetings generate final and finely-honed sets of diagnoses that are modified in field tests only if problems with clinical utility arise. Rather, in keeping with its provenance as an experimental system, the RDoC provides a framework for conducting research in terms of fundamental circuit-based behavioral dimensions that cut across traditional diagnostic categories. While an important aim of the project is to validate particular dimensions as useful for eventual clinical work, an equally important goal is to provide information and experience about how to conceive and implement such an alternative approach to future diagnostic practices that can harness genetics and neuroscience in the service of more effective treatment and prevention. This paper summarizes the rationale for the RDoC project, its essential features, and potential methods of transitioning from DSM/ICD categories to dimensionally-oriented designs in research studies.

摘要

2008 年,美国国立精神卫生研究所(NIMH)在其新的战略计划中纳入了以下目标:“为研究目的开发新的方法,根据可观察行为和神经生物学测量的维度对精神障碍进行分类”。该目标的实施被命名为研究领域标准项目(RDoC)。RDoC 是一项计划倡议,将为拨款、合同、早期阶段试验和类似活动提供资金,目的是开展研究,建立一个研究文献,该文献可以根据神经科学和行为科学而不是描述性现象学为未来版本的精神病学分类学提供信息。RDoC 与 DSM 和 ICD 流程明显不同,在后两者中,广泛的工作组会议生成最终和精细调整的诊断集,只有在临床实用性出现问题时才会在现场测试中进行修改。相反,根据其作为实验系统的由来,RDoC 提供了一个框架,用于根据跨越传统诊断类别的基本基于电路的行为维度进行研究。虽然该项目的一个重要目标是验证特定维度作为最终临床工作的有用性,但同样重要的目标是提供有关如何构想和实施这种替代方法的信息和经验,以利用遗传学和神经科学为更有效的治疗和预防服务。本文总结了 RDoC 项目的基本原理、其基本特征以及从 DSM/ICD 类别过渡到研究中面向维度设计的潜在方法。

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