Kaufman Joan, Gelernter Joel, Hudziak James J, Tyrka Audrey R, Coplan Jeremy D
Yale University School of Medicine and Veteran's Administration Connecticut Health Care Center, New Haven, CT; Kennedy Krieger Institute and Johns Hopkins School of Medicine, Baltimore.
Yale University School of Medicine and Veteran's Administration Connecticut Health Care Center, New Haven, CT.
J Am Acad Child Adolesc Psychiatry. 2015 Aug;54(8):617-25. doi: 10.1016/j.jaac.2015.06.001. Epub 2015 Jun 10.
The Research Domain Criteria (RDoC) project was initiated to develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures. This article reviews the rationale behind the RDoC program, its goals, and central tenets; discusses application of an RDoC framework to research with maltreated children; and highlights some clinical implications of this work.
Published RDoC papers were reviewed, together with relevant preclinical and clinical studies that guide our work on risk and resilience in maltreated children.
The ultimate long-term goal of the RDoC initiative is precision medicine in psychiatry. In the interim, the RDoC initiative provides a framework to organize research to help develop the database required to derive a new psychiatric nomenclature that can appropriately match treatments to patients. The primary focus of RDoC is on neural circuitry, with levels of analyses that span from molecules to behavior. There has been some concern that the RDoC framework is reductionist, with an overemphasis on neural circuits and genetics; however, the briefly reviewed, burgeoning literature on neuroplasticity and epigenetics highlights that this concern is unwarranted, as one cannot study neural circuits and genetics without considering experience.
The study of maltreated children has a number of advantages for the RDoC project, including the following: study of a subset of patients who are often not responsive to standard interventions; examination of a relatively homogenous sample with onset of psychopathology proposed to be associated with stress-related mechanisms; and well-established, relevant animal models to facilitate translational research.
开展研究领域标准（RDoC）项目，旨在基于可观察行为维度和神经生物学测量，开发用于研究目的的精神障碍新分类方法。本文回顾了RDoC项目背后的基本原理、目标和核心原则；讨论了RDoC框架在受虐待儿童研究中的应用；并强调了这项工作的一些临床意义。
回顾已发表的RDoC论文，以及指导我们关于受虐待儿童风险和复原力研究的相关临床前和临床研究。
RDoC计划的最终长期目标是精神病学的精准医学。在此过渡阶段，RDoC计划提供了一个组织研究的框架，以帮助开发推导新的精神病学术语所需的数据库，该术语可使治疗与患者适当匹配。RDoC的主要重点是神经回路，分析水平从分子到行为。有人担心RDoC框架是还原论的，过度强调神经回路和遗传学；然而，简要回顾的关于神经可塑性和表观遗传学的新兴文献表明，这种担忧是没有根据的，因为不考虑经验就无法研究神经回路和遗传学。
对受虐待儿童的研究对RDoC项目有诸多优势，包括：研究一组通常对标准干预无反应的患者；检查一个相对同质的样本，其精神病理学发病被认为与应激相关机制有关；以及完善的、相关的动物模型以促进转化研究。
