Yager Joel, Feinstein Robert E
Department of Psychiatry, MC A011-04, University of Colorado School of Medicine, 13001 East 17th Pl, Aurora, CO 80045.
Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA.
J Clin Psychiatry. 2017 Apr;78(4):423-432. doi: 10.4088/JCP.15nr10476.
Offering a new framework for understanding and studying basic dimensions of normal and abnormal human functioning and mental disorders, the National Institute of Mental Health (NIMH) has initiated the Research Domain Criteria (RDoC) project in which a series of higher order domains, representing major systems of emotion, cognition, motivation, and social behavior, and their constituent operationally defined constructs serve as organizing templates for further research and inquiry, eg, to discover validated biomarkers and endophenotypes. Cutting across traditional DSM diagnoses, the domains are defined as Negative Valence Systems, Positive Valence Systems, Cognitive Systems, Systems for Social Processes, and Arousal/Regulatory Systems. To inform educators, trainees, and practitioners about RDoC, alert them to potential practical applications, and encourage their broad exploration in clinical settings, this article reviews the RDoC domains and their subsystem constructs with regard to potential current clinical considerations and applications. We describe ways in which the RDoC domains and constructs offer transdiagnostic frameworks for complementing traditional practice; suggest clinical questions to help elucidate salient information; and, translating RDoC domains and constructs headings into clinically friendly language, offer a template for the psychiatric review of systems that can serve in clinical notes.
美国国立精神卫生研究所(NIMH)提出了一个新的框架,用于理解和研究正常及异常人类功能与精神障碍的基本维度。该研究所启动了研究领域标准(RDoC)项目,其中一系列高阶领域代表了情绪、认知、动机和社会行为的主要系统,及其构成要素的操作性定义结构,作为进一步研究和探索的组织模板,例如发现经过验证的生物标志物和内表型。这些领域跨越传统的《精神疾病诊断与统计手册》(DSM)诊断分类,被定义为负性效价系统、正性效价系统、认知系统、社会过程系统和觉醒/调节系统。为了让教育工作者、受训人员和从业者了解RDoC,提醒他们注意潜在的实际应用,并鼓励他们在临床环境中广泛探索,本文结合当前潜在的临床考量和应用,对RDoC领域及其子系统结构进行了综述。我们描述了RDoC领域和结构为补充传统实践提供跨诊断框架的方式;提出有助于阐明显著信息的临床问题;并将RDoC领域和结构标题翻译成临床友好的语言,提供一个可用于临床记录的精神系统检查模板。