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研究领域标准(RDoC)能否帮助梳理思维紊乱?

Can RDoC Help Find Order in Thought Disorder?

作者信息

Cohen Alex S, Le Thanh P, Fedechko Taylor L, Elvevåg Brita

机构信息

Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.

Department of Clinical Medicine, University of Tromsø-The Arctic University of Norway, Norway.

出版信息

Schizophr Bull. 2017 May 1;43(3):503-508. doi: 10.1093/schbul/sbx030.

Abstract

Thought disorder is a pernicious and nonspecific aspect of numerous serious mental illnesses (SMIs) and related conditions. Despite decades of empirical research on thought disorder, our present understanding of it is poor, our clinical assessments focus on a limited set of extreme behaviors, and treatments are palliative at best. Applying a Research Domain Criteria (RDoC) framework to thought disorder research offers advantages to explicate its phenotype; isolate its mechanisms; and develop more effective assessments, treatments, and potential cures. In this commentary, we discuss ways in which thought disorder can be understood within the RDoC framework. We propose operationalizing thought disorder within the RDoC construct of language using psycholinguistic sciences, to help objectify and quantify language within individuals; technologically sophisticated paradigms, to allow naturalistic behavioral sampling techniques with unprecedented ecological validity; and computational modeling, to account for a network of interconnected and dynamic linguistic, cognitive, affective, and social functions. We also highlight challenges for understanding thought disorder within an RDoC framework. Thought disorder likely does not occur as an isomorphic dysfunction in a single RDoC construct, but rather, as multiple potential dysfunctions in a network of RDoC constructs. Moreover, thought disorder is dynamic over time and context within individuals. In sum, RDoC is a useful framework to integrate multidisciplinary research efforts aimed at operationalizing, understanding, and ameliorating thought disorder.

摘要

思维障碍是众多严重精神疾病(SMIs)及相关病症中有害且非特异性的一个方面。尽管对思维障碍进行了数十年的实证研究,但我们目前对它的理解仍很有限,临床评估集中在有限的一组极端行为上,而且治疗充其量只是姑息性的。将研究领域标准(RDoC)框架应用于思维障碍研究,有助于阐明其表型、分离其机制,并开发更有效的评估、治疗方法及潜在的治愈手段。在这篇评论中,我们讨论了在RDoC框架内理解思维障碍的方法。我们建议利用心理语言学,在RDoC的语言结构中对思维障碍进行操作化,以帮助客观化和量化个体内部的语言;采用技术复杂的范式,以实现具有前所未有的生态效度的自然主义行为抽样技术;运用计算建模,以解释相互关联且动态的语言、认知、情感和社会功能网络。我们还强调了在RDoC框架内理解思维障碍所面临的挑战。思维障碍可能并非以单一RDoC结构中的同构功能障碍形式出现,而是以RDoC结构网络中的多种潜在功能障碍形式出现。此外,思维障碍在个体内部随时间和情境而动态变化。总之,RDoC是一个有用的框架,可整合旨在对思维障碍进行操作化、理解和改善的多学科研究工作。

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