NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Australia.
PLoS One. 2020 Dec 16;15(12):e0243057. doi: 10.1371/journal.pone.0243057. eCollection 2020.
RDoC conceptualises psychopathology as neurobiologically-rooted behavioural psychological "constructs" that span dimensionally from normality to pathology, but its clinical utility remains controversial.
To explore RDoC's potential clinical utility by examining antidepressant effectiveness through Negative Valence Systems (NVS) domain constructs.
A systematic review was conducted on Web of Science, MEDLINE, EMBASE and PsycINFO for antidepressant trials that included psychometric instruments assessed by Watson, Stanton & Clark (2017) to represent NVS constructs of Acute Threat, Potential Threat and Loss.
221 citations were identified; 13 were included in qualitative synthesis, none for quantitative analysis. All suffered from significant bias risks. 9 antidepressants were investigated, most within 1 construct, and most were found to be effective. Paroxetine, citalopram and fluvoxamine were found to be effective for Acute Threat, fluoxetine, desvenlafaxine and sertraline for Potential Threat, and sertraline, fluvoxamine, fluoxetine and desvenlafaxine effective for Loss. Nefazodone was found to be ineffective for acute fear.
Preliminary evidence supports RDoC NVS constructs' clinical utility in assessing antidepressant effectiveness, but lack of discriminant validity between Potential Threat and Loss supports their recombination into a single Distress construct. Finding of effectiveness within "normal" construct levels support the utility of a dimensional approach. Testable hypotheses were generated that can further test RDoC's clinical utility.
RDoC 将精神病理学概念化为具有神经生物学基础的行为心理“结构”，这些结构从正常到病理呈维度分布，但它的临床实用性仍存在争议。
通过研究抗抑郁药对消极价值系统（NVS）领域结构的影响，探索 RDoC 的潜在临床实用性。
在 Web of Science、MEDLINE、EMBASE 和 PsycINFO 上对包括 Watson、Stanton 和 Clark（2017）评估的心理计量工具的抗抑郁试验进行了系统综述，这些工具代表了 NVS 的急性威胁、潜在威胁和损失结构。
确定了 221 条引文；13 条被纳入定性综合分析，没有一条用于定量分析。所有研究都存在严重的偏倚风险。研究了 9 种抗抑郁药，大多数在一个结构内，大多数被发现是有效的。帕罗西汀、西酞普兰和氟伏沙明被发现对急性威胁有效，氟西汀、去甲文拉法辛和舍曲林对潜在威胁有效，舍曲林、氟伏沙明、氟西汀和去甲文拉法辛对损失有效。奈法唑酮被发现对急性恐惧无效。
初步证据支持 RDoC NVS 结构在评估抗抑郁药疗效方面的临床实用性，但潜在威胁和损失之间缺乏判别效度支持将它们重新组合成一个单一的痛苦结构。在“正常”结构水平内发现的有效性支持了维度方法的实用性。生成了可进一步测试 RDoC 临床实用性的可测试假设。
