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管理精神病理学中的临床异质性:脑研究的观点。

Managing clinical heterogeneity in psychopathology: Perspectives from brain research.

机构信息

Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas.

Department of Psychology, Northwestern University.

出版信息

J Psychopathol Clin Sci. 2024 Nov;133(8):599-604. doi: 10.1037/abn0000949.

Abstract

Clinical heterogeneity is a significant factor to contend with when seeking to organize, understand, and treat psychopathology. In recent years, the field has prioritized efforts to minimize nonmeaningful heterogeneity and leverage meaningful heterogeneity to improve assessment and diagnostics, inform mechanistic understanding, and facilitate the development of novel treatments. Indeed, exciting developments such as the National Institute for Mental Health Research Domain Criteria and the Hierarchical Taxonomy of Psychopathology have provided powerful frameworks for facing clinical complexity. While these developments have spurred many advancements, the movement has yet to effectively harness the tremendous potential provided by the brain. Initial work incorporating brain data has focused on validating clinical observations with a biomarker rather than leveraging the brain to provide unique insight into meaningful clinical heterogeneity. To provide future guidance and examples of innovation in the area, we solicited articles from teams seeking to utilize brain research to manage clinical heterogeneity. The search resulted in a diverse illustration of how best to leverage brain data to greater mechanistic understanding and clinical utility. In this introduction, we consider this work and discuss strategies through which brain data can best be used to provide unique insight into clinical heterogeneity. As the science of psychopathology continues to grapple with the promise and costs inherent in utilizing this powerful and complex array of methodologies, it will be important to leverage unique insights from brain science. This special issue provides a useful guide for new and upcoming work and a catalyst for moving the field forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

临床异质性是在组织、理解和治疗精神病理学时需要应对的一个重要因素。近年来,该领域已优先努力减少无意义的异质性,并利用有意义的异质性来改善评估和诊断、增进对机制的理解,并促进新的治疗方法的发展。事实上,令人兴奋的发展,如国家心理健康研究所研究领域标准和精神病理学分层分类法,为应对临床复杂性提供了强大的框架。虽然这些发展推动了许多进展,但该领域尚未有效地利用大脑提供的巨大潜力。最初的工作是将大脑数据与生物标志物相结合,以验证临床观察结果,而不是利用大脑提供对有意义的临床异质性的独特见解。为了为该领域的未来提供指导和创新范例,我们向寻求利用大脑研究来管理临床异质性的团队征集文章。搜索结果展示了如何最好地利用大脑数据来提高对机制的理解和临床实用性的多样性。在这篇介绍中,我们考虑了这项工作,并讨论了利用大脑数据提供对临床异质性的独特见解的最佳策略。随着精神病理学科学继续应对利用这种强大而复杂的方法学所固有的承诺和成本,利用大脑科学的独特见解将非常重要。本期特刊为新的和即将到来的工作提供了有用的指南,并为推动该领域的发展提供了催化剂。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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