Developing Research Domain Criteria (RDoC) to improve diagnosis and treatment of social deficits in psychiatric disorders: The Mirror Neuron System as a model

摘要

The recent release of the new Diagnostic and Statistical Manual -5 (DSM-5) (American Psychiatric Association et al, 2013) has sparked a rich debate about the validity of psychiatric diagnoses. In his Director's blog, the head of the National Institutes of Mental Health, Dr. Thomas Insel, described the new DSM as a "dictionary" with good definitions and labels for disorders that make it reliable, but questioned its neuro-biological validity (Director's Blog: Transforming Diagnosis). Despite major advances in neuroscience in the last two decades, psychiatric diagnoses continue to be based on phenomenological descriptions, rather than being firmly planted in neurobiological mechanisms. To remedy this gap, he and others have suggested using the Research Domain Criteria (RDoCs) to develop a new system of diagnosis and treatment based on brain circuitry. The model assumes that mental disorders may be understood as neural circuit impairments, which lead to impairments at the level of cognition, emotions and behavior, and function. Five major RDoC domains have been identified - 1) Negative Valence Systems, 2) Positive Valence Systems, 3) Cognitive Systems, 4) Systems for Social Processes and 5) Arousal/Modulatory Systems, that cross current DSM diagnostic lines (Director's Blog: Transforming Diagnosis).