Insel & Cuthbert (2015) Brain disorders
7 important questions on Insel & Cuthbert (2015) Brain disorders
What does de Research domain criteria entail (RDoc)?
the framework would focus on systems or dimensions with both cognitive and biological validity.
Efficacy of psychological and pharmacological treatment for mental disorder is +/- 50%.
Likely reasons for the lack of higher efficacy despite all the research:
Psychiatric syndromes are hugely diverse: for depression, two patients could share only one symptom. 636120 unique symptom profiles to match a diagnosis of PTSD
2. Lack of mechanistic understanding
Lack of mechanistic specificity understanding precludes tailored treatment.
Voorbeeld van bill > social anxiety disorder, schizophrenia, PTSD (trauma, maybe something in past happens?), paranoid, generalized anxiety
Comorbidity and the need for a transdiagnostic perspective
Possible explanations
1. Poor discriminant validity
2. One disorder may act as a risk factor for another
3. Common risk (predisposing, precipitating or perpetuating)
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What does an transdialogisctic approach entail
- Functional approach;
Dissect the syndrome in component parts
Focus on individual patient and central problematic behavior
Focus on common processes of etiology or maintenance
What is a widely adopted transdiagnostic approach
What is the idea with precision medicine (more target approach to disease)
What is important while measuring to understand the various aspects of dysfunction associated with disorders
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