The Research Domain Criteria (RDoC): An analysis of methodological and conceptual challenges

“Adding to these replicability concerns are findings that the average statistical power of functioning brain imaging studies is only about 8%, which is considerably lower than in most other domains of psychological and psychiatric research (Button et al., 2013).”

“adapt to particular social circumstances; emergent properties of neurobiological structures can lead to healthy adaptation or pathology across different environments; and self-reflection, narrative interpretation of experience, and patterns of interaction with others (called the interactome after the connectome, which…”

“This issue for the RDoC approach has already been highlighted by Berenbaum (2013) and reiterated by Lilienfield (2014), and addressed directly by Cuth-bert and Kozak (2013) and Cuthbert (2014).”

“…greater attention (e.g. neglect of measurement error when assessing mechanisms; ignoring potential distinctions between biological predispositions from behavioral manifestations; poor conceptual validity; underemphasized role of the environment; Lilienfeld, 2014; Lilienfeld & Treadway, 2016).”

“…researchers would be wise to consider possible challenges (e.g. risk of biological reductionism which limits understanding of psychopathology, psychometric problems of laboratory-based measures) as well as ways to address them (see Franklin, Jamieson, Glenn, & Nock, 2014; Lilienfeld, 2014).”

“As aptly put by Lilienfeld (2014): “ Yet investigators … must be careful not to confuse biological mediation with biological etiology.”

“A key distinction that has received little attention in the RDoC literature is that between biological predispositions to psychopathology and their behavioral manifestations (Lilienfeld 2014b).”

“The classification manuals advanced the field tremendously, but they have also been criticised for their lack of reliability, validity, and clinical utility (e.g., Borsboom, 2008; Lilienfeld, 2014).”

“other processes as predicted (Lilienfeld, 2014).”

“The distinctions that can be drawn at the level of brain functioning may not clearly translate upward to behavior-based measures such as screening measures and diagnostic interviews (130).”

“Alternative ways to conceptualize, understand, and treat mental disorders are gaining scientific attention, including Research Domain Criteria (Lilienfeld, 2014) and trans-diagnostic treatments (Barlow et al., 2011).”

“ORIGINAL RESEARCH published: 26 August 2015 doi: 10.3389/fpsyg.2015.01280 Frontiers in Psychology | www.frontiersin.org 1 August 2015 | Volume 6 | Article 1280 Edited by: Eduardo A. Garza-Villarreal, National Institute of Psychiatry, Mexico Reviewed by: Sharna Jamadar, Monash University, Australia Kristine Rømer Thoms…”

“The prioritization of neural systems is problematic in terms of both reliability (measurement error at these more “objective” units of analysis is overlooked: Hajcak & Patrick, 2015; Lilienfeld, 2014) and validity (psychological/mental states cannot be reduced to physical/brain systems: Barrett, 2012; Miller, 2010).”

“The psychometric properties of most neural measures that have been examined in relation to psychopathology and other individual difference variables have not been evaluated sufficiently (Hajcak & Patrick, 2015; Lilienfeld, 2014).”

“…leading scholars in the psychopathology area have called attention to limitations of the RDoC research framework and raised questions about its ability to alter diagnostic conceptions and advance knowledge in significant ways (Kraemer, 2015; Lilienfeld, 2014; Weinberger, Glick, & Klein, 2015).”

“As discussed in detail by Lilienfeld (2014), these include the strong emphasis of RDoC on biological measures (at the risk of ignoring other domains of measurement) and psychometric considerations such as measurement error and construct validity.”

“Both continuous and categorical approaches are useful and necessary (Lilienfeld 2014), and we encourage researchers to come up with alternatives and better strategies to compare the CU traits only versus multidimensional psychopathy approaches.”

“Both continuous and categorical approaches are useful and necessary (see for example also Farrington and Loeber, 2000; Lilienfeld 2014).”

“, Knottnerus, J. A., Green, L., van der Horst, H., Jadad, A. R., Kromhout, D., Leonard, B., Lorig, K., Loureiro, M. I., van der Meer, J. W., Schnabel, P., Smith, R., van Weel, C., & Smid, H. (2011). How should we define health? BMJ, 343, Article 4163.”

“Such biologically oriented approaches to understanding psychopathology and individual differences require neural measures with good psychometric properties (2).”

“The existing published papers on RDoC have not directly discussed the importance of risk to the initiative (although see Lilienfeld, 2014).”

“Harkness, Reynolds, and Lilienfeld (2014) provide a compelling adaptive systems framework where the dimensions of Criterion B are understood as representing failures in the evolutionary system of danger detection (negative affectivity, internalizing anxious disorders), resource acquisition…”

“…for diagnostic purposes when instead it is explicitly – at least to date – meant to guide basic research on vulnerabilities to and expressions of psychopathology (for further discussion see Franklin et al., 2015; Lilienfeld, 2014; Lilienfeld & Treadway, 2016).1 These are legitimate concerns.”

“Psychology and related disciplines have a rich history of rigorous psychometric evaluation of their self-report measures, but the reliability and validity of physiological measures within laboratory tasks have often been presumed rather than demonstrated (Lilienfeld, 2014).”

“…the current study, there is a growing emphasis n moving beyond investigation of unitary constructs pertaining to reard processing, and instead examining the multidimensional nature f reward processing as related to different forms of psychopathology e.g., Berridge et al., 2009 ; Lilienfeld, 2014 ).”

“…that is practically useful by both physicians and researchers. observational nosology does not lend itself to being concretely linked to the circuitry of the brain, the RDoC framework has suffered from criticism in many ways opposite to that of the DSM (Lillienfeld, 2014; Casey et al., 2015).”

“However, the RDoC proposal has had a mixed reception in its current form, being criticized for failing to adequately address the challenges it was designed for, while moreover introducing other problems, such as a lack of construct validity and a disconnect from clinical relevance (12– 15).”

“First, the claim that the RDoC is too neurocentric (Berenbaum, 2013; Hershenberg & Goldfried, 2015; Hoffman & Zachar, 2017; Kirmayer & Crafa, 2014; Lilienfeld, 2014; Lilienfeld & Treadway, 2016).”

“Many of these more narrowly focused constructs within the hierarchical models of psychopathology are similar to those outlined in the RDoC framework rather than diagnostic systems (such as the DSM or ICD) that do not represent valid disease entities (88,136).”

“…systems Intense debate has occurred in the area of psychopathology for the last 30 years or so, concerning the nature of mental disorders and their classification (e.g. Borsboom, Epskamp, Kievit, Cramer, & Schmittmann, 2011; Cuthbert & Kozak, 2013; Kincaid & Sullivan, 2014; Lilienfeld, 2014).”

“…raising suspicion that enhanced diagnostic reliability may have come at the expense of validity; in other words, as a field, we may be overemphasizing categories that are, in fact, minor variations of broader underlying syndromes (Andrews, 1990, 1996; Blashfield et al., 2014; Lilienfeld, 2014).”

“The RDoC enterprise is a work in progress and has been termed a “calculated gamble” by Lilienfeld [44].”

“This has included calls for incorporating the metrics of prognosis, caseness, and disability (81) while also attending to the need for improved reliability of experimental indices, brain and behavior alike (82).”

“To facilitate this endeavor, new approaches for assessing mental health problems are needed (Lilienfeld, 2014; Patrick and Hajcak, 2016).”

“However, a fundamental concern with diagnostic categories is that they define disorders exclusively by signs and symptoms associated with the individual’s subjective experiences and overt presentations, rather than underlying psychological and neurobiological substrates (Lilienfeld, 2014; Lilienfeld & Treadway, 2016).”

“The focus of this concept was on researching the functional abnormalities of the brain circuits underlying the symptoms rather than the disease itself.(121,122) The main characteristics of ASD are social deficit, restricted interests and repetitive behaviors.”

“While the inconsistencies regarding BPD described in the introduction can be seen as a prime example for the necessity of the RDoC approach, it seems important to exercise caution and not draw premature conclusions (Lilienfeld, 2014).”

“, neuroimaging, self-reports, ecologically valid lab-based assessments) may help identify the best metric for detecting early risk for internalizing problems, as assessments of RNT at different units of analysis may differentially relate to later maladaptive functioning (Lilienfeld, 2014).”

“One of the more trenchant critiques, thus far, is by Lilienfeld (2014), who notes that because the RDoC scheme lacks grounding in psychometrics and has demonstrated neither reliability and validity, it cannot replace the DSM or the International Classification of Diseases (World Health…”

“time of day of testing, nature of laboratory setting) that contribute to low crosssituational and temporal consistency (Lilienfeld, 2014).”

“However, it remains unclear how variables in the realms of biology and biologically-based behavior can be related most effectively to clinical symptom variables (Lilienfeld, 2014; Weinberger, Glick, & Klein, 2015).”

“Lilienfeld (2014) summarises the standard complaints in a recent review article.”

“One reason that many behavioral measures may be unstable across testing sessions is state variation, such as being more fatigued on one day completing a task than another (Hitchcock et al., 2017; Lilienfeld, 2014).”

“At an observational level the fit of the categorical model is poor: risk factors and symptoms are continuously distributed in the population [12] and mental disorders are experienced as highly comorbid – at least 50% of people with a mental health diagnosis have more than one [13– 18].”

“…& 8); they are not theoretically coherent and do not refer to causal mechanisms (6 & 7); and analogous concepts have not demonstrated causal relationships (9 - see for example the Research Domain Criteria project which aims to identify causal processes underlying psychopathology; Lilienfeld, 2014).”

“(3) A salience/emotional processing network (SN), in which the right anterior insula and dorsal anterior cingulate cortex (dACC) are the primary hubs, assesses the significance of a stimulus and, together with amygdala activity, assigns emotional and motivational value to the stimulus.”

“Critics have argued (e.g., Lilienfeld, 2014) that the RDoC framework may be overly reductionistic and not adequately considerate of the principle of multifinality, which holds that identical biological predispositions can be expressed in markedly different ways.”

“Vigorous debate has occurred in the area of psychopathology for the last 30 years or so, concerning the nature of mental disorders and their classification (e.g., Borsboom, Epskamp, Kievit, Cramer, & Schmittmann, 2011; Cuthbert & Kozak, 2013; Kincaid & Sullivan, 2014; Lilienfeld, 2014).”

“Although there is concern that RDoC overweights biological phenomena (e.g., Goldfried, 2016; Lilienfeld, 2014; Lilienfeld & Treadway, 2016), in fact RDoC is carefully and explicitly agnostic about the mechanistic and causal relationships between psychology and biology and more radically advocates…”

“…that one can study disease mechanisms even in species that do not actually fall ill with the disease of interest, as long as the species has, or is made to possess, homologs of genes that are linked to this disease in Homo sapiens [Rubin et al., 2000; Gould and Gottesman, 2006; Lilienfeld, 2014].”

“Despite its merits in neurobiological inter-pretability, it is still questioned for its poor theoretical constructs due to its “ reductionist ” assumptions 30,31 .”

“Despite its relatively short tenure, the composition, merits, and shortcomings of the RDoC framework have been discussed extensively (Beauchaine & Hinshaw, 2020; Casey, Oliveri, & Insel, 2014; Cuthbert & Insel, 2010; Franklin, Jamieson, Glenn, & Nock, 2015; Garber & Bradshaw, 2020; Insel et al., 2010; Lilienfeld, 2014…”

“…for dissatisfaction with this type of syndrome-based classifications, as captured by the DSM 5 and ICD, are heterogeneity, low construct validity, and the categorical measurement of disorders (Lilienfeld, 2014; Lilienfeld, Smith, & Watts, 2013; for a philosophical discussion, see Murphy 2009).”

“We operationalized SA as a continuous variable, in line with current dimensional models (Black and Grant, 2014; Kraemer, 2007; Hershenberg and Goldfried, 2015; Lilienfeld, 2014; Van Orden and Areán, 2015).”

“In other words, we should not “confuse biological mediation (the brain) with biological etiology” (Lilienfeld, 2014).”

“Furthermore, the categorical approach does not take into account the severity of the symptomatology, including the clinical relevance of sub-threshold symptomatology (5) and is less reliable and valid than a dimensional approach (2, 6).”

“Thus, the ensuing classifications tend to cover widely heterogeneous groups of people that for clinical and research purposes should be kept apart (Lilienfeld, 2014; Lilienfeld et al., 2013; Murphy, 2006; Poland & Von Eckardt, 2013).”

“While many have concerns surrounding the potential neurocentricism and reductionism of the RDoC movement (Berenbaum, 2013; Hershenberg & Goldfried, 2015; Kirmayer & Crafa, 2014; Lilienfeld, 2014; Lilienfeld & Treadway, 2016; Nielsen & Ward, 2018; Wakefield, 2014), the shift to focusing on transdiagnostic mechanisms an…”

“Taken together, these issues suggest that improved diagnostic reliability may have come at the expense of validity (Andrews, 1990, 1996; Blashfield et al., 2014; Lilienfeld, 2014).”

“RDoC constructs are focused not only on biological etiology but also on biological mediation of vulnerability and resilience to psychopathology (Lilienfeld, 2014), including in relation to environment and neurodevelopment.”