Towards a new conceptual framework for psychopathology: Embodiment, enactivism, and embedment

Psychopathology classification is at a conceptual crossroads. It is becoming increasingly accepted that the flaws of the DSM relate to its struggles to pick out “real” entities as opposed to clusters of symptoms. The Research Domain Criteria (RDoC) was formulated in response to this failure, and attempts to address the concerns confronting the DSM by shifting to a causal and continuous model of psychopathology. Noting key criticisms of neurocentricism and problems with conceptual validity leveled at the RDoC, we argue that they stem from its grounding in the metaphysical position of eliminative materialism, or at least material-reductionism. We propose that 3e cognition (viewing the mind as embodied, embedded, and enactive) offers a superior alternative to eliminative materialism. A 3e-informed framework of mental disorder is sketched out and its advantages as a basis for classifying and conceptualizing mental disorders are considered.

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Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC)

Psychological Science in the Public Interest ◽

10.1177/1529100617727266 ◽

2017 ◽

Vol 18 (2) ◽

pp. 72-145 ◽

Cited By ~ 157

Author(s):

Lee Anna Clark ◽

Bruce Cuthbert ◽

Roberto Lewis-Fernández ◽

William E. Narrow ◽

Geoffrey M. Reed

Keyword(s):

Mental Disorders ◽

Mental Disorder ◽

International Classification Of Diseases ◽

The United States ◽

Classification Systems ◽

Prescribe Medication ◽

Research Domain Criteria ◽

Classification Of Diseases ◽

Key Issues ◽

Research Domain

The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals—the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders—provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health’s Research Domain Criteria provides a framework that emphasizes integration of basic behavioral and neuroscience research to deepen the understanding of mental disorder. We identify four key issues that present challenges to understanding and classifying mental disorder: etiology, including the multiple causality of mental disorder; whether the relevant phenomena are discrete categories or dimensions; thresholds, which set the boundaries between disorder and nondisorder; and comorbidity, the fact that individuals with mental illness often meet diagnostic requirements for multiple conditions. We discuss how the three systems’ approaches to these key issues correspond or diverge as a result of their different histories, purposes, and constituencies. Although the systems have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.

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Problems of psychopathologic systematics: alternative approaches and clinical practice requests

Neurology Bulletin ◽

10.17816/nb34129 ◽

2020 ◽

Vol LII (2) ◽

pp. 20-28

Author(s):

Мikhail L. Zobin ◽

Natalia V. Ustinova

Keyword(s):

Clinical Practice ◽

Mental Disorders ◽

Conceptual Framework ◽

Reliability And Validity ◽

Research Domain Criteria ◽

Advantages And Disadvantages ◽

Diagnostic Categories ◽

Clinical Instability ◽

Alternative Approaches ◽

Research Domain

The reliability and validity of traditional classifications give rise to justifiable criticism because of the conventionality of the boundaries between norm and pathology, fuzzy delimitation of disorders and their frequent co-occurrence, heterogeneity and clinical instability of symptoms within the diagnostic categories. There is little evidence that the majority of mental disorders are discrete entities. Discontent with the expert consensus classifications have led to attempts at a new quantitative and empirical systematization of psychopathology. Two alternative projects have been proposed: Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP). The aim of the paper is to clarify the conceptual framework of RDoC and HiTOP, discuss their advantages and disadvantages in terms of the prospects for use in clinical practice.

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Evolution and Mental Disorders

Evolutionary Psychopathology ◽

10.1093/med-psych/9780190246846.003.0005 ◽

2018 ◽

pp. 129-152

Author(s):

Marco Del Giudice

Keyword(s):

Mental Disorders ◽

Mental Disorder ◽

Psychiatric Comorbidity ◽

Broad Sense ◽

Network Approach ◽

Research Domain Criteria ◽

Developmental Processes ◽

Definition Of ◽

Research Domain

The chapter discusses the definition of mental disorder, reviews the biological explanations for vulnerability to disease, and presents a detailed taxonomy of undesirable conditions that may be regarded as disorders in a broad sense (whether or not they involve genuine dysfunctions). After detailing the main evolutionary and developmental processes that can lead to psychopathology, the chapter addresses some important questions about the structure and classification of disorders and the nature of psychiatric comorbidity. The chapter also considers the strengths and weaknesses of other emerging approaches: computational psychiatry, the network approach to psychopathology, the Research Domain Criteria (RDoC), and transdiagnostic models such as the Hierarchical Taxonomy of Psychopathology (HiTOP).

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A knowledge network for a dynamic taxonomy of psychiatric disease

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2015.17.1/rkrishnan ◽

2015 ◽

Vol 17 (1) ◽

pp. 79-87 ◽

Cited By ~ 1

Keyword(s):

Mental Disorders ◽

Strategic Plan ◽

Research Community ◽

Mental Illnesses ◽

Knowledge Network ◽

Psychiatric Disease ◽

The Novel ◽

Research Domain Criteria ◽

Novel Approach ◽

Research Domain

The Research Domain Criteria (RDoC) project was initiated by the National Institute of Mental Health (NIMH) in early 2009 as the implementation of Goal 1.4 of its just-issued strategic plan. In keeping with the NIMH mission, to "transform the understanding and treatment of mental illnesses through basic and clinical research," RDoC was explicitly conceived as a research-related initiative. The statement of the relevant goal in the strategic plan reads: "Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures." Due to the novel approach that RDoC takes to conceptualizing and studying mental disorders, it has received widespread attention, well beyond the borders of the immediate research community. This review discusses the rationale for the experimental framework that RDoC has adopted, and its implications for the nosology of mental disorders in the future.

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Normality and Diversity

Mind Shift ◽

10.1093/oso/9780198801634.003.0015 ◽

2021 ◽

pp. 222-238

Author(s):

John Parrington

Keyword(s):

Autism Spectrum Disorder ◽

Bipolar Disorder ◽

Autism Spectrum Disorders ◽

Social Interaction ◽

Mental Disorders ◽

Mental Disorder ◽

Autism Spectrum ◽

Human Society ◽

Normal Spectrum ◽

The Mind

This chapter begins by arguing that the different approaches to mental disorders are united in viewing such mental conditions as abnormal. Yet is it really the case that everything termed a mental ‘disorder’ is indeed so? Or could it be that in diagnosing conditions that affect the mind, we are ignoring the possibility that some ‘disorders’ may be part of the normal spectrum of human diversity? To take this argument further, could it even be the case that such diversity is an important component of human society and a source of some of its richness and achievements? The chapter looks at these possibilities, with particular reference to two quite different mental conditions—autism spectrum disorder and bipolar disorder. Autism spectrum disorders have been described as characterized by 'impairments in social interaction and both verbal and non-verbal communication, along with restricted, repetitive or stereotyped behaviour'. Meanwhile, the high and low phases of bipolar disorder are often so extreme that they interfere with everyday life; consequentially this can be a highly debilitating disorder. However, there is also an association of both types of mental disorder with great creativity, and high levels of intelligence.

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Research Domain Criteria and OCD

10.1093/med/9780190228163.003.0062 ◽

2017 ◽

Author(s):

Eyal Kalanthroff ◽

Gideon E. Anholt ◽

Helen Blair Simpson

Keyword(s):

Mental Health ◽

United States ◽

Mental Disorders ◽

The United States ◽

Self Report ◽

Research Domain Criteria ◽

Diagnostic Systems ◽

Behavioral Measures ◽

Research Domain

This chapter discusses the Research Domain Criteria (RDoC) project, an initiative of the National Institutes of Mental Health (NIMH) of the United States to develop for research purposes new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures, and explores how the hallmark symptoms of OCD (obsessions, compulsions, and anxiety) can be mapped onto RDoC domains. Unlike current categorical diagnostic systems (e.g., DSM), RDoC seeks to integrate many levels of information (from genomics to self-report) to validate dimensions defined by neurobiology and behavioral measures that cut across current disorder categories. The chapter explores, for heuristic reasons, how the RDoC matrix might be used to elucidate the neurobehavioral domains of dysfunction that lead to the characteristic symptoms of OCD. It then selectively reviews the OCD literature from the perspective of the RDoC domains, aiming to guide future transdiagnostic studies to examine specific neurobehavioral domains across disorders.

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Research Domain Criteria: cognitive systems, neural circuits, and dimensions of behavior

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2012.14.1/smorris ◽

2012 ◽

Vol 14 (1) ◽

pp. 29-37 ◽

Cited By ~ 78

Keyword(s):

Mental Disorders ◽

Neural Circuits ◽

Integrative Approach ◽

Research Domain Criteria ◽

Diagnostic Systems ◽

Research Perspective ◽

Treatment And Prevention ◽

Regulatory Systems ◽

Positive Valence ◽

Research Domain

Current diagnostic systems for mental disorders were established before the tools of neuroscience were available, and although they have improved the reliability of psychiatric classification, progress toward the discovery of disease etiologies and novel approaches to treatment and prevention may benefit from alternative conceptualizations of mental disorders. The Research Domain Criteria (RDoC) initiative is the centerpiece of NIMH's effort to achieve its strategic goal of developing new methods to classify mental disorders for research purposes. The RDoC matrix provides a research framework that encourages investigators to reorient their research perspective by taking a dimensional approach to the study of the genetic, neural, and behavioral features of mental disorders, RDoCs integrative approach includes cognition along with social processes, arousal/regulatory systems, and negative and positive valence systems as the major domains, because these neurobehavioral systems have all evolved to serve the motivational and adaptive needs of the organism. With its focus on neural circuits informed by the growing evidence of the neurodevelopmental nature of many disorders and its capacity to capture the patterns of co-occurrence of behaviors and symptoms, the RDoC approach holds promise to advance our understanding of the nature of mental disorders.

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