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Debate over the merits and demerits of DSM-5 has been the talk of the town since release of the manual in May of last year. Despite all the anticipation, no Copernican revolution has occurred. DSM still follows the medical model of disease, defining nosological categories on the basis of clusters of symptoms. These categories are thought to represent disorders with a specific longitudinal course, prognosis, and (to a degree) response to treatment. Many of us, however, may be less familiar with an effort, equally important, that is slowly but steadily informing the way research in neuroscience and psychiatry is being conceptualized and carried out.
In 2010 NIMH released a blueprint, titled Research Domain Criteria (RDoC), intended to serve as a framework for neuroscience research. RDoC takes an approach different from that of DSM. It assumes (1) that mental disorders can be explained in terms of brain circuits and (2) that abnormalities of these circuits are identifiable and will lead to the discovery of “biosignatures”, ultimately to be integrated with clinical data. This effort should lead to a classification system based, as is generally the norm in medicine generally, on etiology and/or pathophysiology. Unlike DSM, RDoC is not yet a diagnostic system; rather, it is an attempt to create one.
In a major change, RDoC shifts the pivot of research away from symptoms and to the level of brain circuitry in an effort to identify circuit-based functional constructs. These functional constructs are grouped under broader domains of brain function.
But what exactly are these constructs and domains? Let's take the example of cognition. Cognition constitutes a domain, like other brain functions identified by RDoC (e.g., negative affect, social processes positive affect, and regulatory systems). The domain labeled “cognition” subsumes a variety of constructs that can be the object of investigation: attention, long-term memory, cognitive control, working memory, executive function,