Toward New Approaches to Psychotic Disorders: The NIMH Research Domain Criteria Project

National Institute of Mental Health, 6001 Executive Boulevard, MSC 9625, Bethesda, MD 20892.
Schizophrenia Bulletin (Impact Factor: 8.45). 10/2010; 36(6):1061-2. DOI: 10.1093/schbul/sbq108
Source: PubMed
Download full-text


Available from: Thomas R Insel, Jun 04, 2015
  • Source
    • "The need for psychiatrists continues to grow. Second, important conceptual changes such as research domain criteria (RDoC) are gaining traction, raising hope for more valid approaches to organizing the translational body of knowledge central to psychiatric disorders (Cuthbert and Insel, 2010). Third, the neural circuits of behavioral domains such as attention, memory executive functions, thought processes, emotion perception and reward seeking have been increasingly well delineated using modern imaging techniques. "

    11/2015; DOI:10.1016/j.ajp.2015.10.001
  • Source
    • "The current study aimed to address this issue by implementing the MATRICS Consensus Cognitive Battery (MCCB), which was developed by the National Institute of Mental Health's (NIMH) Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS). The MCCB identified seven separable dysfunctional cognitive factors in the disorder, two of which (attention and working memory) are concurrent with the cognitive constructs of the NIMH Research Domain Criteria (RDoC) (Cuthbert and Insel, 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: While cognitive impairments are prevalent in first-episode psychosis, the course of these deficits is not fully understood. Most deficits appear to remain stable, however there is uncertainty regarding the trajectory of specific cognitive domains after illness onset. This study investigates the longitudinal course of cognitive deficits four years after a first-episode of psychosis and the relationship of performance with clinical course and response to treatment. Twenty three individuals with psychotic illness, matched with 21 healthy volunteers, were assessed using the MATRICS Consensus Cognitive Battery at illness onset and 4years later. We also investigated the relationship between cognitive deficits and quality of life and clinical indices. Verbal learning and two measures of processing speed had marked poorer trajectory over four years compared to the remaining cognitive domains. Processing speed performance was found to contribute to the cognitive deficits in psychosis. Poorer clinical outcome was associated with greater deficits at illness onset in reasoning and problem solving and social cognition. Cognitive deficits did not predict quality of life at follow-up, nor did diagnosis subtype differentiate cognitive performance. In conclusion, an initial psychotic episode may be associated with an additional cost on verbal learning and two measures of processing speed over a time spanning at least four years. Moreover, processing speed, which has been manipulated through intervention in previous studies, may represent a viable therapeutic target. Finally, cognition at illness onset may have a predictive capability of illness course.
    Schizophrenia Research 09/2015; DOI:10.1016/j.schres.2015.09.007 · 3.92 Impact Factor
  • Source
    • "While memory impairments in ADHD are likely more circumscribed (Castel et al., 2011), impairments in bipolar disorder may be closer to those found in schizophrenia, particularly among cases with psychotic symptoms (Glahn et al., 2006; Hill et al., 2013). Thus, it is important to assess the structure of cognitive dysfunction across diagnostic boundaries (Cuthbert and Insel, 2010). This study sought to clarify the distribution and covariation of impairments across domains of memory in patients with schizophrenia and to determine to the extent to which these impairments are shared with bipolar disorder and ADHD. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Schizophrenia patients exhibit impaired working and episodic memory, but this may represent generalized impairment across memory modalities or performance deficits restricted to particular memory systems in subgroups of patients. Furthermore, it is unclear whether deficits are unique from those associated with other disorders. Healthy controls (n=1101) and patients with schizophrenia (n=58), bipolar disorder (n=49) and attention-deficit-hyperactivity-disorder (n=46) performed 18 tasks addressing primarily verbal and spatial episodic and working memory. Effect sizes for group contrasts were compared across tasks and the consistency of subjects' distributional positions across memory domains was measured. Schizophrenia patients performed poorly relative to the other groups on every test. While low to moderate correlation was found between memory domains (r=.320), supporting modularity of these systems, there was limited agreement between measures regarding each individual's task performance (ICC=.292) and in identifying those individuals falling into the lowest quintile (kappa=0.259). A general ability factor accounted for nearly all of the group differences in performance and agreement across measures in classifying low performers. Pathophysiological processes involved in schizophrenia appear to act primarily on general abilities required in all tasks rather than on specific abilities within different memory domains and modalities. These effects represent a general shift in the overall distribution of general ability (i.e., each case functioning at a lower level than they would have if not for the illness), rather than presence of a generally low-performing subgroup of patients. There is little evidence that memory impairments in schizophrenia are shared with bipolar disorder and ADHD. Copyright © 2015 Elsevier B.V. All rights reserved.
    Schizophrenia Research 08/2015; 168(1). DOI:10.1016/j.schres.2015.08.014 · 3.92 Impact Factor
Show more