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Abstract

Purpose of Review We discuss the implications of the Research Domain Criteria (RDoC) initiative for neuroscience research on personality disorder (PD). To organize our review, we construct a preliminary conceptual mapping of PD symptom criteria onto RDoC constructs. We then highlight recent neuroscience research, often built around concepts that correspond to RDoC elements, and discuss the findings in reference to the constructs we consider most pertinent to PD. Recent Findings PD symptoms were strongly conceptually tied to RDoC constructs within the Social Processes domain, implicating brain systems involved in interpersonal rejection, facial emotion perception, and self-referential processes. Negative and Positive Valence Systems were conceptually associated with many PD symptoms, with particular relevance ascribed to the latter’s Reward Valuation construct, which could reflect a more widespread disruption of computational processes involved in estimating the probability and benefits of a future outcome. Within the Cognitive Systems domain, the Cognitive Control construct mainly related to PD symptoms associated with impulse control, suggesting a connection to neural circuits that underlie goal selection and behavioral control. Arousal and Regulatory Systems could only be conceptually mapped onto PD symptoms through the Arousal construct, with different symptoms reflecting either a higher or lower biological sensitivity to internal and external stimuli. Summary The RDoC framework has promise to advance neuroscience research on PD. The Social Processes domain is especially relevant to PD, although constructs falling within the other RDoC domains could also yield important insights into the neurobiology of PD and its connections with other forms of psychopathology. Identifying RDoC constructs (e.g., habit formation) that subserve more fundamental processes relevant to personality functioning warrants further investigation.
PERSONALITY DISORDERS (K BERTSCH, SECTION EDITOR)
The NIMH Research Domain Criteria (RDoC) Initiative and Its
Implications for Research on Personality Disorder
Jacob W. Koudys
1,2
&Jenna M. Traynor
1
&Achala H. Rodrigo
1,2
&Dean Carcone
1,2
&Anthony C. Ruocco
1,2
Published online: 27 April 2019
#Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Purpose of Review We discuss the implications of the Research Domain Criteria (RDoC) initiative for neuroscience research on
personality disorder (PD). To organize our review, we construct a preliminary conceptual mapping of PD symptom criteria onto
RDoC constructs. We then highlight recent neuroscience research, often built around concepts that correspond to RDoC ele-
ments, and discuss the findings in reference to the constructs we consider most pertinent to PD.
Recent Findings PD symptoms were strongly conceptually tied to RDoC constructs within the Social Processes domain, impli-
cating brain systems involved in interpersonal rejection, facial emotion perception, and self-referential processes. Negative and
Positive Valence Systems were conceptually associated with many PD symptoms, with particular relevance ascribed to the
latters Reward Valuation construct, which could reflect a more widespread disruption of computational processes involved in
estimating the probability and benefits of a future outcome. Within the Cognitive Systems domain, the Cognitive Control
construct mainly related to PD symptoms associated with impulse control, suggesting a connection to neural circuits that underlie
goal selection and behavioral control. Arousal and Regulatory Systems could only be conceptually mapped onto PD symptoms
through the Arousal construct, with different symptoms reflecting either a higher or lower biological sensitivity to internal and
external stimuli.
Summary The RDoC framework has promise to advance neuroscience research on PD. The Social Processes domain is espe-
cially relevant to PD, although constructs falling within the other RDoC domains could also yield important insights into the
neurobiology of PD and its connections with other forms of psychopathology. Identifying RDoC constructs (e.g., habit forma-
tion) that subserve more fundamental processes relevant to personality functioning warrants further investigation.
Keywords Research domain criteria .Personality disorder .Negative valence systems .Positive valence systems .Cognitive
systems .Social processes
Introduction
The National Institute of Mental Health proposed the
Research Domain Criteria (RDoC) in 2010 [1] as a new com-
mon framework for the development and integration of re-
search across multiple domains and levels of analysis. The
structure of the RDoC framework has been revised and up-
dated during its development and initial deployment, with the
most recent version published online on May 30, 2018 [2,
3••]. In the current framework, psychological constructs are
organized within five superordinate domains: Negative
Vale nce S y s t em s ,Positive Valence Systems,Cognitive
Systems,Social Processes,andArousal and Regulatory
Systems. Each domain is further divided into constructs and
subconstructs, each of which contains elements which may be
explored using seven different units of analysis: Molecules,
Cells,Circuits,Physiology,Behaviors,Self-Reports,and
Paradigms. These constructs and units of analysis form the
rows and columns, respectively, of the RDoC Matrix. Prior to
May 2017, a Genes column was also represented as a unit of
analysis but was removed due to the present lack of robust
evidence of association between specific genes and
This article is part of the Topical Collection on Personality Disorders
*Anthony C. Ruocco
anthony.ruocco@utoronto.ca
1
Department of Psychology, University of Toronto Scarborough,
Toronto M1C 1A4, Canada
2
Department of Psychological Clinical Science, University of
Toronto, Toronto, Canada
Current Psychiatry Reports (2019) 21: 37
https://doi.org/10.1007/s11920-019-1023-2
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Despite its long history (beginning in 192 AD, when Galen linked the three maladaptive Hippocratic humors to personality types), psychiatric nosology has grappled with how best to classify personality disorders (PDs). Over the years, this challenge has been reflected in alternative approaches, such as subtypes within categories (e.g., Russ et al. 2008), prototypes (e.g., Westen et al. 2006), Research Domain Criteria (RDoC) (Koudys et al. 2019), transdiagnostic approaches (Livesley 2003), clinical staging (Chanen et al. 2016), and the Hierarchical Taxonomy of Psychopathology (HiTOP) (Kotov et al. 2017). Common among alternative approaches have been persistent criticisms of the International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM) categorical diagnostic systems and vocal calls to abolish such systems in favor of a dimensional classification system. ...
... Specifically, these theories (Blatt & Lerner 1983;Fonagy & Bateman 2009;Kernberg 1967Kernberg , 1984Livesley 2003;Masterson 1988) postulate that the defining features and core of personality pathology, and thus the general severity criterion common to all PDs, are defined as maladaptive self and interpersonal functioning, denoting an intrapsychic delay or impairment that interferes with an individual's capacity for understanding and managing the self in affectively charged attachment and/or interpersonal contexts, thereby prohibiting or delaying adequate adult role function. Further excitement over the introduction of LPF was generated because of its close alignment with the National Institute of Mental Health RDoC domain of Systems for Social Processes, which includes the processes of affiliation and attachment, social communication, perception and understanding of self, and perception and understanding of others, thereby opening up the possibility of neuroscientific advances in the conceptualization of personality pathology , Koudys et al. 2019). ...
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Level of Personality Functioning (LPF) represents the entry criterion (Criterion A) of the Alternative Model for Personality Disorders (AMPD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is defined as a dimensional general severity criterion common to all personality disorders and conceptually independent of personality types or traits, and it represents maladaptive self (identity and self-direction) and interpersonal (empathy and intimacy) functioning. We review the history, measurement, and significance of LPF. We show that the inclusion of LPF in the AMPD is well justified if it is defined as a general adaptive failure of a subjective intrapsychic system needed to fulfill adult life tasks. If so defined, LPF distinguishes itself from maladaptive traits (Criterion B of the AMPD) and captures the contribution humans make as agentic authors to the interpretation and management of the self. While Criterion B maladaptive traits provide important descriptive nuance to manifestations of personality pathology, maladaptive LPF is conditional to the diagnosis of personality disorder. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 17 is May 7, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... Impulsivity is a core symptom of BPD that is stable across time and predicts BPD psychopathology over several years (Links, Heslegrave, & Reekum, 1999). The cognitive processes underlying impulsivity in BPD have not yet been fully identified, although deficits in so-called 'executive functions' that facilitate goal-directed behaviors are likely candidates (Koudys, Traynor, Rodrigo, Carcone, & Ruocco, 2019). Deficits in multiple related executive functions have been implicated in BPD, including in response inhibition, cognitive flexibility, decisionmaking, problem-solving, and planning (Paret, Jennen-Steinmetz, & Schmahl, 2017;Ruocco, 2005;Unoka & Richman, 2016). ...
... Similarly, the results of the present investigation speak to the potential utility of incorporating dimensional assessments of pathological personality trait domains into neurobiological research on PD, as we determined that an impulsiveness dimension was significantly associated with activation in prefrontal brain regions. Relationships between pathological personality traits and potential neuroimaging-based biomarkers should be explored in future research, as this work could illuminate the neurobiology of traits contained in proposed dimensional conceptualizations of PD according to the National Institute of Mental Health's Research Domain Criteria initiative (Koudys et al., 2019). ...
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Background Impulsivity is a central symptom of borderline personality disorder (BPD) and its neural basis may be instantiated in a frontoparietal network involved in response inhibition. However, research has yet to determine whether neural activation differences in BPD associated with response inhibition are attributed to attentional saliency, which is subserved by a partially overlapping network of brain regions. Methods Patients with BPD ( n = 45) and 29 healthy controls (HCs; n = 29) underwent functional magnetic resonance imaging while completing a novel go/no-go task with infrequent odd-ball trials to control for attentional saliency. Contrasts reflecting a combination of response inhibition and attentional saliency (no-go > go), saliency processing alone (oddball > go), and response inhibition controlling for attentional saliency (no-go > oddball) were compared between BPD and HC. Results Compared to HC, BPD showed less activation in the combined no-go > go contrast in the right posterior inferior and middle-frontal gyri, and less activation for oddball > go in left-hemispheric inferior frontal junction, frontal pole, superior parietal lobe, and supramarginal gyri. Crucially, BPD and HC showed no activation differences for the no-go > oddball contrast. In BPD, higher vlPFC activation for no-go > go was correlated with greater self-rated BPD symptoms, whereas lower vlPFC activation for oddball > go was associated with greater self-rated attentional impulsivity. Conclusions Patients with BPD show frontoparietal disruptions related to the combination of response inhibition and attentional saliency or saliency alone, but no specific response inhibition neural activation difference when attentional saliency is controlled. The findings suggest a neural dysfunction in BPD underlying attention to salient or infrequent stimuli, which is supported by a negative correlation with self-rated impulsiveness.
... Additionally, we expected that probands with BPD, relatives, and controls, might differ in their extent of activation in the right middle and superior frontal gyri, as well as the left middle and inferior frontal gyri, given meta-analytic and other neuroimaging findings pertaining to the GNG task (Swick et al., 2011;Rodrigo et al., 2014). Finally, we predicted that higher impulsive traits would be related to lower PFC activation during response inhibition regardless of comorbid diagnosis, consistent with a trans-diagnostic neuroscience approach to defining the neurocircuitry of personality psychopathology, such as the Research Domain Criteria (RDoC) initiative (Koudys et al., 2019). Therefore, this study takes an important step toward understanding how the familial risk for BPD is reflected in the neurophysiology of response inhibition and provides a basis for research on related biomarkers for the diagnosis and associated impulsive traits. ...
... Similarly, while we did not assess every psychiatric diagnosis characterized by impulsivity (e.g., gambling disorder, attention-deficit/hyperactivity disorder). Our strategy to deal with questions of specificity and diagnostic comorbidity was to link the biomarkers to impulsive traits in a trans-diagnostic manner (i.e., regardless of psychiatric diagnosis), consistent with neuroscience-oriented research approaches, such as RDoC (Koudys et al., 2019). Third, several exclusions were applied to reduce the likelihood that the obtained results are influenced to confounding factors (e.g., current substance use disorder, neurologic illness). ...
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Understanding of the biological factors that run in families affected with borderline personality disorder (BPD) is limited. The authors investigated the familial aggregation of neurophysiological biomarkers of response inhibition in the first-degree biological relatives of probands with BPD and associations with psychiatric diagnosis and impulsive traits. In the present study, psychiatric diagnoses and impulsive traits were measured in BPD probands (n = 86), psychiatrically affected and non-affected relatives (n = 60) and controls (n = 83). While undergoing neuroimaging using functional near-infrared spectroscopy, prefrontal cortex (PFC) activation was measured during a go/no-go response inhibition task and compared between probands, relatives and controls. Additionally, non-psychiatrically affected relatives and controls were contrasted to examine the potential impact of familial risk for BPD on response inhibition-related PFC activation in the absence of confounding psychiatric morbidity. Probands showed bilateral decreases in PFC activation during response inhibition compared to relatives and controls. Conversely, both affected and non-affected relatives displayed higher activation than controls and probands in left lateral/medial and right medial PFC, although non-affected relatives showed a lesser extent of activation than affected relatives. Probands and controls reporting greater impulsive traits displayed deactivation across the PFC during response inhibition, whereas relatives showed increased activation. In this first family study of neuroimaging biomarkers in BPD, we showed that the familial risk for BPD is reflected in activation of the PFC during response inhibition, with lifetime psychiatric diagnosis and higher impulsive traits in relatives associated with larger increases in PFC activity. Higher PFC activity during response inhibition including among non-affected relatives could reflect a neurophysiological compensatory mechanism.
... Er zijn ook aanwijzingen dat cognitieve problemen in de kindertijd, en dan met name problemen in het executief functioneren, de aanwezigheid van allerlei psychische stoornissen, waaronder dwangstoornissen, gedragsstoornissen en schizofrenie spectrum stoornissen, op latere leeftijd voorspellen (Caspi et al., 2014). Mogelijk zijn deze tekorten in cognitief functioneren een uiting van neuro-anatomische afwijkingen die tegelijkertijd ook de kwetsbaarheid voor psychische stoornissen vergroten (Caspi & Moffit, 2018;Koudys et al., 2019). ...
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... Self-interpersonal impairment across PD diagnoses may contribute to a significant degree of shared variance in FC in these four networks, a hypothesis that has yet to be explored in a PD sample using a cross-cutting measure of personality impairment. In fact, there is a clear paucity of research that explores the dimensional neurobiology of PD, as fMRI has almost exclusively been used to characterize the neural underpinnings of specific PD diagnoses, despite the potential of dimensional, neuroscience-based research to illuminate the neurobiology of PD (Koudys, Traynor, Rodrigo, Carcone, & Ruocco, 2019). ...
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... Further to this, larger neurocognitive studies with suitable control or clinical groups would help to disentangle the specific profile of deficits common to comorbid personality disorder and SUD. This future work may help to establish transdiagnostic components that may inform future advances in assessment, treatment targets, clinical practice, and research (Koudys et al., 2019;Ruggero et al., 2019). Studies aiming to improve treatment outcomes in both SUD (Verdejo-Garcia et al., 2019) and personality disorder are increasingly focused on elucidating neuroscientific mechanisms that can guide the development of novel treatments (e.g., Herpertz et al., 2020;Pascual et al., 2015;Vita et al., 2018) and these may specifically be adapted to account for the common co-occurrence of SUD and BPD, adding to a small number of treatment studies (Pennay et al., 2011). ...
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