Abstract
Just as the DSM-5 was about to be finalized, the National Institute for Mental Health (NIMH) launched its “Research Domain Criteria” (RDoC) initiative, a project that has been seen by many as a disavowal of the type of nosological enterprise incarnated by the DSM itself, from DSM-III to DSM-5. In our paper, we first want to describe the context in which RDoC appeared and demonstrate that, if it is not a disavowal of the DSM-5’s work, it certainly signals the abandonment of a method of trying to establish a valid nosology; a paradigm shift in nosology so to speak. We will then question if RDoC is a reductionist enterprise. We will explain why RDoC is not reductionist in a strong and naïve sense, but why it could be understood as reductionist in a weaker sense. If this weaker form of reductionism does not possess the problems the stronger forms of reductionism do, it might nonetheless generate problems of its own that researchers should be aware of. We will try to delineate some of these problems.
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Notes
- 1.
As stated on the website of the NIMH, the RDoC project is an initiative that aims to “define basic dimensions of functioning (such as fear circuitry or working memory) to be studied across multiple units of analysis, from genes to neural circuits to behaviors, cutting across disorders as traditionally defined. The intent is to translate rapid progress in basic neurobiological and behavioral research to an improved integrative understanding of psychopathology and the development of new and/or optimally matched treatments for mental disorders” (NIMH, “Research Domain Criteria” Web. April 5th, 2014, http://www.nimh.nih.gov/research-priorities/rdoc/index.shtml).
- 2.
- 3.
The NIMH lists a number of publications on its website which describes the RDoC project (http://www.nimh.nih.gov/research-priorities/rdoc/nimh-rdoc-publications.shtml). Among the authors of these papers, we find Thomas Insel (actual director of the NIMH), Bruce Cuthbert (director of NIMH Division of Translation Research), Sarah E. Morris (chief of project of the NIMH Schizophrenia Spectrum Disorders Research Program), Charles A. Sanislow (who now works at Yale Psychiatric Institute, but used to be the program chief of NIMH Extramural Research in the Mood and Sleep Disorders Research), Daniel S. Pine (chief of the NIMH Section of Development and Affective Neuroscience). These researchers, as well a few other co-authors, are responsible for presenting, articulating, and defending (if necessary) the RDoC project. It is to them that we are referring when we are talking about the “RDoC advocates.” We are aware that other members of the project—for instance, participants to the workshops that were convened to define the constructs that figure in the RDoC framework—might not share the views expressed by the leading advocates of the project.
- 4.
RDoC initial framework was completed in 2012. As Morris and Cuthbert are saying, “the iterative process of evaluating and refining the constructs will likely occur over a 5 to 10-year timeframe, followed by ongoing modification based on new scientific discoveries” (2012, p. 33). We are not aware of any set timeframe for the production of a complete nosology of the type of the DSM.
- 5.
For that reason, RDoC constructs are not planned to be ready to be used for clinical diagnostics for at least a decade or two (NIMH 2011a).
- 6.
For instance, normal response to threat (i.e. fear response and learning) depends crucially on a neural circuit involving different nuclei inside the amygdala (Ledoux 2012).
- 7.
For instance, a neural reductionist might consider that psychological laws are useful because they enable him to formulate generalizations in a more compact and economical format than neural laws.
- 8.
See, for instance, Wilkinson and Pickett (2009).
- 9.
One editor of this volume asked us about how serious we thought that these claims were. After all, he remarked, in psychiatry, as well as in society in general, reductionism is often perceived as a bad thing, so maybe what RDoC advocates are saying is just lip service. We agree that pressures of that kind against crude reductionism exist, but we like to think that the RDoC’S claims proceed instead from a heightened degree of “philosophical sophistication” in the understanding the scientific goings-on of psychiatric research (that idea have been suggested to us by Peter Zachar, personal communication). So in this section, we will explain the epistemological position that is explicitly adopted by the RDoC and its advocates. In section “Real Fears,” we will indicate potential slip backs due to ideological convictions that are independent of their epistemological position.
- 10.
This is not to say that ideological convictions cannot be responsible for the focus on these factors. We will come back on that in section “Real Fears.”
- 11.
As we stated earlier, we think that the decision to focus on one level can be warranted by epistemological considerations. We do not want to claim that it is always warranted by such considerations (see section “Real Fears”).
- 12.
To be sure, research has to show that an early intervention does have an impact on a condition, which might not be the case with all early interventions; see for instance, Wagner 2005.
- 13.
Such models refer to “the reversible regulation of various genomic functions, occurring independently of DNA sequence, mediated principally through changes in DNA methylation and chromatin structure.” (Rutten and Mill 2009, p. 1045).
- 14.
Cuthbert himself is aware of this problem and suggests that RDoC will succeed only if it takes an open-minded approach: “[p]erhaps the outcomes for RDoC might be accessed by the number of research programs that, freed from the strictures of current diagnostic guidelines, outstrip the RDoC matrix to move in entirely new directions that transcend the organization of the current system” (2014, p. 35).
- 15.
Lewontin (1992) voiced such complaints about genome research.
- 16.
Some complain that a similar phenomenon occurred in the domain of epidemiology earlier in the century (see for instance De Vreese et al. 2010, p. 379).
- 17.
A similar complaint has been made in a recent editorial of the journal Nature in which attention was attracted to the fact that “studies on psychological treatments [were] ‘scandalously undersupported’, despite their ‘potential to make a substantive difference to patients’. It concluded that ‘many funding agencies around the world are too keen solely to support mechanistic investigations with potential long-term payoffs, and too unwilling to appreciate that part of their portfolio should be oriented towards identifying immediately effective psychological interventions” (quoted by Fava 2014, p. 49).
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Faucher, L., Goyer, S. (2015). RDoC: Thinking Outside the DSM Box Without Falling into a Reductionist Trap. In: Demazeux, S., Singy, P. (eds) The DSM-5 in Perspective. History, Philosophy and Theory of the Life Sciences, vol 10. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-9765-8_12
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