Psychopathology research has clearly embraced imaging studies of patients with psychiatric disease. Genes and molecules still play an important role in RDoC, representing specifications of the constructs at different levels of analysis, but it is the existence of an associated brain circuit that is necessary for a behavior to be included. For a “construct” (i.e., a behavior that spans a dimension of normal to abnormal functioning) to be included in RDoC, there must be a plausibly associated brain circuit.
1994) syndromes (e.g., schizophrenia, major depressive disorder) but rather in terms of dimensions of neurobiology and observable behavior (e.g., sustained responsiveness to reward perception and understanding of self and others Cuthbert & Insel 2013).
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In RDoC, psychopathology is not viewed in terms of traditional Diagnostic and Statistical Manual of Mental Disorders (DSM Am. 2010) initiative at the National Institute of Mental Health (NIMH).
Most recently, the place of the brain at the top of this rarified hierarchy was underscored with the emergence of the Research Domain Criteria (RDoC Insel et al. Contemporary biological models of mental illness often emphasize the importance of a “holy trinity” consisting of genes, molecules, and circuits. In more recent times, dramatic methodological advances in brain imaging opened the floodgates for a deluge of studies reporting that the brains of the mentally ill are different in structure, function, resting activity, and connectivity from those of the mentally healthy. This transition arguably began with the introduction of pharmacological and biological treatments for severe mood disorders and psychosis (e.g., the introduction of chlorpromazine and electroconvulsive therapy into psychiatric practice in the 1940s and 1950s) and the accumulating evidence of the heritability of psychiatric syndromes arising from twin and family studies (e.g., Gottesman 1991). Today, psychopathology research has clearly shifted toward a more biological, brain-centric focus. 1956), parental styles (e.g., refrigerator mothers and autism Kanner 1943), and the familial emotional climate (e.g., expressed emotion and relapse Brown 1959). During this period, the spotlight shone most brightly on psychological etiologies such as communication patterns (e.g., double bind communications and schizophrenia Bateson et al. Moreover, although prevailing diathesis-stress models of mental illness ( Monroe & Simons 1991) surely could accommodate both biological and psychological vulnerabilities and exacerbations, mid-twentieth-century research on the etiology of severe psychopathologies put greatest emphasis on the importance of psychological factors rather than biological ones. Although certainly relevant to some forms of mental illness (e.g., amnesia in dissociative disorders), these kinds of deficits do not really capture the dramatic emotional and social changes that form the bedrock symptoms of psychopathology. Historically, neurological injuries have largely been seen as causing deficits in cognitive domains such as memory. The major premise of this review is that neuropathology provides a royal road for understanding psychopathology. We conclude that neurodegenerative diseases can play an important role in future approaches to the assessment, prevention, and treatment of mental illness. Neurodegenerative diseases provide a powerful model system for studying the neural correlates of psychopathological symptoms this is supported by evidence indicating convergence with psychiatric syndromes (e.g., symptoms of disinhibition associated with dysfunction in orbitofrontal cortex in both frontotemporal dementia and bipolar disorder). We focus on two neurodegenerative diseases (i.e., Alzheimer's disease and frontotemporal dementia) that are common and well characterized in terms of emotion, cognition, and social behavior and in patterns of associated atrophy. We discuss five common symptoms that occur in both neurodegenerative disease and psychopathology (i.e., anxiety, dysphoric mood, apathy, disinhibition, and euphoric mood) and their associated neural circuitry. Because neurodegenerative diseases have patterns of brain atrophy that are much clearer than those of psychiatric disorders, they may provide a window into the neural bases of common emotional and behavioral symptoms.
Disruptions in emotional, cognitive, and social behavior are common in neurodegenerative disease and in many forms of psychopathology.
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