Overview of the Research Domain Criteria (RDOC) Approach

Researchers looking at video screens.

Getty / Tom Werner

 

The Research Domain Criteria (RDoC) is a research framework for new approaches to understanding and treating mental disorders. This conceptual framework was designed to integrate various types of information including genetics, molecules, cells, circuitry, behavior, physiology, and self-report.

In addition, the RDoC considers a range of behavior from normal to abnormal rather than being a diagnostic guide with categories.

In this way, The RDoC is not currently meant to replace diagnostic systems. Rather, it has an aim to aid understanding of mental health and to guide research to identify effective treatments.

History of RDoC

The RDoC was developed by the National Institute of Mental Health (NIMH) to be a biologically valid approach that incorporated genetics, neuroscience, and behavioral science.

It grew out of criticism levied by NIMH director Thomas Insel in 2013 regarding the Diagnostic and Statistical Manual of Mental Disorders' (DSM) failure to base diagnoses on objective laboratory measures. Insel argued that patients deserved better and the RDoc was launched based on four assumptions:

  • Diagnoses must be based on biology as well as on symptoms.
  • Mental disorders involve brain circuitry and therefore are biological illnesses.
  • Levels of analysis must be considered across dimensions of function.
  • Mapping of different aspects of disorders will aid the development of targeted treatments.

Experts then focused on various domains and identified constructs for research.

Structure of RDoC

The Research Domain Criteria are made up of five domains, each containing a set of constructs that include elements, processes, mechanisms, and responses. They are listed briefly below.

It also refers to "units of analysis," which are molecular, genetic, circuitry, and behavioral.

An RDoc matrix is also available that shows how the domains, constructs, and units of analysis all relate to each other. It is also understood that the matrix will change as new research emerges.

Negative Valence Systems

The negative valence systems domain refers to responses to adverse situations such as fear, anxiety, or loss.

Acute Threat (Fear)

The fear construct refers to the activation of the brain to engage behaviors that protect you from perceived danger. Fear may be elicited by internal and external events and influenced by a variety of factors. For example, when faced with an unfriendly dog, your fear might motivate you to escape to a safe place. Acute fear would be most akin to a phobic reaction.

Potential Threat (Anxiety)

Different from fear, anxiety refers to the brain system that responds to potential threat that is distant, not clearly defined, or unlikely to happen. Anxiety results in you scanning for risks instead of running for safety. Anxiety described in this way would be most akin to generalized anxiety.

Sustained Threat

Unlike acute threat or potential threat, sustained threat refers to an emotional state caused by prolonged exposure to situations (internal or external) that it would be adaptive to avoid or escape. Exposure to this situation (whether it is actual or anticipated) has long-lasting effects of emotions, thinking, and your body long after the threat is gone. Sustained threat described in this way would be most akin to post-traumatic stress.

Loss

Loss refers to losses of any kind that cause grief or sustained loss-related behaviors such as losing a loved one, ending a relationship, losing your home, etc. Loss defined in this way, and its outcomes, would be most comparable to the symptoms of depression.

Frustrative Nonreward

Frustrative nonreward refers to not obtaining something or having it taken away, and the effects that this has on a person.

Positive Valence Systems

Positive Valence Systems refers to responses to positive situations such as reward-seeking behavior.

Reward Responsiveness

What is your response to expecting to receive a reward, receiving a reward, and repeatedly receiving a reward? This is what reward responsiveness measures. It has three sub-constructs as follows:

  • Reward Anticipation - This refers to how you anticipate a reward in the future in terms of your language, behavior, and neural systems.
  • Initial Response to Reward - This refers to your brain responses, speech, and behavior when receiving a reward.
  • Reward Satiation - This refers to how a reward changes for you over time as you receive it repeatedly, in terms of what you say, how you act, and how your brain responds.

Reward Learning

Reward learning refers to how you change your behavior to adapt to the circumstances of rewards. It has three sub-constructs as outlined below:

  • Probabilistic and Reinforcement Learning - This refers to you learning what to do to receive a reward, even when your behavior does not always give you that reward.
  • Reward Prediction Error - This refers to assimilating information about rewards being different than what you expected, such as when they are larger or smaller than predicted.
  • Habit - Habit refers to those things you learn to do and that become automatic. Often they start out as being motivated by rewards, but may eventually just continue on out of force of habit and be resistant to change. Habits can become unhelpful in this way.

Reward Valuation 

Reward valuation refers to everything related to you deciding the value of a reward and is influenced by things like social context, biases, memory, and deprivation. It has three sub-constructs as outlined below:

Reward (ambiguity/risk) - A reward is valued in terms of its size, positive versus negative elements, and how predictable it is.

Delay - Delay refers to deciding how valuable a reward is based on its size and how long it will be before you get it.

Effort - Effort refers to you deciding how valuable a reward is based on its size and how much effort you need to expend to get it.

Cognitive Systems

The cognitive systems domain refers to all your cognitive processes.

Attention

Attention refers to everything related to accessing limited capacity systems including awareness, perception, and motor action.

Perception

Perception refers to the processes involved in representing your external environment, getting information from it, and making predictions about it. Perception consists of three sub-constructs: Visual Perception, Auditory Perception, and Olfactory/Somatosensory/Multimodal/Perception.

Declarative Memory

Declarative memory refers to memory for facts and events.

Language

Language refers to how we represent the world and concepts through verbal communication.

Cognitive Control

This refers to your ability to make decisions about your cognitive and emotional systems to guide your behavior. It consists of three sub-constructs: Goal Selection, Updating, Representation, and Maintenance; Response Selection; Inhibition/Suppression; and Performance Monitoring.

Working Memory

Finally, working memory refers to updating of goal and task information and consists of four sub-constructs: Active Maintenance, Flexible updating, Limited Capacity, and Inference Control.

Systems for Social Processes

Systems for Social Processes refers to how you relate to other people including perceptions and interpretation.

Affiliation and Attachment

Affiliation refers to engaging with others in social interaction while attachment is developing social bonds. Each of these involves a range of processes such as detecting social cues.

Social Communication

Social communication refers to how you communicate with other people. This involves processes such as recognizing emotions, eye contact, etc. It involves four subconstructs: Reception of Facial Communication, Production of Facial Communication, Reception of Non-Facial Communication, and Production of Non-Facial Communication.

Perception and Understanding of Self

Perception and Understanding of Self refers to understanding and making judgments about yourself. This might involve processes such as recognizing your emotional state and self-monitoring. It includes two sub-constructs: Agency and Self-Knowledge.

Perception and Understanding of Others

Perception and Understanding of Others refers to the processes involved in perceiving and understanding other people. It includes three subconstructs: Animacy Perception, Action Perception, and Understanding Mental States.

Arousal/Regulatory Systems

Arousal/Regulatory Systems refers to homeostatic regulation of systems for sleep, energy balance, etc.

Arousal

Arousal refers to sensitivity to external and internal stimuli and can be regulated by homeostatic drives such as hunger, thirst, sleep, and sex.

Circadian Rhythms

Circadian rhythms refers to the timing of your biological systems for optimal physical and mental health.

Sleep and wakefulness

Sleep and wakefulness refers to all processes involved in sleep and is affected by homeostatic regulation.

Sensorimotor Systems

Sensorimotor systems refers to how you learn to control and execute motor behaviors.

Motor Actions

This refers to all processes related to engaging in motors actions. It involves the following sub-constructs: Action Planning and Selection, Sensorimotor Dynamics, Initiation, Execution, Inhibition and termination, Agency and ownership, Habit, and Innate motor patterns.

Purpose of RDoC

What is the purpose of the Research Domain Criteria? Whereas currently, mental disorders are understood in terms of categories based on symptoms, the RDoC proposes that mental illness is better understood based on neuroscience.

What is the underlying disease process that is causing your symptoms?

That is what RDoC researchers want to determine. It's not so much important that you have a cluster of symptoms that have been labeled as depression. Rather, they want to identify each symptom that you have and trace it back to its neurobiological roots. It's really a fascinating approach!

What if we could link your biology to your dysfunctional thoughts? What if we could figure out measurable characteristics of you that relate to the symptoms that you are experiencing?

The value in this approach is that it brings together clinical and basic sciences to identify aspects of disorders that span different areas including executive functioning, perception, emotion, etc.

So, the purpose of the RDoC is to encourage research that identifies underlying causes of mental illness and how to determine how to treat them.

RDoC vs. DSM and ICD

How does the RDoC differ from other systems like the DSM and International Classification of Diseases (ICD)?

Just an aside: The ICD is the most popular alternative to the DSM, is created by the World Health Organization, and is used to track prevalence and for health insurance purposes.

  • First, the RDoC was not designed to replace the DSM or ICD—at least not right now. Its purpose is to be a research framework, particularly since the NIMH chose to no longer use the DSM as criteria for clinical trials.
  • Second, the RDoC is dimensional rather than categorical. It describes behavior in a range from normal to abnormal, rather than in terms of either/or clinical diagnoses.
  • Third, it works from the ground up, starting with brain-behavior relations and linking those to clinical symptoms. On the other hand, DSM and ICD work from the top-down, starting with categories and determining what fits in those categories.
  • Fourth, RDoC incorporates a wider range of data such as genetics, biology, and physiology, whereas the DSM only incorporates symptom reports or observations.

In this way, if a diagnosis was ever based on RDoC, it was related to the underlying causes of dysfunction and any treatment would be very targeted. In this way, it follows the medical model approach in the hopes of finding better treatments.

A Word From Verywell

Are you still confused about RDoc? In a nutshell, this research framework can be thought of as a very granular way of looking at mental illness and how to treat it. Because in the end, it is the treatment that is the goal of research.

Imagine if you will that you're experiencing symptoms of depression. A psychologist would diagnose you according to the DSM with depression, and you'd receive talk therapy and/or medication.

According to RDoC, each of your symptoms would be examined independently in terms of the underlying biological and neurological causes to determine the best treatment(s) for you. That's, of course, a very long way out—these are just at the research phase right now. But, that is the future, and it looks much more promising than the system that we currently have in place to diagnose and treat mental illness.

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