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Rief W, Hofmann SG, Berg M, Forbes MK, Pizzagalli DA, Zimmermann J, Fried E, Reed GM. Do We Need a Novel Framework for Classifying Psychopathology? A Discussion Paper. Clin Psychol Eur 2023; 5:e11699. [PMID: 38357431 PMCID: PMC10863678 DOI: 10.32872/cpe.11699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
Introduction The ICD-11 and DSM-5 are the leading systems for the classification of mental disorders, and their relevance for clinical work and research, as well as their impact for policy making and legal questions, has increased considerably. In recent years, other frameworks have been proposed to supplement or even replace the ICD and the DSM, raising many questions regarding clinical utility, scientific relevance, and, at the core, how best to conceptualize mental disorders. Method As examples of the new approaches that have emerged, here we introduce the Hierarchical Taxonomy of Psychopathology (HiTOP), the Research Domain Criteria (RDoC), systems and network approaches, process-based approaches, as well as a new approach to the classification of personality disorders. Results and Discussion We highlight main distinctions between these classification frameworks, largely related to different priorities and goals, and discuss areas of overlap and potential compatibility. Synergies among these systems may provide promising new avenues for research and clinical practice.
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Affiliation(s)
- Winfried Rief
- Clinical Psychology and Psychotherapy Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Stefan G. Hofmann
- Translational Clinical Psychology Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Max Berg
- Clinical Psychology and Psychotherapy Group, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Miriam K. Forbes
- School of Psychological Sciences, Australian Hearing Hub, Macquarie University Sydney, Sydney, Australia
| | - Diego A. Pizzagalli
- Department of Psychiatry, Center for Depression, Anxiety and Stress Research & McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | - Eiko Fried
- Clinical Psychology Group, Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Geoffrey M. Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Makowski C, Brown TT, Zhao W, Hagler DJ, Parekh P, Garavan H, Nichols TE, Jernigan TL, Dale AM. Leveraging the Adolescent Brain Cognitive Development Study to improve behavioral prediction from neuroimaging in smaller replication samples. bioRxiv 2023:2023.06.16.545340. [PMID: 37398195 PMCID: PMC10312746 DOI: 10.1101/2023.06.16.545340] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Magnetic resonance imaging (MRI) is a popular and useful non-invasive method to map patterns of brain structure and function to complex human traits. Recently published observations in multiple large scale studies cast doubt upon these prospects, particularly for prediction of cognitive traits from structural and resting state functional MRI, which seems to account for little behavioral variability. We leverage baseline data from thousands of children in the Adolescent Brain Cognitive DevelopmentSM (ABCD®) Study to inform the replication sample size required with both univariate and multivariate methods across different imaging modalities to detect reproducible brain-behavior associations. We demonstrate that by applying multivariate methods to high-dimensional brain imaging data, we can capture lower dimensional patterns of structural and functional brain architecture that correlate robustly with cognitive phenotypes and are reproducible with only 41 individuals in the replication sample for working memory-related functional MRI, and ~100 subjects for structural MRI. Even with 100 random re-samplings of 50 subjects in the discovery sample, prediction can be adequately powered with 98 subjects in the replication sample for multivariate prediction of cognition with working memory task functional MRI. These results point to an important role for neuroimaging in translational neurodevelopmental research and showcase how findings in large samples can inform reproducible brain-behavior associations in small sample sizes that are at the heart of many investigators' research programs and grants.
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Affiliation(s)
- Carolina Makowski
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Timothy T Brown
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Weiqi Zhao
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, USA
- Department of Cognitive Science, University of California San Diego, La Jolla, California USA
| | - Donald J Hagler
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Pravesh Parekh
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Thomas E Nichols
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU
| | - Terry L Jernigan
- Department of Cognitive Science, University of California San Diego, La Jolla, California USA
| | - Anders M Dale
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, USA
- Department of Radiology, University of California San Diego, La Jolla, California, USA
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
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Segal A, Parkes L, Aquino K, Kia SM, Wolfers T, Franke B, Hoogman M, Beckmann CF, Westlye LT, Andreassen OA, Zalesky A, Harrison BJ, Davey CG, Soriano-Mas C, Cardoner N, Tiego J, Yücel M, Braganza L, Suo C, Berk M, Cotton S, Bellgrove MA, Marquand AF, Fornito A. Regional, circuit and network heterogeneity of brain abnormalities in psychiatric disorders. Nat Neurosci 2023; 26:1613-1629. [PMID: 37580620 PMCID: PMC10471501 DOI: 10.1038/s41593-023-01404-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
The substantial individual heterogeneity that characterizes people with mental illness is often ignored by classical case-control research, which relies on group mean comparisons. Here we present a comprehensive, multiscale characterization of the heterogeneity of gray matter volume (GMV) differences in 1,294 cases diagnosed with one of six conditions (attention-deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, depression, obsessive-compulsive disorder and schizophrenia) and 1,465 matched controls. Normative models indicated that person-specific deviations from population expectations for regional GMV were highly heterogeneous, affecting the same area in <7% of people with the same diagnosis. However, these deviations were embedded within common functional circuits and networks in up to 56% of cases. The salience-ventral attention system was implicated transdiagnostically, with other systems selectively involved in depression, bipolar disorder, schizophrenia and attention-deficit/hyperactivity disorder. Phenotypic differences between cases assigned the same diagnosis may thus arise from the heterogeneous localization of specific regional deviations, whereas phenotypic similarities may be attributable to the dysfunction of common functional circuits and networks.
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Affiliation(s)
- Ashlea Segal
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia.
| | - Linden Parkes
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Rutgers University, Piscataway, NJ, USA
| | - Kevin Aquino
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
- School of Physics, University of Sydney, Sydney, New South Wales, Australia
- BrainKey Inc, Palo alto, CA, USA
| | - Seyed Mostafa Kia
- Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, the Netherlands
| | - Thomas Wolfers
- Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TÜCMH), University of Tübingen, Tübingen, Germany
| | - Barbara Franke
- Department of Psychiatry, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Human Genetics, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Martine Hoogman
- Department of Psychiatry, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Human Genetics, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Christian F Beckmann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, the Netherlands
- Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Christopher G Davey
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
- Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Narcís Cardoner
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Leah Braganza
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Chao Suo
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
- Australian Characterisation Commons at Scale (ACCS) Project, Monash eResearch Centre, Melbourne, Victoria, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Sue Cotton
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Andre F Marquand
- Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, the Netherlands
- Department of Neuroimaging, Centre of Neuroimaging Sciences, Institute of Psychiatry, King's College London, London, UK
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia.
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