Читать книгу Introduction to Abnormal Child and Adolescent Psychology - Robert Weis - Страница 43

The National Institute of Mental Health (NIMH) is attempting to move beyond the current DSM-5 system of classifying mental disorders based on descriptions of signs and symptoms (Insel & Lieberman, 2013). NIMH has launched the Research Domain Criteria (RDoC) initiative to identify the genetic and biological causes of each disorder. The RDoC are based on the assumption that mental disorders are “biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior” (Insel & Lieberman, 2013). The goal of this initiative is to use genetic and biomedical research to identify the underlying causes of these disorders in order to provide more effective treatments. Specifically, research targets several levels of analysis: genes, molecules, cells, neural circuits, physiology, and behavior.

Critics of DSM-5 argue that instead of being a “bible” of mental disorders, it functions more like a dictionary—providing mere definitions in terms of observable signs and self-reported symptoms. Instead, advocates of the RDoC initiative argue that a new system is needed that addresses the underlying genetic and neurological causes for each disorder (Reed, Robles, & Dominguez-Martinez, 2018).

The DSM-5 and RDoC initiative reflect different approaches to conceptualizing mental disorders (Lilienfeld & Treadway, 2016). Time will tell if classification based on underlying genetic risk and neural circuitry increases diagnostic validity and leads to more effective treatment than one based on description. In the meantime, psychologists should not forget the rich information that is gained from approaching childhood disorders from both biological and psychosocial perspectives in the context of youths’ development and surroundings. Recent advances in mental health research indicate that psychological, familial, and sociocultural influences are at least as important in explaining the cause and maintenance of childhood disorders as the genetic and biological factors emphasized by these other diagnostic systems (Cicchetti, 2016a, 2016b). Furthermore, most evidence-based treatments for these disorders operate at these “higher” levels by improving the psychological, familial, and sociocultural functioning of children and families (Christophersen & Vanscoyoc, 2013). We must not neglect these psychosocial interventions for helping at-risk youths while simultaneously looking to the future.

Review

 A DSM-5 diagnosis is parsimonious, it allows professionals to communicate clearly with each other, and it can be helpful in predicting outcomes and planning treatment. A diagnosis can also help children gain access to educational or psychological services, help caregivers understand their child’s behavior, and facilitate research.

 A DSM-5 diagnosis may not provide a detailed description of the child’s strengths and functioning, may not reflect the child’s developmental or environmental context, and may focus too much on the child rather than on important people in his or her life.

 Whereas a DSM-5 diagnosis is based largely on the signs and symptoms of each disorder, the proposed RDoC initiative classifies children based on underlying biological causes.