A new multi-site brain imaging study in The American Journal of Psychiatry shows that sub-groups of people use their brains differently when imitating emotional faces — a task that reflects their ability to interact socially. Interestingly, individuals with schizophrenia do not have categorically different social brain function than those without mental illness, but fall into different sub-groups that may respond to different types of treatments. These findings call into question the most common research approaches in mental health.
“We know that, on average, people with schizophrenia have more social impairment than people in the general population,” says senior author Dr. Aristotle Voineskos in the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH) in Toronto. “But we needed to take an agnostic approach and let the data tell us what the brain-behavioural profiles of our study participants looked like. It turned out that the relationship between brain function and social behaviour had nothing to do with conventional diagnostic categories in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).”
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Mental illnesses, such as major depression, bipolar disorder and post-traumatic stress disorder, affect nearly 1 in 5 adults in the United States, according to the National Alliance on Mental Illness. Many aspects of these illnesses remain something of a mystery, despite the progress made in understanding them by researchers studying these disorders in the last half century.
Even so, clinicians and researchers, together with patients and their families, have made significant strides identifying and treating mental illnesses. Two major diagnostic manuals — the Diagnostic and Statistical Manual of Mental Disorders (DSM), used primarily in the U.S., and the International Classification of Diseases (ICD), used internationally — provide clinicians, researchers and patients a structured approach to diagnosing mental health. Further, the federal National Institute of Mental Health also uses a new framework for researching mental illness, called the Research Domain Criteria, or R-DoC.
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A consortium of psychologists and psychiatrists has developed a new, evidence-based alternative to the mental health field’s long-established diagnostic tools for the classification, treatment, and research of mental disorders, according to a University at Buffalo psychologist who is one of the co-authors of a paper that explains the groundbreaking approach.
The Hierarchical Taxonomy of Psychopathology (HiTOP) addresses what the authors say are limitations to the reliability and validity of traditional models like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association’s (APA) authoritative handbook used by clinicians and researchers around the world to diagnose and treat mental disorders.
“HiTOP is the first attempt by any group of individuals to put forth a classification and diagnostic system that has the features we’ve described,” says Leonard Simms, an associate professor in UB’s Department of Psychology and one of the 40 researchers who worked with team leaders Roman Kotov of Stony Brook University, Robert Krueger of University of Minnesota, and David Watson of University of Notre Dame on the study that appears in the latest issue of the Journal of Abnormal Psychology.
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