Abstract
Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and then grouped into a psychiatric category. I highlight this primarily through analysing research domain criteria (RDoC). RDoC’s importance makes it worth scrutinizing, and this assessment also serves as a case study with relevance for other areas of psychiatry. RDoC takes inadequacies of existing psychiatric categories as holding back causal investigation. Consequently, RDoC aims to circumnavigate existing psychiatric categories by directly investigating the causal basis of symptoms. The unique methodological approach of RDoC exploits the supposed lack of influence of psychiatric categories on symptom modelling, taking psychiatric symptoms as the same regardless of which psychiatric category is employed or if no psychiatric category is employed. But this supposition is not always true. I will show how psychiatric categories can influence symptom modelling, whereby identical behaviours can be considered as different symptoms based on an individual’s psychiatric diagnosis. If the modelling of symptoms is influenced by psychiatric categories, then psychiatric categories will still play a role, a situation which RDoC researchers explicitly aim to avoid. I discuss four ways RDoC could address this issue. This issue also has important implications for factor analysis, cluster analysis, modifying psychiatric categories, and symptom based approaches.
Highlights
Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and grouped into a psychiatric category
Psychiatric symptoms influence which psychiatric categories are employed, but the reverse is not true; the psychiatric category does not influence the modelling of symptoms
It is commonly assumed by psychiatrists that modelling psychiatric symptoms is not influenced by psychiatric categories—that symptoms are modelled in the same way regardless of which, or if any, psychiatric category is employed
Summary
Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and grouped into a psychiatric category. Two individuals might exhibit the behaviour of ‘disliking unexpected changes’ but each individual could have had that behaviour modelled as a different symptom during their DSM diagnosis This could determine which participant meets the requirements for inclusion in a specific RDoC study. Even if each individual were reassessed, any RDoC psychiatrist who had been previously trained within a DSM framework, or previously had employed the DSM, would likely find that years of training and psychiatric practice has unconsciously predisposed them to model behaviour into symptoms in a manner similar to the DSM On all these grounds, the symptoms considered present within the cohort, which will be linked to causes, could be influenced by psychiatric categories. To the degree that this is the case, there is a substantial limit on symptom-based projects intending to abandon psychiatric categories
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