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      What kind of science for psychiatry?

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          Abstract

          Psychiatry has invested its hopes in neuroscience as a path to understanding mental disorders and developing more effective treatments and ultimately cures. Recently, the U.S. NIMH has elaborated this vision through a new framework for mental health research, the Research Domain Criteria (RDoC). This framework aims to orient mental health research toward the discovery of underlying neurobiological and biobehavioral mechanisms of mental disorders that will eventually lead to definitive treatments. In this article we consider the rationale of the RDoC and what it reveals about implicit models of mental disorders. As an overall framework for understanding mental disorders, RDoC is impoverished and conceptually flawed. These limitations are not accidental but stem from disciplinary commitments and interests that are at odds with the larger concerns of psychiatry. A multilevel, ecosocial approach to biobehavioral systems is needed both to guide relevant neuroscience research and insure the inclusion of social processes that may be fundamental contributors to psychopathology and recovery.

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          Most cited references53

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          Puzzlingly High Correlations in fMRI Studies of Emotion, Personality, and Social Cognition.

          Functional magnetic resonance imaging (fMRI) studiesofemotion, personality, and social cognition have drawn much attention in recent years, with high-profile studies frequently reporting extremely high (e.g., >.8) correlations between brain activation and personality measures. We show that these correlations are higher than should be expected given the (evidently limited) reliability of both fMRI and personality measures. The high correlations are all the more puzzling because method sections rarely contain much detail about how the correlations were obtained. We surveyed authors of 55 articles that reported findings of this kind to determine a few details on how these correlations were computed. More than half acknowledged using a strategy that computes separate correlations for individual voxels and reports means of only those voxels exceeding chosen thresholds. We show how this nonindependent analysis inflates correlations while yielding reassuring-looking scattergrams. This analysis technique was used to obtain the vast majority of the implausibly high correlations in our survey sample. In addition, we argue that, in some cases, other analysis problems likely created entirely spurious correlations. We outline how the data from these studies could be reanalyzed with unbiased methods to provide accurate estimates of the correlations in question and urge authors to perform such reanalyses. The underlying problems described here appear to be common in fMRI research of many kinds-not just in studies of emotion, personality, and social cognition.
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            The brain activity map project and the challenge of functional connectomics.

            The function of neural circuits is an emergent property that arises from the coordinated activity of large numbers of neurons. To capture this, we propose launching a large-scale, international public effort, the Brain Activity Map Project, aimed at reconstructing the full record of neural activity across complete neural circuits. This technological challenge could prove to be an invaluable step toward understanding fundamental and pathological brain processes. Copyright © 2012 Elsevier Inc. All rights reserved.
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              Is Open Access

              The Small World of Psychopathology

              Background Mental disorders are highly comorbid: people having one disorder are likely to have another as well. We explain empirical comorbidity patterns based on a network model of psychiatric symptoms, derived from an analysis of symptom overlap in the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Principal Findings We show that a) half of the symptoms in the DSM-IV network are connected, b) the architecture of these connections conforms to a small world structure, featuring a high degree of clustering but a short average path length, and c) distances between disorders in this structure predict empirical comorbidity rates. Network simulations of Major Depressive Episode and Generalized Anxiety Disorder show that the model faithfully reproduces empirical population statistics for these disorders. Conclusions In the network model, mental disorders are inherently complex. This explains the limited successes of genetic, neuroscientific, and etiological approaches to unravel their causes. We outline a psychosystems approach to investigate the structure and dynamics of mental disorders.
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                Author and article information

                Contributors
                Journal
                Front Hum Neurosci
                Front Hum Neurosci
                Front. Hum. Neurosci.
                Frontiers in Human Neuroscience
                Frontiers Media S.A.
                1662-5161
                07 May 2014
                20 June 2014
                2014
                : 8
                : 435
                Affiliations
                Division of Social and Transcultural Psychiatry, McGill University & Institute of Community and Family Psychiatry, Jewish General Hospital Montreal, QC, Canada
                Author notes

                Edited by: Jan Slaby, Freie Universität Berlin, Germany

                Reviewed by: Sören Krach, Philipps-University Marburg, Germany; Matthew R. Broome, University of Oxford, UK

                *Correspondence: Laurence J. Kirmayer, Institute of Community and Family Psychiatry, 4333 Chemin de la Côte-Ste-Catherine, Montreal, QC H3T 1E4, Canada e-mail: laurence.kirmayer@ 123456mcgill.ca

                This article was submitted to the journal Frontiers in Human Neuroscience.

                Article
                10.3389/fnhum.2014.00435
                4092362
                323d982e-2a13-4161-b923-404f26b9bbd7
                Copyright © 2014 Kirmayer and Crafa.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 11 April 2014
                : 29 May 2014
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 100, Pages: 12, Words: 0
                Categories
                Neuroscience
                Review Article

                Neurosciences
                critical neuroscience,psychiatric diagnosis,nosology,research domain criteria,culture,social context,systems science

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