9. Research Domain Criteria(RDoC: 研究領域分類基準【増山訳】)
5つの分類から症状を遺伝子,神経伝達物質,脳機能や行動面などから
発生機序を理解
あくまで症状の分類であり,診断基準ではない
3つの仮説に基づいてNIMHが作成
・精神疾患は脳の障害である
・神経回路の機能不全は神経科学,電気生理学,
fMRIの測定ツール,もしくは新しい手法によって測定できる
・神経科学や遺伝学の知見から,臨床における症状や徴候を
増強できる
・Negative Valence Systems
・Positive Valence Systems
・Cognitive Systems
・System for Social Processes
・Arousal / Regulatory Processes
10. Domain: Negative Valence System
Construct: Loss
Genes Molecules Cells Circuits Physiology Behavior Self-
Reports
Paradigm
s
MAOA,
COMT,
DAT1,
5HTTR,
5HTRs
Downregula
tion of
glucocortico
id receptors;
Upregulatio
n of CRH;
Estrogens;
Androgens;
Oxytocin;
Vasopressin;
Inflammator
y molecules
Sustained amygdala
reactivity; Decreased DLPFC
recruitment; Decreased
vmPFC (incl. rostral
cingulate); Increased insula
activation; Increased
posterior cingulate activity;
Decreased R parietal; PVN;
Hippocampus; Orbitofrontal
cortex; Habit systems
(striatum/
caudate/accumbens);
Increased default mode
activity; Dysregulated
reward circuitry
ANS & HPA &
neuroimmune
dysregulation;
Prolonged
psychophysiol
ogical
reactivity
Rumination;
Withdrawal; Worry;
Crying; Sadness;
Loss-relevant recall
bias; shame;
Attentional bias to
negative valenced
information; Guilt;
Morbid Thoughts;
Psychomotor
retardation;
Anhedonia;
Increased self-focus;
Deficits in executive
function (e.g.,
impaired sustained
attention); Loss of
drive (sleep,
appetite, libido);
Amotivation
Change in
attribution
al Style;
Hopelessn
ess
具体的には・・
RDoC NIMH詳しくは