Artikelen Psychopathologie
Michelini et. al (2021) – Week 1
Abstract
- Research domain criteria (RDoC) and Hierarchical taxonomy of
psychopathology (HiTOP) propose 2 alternative approaches to speed
up the process of studying/classifying and treating psychopathology.
- RDoC is rooted in neuroscience and has the goal of increasing
understanding of biobehavioural systems underlying
psychopathology + to inform future classifications.
Its behavioural framework may help to clarify the
underpinnings of the clinical dimensions of HiTOP.
- HiTOP is a dimensional classification system, based on covariation of
symptoms of psychopathology and maladaptive traits. Its goal is to
provide more informative research and treatment.
HiTOP may provide psychometrically robust clinical targets for
RDoC research.
Introduction
There are major limitations to categorical classification that makes them a
poor guide for research and clinical practice.
- They don’t reflect the evidence that forms of psychopathology and
their underlying processes are continuous.
- Low diagnostic reliability, diagnostic instability and failure to
recognize subthreshold presentations.
Also, traditional diagnoses are based on subjective reports and
observations of symptoms. These do NOT consider underlying
pathopsychological mechanisms.
Third, traditional diagnoses are focused on individual diagnoses, ignoring
comorbidity and developmental continuity between disorders.
Fourth, DSM and ICD do not provide tools to consider the heterogeneity
within each diagnosis.
,Similarities and differences between RDoC and HiTOP
Similarities:
1. Moving away from diagnostic categories
2. Work-in-progress approach: both frameworks are designed to evolve
with new evidence.
Differences:
1. Delineation of dimension: RDoC constructs/domains are defined
based on consensus of experts regarding biobehavioural systems
relevant to mental health. HiTOP dimensions reflect covariation
among signs, symptoms, diagnoses, and maladaptive behaviors.
2. Content and units of analysis: RDoC focuses on neurobiology,
whereas HiTOP focuses on signs, symptoms and diagnoses and
maladaptive behaviours.
, 3. Current gaps and limitations: RDoC does not include majority of
signs/symptoms/behaviours, whereas HiTOP does.
Conclusion
Dimensional approach to clinical research by using both is the most
promising.
Astle et. Al (2018) Learning difficulties –
Week 1
Abstract
- Applying strict exclusionary criteria overemphasizes within group
homogeneity and between group differences, and fails to capture
comorbidity.
- 4 Groups of children were identified:
Children with broad cognitive difficulties and severe
reading/spelling/maths problems.
Children with age-typical cognitive abilities and learning
profiles.
Children with working memory problems.
Children with phonological difficulties.
The learning profiles for the children with working memory problems and
those with phonological difficulties did not differ.
, In this study
- First to apply machine learning to understand heterogeneity in
struggling learners.
- Large sample, including multiple differencesRich phenotyping with
detailed behavioral, cognitive, and neuroimaging assessments.
Discussion
- We used machine learning to identify the cognitive profiles within a
large heterogeneous sample of children with learning-related
problems. These profiles were represented as topographical maps.
- None of the characteristics of the children (e.g. diagnosis) were
predictive of the cognitive profiles identified by the machine
learning.
- However, also downside to machine learning: mapping process is
continuous, with no obvious boundaries, which makes it difficult to
have a clear rationale about the formation of groups.
Artikel Lai, Mental health challenges faced
by autistic people (2023) - Week 2
Main
The mental health struggles of people with autism can be understood by 2
factors: neurodevelopmental and physical health factors and the
neurodiversity paradigm.
Neurodiversity paradigm: advocates for social changes that are
inclusive of autistic and other neurodivergent people. The paradim
undamentally humanistic and compatible with the prevailing bio-
psycho-social formulations—two widely accepted stances of
contemporary clinical practices.
Co-occurring neurodevelopmental disorders
- Intellectual disabilities in the autism population is around 18.6% or
34.8%.
- Pooled prevalence of ADHD in autism = 28%, and 10% for epilepsy.
Autistic people with intellectual disability have more developmental delays
and neurological disorders. Autistic people without intellectual disability
have more psychiatric diagnoses.
The neurodevelopmental co-occurrences are associated with an increased
risk of mental health problems. For example:
Michelini et. al (2021) – Week 1
Abstract
- Research domain criteria (RDoC) and Hierarchical taxonomy of
psychopathology (HiTOP) propose 2 alternative approaches to speed
up the process of studying/classifying and treating psychopathology.
- RDoC is rooted in neuroscience and has the goal of increasing
understanding of biobehavioural systems underlying
psychopathology + to inform future classifications.
Its behavioural framework may help to clarify the
underpinnings of the clinical dimensions of HiTOP.
- HiTOP is a dimensional classification system, based on covariation of
symptoms of psychopathology and maladaptive traits. Its goal is to
provide more informative research and treatment.
HiTOP may provide psychometrically robust clinical targets for
RDoC research.
Introduction
There are major limitations to categorical classification that makes them a
poor guide for research and clinical practice.
- They don’t reflect the evidence that forms of psychopathology and
their underlying processes are continuous.
- Low diagnostic reliability, diagnostic instability and failure to
recognize subthreshold presentations.
Also, traditional diagnoses are based on subjective reports and
observations of symptoms. These do NOT consider underlying
pathopsychological mechanisms.
Third, traditional diagnoses are focused on individual diagnoses, ignoring
comorbidity and developmental continuity between disorders.
Fourth, DSM and ICD do not provide tools to consider the heterogeneity
within each diagnosis.
,Similarities and differences between RDoC and HiTOP
Similarities:
1. Moving away from diagnostic categories
2. Work-in-progress approach: both frameworks are designed to evolve
with new evidence.
Differences:
1. Delineation of dimension: RDoC constructs/domains are defined
based on consensus of experts regarding biobehavioural systems
relevant to mental health. HiTOP dimensions reflect covariation
among signs, symptoms, diagnoses, and maladaptive behaviors.
2. Content and units of analysis: RDoC focuses on neurobiology,
whereas HiTOP focuses on signs, symptoms and diagnoses and
maladaptive behaviours.
, 3. Current gaps and limitations: RDoC does not include majority of
signs/symptoms/behaviours, whereas HiTOP does.
Conclusion
Dimensional approach to clinical research by using both is the most
promising.
Astle et. Al (2018) Learning difficulties –
Week 1
Abstract
- Applying strict exclusionary criteria overemphasizes within group
homogeneity and between group differences, and fails to capture
comorbidity.
- 4 Groups of children were identified:
Children with broad cognitive difficulties and severe
reading/spelling/maths problems.
Children with age-typical cognitive abilities and learning
profiles.
Children with working memory problems.
Children with phonological difficulties.
The learning profiles for the children with working memory problems and
those with phonological difficulties did not differ.
, In this study
- First to apply machine learning to understand heterogeneity in
struggling learners.
- Large sample, including multiple differencesRich phenotyping with
detailed behavioral, cognitive, and neuroimaging assessments.
Discussion
- We used machine learning to identify the cognitive profiles within a
large heterogeneous sample of children with learning-related
problems. These profiles were represented as topographical maps.
- None of the characteristics of the children (e.g. diagnosis) were
predictive of the cognitive profiles identified by the machine
learning.
- However, also downside to machine learning: mapping process is
continuous, with no obvious boundaries, which makes it difficult to
have a clear rationale about the formation of groups.
Artikel Lai, Mental health challenges faced
by autistic people (2023) - Week 2
Main
The mental health struggles of people with autism can be understood by 2
factors: neurodevelopmental and physical health factors and the
neurodiversity paradigm.
Neurodiversity paradigm: advocates for social changes that are
inclusive of autistic and other neurodivergent people. The paradim
undamentally humanistic and compatible with the prevailing bio-
psycho-social formulations—two widely accepted stances of
contemporary clinical practices.
Co-occurring neurodevelopmental disorders
- Intellectual disabilities in the autism population is around 18.6% or
34.8%.
- Pooled prevalence of ADHD in autism = 28%, and 10% for epilepsy.
Autistic people with intellectual disability have more developmental delays
and neurological disorders. Autistic people without intellectual disability
have more psychiatric diagnoses.
The neurodevelopmental co-occurrences are associated with an increased
risk of mental health problems. For example:
