\nThere’s Such a Thing as Too Much Neuroscience<\/a><\/div>\nNew York Times<\/font><\/strong><\/div>\nBy JOHN C. MARKOWITZ<\/div>\nOCT. 14, 2016<\/div>\nThe United States government recently announced its new director of the National Institute of Mental Health, Dr. Joshua Gordon. If you think that’s just bureaucracy as usual, think again. Mental health research, under the leadership of the previous director, Dr. Thomas Insel, underwent a quiet crisis, one with worrisome implications for the treatment of mental health. I hope Dr. Gordon will resolve it. For decades, the National Institute of Mental Health provided crucial funding for American clinical research to determine how well psychotherapies worked as treatments [on their own as well as when combined with medications]. This research produced empirical evidence supporting the effectiveness of cognitive behavioral therapy, interpersonal psychotherapy and other talking treatments.<\/p>\n
But over the past 13 years, Dr. Insel increasingly shifted the institute’s focus to neuroscience, strangling its clinical research budget. Dr. Insel wasn’t wrong to be enthusiastic about the possibilities of neuroscientific research. Compared with the psychiatric diagnoses listed in the Diagnostic and Statistical Manual of Mental Disorders [D.S.M.], which can be vague and flawed, brain-based research holds out the promise of a precise and truly scientific understanding of mental illness…<\/p>\n
In 2010, the institute introduced a system of brain diagnostics known as “research domain criteria.” These criteria discard diagnoses like post-traumatic stress disorder, examining instead phenomena such as “response to an acute threat” [i.e., fear] at various scientific levels: genes, the molecules they produce, cells, brain circuits, physiology and behavior. Establishing links up and down this ladder — linking a gene to a neurohormonal molecule, and ultimately to a behavior — produces what is called “translational” research…<\/p>\n
Nonetheless, translational research has become virtually required for funding. Although the “neurosignature” targets of the research domain criteria are not demonstrably any more useful than D.S.M. diagnoses, and though they are far more distant from clinical symptoms and treatments, the institute favors them. As a result, clinical research has slowed to a trickle, now accounting for only 10 percent of the institute’s budget. Many clinical researchers like myself worry that this kind of research will disappear. We have too often been reluctant to voice our protest, for fear of incurring the institute’s displeasure [and losing whatever opportunities we still have for funding]…<\/p>\n
We need both neuroscience and clinical research. I hope the institute will re-establish that balance.<\/div>\n<\/blockquote>\nThe Research Domain Criteria <\/font>[RDoC<\/font>] have been vague at best. The idea rests on the notion that mental illnesses are biologically determined – that if we collect a large enough cohort and a database full of their biological parameters and responses, "big data" techniques will identify the elusive groupings. I assume it has been a bust, and that’s why he left. That’s based on a comment he made in a New Scientist<\/font><\/em> interview<\/a> as he was exiting: <\/div>\n\nQuestion: <\/font><\/strong><\/font><\/strong>Are you saying Google is a better place to do mental-health research than the NIMH?<\/div>\n