Application of Research Domain Criteria to childhood and adolescent impulsive and addictive disorders: Implications for treatment

Abstract

The Research Domain Criteria (RDoC) initiative provides a large-scale, dimensional framework for the integration of research findings across traditional diagnoses, with the long-term aim of improving existing psychiatric treatments. A neurodevelopmental perspective is essential to this endeavor. However, few papers synthesizing research findings across childhood and adolescent disorders exist. Here, we discuss how the RDoC framework may be applied to the study of childhood and adolescent impulsive and addictive disorders in order to improve neurodevelopmental understanding and to enhance treatment development. Given the large scope of RDoC, we focus on a single construct highly relevant to addictive and impulsive disorders - initial responsiveness to reward attainment. Findings from genetic, molecular, neuroimaging and other translational research methodologies are highlighted.

Keywords: Development; Dopamine; Impulsivity; Reward sensitivity; Substance use; fMRI.

Figure 1. Schematic diagram depicting organization of Initial Responsiveness to Reward Attainment within the RDoC matrix

Matrix overview: The RDoC matrix is composed of five domains organized into rows. Each domain (e.g., Positive Valence Systems) is hierarchically organized into constructs and subconstructs (due to space limitations, subconstructs are not shown above) also conceptualized as rows. Constructs and subconstructs may be studied across different units of analysis, conceptualized as columns. Initial Responsiveness to Reward Attainment: Within the matrix for initial responsiveness to reward attainment (a construct within Positive Valence Systems), items shown in bold font correspond to items currently included in the online RDoC matrix. Items shown in italics correspond to items proposed by the authors which are not currently included under this construct in the online matrix (http://www.nimh.nih.gov/research-priorities/rdoc/rdoc-constructs.shtml#initial_responsiveness; November 2015). NAcc = nucleus accumbens, mOFC=medial orbitofrontal cortex, vmPFC=ventromedial prefrontal cortex, ACC=anterior cingulate cortex, VTA=ventral tegmental area, BOLD=blood oxygenation level dependent, PANAS=Positive and Negative Affect Scale, TEPS=Temporal Experience of Pleasure Scale, MID=Monetary Incentive Delay task

Figure 2. Theorized postnatal development of selected aspects of the human reward system warranting further study

Figure 2 is a schematic diagram depicting the theorized longitudinal developmental trajectories for selected white-matter tissue tracts, functional responses and aspects of dopaminergic development hypothesized to relate to initial responsiveness to reward attainment (RDoC) and to the development of childhood and adolescent addictive and impulsive disorders. Trajectories are based on data reported in (Casey, 2014; Galvan, et al., 2006; Giedd, 2004; Gogtay, et al., 2004; Lebel & Beaulieu, 2011; Lebel, et al., 2008; Raznahan, et al., 2014; Wahlstrom, et al., 2010b). DLPFC = dorsolateral prefrontal cortex; OFC = orbitofrontal cortex; PFC = prefrontal cortex