RDoC: The Card Game

Date Published: March 21, 2018

Contributing Authors: Belinda S. Bandstra, MD, MA, Tatiana Ramage, MD, and Leanne Williams, PhD

Overview: Advances in neuroscience are driving evolving views on how best to conceptualize mental illness. Currently, psychiatric diagnostic practice relies on self-report and observable behavior. However, increasing clinical and neurobiological data1-5 suggest that the validity of current symptom-based diagnostic systems is limited by artificial categorization of psychiatric disorders that in fact have distinct etiologies.  To address this issue, the Research Domain Criteria (RDoC) was introduced by the National Institute of Mental Health in 2009 in an attempt to integrate multiple levels of information in a biologically-valid framework.

Currently the RDoC framework is intended to guide neuroscience research and not clinical practice. It is expected however to inform new versions of psychiatric classification and potentially change clinical practice as a whole. Therefore, it is important that clinicians be familiar with the concept and purpose of RDoC, both to close the gap between clinical and research conceptualization of mental illness, as well as to give perspective on how neuroscience research is transforming clinical thinking and practice in the field of psychiatry.

The following learning activity aims to introduce the concept of RDoC through an interactive game that organizes the content onto a large visual display. In this session, learners will become familiar with the central principles and organization of RDoC and then practice conceptualizing a patient case using this neurobiologically informed approach.

Author Contributions: Belinda S. Bandstra, MD, MA, is an Assistant Director of Residency Training and Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. Tatiana Ramage, MD, is a PGY-2 resident at the San Mateo County Residency Program.  Leanne Williams, PhD. is a Professor of Psychiatry and Behavioral Sciences at Stanfor University School of Medicine. David A. Ross, MD, PhD is the contributing editor for this session on pain pathways. The National Neuroscience Curriculum Initiative is a collaborative effort with the American Association of Directors of Psychiatric Residency Training (AADPRT) and the American Psychiatric Association (APA) Council on Medical Education and Lifelong Learning and receives grant support from the NIH (R25 MH101076 02S1 and R25 MH086466 07S1) ©National Neuroscience Curriculum Initiative.

Special Thanks to Kristin Raj, MD, and Agnes Kalinowski, MD, PhD for comments on case.