Neurocognitive endophenotypes of impulsivity and compulsivity: towards dimensional psychiatry

A key criticism of the main diagnostic tool in psychiatry, the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV), is that it lacks a biological footing. In this article, we argue for a biological approach to psychiatry based on ‘neurocognitive endophenotypes’, whereby changes in...

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Bibliographic Details
Published in:Trends in cognitive sciences 2012-01, Vol.16 (1), p.81-91
Main Authors: Robbins, Trevor W, Gillan, Claire M, Smith, Dana G, de Wit, Sanne, Ersche, Karen D
Format: Article
Language:English
Subjects:
Biological Psychiatry
Compulsive Behavior
Diagnostic and Statistical Manual of Mental Disorders
Endophenotypes
Feeding and Eating Disorders - diagnosis
Humans
Impulsive Behavior
Neurobiology
Neurology
Obsessive-Compulsive Disorder - classification
Obsessive-Compulsive Disorder - diagnosis
Psychiatry
Substance-Related Disorders - diagnosis
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Summary:A key criticism of the main diagnostic tool in psychiatry, the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV), is that it lacks a biological footing. In this article, we argue for a biological approach to psychiatry based on ‘neurocognitive endophenotypes’, whereby changes in behavioural or cognitive processes are associated with discrete deficits in defined neural systems. We focus on the constructs of impulsivity and compulsivity as key examples of the approach and discuss their possible cross-diagnostic significance, applying them to co-morbidities and commonalities across a range of disorders (attention-deficit/hyperactivity disorder, substance dependence, obsessive-compulsive disorder and eating disorders). We argue that this approach has important implications for the future classification of psychiatric disorders, genetics and therapeutics.
ISSN:1364-6613
1879-307X
DOI:10.1016/j.tics.2011.11.009