Where is RDoC headed? A look at the eating disorders FOA

Thomas Insel, director of NIMH, made a splash recently with the announcement that NIMH funding will be less strictly tied to the DSM. That by itself would be good news, given all the problems with DSM. But the proposed replacement, the Research Domain Criteria (RDoC), has worried some people that NIMH is pursuing biology to the exclusion of other levels of analysis, as opposed to taking a more integrated approach.

We can try to divine NIMH future directions from RDoC description and the director’s blog post, but it’s hard to tell whether mentions of behavior and phenomenology reflect real priorities or just lip service. Likewise for social and cultural factors. They come up in a discussion of “environmental aspects” that might interact with neural circuits, but they do not appear as focal units of analysis in the RDoC matrix, leaving them in a somewhat ambiguous state.

Another approach is to look at revealed preferences. Regardless of what anybody is saying, how is NIMH actually going to spend its money?

As an early indication, the NIMH RDoC overview page links to 2 funding opportunity announcements (FOAs) that are based on RDoC. Presumably these are examples of where RDoC-driven research is headed. One of the FOAs is for eating disorders. Here is the overview:

Eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), and their variants, are a major source of physical and psychological morbidity and constitute the major contribution to excess mortality from psychiatric disorders.  Clinical presentations of eating disorders are highly heterogeneous, involving broad and often overlapping symptomatology, which is often further complicated by metabolic and nutritional challenges that result from restricted food intake, excessive exercise, and repeated binge and/or purge episodes.  The recognition that relatively specific behaviors, cognitive operations, and affective processes are primarily implemented by particular neural circuits suggests that dysregulated functions and associated neural circuits should be a critical focus of study, and, ultimately, the target of assessment and treatment for eating disorders.

Here is a list of words that do not appear anywhere in the eating disorders FOA:

peer (when not followed by “review” referring to the funding processes)
body image
self (when not followed by “-report” in a rote recital of the RDoC units of anlaysis)

And maybe I shouldn’t get too hung up on a choice of a definite vs. indefinite article, but what’s up with stating that neural circuits should be “ultimately, the target of assessment and treatment”?

Eating disorders isn’t my area. So I might have missed something. Perhaps NIMH is planning to issue another RDoC-based eating disorders FOA that invites research on sociocultural factors. Or maybe I’m missing some other important way that they will be incorporated into NIMH’s priorities for studying eating disorders. But if not — if NIMH thinks that basic research on media, on family environments, on peer influence, on self-concept, on cultural norms are not terribly important for understanding and treating eating disorders — well, that’s really hard to defend. And not a good sign of where things are headed more broadly.

You are not your brain

I just read a very interesting Salon interview with Alva Noe. Noe is a philosopher who has a new book out, titled Out of Our Heads: Why Your Are Not Your Brain and Other Lessons from the Biology of Consciousness.

In the interview, Noe argues that many attempts by neuroscientists to explain consciousness are misguided. He stipulates that understanding the brain is necessary for understanding consciousness. But understanding the brain is not sufficient. Thus, he takes exception to statements like the following from Francis Crick:

You, your joys and your sorrows, your memories and your ambitions, your sense of personal identity and free will, are in fact no more than the behavior of a vast assembly of nerve cells and their associated molecules.

At the outset of the interview, I wondered if Noe was going in the direction of fuzzy, anti-scientific holism. But that was not the case at all. When Noe says that the brain is necessary but not sufficient for consciousness, he is arguing for a rigorous scientific approach to studying the mind, but one that takes a fundamentally different view of what consciousness is. To Noe, consciousness is irreducibly about the relationship between the brain and the outside world. That “irreducibly” is key. It’s not just enough for neuroscientists to say, “Well, yeah, I’ve got stimuli in my fMRI designs.” In accounting for conscious experience, you have to go deeper.

The core of Noe’s argument reminds me a lot of the early conflict in psychology between structuralists and functionalists. The structuralists believed that if you want to understand some aspect of mind, you needed to break it down into its lower-level constituent pieces. The functionalists believed that to understand an aspect of the mind, you needed to understand how it relates to the organism and its environment. So, for example, a structuralist might study emotions by trying to identify components of emotion: stimulus, appraisal, physiological response, expressive behavior, etc. And in modern times, many structuralists try to understand emotions by understanding the interactions of brain networks. By contrast, a functionalist might study emotions by asking what does and does not trigger them, how emotions relate to the individual’s goals and beliefs, and how an emotion can change an organism’s relationship with its environment.

The structuralism-functionalism debate was a contentious one in the early days of psychology. If you think the obvious answer is “you need to do both,” you’re right, but only trivially so. It’s easy to pay lip service; but in practice, it’s a challenge to do research and formulate theories in a way that doesn’t hew to one or the other approach. Many neuroscientists would repudiate overt expressions of greedy reductionism, but they approach conscious experience like structuralists. This approach leads to hidden assumptions that affect how they set their agenda and formulate their theories. And occasionally the hidden assumptions are not so well hidden, like in the Crick quote above, or when misguided neuroscientists assume a direct, invariant relationship between physiological activity and mental experience. (To wit: “they exhibited high levels of activity in the part of the brain called the amygdala, indicating anxiety.” Seriously?)

So although it’s easy to say “you need to do both,” it’s a hell of a lot harder to actually do both in a smart way. The interview mostly focuses on how Noe thinks that neuroscientists are doing things wrong. I’m curious to see whether his book has good ideas about how to do it right.