We’re seeing continued advances in making psychiatric diagnoses—and, therefore, improved treatment. A major step in this direction occurred in 2009 when the National Institute of Mental Health (NIMH) embraced the Research Domain Criteria (RDoC).1 The impetus was clear. Reliance on DSM/ICD diagnoses had produced no improvement in care, and research demonstrated no association of them with underlying pathophysiological abnormalities in the brain or elsewhere. Most thought the failures resulted from: i) the isolated focus on symptoms employed by DSM/ICD criteria, and ii) using a categorical approach where the number of symptoms was critical for a diagnosis; for example, 5 major symptoms of depression made the diagnosis, but 3 or 4 did not.

Instead, the RDoC sought to better understand mental illness by evaluating multiple factors in addition to symptoms and studying them in a continuous or dimensional way. They did this by identifying these six functional (and process) domains of responses to various life stimuli: positive valence, negative valence, social........

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