Meet the Research Domain Criteria

The Pigeonhole Principals

Not long ago, Childhood Obesity News considered two of the major structures under which medical professionals sort diseases. Many healers are not totally on board with either of these taxonomical schemes, but insurance companies and other bureaucracies insist upon them. Worldwide, 60 percent of psychologists use a diagnostic classification system. As we noted, the hallmarks of a good one are simplicity, reliability, and ease of use. The professional who uses the system makes important decisions about the management and treatment of patients’ health problems. A system with fewer categories is preferred—if they are the right ones.

Sections of the Diagnostic and Statistical Manual of Mental Disorders  were vigorously disputed during revisions for the current edition, DSM-5. We are, of course, particularly interested in the parts that cover eating disorders and other conditions impacting childhood obesity. The National Institute of Mental Health (NIMH) believes that the DSM-5 diagnoses are inadequate because they are “based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.” If NIMH has its way, the Diagnostic and Statistical Manual will no longer be the “gold standard.” The agency has announced its intention to no longer support DSM-based research.

It has been determined that fewer than half of the psychologists are in the DSM camp. However, 60 percent of them are said to routinely consult the International Classification of Diseases and Related Health Problems (ICD). Both publications have been referred to as bibles, but really the term should apply to a book that has a fair claim to being the only one in its class.

Other Contenders

Also there is the Research Domain Criteria (RDoC) project, a new government-approved research framework that incorporates genetics, imaging, and cognitive science. NIMH director Dr. Thomas Insel explains:

Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior… Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment…RDoC is nothing less than a plan to transform clinical practice by bringing a new generation of research to inform how we diagnose and treat mental disorders.

Some mental health specialists prefer a very un-system-like system called case formulation, in which each patient suffers from a unique condition. Dr. Adam Blatner says,

A good formulation should be a kind of story, weaving together many threads…The organization of a formulation would depend on whether the patient is suffering from chronic or acute symptoms, or both. Similarly, is the patient involved in complex family interactions or do the symptoms seem to be confined primarily only to the individual? Are there significant associated medical conditions or dysfunctions at the level of cortical neurotransmitters? Are the stressors obvious and significant or minimal and elusive?


Dr. Pretlow’s paper, “Treatment of child/adolescent obesity using the addiction model: A smartphone app pilot study,” will soon be published by the journal Childhood Obesity (and also online, of course.)
Watch this space!

Source: “Psychologists’ perspectives on the diagnostic classification of mental disorders: Results from the WHO-IUPsyS Global Survey, 2015
Source: “Director’s Blog: Transforming Diagnosis, 04/29/13
Source: “The Art of Case Formulation, 09/15/06
Image by Scott Dexter

Leave a Reply

Your email address will not be published.

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources