, Volume 11, Issue 2, pp 175–198 | Cite as

Our circuits, ourselves: What the autism spectrum can tell us about the Research Domain Criteria Project (RDoC) and the neurogenetic transformation of diagnosis

  • Elizabeth Fein
Original Article


The Research Domain Criteria (RDoC) project is an ambitious new initiative by the National Institute of Mental Health that aims to comprehensively redefine mental illnesses as problems of neurogenetic ‘circuitry’. This essay explores potential implications of this nascent approach. Drawing on data from two studies that examine the diagnosis of autism spectrum disorder, itself recently reconceptualized along lines similar to this new diagnostic paradigm, I argue that such ‘circuit disorders’ differ from their predecessors in two significant ways. First, while psychiatric disease entities under the previous paradigm were understood as fundamentally separable from the affected person, circuit disorders are bound up in intimate neuropsychological processes such as memory, perception and desire; they are thus often experienced as constitutive of identity by those living under their description. Second, rather than being limited to matters of ‘clinically significant impairment’, circuit disorders are multivalent, encompassing valued as well as devalued traits. Given that one major aim of the RDoC is to allow for pre-emptive biomedical intervention upon pre-symptomatic states, these emergent qualities of circuit disorders raise complex ethical concerns. I conclude by illustrating the way these concerns become obscured in the transition to an ostensibly value-neutral biophysiological paradigm.


RDoC psychiatry diagnosis autism aspergers mental health 



The research leading to this publication was made possible by generous support from the NIMH (Ruth L. Kirschstein National Research Service Award for Individual Predoctoral Fellows, Award #F31MH082551-02), a National Science Foundation Dissertation Improvement Grant (Award #0823390) and a Dissertation Fieldwork Grant from the Wenner-Gren Foundation for Research in Anthropology (Award #7836). Its contents are the responsibility of the author and – perhaps manifestly – do not necessarily represent the official views of awarding organizations. The author would like to thank Christine El-Ouardani, Kathryn Goldfarb, Chloe Silverman and four anonymous reviewers for their support in developing the arguments in this article, and the students in her “Clinical, Critical and Cultural Approaches to Mental Health” seminar at the University of Chicago for thinking through many of the issues in this article with her.


  1. Adam, D. (2013) On the spectrum. Nature News 496: 216–218.Google Scholar
  2. Alliance of Psychoanalytic Organizations (2006) The Psychodynamic Diagnostic Manual. Silver Spring, MD: Psychodynamic Diagnostic Manual.Google Scholar
  3. Anderson, J. (2008) Neuro-prosthetics, the extended mind, and respect for persons with disability. In: M. Düwell, C. Rehmann-Sutter and D. Mieth (eds.) The Contingent Nature of Life: Bioethics and the Limits of Human Existence. Dordrecht: Springer Science and Business Media, B.V.Google Scholar
  4. Andreasen, N. (2001) Brave New Brain: Conquering Mental Illness in the Era of the Genome. New York: Oxford University Press.Google Scholar
  5. Autism Network International (2013) What is autreat?, accessed 20 January 2013.
  6. Baron-Cohen, S. et al (1998) Does autism occur more often in families of physicists, enigneers and mathematicians? Autism 2 (3): 296–301.CrossRefGoogle Scholar
  7. Baron-Cohen, S., Wheelwright, S., Stott, C., Bolton, P. and Goodyer, I. (1997) Is there a link between engineering and autism? Autism 1 (1): 101–109.CrossRefGoogle Scholar
  8. Bascom, J. (ed.) (2012) Loud Hands: Autistic People, Speaking. Washington DC: The Autistic Press.Google Scholar
  9. Bassman, R. (2001) Whose reality is it anyway? Consumers/survivors/expatients can speak for themselves. Journal of Humanistic Psychology 41 (4): 11–35.CrossRefGoogle Scholar
  10. Belah, R.N., Madsen, R., Sullivan, M., Swidler, A. and Tipton, S.M. (1985) Habits of the Heart: Individualism and Commitment in American Life. Berkeley, CA: University of California Press.Google Scholar
  11. Brodwin, P. (2013) Everyday Ethics: Voices from the Front Line of Community Psychiatry. Berkeley: University of California Press.Google Scholar
  12. Carpenter-Song, E. (2009) Caught in the psychiatric net: Meanings and experiences of ADHD, pediatric bipolar disorder, and mental health treatment among a diverse group of families in the United States. Culture, Medicine and Psychiatry 33 (1): 61–85.CrossRefGoogle Scholar
  13. Chamberlain, J. (1979) On Our Own: Patient-Controlled Alternatives to the Mental Health System. New York: McGraw-Hill.Google Scholar
  14. Chamberlain, J. (1990) The ex-patients movement: Where we’ve been and where we’re going. The Journal of Mind and Behavior 11 (3): 323–336.Google Scholar
  15. Charney, D.S. et al (2002) Neuroscience research agenda to guide development of a pathophysiologically based classification system. In: D. Kupfer, M. First and D. Regier (eds.) A Research Agenda for DSM-V. Washington DC: American Psychiatric Association.Google Scholar
  16. Cheang, H.S., Mottron, L. and Jemel, B. (2009) Seeing things that aren’t there: Perceptions of faces and objects in visual white noise in autism and Asperger’s syndrome. Oral presentation at the International Meeting for Autism Research, Chicago, IL.Google Scholar
  17. Conrad, P. and Schneider, J. (1980) Deviance and Medicalization: From Badness to Sickness. Philadelphia, PA: Temple University Press.Google Scholar
  18. Cuthbert, B.N. (2014) The RDoC framework: Facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 13 (1): 28–35.CrossRefGoogle Scholar
  19. Cuthbert, B.N. and Insel, T. (2013) Toward the future of psychiatric diagnosis: The seven pillars of RDoC. BMC Medicine 11: 126–134.CrossRefGoogle Scholar
  20. Dawson, M. and Mottron, L. (2009) Where autistics excel: Compiling an inventory of autistic cognitive strengths. Poster presented at the International Meeting for Autism Research, Chicago, IL.Google Scholar
  21. Dumit, J. (2004) Picturing Personhood: Brain Scans and Biomedical Identity. Princeton, NJ: Princeton University Press.Google Scholar
  22. Estroff, S. (2004) Subject/subjectivities in dispute: The poetics, politics and performance of first-person narratives of people with schizophrenia. In: J. Jenkins and R. Barrett (eds.) Schizophrenia, Culture and Subjectivity: The Edge of Experience. Cambridge, UK: Cambridge University Press.Google Scholar
  23. Eyal, G., Hart, B., Onculer, E., Oren, N. and Rossi, N. (2010) The Autism Matrix. Cambridge, UK: Polity Press.Google Scholar
  24. Fein, E. (2011) Innocent machines: Asperger’s syndrome and the neurostructural self. In: M. Pickersgill and I. Van Keulen (eds.) Sociological Reflections on the Neurosciences: Advances in Medical Sociology. Vol. 13. Bingley, UK: Emerald Group Publishing.Google Scholar
  25. Fitzgerald, D. (2014) The trouble with brain imaging: Hope, uncertainty and ambivalence in the neuroscience of autism. BioSocieties 9 (3): 241–261.CrossRefGoogle Scholar
  26. Franklin, J., Jamieson, J., Glenn, C. and Nock, M. (2015) How developmental psychopathology theory and research can inform the research domain criteria (RDoC) project. Journal of Clinical Child and Adolescent Psychology 44 (2): 280–290.CrossRefGoogle Scholar
  27. Fugate, C.M., Zentall, S. and Gentry, M. (2013) Creativity and working memory in gifted students with and without characteristics of attention deficit hyperactive disorder: Lifting the mask. Gifted Child Quarterly 57 (4): 234–246.CrossRefGoogle Scholar
  28. Gernsbacher, M.A., Dawson, M. and Mottron, L. (2006) Autism: Common, heritable, but not harmful. Behavioral and Brain Sciences 29 (4): 413–414.CrossRefGoogle Scholar
  29. Hacking, I. (2006) What is Tom saying to Maureen? London Review of Books 28 (9): 3–7.Google Scholar
  30. Haller, B., Dorries, B. and Rahn, J. (2006) Media labeling versus the US disability community identity: A study of shifting cultural language. Disability and Society 21 (1): 61–75.CrossRefGoogle Scholar
  31. Happé, F. and Frith, U. (2006) The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders 36 (1): 5–25.CrossRefGoogle Scholar
  32. Happé, F. and Vital, P. (2009) What aspects of autism predispose to talent? Philosophical Transactions of the Royal Society B 364 (1522): 1369–1375.CrossRefGoogle Scholar
  33. Haraway, D. (1989) The biopolitics of postmodern bodies: Determinations of self in immune system discourse. differences: A Journal of Feminist Cultural Studies 1 (1): 3–43.Google Scholar
  34. Healy, D. and Rucklidge, J.J. (2006) An investigation into the relationship among ADHD symptomatology, creativity, and neuropsychological functioning in children. Child Neuropsychology: A Journal on Normal and Abnormal Development in Childhood and Adolescence 12 (6): 421–438.CrossRefGoogle Scholar
  35. Hermelin, B. (2001) Bright Splinters of the Mind: A Personal Story of Research with Autistic Savants. London: Jessica Kingsley.Google Scholar
  36. Howlin, P., Goode, S., Hutton, J. and Rutter, M. (2009) Savant skills in autism: Psychometric approaches and parental reports. Philosophical Transactions of the Royal Society B 364 (1522): 1359–1367.CrossRefGoogle Scholar
  37. Insel, T. (2013a) Transforming diagnosis,, accessed 29 April 2013.
  38. Insel, T. (2013b) A national dialogue,, accessed 4 June 2013.
  39. Kailes, J. (2010) Language is More Than a Trivial Concern. 10th edn. Playa del Rey, CA: KAILES Publications.Google Scholar
  40. Kéri, S. (2009) Genes for psychosis and creativity: A promoter polymorphism of the neuregulin 1 gene is related to creativity in people with high intellectual achievement. Psychological Science 20 (9): 1070–1073.CrossRefGoogle Scholar
  41. Keshavan, M. and Ongur, D. (2014) The journey from RDC/DSM diagnoses toward RDoC dimensions. World Psychiatry 13 (1): 44–46.CrossRefGoogle Scholar
  42. Kirmayer, L.J. and Crafa, D. (2014) What kind of science for psychiatry? Frontiers in Human Neuroscience 8 (435), doi: 10.3389/fnhum.2014.00435.Google Scholar
  43. Kraemer, F. (2011) Authenticity, anyone? The enhancement of emotions versus neuropharmacology. Neuroethics 4 (1): 51–64.CrossRefGoogle Scholar
  44. Kramer, P. (1993) Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self. New York: Penguin Books.Google Scholar
  45. Kupfer, D. and Regier, T. (2011) Neuroscience, clinical evidence, and the future of psychiatric classification in DSM-5. American Journal of Psychiatry 168 (7): 672–674.CrossRefGoogle Scholar
  46. Lehman, A.F., Alexopoulos, G.S., Goldman, H., Jeste, D. and Üstün, B. (2002) Mental disorders and disability: Time to reevaluate the relationship? In: D. Kupfer, M. First and D. Regier (eds.) A Research Agenda for DSM-V. Washington DC: American Psychiatric Association.Google Scholar
  47. Lende, D. (2014) The research domain criteria of the NIMH and the RDoC vision for mental health research and diagnosis,, accessed 9 February 2014.
  48. Lende, D. and Downey, G. (eds.) (2012) The Encultured Brain: An Introduction to Neuroanthropology. Cambridge, MA: MIT Press.Google Scholar
  49. Lilienfeld, S.O. (2014) The research domain criteria (RDoC): Analysis of methodological and conceptual challenges. Behavior Research and Therapy 62: 129–139.CrossRefGoogle Scholar
  50. Linton, S. (1998) Claiming Disability: Knowledge and Identity. New York: New York University Press.Google Scholar
  51. Luhrmann, T.M. (2001) Of Two Minds: An Anthropologist Looks at American Psychiatry. New York: Vintage Books.Google Scholar
  52. Luhrmann, T.M. (2015) Redefining mental illness. New York Times 17 January.Google Scholar
  53. Magaña, S., Parish, S.L., Rose, R.A., Timberlake, M. and Swaine, J.G. (2012) Racial and ethnic disparities in quality of health care among children with autism and other developmental disabilities. Intellectual and Developmental Disabilities 50 (4): 287–299.CrossRefGoogle Scholar
  54. Mandell, D.S. and Novak, M. (2005) The role of culture in families’ treatment decisions for children with autism spectrum disorders. Mental Retardation and Developmental Disabilities Review 11 (2): 110–115.CrossRefGoogle Scholar
  55. Mandell, D.S., Listerud, J., Levy, S.E. and Pinto-Martin, J.A. (2002) Race differences in the age at diagnosis among medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry 4 (12): 1447–1453.CrossRefGoogle Scholar
  56. Martin, E. (1994) Flexible Bodies: Tracking Immunity in American Culture from the Days of Polio to the Age of AIDS. Boston, MA: Beacon Press.Google Scholar
  57. Metzl, J. (2010) The Protest Psychosis: How Schizophrenia Became a Black Disease. Boston, MA: Beacon Press.Google Scholar
  58. Mottron, L., Dawson, M. and Soulières, I. (2009) Enhanced perception in savant syndrome: Patterns, structure, and creativity. Philosophical Transactions of the Royal Society B 364 (1522): 1385–1391.CrossRefGoogle Scholar
  59. Mottron, L., Dawson, M., Soulières, I., Hubert, B. and Burack, J. (2006) Enhanced perceptual functioning in autism: An update, and eight principles of autistic perception. Journal of Autism and Developmental Disorders 36 (1): 27–43.CrossRefGoogle Scholar
  60. Nadesan, M. (2008) Governmentality, Biopower, and Everyday Life. New York and London: Routledge.Google Scholar
  61. National Institute of Mental Health (2011) NIMH research domain criteria (RDoC), Draft 3.1: June,, accessed June 2013.
  62. National Institute of Mental Health (2015) RFA-MH-16-510: Dimensional Approaches to Research Classification in Psychiatric Disorders (R01). 5 June 2015,, accessed 19 August.
  63. National Institute of Mental Health (n.d.) About NIMH,, accessed 24 February.
  64. National Institute of Mental Health (n.d.) Research Domain Criteria (RDOC),, accessed 19 August.
  65. Ortega, F. and Vidal, F. (2007) Mapping the cerebral subject in contemporary culture. RECIIS – Electronic Journal of Communication Information and Innovation in Health 1 (2): 255–259.Google Scholar
  66. Parnas, J. (2014) The RDoC program: Psychiatry without psyche? World Psychiatry 13 (1): 46–47.CrossRefGoogle Scholar
  67. Quednow, B.B. (2010) Ethics of neuroenhancement: A phantom debate. BioSocieties 5 (1): 153–156.CrossRefGoogle Scholar
  68. Research and Training Center on Independent Living, University of Kansas (2008) Guidelines for Reporting and Writing About People with Disabilities, 7th edn. Lawrence, KS: Author.Google Scholar
  69. Roepstorff, A., Niewöhner, J. and Beck, S. (2010) Enculturing brains through patterned practices. Neural Networks 23 (8–9): 1051–1059.CrossRefGoogle Scholar
  70. Rosenberg, C. (2002) The tyranny of diagnosis: Specific entities and individual experience. The Milbank Quarterly 80 (2): 237–260.CrossRefGoogle Scholar
  71. Rosenberg, C. (2007) Our Present Complaint: American Medicine, Then and Now. Baltimore, MD: Johns Hopkins University Press.Google Scholar
  72. Rose, N. (2003) Neurochemical selves. Society 41 (1): 46–59.CrossRefGoogle Scholar
  73. Rose, N. (2007) The Politics of Life Itself. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
  74. Rose, N. and Abi-Rached, J.M. (2013) Neuro: The New Brain Sciences and the Management of the Mind. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
  75. Sartorius, N. (2014) The only one or one of many? A comment on the RDoC project. World Psychiatry 13 (1): 50–51.CrossRefGoogle Scholar
  76. Schöne-Seifert, B., Talbot, D., Opolka, U. and Ach, J.S. (eds.) (2009) Neuro-Enhancement. Ethik vor neuen Herausforderungen. Paderborn, Germany: Mentis.Google Scholar
  77. Silverman, C. (2011) Understanding Autism: Parents, Doctors, and the History of a Disorder. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
  78. Singh, I. (2005) Will the “real” boy please behave: Dosing dilemmas for parents of boys with ADHD. The American Journal of Bioethics 5 (3): 34–47.CrossRefGoogle Scholar
  79. Snyder, A. (2009) Explaining and inducing savant skills: Privileged access to lower-level, less-processed information. Philosophical Transactions of the Royal Society B 364 (1522): 1399–1405.CrossRefGoogle Scholar
  80. Spiegel, A. (2005) The dictionary of disorder: How one man revolutionized psychiatry. New Yorker 3 January.Google Scholar
  81. Taylor, C. (1991) The Ethics of Authenticity. Cambridge, MA: Harvard University Press.Google Scholar
  82. Terry, J. (1999) An American Obsession: Science, Medicine and Homosexuality in Modern Society. Chicago, IL: University of Chicago Press.CrossRefGoogle Scholar
  83. Treffert, D. (2009) The savant syndrome: An extraordinary condition. A synopsis: Past, present, future. Philosophical Transactions of the Royal Society B 364 (1522): 1351–1357.CrossRefGoogle Scholar
  84. Venton, D. (2011) Q&A: The unappreciated benefits of dyslexia. Wired 11 September,
  85. Verhoeff, B. (2012) What is this thing called autism? A critical analysis of the tenacious search for autism’s essence. BioSocieties 7 (4): 410–432.CrossRefGoogle Scholar
  86. Vidal, F. (2009) Brainhood, anthropological figure of modernity. History of the Human Sciences 22 (1): 5–36.CrossRefGoogle Scholar
  87. Vital, P.M., Ronald, A., Wallace, G. and Happé, F. (2009) Relationship between special abilities and autistic-like traits in a large population-based sample of 8-year-olds. Journal of Child Psychology and Psychiatry 50 (9): 1093–1101.CrossRefGoogle Scholar
  88. Wakefield, J. (2014) Wittgenstein’s nightmare: Why the RDoC grid needs a conceptual dimension. World Psychiatry 13 (1): 38–40.CrossRefGoogle Scholar
  89. Walsh, P., Elsabbagh, M., Bolton, P. and Singh, I. (2011) In search of biomarkers for autism: Scientific, policy and ethical challenges. Nature Reviews Neuroscience 12 (10): 603–612.CrossRefGoogle Scholar
  90. Waterhouse, L. (2013) Rethinking Autism: Variation and Complexity. London: Elsevier Academic Press.Google Scholar
  91. White, H.A. and Shah, P. (2011) Creative style and achievement in adults with ADHD. Personality and Individual Differences 50 (5): 673–677.CrossRefGoogle Scholar
  92. White, H.A. and Shah, P. (2006) Uninhibited imaginations: Creativity in adults with attention-deficit/hyperactivity disorder. Personality and Individual Differences 40 (6): 1121–1131.CrossRefGoogle Scholar
  93. Whooley, O. (2014) Nosological reflections: The failure of DSM-5, the emergence of RDoC, and the decontextualization of mental distress. Society and Mental Health 4 (2): 92–110.CrossRefGoogle Scholar
  94. Wright, K. (2008) Dare to be yourself. Psychology Today 1 May,

Copyright information

© The London School of Economics and Political Science 2015

Authors and Affiliations

  • Elizabeth Fein
    • 1
  1. 1.Department of PsychologyDuquesne UniversityPittsburghUSA

Personalised recommendations