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Neurocognitive heterogeneity across the spectrum of psychopathology: need for improved approaches to deficit detection and intervention

Published online by Cambridge University Press:  27 May 2019

Brian C. Kavanaugh*
Affiliation:
Department of Psychiatry & Human Behavior, E. P. Bradley Hospital, East Providence, RI, USA Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, East Providence, RI, USA
Mary Kathryn Cancilliere
Affiliation:
Department of Psychology, University of Rhode Island, Kingston, RI, USA
Anthony Spirito
Affiliation:
Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, East Providence, RI, USA
*
* Address correspondence to: Brian C. Kavanaugh, E. P. Bradley Hospital/Alpert Medical School of Brown University, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA. (Email: [email protected])

Abstract

Neurocognition is one of the strongest predictors of clinical and functional outcomes across the spectrum of psychopathology, yet there remains a dearth of unified neurocognitive nosology and available neurocognition-targeted interventions. Neurocognitive deficits manifest in a transdiagnostic manner, with no psychiatric disorder uniquely affiliated with one specific deficit. In fact, recent research has identified that essentially all investigated disorders are comprised of 3–4 neurocognitive profiles. This within-disorder neurocognitive heterogeneity has hampered the development of novel, neurocognition-targeted interventions, as only a portion of patients with any given disorder possess neurocognitive deficits that would warrant neurocognitive intervention. The development of criteria and terminology to characterize these neurocognitive deficit syndromes would provide clinicians with the opportunity to more systematically identify and treat their patients and provide researchers the opportunity to develop neurocognition-targeted interventions for patients. This perspective will summarize recent work and discuss possible approaches for neurocognition-focused diagnosis and treatment in psychiatry.

Type
Perspectives
Copyright
© Cambridge University Press 2019

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