Managing clinical heterogeneity in psychopathology: Perspectives from brain research

Clinical heterogeneity is a significant factor to contend with when seeking to organize, understand, and treat psychopathology. In recent years, the field has prioritized efforts to minimize nonmeaningful heterogeneity and leverage meaningful heterogeneity to improve assessment and diagnostics, inform mechanistic understanding, and facilitate the development of novel treatments. Indeed, exciting developments such as the National Institute for Mental Health Research Domain Criteria and the Hierarchical Taxonomy of Psychopathology have provided powerful frameworks for facing clinical complexity. While these developments have spurred many advancements, the movement has yet to effectively harness the tremendous potential provided by the brain. Initial work incorporating brain data has focused on validating clinical observations with a biomarker rather than leveraging the brain to provide unique insight into meaningful clinical heterogeneity. To provide future guidance and examples of innovation in the area, we solicited articles from teams seeking to utilize brain research to manage clinical heterogeneity. The search resulted in a diverse illustration of how best to leverage brain data to greater mechanistic understanding and clinical utility. In this introduction, we consider this work and discuss strategies through which brain data can best be used to provide unique insight into clinical heterogeneity. As the science of psychopathology continues to grapple with the promise and costs inherent in utilizing this powerful and complex array of methodologies, it will be important to leverage unique insights from brain science. This special issue provides a useful guide for new and upcoming work and a catalyst for moving the field forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).