Leading the revolution

Leading the revolution

Cuthbert recognized for efforts to expand scientific approaches to mental health

By Jill Pease

Colleagues consider Bruce Cuthbert, Ph.D., a scientific visionary. The Chronicle of Higher Education describes the project that Cuthbert leads at the National Institute of Mental Health to develop new ways to classify mental disorders “a revolution in mental health.” To honor his contributions to the field of psychopathology, UF awarded Cuthbert the Distinguished Achievement Award at one of the university’s spring graduation ceremonies.

“Dr. Cuthbert is foremost an eminent scholar, a demonstrably outstanding psychological scientist, and a creative thinker who has had a profound impact on newly developing science policy,” said Peter Lang, Ph.D., a graduate research professor in the PHHP department of clinical and health psychology, and Cuthbert’s longtime colleague.

Lang and UF played an important role in Cuthbert’s early research career. More than 35 years ago, Cuthbert moved to Gainesville at the invitation of Lang, his doctoral mentor, to set up a research laboratory that became known for its pioneering work in fear and emotion. A metaphor Lang used on Cuthbert’s first day of doctoral training at the University of Wisconsin-Madison stuck with Cuthbert, and it continued to have meaning throughout their work at UF.

“Dr. Lang said that there are a lot of people who put out fires and that’s a good thing. There are other people who try to understand why fires start and do fireproofing so you never have fires,” Cuthbert said. “The idea being, of course, that it’s good to have therapists who treat people with mental disorders, but ultimately we want to understand the causes of mental disorders so we can prevent the vast majority of them.”

At the UF Center for the Study of Emotion & Attention, Lang, Cuthbert and Margaret Bradley, Ph.D., a research professor in the department of clinical and health psychology, focused on trying to understand the mechanisms behind fear and anxiety disorders. They recognized that many patients did not have only one anxiety disorder, such as social phobia or fear of heights, they may have multiple disorders on a spectrum of severity. Another novel aspect of the team’s work was that it measured biological responses as part of emotions, an approach known as psychophysiology. They were among the first to study the startle reflex in humans, which involves a strong blink reaction to a sudden noise when people are exposed to fearful situations. The team was also one of the first to measure brain waves in response to pictures selected to elicit an emotional response. The database of images they developed, known as the International Affective Picture System, is used all over the world in studies of emotion.

After 17 years at UF, first as a postdoctoral associate, then as a faculty member, Cuthbert joined the National Institute of Mental Health, or NIMH. Since 2009 Cuthbert has led the institute’s Research Domain Criteria Initiative, or RDoC, which represents a major shift in how science views mental health research. In the past, NIMH studies have focused on specific mental disorder diagnoses, such as depression or schizophrenia. The RDoC seeks to expand research on basic behavioral and emotional processes, such as fear, impulse control and reward-related activity, that may underlie multiple disorders. The RDoC effort emphasizes going beyond observable behavior to incorporate multiple measures, including genetics, self-report and physiological responses. Now about half of the clinical translational research at NIMH involves RDoC approaches in some way, said Cuthbert, who served as the institute’s acting director from 2015 to 2016, and the institute funds a few hundred grants for studies that apply different aspects of RDoC principles.

“While the field of clinical psychology has struggled for decades in attempts to describe clinical conditions it has always lagged behind the field of medicine where diagnosis is based on physiological data,” said Jeffrey Fitzsimmons, Ph.D., a graduate of UF’s clinical psychology doctoral program and a UF professor of radiology. “Bruce’s efforts to advance the state of the art in this regard may go down as one of the most important advances in the modern history of psychology. It will set the stage for new and powerful methods for treating a wide range of disorders from anxiety and depression to post-traumatic stress disorders.”

Cuthbert says it is important to acknowledge Lang’s influence on his career and the development of the RDoC, calling Lang’s work “the single largest formative influence affecting the direction of the RDoC.”

Lang’s research serves as an example of how one laboratory can have a large national and international impact through a revolutionary approach, Cuthbert said.

“Florida can be really proud that the work at the university has had such a big influence on changing the shape of mental disorders research in the 21st century, and that’s not an exaggeration.”