Director’s Update: Behavioral Research at NIMH: Reorganizing the Portfolio to Advance Public Health
Update from the Director
Thomas R. Insel, M.D.
Changes at NIMH have raised questions about NIMH funding for basic behavioral science that I would like to address. First, let me say that behavioral science is crucial to our success in meeting the very serious — and growing — challenge of reducing the burden of mental and behavioral disorders. Refining phenotypes, detecting gene-behavior-environment interactions, developing diagnostic tests and new interventions for prevention and treatment, and enhancing rehabilitation and recovery all require basic behavioral science. The methods and principles of behavioral science provide fundamental knowledge about mental and social processes, and how and why certain behaviors occur in specific situations; they provide the tools by which behavior can be accurately measured, shaped, and changed. The Institute and the field have made extraordinary achievements in these areas.
Similar to other NIH institutes, NIMH faces budget increases at or below 2 percent annual growth — well beneath the rate of inflation. In terms of new grant support, this translates from an ability to fund 630 new research project grants in FY 2004 to approximately 559 in FY 2005; this can be achieved only with average reductions of 15-20 percent in the budgets of these new awards. This means reduced growth in all areas of the NIMH portfolio, from basic to clinical to services research. Thus, we must seek ways to build on our past achievements and push the limits of scientific discovery to maximize our impact on public health.
To address opportunities in behavioral research that will help us reach our public health goals, the National Advisory Mental Health Council (NAMHC) has issued two reports over the past five years. Translating Behavioral Science into Action describes the critical role of the behavioral sciences in building translational clinical science. The report notes the large, extant body of research that identifies the specificity and variability of basic behavioral processes in normal populations and that describes a powerful range of methods and technologies for studying behavior. "This work now needs to be extended to include clinical populations, both to test the generalizability of the basic findings and to clarify how people with certain illnesses or symptoms differ from the population at large" (p. 15). The body of the report provides rich examples of basic behavioral science ripe for translation in three priority areas: (1) how basic behavioral processes are altered in mental illness and how these basic processes relate to neurobiological functioning; (2) how mental illnesses and their interventions affect the abilities of individuals to function in diverse settings and roles; and (3) how social and other environmental contexts influence the etiology, prevention, treatment, and care of those suffering from mental disorders.
The second report, Setting Priorities for the Basic Sciences of Brain and Behavior, builds on these priorities by recommending additional strategies to sharpen the focus and impact of the basic science portfolio to better serve the mission of the Institute. The overarching principles that guided this report provide a frame of reference for advancing basic behavioral science in mental health. These include: (1) basic brain and behavioral research should be undertaken in the service of the public health mission of NIMH; (2) basic research that integrates or translates across levels of analysis — from genetic, to molecular, to cellular, to systems, to complex overt behaviors and situations — should be given high priority; (3) research and training that is interdisciplinary should be more heavily emphasized in the basic portfolio; and (4) the time is right to invest more in developing the tools that will allow intensive study of how complex interpersonal, social, and cultural environments affect behavior at the integrative systems level. Based on these principles, the report goes on to outline specific tools and areas of research particularly ripe for increased investment, areas ready for refocus, and areas better served by other Institutes at NIH.
Taking these reports into account, as well as solicited input from our various stakeholders — patients and their advocates; scientists, physicians, and their professional societies; Congress; and the NIMH's advisory council, which includes public members — NIMH has revised priorities for the research portfolio. The Institute now uses three key factors to evaluate new applications submitted for funding: relevance to the mission, traction for making rapid progress, and innovation.
Given that some areas of basic science are far removed from rapid application to etiology, diagnosis, or interventions, how can NIMH apply these criteria? We are looking for basic research that (a) links behavior, brain, and experience and (b) is informed by and, in turn, informs our understanding of etiology, our need for diagnostics, and our quest for new interventions to prevent or treat mental and behavioral disorders. Let me clearly state that not every basic science grant must focus on a specific disorder, nor include clinical populations, nor have a disorder named in its title, nor include measures of both brain and behavior. However, we are placing higher priority on basic behavioral research that either is informed by or informs biology, or seeks translation to solving mental health problems.
Also essential to NIMH priorities is the appraisal of a line of research. At some point, lines of research should move forward to application. What is the point at which basic research should advance to directly inform clinical understanding? It varies tremendously across the many facets of basic science. The two NIMH advisory council reports mentioned above discuss numerous areas in which basic behavioral science is ripe for translation to clinical issues and integration with brain sciences.
The current NIMH portfolio has numerous examples of basic behavioral research that falls within these translational goals. In addition, new applications in basic behavioral science are submitted and accepted for review and continue to be among the research grants selected for funding. For example, in the current portfolio, state-of-the-art tools, such as functional MRI, are being employed with cognitive methods to conduct translational research, as evidenced by the work of Marcel Just at Carnegie-Mellon University. Dr. Just is investigating high-level conceptual processes in language comprehension, including comprehension of causality and non-literal language and the relations of comprehension processes with visual and auditory imagery and emotion recognition. His research will lead to tools for assessing patients with autism and other forms of neuropsychiatric disorder that involve abnormalities of language and communication; it will also provide a basis for future therapies.
Another example of a recently funded new basic behavioral grant is a study by University of Michigan investigator Jennifer Crocker, which starts from the premise that partitions of self and self-value in various domains may be contingent upon external feedback and cues. Dr. Crocker examines the extent to which people tend to make efforts to restore or maintain self in the face of threats to self-worth and the negative effects that such efforts have on the individual. Her research is explicitly related to the potential of understanding the role of self in anxiety, mood, personality, and eating disorders.
Studies on fear extinction in animal models are another example of research with high translational research potential, to conditions such as post-traumatic stress disorder and various other anxiety disorders. Robert Rescorla, a leader in this field who has helped develop the fundamental aspects of learning theory, is focusing a current project on the nature of learning during the extinction of an instrumental response and the role of instrumental and Pavlovian associations in this process. His work sets the context for efforts to understand extinction processes. Recent work on neural mechanisms of fear conditioning and extinction relies on the framework that Dr. Rescorla's research has provided.
To facilitate translation and integration across the Institute, NIMH recently reorganized its extramural research programs into five divisions (from three). Basic behavioral research, including studies of cognition, emotion and behavior, remains a key area in the new structure. For instance, investigators interested in individual and interpersonal functioning or understanding stigma in relation to mental disorders may look to the Division of AIDS and Health and Behavior. Researchers interested in behavioral processes with implications for explicating risk and resilience in mental disorders, prevention, or treatment development may look to one of the two translational divisions (adult and pediatric). Researchers interested in studying basic mechanisms of cognition, emotion, or social cognition with implications for understanding brain-behavior relationships may look to the Division of Neuroscience and Basic Behavioral Science.
Of course, we at NIMH recognize that the changing landscape of science holds the possibility for novel approaches that, in time, will yield benefits for the public health, so we encourage investigators — prior to writing applications — to discuss ideas with NIMH program staff who are actively evaluating specific portfolios. We hope to inspire the creativity and ingenuity of our behavioral science community to address these challenging issues, build on the extraordinary progress to date, and push the scientific envelope to advance public mental health.