The Myth of Optimality in Clinical Neuroscience

Trends Cogn Sci. 2018 Mar;22(3):241-257. doi: 10.1016/j.tics.2017.12.006. Epub 2018 Feb 20.


Clear evidence supports a dimensional view of psychiatric illness. Within this framework the expression of disorder-relevant phenotypes is often interpreted as a breakdown or departure from normal brain function. Conversely, health is reified, conceptualized as possessing a single ideal state. We challenge this concept here, arguing that there is no universally optimal profile of brain functioning. The evolutionary forces that shape our species select for a staggering diversity of human behaviors. To support our position we highlight pervasive population-level variability within large-scale functional networks and discrete circuits. We propose that, instead of examining behaviors in isolation, psychiatric illnesses can be best understood through the study of domains of functioning and associated multivariate patterns of variation across distributed brain systems.

Keywords: brain evolution; clinical neuroscience; individual differences; phenomics; psychiatric illness risk; research domain criteria (RDoC).

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Biological Evolution*
  • Biological Variation, Population*
  • Brain*
  • Genetic Variation*
  • Humans
  • Individuality*
  • Mental Disorders*
  • Neurosciences*
  • Psychiatry*