176 Chapter 8 erable overlap in the intentionality and experience of both NSSI and AN. This overlap consists of the concept of self-harm, but also the concepts of aberrant reward and punishment systems, the focus on the body or bodily structures, and the concept of affect dysregulation. In this perspective, both NSSI and AN could be conceptualized as (disorders of) self-destructiveness, driven by shared factors, with a different means of expression (see figure 2d). Figure 2d Self-destructiveness as new, DSM-transcending concept or psychopathological entity with a distinct neurological basis and a variety of clinical expressions AN and NSSI: a research-domain centered approach As shown above, AN and NSSI share various psychological concepts like reward and punishment, affect regulation and control. A relatively new but promising way to investigate mental disorders is through the Research Domain Criteria (RDoC) framework (National Institute of Mental Health). The RDoC framework aims at understanding the nature of mental health and illness in terms of varying degrees of dysfunction in general psychological and biological systems (59). The RDoC framework focuses on six major domains of human functioning. These domains consist of behavioral constructs, that are studied or assessed using different classes of variables (p.e. genetic, neurocircuit, behavioral, self-report). In our review, we have focused on the clinical and especially neurobiological overlap between AN and NSSI. The RDoC framework could be of value in further exploring the overlap between AN and NSSI in terms of exploring the basic biological and cognitive processes underlying these disorders, to explain comorbidity and to create a dimensional conceptualization of the phenomena AN and NSSI (60). According to our review, there seems to be overlap on several if not all six RDoC domains. In both disorders there is involvement of negative valence systems (e.g. fear, anxiety, nonreward), positive valence systems (p.e. reward, reward learning, habit formation), cognitive systems (p.e. self-perception, cognitive control), systems for social processes (p.e. self-perception, attachment), arousal/ regulatory systems (p.e. homeostatic system, pain regulation) and sensimotor systems (motor actions, sensimotor dynamics). By using the RDoC framework it would be possible to research Cutting Burning Hair pulling Disordered eating behavior (purging etc.) Neurobiology NSSI Etiological factors Psychology Disorder Clinical expressions Emotion regulation Addiction Reward regulation Neurobiology, etiopathogenesis Self-destructiveness General construct Emaciation Purging Burning Intoxication Excessive excercising Clinical expressions Cutting
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