Stuti Jain | October 9th, 2024
Dr. Ashley Watts is one of the newest professors to join the ranks of Vanderbilt’s Department of Psychology. Dr. Watts received her PhD with a specialization in clinical psychology from Emory University and spent the next five years working as research assistant at the University of Missouri. After entering college as a wildlife major, Dr. Watts “stumbled into” research. Once she realized that her interest in studying animal behavior was actually an interest in human behavior, she joined a lab that focused on personality and individual differences. It is that research that has followed her into her career.
Now, Dr. Watts runs The Mechanisms of Addiction and Psychopathology Lab here at Vanderbilt, where she focuses the majority of her work on alcohol addiction. However, more broadly, her research interests lie in psychopathology — in particular, she wants to change the reigning guidelines used to diagnose these pathologies.
Psychopathology is essentially another word for mental disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook that has been used by healthcare professionals all over the world as the general guide to diagnosing mental disorders. The first edition of the DSM was published in 1952, with the most current edition being the fifth edition.
Despite its prevalence in diagnostic settings, Dr. Watts believes that categories created in this manual are arbitrary and do not reflect how psychopathology manifests in reality.
“I’m interested in developing a better classification system that identifies the dimensions on which people vary that promote their expression of mental disorder across their lifespan,” Dr. Watts said. “I believe it is critical to have proper, more specific guidelines for the identification and diagnosis of psychopathology so that professionals can do a better job of identifying targets for treatment and prevention of these disorders.”
Dr. Watts explained that she is trying to identify the basic building blocks of psychopathology so that there are more actionable targets for matching people to treatment. Another benefit of finding these building blocks is that they will help to identify the genetic and neurobiological sources of psychopathology.
Dr. Watts used the example of ADHD to explain what she meant by building blocks.
“ADHD is a diagnostic category. That is absolutely not one thing. There are multiple dimensions of ADHD. So when we throw everything together in one box, we’re doing a really bad job at matching people to specific treatments,” Dr. Watts said. “For instance, hyperactive or impulsive symptoms as opposed to inattentive ones have very different treatment targets, different comorbidity profiles, and different causes.”
She also elaborated on what has driven her to the data-focused approach she exemplifies in her work.
“The way I think about it is that our current diagnostic systems are largely developed based on consensus of psychiatrists — they’re not empirically derived categories,” Dr. Watts said. “So my work takes a quantitative approach to classification, collects information on signs and symptoms of mental dysfunction, and then looks for data-driven dimensions as opposed to consensus- or politically-driven dimensions.”
Her methodology itself is not singular; instead, she employs what she calls a “multi-method approach.” She combines large datasets that track people of all demographics from various sites across the U.S. and uses these to get a sense of what is going on with an individual person or on a larger scale. She focuses on large-scale epidemiological data that is either self-reported or clinician- or interviewer-assessed. By keeping her focus broad, Dr. Watts makes her findings more generalizable and thus more useful when assessing larger or more diverse populations.
While Dr. Watts is currently focused on alcohol addiction, the research in her lab does hit three big psychopathological conditions: ADHD, depression, and addiction. It is through this set of concentrations that Dr. Watts made a surprising discovery: depression does not necessarily pose a strong risk factor for addiction. Now, she is trying to understand the bidirectionality between addiction and other mental disorders instead.
Despite the surprises and obstacles her research has thrown her way, Dr. Watts has never lost sight of her end goal. When asked about what that goal may be, she was resolute in her answer.
“I’d like to do a better job at helping people get the help that they need, which starts with designing a better diagnostic system so that we can match people to the right treatments,” Dr. Watts said. “Ultimately, I’d like to start from early on in the life span and identify the factors that promote the development of addiction and the things that buffer against the risk for it.”
Dr. Watts hopes to contribute to and continue to inspire the creation of a more valid diagnostic system so that more people can get the help they need rather than being labeled with a diagnosis that may not even describe them.
References
American Psychiatric Association. “History of the DSM.” Psychiatry.org, American Psychiatric Association, https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm#:~:text=The%20APA%20Committee%20on%20Nomenclature,to%20focus%20on%20clinical%20use.