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research-article2015
CPXXXX10.1177/2167702614565359Wiecki et al.Computational Psychiatry: Clustering and Classification

Special Series: Computational Psychiatry

Clinical Psychological Science

Model-Based Cognitive Neuroscience 2015, Vol. 3(3) 378­–399


© The Author(s) 2015
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DOI: 10.1177/2167702614565359

Clustering and Classification cpx.sagepub.com

Thomas V. Wiecki, Jeffrey Poland, and Michael J. Frank


Department of Cognitive, Linguistic, and Psychological Science, Brown University

Abstract
Psychiatric research is in crisis. We highlight efforts to overcome current challenges by focusing on the emerging field
of computational psychiatry, which might enable the field to move from a symptom-based description of mental illness
to descriptors based on objective computational multidimensional functional variables. We survey recent efforts toward
this goal and describe a set of methods that together form a toolbox to aid this research program. We identify four levels
in computational psychiatry: (a) behavioral tasks that index various psychological processes, (b) computational models
that identify the generative psychological processes, (c) parameter-estimation methods concerned with quantitatively
fitting these models to subject behavior by focusing on hierarchical Bayesian estimation as a rich framework with
many desirable properties, and (d) machine-learning clustering methods that identify clinically significant conditions
and subgroups of individuals. As a proof of principle, we apply these methods to two different data sets. Finally, we
highlight challenges for future research.

Keywords
computational psychiatry, drift diffusion model, computational cognitive neuroscience, RDoC, response inhibition

Received 9/27/13; Revision accepted 7/15/14

Imagine going to a doctor because of chest pain that has the heart, our understanding of the normally functioning
been bothering you for a couple of weeks. The doctor brain is still, arguably, in its infancy.
would sit down with you, listen carefully to your descrip- Despite this complexity, concerted efforts in the brain
tion of symptoms, and prescribe medication to lower sciences have led to an explosion of knowledge and
blood pressure in case you have a heart condition. After understanding about the healthy and diseased brain in
a couple of weeks, your pain has not subsided. The doc- the past decades. The discovery of highly effective psy-
tor now prescribes medication against reflux, which choactive drugs in the 1950s and 1960s raised expecta-
finally seems to help. In this scenario, not a single medi- tions that psychiatry would progress in a similar fashion.
cal analysis (e.g., electrocardiogram, blood work, or a It is unfortunate that, in retrospect, it appears that these
gastroscopy) was performed, and medication with poten- discoveries were serendipitous in nature, given that little
tially severe side effects was prescribed on a trial-and- progress has been made since (e.g., Hyman, 2012; Insel
error basis. Although highly unlikely to occur if you et al., 2010). This lack of progress also has caused many
walked into a primary care unit with these symptoms major pharmaceuticals companies, such as AstraZeneca
today, this scenario resembles much of contemporary and GlaxoSmithKline, to withdraw from psychiatric drug
psychiatry diagnosis and treatment. development and to close large research centers (Cressey,
There are several reasons for this discrepancy in
sophistication between psychiatry and other fields of
medicine. First and foremost, mental illness affects the Corresponding Authors:
Michael J. Frank and Thomas V. Wiecki, Department of Cognitive,
brain—the most complex biological system yet encoun- Linguistic, and Psychological Science, Brown University, 190 Thayer
tered. Compared with the level of scientific understand- St., Providence, RI 02912-1821
ing achieved on other organs of the human body, such as E-mail: michael_frank@brown.edu and thomas.wiecki@gmail.com

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Computational Psychiatry: Clustering and Classification 379

2011; Nutt & Goodwin, 2011). In addition, research on after nuisance variables are regressed out and that this
mental illness, based on conventional psychiatric diag- clustering shows consistently better recovery of the age-
nostic categories and practices (as reflected in the various groups than if behavioral summary statistics (e.g., mean
editions of the Diagnostic and Statistical Manual of RT and accuracy) are used alone. Moreover, factor analy-
Mental Disorders, DSM; e.g., American Psychiatric sis on the computational parameters extracts meaningful
Association, 2013), has been widely viewed as disap- latent variables that describe cognitive ability. For this
pointing, and the DSM system of classification itself has data set, no identified brain-based mechanism was ana-
been viewed as an impediment to more productive lyzed. In contrast, for the second data set, we relied on a
research. As a consequence, psychiatry is a field in crisis hypothesis-driven approach that suggested a mechanism
(Hyman, 2012; Insel et al., 2010; Poland, Von Eckardt, & for how a specific decision parameter—the decision
Spaulding, 1994; Sahakian, Malloch, & Kennard, 2010). threshold—varies as a function of activity communicated
As outlined in more detail later, a central issue is a lack between frontal cortex and the subthalamic nucleus
of sufficiently powerful theoretical and methodological (STN). A previous study showed that STN deep-brain
resources for managing the features of mental illness stimulation disrupted decision-threshold regulation
(e.g., a lack of measurable quantitative descriptors). This across a group of patients with Parkinson’s disease (PD;
lacuna prevents effective management of the multidi- Cavanagh et al., 2011). In the following, we show that we
mensional hierarchical complexity, dynamic interactivity, can classify individual patients’ brain-stimulation status
causal ambiguity, and heterogeneity of mental illness. (off or on) with relatively high accuracy, given model
And it leads to an explanatory gap of how basic neuro- parameters, and better than that achieved on the basis of
biological processes and other causes result in complex brain-behavior correlations alone.
disorders of the mind (Hyman, 2012; Montague, Dolan,
Friston, & Dayan, 2011).
In the present study, we review current challenges in
Current Challenges in Psychiatry
psychiatry and recent efforts to overcome them. Several The current crisis in psychiatry has complex causes that
examples from the domain of decision making show the are deeply rooted in existing classification systems (e.g.,
promise of moving away from symptom-based descrip- DSM, International Classification of Diseases). In this sec-
tion of mental illness and instead formulating objective, tion, we identify some of the problems these systems
quantifiable computational biomarkers as a basis for fur- introduce and provide indications of the sorts of resources
ther psychiatric research. We then introduce a computa- required for more productive research programs. In the
tional cognitive toolbox that is suited to construct these subsequent section, we review recent attempts to meet
computational biomarkers. We focus on sequential sam- these challenges and the sorts of resources that have
pling models (SSMs) of decision making, which serve as been introduced for this purpose. As other researchers
a case study for how computational models, when fit to before us have done, we proceed to suggest an approach
behavior, have successfully been used to identify and to research of mental disorders that aims to link cognitive
quantify latent neurocognitive processes in healthy and pure neuroscience to mental illness without the
humans. Bayesian methods provide a resourceful frame- restrictions of prior classification schemes (Robbins,
work to fit these models to behavior and establish indi- Gillan, Smith, de Wit, & Ersche, 2012).
vidualized descriptors of neurocognitive function. After
establishing the validity of these models to provide neu-
DSM and research
rocognitive descriptors of individuals, we review how
clustering techniques can be used to construct a map of For decades, the DSM has been the basis of clinical diag-
individual differences based on these neurocognitive nosis, treatment, and research of mental illness. At its
descriptors. core, the DSM defines distinct disorder categories, such
To demonstrate the viability and potential of these as schizophrenia (SZ) and depression, in a way that is
methods, we reanalyze two data sets, thereby providing atheoretical (i.e., with no reference to specific causal
a proof of principle before discussing future challenges hypotheses) and focused on clinical phenomenology.
in application to psychiatric populations. The first data Thus, these categories are mainly derived from translat-
set consists of a group of young and old subjects who ing subjective experience to objective symptomatology
performed three different decision-making tasks (Ratcliff, while assuming unspecified biological, psychological, or
Thapar, & McKoon, 2010). After fitting subjects’ choices behavioral dysfunctions (Poland et al., 1994).
and response-time (RT) distributions with the drift- Although primarily intended to be of value to clini-
diffusion model (DDM) using hierarchical Bayesian cians, the DSM has also played a substantial role as a
parameter estimation, we provide each subject’s param- classification system for scientific research with the goals
eter estimates as inputs to an unsupervised clustering of validating the diagnostic categories and translating
algorithm. We show that the clustering is sensitive to age research results directly into clinical practice. Although

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380 Wiecki et al.

these research goals are commendable, decisions regard- pose challenges to research and require sophisticated tools
ing systematic classification are more often based on per- and techniques for their effective management. These
ceptions of clinical utility rather than scientific merit. As a include hierarchical organization of the brain and various
consequence, DSM-based research programs have failed sorts of interlevel relationship and coordination (e.g., the
to deliver consistent, replicable, and specific results, and explanatory gap), dynamic interactivity, multidimensional
it has been widely observed that the validation of DSM complexity, context sensitivity, identification of norms of
categories has been limited, that DSM categories do not functioning, and identification of meaningful groupings of
provide well-defined phenotypes, and that they have lim- individuals. As we discuss herein, each of these features cre-
ited research utility. ates problems that contribute to an understanding of why
the current crisis in research exists and of the sorts of
resources and strategies required for more productive
Heterogeneity and comorbidity
research programs.
One major problem of contemporary psychiatric classifi-
cation is the heterogeneity of individuals receiving identi- Potential Solutions
cal diagnoses. With respect to symptomatology, one
striking example of this is SZ, with regard to which one As summarized in the preceding discussion, the short-
must exhibit at least two out of five symptoms to receive comings of the current DSM classification system and the
a diagnosis. It is thus possible to have patients with com- problems they pose for research are well documented. In
pletely different symptomatology being diagnosed as the following, we outline some current efforts to address
schizophrenic. It is important, however, that problems of these challenges.
heterogeneity concern more than just symptoms; there is
probably heterogeneity at all levels of analysis, including Research Domain Criteria Project
heterogeneity of causal processes (Poland et al., 1994). and a Roadmap for Mental Health
And, as we discuss later, such heterogeneity is not just a
feature of clinical populations but also may be a feature
Research in Europe
of the general population. As a consequence, heteroge- The Research Domain Criteria Project (RDoC) is an initia-
neity poses a serious challenge for research (e.g., it intro- tive by the National Institute of Mental Health (Insel et
duces uncontrolled sources of variance, it limits the al., 2010). RDoC improves on previous research efforts
generalizability of results) and points to the necessity of based on the DSM in the following ways. First, as the
developing techniques for its management. name implies, it is conceptualized as a research frame-
Comorbidity is widely believed to constitute a second work only and, thus, is clearly separated from clinical
major problem for psychiatric classification. Defined as practice. Second, RDoC is completely agnostic about
the co-occurrence of multiple disorders in one individ- DSM categories. Instead of a top-down approach that
ual, it has been widely documented that “comorbidity aims to identify neural correlates of psychiatric disorders,
between mental disorders is the rule rather than the RDoC suggests a bottom-up approach that builds on the
exception, invading nearly all canonical diagnostic current understanding of neurobiological underpinnings
boundaries” (Buckholtz & Meyer-Lindenberg, 2012, of different cognitive processes and links those to clinical
p. 996). It is important to differentiate between two rele- phenomena. Third, the RDoC research program inte-
vant types of comorbidity: True comorbidity is a result of grates data from different levels of analysis, such as imag-
independent disorders co-occurring; artificial comorbid- ing, behavior, and self-reports.
ity is a result of separately classifying disorders that have At its core, RDoC is structured into a matrix with col-
overlapping symptom criteria, have a common cause, or umns representing different “units of analysis” and rows
share a pathogenic cascade. This distinction points to a for research domains. The units of analysis include genes,
more general problem concerning the management of molecules, cells, circuits, physiology, behavior, and self-
causal ambiguity that is found at the level of symptoms reports. Research domains are clustered into negative-
but also at other levels of analysis. Specifically, the prob- and positive-valence systems, cognitive systems, systems
lem is one of identifying which causal structures and pro- for social processes, and arousal/regulatory systems.
cesses produce a given clinical presentation or a given Each of these domains is further subdivided into distinct
pattern of functioning at some other level; because clini- processes; for example, cognitive systems include atten-
cal presentations and patterns of functioning can be pro- tion, perception, working memory, declarative memory,
duced by different causal structures and processes, the language behavior, and executive control.
challenge for researchers is to develop techniques for Despite clear improvements over previous DSM-based
identifying and managing such causal ambiguity. research programs, the RDoC initiative currently lacks
In addition to challenges of heterogeneity and comorbid- explicit consideration of computational descriptors. As out-
ity, several other features of the domain of mental illness lined later, computational methods show great promise to

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Computational Psychiatry: Clustering and Classification 381

help link different levels of analysis, elucidate clinical symp- category achieved better performance when classifying
toms, and identify subgroups of healthy control (HC) and within each functional profile than did a classifier trained
patient populations. on the aggregated data. In other words, this implies that
More recent, the European Commission started the the overall population clusters into different cognitive pro-
Roadmap for Mental Health Research in Europe files, and ADHD affects individuals differently on the basis
(ROAMER) initiative with the goal of better integrating of which cognitive profile they exhibit. The results of this
biomedicine, psychology, and public-health insights to study suggested that the source of heterogeneity not only
further research into mental illnesses. may be distinct pathogenic cascades being labeled as the
same disorder but also may be a result of the inherent
heterogeneity present in the overall population—healthy
Neurocognitive phenotyping
and disordered.
In a recent review article, Robbins et al. (2012) suggested The studies discussed all exemplify the danger of
the use of neurocognitive endophenotypes to study men- lumping subjects at the level of symptoms and treating
tal illness: “Neurocognitive endophenotypes would fur- them as one homogeneous category with a single, iden-
nish more quantitative measures of deficits by avoiding tifiable pathological cascade. Instead, these studies used
the exclusive use of clinical rating scales, and thereby MPs to find an alternative characterization of subjects
provide more accurate descriptions of phenotypes for independent of their DSM classification that is (a) quanti-
psychiatric genetics or for assessing the efficacy of novel tatively measurable, (b) a closer approximation to the
treatments” (p. 82). underlying neurocircuitry (Robbins et al., 2012), and (c)
Of particular interest are three studies that use such cognizant of heterogeneity in the general population.
neurocognitive endophenotypes by constructing multidi- Nevertheless, this approach still has problems. First,
mensional profiles (MPs) from behavioral summary sta- although there was less reliance on DSM categories, these
tistics across a battery of various neuropsychological studies still used the diagnostic label for recruiting sub-
tasks used to identify subtypes of attention-deficit/hyper- jects, selecting tasks, framing and testing hypotheses, and
activity disorder (ADHD; Durston et al., 2008; Fair, drawing inferences. It could be imagined, for example,
Bathula, Nikolas, & Nigg, 2012; Sonuga-Barke, 2005). that patients with compulsive disorders, such as obses-
Durston et al. (2008) argued that there are distinct sive-compulsive disorder (OCD) or Tourette’s syndrome,
pathogenic cascades within at least three different brain have abnormalities in similar brain circuits and, conse-
circuits that can lead to symptomatology involved in quently, pathologies, deficits, and impairments may
ADHD. Specifically, abnormalities in dorsal frontostriatal, crosscut these (and other) diagnostic categories. Thus, if
orbito-frontostriatal, or fronto-cerebellar circuits can lead only ADHD patients are recruited, a critical part of the
to impairments of cognitive control, reward processing, picture might be missed. Second, the cognitive-task bat-
and timing, respectively. Core deficits in one or multiple tery covers only certain aspects of cognitive function.
of these brain networks can thus result in a clinical diag- Other tasks that, for example, measure working memory
nosis of ADHD and provide a compelling explanation for or reinforcement learning (RL), both of which involve
the heterogeneity of the ADHD patient population. frontostriatal function, would be a useful addition to help
Preliminary evidence for this hypothesis is provided by resolve causal ambiguity. More specifically, performance
Sonuga-Barke (2005), who used principal component on each individual task is assessed by an aggregate per-
analysis on MPs (based on a neuropsychological task bat- formance score. Recent behavioral and neuropsychologi-
tery) of ADHD patients and identified three distinct sub- cal findings, however, have suggested that executive
types that covaried on timing, cognitive control, and control (as an example) in a single task may instead be
reward. more accurately characterized as a collection of related
A similar approach to identifying clusters in the ADHD but separable abilities, a pattern referred to as the unity
population using MPs was taken by Fair et al. (2012). The and diversity of executive functions. Furthermore, most
authors applied graph theory to identify individual behav- cognitive tasks rely on a concerted and often intricate
ioral functional clusters within not only the ADHD patient interaction of various neural networks and cognitive pro-
population but also HC subjects. It is interesting that the cesses (see, e.g., Collins & Frank, 2012). This task-impu-
authors found that HC and ADHD is not the predominant rity problem complicates identification of separate
dimension along which clusters form. Instead, Fair et al. functional impairments and brain circuits solely on the
uncovered different functional profiles (e.g., one cluster basis of MPs.
might show differences in response inhibition, whereas In sum, although cognitive phenotypes provide a use-
another shows differences in RT variability), each of which ful framework for measuring brain function, there is still
contained both HC and patient subgroups. Nevertheless, ambiguity if behavioral scores that provide an aggregate
and critically, a classifier trained to predict diagnostic measure of various brain networks are used. The idea

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382 Wiecki et al.

that a neural circuit can contribute to different cognitive organization, nonlinear dynamic interactivity, context
functions helps explain why diverse mental illnesses can sensitivity, heterogeneity, and individual variation). Thus,
exhibit similar symptoms (comorbidity; Buckholtz & computational psychiatry holds out considerable promise
Meyer-Lindenberg, 2012). Disentangling these transdiag- as a research program directed at mental illness.
nostic patterns of psychiatric symptoms thus requires On the basis of this approach, Maia and Frank (2011)
identification and measurement of underlying brain cir- identified computational models as a
cuits and functions. Whereas Buckholtz and Meyer-
Lindenberg (2012) proposed the use of functional valuable tool in taming [the complex pathological
imaging studies and genetic analysis, we discuss how cascades of mental illness] as they foster a
computational modeling can contribute to disambiguate mechanistic understanding that can span multiple
the multiple pathways leading to behavioral features. levels of analysis and can explain how changes to
one component of the system (for example,
increases in striatal D2 receptor density) can
Computational psychiatry
produce systems-level changes that translate to
Computational models at different levels of abstraction changes in behavior. (p. 154)
have had tremendous impact on the field of cognitive
neuroscience. The aim is to construct models based on Moreover, three concrete strategies for how computa-
integrated evidence from neuroscience and psychology tional models can be used to study brain dysfunction
to explain neural activity as well as cognitive processes were defined:
and behavior. Although more detailed biologically
inspired models, such as biophysical and neural-network •• Deductive approach: Established neuronal or neu-
models, are generally more constrained by neurobiology, ral-circuit models can be tested for how pathophysi-
they often have many parameters that make them less ologically plausible alterations in neuronal state, for
suitable to fit them directly to human behavior. Conversely, instance, connectivity or neurotransmitter levels
more abstract, algorithmic models often have fewer (e.g., dopamine is known to be reduced in PD),
parameters that allow them to be fit directly to data at the affect system-level activations and behavior. This is
cost of being less detailed about the neurobiology. essentially a bottom-up approach, given that it
Normal linking of one level of analysis to another is use- involves the study of how known or hypothesized
ful to identify plausible neural mechanisms that can be neuronal changes affect higher-level functioning.
tested with quantitative tools. Critically, all of these mod- •• Abductive approach: Computational models can
els allow for increased specificity in the identification of be used to infer neurobiological causes from
different neuronal and psychological processes that are known behavioral differences. In essence, this is a
often lumped together in analyses of task behavior based top-down approach that tries to link behavioral
on summary statistics. consequences back to underlying latent causes.
The nascent field of computational psychiatry uses •• Quantitative abductive approach: Parameters of a
computational models to infer dysfunctional latent pro- computational model are fit to a subject’s behavior
cesses in the brain. Montague et al. (2011) defined the on a suitable task or task battery. Different param-
goal for computational psychiatry as eter values point to differences in underlying neu-
rocircuitry of the associated subject or subject
extract[ing] normative computational accounts of group. These parameters can be used either com-
healthy and pathological cognition useful for paratively to study group differences (e.g., healthy
building predictive models of individuals. . . . and diseased) or as a regressor with, for example,
Achieving this goal will require new types of symptom severity. This approach is more common
phenotyping approaches, in which computational with abstract models than with neural-network
parameters are estimated (neurally and behaviorally) models, given that the former typically have fewer
from human subjects and used to inform the parameters and, thus, can be more easily fit to
models. (p. 75) data.

More generally, the tools and techniques of computa- Case studies in the domain of decision
tional cognitive neuroscience (e.g., modeling at multiple
levels of analysis, parameter estimation, classification
making
algorithms) are especially well suited for representing One key area in which computational models have had
and managing the various features of mental illness iden- tremendous success is in the elucidation of how the dif-
tified earlier (e.g., hierarchical and multidimensional ferent cognitive and neurobiological gears work together

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Computational Psychiatry: Clustering and Classification 383

in the domain of decision making. Many mental illnesses symptom category (e.g., negative symptoms) rather than
can be characterized by aberrant decision making of one SZ as a whole ( J. M. Gold et al., 2012; J. M. Gold, Waltz,
sort or another (Maia & Frank, 2011; Montague et al., Prentice, Morris, & Heerey, 2008; Strauss et al., 2011;
2011). In the following section, we review recent cases in Waltz, Frank, Wiecki, & Gold, 2011).
which computational models of decision making have Using an RL task, Waltz, Frank, Robinson, and Gold
been used to better understand brain disorders. (2007) found that SZ patients showed reduced perfor-
mance in selecting previously rewarded stimuli com-
Computational models of RL: PD and SZ.  Our first pared with HC subjects and that this performance deficit
case study concerns PD. Its most visible symptoms affect was most pronounced in patients with severe negative
the motor system as manifest in hypokinesia, bradykine- symptoms. It is notable that patients with SZ and HC
sia, akinesia, rigidity, tremor, and progressive motor subjects did not differ in their ability to avoid actions
degeneration. However, cognitive symptoms recently leading to negative outcomes. However, as a result of the
have received increased attention. PD is an intriguing task-impurity problem, this behavioral analysis did not
neuropsychiatric disorder because its core pathology is allow researchers to differentiate whether SZ patients
well identified to be the cell death of midbrain dopami- were impaired at learning from positive outcomes or
nergic neurons in the substantia nigra pars compacta. from a failure in representation of the prospective reward
Neural-network models of the basal ganglia interpret this values during decision making. The following is a strat-
brain network as an adaptive action-selection device that egy for resolving this problem.
conditionally gates internal or external actions on the This dichotomy in learning versus representation is
basis of their previous reward history, which is learned also present in two types of RL models—actor-critic and
via dopaminergic signals (Montague, Dayan, & Sejnowski, Q-learning models (Sutton & Barto, 1998). An actor-critic
1996; Schultz, Dayan, & Montague, 1997). Behavioral RL model consists of two modules: an actor and a critic. The
tasks show that the chronic low levels of dopamine in PD critic learns the expected rewards of states and trains the
patients result in a bias toward learning from negative actor to perform actions that lead to better-than-expected
reward-prediction errors (RPEs) at the cost of learning outcomes. The actor itself learns only “action propensi-
from positive RPEs. In extension, we have argued that PD ties,” in essence, stimulus-response links. Q-learning
is not a motor disorder per se but rather an action-selec- models, conversely, learn to associate actions with their
tion disorder in which the progressive decline of motor reward values in each state. Thus, whereas a Q-learning
and cognitive function can be interpreted in terms of model has an explicit representation of which action is
aberrant learning and not to select actions. most valued in each state, the actor-critic model will
In this case study, an existing biological model of healthy choose actions on the basis of those that have previously
brain function was paired with a known and well-localized yielded positive prediction errors—regardless of whether
neuronal dysfunction to extend our understanding of the those arose from an unexpected reward or the absence
symptomatology of a brain disorder and to reconceive the of an expected loss. Thus, the differences between these
nature of the dysfunctions involved. Note, however, that the two models can be exploited to attempt to resolve the
model was not fit to data quantitatively, nor were MPs pro- causal ambiguity exhibited by the results discussed.
vided to resolve residual causal ambiguity associated with In a follow-up study, J. M. Gold et al. (2012) adminis-
the task-impurity problem. In the terminology established tered a new task that paired a neutral stimulus in one
by Maia and Frank (2011), this is an example of the deduc- context with a positive stimulus and in another context
tive approach, in which the model provides a mechanistic with a negative stimulus. Although the neutral stimulus has
bridge that explains how abnormal behavior can result from the same value of zero in both contexts, it is known that
neurocircuit dysfunctions. dopamine signals RPEs that drive learning in the basal
Despite SZ being the focus of intense research during ganglia and code outcomes relative to the expected reward
the past decades, no single theory of its underlying neu- (Montague et al., 1996; Schultz et al., 1997). Thus, in the
ral causes has been able to explain the diverse set of negative context, receiving nothing is better than expected
symptoms that lead to an SZ diagnosis. Current psychiat- and will result in a positive RPE, thereby driving learning
ric practices view the symptomatology of SZ as struc- in the basal ganglia to select this action in the future (Maia,
tured in terms of positive symptoms, such as psychosis; 2010). In a test period in which no rewards were pre-
negative symptoms, such as anhedonia, which refers to sented, subjects had to choose between an action that had
the inability to experience pleasure from activities usu- been rewarding and one that had avoided a loss. Both
ally found enjoyable, such as social interaction; and cog- actions should have been associated with better-than-
nitive deficits (Elvevåg & Goldberg, 2000). expected outcomes. An actor-critic model should thus
Recent progress has been made by the application of show a tendency to select the neutral stimulus, whereas a
RL models to understand individual symptoms or a single Q-learning model with representation of the reward

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384 Wiecki et al.

contingencies should mainly select the one with a higher strategically designing task demands, J. M. Gold et al.
reward. It is intriguing that when both of these models pursued an innovative strategy for resolving problems of
were fit to subject data, the actor-critic model produced a interpretation resulting from task impurity.
better fit for SZ patients with a high degree of negative Another relevant line of work includes that of
symptoms, whereas HC subjects and SZ patients with low Brodersen et al. (2013), who used dynamic causal model-
negative symptoms were better fit by a Q-learning model. ing (Friston, Harrison, & Penny, 2003)—a Bayesian frame-
In other words, patients with negative symptoms largely work for inferring network connectivity between brain
based decisions on learned stimulus-response associations areas from functional MRI (fMRI) data—on HC subjects
instead of expected reward values. It is notable that HC and SZ patients performing a numerical n-back working
subjects and the low-negative-symptom SZ group did not memory task. Supervised learning methods demonstrated
differ significantly in their RL behavior. This study by J. M. a clear benefit (71% accuracy) of using dynamic causal
Gold et al. demonstrated how computational analyses can modeling compared with more traditional methods, such
differentiate between alternative mechanisms that can as functional connectivity (62%). Moreover, clustering
explain deficiencies in reward-based choice. Many RL methods were sensitive to various SZ subtypes, which
tasks can be solved by learning either stimulus-response showed the potential of this approach to identify clini-
contingencies or expected reward values (or both), but the cally meaningful groups in an unsupervised manner.
model and appropriate task manipulation allows one to Finally, we refer to Huys et al. (2012) for an example of
extract to which degree these processes are operative and, how a computational-psychiatry analysis can be used to
thus, helps to resolve the task-impurity problem. relate depressive-symptom severity to a specific cognitive
In a related line of work, Strauss et al. (2011) tested process involved in planning multiple future actions.
HC subjects and SZ patients on an RL task that allowed
subjects to either adopt a safe strategy and exploit the Computational models of response inhibition. 
rewards of actions with previously experienced rewards Besides RL, response inhibition is another widely studied
or explore new actions with perhaps even higher payoffs. phenomenon in cognitive neuroscience relevant to men-
Frank, Doll, Oas-Terpstra, and Moreno (2009) developed tal illness. Response inhibition is required when actions
a computational model that can recover how individual in the planning or execution stage are no longer appro-
subjects balance this exploration-exploitation trade-off. It priate and must be suppressed. The antisaccade task is
is intriguing that in applying this model to SZ patients, one such task that is often used in a psychiatric setting
Strauss et al. found that patients with high anhedonia rat- (e.g., Aichert et al., 2012; Fukumoto-Motoshita et al.,
ings were less willing to explore their environment and 2009). It requires subjects to inhibit a prepotent response
uncover potentially better actions. This result suggests a to a salient stimulus and instead saccade to the opposite
reinterpretation of the computational cognitive process side (Hallett, 1978). A wealth of literature has demon-
underlying lack of social engagement associated with strated reduced performance of psychiatric patients with
anhedonia. For example, one might assume that the lack disorders, including ADHD (Nigg, 2001; Oosterlaan,
of engagement of social activities of anhedonistic patients Logan, & Sergeant, 1998; Schachar & Logan, 1990), OCD
results from an inability to experience pleasure and, as a (Chamberlain, Fineberg, Blackwell, Robbins, & Sahakian,
consequence, a failure to learn the positive value of 2006; Menzies et al., 2007; Morein-Zamir, Fineberg, Rob-
social interaction. Instead, this study suggested that lack bins, & Sahakian, 2010; Penadés et al., 2007), SZ (Bad-
of social engagement associated with anhedonia is a cock, Michie, Johnson, & Combrinck, 2002; Bellgrove et
result of an inability to consider the prospective benefit al., 2006; Huddy et al., 2009), PD (van Koningsbruggen,
of doing something that might lead to better outcomes. Pender, Machado, & Rafal, 2009), and substance-abuse
These results also lead to the prediction that patients with disorders (Monterosso, Aron, Cordova, Xu, & London,
SZ would not, for example, seek out new social interac- 2005; Nigg et al., 2006). However, as demonstrated by
tions (because of the low value placed on exploration) Wiecki and Frank (2013), even a supposedly simple
but could still enjoy social interactions once established. behavioral task, such as the antisaccade task, requires a
Again, computational strategies allow for a reconceptual- finely orchestrated interplay between various brain
ization and disambiguation of clinical phenomena. regions, including frontal cortex and basal ganglia. It thus
In sum, J. M. Gold et al. (2012) and Strauss et al. (2011) cannot be said that decreased accuracy in this task is
used a quantitative abductive approach to infer aberrant evidence of response inhibition deficits per se, given that
computational cognitive processes in RL in a subgroup of the source of this performance impairment can be mani-
SZ patients. By grouping subjects according to symptom fold (i.e., the antisaccade task exhibits the task-impurity
type and severity instead of diagnosis, the authors identi- problem).
fied more refined research targets and addressed the In sum, the use of computational models that allow
problem of heterogeneity. By combining models and mapping of behavior to psychological processes could

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Computational Psychiatry: Clustering and Classification 385

thus be categorized as the computational abductive but fitting such models to data presents significant technical
approach. However, in addition to managing the task- challenges as well. In the following, we identify four levels
impurity problem just mentioned, ambiguity of how psy- of the analysis: Level 1, strategic identification of cognitive
chological processes relate to the underlying neurocircuitry tasks to be employed for the collection of performance
still has to be resolved. By combining different levels of data; Level 2, the fitting of computational models to the
modeling, researchers can better identify and study these performance data; Level 3, parameter estimation; and Level
ambiguities. Ultimately, this might allow development of 4, identification of clusters and relations to clinical symptom
tasks that use specific conditions (e.g., speed-accuracy severity (see Fig. 1 for an overview). We show how hierar-
trade-off, reward modulations, and conflict) to disambigu- chical Bayesian modeling and Bayesian mixture models can
ate the mapping of psychological processes to their neuro- be deployed to engage a variety of challenges at the various
circuitry. The use of biological-process models to test levels of the analysis. Subsequently, we demonstrate the use
different hypotheses about the behavioral and cognitive of these methods on two data sets as a “proof of concept.”
effects of neurocircuit modulations would correspond to The methods identified in this section have direct applica-
the deductive approach. In other words, by combining the bility to the analysis of cognitive functions in mental
research approaches outlined by Maia and Frank (2011), illness.
we can use our understanding of the different levels of
processing to inform and validate how these levels interact
in the healthy and dysfunctional brain.
Level 1: Cognitive tasks
Thus, there are a few example studies in which Cognition spans many mental processes that include atten-
researchers have applied established computational mod- tion, social cognition, memory, emotion, decision making,
els to identify model parameters (which aim to describe and reasoning, to name a few. Various subfields devoted to
specific cognitive functions) and related them to the each of these have developed a range of cognitive tasks that
severity of a specific clinical symptom or used them to purport to reveal the underlying mechanisms. Research in
identify measureable cognitive impairments. Such targets computational psychiatry can draw on these tasks to create
(viz., specific symptoms, measureable impairments) rep- task batteries for the collection of performance data usable
resent more refined research targets than do DSM diag- for the analysis of cognitive function; both the sensitivity
nostic categories. In addition, through the use of and the specificity of tasks to cognitive functions are impor-
strategically designed task batteries and MPs, problems tant characteristics, although the task-impurity problem
of heterogeneity and task impurity can be managed. And complicates the analysis of data and their use in isolating
the combination of various research approaches (e.g., and specifying cognitive functions. Rather than provide a
multiple modeling strategies, task batteries and MPs, task list of tasks used (see the case studies discussed earlier for
manipulations, novel approaches to sampling) can pro- some examples), we discuss desirable properties that cogni-
vide a strategic framework for studying relations between tive tasks should exhibit. A single cognitive task used in
neural and computational levels of analysis in mental computational psychiatry ideally should be tuned to assess
illness. a specific cognitive function, separable from others; this is
enabled by the following:
Levels of Computational Psychiatry •• a task analysis that identifies what functions are
Thus far, we have identified a variety of challenges to engaged and how they are engaged;
research concerning mental illness and various strategies •• parsimony in relying on as few cognitive processes
that have been employed to meet those challenges. as possible;
Special attention has been given to computational psy- •• stress on cognitive processing in some way to
chiatry as an especially promising research program. In reveal break-off points and allow a sensitive mea-
all cases, promise for effectively meeting the research sure of the target function;
challenges depends on the availability of conceptual and •• an established theory regarding the neural corre-
representational resources and associated strategies and lates of the target functions; and
techniques that are sufficiently powerful, given the fea- •• an established computational model that links
tures of the domain of mental illness and the problems it behavior to psychological-process parameters.
poses for research.
In this section, we provide an overview of a four-level Given the task-impurity problem and other forms of causal
approach to the computational analysis of cognitive func- ambiguity, task batteries ideally should be strategically
tion and dysfunction by focusing on decision making and constructed to measure a range of relevant cognitive func-
using SSMs as a concrete example (see Table 1 for a delin- tions and other variables to aid in the interpretation of task
eation of terminology applicable to our discussion). Such performance and the isolation of specific functions and
models provide a versatile tool to model cognitive function, dysfunctions. This can be achieved by including covarying

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386 Wiecki et al.

Table 1. Terminology

Term Definition
Psychological-process model A computational model that tries to parameterize the cognitive processes
underlying behavior. This class of models is not primarily concerned with neural
implementations of these processes. Often these models have a parsimonious
parameterization that allows them to be fit to behavior.
Drift-diffusion model An evidence-accumulation model used in decision-making research.
Reinforcement learning Learning to adapt behavior to maximize rewards and minimize punishment.
Parameter estimation/fitting The process of finding parameters that best capture the behavior on a certain task.
Bayesian modeling A parameter-estimation method that allows for great flexibility in defining structure and
prior information about a certain domain.
Comorbidity The co-occurrence of multiple disorders in one individual.
Heterogeneity The fact that there is systematic variation between subjects diagnosed with the same
mental illness.
Task-impurity problem The fact that no single cognitive task measures just one construct but that task
performance is a mixture of distinct cognitive processes.
Multidimensional profile A multidimensional descriptor of a subject’s cognitive abilities as measured by
summary statistics (e.g., accuracy) of cognitive tasks spanning multiple cognitive
domains.
Computational multidimensional profile A multidimensional profile that includes parameters estimated from a psychological-
process model that (a) more directly relates to cognitive ability and (b) deconstructs
different cognitive processes that contribute to individual task performance (i.e., task-
impurity problem).

Level 1: Level 2: Level 3: Level 4:


Clinical and
Cognitive-Task Computational Parameter Classification and
Nonclinical Population
Battery Modeling Estimation Clustering

Fig. 1.  Illustration of the four levels of computational psychiatry. Clinical and nonclinical populations are tested on a battery of cognitive tasks.
Computational models can relate raw task performance (e.g., response time and accuracy) to psychological and neurocognitive processes. These
models can be estimated via various methods (depicted is a simplified graphic of the HDDM or hierarchical drift-diffusion model). Finally, on the
basis of a resulting computational multidimensional profile, supervised and unsupervised learning algorithms can be trained to either predict dis-
ease state, uncover groups and subgroups in clinical and healthy populations, or relate model parameters to clinical symptom severity.

factors (i.e., conditions) in individual tasks that affect only models. Although each of these is informative in its own
one mental function, which can then be identified. For regard in elucidating mental function and dysfunction, we
example, Collins and Frank (2012) were able to separately focus here on psychological-process models. This class of
estimate the contributions of working memory and RL in a model has the unique advantage of being simple enough
single task by testing multiple conditions that increased so that it can be fit directly to behavior; that is, it is pre-
load on working memory alone. Because working mem- ferred, from a statistical analysis point of view, given the
ory contributions can contaminate the estimation of the RL level of data collected. The fitted parameters often quan-
component, this manipulation enabled a model to not tify cognitive ability in terms of psychological-process
only capture the WM component but also better estimate variables rather than behavioral summary statistics. For
the RL component. example, in a simple detection task, one might consider
the RT speed as a good measure of task performance.
However, by adjusting the speed-accuracy trade-off, mean
Level 2: Computational models RT can easily be shortened just by increasing the false
Computational models in cognitive neuroscience exist on alarm rate. This obviously would not indicate an individ-
various levels of abstraction that range from biophysical ual’s superior processing abilities. An SSM analysis, how-
neuronal models to abstract psychological-process ever, would be able to disentangle response caution (i.e.,

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Computational Psychiatry: Clustering and Classification 387

Response Density
(Upper Boundary)

Upper Response Boundary

Nondecision
(v)

Threshold (a)
Time (t) Rate
Drift
Bias (z)

Lower Response Boundary

Reponse Density
Time
(Lower Boundary)
Fig. 2. Trajectories of multiple drift processes (blue and red lines, middle panel). Evidence is accumulated
over time (x-axis) with drift rate (v) until one of two boundaries, separated by threshold (a), is crossed and a
response is initiated. Upper (blue) and lower (red) panels contain histograms over boundary-crossing times for
two possible responses. The histogram shapes match closely to that observed in response-time measurements
of research subjects.

decision threshold) and processing abilities (i.e., drift modeled as a sequential extraction and accumulation of
rate): These are generative parameters that produce the information from the environment or internal representa-
joint distribution of accuracy and RT. Intuitively, an tions. Once the accumulated evidence crosses a thresh-
increase in decision threshold would lead to more accu- old, a corresponding response is executed. This simple
rate but slower responses, whereas an increase in drift assumption about the underlying psychological process
rate would lead to higher accuracy but also faster has the important property of reproducing not only
responses (Ratcliff & McKoon, 2008). In the following sec- choice probability and mean RT but also the entire distri-
tion, we present a simulation experiment that shows how bution of RTs separately for accurate and erroneous
two groups can be clearly separated in their DDM param- choices in simple two-choice decision-making tasks. It is
eters but strongly overlap when described in terms of RT interesting that this evolution of the decision signal in
and accuracy summary statistics. SSMs can also be interpreted as a Bayesian update pro-
cess (e.g., Bitzer, Park, Blankenburg, & Kiebel, 2014;
SSMs. As outlined earlier, RL models have already Deneve, 2008; J. I. Gold & Shadlen, 2002; Huang & Rao,
proven to be a valuable tool in explaining neuropsycho- 2013). This may be useful because it would place SSMs
logical disorders and their symptoms. A computational- under a more axiomatic framework and prevent the
psychiatric framework that aims to explain the impression that SSMs are merely convenient heuristics.
multifaceted domain of mental illness must include com- The DDM models decision making in two-choice
putational cognitive neuroscience models that cover a tasks. Each choice is represented as an upper and lower
broad range of cognitive processes (see, e.g., O’Reilly, boundary. A drift process accumulates evidence over
Munakata, Frank, Hazy, & Contributors, 2012, for a broad time until it crosses one of the two boundaries and initi-
coverage of such models). We focus on SSMs as an illus- ates the corresponding response (Ratcliff & Rouder, 1998;
trative example of how these models have been applied Smith & Ratcliff, 2004). The speed with which the accu-
to study normal and aberrant neurocognitive phenom- mulation process approaches one of the two boundaries
ena, how they can be fit to data using Bayesian estima- is called the drift rate and represents the relative evi-
tion, and how subgroups of similar subjects can be dence for or against a particular response. Because there
inferred using mixture models. is noise in the drift process, the time of the boundary
SSMs (e.g., Townsend & Ashby, 1983), such as the crossing and the selected response will vary between tri-
DDM, have established themselves as the de facto stan- als. The distance between the two boundaries (i.e.,
dard for modeling data from simple decision-making threshold) influences how much evidence must be accu-
tasks (e.g., Smith & Ratcliff, 2004). Each decision is mulated until a response is executed. A lower threshold

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388 Wiecki et al.

makes responding faster in general but increases the predictive of more accurate but slower decisions, as
influence of noise on decision making, whereas a higher expected as a result of threshold regulation (Cavanagh et
threshold leads to more cautious responding. RT, how- al., 2011; Zaghloul et al., 2012; Zavala et al., 2013). These
ever, is not solely composed of the decision-making pro- results provide a computational cognitive explanation for
cess—perception, movement initiation, and execution all the clinical symptom of impulsivity observed in PD
take time and are summarized into one variable called patients receiving deep-brain stimulation (Bronstein et
nondecision time. The starting point of the drift process al., 2011; Frank, Samanta, et al., 2007; Hälbig et al., 2009).
relative to the two boundaries can influence whether one
response has a prepotent bias. This pattern gives rise to Application to computational psychiatry. Despite
the RT distributions of both choices (see Fig. 2 for trajec- its long history, the DDM has been applied to the study
tories of multiple drift processes; mathematical details of of psychopathology only recently. For example, threat/
the methods motivated herein can be found in the Drift- no-threat categorization tasks (e.g., “Is this word threat-
Diffusion Model section in the Supplemental Material ening or not?”) are used in anxiety research to explore
available online). biases to threat responses. Subjects with high anxiety are
more likely to classify a word as threatening than are
Relationship to cognitive neuroscience. SSMs were low-anxiety subjects, although the explanation of this
originally developed from a pure information-processing bias is unclear. One hypothesis assumes that this behav-
point of view and primarily used in psychology as a high- ior results from an increased response bias toward threat-
level approximation of the decision process. More recent ening words in anxious people (Becker & Rinck, 2004;
efforts in cognitive neuroscience have simultaneously (a) Manguno-Mire, Constans, & Geer, 2005; Windmann &
validated core assumptions of the model by showing that Krüger, 1998). Using DDM analysis, White (2009) showed
neurons indeed integrate evidence probabilistically dur- that instead of a response bias (or a shifted starting point
ing decision making ( J. I. Gold & Shadlen, 2007; Smith & in DDM terminology), anxious people showed a percep-
Ratcliff, 2004) and (b) applied this model to describe and tual bias toward classifying threatening words, as indi-
understand neural correlates of cognitive processes (e.g., cated by an increased DDM drift rate.
Cavanagh et al., 2011; Forstmann, Anwander, et al., 2010). In a recent review article, White, Ratcliff, Vasey, and
Furthermore, multiple routes to decision-threshold McKoon (2010) used this case study to highlight the poten-
modulation have been identified, thereby demonstrating tial of the DDM to elucidate research into mental illness.
the value of this modeling approach for managing prob- Note that in this study, the authors did not hypothesize
lems of the context sensitivity of cognitive function, about the underlying neural cause of this threat bias.
causal ambiguity, and the task-impurity problem. On one Although there is some evidence that bias in decision
hand, decision threshold in the speed-accuracy trade-off making is correlated with activity in the parietal network
is modulated by changes in the functional connectivity (Forstmann, Brown, Dutilh, Neumann, & Wagenmakers,
between presupplementary motor area and striatum 2010), this was not tested in respect to threatening words.
(Forstmann, Anwander, et al., 2010). On the other hand, Ultimately, we suggest that this research strategy should be
neural-network modeling validated by studies of PD applied to infer neural correlates of psychological DDM
patients implanted with a deep-brain stimulator (Frank, decision-making parameters using functional methods
Samanta, Moustafa, & Sherman, 2007) suggests that the such as fMRI and employing modeling techniques at mul-
STN is implicated in raising the decision threshold if tiple levels of analysis.
there is conflict between two options associated with The DDM has also been successfully used to show that
similar rewards. This result was further corroborated by ADHD subjects were less able to raise their decision thresh-
Cavanagh et al. (2011), who found that trial-to-trial varia- old when accuracy demands were high (Mulder et al.,
tions in frontal theta power (as measured by electroen- 2010). It is interesting that the amount by which ADHD
cephalography, EEG, as a measure of response conflict; subjects did not modulate their decision threshold corre-
Cavanagh, Zambrano-Vazquez, & Allen, 2012) is corre- lated strongly with patients’ impulsivity/hyperactivity rat-
lated with an increase in decision threshold during high- ing. Moreover, this correlation was specific to impulsivity
conflict trials. As predicted, this relationship was reversed and not inattentiveness. Note that in this case, the use of
when STN function was disrupted by deep-brain stimula- the DSM category (ADHD) may have obscured a more
tion in PD patients. When deep-brain stimulators were robust transdiagnostic association between decision-thresh-
turned off, patients exhibited the same conflict-induced old modulation and hyperactivity, and “hyperactivity” itself
regulation of decision threshold as a function of cortical may mask a variety of different causal processes.
theta. Similarly, intraoperative recordings of STN field A recent study by Pe, Vandekerckhove, and Kuppens
potentials and neuronal spiking showed that STN activity (2013) showed that the DDM could also be used to
responds to conflict during decision making, and is explain previously conflicting reports on the influence of

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Computational Psychiatry: Clustering and Classification 389

negative distractors on the emotional flanker task in the estimation of other subjects generally leads to more
depressed patients. Specifically, depression and rumina- accurate parameter recovery (Wiecki, Sofer, & Frank,
tion (a core symptom of depression) were associated 2013) in cases in which little data are available, as is often
with enhanced processing of negative information. These the case in clinical and neurocognitive experiments. One
results further support the theory that depression is char- alternative is to aggregate all subject data into one meta-
acterized by biased processing of negatively connotated subject and estimate one set of parameters for the whole
information. Critically, this result could not be established group. Although useful in some settings, this approach is
by analyzing mean RT or accuracy alone, thereby dem- unsuited for the setting of computational psychiatry,
onstrating the enhanced sensitivity to cognitive behavior given that individual differences play a huge role.
of computational models.
In sum, SSMs show great promise as a tool for compu- Hierarchical Bayesian models.  Statistics and machine
tational psychiatry. In helping to map out the complex learning have developed efficient and versatile Bayesian
interplay of cognitive processes and their neural corre- methods to solve various inference problems (Poirier,
lates in mental illness, such models can play a role in 2006). They more recently have seen wider adoption in
resolving task impurity and other forms of causal ambi- applied fields such as genetics (Stephens & Balding,
guity, identifying and measuring cognitive impairments, 2009) and psychology (e.g., Clemens, De Vrijer, Selen,
and associating such impairments with both symptoms Van Gisbergen, & Medendorp, 2011). One reason for this
and neural correlates. However, their applicability Bayesian revolution is the ability to quantify the certainty
depends on the ability to accurately estimate them to one has in a particular estimation. Moreover, hierarchical
construct individual computational MPs (CMPs). Such Bayesian models provide an elegant solution to the prob-
CMPs are parameter profiles that represent an individu- lem of estimating parameters of individual subjects out-
al’s functioning as measured by the specific parameters lined earlier (viz., the problem of neglecting similarities
that make up the profile and derived from fitting the of parameters across subjects). Under the assumption
model to task-performance data. In the next section, we that subjects within each group are similar to each other,
review different (Level 3) parameter-estimation tech- but not identical, a hierarchical model can be constructed
niques with a special focus on Bayesian methods that are in which individual parameter estimates are constrained
usable for estimating parameters in the DDM and for by group-level distributions (Nilsson, Rieskamp, &
generating individual CMPs. Finally, once SSMs can be fit Wagenmakers, 2011; Shiffrin, Lee, & Kim, 2008), and
accurately, we move on to identify (Level 4) clustering more so if group members are similar to each other.
methods that can be used in a Bayesian framework to Thus, hierarchical Bayesian estimation leverages simi-
identify meaningful clusters of individuals, given their larity between individual subjects to share statistical
cognitive profiles (CMPs). power and increase sensitivity in parameter estimation.
However, note that in our computational-psychiatry
application, the homogeneity assumption that all subjects
Level 3: Parameter estimation come from the same normal distribution is almost cer-
It is critical to have robust and sensitive estimation meth- tainly violated (see earlier discussion). For example, dif-
ods to identify computational parameters in a variable ferences between subgroups of ADHD subjects would be
clinical population with the DDM. In the following, we decreased as the normality assumption pulls them closer
describe traditional parameter-estimation methods and together. To deal with the heterogeneous data often
their pitfalls. We then explain how Bayesian estimation encountered in psychiatry, we discuss mixture models in
provides a complete framework that avoids these pitfalls. a later section. A detailed description of the mathematical
details and inference methods of Bayesian statistics rele-
Random versus fixed parameters across groups of vant for this endeavor can be found in the Bayesian
subjects.  Fitting of computational models traditionally is Inference section in the Supplemental Material.
treated as an optimization problem in which an objective
function is minimized. Psychological experiments often Level 4: Supervised and unsupervised
test multiple subjects on the same behavioral task. Mod-
els are then fit either to individual subjects or to the
learning
aggregated group data. Both approaches are not ideal. Given that parameters have been estimated, or even
When models are fit to individual subjects, we neglect given behavioral statistics alone, how can we group indi-
any similarity the parameters are likely to have. Although viduals into clusters that might be relevant for diagnostic
we do not necessarily have to make use of this property categories or treatments? Bayesian clustering algorithms
to make useful inferences if we have lots of data, the abil- are particularly relevant to our objective, given that they
ity to infer subject parameters on the basis of (a) deal with the heterogeneity encountered in

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390 Wiecki et al.

computational psychiatry and (b) have the potential to Example Applications


bootstrap new classifications on the basis of measurable,
quantitative, computational endophenotypes. Because In this last section, we provide a proof of concept by
we are describing a toolbox using hierarchical Bayesian demonstrating how the earlier described techniques
estimation techniques, we focus this section on mixture (Levels 1–4) can be combined to (a) recover clusters
models, given that they are easily integrated into this associated with age, on the basis of CMPs as extracted by
framework. Where possible, we highlight connections to the DDM; and (b) predict brain state (deep-brain stimula-
more traditional clustering methods (e.g., “k-means”). tion on/off).

Gaussian mixture models.  Gaussian mixture models Supervised and unsupervised learning
(GMMs) assume parameters to be distributed according
of age
to one of several Gaussian distributions (i.e., clusters).
Specifically, given the number of clusters k, each cluster To demonstrate the concepts presented here, we reana-
mean and variance is estimated from the data. This type lyzed a data set collected and published by Ratcliff et al.
of model is capable of solving our earlier identified (2010). The data set consists of two groups of human
problem of assuming heterogeneous subjects to be nor- subjects, young (mean age 20.8) and old (mean age 68.6),
mally distributed: By allowing individual subject param- tested on three different tasks: (a) a numerosity-discrimi-
eters to be assigned to different clusters, we allow nation task that involved estimation of whether the num-
estimation of different subgroups in our patient and HC ber of asterisks presented on the screen was more or less
populations. Note, however, that the number k of how than 50 (such that trials with close to 50 asterisks were
many clusters should be estimated must be specified a harder than were those with far fewer or far greater), (b)
priori in a GMM and remain fixed for the course of the a lexical decision task that required subjects to decide
estimation. This is problematic, given that we do not whether a presented string of letters is an existing word
necessarily know how many subgroups to expect in of the English language, and (c) a memory-recognition
advance. Bayesian nonparametrics solve this issue by task that presented words to be remembered in a training
inferring the number of clusters from data. Dirichlet pro- phase that were subsequently tested for recall together
cesses GMMs (DPGMMs) belong to the class of Bayesian with distractor words. Details of the tasks (including the
nonparametrics ­(Antoniak, 1974). They can be viewed as conditions tested), subject characteristics, and DDM anal-
a variant of GMMs with the critical difference that they yses can be found in the original publication (Ratcliff
infer the number of clusters from the data (for a review, et al., 2010).
see Gershman & Blei, 2012). An arguably simpler alter- We used the hierarchical DDM (HDDM) toolbox
native, however, is to run multiple clusterings tested with (Wiecki et al., 2013) to perform hierarchical Bayesian
different numbers of clusters and perform model com- estimation of DDM parameters from subjects’ RT and
parison, as we discuss next. choice data without taking the different groups into
account. We concatenated the DDM parameters of each
Model comparison.  Model comparison provides mea- subject in three tasks into one 22-dimensional CMP.
sures to evaluate how well a model can explain the data We next performed factor analysis on the CMP vectors.
while at the same time penalizing model complexity. Factor analysis is a statistical technique that uses correla-
Measures such as the Bayesian information criterion tions between parameters to find latent variables (called
(mathematical details can be found in the Model Com- factors). Intuitively, highly correlated parameters will be
parison section in the Supplemental Material) can be loaded onto the same factor. As shown in the factor-load-
used to choose the GMM with the least number of clus- ing matrix in Figure 3, DDM parameters related to pro-
ters that still provide a good fit to the data. Moreover, cessing capability (i.e., drift rate) in the three tasks are
model comparison is used to select between computa- loaded onto the first four factors, whereas nondecision
tional cognitive models that often allow formulation of times and thresholds in the three tasks are loaded onto
several plausible accounts of cognitive behavior. Of par- Factors 5 and 6, respectively. Thus, instead of the 22 orig-
ticular note are Bayes factors that measure the evidence inal dimensions, we are able to describe the cognitive
of a particular model in comparison with other, compet- variables of individuals using six latent factors.
ing models (Kass & Raftery, 1993). More recent, and Classification of impairments and dysfunctions based
highly relevant to the field of computational psychiatry, on CMPs is a critical requirement for the clinical applica-
these methods have been extended to provide proper tion of computational psychiatry. Although classification
random-effects inference on model structure in heteroge- of age might not have clinical relevancy, it provides an
neous populations (Stephan, Penny, Daunizeau, Moran, ideal testing environment because age is objectively mea-
& Friston, 2009). surable (as opposed to, e.g., SZ, as described earlier). To

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Computational Psychiatry: Clustering and Classification 391

Factor Loadings
Lexical: drift, high freq

Lexical: drift, low freq 0.9

Lexical: drift, very low freq

Lexical: drift, nonword


0.8
IQ

Intensity: drift, very low sig


0.7
Intensity: drift, low sig

Intensity: drift, med sig

Intensity: drift, high sig 0.6

Recollection: drift, 1-high


Parameters

Recollection: drift, 1-low


0.5

Recollection: drift, 2-high

Recollection: drift, 2-low


0.4
Recollection: drift, 3-high

Recollection: drift, 3-low


0.3
Lexical: nondecision time

Intensity: : nondecision time

Recollection: : nondecision time 0.2

Lexical: decision threshold

Intensity: decision threshold


0.1
Recollection: decision threshold

Intensity: drift criterion

1 2 3 4 5 6
Factors
Fig. 3.  Factor-loading matrix. Drift-diffusion model parameters of three tasks are presented along
the y-axis; the extracted factors are distributed along the x-axis. Color codes indicate loading
strengths. See the textual discussion for more details. freq = frequency; sig = significance.

classify young versus old, we employed logistic regres- (by using cross-validation). Classification performance
sion (using Level-2 regularization) on a subset of the data was very high (up to 95% accuracy; not shown), which
and evaluated its prediction accuracy using held-out data demonstrated that cognitive tasks show great potential

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392 Wiecki et al.

GMM With Two Components GMM With Three Components


0.5 0.5

Adjusted Mutual Information


0.4
Adjusted Mutual Information

0.4
0.33***
0.3 0.29***
0.3
0.25**
0.2
0.2
0.13*
0.11** 0.1
0.1 0.06 0.05
0.04**
0.0
0.0 DDM DDM – IQ RT Summary RT Summary
DDM DDM – IQ RT Summary RT Summary Stats Stats – QI
Stats Stats – QI
Fig. 5. Results: adjusted mutual information scores (higher is better,
Fig. 4. Results: adjusted mutual information scores (higher is better, where 1 would mean perfect label recovery and 0 would mean chance
where 1 would mean perfect label recovery and 0 would mean chance level) for age after estimation of a Gaussian mixture model (GMM)
level) for age after estimation of a Gaussian mixture model (GMM) with three components on drift-diffusion-model (DDM) factors (see text
with two components on drift-diffusion-model (DDM) factors (see text for more details on the factor analysis) and on DDM factors after the
for more details on the factor analysis) and on DDM factors after the contribution of IQ was regressed out. Error bars represent standard
contribution of IQ was regressed out. Error bars represent standard deviations assessed via bootstrap. Asterisks denote significantly higher
deviations assessed via bootstrap. Asterisks denote significantly higher chance performance (*p < .05, ***p < .001). RT = response time.
chance performance (**p < .01). RT = response time.

for classifying differences in brain functioning. In this notable that the age cluster is not recovered at all when
case, there was no benefit to using DDM parameters the DDM factors are used. Follow-up analysis suggests
compared with using summary statistics on RT and accu- that the clustering selected by GMM picks up on some of
racy, given that the differences in behavioral profiles the structure introduced by IQ (adjusted mutual informa-
between subjects with large differences in age were quite tion = 0.1; not shown). This indeed represents a potential
stark. There are several examples in which usage of a problem for this unsupervised approach, given that there
computational model does yield a significant increase in are many sources of individual variation, such as age, IQ,
classification accuracy (see later discussion; also see or education, we might not be interested in when want-
Brodersen et al., 2013) and may be more likely to do so ing clusters sensitive to pathological sources of variation.
if the patterns are more nuanced. To address this problem, we regressed the contribution
When these techniques are used to classify a mental of IQ out of every factor to remove this source of varia-
illness such as SZ, there is concern about the validity of tion. Running GMM on these new regressed factors, we
our labels. If SZ does not represent a homogeneous, observed that the algorithm now clusters into different
clearly defined group of individuals but, rather, patients age-groups (adjusted mutual information is 0.25, which
with various cognitive and mental abnormalities, how corresponds to an accuracy of approximately 75%). This
could we expect a classifier to predict such an elusive, might thus provide a viable technique in removing
ill-defined label? One potential way to deal with this unwanted sources of interindividual variation, given that
problem is to use an unsupervised clustering algorithm variables such as age, IQ, or education could just be
to find a new grouping that is hopefully more sensitive to regressed out before doing the clustering—if these nui-
the neurocognitive deficits (Fair et al., 2012). As a proof sance variables are known and measured.
of principle, we tested how well GMM clustering could The main issue here is that multiple factors can con-
recover age-groupings in an unsupervised manner. Note tribute to clusterings of neurocognitive parameters. A
that in a clinically more relevant setting, we would not different solution to this problem is presented in Figure
necessarily know the correct grouping ahead of time. 5, in which we estimated a GMM allowing for an addi-
Figure 4 shows the adjusted mutual information (which is tional cluster (three clusters total). As the figure shows,
1 if we perfectly recover the original grouping and 0 if we even when not regressing IQ out of the parameters, the
group by chance) for age when estimating two clusters clustering solution shows a clear sensitivity to age, albeit
based on six latent factors extracted using factor analysis none to IQ. Moreover, the use of summary statistics on
(we did not include IQ in the factor analysis here). It is RT and accuracy (mean and standard deviation) alone

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Computational Psychiatry: Clustering and Classification 393

did not achieve a comparable level of recovery with the Classfiying Simulated Date
GMM (see Figs. 3 and 4). We also performed model 1.0
comparison using BIC (not shown) to find the best num-
ber of clusters when we successively tested different 0.91***
0.9
numbers of clusters. We found that adding more clusters

Area Under the Curve


monotonically decreased BIC thus favoring models with
many clusters, despite the added complexity of these 0.8
models. This might not be surprising given that there are
many other individual differences beyond age and IQ 0.7 0.68*
that could affect group membership. It does represent a
problem for this approach, however, given that it is not
immediately clear what level of representation should be 0.6
chosen if a purely unsupervised measure such as BIC
does not provide guidance. 0.5
In conclusion, we demonstrated how computational DDM Summary Stats
modeling and latent variable models can be used to con- Fig. 6. Area under the receiver operating characteristic curve that
struct CMPs of individuals tested on multiple cognitive relates to classification accuracy of simulated response-time data from
decision-making tasks. Using supervised machine-learn- the drift-diffusion model (DDM). DDM represents parameters recov-
ing methods, we were able to achieve up to 95% accu- ered in a hierarchical DDM fit ignoring the group labels. Summary sta-
tistics are mean and standard deviation of response time and accuracy.
racy in classifying young versus old age. Finally, after we Error bars represent standard deviations. Asterisks indicate accuracy
regressed IQ out as a nuisance variable, unsupervised significantly higher than chance (*p < .05, ***p < .001).
clustering was able to group young and old individuals
on the basis of the structure of the CMP space.
conditions under which DDM provides a clear benefit
over using the simpler summary statistics.
Simulation experiment
Although the preceding example demonstrated a clear Predicting brain state on the
benefit in using the DDM for unsupervised clustering, the
basis of EEG
model parameters were less beneficial compared with
simple behavioral summary statistics (RT and accuracy) The previously discussed age example clearly demon-
when we performed supervised classification. This find- strated the potential of this approach in a data-driven,
ing raises the question whether DDM parameters derived hypothesis-free manner. To complement this example, we
on the basis of behavioral measures alone can, in prin- tested whether it was possible, using computational meth-
ciple, provide a benefit in supervised learning over sum- ods, to classify patients’ brain state using computational
mary statistics. We thus performed a simple experiment parameters related to measures of impulsivity. We reana-
in which we simulated data from the DDM generating lyzed a data set from our lab in which PD patients
two groups with 40 subjects each. The mean parameters implanted with deep-brain stimulators in the STN were
of the two groups differed in threshold, drift rate, and tested on a reward-based decision-making task (Cavanagh
nondecision time (exact values can be found in the et al., 2011). STN deep-brain stimulation is very effective
Parameters Used in Simulation Study section in the in treating the motor symptoms of the disease but can
Supplemental Material). We then recovered DDM param- sometimes cause cognitive deficits and impulsivity
eters by estimating the HDDM (without allowing group (Bronstein et al., 2011; Hälbig et al., 2009). Prior work has
to influence fit, which would be an unfair bias). Summary shown that when faced with conflict between different
statistics consisted of mean and standard deviation of RT reward values during decision making, HC subjects and
and accuracy. Figure 6 shows the area under the curve patients off deep-brain stimulation adaptively slow down
using logistic regression with Level-2 regularization in a to make a more considered choice, whereas STN deep-
10-fold cross-validation. As the figure shows, for this brain stimulation induces fast impulsive actions. In this
parameter setting, the DDM-recovered parameters pro- study, we showed that the degree of RT slowing for high-
vide a large benefit over summary statistics. During the conflict trials was related to the degree to which frontal
exploration of various generative parameter settings, theta power increased. DDM model fits revealed that theta
however, we also found that other settings do not lead to power increases were specifically related to an increase in
an improvement, similar to the result obtained on the decision threshold, thereby leading to more cautious but
aging data set. Further research is necessary to establish accurate responding, whereas deep-brain stimulation

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394 Wiecki et al.

Classifying DBS State Logistic Regression Coefficients


1.0

0.81* 0.52
0.8 0.5
Area Under the Curve

0.67
0.3

Absolute Coefficient
0.4 0.38

0.4 0.3 0.28

0.2
0.2

0.0
DDM – Theta RT – Theta 0.1
Coefficients Coefficients
Fig. 7.  Out-of-sample classification accuracy using logistic regression 0.0
to deep-brain-stimulation (DBS) state comparing drift-diffusion-model a_dbs theta_diff_LC theta_diff_HC
(DDM) coefficients and using regression between response time (RT)
and theta power. Error bars indicate standard deviations based on a Fig. 8.  Results: absolute coefficients of logistic regression model using
bootstrap. The asterisk encodes significance (*p < .05). three predictors. Intuitively, the higher the coefficient, the more it con-
tributes to separability of deep-brain-stimulation (DBS) state. The differ-
ence in threshold between DBS on and off is a_dbs; theta_diff_LC and
theta_diff_HC are the differences in trial-by-trial regression coefficients
prevented patients from increasing their threshold despite between theta power (as measured via electroencephalography) and
increases in cortical theta, which led to impulsive choice. decision threshold for low- and high-conflict trials, respectively.
These findings lend support to a computational
hypothesis based on a variety of data across species job of the classifier then becomes the classification of
regarding the neural mechanisms for decision-threshold whether an individual is in the deep-brain stimulation on
regulation. However, the findings were significant at the or off state on the basis of the change in coefficients. The
group level. Here, we tested whether we could classify features based on raw RT data were created in a similar
individual patients’ deep-brain-stimulation status know- manner: Instead of using the regression coefficients of
ing only their DDM parameters (estimated from RT and the influence of theta on decision threshold, we included
choice data). We also included as a predictor the degree the influence of theta directly on RT in low and high
to which frontal theta modulated decision threshold conflict (shown to be significantly correlated in Cavanagh
(effectively, another DDM parameter). Specifically, we et al., 2011) as well as the difference in mean RT between
used logistic regression with Level-2 regularization and deep-brain stimulation on and off.
cross-validation. The features for the classifier were the As shown in Figure 7, use of the DDM analysis greatly
difference in thresholds in the two brain states (on and improved classification accuracy. It is interesting that of
off deep-brain stimulation) and the difference in the all the parameters fed into the classifier, the degree to
theta-threshold regression coefficients in high- and low- which theta related to threshold adjustments in high-con-
conflict trials (on and off deep-brain stimulation). The flict trials was most predictive of deep-brain stimulation
classifier tries to predict which brain state a new subject state (see Fig. 8 for absolute coefficients of the logistic
is in on the basis of these difference parameters without regression model using three predictors). This result is
informing it as to which one corresponds to the on or off consistent with that obtained in Cavanagh et al. (2011)
state. We randomly sampled binary labels for each sub- but extends it to show how an individual patient’s brain
ject. The label indicated whether the features were coded state, as a biomarker of impulsivity, can be diagnosed.
relative to the on or off state. Intuitively, if the label were We thus demonstrated that this DDM analysis can be
0 for a subject, the features would contain the change in combined with brain measures (here EEG, but other
regression coefficients (theta_diff_LC for low conflict and measures, such as fMRI, are just as viable) to predict very
theta_diff_HC for high conflict) and threshold (a_dbs) specific changes in brain state. Critically, the influence of
when going from deep-brain stimulation on to off. EEG on RT alone, although significant in Cavanagh et al.
Conversely, if the label were 1, the features would con- (2011), did not allow for the same accuracy as the DDM
tain the change in regression coefficients and threshold analysis. Moreover, this example shows the value of
when going from deep-brain stimulation off to on. The being hypothesis driven, given that this link between

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Computational Psychiatry: Clustering and Classification 395

decision threshold and theta in high-conflict trials (which the placebo effect. More objective and quantitative mea-
was recovered as the most discriminative feature) was sures of neurocognitive function are likely to improve
suggested by earlier, biologically plausible modeling on these current issues. Moreover, many psychiatric
efforts (Wiecki & Frank, 2013). drugs fail in Phase 3 clinical trials even though they
Although aggregate performance scores (i.e., MPs, show promising results for a small subset of enrolled
such as mean accuracy or mean RT) could, in principle, patients. If that subset could be identified by cognitive
be used for classification and clustering, there are some testing, the output of the drug-discovery pipeline could
unique advantages of using CMPs: be enhanced.
Although the potential fruits of this research program
•• Computational models distill domain knowledge are thus promising, the expected challenges to be over-
of the cognitive processes underlying task perfor- come are nevertheless substantial. We cannot rely on DSM
mance. For this reason, they can be seen as feature categories or a foundational understanding of the brain to
extraction methods that reduce nuisance variables bootstrap a new system in which to redefine mental ill-
and find a process-based representation of cogni- ness. Among the main challenges is finding a good descrip-
tive ability and, thus, make it easier for the classi- tion of normal and abnormal cognitive function. Are there
fier to separate different groups. distinct clusters of cognitive dysfunction (and if so, how
•• Computational modeling can help with the task- many), or is there a continuum with an arbitrary threshold
impurity problem. Aggregate performance scores on where mental illness begins? This article provides an
summarize the contribution of a mixture of cognitive example for how regressing out IQ can allow for better
processes involved in a task. Computational models classification of age. In more complex psychiatric condi-
try to deconstruct behavior into its individual com- tions, we clearly may not always have access to variables
ponents and identify separable cognitive processes. that affect clustering of behavioral phenotypes in ways
•• Neurocognitive models often assume cognitive over which we would like to abstract.
processes to be implemented by certain networks Although the new transdimensional approach of RDoC
of the brain. For this reason, a computational by the National Institute of Mental Health is very promis-
parameter identified to have predictive power can ing, it must be open to additional levels of descriptions,
be linked much easier to neural processes than such as the neurocognitive computations of the brain.
aggregate performance scores. Computational psychiatry could then be embedded in
this framework and translate neurocognitive research
findings to other domains, including genetics, neurosci-
Applications and Challenges ence, and clinical psychology.
How could this research program improve mental-health
diagnosis, treatment, and research? The ultimate hope is that
Conclusions
psychiatric diagnosis could move away from a symptom-
based classification of mental illness and instead use quan- In the light of the crisis in mental-health research and
tifiable biomarkers. CMPs could contribute to this by practice and the widely recognized problems with con-
quantifying subjects’ cognitive abilities in terms of psycho- ventional psychiatric classification based on the DSM,
logical-process variables that describe the efficacy of their computational psychiatry is an emerging field that shows
neural circuitry. great promise for pursuing research aimed at understand-
Psychiatric drugs, as well as other forms of treatment, ing mental illness. Computational psychiatry provides
including deep-brain stimulation, have a high degree of powerful conceptual and methodological resources that
variability in their efficacy across individuals. By identify- enable management of the various features of mental ill-
ing pathological cascades and how they interact with ness and the various challenges with which researchers
treatment, we might be able to predict which form of must cope. More specific, by fitting computational mod-
treatment would be effective for an individual and opti- els to behavioral data, we can estimate computational
mize treatment variables. parameters and construct CMPs that provide measures of
With regard to clinical research, computational psy- functioning in one or another cognitive domain. Such
chiatry can provide tools to link clinical symptoms to measures are potentially of value in research contexts
neurocognitive dysfunction that can open the door to a previously organized around symptom-based classifica-
deeper level of understanding as well as provide novel tion as implemented by the DSM. CMPs may function as
targets for future studies into the causes of mental ill- both more precise targets of research and more powerful
ness. For pharmacological research, assessment of a explanatory resources for understanding individual dif-
drug mechanism and its efficacy by clinical ratings alone ferences, significant groupings, dynamic interactivity, and
is often noisy, hard to interpret, and biased as a result of hierarchical organization of the brain.

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396 Wiecki et al.

Decision making appears to provide a good frame- Funding


work for studying mental illness, given that many disor- This research was supported by National Institute of Mental
ders show abnormalities in core decision-making Health Grant R01 MH080066-01.
processes. Strategically designed task batteries can pro-
vide the behavioral basis for studying such abnormalities. Supplemental Material
SSMs have a good track record in describing individual Additional supporting information may be found at
differences in decision making and can be linked to neu- http://cpx.sagepub.com/content/by/supplemental-data
ronal processes. Hierarchical Bayesian estimation pro-
vides a compelling toolbox to fit these models directly to References
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