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Somma A, Gialdi G, Krueger RF, Markon KE, Fossati A. Predicting nonsuicidal self-injury and suicidal risk: A comparison between the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Section II personality disorder and alternative model of personality disorders dimensions. Personal Disord 2024; 15:282-292. [PMID: 38602835 DOI: 10.1037/per0000658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The clinical relevance of nonsuicidal self-injury (NSSI) has received growing recognition, and NSSI represents a relevant risk factor for suicide. The present study aimed at running a head-to-head comparison between interview scores of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Section II personality disorders (PDs) criteria, and DSM-5 Alternative Model of Personality Disorder (AMPD) Criterion A and Criterion B measures in providing significant and relevant information for understanding NSSI and suicidal ideation and behavior among psychotherapy participants. To this aim, a clinical sample of 103 adult participants was administered the Clinician-Administered Nonsuicidal Self-Injury Disorder Index (CANDI), the Columbia Suicide Severity Rating Scale (C-SSRS), as well as the Structured Clinical Interview for DSM-5 Personality Disorders, the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I, and a self-report measure of dysfunctional personality traits (i.e., the Personality Inventory for DSM-5 [PID-5]). Logistic ordinal regression dominance analysis results showed that, when compared to the 10 DSM-5 Section II PD symptom counts, the DSM-5 Section III PD measure scores provided the same amount of information in the CANDI Global Severity Index scores (Nagelkerke pseudo-R² value = .41), and a markedly larger information quantity in the case of the C-SSRS Suicidal Ideation (+35.1%), and Suicidal Behavior Index (+35.9%) levels. As a whole, our data suggested the clinical usefulness of the DSM-5 AMPD in understanding NSSI and suicidal ideation and behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Miller ML, Hsu T, Markon KE, Grekin R, Thomas EBK. A panel network analysis of posttraumatic stress disorder and obsessive-compulsive disorder symptoms across the perinatal period. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2024; 133:445-455. [PMID: 38815083 DOI: 10.1037/abn0000916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
The perinatal period is marked by a higher risk of experiencing depressive, anxiety, and/or trauma-related symptoms, a phenomenon that affects millions of individuals each year. Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) symptoms commonly co-occur but have rarely been examined together beyond prevalence estimates in the perinatal period. Our study aimed to explore patterns of associations among OCD and PTSD symptoms to elucidate within- and between-person effects and how these effects may change over time. Participants (N = 270) were recruited during pregnancy from an academic medical center affiliated with a midwestern university. PTSD, OCD, and depressive symptoms were assessed at pregnancy, 4, 8, and 12 weeks postpartum. A panel graphical vector autoregression model was used to estimate networks. The temporal network provided information regarding directed predictive effects between symptoms, and hyperarousal, neutralizing, and ordering were the most stable and predictive symptoms across time. The contemporaneous network, which yields undirected partial correlations between symptoms at a given moment, indicated that there were positive associations between intrusions and avoidance, hyperarousal and negative alterations in cognitions and mood, as well as between hyperarousal and dysphoria. This study identified hyperarousal and neutralizing as the PTSD and OCD symptoms with the strongest stability, predictive power, and association with other symptoms. Clinically, this indicates that screening for hyperarousal and neutralizing symptoms may identify individuals who could maximally benefit from treatment in the perinatal period. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Markon KE, Mann F, Freilich C, Cole S, Krueger RF. Associations between epigenetic age acceleration and longitudinal measures of psychosocioeconomic stress and status. Soc Sci Med 2024; 352:116990. [PMID: 38824837 PMCID: PMC11239272 DOI: 10.1016/j.socscimed.2024.116990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/10/2024] [Accepted: 05/15/2024] [Indexed: 06/04/2024]
Abstract
Relationships between epigenetic aging markers and psychosocial variables such as socioeconomic status and stress have been well-documented, but are often examined cross-sectionally or retrospectively, and have tended to focus on objective markers of SES or major life events. Here, we examined associations between psychosocial variables, including measures of socioeconomic status and social stress, and epigenetic aging markers in adulthood, using longitudinal data spanning three decades from the Midlife in the United States (MIDUS) study. The largest effects were observed for epigenetic markers of change in health, such as DunedinPACE and GrimAge, and for associations involving education, income, net assets, general social stress, inequality-related stress, and financial stress. Analyses of polygenic indices suggests that at least in the case of education, the link to epigenetic aging cannot be accounted for by common genetic variants.
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Freilich CD, Markon KE, Cole SW, Krueger RF. Loneliness, epigenetic age acceleration, and chronic health conditions. Psychol Aging 2024; 39:337-349. [PMID: 38635160 PMCID: PMC11283257 DOI: 10.1037/pag0000822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Having associations with a range of adverse physical health outcomes including mortality, loneliness is increasingly recognized as a pressing public health concern, but the mechanisms studied to date do not yet explain all loneliness-related health risk. We sought to evaluate whether epigenetic influences on DNA methylation could help explain the relationship between loneliness and health. To do so, we first estimated associations between loneliness and epigenetic age acceleration (EAA) in a subsample of participants in the study of midlife in the United States (n = 1,310), before testing whether EAA mediated and/or moderated the association between loneliness and the onset of chronic health conditions in older adulthood (n = 445 completing longitudinal follow-ups). Greater loneliness was weakly associated with greater EAA in the Horvath, DunedinPACE, and GrimAge measures after accounting for demographic (0.08 ≤ β ≤ 0.11) and behavioral (0.06 ≤ β ≤ 0.08) covariates. Loneliness also predicted increases in chronic condition counts and these effects were more pronounced for individuals with higher DunedinPACE EAA values (interaction term β = 0.09, p = .009), suggesting possible synergistic impacts. EAA measures appear to be promising in helping to understand individual variations in the health impacts of loneliness, but the specific mechanisms involved require further research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Hopwood CJ, Morey LC, Markon KE. What is a psychopathology dimension? Clin Psychol Rev 2023; 106:102356. [PMID: 37926058 DOI: 10.1016/j.cpr.2023.102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/06/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
Coherence in the science and practice of mental health assessment depends upon a tight connection between psychopathology concepts that are used and the way those concepts are operationalized and defined. In contrast, the use of the same word to mean more than one thing contributes to incoherence, inefficiency, and confusion. In this paper, we review three possible meanings of the word "dimension" as it relates to the assessment of psychopathology and describe how the indiscriminate use of this word has caused confusion in the general context of the transition to a more evidence-based approach to mental health diagnosis. We attempt to disambiguate the term "dimension" by demarcating three concepts that can be distinguished based on different empirical standards: continuous variables, unidimensional dimensions, and distinct dimensions.
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Markon KE. Meeting counterfactual causality criteria is not the problem. Behav Brain Sci 2023; 46:e195. [PMID: 37694921 DOI: 10.1017/s0140525x22002138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Counterfactual causal interpretations of family genetic effects are appropriate, but neglect an important feature: Provision of unique information about expected outcomes following an independent decision, such as a decision to intervene. Counterfactual causality criteria are unlikely to resolve controversies about behavioral genetic findings; such controversies are likely to continue until counterfactual inferences are translated into interventional hypotheses and designs.
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Somma A, Krueger RF, Markon KE, Gialdi G, Di Leva N, Falcone E, Villa M, Frau C, Fossati A. Are problem buying and problem gambling addictive, impulsive, or compulsive in nature? A network analysis and latent dimension analysis study in Italian community-dwelling adults. Psychiatry Res 2023; 321:115100. [PMID: 36774751 DOI: 10.1016/j.psychres.2023.115100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/28/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
Prominent scholars suggested that the impulsive-obsessive compulsive continuum may represent a framework to understand both substance and behavioral addictions. However, the characterization of pathological buying (PB) and problem gambling (PG) within the compulsive-impulsive spectrum has not been extensively investigated. To explore the relationships among PB, PG, alcohol and substance abuse, DSM-5 obsessive-compulsive and related disorders, and impulsive dimensions, a sample of 1,005 Italian community-dwelling adult participants (55.5% female), was administered self-reported measures of PB, PG, and other theoretically-relevant constructs. We expected to observe a multidimensional structure in our data; moreover, DSM-5 obsessive compulsive and related disorders were hypothesized to be accounted for by a common dimension. Three dimensions were identified and replicated across two different, non-redundant methods (i.e., exploratory graph analysis and exploratory factor analysis), namely, substance use and gambling, obsessive and compulsive phenomena, and impulsivity dimensions. Specifically, PG seemed to represent a behavioral variant of addiction vulnerability, PB seemed more akin to obsessive-compulsive spectrum disorders, and disinhibition dimension represented the common core of negative urgency, lack of premeditation, lack of perseverance, sensation seeking (SS), and positive urgency. Our findings may be helpful in improving our knowledge on the similarities and differences between PB and PG.
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Somma A, Krueger RF, Markon KE, Gialdi G, Frau C, Fossati A. The joint hierarchical structure of psychopathology and dysfunctional personality domain indicators among community-dwelling adults. Personal Ment Health 2023; 17:3-19. [PMID: 35770737 DOI: 10.1002/pmh.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022]
Abstract
To examine the hierarchical structure of psychopathology and dysfunctional personality domains, 2416 Italian community-dwelling adult volunteers were administered a set of psychometrically sound psychopathology measures and the Personality Inventory for DSM-5 Brief Form+ (PID-5-BF+). Parallel analysis, minimum average partial, and very simple structure results suggested that 1-6 principal components (PCs) should be retained. Goldberg's bass-ackwards model of the joint psychopathology measure and PID-5-BF+ ipsatized domain scale correlation matrix evidenced a hierarchical structure that was consistent with the working model proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium. Hierarchical agglomerative cluster analysis around latent variables of the psychopathology indicators and PID-5-BF+ domain scales recovered four latent dimensions, which were akin to the corresponding bass-ackwards components and nicely reproduced the HiTOP Internalizing, Externalizing, Thought Disorder, and Eating Pathology dimensions.
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Momany AM, Jasper E, Markon KE, Nikolas MA, Ryckman KK. Latent class analysis to characterize neonatal risk for neurodevelopmental differences. J Child Psychol Psychiatry 2023; 64:100-109. [PMID: 35837724 PMCID: PMC9771897 DOI: 10.1111/jcpp.13671] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Neonatal risk factors, such as preterm birth and low birth weight, have been robustly linked to neurodevelopmental deficits, yet it is still unclear why some infants born preterm and/or low birth weight experience neurodevelopmental difficulties while others do not. The current study investigated this heterogeneity in neurodevelopmental abilities by examining additional neonatal morbidities as risk factors, utilizing latent class analysis to classify neonates into groups based on similar neonatal risk factors, and including neonates from the full spectrum of gestational age. METHODS Neonates who received neonatal care at an academic public hospital during an almost 10-year period (n = 19,951) were included in the latent class analysis, and 21 neonatal indicators of health were used. Neonatal class, sex, and the interaction between neonatal class and sex were used to examine differences in neurodevelopment at 18 months of age in a typically developing population. RESULTS The best fitting model included five infant classes: healthy, hypoxic, critically ill, minorly ill, and complicated delivery. Scores on the parent-rated neurodevelopmental measure differed by class such that infants in the critically ill, minorly ill, and complicated delivery classes had lower scores. There was no main effect of sex on the neurodevelopmental measure scores, but the interaction between sex and neonatal class was significant for three out of five neurodevelopmental domains. CONCLUSIONS The current study extends the understanding of risk factors in neurodevelopment by including several neonatal medical conditions that are often overlooked and by using a person-centered, as opposed to variable-centered, approach. Future work should continue to examine risk factors, such as maternal health during pregnancy and medical interventions for newborns, in relation to neonatal risks and neurodevelopment by using a person-centered approach.
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Markon KE. Reliability as Lindley Information. MULTIVARIATE BEHAVIORAL RESEARCH 2022:1-28. [PMID: 36539390 DOI: 10.1080/00273171.2022.2136613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This paper introduces a definition of reliability based on Lindley information, which is the mutual information between an observed measure and latent attribute. This definition reduces to the traditional definition of reliability in the case of normal variables, but can be applied to any joint distribution of observed and latent variables. Importantly, unlike traditional definitions of reliability, this formulation of reliability applies to vector- or matrix-valued estimates and summaries of responses, and therefore generalizes reliability to sets of scores and estimates in addition to individual scores and estimates. This formulation also leads to new bounds for reliability, as well as newly reported relationships between reliability and the traditional Fisher information function familiar in item response theory literature. This form of reliability can be estimated using formulae, or methods used in Bayesian inference such as Markov Chain Monte Carlo (MCMC) depending on the case. Examples based on well-studied datasets are provided, as well as applications to drift-diffusion modeling and randomly-varying intraindividual covariance structures.
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Somma A, Krueger RF, Markon KE, Gialdi G, Boscaro L, Fossati A. Post-traumatic disorder symptom severity in the perspective of hierarchical taxonomy of psychopathology spectra and dysfunctional personality domains among trauma-exposed community-dwelling women. Personal Ment Health 2022; 16:47-58. [PMID: 34240811 DOI: 10.1002/pmh.1525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 11/08/2022]
Abstract
To assess the relationships between post-traumatic stress disorder (PTSD) components, Hierarchical Taxonomy of Psychopathology (HiTOP) spectra, and dysfunctional personality domains, the Post-Traumatic Checklist for DSM-5 (PCL-5); the Personality Inventory for DSM-5-Brief Form+ (PID-5BF+); and self-report measures of HiTOP Internalizing, Thought Disorders, and Externalizing spectra were administered to 387 trauma-exposed Italian community-dwelling women. Before structural equation modeling (SEM), measurement components of models were assessed using confirmatory factor analyses. Both taxometric and Gaussian mixture analysis results were consistent with a dimensional representation of the PCL-5 scores. SEM results showed that PTSD components, at least as they were operationalized by the PCL-5 scores, were positively, significantly, and substantially associated with HiTOP Internalizing and Thought Disorder Spectra latent dimensions, as well as with Negative Affectivity, Detachment, and Psychoticism personality domains.
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Somma A, Krueger RF, Markon KE, Gialdi G, Colanino M, Ferlito D, Liotta C, Fossati A. A nine-month study on the course of COVID-19 related perceived post-traumatic stress disorder among Italian community-dwelling adults. J Psychiatr Res 2021; 141:146-151. [PMID: 34214742 PMCID: PMC8579247 DOI: 10.1016/j.jpsychires.2021.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/09/2021] [Accepted: 06/13/2021] [Indexed: 11/30/2022]
Abstract
The present study aimed to evaluate base rate estimates, course of, and psychopathology and personality risk factors for COVID-19-related post-traumatic stress disorder (PTSD) in community-dwelling adults during the pandemic. 203 participants from a sample of 811 Italian community-dwelling adults agreed to participate in a nine-month, three-wave (Wave 1: March 2020; Wave 2: June 2020; Wave 3: December 2020) longitudinal study. Participants in the longitudinal study did not differ from the cross-sectional original sample on age, gender, civil status, educational level, occupation, and Italian area of residence. At each wave, participants were administered the PTSD scale of the International Trauma Questionnaire (ITQ), DSM-5 measures of acute stress, dissociation, depression and anxiety, as well as a maladaptive personality domain measure at Wave 1. Participants were instructed to answer to the ITQ items based only on COVID-19 pandemic and related containment measures. The point prevalence estimates of COVID-19 related PTSD at each wave ranged from 11% to 13%; however, up to roughly 23% of our participants experienced clinically relevant PTSD features during nine months of the COVID-19 pandemic in Italy. Multiple logistic regression results showed that experiencing internalizing symptoms (i.e., mostly acute stress) and selected personality features (i.e., Negative Affectivity and Psychoticism) at Wave 1 represent risk factors for PTSD symptoms at later waves. These findings extend previous knowledge on COVID-19 related PTSD and support the need for preventive and treatment interventions for PTSD during the COVID-19 pandemic.
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Sellbom M, Forbush KT, Gould SR, Markon KE, Watson D, Witthöft M. HiTOP Assessment of the Somatoform Spectrum and Eating Disorders. Assessment 2021; 29:62-74. [PMID: 34105380 DOI: 10.1177/10731911211020825] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report on Phase 1 efforts of the Hierarchical Taxonomy of Psychopathology (HiTOP) measurement subgroup tasked with developing provisional scales for the somatoform spectrum and eating disorders. In Study 1, items were written to assess five somatoform spectrum constructs (bodily distress symptoms, conversion symptoms, health anxiety, disease conviction, and somatic preoccupation). Scale development analyses were conducted on 550 university students. The conversion symptom items were too infrequently endorsed and were set aside for Phase 2. Analyses of the other items yielded four scales corresponding closely to their hypothesized structure. In Study 2, we delineated 15 specific feeding and eating disorder constructs. A sample of 400 university students were administered candidate items and several eating disorder questionnaires for criterion validity. Analyses yielded six scales capturing previously described constructs, tapping content related to body image and weight concerns, restricting and purging, cognitive restraint, binging, excessive exercise, and muscle building. Two scales representing additional constructs deemed to be of high clinical import-negative attitude towards obesity and avoidant/restrictive food intake disorder-were retained for Phase 2, for a total of eight scales. Overall, we concluded that Phase 1 had been successful at generating a comprehensive set of provisional scales for inclusion in Phase 2.
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Somma A, LeBeau RT, Krueger RF, Markon KE, Gialdi G, Frau C, Boscaro L, Liberatore G, Fossati A. The relationship between obsessive-compulsive spectrum disorders and DSM-5 dysfunctional personality domains in a nonclinical sample of Italian women. Personal Ment Health 2021; 15:147-156. [PMID: 33393216 DOI: 10.1002/pmh.1502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/28/2020] [Accepted: 12/07/2020] [Indexed: 11/09/2022]
Abstract
To evaluate the usefulness of the DSM-5 maladaptive personality domains in explaining the similarities and differences among four disorders included in the obsessive-compulsive spectrum, 428 Italian community-dwelling women (mean age = 31.96 years, SD = 12.30 years) were administered the Obsessive-Compulsive Spectrum Disorder Scales and the Personality Inventory for DSM-5-Short Form as part of an ongoing online survey on women's health. Multiple Indicators Multiple Causes (MIMIC) confirmatory bifactor analysis results showed that the OCSD general factor (i.e., obsessive-compulsive spectrum factor) was positively associated with Negative Affectivity, whereas Body Dysmorphic Disorder (BDD), Hoarding Disorder (HD), and Skin-Picking Disorder (SPD) specific factors showed significant and substantial differential relationships with dysfunctional personality domains. Specifically, BDD was positively associated with Negative Affectivity, Detachment and Psychoticism domains; HD was associated with high Negative Affectivity and Psychoticism; and SPD was associated with Detachment. © 2020 John Wiley & Sons, Ltd.
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Forbes MK, Greene AL, Levin-Aspenson HF, Watts AL, Hallquist M, Lahey BB, Markon KE, Patrick CJ, Tackett JL, Waldman ID, Wright AGC, Caspi A, Ivanova M, Kotov R, Samuel DB, Eaton NR, Krueger RF. Three recommendations based on a comparison of the reliability and validity of the predominant models used in research on the empirical structure of psychopathology. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:297-317. [PMID: 33539117 DOI: 10.1037/abn0000533] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
The present study compared the primary models used in research on the structure of psychopathology (i.e., correlated factor, higher-order, and bifactor models) in terms of structural validity (model fit and factor reliability), longitudinal measurement invariance, concurrent and prospective predictive validity in relation to important outcomes, and longitudinal consistency in individuals' factor score profiles. Two simpler operationalizations of a general factor of psychopathology were also examined-a single-factor model and a count of diagnoses. Models were estimated based on structured clinical interview diagnoses in two longitudinal waves of nationally representative data from the United States (n = 43,093 and n = 34,653). Models that included narrower factors (fear, distress, and externalizing) were needed to capture the observed multidimensionality of the data. In the correlated factor and higher-order models these narrower factors were reliable, largely invariant over time, had consistent associations with indicators of adaptive functioning, and had moderate stability within individuals over time. By contrast, the fear- and distress-specific factors in the bifactor model did not show good reliability or validity throughout the analyses. Notably, the general factor of psychopathology (p factor) performed similarly well across tests of reliability and validity regardless of whether the higher-order or bifactor model was used; the simplest (single factor) model was also comparable across most tests, with the exception of model fit. Given the limitations of categorical diagnoses, it will be important to repeat these analyses using dimensional measures. We conclude that when aiming to understand the structure and correlates of psychopathology it is important to (a) look beyond model fit indices to choose between different models, (b) examine the reliability of latent variables directly, and (c) be cautious when isolating and interpreting the unique effects of specific psychopathology factors, regardless of which model is used. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Forbes MK, Wright AGC, Markon KE, Krueger RF. Quantifying the Reliability and Replicability of Psychopathology Network Characteristics. MULTIVARIATE BEHAVIORAL RESEARCH 2021; 56:224-242. [PMID: 31140875 PMCID: PMC6883148 DOI: 10.1080/00273171.2019.1616526] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Pairwise Markov random field networks-including Gaussian graphical models (GGMs) and Ising models-have become the "state-of-the-art" method for psychopathology network analyses. Recent research has focused on the reliability and replicability of these networks. In the present study, we compared the existing suite of methods for maximizing and quantifying the stability and consistency of PMRF networks (i.e., lasso regularization, plus the bootnet and NetworkComparisonTest packages in R) with a set of metrics for directly comparing the detailed network characteristics interpreted in the literature (e.g., the presence, absence, sign, and strength of each individual edge). We compared GGMs of depression and anxiety symptoms in two waves of data from an observational study (n = 403) and reanalyzed four posttraumatic stress disorder GGMs from a recent study of network replicability. Taken on face value, the existing suite of methods indicated that overall the network edges were stable, interpretable, and consistent between networks, but the direct metrics of replication indicated that this was not the case (e.g., 39-49% of the edges in each network were unreplicated across the pairwise comparisons). We discuss reasons for these apparently contradictory results (e.g., relying on global summary statistics versus examining the detailed characteristics interpreted in the literature) and conclude that the limited reliability of the detailed characteristics of networks observed here is likely to be common in practice, but overlooked by current methods. Poor replicability underpins our concern surrounding the use of these methods, given that generalizable conclusions are fundamental to the utility of their results.
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Forbes MK, Wright AGC, Markon KE, Krueger RF. On Unreplicable Inferences in Psychopathology Symptom Networks and the Importance of Unreliable Parameter Estimates. MULTIVARIATE BEHAVIORAL RESEARCH 2021; 56:368-376. [PMID: 33599559 PMCID: PMC8654099 DOI: 10.1080/00273171.2021.1886897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We recently wrote an article comparing the conclusions that followed from two different approaches to quantifying the reliability and replicability of psychopathology symptom networks. Two commentaries on the article have raised five core criticisms, which are addressed in this response with supporting evidence. 1) We did not over-generalize about the replicability of symptom networks, but rather focused on interpreting the contradictory conclusions of the two sets of methods we examined. 2) We closely followed established recommendations when estimating and interpreting the networks. 3) We also closely followed the relevant tutorials, and used examples interpreted by experts in the field, to interpret the bootnet and NetworkComparisonTest results. 4) It is possible for statistical control to increase reliability, but that does not appear to be the case here. 5) Distinguishing between statistically significant versus substantive differences makes it clear that the differences between the networks affect the inferences we would make about symptom-level relationships (i.e., the basis of the purported utility of symptom networks). Ultimately, there is an important point of agreement between our article and the commentaries: All of these applied examples of cross-sectional symptom networks are demonstrating unreliable parameter estimates. While the commentaries propose that the resulting differences between networks are not genuine or meaningful because they are not statistically significant, we propose that the unreplicable inferences about the symptom-level relationships of interest fundamentally undermine the utility of the symptom networks.
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Zhang KA, Markon KE. Age and Gender Measurement Noninvariance of the Adult ADHD Self-Report Scale Screener. J Atten Disord 2021; 25:403-413. [PMID: 30449230 DOI: 10.1177/1087054718808059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The nature and form of demographics-related differences in ADHD self-reported symptoms across adulthood is currently poorly understood. This study explored the psychometrics of the Adult ADHD Self-Report Scale Screener (ASRS-6), including its age- and gender-related measurement invariance. Method: Structural equation models were used to analyze adult data-aged 16 to 95 years-from the 2007 British Adult Psychiatric Morbidity Survey. Results: The three-factor model (disorganization, inattention, hyperactivity) outperformed one- and two-factor models. Self-reported attentional deficits may be more pathognomonic of overall self-reported ADHD in adults than other symptoms. All items exhibited age measurement noninvariance while only a subset exhibited gender measurement noninvariance. Individuals who are male and younger tend to have lower thresholds for endorsement for ASRS-6 items than individuals who are female and older. Conclusion: The ASRS-6 does not appear to be unidimensional, and self-reported ASRS-6 symptomatology changes in meaning with age.
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Krueger RF, Kotov R, Watson D, Forbes MK, Eaton NR, Ruggero CJ, Simms LJ, Widiger TA, Achenbach TM, Bach B, Bagby RM, Bornovalova MA, Carpenter WT, Chmielewski M, Cicero DC, Clark LA, Conway C, DeClercq B, DeYoung CG, Docherty AR, Drislane LE, First MB, Forbush KT, Hallquist M, Haltigan JD, Hopwood CJ, Ivanova MY, Jonas KG, Latzman RD, Markon KE, Miller JD, Morey LC, Mullins-Sweatt SN, Ormel J, Patalay P, Patrick CJ, Pincus AL, Regier DA, Reininghaus U, Rescorla LA, Samuel DB, Sellbom M, Shackman AJ, Skodol A, Slade T, South SC, Sunderland M, Tackett JL, Venables NC, Waldman ID, Waszczuk MA, Waugh MH, Wright AG, Zald DH, Zimmermann J. Les progrès dans la réalisation de la classification quantitative de la psychopathologie ☆. ANNALES MEDICO-PSYCHOLOGIQUES 2021; 179:95-106. [PMID: 34305151 PMCID: PMC8309948 DOI: 10.1016/j.amp.2020.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.
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Somma A, Borroni S, Gialdi G, Carlotta D, Emanuela Giarolli L, Barranca M, Cerioli C, Franzoni C, Masci E, Manini R, Luca Busso S, Ruotolo G, Krueger RF, Markon KE, Fossati A. The Inter-Rater Reliability and Validity of the Italian Translation of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders Module I and Module II: A Preliminary Report on Consecutively Admitted Psychotherapy Outpatients. J Pers Disord 2020; 34:95-123. [PMID: 33834856 DOI: 10.1521/pedi_2020_34_511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To evaluate the reliability and convergent validity of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders (SCID-5-AMPD) Module I and Module II, 88 adult psychotherapy participants were administered the Italian translations of the SCID-5-AMPD Module I and Module II, Level of Personality Functioning Scale-Brief Form (LPFS-BF), Level of Personality Functioning Scale-Self Report (LPFS-SF), Personality Inventory for DSM-5 (PID-5), Personality Diagnostic Questionnaire-4+ (PDQ-4+), and Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) relying on a Williams crossover design. SCID-5-AMPD Module I and Module II showed excellent inter-rater reliability. In terms of convergent validity, meaningful associations were observed between SCID-5-AMPD Module I scores and self-report measures of Criterion A; similarly, SCID-5-AMPD Module II trait scores were meaningfully related to PID-5 trait scores. As a whole, our preliminary findings supported the clinical utility of DSM-5 AMPD.
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Hopwood CJ, Krueger RF, Watson D, Widiger TA, Althoff RR, Ansell EB, Bach B, Bagby RM, Blais MA, Bornovalova MA, Chmielewski M, Cicero DC, Conway C, De Clerq B, De Fruyt F, Docherty AR, Eaton NR, Edens JF, Forbes MK, Forbush KT, Hengartner MP, Ivanova MY, Leising D, Lukowitsky MR, Lynam DR, Markon KE, Miller JD, Morey LC, Mullins-Sweatt SN, Ormel J, Patrick CJ, Pincus AL, Ruggero C, Samuel DB, Sellbom M, Tackett JL, Thomas KM, Trull TJ, Vachon DD, Waldman ID, Waszczuk MA, Waugh MH, Wright AGC, Yalch MM, Zald DH, Zimmermann J. Commentary on "The Challenge of Transforming the Diagnostic System of Personality Disorders". J Pers Disord 2020; 34:1-4. [PMID: 30802176 DOI: 10.1521/pedi_2019_33_00] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Somma A, Krueger RF, Markon KE, Alajmo VBM, Arlotta E, Beretta S, Boni F, Busso SL, Manini R, Nazzaro G, Maffei C, Fossati A. DSM-5 Alternative Model of Personality Disorder Dysfunctional Personality Traits as Predictors of Self-Reported Aggression in an Italian Sample of Consecutively Admitted, Personality-Disordered Psychotherapy Patients. J Pers Disord 2020; 34:5-24. [PMID: 31206343 DOI: 10.1521/pedi_2019_33_430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In order to assess the relationships between DSM-5 Alternative Model of Personality Disorder (AMPD) maladaptive personality traits and self-reports of aggression, 508 Italian adult participants who met at least one DSM-IV Axis II/DSM-5 Section II personality disorder (PD) diagnosis were administered the Personality Inventory for DSM-5 (PID-5) and the Aggression Questionnaire (AQ). Analysis results showed that multiple regression results, PID-5 Hostility, Callousness, and Risk Taking trait scale scores explained a large amount of variance in AQ Physical Aggression (PA) scores. Moreover, PID-5 Hostility, Callousness, and Risk Taking explained more than 20% of the variance in the AQ Physical Aggression scale scores that was left unexplained by selected continuously scored DSM-IV Axis II/DSM-5 Section II PDs, whereas SCID-II Paranoid, Narcissistic, Borderline, and Antisocial PDs added only 4% of variance to the amount of variance in AQ Physical Aggression scores that was already explained by the PID-5 trait scale scores.
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Somma A, Gialdi G, Krueger RF, Markon KE, Frau C, Lovallo S, Fossati A. Dysfunctional personality features, non-scientifically supported causal beliefs, and emotional problems during the first month of the COVID-19 pandemic in Italy. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 165:110139. [PMID: 32501318 PMCID: PMC7247995 DOI: 10.1016/j.paid.2020.110139] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 12/15/2022]
Abstract
The present study aimed at assessing the impact of demographic characteristics, maladaptive personality traits and causal beliefs about COVID-19 on perceived emotional problems in a sample of Italian community-dwelling adults (N = 1043) in the first month of the social distancing period due to the COVID-19 pandemic in Italy. Hierarchical logistic regression analysis results showed that dysfunctional personality domains and non-scientifically supported causal beliefs explained all the variance that was originally explained by demographic variables (i.e., age and gender). In particular, negative affectivity and detachment represented relevant risk factors for reduced emotional well-being in our sample. A significant positive association was observed also between emotional problems and supernatural causal beliefs on the COVID-19 infection. Our data supported the importance of considering the impact of quarantine measures on psychological well-being, while suggesting possible risk factors related to individual differences in personality and causal beliefs.
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DeYoung CG, Chmielewski M, Clark LA, Condon DM, Kotov R, Krueger RF, Lynam DR, Markon KE, Miller JD, Mullins-Sweatt SN, Samuel DB, Sellbom M, South SC, Thomas KM, Watson D, Watts AL, Widiger TA, Wright AGC. The distinction between symptoms and traits in the Hierarchical Taxonomy of Psychopathology (HiTOP). J Pers 2020; 90:20-33. [PMID: 32978977 DOI: 10.1111/jopy.12593] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 12/11/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirically and quantitatively derived dimensional classification system designed to describe the features of psychopathology and, ultimately, to replace categorical nosologies. Among the constructs that HiTOP organizes are "symptom components" and "maladaptive traits," but past HiTOP publications have not fully explicated the distinction between symptoms and traits. We propose working definitions of symptoms and traits and explore challenges, exceptions, and remaining questions. Specifically, we propose that the only systematic difference between symptoms and traits in HiTOP is one of time frame. Maladaptive traits are dispositional constructs that describe persistent tendencies to manifest features of psychopathology, whereas symptoms are features of psychopathology as they are manifest during any specific time period (from moments to days to months). This has the consequence that almost every HiTOP dimension, at any level of the hierarchy, can be assessed as either a trait or a symptom dimension, by adjusting the framing of the assessment. We discuss the implications of these definitions for causal models of the relations between symptoms and traits and for distinctions between psychopathology, normal personality variation, and dysfunction.
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