1
|
Neufeld SAS, St Clair M, Brodbeck J, Wilkinson PO, Goodyer IM, Jones PB. Measurement Invariance in Longitudinal Bifactor Models: Review and Application Based on the p Factor. Assessment 2024; 31:774-793. [PMID: 37350099 PMCID: PMC11092300 DOI: 10.1177/10731911231182687] [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: 06/24/2023]
Abstract
Bifactor models are increasingly being utilized to study latent constructs such as psychopathology and cognition, which change over the lifespan. Although longitudinal measurement invariance (MI) testing helps ensure valid interpretation of change in a construct over time, this is rarely and inconsistently performed in bifactor models. Our review of MI simulation literature revealed that only one study assessed MI in bifactor models under limited conditions. Recommendations for how to assess MI in bifactor models are suggested based on existing simulation studies of related models. Estimator choice and influence of missing data on MI are also discussed. An empirical example based on a model of the general psychopathology factor (p) elucidates our recommendations, with the present model of p being the first to exhibit residual MI across gender and time. Thus, changes in the ordered-categorical indicators can be attributed to changes in the latent factors. However, further work is needed to clarify MI guidelines for bifactor models, including considering the impact of model complexity and number of indicators. Nonetheless, using the guidelines justified herein to establish MI allows findings from bifactor models to be more confidently interpreted, increasing their comparability and utility.
Collapse
|
2
|
Huang X, Gao L, Xiao J, Li L, Shan X, Chen H, Chai X, Duan X. Family Environment Modulates Linkage of Transdiagnostic Psychiatric Phenotypes and Dissociable Brain Features in the Developing Brain. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00081-8. [PMID: 38537777 DOI: 10.1016/j.bpsc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/26/2024] [Accepted: 03/16/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Family environment has long been known for shaping brain function and psychiatric phenotypes, especially during childhood and adolescence. Accumulating neuroimaging evidence suggests that across different psychiatric disorders, common phenotypes may share common neural bases, indicating latent brain-behavior relationships beyond diagnostic categories. However, the influence of family environment on the brain-behavior relationship from a transdiagnostic perspective remains unknown. METHODS We included a community-based sample of 699 participants (ages 5-22 years) and applied partial least squares regression analysis to determine latent brain-behavior relationships from whole-brain functional connectivity and comprehensive phenotypic measures. Comparisons were made between diagnostic and nondiagnostic groups to help interpret the latent brain-behavior relationships. A moderation model was introduced to examine the potential moderating role of family factors in the estimated brain-behavior associations. RESULTS Four significant latent brain-behavior pairs were identified that reflected the relationship of dissociable brain network and general behavioral problems, cognitive and language skills, externalizing problems, and social dysfunction, respectively. The group comparisons exhibited interpretable variations across different diagnostic groups. A warm family environment was found to moderate the brain-behavior relationship of core symptoms in internalizing disorders. However, in neurodevelopmental disorders, family factors were not found to moderate the brain-behavior relationship of core symptoms, but they were found to affect the brain-behavior relationship in other domains. CONCLUSIONS Our findings leveraged a transdiagnostic analysis to investigate the moderating effects of family factors on brain-behavior associations, emphasizing the different roles that family factors play during this developmental period across distinct diagnostic groups.
Collapse
Affiliation(s)
- Xinyue Huang
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Leying Gao
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Jinming Xiao
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Lei Li
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaolong Shan
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Huafu Chen
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaoqian Chai
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
| | - Xujun Duan
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
| |
Collapse
|
3
|
Ormel J, Vos M, Laceulle OM, Vrijen C, van der Laan CM, Nolte IM, Hartman CA. Distal-to-proximal etiologically relevant variables associated with the general (p) and specific factors of psychopathology. J Child Psychol Psychiatry 2024. [PMID: 38503697 DOI: 10.1111/jcpp.13979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The general factor of psychopathology, often denoted as p, captures the common variance among a broad range of psychiatric symptoms. Specific factors are co-modeled based on subsets of closely related symptoms. This paper investigated the extent to which wide-ranging genetic, personal, and environmental etiologically relevant variables are associated with p and specific psychopathology factors. METHODS Using data from four waves (ages 11-19) of TRAILS, we modeled a bifactor model of p and four specific factors [internalizing, externalizing, ADHD, Autism Spectrum Disorder (ASD)]. Next, we examined the associations of 19 etiologically relevant variables with these psychology factors using path models that organized the variables according to the distal-to-proximal risk principle. RESULTS Collectively, the etiologically relevant factors, including temperament traits, accounted for 55% of p's variance, 46% in ADHD, 35% in externalizing, 19% in internalizing, and 7% in ASD. The low 7% is due to insufficient unique variance in ASD indicators that load more strongly on p. Excluding temperament, variables accounted for 29% variance in p, 9% ADHD, 14% EXT, 7% INT, and 4% ASD. Most etiologically relevant factors were generic, predicting p. In addition, we identified effects on specific factors in addition to effects on p (e.g., parental SES, executive functioning); only effects on specific factors (e.g., parental rejection); opposite effects on different factors [e.g., diurnal cortisol (high INT but low EXT, p); developmental delay (high ASD and p but low EXT)]. Frustration, family functioning, parental psychopathology, executive functioning, and fearfulness had strong effects on p. CONCLUSIONS (1) Strong generic effects on p suggest that etiologically relevant factors and psychopathology tend to cluster in persons. (2) While many factors predict p, additional as well as opposite effects on specific factors indicate the relevance of specific psychopathology factors in understanding mental disorder. (3) High frustration, neurodevelopmental problems, and a disadvantaged family environment primarily characterize p.
Collapse
Affiliation(s)
- Jonah Ormel
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Melissa Vos
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Odilia M Laceulle
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Charlotte Vrijen
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Camiel M van der Laan
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ilja M Nolte
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
4
|
Yang Y, Zhu X, Auyeung B, Obsuth I, Murray A. Associations Between Reward and Future-Related Orientations and General and Specific Mental Health Issues in Adolescence. Res Child Adolesc Psychopathol 2024; 52:385-397. [PMID: 37804397 PMCID: PMC10896876 DOI: 10.1007/s10802-023-01136-y] [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] [Accepted: 09/29/2023] [Indexed: 10/09/2023]
Abstract
Adolescence is characterised by a peak in sensation seeking accompanied by gradually developing self-control skills. Adolescents typically show steeper delay discounting performance than other age groups; a feature that is transdiagnostically related to a variety of mental health disorders. However, delay discounting performance is not a singular mental process but involves both risk/reward and future orientation elements, usually operationalised as probability/risk and time discounting tasks, respectively. To clarify the specific relations between the risk/reward and future orientation elements of delay discounting and different types of mental health problems, two bi-factor models and a series of structural equation models (SEMs) were fitted to multi-informant (parent and adolescent self-reported) mental health data from a large UK study. A transdiagnostic promotive role of future orientation was found using bi-factor modelling to separate general and dimension-specific mental health variation; however, this was limited to parent reports. In addition, future orientation was negatively associated with conduct problems and ADHD symptoms, but positively associated with emotional problems. Risk aversion was negatively associated with conduct problems, but positively associated with emotional and peer problems. The findings highlight that risk/reward and future orientation elements of delay discounting play partly distinct roles in different mental health problems and can serve both promotive and risk roles during adolescence. Findings also illuminate which elements of delay discounting should be intervention targets for different mental health concerns.
Collapse
Affiliation(s)
- Yi Yang
- Department of Psychology, University of Edinburgh, Edinburgh, UK.
| | - Xinxin Zhu
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Bonnie Auyeung
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ingrid Obsuth
- Clinical Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
5
|
Brinkman AH, Barry TD, Lindsey RA. The Relation of Parental Expressed Emotion, Parental Affiliate Stigma, and Typically-developing Sibling Internalizing Behavior in Families with a Child with ASD. J Autism Dev Disord 2023; 53:4591-4603. [PMID: 36180666 DOI: 10.1007/s10803-022-05760-3] [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] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
Caregivers of children with autism spectrum disorder (ASD) experience greater stress, expressed emotion (EE), and affiliate stigma than caregivers of children without ASD. Siblings of children with ASD often experience greater negative functioning than siblings of individuals without ASD. The current study found significant interrelations among symptom severity and externalizing behavior in children with ASD; parental stress, affiliate stigma, and EE; and TD sibling internalizing behavior. In addition, certain subcomponents of affiliate stigma predicted unique variance in EE and TD sibling internalizing behavior. Findings may increase understanding of psychosocial functioning in families with children with ASD and allow clinicians to improve outcomes for all family members. Limitations of the study included self-report data, limited sample diversity, and a cross-sectional design.
Collapse
Affiliation(s)
- Aurora H Brinkman
- Department of Psychology, Washington State University, Johnson Tower 233, PO Box 644820, 99164-4820, Pullman, WA, USA
| | - Tammy D Barry
- Department of Psychology, Washington State University, Johnson Tower 233, PO Box 644820, 99164-4820, Pullman, WA, USA.
| | | |
Collapse
|
6
|
Brislin SJ, Martz ME, Joshi S, Duval ER, Gard A, Clark DA, Hyde LW, Hicks BM, Taxali A, Angstadt M, Rutherford S, Heitzeg MM, Sripada C. Differentiated nomological networks of internalizing, externalizing, and the general factor of psychopathology (' p factor') in emerging adolescence in the ABCD study. Psychol Med 2022; 52:3051-3061. [PMID: 33441214 PMCID: PMC9693677 DOI: 10.1017/s0033291720005103] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/04/2020] [Accepted: 12/03/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Structural models of psychopathology consistently identify internalizing (INT) and externalizing (EXT) specific factors as well as a superordinate factor that captures their shared variance, the p factor. Questions remain, however, about the meaning of these data-driven dimensions and the interpretability and distinguishability of the larger nomological networks in which they are embedded. METHODS The sample consisted of 10 645 youth aged 9-10 years participating in the multisite Adolescent Brain and Cognitive Development (ABCD) Study. p, INT, and EXT were modeled using the parent-rated Child Behavior Checklist (CBCL). Patterns of associations were examined with variables drawn from diverse domains including demographics, psychopathology, temperament, family history of substance use and psychopathology, school and family environment, and cognitive ability, using instruments based on youth-, parent-, and teacher-report, and behavioral task performance. RESULTS p exhibited a broad pattern of statistically significant associations with risk variables across all domains assessed, including temperament, neurocognition, and social adversity. The specific factors exhibited more domain-specific patterns of associations, with INT exhibiting greater fear/distress and EXT exhibiting greater impulsivity. CONCLUSIONS In this largest study of hierarchical models of psychopathology to date, we found that p, INT, and EXT exhibit well-differentiated nomological networks that are interpretable in terms of neurocognition, impulsivity, fear/distress, and social adversity. These networks were, in contrast, obscured when relying on the a priori Internalizing and Externalizing dimensions of the CBCL scales. Our findings add to the evidence for the validity of p, INT, and EXT as theoretically and empirically meaningful broad psychopathology liabilities.
Collapse
Affiliation(s)
- Sarah J. Brislin
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Meghan E. Martz
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Sonalee Joshi
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Elizabeth R. Duval
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Arianna Gard
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - D. Angus Clark
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Luke W. Hyde
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Brian M. Hicks
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Aman Taxali
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Saige Rutherford
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Mary M. Heitzeg
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Chandra Sripada
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| |
Collapse
|
7
|
Watts AL, Makol BA, Palumbo IM, De Los Reyes A, Olino TM, Latzman RD, DeYoung CG, Wood PK, Sher KJ. How Robust Is the p Factor? Using Multitrait-Multimethod Modeling to Inform the Meaning of General Factors of Youth Psychopathology. Clin Psychol Sci 2022; 10:640-661. [PMID: 36090949 PMCID: PMC9454373 DOI: 10.1177/21677026211055170] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We used multitrait-multimethod (MTMM) modeling to examine general factors of psychopathology in three samples of youth (Ns = 2119, 303, 592) for whom three informants reported on the youth's psychopathology (e.g., child, parent, teacher). Empirical support for the p-factor diminished in multi-informant models compared with mono-informant models: the correlation between externalizing and internalizing factors decreased and the general factor in bifactor models essentially reflected externalizing. Widely used MTMM-informed approaches for modeling multi-informant data cannot distinguish between competing interpretations of the patterns of effects we observed, including that the p-factor reflects, in part, evaluative consistency bias or that psychopathology manifests differently across contexts (e.g., home vs. school). Ultimately, support for the p-factor may be stronger in mono-informant designs, although it is does not entirely vanish in multi-informant models. Instead, the general factor of psychopathology in any given mono-informant model likely reflects a complex mix of variances, some substantive and some methodological.
Collapse
Affiliation(s)
- Ashley L Watts
- Department of Psychological Sciences, University of Missouri, Columbia, MO, 65211
| | - Bridget A Makol
- Department of Psychology, University of Maryland, College Park, MD, 20742
| | | | | | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, 19122
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA, 30303
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - Phillip K Wood
- Department of Psychological Sciences, University of Missouri, Columbia, MO, 65211
| | - Kenneth J Sher
- Department of Psychological Sciences, University of Missouri, Columbia, MO, 65211
| |
Collapse
|
8
|
Conway CC, Forbes MK, South SC. A Hierarchical Taxonomy of Psychopathology (HiTOP) Primer for Mental Health Researchers. Clin Psychol Sci 2022; 10:236-258. [PMID: 35599839 PMCID: PMC9122089 DOI: 10.1177/21677026211017834] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Mental health research is at an important crossroads as the field seeks more reliable and valid phenotypes to study. Dimensional approaches to quantifying mental illness operate outside the confines of traditional categorical diagnoses, and they are gaining traction as a way to advance research on the causes and consequences of mental illness. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a leading dimensional research paradigm that synthesizes decades of data on the major dimensions of psychological disorders. In this article, we demonstrate how to use the HiTOP model to formulate and test research questions through a series of tutorials. To boost accessibility, data and annotated code for each tutorial are included at OSF (https://osf.io/8myzw). After presenting the tutorials, we outline how investigators can use these ideas and tools to generate new insights in their own substantive research programs.
Collapse
Affiliation(s)
| | - Miriam K. Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | | | | |
Collapse
|
9
|
The P-factor and its genomic and neural equivalents: an integrated perspective. Mol Psychiatry 2022; 27:38-48. [PMID: 33526822 PMCID: PMC8960404 DOI: 10.1038/s41380-021-01031-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/01/2020] [Accepted: 01/13/2021] [Indexed: 01/30/2023]
Abstract
Different psychiatric disorders and symptoms are highly correlated in the general population. A general psychopathology factor (or "P-factor") has been proposed to efficiently describe this covariance of psychopathology. Recently, genetic and neuroimaging studies also derived general dimensions that reflect densely correlated genomic and neural effects on behaviour and psychopathology. While these three types of general dimensions show striking parallels, it is unknown how they are conceptually related. Here, we provide an overview of these three general dimensions, and suggest a unified interpretation of their nature and underlying mechanisms. We propose that the general dimensions reflect, in part, a combination of heritable 'environmental' factors, driven by a dense web of gene-environment correlations. This perspective calls for an update of the traditional endophenotype framework, and encourages methodological innovations to improve models of gene-brain-environment relationships in all their complexity. We propose concrete approaches, which by taking advantage of the richness of current large databases will help to better disentangle the complex nature of causal factors underlying psychopathology.
Collapse
|
10
|
Álvarez-Couto M, García-Villamisar D, Sáez-Suanes GP, d'Orey Roquete M. Variables predicting the association between autistic traits and externalizing symptoms among young adults. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-06-2020-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Considering the high comorbidity of autism spectrum disorder (ASD) with externalizing disorders and that ASD is considered as a continuum, which implies the identification of it features in the whole population, the purpose of this paper is to know the characteristics of the association of externalizing symptoms in the population with ASD traits.
Design/methodology/approach
One hundred and seventeen postsecondary students participated in the study, providing responses to a battery of self-reported tests.
Findings
The existence of a significant association between ASD and attention deficit hyperactivity disorder (ADHD) (0.519; p < 0.01) was proved. Regression analyses showed that problems in executive functioning, working memory deficits and difficulties in the use of emotion regulation strategies predicted the presence of ADHD traits (F = 36.757, R2 = 62.3%, p < 0. 01) and impulsivity behavior (F = 18.249, R2 = 45.1%, p < 0.01).
Research limitations/implications
Externalizing symptomatology in people with higher ASD traits is extended to the general population. Future research should study other problematic behaviors, such as aggression or self-harm, to continue generating appropriate interventions.
Originality/value
The results reported reinforce the study of ASD as a dimensional disorder, in line with the latest advances in the classification of psychopathology. Considering which variables are behind the problematic behaviors allows interventions to be focused on these factors, contributing to their reduction and to the improvement of professional practices.
Collapse
|
11
|
Knott R, Johnson BP, Tiego J, Mellahn O, Finlay A, Kallady K, Kouspos M, Mohanakumar Sindhu VP, Hawi Z, Arnatkeviciute A, Chau T, Maron D, Mercieca EC, Furley K, Harris K, Williams K, Ure A, Fornito A, Gray K, Coghill D, Nicholson A, Phung D, Loth E, Mason L, Murphy D, Buitelaar J, Bellgrove MA. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project design and methodologies: a dimensional approach to understanding neurobiological and genetic aetiology. Mol Autism 2021; 12:55. [PMID: 34353377 PMCID: PMC8340366 DOI: 10.1186/s13229-021-00457-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/05/2021] [Indexed: 11/20/2022] Open
Abstract
Background ASD and ADHD are prevalent neurodevelopmental disorders that frequently co-occur and have strong evidence for a degree of shared genetic aetiology. Behavioural and neurocognitive heterogeneity in ASD and ADHD has hampered attempts to map the underlying genetics and neurobiology, predict intervention response, and improve diagnostic accuracy. Moving away from categorical conceptualisations of psychopathology to a dimensional approach is anticipated to facilitate discovery of data-driven clusters and enhance our understanding of the neurobiological and genetic aetiology of these conditions. The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project is one of the first large-scale, family-based studies to take a truly transdiagnostic approach to ASD and ADHD. Using a comprehensive phenotyping protocol capturing dimensional traits central to ASD and ADHD, the MAGNET project aims to identify data-driven clusters across ADHD-ASD spectra using deep phenotyping of symptoms and behaviours; investigate the degree of familiality for different dimensional ASD-ADHD phenotypes and clusters; and map the neurocognitive, brain imaging, and genetic correlates of these data-driven symptom-based clusters. Methods The MAGNET project will recruit 1,200 families with children who are either typically developing, or who display elevated ASD, ADHD, or ASD-ADHD traits, in addition to affected and unaffected biological siblings of probands, and parents. All children will be comprehensively phenotyped for behavioural symptoms, comorbidities, neurocognitive and neuroimaging traits and genetics. Conclusion The MAGNET project will be the first large-scale family study to take a transdiagnostic approach to ASD-ADHD, utilising deep phenotyping across behavioural, neurocognitive, brain imaging and genetic measures. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-021-00457-3.
Collapse
Affiliation(s)
- Rachael Knott
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia.
| | - Beth P Johnson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Olivia Mellahn
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Amy Finlay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kathryn Kallady
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Maria Kouspos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Vishnu Priya Mohanakumar Sindhu
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Ziarih Hawi
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Aurina Arnatkeviciute
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Tracey Chau
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Dalia Maron
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Emily-Clare Mercieca
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kirsten Furley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Katrina Harris
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Department of Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Department of Developmental Paediatrics, Monash Children's Hospital, 246 Clayton Rd, Clayton, VIC, 3168, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Alexandra Ure
- Department of Paediatrics, Monash University, Melbourne, VIC, 3800, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Department of Mental Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Neurodevelopment and Disability Research, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| | - Kylie Gray
- Centre for Educational Development, Appraisal, and Research, University of Warwick, Coventry, CV4 7AL, UK.,Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Melbourne, VIC, 3168, Australia
| | - David Coghill
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia.,Department of Mental Health, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Neurodevelopment and Disability Research, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Ann Nicholson
- Faculty of Information and Technology, Monash University, Melbourne, VIC, 3800, Australia
| | - Dinh Phung
- Faculty of Information and Technology, Monash University, Melbourne, VIC, 3800, Australia
| | - Eva Loth
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Luke Mason
- Centre for Brain and Cognitive Development, Birkbeck, University of London, Henry Welcome Building, Malet Street, London, WC1E 7HX, UK
| | - Declan Murphy
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Melbourne, VIC, 3800, Australia
| |
Collapse
|
12
|
Stanton K, DeLucia EA, Brown MFD, McDonnell CG. Advancing understanding of the classification of broad autism phenotype and attention-deficit/hyperactivity disorder symptom dimensions within the Hierarchical Taxonomy of Psychopathology. Personal Ment Health 2021; 15:113-123. [PMID: 33225627 DOI: 10.1002/pmh.1498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 12/20/2022]
Abstract
Research on personality and psychopathology associations has informed the classification of many symptom dimensions within the Hierarchical Taxonomy of Psychopathology (HiTOP). However, classification of symptom dimensions defining autism and attention-deficit/hyperactivity disorder (ADHD) within the HiTOP framework remains unclear in many ways. To address this issue, we examined the joint factor structure of (a) measures assessing characteristics relevant to ADHD and autism and (b) normal range personality traits in a sample of 547 adults recruited from Amazon Mechanical Turk, many of whom reported elevated autism-relevant and ADHD-relevant characteristics. We also examined how factors identified in these analyses correlated with measures of internalizing symptoms and select externalizing traits. Our results indicated that some measures assessing autism-relevant and ADHD-relevant characteristics (e.g. communication issues, hyperactivity/impulsivity) defined a distinct Attention and Communication Difficulties factor, with scores on this factor correlating strongly with internalizing symptom ratings. However, other relevant characteristics such as aloofness may be indicators of existing HiTOP spectra such as detachment. We discuss how these findings inform classification of autism-relevant and ADHD-relevant characteristics within the HiTOP, as well as key future directions for extending the limited research in this area.
Collapse
Affiliation(s)
- Kasey Stanton
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.,Department of Psychology, Western University, London, Ontario, Canada
| | - Elizabeth A DeLucia
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Matthew F D Brown
- Department of Psychology, Western University, London, Ontario, Canada
| | - Christina G McDonnell
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| |
Collapse
|
13
|
Wilson S, Olino TM. A developmental perspective on personality and psychopathology across the life span. J Pers 2021; 89:915-932. [PMID: 33550639 PMCID: PMC10142293 DOI: 10.1111/jopy.12623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/16/2022]
Abstract
Taking a developmental perspective, guided by core principles of developmental science and developmental psychopathology, is necessary to move the fields of personality science and psychopathology forward. Personality and psychopathology can be delineated using hierarchical models of individual differences, as evidenced by decades of converging evidence across community and psychiatric samples, countries and cultures, and ages and developmental periods. A large body of empirical research likewise documents associations between personality and various forms of psychopathology. Cross-sectional investigations of personality-psychopathology links in samples of adults now yield diminishing returns. Prospective, longitudinal investigations that assess personality, psychopathology, and their co-development across the life span are needed to determine their temporal ordering, capture dynamic associations over time and development, and elucidate causal origins and underlying mechanisms. We lay out a developmental framework that integrates across the developmental, personality, and psychopathology literatures in order to further understanding and guide future investigations of the nature of personality-psychopathology links.
Collapse
Affiliation(s)
- Sylia Wilson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, USA
| |
Collapse
|
14
|
Wood JJ, Wood KS, Cho AC, Rosenau KA, Guevara MC, Galán C, Bazzano A, Zeldin AS, Hellemann G. Modular cognitive behavioral therapy for autism-related symptoms in children: A randomized controlled trial. J Consult Clin Psychol 2021; 89:110-125. [PMID: 33705167 PMCID: PMC8284564 DOI: 10.1037/ccp0000621] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To date, no one-on-one psychotherapy protocol for elementary and middle school-aged children with autism spectrum disorder (ASD) has been found to be efficacious for treating autism-related symptoms such as failure to initiate social interactions. This study compared modular cognitive behavioral therapy (CBT) with enhanced standard community treatment (ESCT) in terms of impact on the severity of autism-related symptoms. METHOD Children with ASD (N = 107; aged 6-13 years) were randomly assigned to a treatment condition (CBT or ESCT). Both treatments provided 32 therapy sessions. The CBT condition utilized a modular design, matching specific evidence-based treatment elements to each child's clinical needs (e.g., social-communication symptoms). The ESCT condition provided social skills training and cognitive behavioral training in a structured and linear group therapy format. The primary outcome measure was independent evaluator ratings of peer engagement during school recess using a structured and validated observation system. Parents also made session-by-session ratings on personalized autism-related symptom profiles throughout treatment. RESULTS CBT outperformed ESCT on the primary outcome measure (p < .001; d = .50; 95% CI [.06, .93]) and the secondary outcome measure (p = .003; d = .87; 95% CI [.45, 1.27]). CONCLUSIONS The modular one-on-one CBT program evaluated in this study may be beneficial for reducing the severity of autism-related symptoms in some children with ASD. Further research is needed to clarify the extent of the treatment effect and the feasibility of implementation for therapists in the community. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Jeffrey J. Wood
- Department of Education, Division of Human Development and Psychology, University of California, Los Angeles
- David Geffen School of Medicine, University of California, Los Angeles
| | - Karen Sze Wood
- David Geffen School of Medicine, University of California, Los Angeles
| | - An Chuen Cho
- Department of Education, Division of Human Development and Psychology, University of California, Los Angeles
| | - Kashia A. Rosenau
- Department of Education, Division of Human Development and Psychology, University of California, Los Angeles
| | | | | | - Alicia Bazzano
- David Geffen School of Medicine, University of California, Los Angeles
| | | | - Gerhard Hellemann
- David Geffen School of Medicine, University of California, Los Angeles
| |
Collapse
|
15
|
Watts AL, Lane SP, Bonifay W, Steinley D, Meyer FAC. Building theories on top of, and not independent of, statistical models: The case of the p-factor. PSYCHOLOGICAL INQUIRY 2021; 31:310-320. [PMID: 33510565 PMCID: PMC7839945 DOI: 10.1080/1047840x.2020.1853476] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Ashley L. Watts
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Sean P. Lane
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Wes Bonifay
- Department of Education, School, and Counseling Psychology, University of Missouri, Columbia, MO, USA
| | - Douglas Steinley
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | | |
Collapse
|
16
|
Smith ZR, Zald DH, Lahey BB. Sluggish Cognitive Tempo and Depressive Symptoms in Children and Adolescents Predict Adulthood Psychopathology. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1591-1601. [PMID: 32918187 PMCID: PMC10704703 DOI: 10.1007/s10802-020-00692-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Sluggish cognitive tempo (SCT) is characterized by behavioral symptoms reflecting slowness and lethargy (e.g., sluggishness, appearing sleepy) and inconsistent alertness/mental confusion (e.g., daydreaming, fogginess). SCT is substantially correlated with the inattentive symptoms of attention-deficit/hyperactivity disorder (ADHD) and may be part of that domain, but in cross-sectional data, SCT is also strongly associated with both inattention and depression. To date, no study has examined the prospective associations of SCT symptoms in childhood/adolescence with symptoms of ADHD and internalizing problems in adulthood. Using a sample of 449 twin children and adolescent pairs, prospective multiple regression analyses examined whether self- and parent-reported SCT, depression, and parent-reported symptoms of ADHD predicted symptoms in adulthood 12 years later. SCT and depression at time one were strongly correlated (self-reported SCT and depression r = 0.84; parent-reported SCT and depression r = 0.78). When adult outcomes were separately regressed on each youth symptom dimension, self-reported SCT (β = 0.26, p < 0.0001) and depression (β = 0.13, p < 0.0001) each predicted adult symptoms of depression and self-reported SCT predicted inattention (β = 0.12, p = 0.0026). Parent-reported depression, but not parent-reported SCT, predicted self-reported adult depression symptoms (β = 0.17, p = 0.0003). In contrast, when each adult outcome was regressed simultaneously on youth self-reported SCT and depression, neither predicted adulthood inattention or depression. These findings indicate that SCT in childhood and adolescence is strongly associated concurrently and predictively with both inattention and depression. Theoretical and clinical applications of the construct of SCT must take its robust association with both inattention and depression into account.
Collapse
|
17
|
Rozalski V, Benning SD. Divergences among Three Higher-Order Self-Report Psychopathology Factors in Normal-Range Personality and Emotional Late Positive Potential Reactivity. JOURNAL OF RESEARCH IN PERSONALITY 2020; 82. [PMID: 32863467 DOI: 10.1016/j.jrp.2019.103861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Personality is related to psychopathology and its higher-order structures, but there is little research regarding neurobiological associations of higher-order psychopathology factors. This study examined the factor structure of a wide range of psychopathology and its associations with both personality and emotional reactivity revealed through the late positive potential (LPP) in a sample of 275 undergraduates. A three-factor structure of psychopathology emerged comprising Internalizing (INT), Externalizing (EXT), and Aberrant Experiences (ABX). EXT predicted aggressive disconstraint, whereas both INT and ABX predicted Alienation and Stress Reaction. INT uniquely predicted low Well-Being, and ABX predicted a rigid absorption combined with interpersonal detachment. ABX correlated with reduced parietal emotional LPP reactivity, whereas INT correlated with stronger frontal LPP reactivity to emotional versus neutral pictures.
Collapse
|
18
|
Heterogeneity of executive functions among preschool children with psychiatric symptoms. Eur Child Adolesc Psychiatry 2020; 29:1237-1249. [PMID: 31709476 PMCID: PMC7497399 DOI: 10.1007/s00787-019-01437-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/02/2019] [Indexed: 11/02/2022]
Abstract
The aim of the present study was to investigate associations between internalizing and externalizing symptoms and deficits in executive functions (EF) as well as to examine the overall heterogeneity of EFs in a sample of preschool children attending a psychiatric clinic (n = 171). First, based on cut-off points signifying clinical levels of impairment on the parent-completed Child Behavior Checklist (CBCL), children were assigned into groups of internalizing, externalizing, combined or mild symptoms and compared to a reference group (n = 667) with regard to day care teacher ratings of EFs on the Attention and Executive Function Rating Inventory-Preschool (ATTEX-P). Second, latent profile analysis (LPA) was employed to identify distinct subgroups of children representing different EF profiles with unique strengths and weaknesses in EFs. The first set of analyses indicated that all symptom groups had more difficulties in EFs than the reference group did, and the internalizing group had less inhibition-related problems than the other symptom groups did. Using LPA, five EF profiles were identified: average, weak average, attentional problems, inhibitory problems, and overall problems. The EF profiles were significantly associated with gender, maternal education level, and psychiatric symptom type. Overall, the findings suggest that the comparison of means of internalizing and externalizing groups mainly captures the fairly obvious differences in inhibition-related domains among young psychiatric outpatient children, whereas the person-oriented approach, based on individual differences, identifies heterogeneity related to attentional functions, planning, and initiating one's action. The variability in EF difficulties suggests that a comprehensive evaluation of a child's EF profile is important regardless of the type of psychiatric symptoms the child presents with.
Collapse
|
19
|
Rodriguez-Seijas C, Gadow KD, Rosen TE, Kim H, Lerner MD, Eaton NR. A transdiagnostic model of psychiatric symptom co-occurrence and autism spectrum disorder. Autism Res 2019; 13:579-590. [PMID: 31647197 DOI: 10.1002/aur.2228] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/28/2019] [Accepted: 09/11/2019] [Indexed: 12/28/2022]
Abstract
Understanding whether the co-occurrence of psychiatric symptoms within autism spectrum disorder (ASD) are specific to the ASD diagnosis or reflect similar higher-order patterns observed in both ASD and non-ASD samples, or a confluence of the two, is of critical importance. If similar, it would suggest that comorbid psychiatric conditions among individuals with ASD are not symptoms of specific, non-ASD psychiatric disorders per se, but reflect a general liability to psychopathology associated with ASD. To this end, the current study examined whether the higher-order structure of co-occurring psychiatric symptoms was the same within ASD and non-ASD youth. Parents of clinic-referred youth with (n = 280) and without (n = 943) ASD completed a DSM-IV-referenced psychiatric symptom rating scale. A confirmatory factor analytic framework was used to examine four levels of measurement invariance across groups to determine the extent to which transdiagnostic factors were comparable. Transdiagnostic factors were characterized by symptoms of the same disorders (configural invariance) and the same factor loadings across groups (metric invariance). Furthermore, both groups evidenced equivalent numbers of symptoms of most psychiatric conditions with the notable exceptions of attention deficit hyperactivity disorder (ADHD) and social anxiety (partial strong invariance), which were higher in the ASD sample. It was concluded that disparities in the co-occurrence of psychiatric symptoms between youth with and without ASD may be largely reflective of transdiagnostic factor level differences associated with ASD and not indicative of the ASD diagnosis per se. However, for ADHD and social anxiety, there appears to be some specific associations with the ASD diagnosis. Autism Res 2020, 13: 579-590. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Few transdiagnostic dimensions relate common mental disorder diagnoses with one another. These dimensions explain psychiatric comorbidity (i.e., the finding that many persons possess several disorder diagnoses simultaneously). However, it is unclear if these dimensions differ among children with autism spectrum disorder (ASD), compared with their non-ASD counterparts. The results of this study demonstrate that underlying transdiagnostic dimensions are similar in both ASD and non-ASD children. However, there appear to be ASD-specific differences when it comes to social anxiety and attention deficit hyperactivity disorder.
Collapse
Affiliation(s)
| | - Kenneth D Gadow
- Department of Psychiatry, Stony Brook University, Stony Brook, New York
| | - Tamara E Rosen
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Hyunsik Kim
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, New York
| |
Collapse
|
20
|
Delineating and validating higher-order dimensions of psychopathology in the Adolescent Brain Cognitive Development (ABCD) study. Transl Psychiatry 2019; 9:261. [PMID: 31624235 PMCID: PMC6797772 DOI: 10.1038/s41398-019-0593-4] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 09/09/2019] [Accepted: 09/24/2019] [Indexed: 01/03/2023] Open
Abstract
Hierarchical dimensional systems of psychopathology promise more informative descriptions for understanding risk and predicting outcome than traditional diagnostic systems, but it is unclear how many major dimensions they should include. We delineated the hierarchy of childhood and adult psychopathology and validated it against clinically relevant measures. Participants were 9987 9- and 10-year-old children and their parents from the Adolescent Brain Cognitive Development (ABCD) study. Factor analyses of items from the Child Behavior Checklist and Adult Self-Report were run to delineate hierarchies of dimensions. We examined the familial aggregation of the psychopathology dimensions, and the ability of different factor solutions to account for risk factors, real-world functioning, cognitive functioning, and physical and mental health service utilization. A hierarchical structure with a general psychopathology ('p') factor at the apex and five specific factors (internalizing, somatoform, detachment, neurodevelopmental, and externalizing) emerged in children. Five similar dimensions emerged also in the parents. Child and parent p-factors correlated highly (r = 0.61, p < 0.001), and smaller but significant correlations emerged for convergent dimensions between parents and children after controlling for p-factors (r = 0.09-0.21, p < 0.001). A model with child p-factor alone explained mental health service utilization (R2 = 0.23, p < 0.001), but up to five dimensions provided incremental validity to account for developmental risk and current functioning in children (R2 = 0.03-0.19, p < 0.001). In this first investigation comprehensively mapping the psychopathology hierarchy in children and adults, we delineated a hierarchy of higher-order dimensions associated with a range of clinically relevant validators. These findings hold important implications for psychiatric nosology and future research in this sample.
Collapse
|
21
|
Kim H, Keifer C, Rodriguez-Seijas C, Eaton N, Lerner M, Gadow K. Quantifying the Optimal Structure of the Autism Phenotype: A Comprehensive Comparison of Dimensional, Categorical, and Hybrid Models. J Am Acad Child Adolesc Psychiatry 2019; 58:876-886.e2. [PMID: 30768420 PMCID: PMC6488452 DOI: 10.1016/j.jaac.2018.09.431] [Citation(s) in RCA: 30] [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] [Received: 02/16/2018] [Revised: 09/22/2018] [Accepted: 10/18/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The two primary-seemingly contradictory-strategies for classifying child psychiatric syndromes are categorical and dimensional; conceptual ambiguities appear to be greatest for polythetic syndromes such as autism spectrum disorder (ASD). Recently, a compelling alternative has emerged that integrates both categorical and dimensional approaches (ie, a hybrid model), thanks to the increasing sophistication of analytic procedures. This study aimed to quantify the optimal phenotypic structure of ASD by comprehensively comparing categorical, dimensional, and hybrid models. METHOD The sample comprised 3,825 youth, who were consecutive referrals to a university developmental disabilities or child psychiatric outpatient clinic. Caregivers completed the Child and Adolescent Symptom Inventory-4R (CASI-4R), which includes an ASD symptom rating scale. A series of latent class analyses, exploratory and confirmatory factor analyses, and factor mixture analyses was conducted. Replication analyses were conducted in an independent sample (N = 2,503) of children referred for outpatient evaluation. RESULTS Based on comparison of 44 different models, results indicated that the ASD symptom phenotype is best conceptualized as multidimensional versus a categorical or categorical-dimensional hybrid construct. ASD symptoms were best characterized as falling along three dimensions (ie, social interaction, communication, and repetitive behavior) on the CASI-4R. CONCLUSION Findings reveal an optimal structure with which to characterize the ASD phenotype using a single, parent-report measure, supporting the presence of multiple correlated symptom dimensions that traverse formal diagnostic boundaries and quantify the heterogeneity of ASD. These findings inform understanding of how neurodevelopmental disorders can extend beyond discrete categories of development and represent continuously distributed traits across the range of human behaviors.
Collapse
|
22
|
Screening of Broader Autism Phenotype Symptoms in Siblings: Support for a Distinct Model of Symptomatology. J Autism Dev Disord 2019; 49:4686-4690. [PMID: 31385174 DOI: 10.1007/s10803-019-04157-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Research on siblings of youth with autism spectrum disorder (ASD) suggests that some phenotypic presentation, known as the broader autism phenotype (BAP), is common among siblings without an ASD diagnosis (e.g., Ruzich et al. in Autism Res 9(6):658-665, 2016). Whereas the symptoms that underlie both ASD and the BAP share commonality, the structure of these symptoms in youth with ASD and their siblings may differ. The current study assessed whether differences arise in the factor structure of the Children's Social Behavior Questionnaire (CSBQ) between youth with ASD and their siblings in a sample of 221 sibling dyads. Results suggest similar factor structures for ASD and BAP; however, number of symptoms endorsed, as opposed to the degree of severity, may better differentiate BAP.
Collapse
|
23
|
Constantinou MP, Goodyer IM, Eisler I, Butler S, Kraam A, Scott S, Pilling S, Simes E, Ellison R, Allison E, Fonagy P. Changes in General and Specific Psychopathology Factors Over a Psychosocial Intervention. J Am Acad Child Adolesc Psychiatry 2019; 58:776-786. [PMID: 30768397 DOI: 10.1016/j.jaac.2018.11.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 11/16/2018] [Accepted: 01/08/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Recent research suggests that comorbidity in child and adolescent psychiatric symptoms can be summarized by a single latent dimension known as the p factor and more specific factors summarizing clusters of symptoms. This study investigated within- and between-person changes in general and specific psychopathology factors over a psychosocial intervention. METHOD A secondary analysis was conducted of the Systemic Therapy for At-Risk Teens study, a pragmatic randomized controlled trial that compared the effects of multisystemic therapy with those of management as usual for decreasing antisocial behavior in 684 adolescents (82% boys; 11-18 years old at baseline) over an 18-month period. The general p factor and specific antisocial, attention, anxiety, and mood factors were estimated from a symptom-level analysis of a set of narrowband symptom scales measured repeatedly during the study. General and specific psychopathology factors were assessed for reliability, validity, and within- and between-person change using a parallel process multilevel growth model. RESULTS A revised bi-factor model that included a general p factor and specific anxiety, mood, antisocial, and attention factors with cross-loadings fit the data best. Although the factor structure was multidimensional, the p factor accounted for most of the variance in total scores. The p factor, anxiety, and antisocial factors predicted within-person variation in external outcomes. Furthermore, the p factor and antisocial factors showed within-person declines, whereas anxiety showed within-person increases, over time. Despite individual variation in baseline factor scores, adolescents showed similar rates of change. CONCLUSION The bi-factor model is useful for teasing apart general and specific therapeutic changes that are conflated in standard analyses of symptom scores. CLINICAL TRIAL REGISTRATION INFORMATION START (Systemic Therapy for At Risk Teens): A National Randomised Controlled Trial to Evaluate Multisystemic Therapy in the UK Context; http://www.isrctn.com; ISRCTN77132214.
Collapse
Affiliation(s)
| | | | - Ivan Eisler
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, University College London, UK
| | - Stephen Butler
- University of Prince Edward Island, Charlottetown, Canada
| | - Abdullah Kraam
- University of Leeds and Leeds Community Healthcare NHS Trust, Leeds, UK
| | - Stephen Scott
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Stephen Pilling
- Division of Psychology and Language Sciences, University College London, UK
| | - Elizabeth Simes
- Division of Psychology and Language Sciences, University College London, UK
| | - Rachel Ellison
- Division of Psychology and Language Sciences, University College London, UK
| | - Elizabeth Allison
- Division of Psychology and Language Sciences, University College London, UK
| | - Peter Fonagy
- Division of Psychology and Language Sciences, University College London, UK
| |
Collapse
|
24
|
Becker SP, Willcutt EG. Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology. Eur Child Adolesc Psychiatry 2019; 28:603-613. [PMID: 29524018 PMCID: PMC6131087 DOI: 10.1007/s00787-018-1136-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/23/2018] [Indexed: 02/06/2023]
Abstract
Sluggish cognitive tempo (SCT) is separable from attention-deficit/hyperactivity disorder (ADHD) and other psychopathologies, and growing evidence demonstrates SCT to be associated with impairment in both children and adults. However, it remains unclear how SCT should optimally be conceptualized. In this article, we argue that multiple models of psychopathology should be leveraged to make substantive advances to our understanding of SCT. Both categorical and dimensional approaches should be used, including the Diagnostic and Statistical Manual of Mental Disorders (DSM) nosology, the Research Domain Criteria (RDoC) initiative, and hierarchical models of psychopathology. Studies are needed to determine whether individuals categorized with SCT can be reliably identified and differentiated from individuals without SCT in pathophysiological, neuropsychological, behavioral, and daily life functioning. Studies are also needed to evaluate the validity and utility of SCT as a transdiagnostic and dimensional construct. In considering SCT as a dimensional and potentially transdiagnostic construct, we describe ways in which SCT might be examined within the RDoC framework, including negative valence systems, cognitive systems, and arousal/regulatory systems, as well as within hierarchical models of psychopathology. Conceptualizing SCT within both categorical and dimensional models of psychopathology will help to better understand the causes, developmental pathways, and clinical implications of SCT, both as a construct in its own right and also in relation to other psychopathologies.
Collapse
Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA.
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 10006, Cincinnati, OH, 45229, USA.
| | - Erik G Willcutt
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA
| |
Collapse
|
25
|
Guerrera S, Menghini D, Napoli E, Di Vara S, Valeri G, Vicari S. Assessment of Psychopathological Comorbidities in Children and Adolescents With Autism Spectrum Disorder Using the Child Behavior Checklist. Front Psychiatry 2019; 10:535. [PMID: 31404318 PMCID: PMC6676343 DOI: 10.3389/fpsyt.2019.00535] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 07/10/2019] [Indexed: 12/28/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterized by psychiatric and behavioral comorbidities. The Child Behavior Checklist (CBCL) provides valid and well-established measures of emotional, behavioral, and social problems in children and adolescents. The aim of the present study was to verify whether emotional, behavioral, and social problems were modulated by ASD symptom severity, cognitive development, gender, and age by analyzing the CBCL in a large group of children and adolescents with ASD. The results show that around 30% of participants with ASD exhibited internalizing problems and only 6% externalizing problems, with males exhibiting more internalizing problems than females. No correlation was found between CBCL scores and indices of ASD severity. However, higher CBCL Total Problems scores were found in older children and in children with lower cognitive abilities. The detection of behavioral and emotional problems allows children with ASD to undergo specific and individualized treatment that takes into account their psychopathological problems.
Collapse
Affiliation(s)
- Silvia Guerrera
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| | - Deny Menghini
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| | - Eleonora Napoli
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| | - Silvia Di Vara
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| | - Giovanni Valeri
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Rome, Italy
| |
Collapse
|
26
|
Re-evaluation of the Latent Structure of Common Childhood Disorders: Is There a General Psychopathology Factor (P-Factor)? Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-0017-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
|
27
|
Bloemen AJP, Oldehinkel AJ, Laceulle OM, Ormel J, Rommelse NNJ, Hartman CA. The association between executive functioning and psychopathology: general or specific? Psychol Med 2018; 48:1787-1794. [PMID: 29521611 DOI: 10.1017/s0033291717003269] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND We modeled both psychopathology and executive function (EF) as bi-factor models to study if EF impairments are transdiagnostic or relate to individual syndromes, and concurrently, if such associations are with general EF or specific EF impairments. METHODS Data were obtained from the Tracking Adolescents' Individual Lives Survey (TRAILS; N = 2230). Psychopathology was assessed with parent-report questionnaires at ages 11, 14, 16, and 19, and EF with tasks from the Amsterdam Neuropsychological Tasks program at ages 11 and 19. Bi-factor models were fitted to the data using confirmatory factor analysis. Correlations were estimated to study the associations between general or specific components of both psychopathology and EF. RESULTS A bi-factor model with a general psychopathology factor, alongside internalizing (INT), externalizing, attention deficit/hyperactivity (ADHD), and autism spectrum (ASD) problem domains, and a bi-factor model with a general EF factor, alongside specific EFs were adequately fitting measurement models. The best-fitting model between EF and psychopathology showed substantial associations of specific EFs with the general psychopathology factor, in addition to distinct patterns of association with ASD, ADHD, and INT problems. CONCLUSIONS By studying very diverse psychopathology domains simultaneously, we show how EF impairments cross diagnostic boundaries. In addition to this generic relation, ADHD, ASD, and INT symptomatology show separable profiles of EF impairments. Thus, inconsistent findings in the literature may be explained by substantial transdiagnostic EF impairments. Whether general EF or specific EFs are related to psychopathology needs to be further studied, as differences in fit between these models were small.
Collapse
Affiliation(s)
- A J P Bloemen
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - A J Oldehinkel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - O M Laceulle
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - J Ormel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - N N J Rommelse
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C A Hartman
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| |
Collapse
|
28
|
Oerlemans AM, Rommelse NNJ, Buitelaar JK, Hartman CA. Examining the intertwined development of prosocial skills and ASD symptoms in adolescence. Eur Child Adolesc Psychiatry 2018; 27:1033-1046. [PMID: 29383553 PMCID: PMC6060879 DOI: 10.1007/s00787-018-1114-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/15/2018] [Indexed: 11/30/2022]
Abstract
Autism spectrum disorder (ASD) and reduced prosocial behaviour are strongly intertwined. However, social interactions with peers may be increasingly practiced over the course of development and may instigate a reduction in ASD symptoms and vice versa. We, therefore, sought to determine if, during adolescence, possible improvements in prosocial behaviours and ASD symptoms may benefit one another over time. Participants were 2773 adolescents from the Tracking Adolescents' Individual Lives Survey (TRAILS) cohorts. Measurements took place over three waves (mean ages: 11.1, 13.4, and 16.2 years). Longitudinal associations between teacher-rated classroom prosocial skills and parent-rated ASD symptoms were examined using the random intercept cross-lagged panel model (RI-CLPM). In addition to estimating the stable, between-person associations, the dynamical effects between prosocial skills and ASD symptoms over time were estimated at the within-person level. At the between-person level, prosocial skills and ASD symptoms were substantially negatively correlated. At the within-person level, a small and unexpected positive cross-lagged effect from wave 1 ASD symptoms on wave 2 prosocial skills was observed. We added to the existing literature by showing that, in addition to replicating the already firmly established between-person association between low prosocial skills and ASD, within-person gains in prosocial skills do not lead to subsequent reduction of ASD symptoms, and reductions in ASD symptoms do not lead to subsequent enhancement of prosocial skills. We, therefore, conclude from our findings that the inverse association between autistic symptoms and prosocial skills in adolescence is highly stable.
Collapse
Affiliation(s)
- Anoek M Oerlemans
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.
| | - Nanda N J Rommelse
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
29
|
Murray AL, Booth T, Eisner M, Obsuth I, Ribeaud D. Quantifying the Strength of General Factors in Psychopathology: A Comparison of CFA with Maximum Likelihood Estimation, BSEM, and ESEM/EFA Bifactor Approaches. J Pers Assess 2018; 101:631-643. [DOI: 10.1080/00223891.2018.1468338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Aja Louise Murray
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Tom Booth
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Manuel Eisner
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Ingrid Obsuth
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| |
Collapse
|
30
|
Castellanos-Ryan N, Brière FN, O'Leary-Barrett M, Banaschewski T, Bokde A, Bromberg U, Büchel C, Flor H, Frouin V, Gallinat J, Garavan H, Martinot JL, Nees F, Paus T, Pausova Z, Rietschel M, Smolka MN, Robbins TW, Whelan R, Schumann G, Conrod P. The structure of psychopathology in adolescence and its common personality and cognitive correlates. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 125:1039-1052. [PMID: 27819466 PMCID: PMC5098414 DOI: 10.1037/abn0000193] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The traditional view that mental disorders are distinct, categorical disorders has been challenged by evidence that disorders are highly comorbid and exist on a continuum (e.g., Caspi et al., 2014; Tackett et al., 2013). The first objective of this study was to use structural equation modeling to model the structure of psychopathology in an adolescent community-based sample (N = 2,144) including conduct disorder, attention-deficit/hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), obsessive–compulsive disorder, eating disorders, substance use, anxiety, depression, phobias, and other emotional symptoms, assessed at 16 years. The second objective was to identify common personality and cognitive correlates of psychopathology, assessed at 14 years. Results showed that psychopathology at 16 years fit 2 bifactor models equally well: (a) a bifactor model, reflecting a general psychopathology factor, as well as specific externalizing (representing mainly substance misuse and low ADHD) and internalizing factors; and (b) a bifactor model with a general psychopathology factor and 3 specific externalizing (representing mainly ADHD and ODD), substance use and internalizing factors. The general psychopathology factor was related to high disinhibition/impulsivity, low agreeableness, high neuroticism and hopelessness, high delay-discounting, poor response inhibition and low performance IQ. Substance use was specifically related to high novelty-seeking, sensation-seeking, extraversion, high verbal IQ, and risk-taking. Internalizing psychopathology was specifically related to high neuroticism, hopelessness and anxiety-sensitivity, low novelty-seeking and extraversion, and an attentional bias toward negatively valenced verbal stimuli. Findings reveal several nonspecific or transdiagnostic personality and cognitive factors that may be targeted in new interventions to potentially prevent the development of multiple psychopathologies. This study provides support for a spectrum and common liability model of psychopathology, with findings showing that in a community sample of European adolescents: a) internalizing and externalizing psychopathology share substantial variance that can be modeled as a general psychopathology factor; and (b) that the common variance across psychopathologies is associated with personality traits related to high disinhibition/impulsivity, low agreeableness, high neuroticism and hopelessness, as well as different aspect of cognitive function, namely high delay-discounting, poor response inhibition and low performance IQ.
Collapse
Affiliation(s)
| | | | | | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University
| | - Arun Bokde
- Institute of Neuroscience, School of Medicine, Trinity College
| | - Uli Bromberg
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf
| | - Christian Büchel
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University
| | - Vincent Frouin
- Neurospin, Atomic Energy and Alternative Energies Commission
| | - Juergen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf
| | | | - Jean-Luc Martinot
- Imaging and Psychiatry (Unit 1000), Institut National de la Santé et de la Recherche Médicale (INSERM CEA), University Paris Sud
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University
| | - Tomas Paus
- Rotman Research Institute, Department of Psychology, University of Toronto
| | | | - Marcella Rietschel
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University
| | | | | | | | - Gunter Schumann
- MRC Social, Genetic, and Developmental Psychiatry (SGDP) Centre
| | - Patricia Conrod
- Department of Psychiatry, University of Montreal, CHU Sainte-Justine Hospital
| |
Collapse
|
31
|
Waldman ID, Poore HE, van Hulle C, Rathouz PJ, Lahey BB. External validity of a hierarchical dimensional model of child and adolescent psychopathology: Tests using confirmatory factor analyses and multivariate behavior genetic analyses. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 125:1053-1066. [PMID: 27819467 DOI: 10.1037/abn0000183] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Several recent studies of the hierarchical phenotypic structure of psychopathology have identified a General psychopathology factor in addition to the more expected specific Externalizing and Internalizing dimensions in both youth and adult samples and some have found relevant unique external correlates of this General factor. We used data from 1,568 twin pairs (599 MZ & 969 DZ) age 9 to 17 to test hypotheses for the underlying structure of youth psychopathology and the external validity of the higher-order factors. Psychopathology symptoms were assessed via structured interviews of caretakers and youth. We conducted phenotypic analyses of competing structural models using Confirmatory Factor Analysis and used Structural Equation Modeling and multivariate behavior genetic analyses to understand the etiology of the higher-order factors and their external validity. We found that both a General factor and specific Externalizing and Internalizing dimensions are necessary for characterizing youth psychopathology at both the phenotypic and etiologic levels, and that the 3 higher-order factors differed substantially in the magnitudes of their underlying genetic and environmental influences. Phenotypically, the specific Externalizing and Internalizing dimensions were slightly negatively correlated when a General factor was included, which reflected a significant inverse correlation between the nonshared environmental (but not genetic) influences on Internalizing and Externalizing. We estimated heritability of the general factor of psychopathology for the first time. Its moderate heritability suggests that it is not merely an artifact of measurement error but a valid construct. The General, Externalizing, and Internalizing factors differed in their relations with 3 external validity criteria: mother's smoking during pregnancy, parent's harsh discipline, and the youth's association with delinquent peers. Multivariate behavior genetic analyses supported the external validity of the 3 higher-order factors by suggesting that the General, Externalizing, and Internalizing factors were correlated with peer delinquency and parent's harsh discipline for different etiologic reasons. (PsycINFO Database Record
Collapse
|
32
|
The generalizability of the structure of substance abuse and antisocial behavioral syndromes: A systematic review. Psychiatry Res 2018; 259:412-421. [PMID: 29120851 DOI: 10.1016/j.psychres.2017.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/29/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although several authors have suggested that a single externalizing spectrum encompassing both antisocial behavioral syndromes and substance use disorder is to be preferred, this assumption has not been evaluated systematically throughout studies. PURPOSE The objective was to establish the generalizability of transdiagnostic models of externalizing disorders across different types of disorders and populations, in regard to the strength of the evidence. METHOD We conducted a systematic literature review using combinations of two sets of keywords: 1) "antisocial", "externalizing", "conduct disorder", "disruptive behavior disorder", "substance abuse", "substance-related disorder", "cannabis", "cocaine", "hallucinogen", "alcoholism", "opioid"; 2) "latent structure", "factor analysis", "multivariate analysis". RESULTS Models supporting a superordinate factor appeared dominant in a limited set of different populations, on which the majority of the research sample was focused. CONCLUSIONS Although the externalizing spectrum model is a promising angle for future research and treatment, extending research on this model in a higher diversity of populations is recommended to enhance the understanding and applicability of the externalizing spectrum model.
Collapse
|
33
|
Sokolova E, Oerlemans AM, Rommelse NN, Groot P, Hartman CA, Glennon JC, Claassen T, Heskes T, Buitelaar JK. A Causal and Mediation Analysis of the Comorbidity Between Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). J Autism Dev Disord 2017; 47:1595-1604. [PMID: 28255761 PMCID: PMC5432632 DOI: 10.1007/s10803-017-3083-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Autism spectrum disorder (ASD) and Attention-deficit/hyperactivity disorder (ADHD) are often comorbid. The purpose of this study is to explore the relationships between ASD and ADHD symptoms by applying causal modeling. We used a large phenotypic data set of 417 children with ASD and/or ADHD, 562 affected and unaffected siblings, and 414 controls, to infer a structural equation model using a causal discovery algorithm. Three distinct pathways between ASD and ADHD were identified: (1) from impulsivity to difficulties with understanding social information, (2) from hyperactivity to stereotypic, repetitive behavior, (3) a pairwise pathway between inattention, difficulties with understanding social information, and verbal IQ. These findings may inform future studies on understanding the pathophysiological mechanisms behind the overlap between ASD and ADHD.
Collapse
Affiliation(s)
- Elena Sokolova
- Radboud University, Postbus 9010, 6500, Nijmegen, The Netherlands.
- Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands.
| | - Anoek M Oerlemans
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nanda N Rommelse
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Perry Groot
- Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tom Claassen
- Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | - Tom Heskes
- Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| |
Collapse
|
34
|
Beyond comorbidity: Toward a dimensional and hierarchical approach to understanding psychopathology across the life span. Dev Psychopathol 2017; 28:971-986. [PMID: 27739384 DOI: 10.1017/s0954579416000651] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We propose a novel developmentally informed framework to push research beyond a focus on comorbidity between discrete diagnostic categories and to move toward research based on the well-validated dimensional and hierarchical structure of psychopathology. For example, a large body of research speaks to the validity and utility of the internalizing and externalizing spectra as organizing constructs for research on common forms of psychopathology. The internalizing and externalizing spectra act as powerful explanatory variables that channel the psychopathological effects of genetic and environmental risk factors, predict adaptive functioning, and account for the likelihood of disorder-level manifestations of psychopathology. As such, our proposed theoretical framework uses the internalizing and externalizing spectra as central constructs to guide future psychopathology research across the life span. The framework is particularly flexible, because any of the facets or factors from the dimensional and hierarchical structure of psychopathology can form the focus of research. We describe the utility and strengths of this framework for developmental psychopathology in particular and explore avenues for future research.
Collapse
|
35
|
Pezzoli P, Antfolk J, Santtila P. Phenotypic factor analysis of psychopathology reveals a new body-related transdiagnostic factor. PLoS One 2017; 12:e0177674. [PMID: 28542328 PMCID: PMC5436748 DOI: 10.1371/journal.pone.0177674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 05/01/2017] [Indexed: 12/11/2022] Open
Abstract
Comorbidity challenges the notion of mental disorders as discrete categories. An increasing body of literature shows that symptoms cut across traditional diagnostic boundaries and interact in shaping the latent structure of psychopathology. Using exploratory and confirmatory factor analysis, we reveal the latent sources of covariation among nine measures of psychopathological functioning in a population-based sample of 13024 Finnish twins and their siblings. By implementing unidimensional, multidimensional, second-order, and bifactor models, we illustrate the relationships between observed variables, specific, and general latent factors. We also provide the first investigation to date of measurement invariance of the bifactor model of psychopathology across gender and age groups. Our main result is the identification of a distinct "Body" factor, alongside the previously identified Internalizing and Externalizing factors. We also report relevant cross-disorder associations, especially between body-related psychopathology and trait anger, as well as substantial sex and age differences in observed and latent means. The findings expand the meta-structure of psychopathology, with implications for empirical and clinical practice, and demonstrate shared mechanisms underlying attitudes towards nutrition, self-image, sexuality and anger, with gender- and age-specific features.
Collapse
Affiliation(s)
- Patrizia Pezzoli
- Department of Psychology, Åbo Akademi University, Turku, Finland
- * E-mail:
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
- Turku Brain and Mind Centre, Turku, Finland
| | - Pekka Santtila
- Department of Psychology, Åbo Akademi University, Turku, Finland
| |
Collapse
|
36
|
Nigg JT. Annual Research Review: On the relations among self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition for developmental psychopathology. J Child Psychol Psychiatry 2017; 58:361-383. [PMID: 28035675 PMCID: PMC5367959 DOI: 10.1111/jcpp.12675] [Citation(s) in RCA: 688] [Impact Index Per Article: 98.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Self-regulation (SR) is central to developmental psychopathology, but progress has been impeded by varying terminology and meanings across fields and literatures. METHODS The present review attempts to move that discussion forward by noting key sources of prior confusion such as measurement-concept confounding, and then arguing the following major points. RESULTS First, the field needs a domain-general construct of SR that encompasses SR of action, emotion, and cognition and involves both top-down and bottom-up regulatory processes. This does not assume a shared core process across emotion, action, and cognition, but is intended to provide clarity on the extent of various claims about kinds of SR. Second, top-down aspects of SR need to be integrated. These include (a) basic processes that develop early and address immediate conflict signals, such as cognitive control and effortful control (EC), and (b) complex cognition and strategies for addressing future conflict, represented by the regulatory application of complex aspects of executive functioning. Executive function (EF) and cognitive control are not identical to SR because they can be used for other activities, but account for top-down aspects of SR at the cognitive level. Third, impulsivity, risk-taking, and disinhibition are distinct although overlapping; a taxonomy of the kinds of breakdowns of SR associated with psychopathology requires their differentiation. Fourth, different aspects of the SR universe can be organized hierarchically in relation to granularity, development, and time. Low-level components assemble into high-level components. This hierarchical perspective is consistent across literatures. CONCLUSIONS It is hoped that the framework outlined here will facilitate integration and cross-talk among investigators working from different perspectives, and facilitate individual differences research on how SR relates to developmental psychopathology.
Collapse
Affiliation(s)
- Joel T Nigg
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| |
Collapse
|
37
|
Murray AL, Eisner M, Ribeaud D. The Development of the General Factor of Psychopathology 'p Factor' Through Childhood and Adolescence. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 44:1573-1586. [PMID: 26846993 DOI: 10.1007/s10802-016-0132-1] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Recent studies have suggested that the structure of psychopathology may be usefully represented in terms of a general factor of psychopathology (p-factor) capturing variance common to a broad range of symptoms transcending diagnostic domains in addition to specific factors capturing variance common to smaller subsets of more closely related symptoms. Little is known about how the general co-morbidity captured by this p-factor develops and whether general co-morbidity increases or decreases over childhood and adolescence. We evaluated two competing hypotheses: 1) dynamic mutualism which predicts growth in general co-morbidity and associated p-factor strength over time and 2) p-differentiation which predicts that manifestations of liabilities towards psychopathology become increasingly specific over time. Data came from the Zurich Project on the Social Development of Children and Youths (z-proso), a longitudinal study of a normative sample (approx. 50 % male) measured at 8 time points from ages 7 to 15. We operationalised general co-morbidity as p-factor strength in a bi-factor model and used omega hierarchical to track how this changed over development. In contrast to the predictions of both dynamic mutualism and p-differentiation, p-factor strength remained relatively constant over the studied period suggesting that such processes do not govern the interplay between psychopathological symptoms during this phase of development. Future research should focus on earlier phases of development and on factors that maintain the consistency of symptom-general covariation across this period.
Collapse
Affiliation(s)
- Aja Louise Murray
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, CB3 9DA, UK.
| | - Manuel Eisner
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, CB3 9DA, UK
| | - Denis Ribeaud
- Criminological Research Unit, Chair of Sociology, Swiss Federal Institute of Technology Zurich (ETH), Zurich, Switzerland
| |
Collapse
|
38
|
Murray AL, Eisner M, Obsuth I, Ribeaud D. Situating violent ideations within the landscape of mental health: Associations between violent ideations and dimensions of mental health. Psychiatry Res 2017; 249:70-77. [PMID: 28073033 DOI: 10.1016/j.psychres.2017.01.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 12/29/2016] [Accepted: 01/01/2017] [Indexed: 11/24/2022]
Abstract
Violent ideations occur more frequently in individuals with mental health problems. They may be of interest in clinical contexts as possible indicators of dangerousness, as corollaries of mental health problems, as candidate treatment targets and as potentially playing a role in perpetuation or onset of symptoms. In spite of their relevance to mental health, some fundamental questions about their place within the broader landscape of mental health problems remain unanswered. To provide a basic characterisation of the relations between violent ideations and dimensions of mental health and provide a foundation for future research in this area we factor analysed a measure of violent ideations and an omnibus measure of mental health dimensions in a normative sample of 1306 youth (at age 17). Results supported a separate dimension of violent ideations with a small to moderate correlation with five other dimensions of mental health: internalising, prosociality, ADHD, indirect/proactive aggression, and physical/reactive aggression. Controlling for comorbidity among mental health dimensions, all but ADHD had unique relations with violent ideations. This suggests that violent ideations are potentially of broad relevance to mental health and related behaviours and there should be a greater research effort aimed at understanding their possible role in mental health.
Collapse
Affiliation(s)
- Aja Louise Murray
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK.
| | - Manuel Eisner
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Ingrid Obsuth
- Violence Research Centre, Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Denis Ribeaud
- Criminological Research Unit, Chair of Sociology, Swiss Federal Institute of Technology Zurich (ETH), Zurich, Switzerland
| |
Collapse
|
39
|
Lahey BB, Krueger RF, Rathouz PJ, Waldman ID, Zald DH. A hierarchical causal taxonomy of psychopathology across the life span. Psychol Bull 2017; 143:142-186. [PMID: 28004947 PMCID: PMC5269437 DOI: 10.1037/bul0000069] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We propose a taxonomy of psychopathology based on patterns of shared causal influences identified in a review of multivariate behavior genetic studies that distinguish genetic and environmental influences that are either common to multiple dimensions of psychopathology or unique to each dimension. At the phenotypic level, first-order dimensions are defined by correlations among symptoms; correlations among first-order dimensions similarly define higher-order domains (e.g., internalizing or externalizing psychopathology). We hypothesize that the robust phenotypic correlations among first-order dimensions reflect a hierarchy of increasingly specific etiologic influences. Some nonspecific etiologic factors increase risk for all first-order dimensions of psychopathology to varying degrees through a general factor of psychopathology. Other nonspecific etiologic factors increase risk only for all first-order dimensions within a more specific higher-order domain. Furthermore, each first-order dimension has its own unique causal influences. Genetic and environmental influences common to family members tend to be nonspecific, whereas environmental influences unique to each individual are more dimension-specific. We posit that these causal influences on psychopathology are moderated by sex and developmental processes. This causal taxonomy also provides a novel framework for understanding the heterogeneity of each first-order dimension: Different persons exhibiting similar symptoms may be influenced by different combinations of etiologic influences from each of the 3 levels of the etiologic hierarchy. Furthermore, we relate the proposed causal taxonomy to transdimensional psychobiological processes, which also impact the heterogeneity of each psychopathology dimension. This causal taxonomy implies the need for changes in strategies for studying the etiology, psychobiology, prevention, and treatment of psychopathology. (PsycINFO Database Record
Collapse
Affiliation(s)
| | | | - Paul J Rathouz
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine
| | | | | |
Collapse
|
40
|
Hartman CA, Geurts HM, Franke B, Buitelaar JK, Rommelse NNJ. Changing ASD-ADHD symptom co-occurrence across the lifespan with adolescence as crucial time window: Illustrating the need to go beyond childhood. Neurosci Biobehav Rev 2016; 71:529-541. [PMID: 27629802 DOI: 10.1016/j.neubiorev.2016.09.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 07/29/2016] [Accepted: 09/04/2016] [Indexed: 10/21/2022]
Abstract
Literature on the co-occurrence between Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) is strongly biased by a focus on childhood age. A review of the adolescent and adult literature was made on core and related symptoms of ADHD and ASD. In addition, an empirical approach was used including 17,173 ASD-ADHD symptom ratings from participants aged 0 to 84 years. Results indicate that ASD/ADHD constellations peak during adolescence and are lower in early childhood and old age. We hypothesize that on the border of the expected transition to independent adulthood, ASD and ADHD co-occur most because social adaptation and EF skills matter most. Lower correlations in childhood and older age may be due to more diffuse symptoms reflecting respectively still differentiating and de-differentiating EF functions. We plea for a strong research focus in adolescence which may -after early childhood- be a second crucial time window for catching-up pattern explaining more optimal outcomes. We discuss obstacles and oppportunities of a full lifespan approach into old age.
Collapse
Affiliation(s)
- Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center of Psychopathology and Emotion Regulation (ICPE) & Research School of Behavioral and Cognitive Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Hilde M Geurts
- Department of Psychology, Brain and Cognition, d'Arc, & Cognitive Science Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands; Dr Leo Kannerhuis, Autism Clinic, Amsterdam, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands; Karakter, Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Nanda N J Rommelse
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands; Karakter, Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| |
Collapse
|
41
|
Externalizing and Internalizing Symptoms Moderate Longitudinal Patterns of Facial Emotion Recognition in Autism Spectrum Disorder. J Autism Dev Disord 2016; 46:2621-2634. [DOI: 10.1007/s10803-016-2800-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
42
|
Family process and youth internalizing problems: A triadic model of etiology and intervention. Dev Psychopathol 2016; 29:273-301. [DOI: 10.1017/s095457941600016x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDespite major advances in the development of interventions for youth anxiety and depression, approximately 30% of youths with anxiety do not respond to cognitive behavioral treatment, and youth depression treatments yield modest symptom decreases overall. Identifying networks of modifiable risk and maintenance factors that contribute to both youth anxiety and depression (i.e., internalizing problems) may enhance and broaden treatment benefits by informing the development of mechanism-targeted interventions. A particularly powerful network is the rich array of family processes linked to internalizing problems (e.g., parenting styles, parental mental health problems, and sibling relationships). Here, we propose a new theoretical model, the triadic modelof family process, to organize theory and evidence around modifiable, transdiagnostic family factors that may contribute to youth internalizing problems. We describe the model's implications for intervention, and we propose strategies for testing the model in future research. The model provides a framework for studying associations among family processes, their relation to youth internalizing problems, and family-based strategies for strengthening prevention and treatment.
Collapse
|
43
|
Carragher N, Teesson M, Sunderland M, Newton NC, Krueger RF, Conrod PJ, Barrett EL, Champion KE, Nair NK, Slade T. The structure of adolescent psychopathology: a symptom-level analysis. Psychol Med 2016; 46:981-994. [PMID: 26620582 DOI: 10.1017/s0033291715002470] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Most empirical studies into the covariance structure of psychopathology have been confined to adults. This work is not developmentally informed as the meaning, age-of-onset, persistence and expression of disorders differ across the lifespan. This study investigates the underlying structure of adolescent psychopathology and associations between the psychopathological dimensions and sex and personality risk profiles for substance misuse and mental health problems. METHOD This study analyzed data from 2175 adolescents aged 13.3 years. Five dimensional models were tested using confirmatory factor analysis and the external validity was examined using a multiple-indicators multiple-causes model. RESULTS A modified bifactor model, with three correlated specific factors (internalizing, externalizing, thought disorder) and one general psychopathology factor, provided the best fit to the data. Females reported higher mean levels of internalizing, and males reported higher mean levels of externalizing. No significant sex differences emerged in liability to thought disorder or general psychopathology. Liability to internalizing, externalizing, thought disorder and general psychopathology was characterized by a number of differences in personality profiles. CONCLUSIONS This study is the first to identify a bifactor model including a specific thought disorder factor. The findings highlight the utility of transdiagnostic treatment approaches and the importance of restructuring psychopathology in an empirically based manner.
Collapse
Affiliation(s)
- N Carragher
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| | - M Teesson
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| | - M Sunderland
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| | - N C Newton
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| | - R F Krueger
- Department of Psychology,University of Minnesota,MN,USA
| | - P J Conrod
- Department of Psychiatry,Université de Montréal,Montréal,Canada
| | - E L Barrett
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| | - K E Champion
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| | - N K Nair
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| | - T Slade
- National Drug and Alcohol Research Centre,University of New South Wales,Sydney,Australia
| |
Collapse
|
44
|
Snyder HR, Gulley LD, Bijttebier P, Hartman CA, Oldehinkel AJ, Mezulis A, Young JF, Hankin BL. Adolescent emotionality and effortful control: Core latent constructs and links to psychopathology and functioning. J Pers Soc Psychol 2015; 109:1132-49. [PMID: 26011660 DOI: 10.1037/pspp0000047] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Temperament is associated with important outcomes in adolescence, including academic and interpersonal functioning and psychopathology. Rothbart's temperament model is among the most well-studied and supported approaches to adolescent temperament, and contains 3 main components: positive emotionality (PE), negative emotionality (NE), and effortful control (EC). However, the latent factor structure of Rothbart's temperament measure for adolescents, the Early Adolescent Temperament Questionnaire Revised (EATQ-R; Ellis & Rothbart, 2001) has not been definitively established. To address this problem and investigate links between adolescent temperament and functioning, we used confirmatory factor analysis to examine the latent constructs of the EATQ-R in a large combined sample. For EC and NE, bifactor models consisting of a common factor plus specific factors for some subfacets of each component fit best, providing a more nuanced understanding of these temperament dimensions. The nature of the PE construct in the EATQ-R is less clear. Models replicated in a hold-out dataset. The common components of high NE and low EC where broadly associated with increased psychopathology symptoms, and poor interpersonal and school functioning, while specific components of NE were further associated with corresponding specific components of psychopathology. Further questioning the construct validity of PE as measured by the EATQ-R, PE factors did not correlate with construct validity measures in a way consistent with theories of PE. Bringing consistency to the way the EATQ-R is modeled and using purer latent variables has the potential to advance the field in understanding links between dimensions of temperament and important outcomes of adolescent development.
Collapse
Affiliation(s)
| | | | | | | | | | - Amy Mezulis
- Department of Clinical Psychology, Seattle Pacific University
| | - Jami F Young
- Graduate School of Applied and Professional Psychology, Rutgers University
| | | |
Collapse
|
45
|
Abstract
The field has embarked on an effort to better integrate neurobiological and psychological dimensions of functioning with putative psychopathological syndromes. If successful, this effort aims to be a turning point as impactful as the change, a century ago, away from the study of symptom dimensions and toward the study of psychopathological syndromes. New statistical and neurobiological methods and findings hold considerable promise in this regard, and several papers in the present issue underscore these ongoing and important new directions. For this proposed direction to succeed, however, three guiding principles are necessary. First, the syndromal approach must continue to be viewed as provisional, and not reified. Second, in contrast, individual dimensions of neurobiology, psychology, personality, or symptoms should not be decontextualized but considered in relation to other traits and dimensions, syndromal configurations. Major clinical syndromes cannot be ignored. Third, following the Kraepelian insights of a century ago in addition to the more recent insights of developmental psychopathlogy, trait and dimension aspects of psychopathology need to be understood in their developmental context. Whether an integrated dimensional-categorical-developmental understanding of psychopathology can be extended to the entire nosology or only parts of it remains to be seen.
Collapse
|
46
|
Carragher N, Krueger RF, Eaton NR, Slade T. Disorders without borders: current and future directions in the meta-structure of mental disorders. Soc Psychiatry Psychiatr Epidemiol 2015; 50:339-50. [PMID: 25557024 DOI: 10.1007/s00127-014-1004-z] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/22/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE Classification is the cornerstone of clinical diagnostic practice and research. However, the extant psychiatric classification systems are not well supported by research evidence. In particular, extensive comorbidity among putatively distinct disorders flags an urgent need for fundamental changes in how we conceptualize psychopathology. Over the past decade, research has coalesced on an empirically based model that suggests many common mental disorders are structured according to two correlated latent dimensions: internalizing and externalizing. METHODS We review and discuss the development of a dimensional-spectrum model which organizes mental disorders in an empirically based manner. We also touch upon changes in the DSM-5 and put forward recommendations for future research endeavors. RESULTS Our review highlights substantial empirical support for the empirically based internalizing-externalizing model of psychopathology, which provides a parsimonious means of addressing comorbidity. CONCLUSIONS As future research goals, we suggest that the field would benefit from: expanding the meta-structure of psychopathology to include additional disorders, development of empirically based thresholds, inclusion of a developmental perspective, and intertwining genomic and neuroscience dimensions with the empirical structure of psychopathology.
Collapse
Affiliation(s)
- Natacha Carragher
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia,
| | | | | | | |
Collapse
|
47
|
Affiliation(s)
- Robert F Krueger
- Department of Psychology, University of MinnesotaMinneapolis, MN, 55455, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook UniversityStony Brook, NY, 11794, USA
| |
Collapse
|