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Yalch MM. Dimensional approaches to studying, assessing, and treating traumatic stress: Introduction to the Special Section. J Trauma Stress 2024; 37:357-360. [PMID: 38580619 DOI: 10.1002/jts.23045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/07/2024]
Abstract
Dimensional models of psychopathology are gaining empirical support and are, thus, increasingly common in research and clinical practice. This is true for traumatic stress studies, although the movement toward dimensional conceptualizations of traumatic stress may be somewhat slower, perhaps due at least in part to how trauma is diagnosed. The purpose of this special section is to collect and showcase cutting-edge basic, applied, and conceptual work on dimensional models of traumatic stress. Its goal is to highlight the utility of such models and to facilitate greater connection between traumatic stress studies and the broader dimensional movement in psychopathology.
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Affiliation(s)
- Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
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2
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Caspi A, Houts RM, Fisher HL, Danese A, Moffitt TE. The general factor of psychopathology (p): Choosing among competing models and interpreting p. Clin Psychol Sci 2024; 12:53-82. [PMID: 38236494 PMCID: PMC10794018 DOI: 10.1177/21677026221147872] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Over the past 10 years, the general factor of psychopathology, p, has attracted interest and scrutiny. We review the history of the idea that all mental disorders share something in common, p; how we arrived at this idea; and how it became conflated with a statistical representation, the Bi-Factor Model. We then leverage the Environmental Risk (E-Risk) longitudinal twin study to examine the properties and nomological network of different statistical representations of p. We find that p performed similarly regardless of how it was modelled, suggesting that if the sample and content are the same the resulting p factor will be similar. We suggest that the meaning of p is not to be found by dueling over statistical models but by conducting well-specified criterion-validation studies and developing new measurement approaches. We outline new directions to refresh research efforts to uncover what all mental disorders have in common.
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Affiliation(s)
- Avshalom Caspi
- Department of Psychology & Neuroscience, Duke University
- PROMENTA, Department of Psychology, University of Oslo
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
| | | | - Helen L. Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, Kings’ College London, London, UK
| | - Andrea Danese
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
- National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Terrie E. Moffitt
- Department of Psychology & Neuroscience, Duke University
- PROMENTA, Department of Psychology, University of Oslo
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
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3
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Taylor JJ, Lin C, Talmasov D, Ferguson MA, Schaper FLWVJ, Jiang J, Goodkind M, Grafman J, Etkin A, Siddiqi SH, Fox MD. A transdiagnostic network for psychiatric illness derived from atrophy and lesions. Nat Hum Behav 2023; 7:420-429. [PMID: 36635585 PMCID: PMC10236501 DOI: 10.1038/s41562-022-01501-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 11/23/2022] [Indexed: 01/13/2023]
Abstract
Psychiatric disorders share neurobiology and frequently co-occur. This neurobiological and clinical overlap highlights opportunities for transdiagnostic treatments. In this study, we used coordinate and lesion network mapping to test for a shared brain network across psychiatric disorders. In our meta-analysis of 193 studies, atrophy coordinates across six psychiatric disorders mapped to a common brain network defined by positive connectivity to anterior cingulate and insula, and by negative connectivity to posterior parietal and lateral occipital cortex. This network was robust to leave-one-diagnosis-out cross-validation and specific to atrophy coordinates from psychiatric versus neurodegenerative disorders (72 studies). In 194 patients with penetrating head trauma, lesion damage to this network correlated with the number of post-lesion psychiatric diagnoses. Neurosurgical ablation targets for psychiatric illness (four targets) also aligned with the network. This convergent brain network for psychiatric illness may partially explain high rates of psychiatric comorbidity and could highlight neuromodulation targets for patients with more than one psychiatric disorder.
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Affiliation(s)
- Joseph J Taylor
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Christopher Lin
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Talmasov
- Departments of Neurology and Psychiatry, Columbia University Medical Center, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Michael A Ferguson
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for the Study of World Religions, Harvard Divinity School, Cambridge, MA, USA
| | - Frederic L W V J Schaper
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jing Jiang
- Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Iowa Neuroscience Institute, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Madeleine Goodkind
- Departments of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
- New Mexico Veterans Affairs Healthcare System, Albuquerque, NM, USA
| | - Jordan Grafman
- Departments of Physical Medicine and Rehabilitation, Neurology, & Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Shirley Ryan Ability Lab, Chicago, IL, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Wu Tsai Neurosciences Institute at Stanford, Stanford University School of Medicine, Stanford, CA, USA
- Alto Neuroscience, Los Altos, CA, USA
| | - Shan H Siddiqi
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael D Fox
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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4
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Monk NJ, McLeod GFH, Mulder RT, Spittlehouse JK, Boden JM. Childhood anxious/withdrawn behaviour and later anxiety disorder: a network outcome analysis of a population cohort. Psychol Med 2023; 53:1343-1354. [PMID: 34425926 DOI: 10.1017/s0033291721002889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Several previous studies have identified a continuity between childhood anxiety/withdrawal and anxiety disorder (AD) in later life. However, not all children with anxiety/withdrawal problems will experience an AD in later life. Previous studies have shown that the severity of childhood anxiety/withdrawal accounts for some of the variability in AD outcomes. However, no studies to date have investigated how variation in features of anxiety/withdrawal may relate to continuity prognoses. The present research addresses this gap. METHODS Data were gathered as part of the Christchurch Health and Development Study, a 40-year population birth cohort of 1265 children born in Christchurch, New Zealand. Fifteen childhood anxiety/withdrawal items were measured at 7-9 years and AD outcomes were measured at various interviews from 15 to 40 years. Six network models were estimated. Two models estimated the network structure of childhood anxiety/withdrawal items independently for males and females. Four models estimated childhood anxiety/withdrawal items predicting adolescent AD (14-21 years) and adult AD (21-40 years) in both males and females. RESULTS Approximately 40% of participants met the diagnostic criteria for an AD during both the adolescent (14-21 years) and adult (21-40 years) outcome periods. Outcome networks showed that items measuring social and emotional anxious/withdrawn behaviours most frequently predicted AD outcomes. Items measuring situation-based fears and authority figure-specific anxious/withdrawn behaviour did not consistently predict AD outcomes. This applied across both the male and female subsamples. CONCLUSIONS Social and emotional anxious/withdrawn behaviours in middle childhood appear to carry increased risk for AD outcomes in both adolescence and adulthood.
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Affiliation(s)
- Nathan J Monk
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Canterbury, New Zealand
| | - Geraldine F H McLeod
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Canterbury, New Zealand
| | - Roger T Mulder
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Canterbury, New Zealand
| | - Janet K Spittlehouse
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Canterbury, New Zealand
| | - Joseph M Boden
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Canterbury, New Zealand
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5
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van den Berg H. Evaluating the validity of animal models of mental disorder: from modeling syndromes to modeling endophenotypes. HISTORY AND PHILOSOPHY OF THE LIFE SCIENCES 2022; 44:59. [PMID: 36357538 PMCID: PMC9649475 DOI: 10.1007/s40656-022-00537-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
This paper provides a historical analysis of a shift in the way animal models of mental disorders were conceptualized: the shift from the mid-twentieth-century view, adopted by some, that animal models model syndromes classified in manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), to the later widespread view that animal models model component parts of psychiatric syndromes. I argue that in the middle of the twentieth century the attempt to maximize the face validity of animal models sometimes led to the pursuit of the ideal of an animal model that represented a behaviorally defined psychiatric syndrome as described in manuals such as the DSM. I show how developments within psychiatric genetics and related criticism of the DSM in the 1990s and 2000s led to the rejection of this ideal and how researchers in the first decade of the twenty-first century came to believe that animal models of mental disorders should model component parts of mental disorders, adopting a so-called endophenotype approach.
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Affiliation(s)
- Hein van den Berg
- Department of Philosophy, Institute for Logic, Language and Computation, University of Amsterdam, Postbus 94201 1090 GE, Amsterdam, The Netherlands.
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6
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McCarty SM, Dunsmore JC. Adolescents’ perceptions of helping and aggressing at school: Salience of benefit-harm, extent of impact, and collective dyadic power. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03806-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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7
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Patti MA, Kelsey KT, MacFarlane AJ, Papandonatos GD, Arbuckle TE, Ashley-Martin J, Fisher M, Fraser WD, Lanphear BP, Muckle G, Braun JM. Maternal Folate Status and the Relation between Gestational Arsenic Exposure and Child Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11332. [PMID: 36141604 PMCID: PMC9517145 DOI: 10.3390/ijerph191811332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
Gestational arsenic exposure adversely impacts child health. Folate-mediated 1-carbon metabolism facilitates urinary excretion of arsenic and may prevent arsenic-related adverse health outcomes. We investigated the potential for maternal folate status to modify associations between gestational arsenic exposure and child health. We used data from 364 mother-child pairs in the MIREC study, a prospective pan-Canadian cohort. During pregnancy, we measured first trimester urinary arsenic concentrations, plasma folate biomarkers, and folic acid supplementation intake. At age 3 years, we evaluated twelve neurodevelopmental and anthropometric features. Using latent profile analysis and multinomial regression, we developed phenotypic profiles of child health, estimated covariate-adjusted associations between arsenic and these phenotypic profiles, and evaluated whether folate status modified these associations. We identified three phenotypic profiles of neurodevelopment and three of anthropometry, ranging from less to more optimal child health. Gestational arsenic was associated with decreased odds of optimal neurodevelopment. Maternal folate status did not modify associations of arsenic with neurodevelopmental phenotypic profiles, but gestational arsenic was associated with increased odds of excess adiposity among those who exceed recommendations for folic acid (>1000 μg/day). However, arsenic exposure was low and folate status was high. Gestational arsenic exposure may adversely impact child neurodevelopment and anthropometry, and maternal folate status may not modify these associations; however, future work should examine these associations in more arsenic-exposed or lower folate-status populations.
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Affiliation(s)
- Marisa A. Patti
- Department of Epidemiology, Brown University, 121 S Main St., Providence, RI 02903, USA
| | - Karl T. Kelsey
- Department of Epidemiology, Brown University, 121 S Main St., Providence, RI 02903, USA
| | - Amanda J. MacFarlane
- Nutrition Research Division, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON K1A 0K9, Canada
- Department of Biology, Carleton University, 1125 Colonel By Dr., Ottawa, ON K1S 5B6, Canada
| | - George D. Papandonatos
- Department of Biostatistics, Brown University, 121 S Main St., Providence, RI 02903, USA
| | - Tye E. Arbuckle
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Branch, Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0K9, Canada
| | - Jillian Ashley-Martin
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Branch, Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0K9, Canada
| | - Mandy Fisher
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Branch, Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0K9, Canada
| | - William D. Fraser
- Department D’obstétrique et Gynécologie, Université de Sherbrooke, 2500 Bd de L’Université, Sherbrooke, QC J1K 2R1, Canada
| | - Bruce P. Lanphear
- Department of Health Sciences, Simon Fraser University, 515 W Haastings St., Vancouver, BC V5A 1S6, Canada
| | - Gina Muckle
- School of Psychology, Université Laval, Ville de Québec, 2325 Rue de L’Université, Québec, QC G1V 0B4, Canada
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, 121 S Main St., Providence, RI 02903, USA
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8
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López I, Förster J. Trastornos del neurodesarrollo: dónde estamos hoy y hacia dónde nos dirigimos. REVISTA MÉDICA CLÍNICA LAS CONDES 2022. [DOI: 10.1016/j.rmclc.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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9
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Woodling C, Wygant DB, Umlauf RL, Marek RJ. Somatoform's placement and validity in the hierarchical taxonomy of psychopathology (HiTOP). Psychiatry Res 2022; 313:114593. [PMID: 35533473 DOI: 10.1016/j.psychres.2022.114593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/04/2022] [Accepted: 04/30/2022] [Indexed: 11/24/2022]
Abstract
Limitations of a polythetic-categorical classification system has sparked ongoing quantitative efforts to establish a valid and reliable method for diagnosing mental illness. Dimensional methods of classification, such as the Hierarchical Taxonomy of Psychopathology (HiTOP), have been found to ameliorate the limitations of a categorical approach - despite the provisional placement of a Somatoform spectrum. The current investigation sought to elucidate the placement of the Somatoform spectrum within the HiTOP model, and to further corroborate discriminant and convergent validity of the Somatoform spectrum. Using a sample of patients seeking chronic low-back pain treatment (n = 200), superior model fit suggested Somatoform fits better as a separate spectrum from Internalizing and placing Somatoform as a subfactor of Internalizing did not improve model fit. Discriminant and convergent validity with an external criteria demonstrated distinctiveness of the Somatoform spectrum from the Internalizing spectrum in the HiTOP model.
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Affiliation(s)
- Chloe Woodling
- Department of Psychological Sciences, Ball State University, Indiana
| | - Dustin B Wygant
- Department of Psychology, Eastern Kentucky University, Kentucky
| | | | - Ryan J Marek
- Department of Primary Care and Clinical Medicine, Sam Houston State University, Texas.
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10
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Development and psychometric evaluation of a teacher version of the Ontario child health study emotional behavioural scales (OCHS-EBS-T) for measuring selected DSM-5 disorders in elementary school-aged children. Psychiatry Res 2022; 312:114574. [PMID: 35533590 DOI: 10.1016/j.psychres.2022.114574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022]
Abstract
This paper describes the development and psychometric properties of a teacher version of the Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS-T) for dimensional measurement of six psychiatric disorders in elementary school-aged children based on DSM-5 criteria. Psychometric evaluation of the item and scale properties was conducted in a large, general population study of elementary teacher assessments of 3,072 children aged 4 to 13 years in 2,354 families in Ontario, Canada. Content validity, internal construct validity and internal consistency reliability of the six disorder subscales were assessed. Structural equation modelling was used to assess measurement invariance, internal and external convergent and discriminant validity. Confirmatory factor analyses confirmed unidimensionality of subscales and adequate item-fit to all scales. Measurement equivalence was demonstrated fully for four subscales and partially for two. Internal consistency reliability for all subscales exceeded 0.78, except for the conduct disorder scale in 12- to 13-year-olds. Evidence of internal convergent validity was demonstrated in all cases. Discriminant validity was demonstrated in 27 out of 30 correlation comparisons. External convergent and discriminant validity was demonstrated when comparing the OCHS-EBS-T to a parent/caregiver measure of disorders in 48 out of 60 correlation comparisons. All subscales independently predicted child mental health-related service contact.
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11
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Confirmatory Factor Analysis of Comorbidity between Depression and Aggression in a Child-Adolescent Community Sample: Nosological, Prognosis and Etiological Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084424. [PMID: 35457292 PMCID: PMC9030933 DOI: 10.3390/ijerph19084424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 12/07/2022]
Abstract
Comorbidity between depression and aggression in the child-adolescent population remains a controversial phenomenon. To our knowledge, no longitudinal study using structural equation modeling (SEM) has confirmed whether the relationship between depression and aggression is due to the fact that they share internalizing and externalizing supraordinal factors at the level of the syndrome or is due to the fact that they share common characteristics in relation to an underlying factor at the level of symptoms. We examined longitudinal comorbid relationships in a community sample (N = 251) at three waves ages from 10 to 13 years. The SEM showed that longitudinally, the comorbidity between depression and aggression is due to the fact that they share characteristics of the same underlying factor at the symptom level. These results have implications for the classification, diagnosis, and treatment of comorbidity between depression and aggression in a child-adolescent population.
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12
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Hayne DP, Phillips W, Cosh SM, Price I. Examining personality trait patterns in transdiagnostic dimensions of psychopathology. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Watson D, Levin-Aspenson HF, Waszczuk MA, Conway CC, Dalgleish T, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs KA, Michelini G, Nelson BD, Sellbom M, Slade T, South SC, Sunderland M, Waldman I, Witthöft M, Wright AGC, Kotov R, Krueger RF. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum. World Psychiatry 2022; 21:26-54. [PMID: 35015357 PMCID: PMC8751579 DOI: 10.1002/wps.20943] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma-related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.
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Affiliation(s)
- David Watson
- Department of Psychology, University of Notre Dame, South Bend, IN, USA
| | | | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | - Tim Dalgleish
- Medical Research Council, Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Michael N Dretsch
- US Army Medical Research Directorate - West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, WA, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey A Hobbs
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Giorgia Michelini
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Irwin Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Michael Witthöft
- Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, University of Mainz, Mainz, Germany
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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14
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Chi X, Chen S, Chen Y, Chen D, Yu Q, Guo T, Cao Q, Zheng X, Huang S, Hossain MM, Stubbs B, Yeung A, Zou L. Psychometric Evaluation of the Fear of COVID-19 Scale Among Chinese Population. Int J Ment Health Addict 2022; 20:1273-1288. [PMID: 33456407 PMCID: PMC7799163 DOI: 10.1007/s11469-020-00441-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 01/31/2023] Open
Abstract
Fear is a negative emotional reaction to or persistent worry over an imminent public health event like COVID-19. The COVID-Fear Scale was developed in many countries, but not in China. The current study aims to examine the psychometric properties of Chinese version of the Fear of COVID-19 Scale. Translation into Chinese and back-translation into English were conducted firstly. Item analysis and exploratory factor analysis were conducted in Sample 1, followed by validity tests in Sample 2. Likely, test-retest reliability was conducted in sample 3. A bifactor structure of Chinese version of FCV-19S with a general fear factor and two orthogonal group factors with fear thoughts and physical response was confirmed. Besides, it has good internal consistency reliability (α = .92), composite reliability (CR = .92), and validity correlation validity. The results of the present study confirmed that the Chinese version of FCV-19S has good psychometric properties in the Chinese communities. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-020-00441-7.
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Affiliation(s)
- Xinli Chi
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Shiyun Chen
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Yuying Chen
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Danying Chen
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Qian Yu
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Tianyou Guo
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Qianyu Cao
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Xiaodan Zheng
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Shaojie Huang
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
| | - Md Mahhub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Liye Zou
- Institute of Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
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15
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London EB, Yoo JH. From Research to Practice: Toward the Examination of Combined Interventions for Autism Spectrum Disorders. Brain Sci 2021; 11:1073. [PMID: 34439691 PMCID: PMC8391105 DOI: 10.3390/brainsci11081073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 12/04/2022] Open
Abstract
The use of biological (i.e., medications) in conjunction with applied behavior analysis is relatively common among people with ASD, yet research examining its benefit is scarce. This paper provides a brief overview of the existing literature on the combined interventions, including promising developments, and examines the existing barriers that hinder research in this area, including the heavy reliance on RCTs. Recommendations for possible solutions, including the creation of health homes, are provided in order to move toward a more integrated approach.
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Affiliation(s)
- Eric Bart London
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road Staten Island, New York, NY 10314, USA;
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16
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Bakker GM. Psychotherapy outcome research: Implications of a new clinical taxonomy. Clin Psychol Psychother 2021; 29:178-199. [PMID: 34180112 DOI: 10.1002/cpp.2638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 11/11/2022]
Abstract
Since the publication of DSM-III in 1980, the scientist-practitioner gap in clinical psychology has expanded, as almost all outcome research in clinical psychology has been on diagnosed mental disorders within a medical model using drug trial methodologies, whereas most practising clinicians undertake functional analyses and case formulations of clinical psychological problems (CPPs) and then apply tailored interventions within an ongoing hypothesis-testing methodology. But comparatively reliable assessment and generalizable conclusions in psychotherapy outcome research require a comprehensive theory-derived conception or operational definition of 'CPPs', standardized functional analyses, and a taxonomy of CPPs comparable to DSM's listings of mental disorders. An alternative conception and taxonomy of CPPs have recently been proposed, offering improvements in the reliability and generalizability of case formulation-based psychotherapy outcome research. It conceives of CPPs as instances of the formation and operation of self-sustaining problem-maintaining circles (PMCs) of psychological-level causal elements-that is, at the level of cognitions, behaviours, emotions, and events or situations (stimuli). The paper describes this new conception of CPPs, a subsequent nascent taxonomy of evidence-based PMCs which standardizes the underlying mechanisms that maintain CPPs, and ensuing benefits to research (as well as to practice) in clinical psychology. These benefits include being able to encompass all treatment-worthy CPPs, not just diagnosable mental disorders; to assess theory-derived intervention strategies, not just arbitrary therapy bundles; and to directly feed back into psychological theories, not just expand an atheoretical list of patented "evidence supported therapies."
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Affiliation(s)
- Gary M Bakker
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
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17
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Psychopathology and Neurocognition in the Era of the p-Factor: The Current Landscape and the Road Forward. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2030018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Neurocognitive abilities have frequently been claimed to be involved in the aetiology of psychopathology. Neurocognitive deficits have been reported across many disorders, and theoretical perspectives associate these deficits to the onset and maintenance of the symptomology. Recently, the heterogeneity of symptoms, and comorbidity of disorders, have motivated the development of structural models of psychopathology. Structural models indicate that factors such as internalising, externalising, thought disorder and the p-factor account for a wide variety of symptomology. It is unclear how neurocognitive abilities are best examined within these structures to advance our understanding of psychopathology. In this paper, we use Caspi et al.’s seminal writings as a framework to describe how neurocognitive abilities have been previously associated with categorical disorders and recently associated, and claimed to drive, the factors of psychopathology. We discuss the implications of the p-factor as a substantive construct or statistical artefact, and how this impacts the exploration of neurocognitive abilities and psychopathology. Further, we provide the case for alternative structural approaches, describe an innovative hypothesis of neurocognitive functioning, the multidimensional hypothesis, and explain how this may further our understanding of the heterogeneity of neurocognitive performance and psychopathology at the individual level. Finally, we provide a road forward for the future examination of neurocognitive abilities in psychopathology.
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18
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Understanding trajectories of underlying dimensions of posttraumatic psychopathology. J Affect Disord 2021; 284:75-84. [PMID: 33588239 PMCID: PMC7927420 DOI: 10.1016/j.jad.2021.01.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Research suggests four modal trajectories of psychological symptoms after traumatic injury: Resilient, Chronic, Delayed Onset, Recovery. However, most studies focus on symptoms of psychiatric disorders (e.g., posttraumatic stress disorder, depression), which are limited by heterogeneity and symptom overlap. We examined trajectories of cross-cutting posttraumatic symptom dimensions following traumatic injury and predictors of trajectory membership. METHODS In this longitudinal study of 427 predominantly Hispanic/Latino traumatic injury survivors, posttraumatic psychopathology symptoms were assessed during hospitalization and approximately one and five months post-trauma. Using latent class growth analysis, we estimated trajectories of several posttraumatic symptom dimensions: re-experiencing, avoidance, anxious arousal, numbing, dysphoric arousal, loss, and threat. We then examined sociodemographic and trauma-related characteristics (measured during hospitalization) as predictors of trajectory membership for each dimension. RESULTS Four trajectories (Resilient, Chronic, Delayed Onset, Recovery) emerged for all dimensions except loss and threat, which manifested three trajectories (Resilient, Chronic, Delayed Onset). Across dimensions, membership in the Chronic (vs. Resilient) trajectory was consistently predicted by unemployment (7 of 7 dimensions), followed by older age (3/7), female sex (3/7), and assaultive trauma (2/7). For several dimensions, unemployment also distinguished between participants who presented with similar symptom levels days after trauma, but then diverged over time. LIMITATIONS Measures of posttraumatic symptom dimension constructs differed across assessments. CONCLUSIONS This study provides evidence of distinct trajectories across transdiagnostic symptom dimensions after traumatic injury. Employment status emerged as the most important predictor of trajectory membership. Research is needed to better understand the etiologies and consequences of these posttraumatic symptom dimension trajectories.
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19
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Mohamed Ali O, Kotelnikova Y, Kryski KR, Durbin CE, Hayden EP. Parent personality and children's inattention/hyperactivity problems are related via early caregiving. INFANT AND CHILD DEVELOPMENT 2021. [DOI: 10.1002/icd.2220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ola Mohamed Ali
- Department of Psychology, Brain and Mind Institute University of Western Ontario London Ontario Canada
| | - Yuliya Kotelnikova
- Department of Psychology The University of New Orleans New Orleans Louisiana USA
| | - Katie R. Kryski
- Department of Psychology, Brain and Mind Institute University of Western Ontario London Ontario Canada
| | - C. Emily Durbin
- Department of Psychology Michigan State University East Lansing Michigan USA
| | - Elizabeth P. Hayden
- Department of Psychology, Brain and Mind Institute University of Western Ontario London Ontario Canada
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20
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Kotov R, Krueger RF, Watson D, Cicero DC, Conway CC, DeYoung CG, Eaton NR, Forbes MK, Hallquist MN, Latzman RD, Mullins-Sweatt SN, Ruggero CJ, Simms LJ, Waldman ID, Waszczuk MA, Wright AGC. The Hierarchical Taxonomy of Psychopathology (HiTOP): A Quantitative Nosology Based on Consensus of Evidence. Annu Rev Clin Psychol 2021; 17:83-108. [PMID: 33577350 DOI: 10.1146/annurev-clinpsy-081219-093304] [Citation(s) in RCA: 168] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.
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Affiliation(s)
- Roman Kotov
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York 11794, USA;
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - David C Cicero
- Department of Psychology, University of North Texas, Denton, Texas 76203, USA
| | | | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Nicholas R Eaton
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York 11794, USA;
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Macquarie Park, New South Wales 2109, Australia
| | - Michael N Hallquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, Georgia 30303, USA
| | | | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, Texas 76203, USA
| | - Leonard J Simms
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, New York 14260, USA
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, Georgia 30322, USA
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University, North Chicago, Illinois 60064, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
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21
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Kim YR, Tyrer P, Hwang ST. Personality Assessment Questionnaire for ICD-11 personality trait domains: Development and testing. Personal Ment Health 2021; 15:58-71. [PMID: 32638542 DOI: 10.1002/pmh.1493] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 06/09/2020] [Accepted: 06/21/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND We aimed to develop a questionnaire suitable for the assessment of trait domains in the forthcoming International Classification of Diseases 11th Revision (ICD-11). This questionnaire, the Personality Assessment Questionnaire for ICD-11 (PAQ-11) personality trait domains, was intended as a short and reliable self-report measure. METHOD The initial items were derived from the relevant traits of an established version of the Personality Assessment Schedule. In Phase 1, item selection and scale construction proceeded iteratively using data from 334 female university students and 75 psychiatric patients (combined N = 409) in Korea. In Phase 2, a validation study of the scale was conducted in a subset of the sample from Phase 1, who were deemed to be at high risk of personality disorders (N = 210). RESULTS Exploratory and confirmatory factor analyses of the Personality Assessment Schedule items created a 17-item scale. This scale, PAQ-11, demonstrated adequate convergent and discriminant validity with the five-factor model, the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition traits model and emotional difficulties. The results were consistent with its underlying theoretical structure. CONCLUSIONS The PAQ-11 appears to be potentially promising in terms of clinical utility to assess the five domains of ICD-11 personality disorders. More research must be conducted in other cultural backgrounds with gender-balanced populations. © 2020 John Wiley & Sons, Ltd.
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Affiliation(s)
- Youl-Ri Kim
- Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, Korea.,Institute of Eating Disorders and Mental Health, Inje University, Seoul, Korea
| | - Peter Tyrer
- Centre for Mental Health, Department of Medicine, Imperial College, London, UK
| | - Soon-Taeg Hwang
- Department of Psychology, Chungbuk National University, Cheongju, Korea
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22
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Zimmerman M. Why hierarchical dimensional approaches to classification will fail to transform diagnosis in psychiatry. World Psychiatry 2021; 20:70-71. [PMID: 33432768 PMCID: PMC7801851 DOI: 10.1002/wps.20815] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Mark Zimmerman
- Department of Psychiatry and Human BehaviorBrown University School of Medicine, Rhode Island HospitalProvidenceRIUSA
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23
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Hook RW, Grant JE, Ioannidis K, Tiego J, Yücel M, Wilkinson P, Chamberlain SR. Trans-diagnostic measurement of impulsivity and compulsivity: A review of self-report tools. Neurosci Biobehav Rev 2021; 120:455-469. [PMID: 33115636 PMCID: PMC7116678 DOI: 10.1016/j.neubiorev.2020.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/15/2020] [Accepted: 10/14/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Impulsivity and compulsivity are important constructs, relevant to understanding behaviour in the general population, as well as in particular mental disorders (e.g. attention deficit hyperactivity disorder, obsessive-compulsive disorder). The current paper provides a narrative review of self-report impulsivity and compulsivity scales. METHODS A literature search was conducted using the following terms: ("impulsivity" OR "compulsivity") AND ("self-report" OR "questionnaire" OR "psychometric" OR "scale"). RESULTS 25 impulsive and 11 compulsive scales were identified, which varied considerably in psychometric properties, convenience, and validity. For impulsivity, the most commonly used scales were the BIS and the UPPS-P, whilst for compulsivity, the Padua Inventory was commonly used. The majority of compulsivity scales measured OCD symptoms (obsessions and compulsions) rather than being trans-diagnostic or specific to compulsivity (as opposed to obsessions). Scales capable of overcoming these limitations were highlighted. DISCUSSION This review provides clarity regarding relative advantages and disadvantages of different scales relevant to the measurement of impulsivity and compulsivity in many contexts. Areas for further research and refinement are highlighted.
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Affiliation(s)
- Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, United Kingdom.
| | - Jon E Grant
- Department of Psychiatry, University of Chicago, Pritzker School of Medicine, USA
| | - Konstantinos Ioannidis
- Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, UK
| | - Jeggan Tiego
- Neural Systems and Behaviour Lab, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Australia
| | - Paul Wilkinson
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, United Kingdom; Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, UK
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, United Kingdom; Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, UK
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24
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Abstract
We examine how depression relates to two broad affective dispositions which we call ‘Negative Temperament’ and ‘Positive Temperament’. Depressed individuals characteristically display a particular combination of these traits (high Negative/low Positive Temperament), which also defines the traditional ‘melancholic’ type. Other evidence, however, suggests that this pattern is not unique to depression, but may also characterize other types of disorder: high Negative Temperament, in particular, appears to be nonsignificantly associated with distress‐based psychopathology. Finally, we review data indicating that the etiology of these relations is highly complex. Specifically, it appears that (i) temperament influences the development and course of depression; (ii) depressive episodes can lead to significant changes in temperament, some of which may be permanent; and (iii) temperament and depression may reflect, in part, a common genetic diathesis.
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25
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Royston R, Oliver C, Howlin P, Dosse A, Armitage P, Moss J, Waite J. The Profiles and Correlates of Psychopathology in Adolescents and Adults with Williams, Fragile X and Prader-Willi Syndromes. J Autism Dev Disord 2020; 50:893-903. [PMID: 31802317 PMCID: PMC7010621 DOI: 10.1007/s10803-019-04317-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Psychopathology is prevalent in Williams (WS), fragile X (FXS) and Prader–Willi (PWS) syndromes. However, little is known about the potential correlates of psychopathology in these groups. A questionnaire study was completed by 111 caregivers of individuals with WS (n = 35); FXS (n = 50) and PWS (n = 26). Mean age was 26 years (range 12–57 years); 74 (67%) were male. Multiple regression analyses indicated that higher rates of health problems and sensory impairments predicted higher psychopathology in WS (p < .0001). In PWS, poorer adaptive ability predicted higher overall psychiatric disturbance (p = .001), generalised anxiety (p = .006) and hyperactivity (p = .003). There were no significant predictors in FXS. This study highlights dissociations in the potential risk markers of psychopathology between genetic syndromes. Implications for intervention are discussed.
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Affiliation(s)
- R Royston
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,Division of Psychiatry, University College London, London, W1T 7NF, UK.
| | - C Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - P Howlin
- Department of Psychology, King's College London, Strand, London, WC2R 2LS, UK
| | - A Dosse
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - P Armitage
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - J Moss
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,Institute of Cognitive Neuroscience, University College London, Alexandra House, 17 Queen Square, London, WC1N 3AZ, UK
| | - J Waite
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,School of Life & Health Sciences, Aston University, Birmingham, B4 7ET, UK
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26
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Tang A, Crawford H, Morales S, Degnan KA, Pine DS, Fox NA. Infant behavioral inhibition predicts personality and social outcomes three decades later. Proc Natl Acad Sci U S A 2020; 117:9800-9807. [PMID: 32312813 PMCID: PMC7211953 DOI: 10.1073/pnas.1917376117] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Does infant temperament predict adult personality and life-course patterns? To date, there is scant evidence examining relations between child temperament and adult outcomes, and extant research has relied on limited methods for measuring temperament such as maternal report. This prospective longitudinal study followed a cohort of infants (n = 165) for three decades to examine whether infant behavioral inhibition, a temperament characterized by cautious and fearful behaviors to unfamiliar situations, shapes long-term personality, social relationships, vocational/education, and mental health outcomes in adulthood. At age 14 mo, behavioral inhibition was assessed using an observation paradigm. In adolescence (15 y; n = 115), error monitoring event-related potentials were measured in a flanker task. In adulthood (26 y; n = 109), personality, psychopathology, and sociodemographics were self-reported using questionnaires. We found that infants with higher levels of behavioral inhibition at 14 mo grew up to become more reserved and introverted adults (β = 0.34) with lower social functioning with friends and family (β = -0.23) at age 26. Infant behavioral inhibition was also a specific risk factor for adult internalizing (i.e., anxiety and depression, β = 0.20) psychopathology, rather than a transdiagnostic risk for general and externalizing psychopathology. We identified a neurophysiologic mechanism underlying risk and resilience for later psychopathology. Heightened error monitoring in adolescence moderated higher levels of adult internalizing psychopathology among behaviorally inhibited individuals. These findings suggest meaningful continuity between infant temperament and the development of adult personality. They provide the earliest evidence suggesting that the foundation of long-term well-being is rooted in individual differences in temperament observed in infancy.
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20740;
| | - Haley Crawford
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20740
| | - Santiago Morales
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20740
| | - Kathryn A Degnan
- Department of Psychology, Catholic University of America, Washington, DC 20064
| | - Daniel S Pine
- Intramural Research Program, National Institutes of Mental Health, Bethesda, MD 20892
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20740
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27
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Siless V, Hubbard NA, Jones R, Wang J, Lo N, Bauer CCC, Goncalves M, Frosch I, Norton D, Vergara G, Conroy K, De Souza FV, Rosso IM, Wickham AH, Cosby EA, Pinaire M, Hirshfeld-Becker D, Pizzagalli DA, Henin A, Hofmann SG, Auerbach RP, Ghosh S, Gabrieli J, Whitfield-Gabrieli S, Yendiki A. Image acquisition and quality assurance in the Boston Adolescent Neuroimaging of Depression and Anxiety study. Neuroimage Clin 2020; 26:102242. [PMID: 32339824 PMCID: PMC7184183 DOI: 10.1016/j.nicl.2020.102242] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/19/2020] [Accepted: 03/10/2020] [Indexed: 12/18/2022]
Abstract
The Connectomes Related to Human Diseases (CRHD) initiative was developed with the Human Connectome Project (HCP) to provide high-resolution, open-access, multi-modal MRI data to better understand the neural correlates of human disease. Here, we present an introduction to a CRHD project, the Boston Adolescent Neuroimaging of Depression and Anxiety (BANDA) study, which is collecting multimodal neuroimaging, clinical, and neuropsychological data from 225 adolescents (ages 14-17), 150 of whom are expected to have a diagnosis of depression and/or anxiety. Our transdiagnostic recruitment approach samples the full spectrum of depressed/anxious symptoms and their comorbidity, consistent with NIMH Research Domain Criteria (RDoC). We focused on an age range that is critical for brain development and for the onset of mental illness. This project sought to harmonize imaging sequences, hardware, and functional tasks with other HCP studies, although some changes were made to canonical HCP methods to accommodate our study population and questions. We present a thorough overview of our imaging sequences, hardware, and scanning protocol. We detail similarities and differences between this study and other HCP studies. We evaluate structural-, diffusion-, and functional-image-quality measures that may be influenced by clinical factors (e.g., disorder, symptomatology). Signal-to-noise and motion estimates from the first 140 adolescents suggest minimal influence of clinical factors on image quality. We anticipate enrollment of an additional 85 participants, most of whom are expected to have a diagnosis of anxiety and/or depression. Clinical and neuropsychological data from the first 140 participants are currently freely available through the National Institute of Mental Health Data Archive (NDA).
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Affiliation(s)
- Viviana Siless
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Nicholas A Hubbard
- Massachusetts Institute of Technology, Cambridge, MA, United States; University of Nebraska, Lincoln, Lincoln, NE, United States
| | - Robert Jones
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Jonathan Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Nicole Lo
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Clemens C C Bauer
- Massachusetts Institute of Technology, Cambridge, MA, United States; Northeastern University, Department of Psychology, Boston, MA, United States
| | | | - Isabelle Frosch
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Daniel Norton
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | | | | | | | - Isabelle M Rosso
- McLean Hospital, Belmont, MA, United States; Harvard Medical School, Boston, MA, United States
| | | | | | | | | | | | - Aude Henin
- Massachusetts General Hospital, Boston, MA, United States
| | | | | | - Satrajit Ghosh
- Harvard Medical School, Boston, MA, United States; Massachusetts Institute of Technology, Cambridge, MA, United States
| | - John Gabrieli
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Susan Whitfield-Gabrieli
- Massachusetts Institute of Technology, Cambridge, MA, United States; Northeastern University, Department of Psychology, Boston, MA, United States
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
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28
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Ruggero CJ, Kotov R, Hopwood CJ, First M, Clark LA, Skodol AE, Mullins-Sweatt SN, Patrick CJ, Bach B, Cicero DC, Docherty A, Simms LJ, Bagby RM, Krueger RF, Callahan JL, Chmielewski M, Conway CC, De Clercq B, Dornbach-Bender A, Eaton NR, Forbes MK, Forbush KT, Haltigan JD, Miller JD, Morey LC, Patalay P, Regier DA, Reininghaus U, Shackman AJ, Waszczuk MA, Watson D, Wright AGC, Zimmermann J. Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice. J Consult Clin Psychol 2020; 87:1069-1084. [PMID: 31724426 DOI: 10.1037/ccp0000452] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimensional approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge. METHOD The present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice. RESULTS Potential advantages and limitations of the HiTOP model for clinical utility are reviewed, including with respect to case conceptualization and treatment planning. A HiTOP approach to practice is illustrated and contrasted with an approach based on traditional nosology. Common barriers to using HiTOP in real-world health care settings and solutions to these barriers are discussed. CONCLUSIONS HiTOP represents a viable alternative to classifying mental illness that can be integrated into practice today, although research is needed to further establish its utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University
| | | | - Michael First
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University
| | | | | | | | | | - Bo Bach
- Psychiatric Research Unit, Slagelse Psychiatric Hospital
| | | | | | - Leonard J Simms
- Department of Psychology, University at Buffalo, The State University of New York
| | - R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto
| | | | | | | | | | - Barbara De Clercq
- Department of Developmental, Personality, and Social Psychology, Ghent University
| | | | | | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | | | | | | | | | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, University College London
| | - Darrel A Regier
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University
| | | | | | | | - David Watson
- Department of Psychology, University of Notre Dame
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29
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Towards a new model of understanding – The triple network, psychopathology and the structure of the mind. Med Hypotheses 2019; 133:109385. [DOI: 10.1016/j.mehy.2019.109385] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/22/2019] [Accepted: 08/28/2019] [Indexed: 11/22/2022]
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30
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Khoo S, Stanton K, Clark LA, Watson D. Facet-Level Personality Relations of the Symptom Dimensions of the Tripartite Model. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09763-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Allen TA, DeYoung CG, Bagby RM, Pollock BG, Quilty LC. A Hierarchical Integration of Normal and Abnormal Personality Dimensions: Structure and Predictive Validity in a Heterogeneous Sample of Psychiatric Outpatients. Assessment 2019; 27:643-656. [PMID: 31729250 DOI: 10.1177/1073191119887442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hierarchical, quantitative models of psychopathology focus primarily on higher-order constructs, whereas less is known about the structure and content comprising lower-order dimensions of psychopathology. Here, we address this gap in the literature by using targeted factor analysis to integrate the 25 maladaptive facet-level traits of the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorder-Fifth edition and the 10 aspect-level traits of the normal personality hierarchy within a sample of 198 psychiatric outpatients. A 10-factor solution replicated previous work, with each of the 10 aspects primarily characterizing only one factor. In addition, the 10 factors differentially predicted a range of diagnoses, including alcohol use disorder, major depression, panic disorder, social anxiety, and borderline and avoidant personality disorders. Our results suggest that research on the development, causes, and structure of lower-order traits within the normal personality hierarchy may serve as an important guide to research on the causes and structure of maladaptive personality.
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Affiliation(s)
| | | | - R Michael Bagby
- University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Bruce G Pollock
- University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lena C Quilty
- University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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32
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ERN as a transdiagnostic marker of the internalizing-externalizing spectrum: A dissociable meta-analytic effect. Neurosci Biobehav Rev 2019; 103:133-149. [DOI: 10.1016/j.neubiorev.2019.06.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/31/2019] [Accepted: 06/09/2019] [Indexed: 12/30/2022]
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33
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Bakker GM. A new conception and subsequent taxonomy of clinical psychological problems. BMC Psychol 2019; 7:46. [PMID: 31291999 PMCID: PMC6617608 DOI: 10.1186/s40359-019-0318-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/12/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A taxonomy of the objects of study, theory, assessment, and intervention is critical to the development of all clinical sciences. Clinical psychology has been conceptually and administratively dominated by the taxonomy of an adjacent discipline - psychiatry's Diagnostic and statistical manual of mental disorders (DSM). Many have called for a 'paradigm shift' away from a medical nosology of diseases toward clinical psychology's own taxonomy of clinical psychological problems (CPPs), without being able to specify what is to be listed and classified. MAIN TEXT An examination of DSM's problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists actually do, leads to the proposal that: The critical psychological-level phenomenon underlying CPPs is the occurrence of 'problem-maintaining circles' (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. This concept provides an empirically-derived, theory-based, treatment-relevant, categorical, essentialist, parsimonious, and nonstigmatizing definition of CPPs. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to 'counseling', clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be 'cured' by PMC-breaking alone. CONCLUSION A subsequent classification and coding system of PMCs is proposed, and expected benefits to research, communication, and the quality of case formulation in clinical psychology are described, reliant upon a development effort of some meaningful fraction of that which has been devoted to the DSM.
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Affiliation(s)
- Gary M Bakker
- School of Medicine, University of Tasmania, Locked Bag 1377, Launceston, Tasmania, 7250, Australia.
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34
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Duncan L, Georgiades K, Wang L, Comeau J, Ferro MA, Van Lieshout RJ, Szatmari P, Bennett K, MacMillan HL, Lipman EL, Janus M, Kata A, Boyle MH. The 2014 Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) Part I: A Checklist for Dimensional Measurement of Selected DSM-5 Disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:423-433. [PMID: 30376365 PMCID: PMC6591754 DOI: 10.1177/0706743718808250] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe the development and psychometric properties of the 2014 Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) for dimensional measurement of 7 disorders based on criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). METHODS Scale items were selected by agreement among 19 child psychologists and psychiatrists rating the correspondence between item descriptions and DSM-5 symptoms. Psychometric evaluation of the item properties and parent/caregiver and youth scales came from a general population study of 10,802 children and youth aged 4 to 17 years in 6537 families. Test-retest reliability data were collected from a subsample of 280 children and their caregivers who independently completed the OCHS-EBS checklist on 2 occasions 7 to 14 days apart. Structural equation modelling was used to assess internal and external convergent and discriminant validity-the latter tested against the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). RESULTS Confirmatory factor analyses exhibited adequate item fit to all scales. Except for conduct disorder and youth-assessed separation anxiety disorder, internal (Cronbach's α) and test-retest reliability (Pearson's r) for scale scores were 0.70 or above. Except for youth-assessed conduct disorder, the OCHS-EBS met criteria for internal and convergent and discriminant validity. Compared with the MINI-KID, the OCHS-EBS met criteria for external convergent and discriminant validity. CONCLUSIONS The OCHS-EBS provide reliable and valid dimensional measurement of 7 DSM-5 disorders assessed by caregivers and youth in the general population. Part II describes use of the OCHS-EBS as a categorical (present/absent) measure of disorder.
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Affiliation(s)
- Laura Duncan
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,3 Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Li Wang
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,3 Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario
| | - Jinette Comeau
- 4 Department of Sociology, King's University College at Western University, London, Ontario
| | - Mark A Ferro
- 5 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario
| | - Ryan J Van Lieshout
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Peter Szatmari
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,6 Department of Psychiatry, Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, Ontario
| | - Kathryn Bennett
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,3 Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario
| | - Harriet L MacMillan
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,7 Department of Paediatrics, McMaster University, Hamilton, Ontario
| | - Ellen L Lipman
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Magdalena Janus
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Anna Kata
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Michael H Boyle
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
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de Vos S, Patten S, Wit EC, Bos EH, Wardenaar KJ, de Jonge P. Subtyping psychological distress in the population: a semi-parametric network approach. Epidemiol Psychiatr Sci 2019; 29:e36. [PMID: 31088585 PMCID: PMC8061241 DOI: 10.1017/s204579601900026x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 02/24/2019] [Accepted: 04/14/2019] [Indexed: 11/08/2022] Open
Abstract
AIMS The mechanisms underlying both depressive and anxiety disorders remain poorly understood. One of the reasons for this is the lack of a valid, evidence-based system to classify persons into specific subtypes based on their depressive and/or anxiety symptomatology. In order to do this without a priori assumptions, non-parametric statistical methods seem the optimal choice. Moreover, to define subtypes according to their symptom profiles and inter-relations between symptoms, network models may be very useful. This study aimed to evaluate the potential usefulness of this approach. METHODS A large community sample from the Canadian general population (N = 254 443) was divided into data-driven clusters using non-parametric k-means clustering. Participants were clustered according to their (co)variation around the grand mean on each item of the Kessler Psychological Distress Scale (K10). Next, to evaluate cluster differences, semi-parametric network models were fitted in each cluster and node centrality indices and network density measures were compared. RESULTS A five-cluster model was obtained from the cluster analyses. Network density varied across clusters, and was highest for the cluster of people with the lowest K10 severity ratings. In three cluster networks, depressive symptoms (e.g. feeling depressed, restless, hopeless) had the highest centrality. In the remaining two clusters, symptom networks were characterised by a higher prominence of somatic symptoms (e.g. restlessness, nervousness). CONCLUSION Finding data-driven subtypes based on psychological distress using non-parametric methods can be a fruitful approach, yielding clusters of persons that differ in illness severity as well as in the structure and strengths of inter-symptom relationships.
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Affiliation(s)
- S. de Vos
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - S. Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - E. C. Wit
- University of Groningen, Johann Bernoulli Institute of Mathematics and Computer Science, Groningen, The Netherlands
| | - E. H. Bos
- Department of Developmental Psychology, University of Groningen, Faculty of Behavioural and Social Sciences, Groningen, The Netherlands
| | - K. J. Wardenaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, The Netherlands
| | - P. de Jonge
- Department of Developmental Psychology, University of Groningen, Faculty of Behavioural and Social Sciences, Groningen, The Netherlands
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36
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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: 51] [Impact Index Per Article: 10.2] [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.
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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
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37
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Abstract
Despite widespread use, how clinicians use the DSM in psychiatric practice is not well understood. Recognizing public and professional attitudes toward the DSM are integral to future DSM development, to assess a commonly held assumption such as that the DSM is used primarily for coding, and to assess its clinical utility. A convenience sample of Psychiatric Times readers was surveyed to assess the DSM's use in clinical practice. A total of 394 behavioral health care practitioners fully completed the online survey. Results suggest that the DSM, beyond administrative and billing use, is used for communication with health care providers, for teaching diagnoses to trainees, and, importantly, as an educational tool to inform patients and caregivers alike.
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38
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Cuthbert BN. The PRISM project: Social withdrawal from an RDoC perspective. Neurosci Biobehav Rev 2019; 97:34-37. [DOI: 10.1016/j.neubiorev.2018.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/02/2018] [Accepted: 08/10/2018] [Indexed: 11/26/2022]
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39
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Fingelkurts AA, Fingelkurts AA. Brain space and time in mental disorders: Paradigm shift in biological psychiatry. Int J Psychiatry Med 2019; 54:53-63. [PMID: 30073888 DOI: 10.1177/0091217418791438] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Contemporary psychiatry faces serious challenges because it has failed to incorporate accumulated knowledge from basic neuroscience, neurophilosophy, and brain-mind relation studies. As a consequence, it has limited explanatory power, and effective treatment options are hard to come by. A new conceptual framework for understanding mental health based on underlying neurobiological spatial-temporal mechanisms of mental disorders (already gained by the experimental studies) is beginning to emerge.
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40
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Affiliation(s)
- Colin G. DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Robert F. Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
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41
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Huprich SK. Moving beyond categories and dimensions in personality pathology assessment and diagnosis. Br J Psychiatry 2018; 213:685-689. [PMID: 30106357 DOI: 10.1192/bjp.2018.149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
It has been suggested that a dimensional model of personality pathology should be adopted for the development and refinement of personality disorder classification. In this article, the advantages and challenges of moving toward a dimensional model are briefly reviewed. However, it is suggested that although categories and dimensions are valuable frameworks for personality pathology diagnosis, an expansion beyond categories and dimensions is needed to improve the shortcoming seen in current diagnostic systems. Ideas and examples are offered for how this might occur.Declaration of interestNone.
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Affiliation(s)
- Steven K Huprich
- Professor, Department of Psychology,University of Detroit Mercy,USA
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42
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Elliott ML, Romer A, Knodt AR, Hariri AR. A Connectome-wide Functional Signature of Transdiagnostic Risk for Mental Illness. Biol Psychiatry 2018; 84:452-459. [PMID: 29779670 PMCID: PMC6119080 DOI: 10.1016/j.biopsych.2018.03.012] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND High rates of comorbidity, shared risk, and overlapping therapeutic mechanisms have led psychopathology research toward transdiagnostic dimensional investigations of clustered symptoms. One influential framework accounts for these transdiagnostic phenomena through a single general factor, sometimes referred to as the p factor, associated with risk for all common forms of mental illness. METHODS We build on previous research identifying unique structural neural correlates of the p factor by conducting a data-driven analysis of connectome-wide intrinsic functional connectivity (n = 605). RESULTS We demonstrate that higher p factor scores and associated risk for common mental illness maps onto hyperconnectivity between visual association cortex and both frontoparietal and default mode networks. CONCLUSIONS These results provide initial evidence that the transdiagnostic risk for common forms of mental illness is associated with patterns of inefficient connectome-wide intrinsic connectivity between visual association cortex and networks supporting executive control and self-referential processes, networks that are often impaired across categorical disorders.
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Affiliation(s)
- Maxwell L Elliott
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.
| | - Adrienne Romer
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Annchen R Knodt
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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43
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Abstract
In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able to measure a person's liability to mental disorder, comorbidity among disorders, persistence of disorders over time, and severity of symptoms. This single dimension of general psychopathology has been termed "p," because it conceptually parallels a dimension already familiar to behavioral scientists and clinicians: the "g" factor of general intelligence. As the g dimension reflects low to high mental ability, the p dimension represents low to high psychopathology severity, with thought disorder at the extreme. The dimension of p unites all disorders. It influences present/absent status on hundreds of psychiatric symptoms, which modern nosological systems typically aggregate into dozens of distinct diagnoses, which in turn aggregate into three overarching domains, namely, the externalizing, internalizing, and psychotic experience domains, which finally aggregate into one dimension of psychopathology from low to high: p. Studies show that the higher a person scores on p, the worse that person fares on measures of family history of psychiatric illness, brain function, childhood developmental history, and adult life impairment. A dimension of p may help account for ubiquitous nonspecificity in psychiatry: multiple disorders share the same risk factors and biomarkers and often respond to the same therapies. Here, the authors summarize the history of the unidimensional idea, review modern research into p, demystify statistical models, articulate some implications of p for prevention and clinical practice, and outline a transdiagnostic research agenda. [AJP AT 175: Remembering Our Past As We Envision Our Future October 1910: A Study of Association in Insanity Grace Helen Kent and A.J. Rosanoff: "No sharp distinction can be drawn between mental health and mental disease; a large collection of material shows a gradual and not an abrupt transition from the normal state to pathological states."(Am J Psychiatry 1910; 67(2):317-390 )].
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Affiliation(s)
- Avshalom Caspi
- From the Department of Psychology and Neuroscience, the Department of Psychiatry and Behavioral Sciences, and the Center for Genomic and Computational Biology, Duke University, Durham, N.C.; and the Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
| | - Terrie E Moffitt
- From the Department of Psychology and Neuroscience, the Department of Psychiatry and Behavioral Sciences, and the Center for Genomic and Computational Biology, Duke University, Durham, N.C.; and the Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
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44
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Suzuki T, South SC, Samuel DB, Wright AGC, Yalch MM, Hopwood CJ, Thomas KM. Measurement invariance of the DSM-5 Section III pathological personality trait model across sex. Personal Disord 2018; 10:114-122. [PMID: 29952589 DOI: 10.1037/per0000291] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The dimensional pathological personality trait model proposed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), Section III Criterion B, has shown promising results for its validity and utility in conceptualizing personality pathology. However, as its structural equivalence across sex is yet to be tested, the validity for the model across males and females remains uncertain. In the present article, we examined sex measurement invariance of the DSM-5 trait model in a large undergraduate sample using the Personality Inventory for DSM-5. A series of confirmatory and exploratory factor analyses suggested that, although the exact facet-domain relationships as specified in the DSM-5 were not observed, the facets generally organize into a model with five latent factors similar to those listed in the DSM-5 Section III Criterion B. Further, these five factors were fully measurement invariant across sex at the configural, metric, and scalar levels. Examination of the latent trait mean levels suggests that females tend to have higher scores on latent Negative Affectivity, whereas males tend to have higher scores on latent Antagonism, Detachment, Psychoticism, and Disinhibition. These results indicate that the DSM-5 Section III pathological personality trait model is fully structurally equivalent across sex, a property that is lacking in the traditional categorical model in Section II. This further validates the use of the dimensional DSM-5 trait model for personality disorder assessment and conceptualization in both research and clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Susan C South
- Department of Psychological Sciences, Purdue University
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45
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Heinze K, Lin A, Nelson B, Reniers RLEP, Upthegrove R, Clarke L, Roche A, Lowrie A, Wood SJ. The impact of psychotic experiences in the early stages of mental health problems in young people. BMC Psychiatry 2018; 18:214. [PMID: 29954377 PMCID: PMC6025824 DOI: 10.1186/s12888-018-1767-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/23/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Anxiety and depressive symptoms and psychotic experiences constitute common features of emerging mental disorders in young people. Psychotic experiences and the ultra-high risk (UHR) state for psychosis appear to have a particular importance for clinical presentation, progression of symptomatology, quality of life and functioning, but the impact of psychotic experiences in individuals seeking help at non-UHR services, compared to UHR services, is under-researched. METHODS Sixty-nine young people (Mage ± SD at baseline = 20.8 ± 2.6, range 16-26 years, 48 females) presenting to mental health services were grouped according to UHR and non-UHR status. They were assessed at baseline for anxiety and depressive symptoms, psychological distress, psychosocial functioning and quality of life. They were followed up at three, six, and 12 months. Data were analysed using mixed linear modelling. RESULTS UHR individuals reported higher levels of depressive symptoms and psychological distress, and lower levels of role functioning and quality of life compared to non-UHR individuals. No differences were reported for anxiety symptoms or social functioning. Decline in psychosocial functioning was not associated with clinical deterioration or reduction of quality of life. CONCLUSIONS Psychotic experiences appear to be particularly associated with depressive symptoms and psychological distress, impaired role functioning and quality of life in help-seeking young people in the medium-term. It is therefore important to pay special attention to psychotic experiences in the early stages of mental health problems even if psychotic symptoms are not the main motivation for help-seeking.
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Affiliation(s)
- Kareen Heinze
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK. .,Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Ashleigh Lin
- 0000 0000 8828 1230grid.414659.bTelethon Kids Institute, Perth, Australia
| | - Barnaby Nelson
- grid.488501.0Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia ,0000 0001 2179 088Xgrid.1008.9Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Renate L. E. P. Reniers
- 0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK ,0000 0004 1936 7486grid.6572.6Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Rachel Upthegrove
- 0000 0004 1936 7486grid.6572.6School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK ,0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK ,0000 0004 1936 7486grid.6572.6Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Latoya Clarke
- 0000 0000 8809 1613grid.7372.1Warwick Medical School, University of Warwick, Coventry, UK
| | - Ayesha Roche
- 0000 0004 1936 9262grid.11835.3eDepartment of Psychology, University of Sheffield, Sheffield, UK
| | - Angelique Lowrie
- 0000 0004 1936 7486grid.6572.6School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Stephen J. Wood
- 0000 0004 1936 7486grid.6572.6School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK ,0000 0004 1936 7486grid.6572.6Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, UK ,grid.488501.0Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia ,0000 0001 2179 088Xgrid.1008.9Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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46
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Romer AL, Knodt AR, Houts R, Brigidi BD, Moffitt TE, Caspi A, Hariri AR. Structural alterations within cerebellar circuitry are associated with general liability for common mental disorders. Mol Psychiatry 2018; 23:1084-1090. [PMID: 28397842 PMCID: PMC5636639 DOI: 10.1038/mp.2017.57] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 02/07/2017] [Accepted: 02/10/2017] [Indexed: 12/31/2022]
Abstract
Accumulating mental-health research encourages a shift in focus toward transdiagnostic dimensional features that are shared across categorical disorders. In support of this shift, recent studies have identified a general liability factor for psychopathology-sometimes called the 'p factor'- that underlies shared risk for a wide range of mental disorders. Identifying neural correlates of this general liability would substantiate its importance in characterizing the shared origins of mental disorders and help us begin to understand the mechanisms through which the 'p factor' contributes to risk. Here we believe we first replicate the 'p factor' using cross-sectional data from a volunteer sample of 1246 university students, and then using high-resolution multimodal structural neuroimaging, we demonstrate that individuals with higher 'p factor' scores show reduced structural integrity of white matter pathways, as indexed by lower fractional anisotropy values, uniquely within the pons. Whole-brain analyses further revealed that higher 'p factor' scores are associated with reduced gray matter volume in the occipital lobe and left cerebellar lobule VIIb, which is functionally connected with prefrontal regions supporting cognitive control. Consistent with the preponderance of cerebellar afferents within the pons, we observed a significant positive correlation between the white matter integrity of the pons and cerebellar gray matter volume associated with higher 'p factor' scores. The results of our analyses provide initial evidence that structural alterations in corticocerebellar circuitry supporting core functions related to the basic integration, coordination and monitoring of information may contribute to a general liability for common mental disorders.
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Affiliation(s)
- Adrienne L. Romer
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA,Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA
| | - Annchen R. Knodt
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA,Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA
| | - Renate Houts
- Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA
| | - Bartholomew D. Brigidi
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA
| | - Terrie E. Moffitt
- Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA,Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705 USA,Center for Genomic and Computational Biology, Duke University, Durham, NC 27705 USA,Social, Genetic, and Developmental Psychiatry Research Center, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, England
| | - Avshalom Caspi
- Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA,Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705 USA,Center for Genomic and Computational Biology, Duke University, Durham, NC 27705 USA,Social, Genetic, and Developmental Psychiatry Research Center, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, England
| | - Ahmad R. Hariri
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA,Department of Psychology & Neuroscience, Duke University, Durham, NC 27705 USA
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47
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The Multidimensional Nature of Psychopathy: Five Recommendations for Research. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018. [DOI: 10.1007/s10862-018-9657-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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48
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Kotov R, Foti D, Li K, Bromet EJ, Hajcak G, Ruggero CJ. Validating dimensions of psychosis symptomatology: Neural correlates and 20-year outcomes. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 125:1103-1119. [PMID: 27819471 DOI: 10.1037/abn0000188] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Heterogeneity of psychosis presents significant challenges for classification. Between 2 and 12 symptom dimensions have been proposed, and consensus is lacking. The present study sought to identify uniquely informative models by comparing the validity of these alternatives. An epidemiologic cohort of 628 first-admission inpatients with psychosis was interviewed 6 times over 2 decades and completed an electrophysiological assessment of error processing at year 20. We first analyzed a comprehensive set of 49 symptoms rated by interviewers at baseline, progressively extracting from 1 to 12 factors. Next, we compared the ability of resulting factor solutions to (a) account for concurrent neural dysfunction and (b) predict 20-year role, social, residential, and global functioning, and life satisfaction. A four-factor model showed incremental validity with all outcomes, and more complex models did not improve explanatory power. The 4 dimensions-reality distortion, disorganization, inexpressivity, and apathy/asociality-were replicable in 5 follow-ups, internally consistent, stable across assessments, and showed strong discriminant validity. These results reaffirm the value of separating disorganization and reality distortion, are consistent with recent findings distinguishing inexpressivity and apathy/asociality, and suggest that these 4 dimensions are fundamental to understanding neural abnormalities and long-term outcomes in psychosis. (PsycINFO Database Record
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Affiliation(s)
- Roman Kotov
- Department of Psychiatry, Stony Brook University
| | - Dan Foti
- Department of Psychology, Purdue University
| | - Kaiqiao Li
- Department of Psychology, Stony Brook University
| | | | - Greg Hajcak
- Department of Psychology, Stony Brook University
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49
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Manifestations of personality impairment severity: comorbidity, course/prognosis, psychosocial dysfunction, and 'borderline' personality features. Curr Opin Psychol 2017; 21:117-121. [PMID: 29291458 DOI: 10.1016/j.copsyc.2017.12.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 12/15/2017] [Accepted: 12/15/2017] [Indexed: 12/20/2022]
Abstract
Impairment in personality functioning (briefly, personality impairment) is the core pathology in personality disorder (PD) and an essential indicator of PD-severity. It also is a difficult construct to define and assess. We argue that personality-impairment severity is a latent construct that can be modeled with four indicators: within-PD comorbidity, problematic course/prognosis of both PD and comorbid clinical syndromes, PD-associated psychosocial dysfunction, and features of DSM-5-II borderline PD (BPD). Our literature review documents interrelations among the first three indicators, and studies of PD structure reveal a higher order factor of general PD severity marked most strongly by BPD features. Together, these findings indicate that BPD features may be helpful in the important tasks of defining and assessing personality-impairment severity.
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50
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Dornbach-Bender A, Ruggero CJ, Waszczuk MA, Gamez W, Watson D, Kotov R. Mapping emotional disorders at the finest level: Convergent validity and joint structure based on alternative measures. Compr Psychiatry 2017; 79:31-39. [PMID: 28754505 DOI: 10.1016/j.comppsych.2017.06.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 05/15/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Traditional categorization of emotional disorders suffers from within-disorder heterogeneity and excessive comorbidity. Quantitative nosology instead proposes grouping homogenous components of these disorders within a higher order internalizing dimension. However, the precise number, composition, and hierarchical structure of these components remains unclear and varies based on assessment tools. METHODS The present study jointly examined two assessment systems with the broadest coverage of homogeneous emotional disorder components-the revised Interview for Mood and Anxiety Symptoms (IMAS-R) and the self-report-based expanded version of the Inventory of Depression and Anxiety Symptoms (IDAS-II)-to map their convergent and discriminant validity and joint structure in outpatient (N=426) and treated student (N=306) samples. RESULTS Results identified 33 non-redundant components of emotional disorders. Most demonstrated strong convergent and discriminant validity between these two instruments. However, the IMAS-R provided more detailed and differentiated characterization of the content subsumed within three IDAS-II scales, and seven of the 33 components were unique to one measure or the other. Joint analysis of scales from both measures supported a four factor (i.e., distress, fear, OCD, mania) mid-level structure of emotional disorders. CONCLUSIONS Using multiple measures, methods, and samples, the present study provided evidence for the validity of core lower order components of the internalizing dimension and suggested they cluster into as many as four distinct factors reflecting distress, fear, OCD, and mania.
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Affiliation(s)
- Allison Dornbach-Bender
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, United States.
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, United States.
| | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, HSC, Level T-10, Room 060F, Stony Brook, NY 11794-8101, United States.
| | - Wakiza Gamez
- Department of Psychology, University of Iowa, Iowa City, IA, USA.
| | - David Watson
- Department of Psychology, 118 Haggar Hall, University of Notre Dame, Notre Dame, IN 46556, United States.
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, HSC, Level T-10, Room 060H, Stony Brook, NY 11794-8101, United States.
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