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Michelini G, Carlisi CO, Eaton NR, Elison JT, Haltigan JD, Kotov R, Krueger RF, Latzman RD, Li JJ, Levin-Aspenson HF, Salum GA, South SC, Stanton K, Waldman ID, Wilson S. Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum. World Psychiatry 2024; 23:333-357. [PMID: 39279404 PMCID: PMC11403200 DOI: 10.1002/wps.21225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Abstract
Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These "neurodevelopmental conditions" are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a "neurodevelopmental spectrum" ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.
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Affiliation(s)
- Giorgia Michelini
- Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Christina O Carlisi
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - John D Haltigan
- Department of Psychiatry, Division of Child and Youth Mental Health, University of Toronto, Toronto, ON, Canada
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | - James J Li
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Giovanni A Salum
- Child Mind Institute, New York, NY, USA
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para a Infância e Adolescência, São Paulo, Brazil
| | - Susan C South
- Department of Psychological Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Kasey Stanton
- Department of Psychology, University of Wyoming, Laramie, WY, USA
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Jacobs GR, Ameis SH, Szatmari P, Haltigan JD, Voineskos AN. Bifactor models of psychopathology using multi-informant and multi-instrument dimensional measures in the ABCD study. JCPP ADVANCES 2024; 4:e12228. [PMID: 38827988 PMCID: PMC11143956 DOI: 10.1002/jcv2.12228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 11/20/2023] [Indexed: 06/05/2024] Open
Abstract
Background Due to limitations of categorical definitions of mental illness, there is a need for quantitative empirical investigations of the dimensional structure of psychopathology. Using exploratory bifactor methods, this study investigated a comprehensive and representative structure of psychopathology in children to better understand how psychotic-like experiences (PLEs), autism spectrum disorder (ASD) symptoms, impulsivity, and sensitivity to reward and punishment, may be integrated into extant general factor models of psychopathology. Methods We used seven child-report and three parent-report instruments capturing diverse mental health symptoms in 11,185 children aged 9-10 from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study. We built on previous modeling frameworks by conducting both split sample and full sample factor analytic approaches that harnessed recent methodological advances in bifactor exploratory structural equation modeling (B-ESEM) to examine a wide range of psychopathology measures not previously integrated into a single analysis. Validity of psychopathology dimensions was examined by investigating associations with sex, age, cognition, imaging measures, and medical service usage. Results All four factor analytic models showed excellent fit and similar structure within informant. PLEs loaded most highly onto a general psychopathology factor, suggesting that they may reflect non-specific risk for mental illness. ASD symptoms loaded separately from attention/hyperactivity symptoms. Symptoms of impulsivity and sensitivity to reward and punishment loaded onto specific factors, distinct from externalizing and internalizing factors. All identified factors were associated with clinically relevant risk factors, providing preliminary evidence for their construct validity. Conclusion By integrating diverse child-report and parent-report psychopathology measures for children in the ABCD sample, we deliver data on the quantitative structure of psychopathology for an exceptionally large set of measurements and discuss implications for the field.
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Affiliation(s)
- Grace R. Jacobs
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Institute of Medical ScienceTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Stephanie H. Ameis
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Institute of Medical ScienceTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Department of PsychiatryTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- The Hospital for Sick ChildrenTorontoOntarioCanada
| | - Peter Szatmari
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Department of PsychiatryTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- The Hospital for Sick ChildrenTorontoOntarioCanada
| | - John D. Haltigan
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- The Hospital for Sick ChildrenTorontoOntarioCanada
| | - Aristotle N. Voineskos
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Institute of Medical ScienceTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Department of PsychiatryTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
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Lynch SJ, Sunderland M, Forbes MK, Teesson M, Newton NC, Chapman C. Structure of psychopathology in adolescents and its association with high-risk personality traits. Dev Psychopathol 2024; 36:379-394. [PMID: 36700360 DOI: 10.1017/s0954579422001262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The present study examined high-risk personality traits and associations with psychopathology across multiple levels of a hierarchical-dimensional model of psychopathology in a large adolescent, general population sample. Confirmatory factor analyses were run using data from two randomized controlled trials of Australian adolescents (N = 8,654, mean age = 13.01 years, 52% female). A higher-order model - comprised of general psychopathology, fear, distress, alcohol use/harms, and conduct/inattention dimensions - was selected based on model fit, reliability, and replicability. Indirect-effects models were estimated to examine the unique associations between high-risk personality traits (anxiety sensitivity, negative thinking, impulsivity, and sensation seeking) and general and specific dimensions and symptoms of psychopathology. All personality traits were positively associated with general psychopathology. After accounting for general psychopathology, anxiety sensitivity was positively associated with fear; negative thinking was positively associated with distress; impulsivity was positively associated with conduct/inattention; and sensation seeking was positively associated with alcohol use/harms and conduct/inattention, and negatively associated with fear. Several significant associations between personality traits and individual symptoms remained after accounting for general and specific psychopathology. These findings contribute to our understanding of the underlying structure of psychopathology among adolescents and have implications for the development of personality-based prevention and early intervention programs.
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Affiliation(s)
- Samantha J Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Miriam K Forbes
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Ford JD. Why We Need a Developmentally Appropriate Trauma Diagnosis for Children: a 10-Year Update on Developmental Trauma Disorder. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:403-418. [PMID: 37234835 PMCID: PMC10205922 DOI: 10.1007/s40653-021-00415-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 05/28/2023]
Abstract
Developmental Trauma Disorder (DTD) was proposed almost two decades ago as a psychiatric diagnosis for children who have been traumatically victimized and whose attachment bonding with primary caregivers has been compromised. DTD was designed to complement and extend post-traumatic stress disorder (PTSD) by addressing forms of trauma-related biopsychosocial dysregulation not included in PTSD, many of which are attributed to other psychiatric disorders. In the past decade, evidence from clinician surveys and research field trial studies has provided evidence of DTD's validity and potential clinical utility. The growing evidence base for DTD is summarized and clinical rationales for the proposed DTD symptoms are described. DTD shows promise as a developmentally-attuned traumatic stress diagnosis for traumatized children.
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Affiliation(s)
- Julian D. Ford
- University of Connecticut School of Medicine, Farmington, USA
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Haahr-Pedersen I, Vallières F, Hansen M, Aldamman K, Schmidt-Rasmussen V, Bramsen RH, Spitz P, Hyland P. Evidence of a traumatic stress dimension of psychopathology among at-risk children living in Denmark. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04381-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
AbstractThe Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative model of psychopathology. HiTOP proposes that trauma-related distress is a facet of Internalizing psychopathology, but recent evidence with young people suggests that it may reflect a unique dimension of psychopathology. This study assessed the latent structure of child and adolescent psychopathology to determine whether there is evidence of a unique ‘Traumatic Stress’ dimension, and how dimensions of psychopathology are associated with specific types of childhood adversity and trauma, and suicidal ideation and self-injurious behavior. Participants were children and adolescents aged 1–17 years (N = 1,800) who were in contact with the Danish child protection system due to suspected child abuse. Confirmatory factor analysis was used to determine the optimal latent structure of psychopathology, and structural equation modelling was used to determine how the dimensions of psychopathology were associated with different forms of trauma and adversity and suicidality/self-harm. The best fitting model included three factors of Internalizing, Externalizing, and Traumatic Stress. The Traumatic Stress dimensions was associated with older age, living outside of the family home, parental mental illness, higher levels of parental conflict, and the presence of domestic violence in the child’s home. The Traumatic Stress dimension was not associated with suicidality/self-harm. This study provides additional evidence of a distinct dimension of Traumatic Stress among young people. Further studies are needed to determine if these findings are replicable, particularly in older participants.
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Afzali MH, Dagher A, Bourque J, Spinney S, Conrod P. Cross-lagged Relationships Between Depressive Symptoms and Altered Default Mode Network Connectivity Over the Course of Adolescence. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:774-781. [PMID: 34929346 DOI: 10.1016/j.bpsc.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/05/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although the peak onset of depressive symptoms occurs during adolescence, very few studies have directly examined depression-related changes in resting-state (RS) default mode network activity during adolescence, controlling for potential neural markers of risk. METHODS This study used data from a longitudinal adolescent cohort to investigate age-specific, persistent (i.e., lagged), and dynamic associations between RS functional connectivity within the default mode network and depressive symptoms during adolescence using a random intercept cross-lagged panel framework. The Neuroventure sample consisted of 151 adolescents ages 12-14 at study entry without any neurological illness who were assessed three times during a 5-year follow-up with 97% follow-up across the three assessments. Depressive symptoms were measured using the depression subscale of the Brief Symptoms Inventory. RS functional magnetic resonance imaging data were collected using a 3T Siemens Magnetom Trio scanner in a single 6-minute sequence. RESULTS After controlling for relationships between random intercepts, future depression risk was predicted by RS couplings in the perigenual anterior cingulate cortex and anterior dorsomedial prefrontal cortex (β = -0.69, p = .014) and in the left inferior parietal lobule and anterior superior frontal gyrus (β = -0.43, p = .035). Increases in depressive symptoms at previous time points significantly predicted changes in functional connectivity between the posterior cingulate cortex and the precuneus and posterior middle temporal gyrus (β = 0.37, p = .039) and between the dorsal precuneus and posterior middle temporal gyrus (β = 0.47, p = .036). CONCLUSIONS This study was able to disassociate the RS brain markers of depression from those that appear to follow early-onset depression.
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Affiliation(s)
- Mohammad H Afzali
- Department of Psychiatry, University of Montréal, Montreal, Québec, Canada
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Josiane Bourque
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean Spinney
- Department of Psychiatry, University of Montréal, Montreal, Québec, Canada; Department of Computer Science and Operations Research, University of Montréal, Montreal, Québec, Canada; Mila - Quebec AI Institute, Montreal, Québec, Canada
| | - Patricia Conrod
- Department of Psychiatry, University of Montréal, Montreal, Québec, Canada; Centre Hospitalier Universitaire Sainte-Justine, Research Centre, Montreal, Québec, Canada.
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Hyland P, Karatzias T, Ford JD, Fox R, Spinazzola J. The Latent Structure of Child and Adolescent Psychopathology and its Association with Different Forms of Trauma and Suicidality and Self-Harm : LATENT STRUCTURE OF PSYCHOPATHOLOGY. Res Child Adolesc Psychopathol 2022; 50:1501-1513. [PMID: 35476235 PMCID: PMC9616783 DOI: 10.1007/s10802-022-00925-1] [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] [Accepted: 04/04/2022] [Indexed: 11/24/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a multidimensional and hierarchical model of the latent structure of psychopathology. While HiTOP has received much support in child/adolescent community samples, fewer studies have assessed this model in clinical samples of children/adolescents. Here, we modelled the latent structure of 45 symptoms of psychopathology from a clinical sample of children/adolescents and assessed how dimensions of psychopathology were related to specific forms of trauma and suicidality/self-harm. Clinician-derived assessments were obtained from 507 people aged 7-18 years. Confirmatory factor analysis was used to determine the optimal fitting model, and structural equation modelling was used to estimate associations with trauma exposure and suicidality/self-harm. The best fitting model(s) included five first-order factors reflecting Fear, Distress, Externalizing, Thought Disorder, and Traumatic Stress, with a higher-order general factor (p) accounting for the covariation between these factors. Unique associations were identified between specific forms of trauma and each dimension of psychopathology. p was strongly associated with suicidality/self-harm, and of the first-order factors, Distress was most strongly associated with suicidality/self-harm. Findings support the predictions of HiTOP that the latent structure of child/adolescent psychopathology can be effectively described by a multidimensional and hierarchal model. Moreover, we found tentative evidence for a unique dimension of Traumatic Stress psychopathology. Our findings also highlight the unique associations between specific forms of early life trauma and specific dimensions of psychopathology, and the importance of Distress related psychopathology for suicidality/self-harm in children and adolescents.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Thanos Karatzias
- Department of Psychology, Edinburgh Napier University, Edinburgh, Scotland
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Robert Fox
- School of Business, National College of Ireland, Dublin, Ireland
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Forbes MK, Sunderland M, Rapee RM, Batterham PJ, Calear AL, Carragher N, Ruggero C, Zimmerman M, Baillie AJ, Lynch SJ, Mewton L, Slade T, Krueger RF. A detailed hierarchical model of psychopathology: From individual symptoms up to the general factor of psychopathology. Clin Psychol Sci 2021; 9:139-168. [PMID: 33758691 PMCID: PMC7983870 DOI: 10.1177/2167702620954799] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Much of our knowledge about the relationships among domains of psychopathology is built on the diagnostic categories described in the Diagnostic and Statistical Manual of Mental Disorders (DSM), with relatively little research examining the symptom-level structure of psychopathology. The aim of this study was to delineate a detailed hierarchical model of psychopathology-from individual symptoms up to a general factor of psychopathology-allowing both higher- and lower-order dimensions to depart from the structure of the DSM. We explored the hierarchical structure of hundreds of symptoms spanning 18 DSM disorders, in two large samples-one from the general population in Australia (n = 3175), and the other a treatment-seeking clinical sample from the USA (n = 1775). There was marked convergence between the two samples, offering new perspectives on higher-order dimensions of psychopathology. We also found several noteworthy departures from the structure of the DSM in the symptom-level data.
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Affiliation(s)
- Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Natacha Carragher
- Office of Medical Education, University of New South Wales, Sydney, Australia
- Alcohol, Drugs and Addictive Behaviors, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | | | | | - Andrew J Baillie
- Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Samantha J Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Mewton
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Vine V, Byrd AL, Mohr H, Scott LN, Beeney JE, Stepp SD. The Structure of Psychopathology in a Sample of Clinically Referred, Emotionally Dysregulated Early Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1379-1393. [PMID: 32725338 PMCID: PMC7990491 DOI: 10.1007/s10802-020-00684-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This investigation answers and amplifies calls to model the transdiagnostic structure of psychopathology in clinical samples of early adolescents and using stringent psychometric criteria. In 162 clinically referred, clinically evaluated 11-13-year-olds, we compared a correlated two-factor model, containing latent internalizing and externalizing factors, to a bifactor model, which added a transdiagnostic general factor. We also evaluated the bifactor model psychometrically, including criterion validity with broad indicators of psychosocial functioning. In doing so, we compared alternative approaches to defining and interpreting criterion validity: a recently proposed incremental definition based on amounts of variance in criterion factors explained, and the more typical definition based on the presence of conceptually meaningful relationships. While traditional fit statistics favored the bifactor model as expected, psychometric analyses added important nuance. Despite moderate reliability, the general factor was not fully transdiagnostic (i.e., was not informed by several externalizing scores), and was partially redundant with internalizing scores. Approaches to criterion validity yielded opposing results. Compared to the correlated two-factor model, the bifactor model redistributed, without incrementally increasing, the total variance explained in criterion indicators of psychosocial functioning. Yet, the bifactor model did improve the precision of clinically important relationships to psychosocial functioning, raising questions about meaningful tests of bifactor psychopathology models.
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Affiliation(s)
- Vera Vine
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA.
| | - Amy L Byrd
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Harmony Mohr
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Lori N Scott
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Joseph E Beeney
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Stephanie D Stepp
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
- Department of Psychology, University of Pittsburgh School of Arts and Sciences, Pittsburgh, PA, USA
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Afzali MH, Dagher A, Edalati H, Bourque J, Spinney S, Sharkey RJ, Conrod P. Adolescent Resting-State Brain Networks and Unique Variability of Conduct Problems Within the Externalizing Dimension. J Pers Disord 2020; 34:609-627. [PMID: 33074059 DOI: 10.1521/pedi.2020.34.5.609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The externalizing psychopathological dimension is associated with alterations in adolescents' functional brain connectivity. The current study aims to identify the functional correlates of the unique variability in conduct problems within the context of the broad externalizing dimension. The broad externalizing dimension and unique variability in conduct problems were estimated using a bifactor model. Resting-state data were available for a sample of 125 adolescents. Based on multiresolution parcellation of functional brain networks atlas, major resting-state functional brain networks and the connectivity correlates of unique conduct problems and the broad externalizing dimension were established. The broad externalizing dimension was related to connectivity alterations in the ventral attention/salience network, while unique variability in conduct problems dimension was related to connectivity alterations in the cerebellum crusi as well as the mesolimbic network. The current study is a first step toward the identification of functional resting-state network correlates of broad and specific variability in the externalizing dimension.
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Affiliation(s)
- Mohammad H Afzali
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
| | - Hanie Edalati
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada
| | - Josiane Bourque
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean Spinney
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada
| | | | - Patricia Conrod
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada
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11
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The structure of psychopathology and association with poor sleep, self-harm, suicidality, risky sexual behavior, and low self-esteem in a population sample of adolescents. Dev Psychopathol 2020; 33:1208-1219. [PMID: 32468983 DOI: 10.1017/s0954579420000437] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is a growing body of evidence highlighting the presence of a single general dimension of psychopathology that can account for multiple associations across mental and substance use disorders. However, relatively little evidence has emerged regarding the validity of this model with respect to a range of factors that have been previously implicated across multiple disorders. The current study utilized a cross-sectional population survey of adolescents (n = 2,003) to examine the extent to which broad psychopathology factors account for specific associations between psychopathology and key validators: poor sleep, self-harm, suicidality, risky sexual behavior, and low self-esteem. Confirmatory factor models, latent class models, and factor mixture models were estimated to identify the best structure of psychopathology. Structural equation models were then estimated to examine the broad and specific associations between each psychopathology indicator and the validators. A confirmatory factor model with three lower-order factors, representing internalizing, externalizing, and psychotic-like experiences, and a single higher-order factor evidenced the best fit. The associations between manifest indicators of psychopathology and validators were largely nonspecific. However, significant and large direct effects were found between several pairwise associations. These findings have implications for the identification of potential targets for intervention and/or tailoring of prevention programs.
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12
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The relationship between attachment styles and internalizing/externalizing problems: The mediating role of self-criticism. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00174-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Brownlie E, Beitchman JH, Chaim G, Wolfe DA, Rush B, Henderson J. Early Adolescent Substance Use and Mental Health Problems and Service Utilisation in a School-based Sample. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:116-125. [PMID: 29929386 PMCID: PMC6405806 DOI: 10.1177/0706743718784935] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This paper reports on substance use, mental health problems, and mental health service utilisation in an early adolescent school-based sample. METHOD Participants were 1,360 grade 7 and 8 students from 4 regions of Ontario, Canada. Students completed an in-class survey on mental health and substance use. The sampling strategy and survey items on demographics, substance use, service utilisation, and distress were adapted from the Ontario Student Drug Use and Health Survey. Internalising and externalising mental health problems were assessed using the Global Assessment of Individual Needs - Short Screener. Distress was defined as fair or poor self-rated mental health. RESULTS Rates of internalising and/or externalising problems above the threshold exceeded 30%; yet, fewer than half had received mental health services in the past 12 mo. Substance use was associated with increased odds of internalising and externalising problems above the threshold and distress. Youth using cannabis had 10-times the odds of exceeding the threshold for internalising or externalising problems. The use of substances other than alcohol or cannabis was associated with increased odds of fair or poor self-rated mental health among grade 8 students. Of the youth who confirmed at least a substance use problem, most also reported mental health problems; this association was stronger among girls than boys. CONCLUSIONS Early adolescent substance use was associated with concurrent self-reported mental health problems in a non-clinical sample. The low levels of service utilisation reported highlight the need for improved access to early identification and intervention to prevent the development of concurrent disorders.
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Affiliation(s)
- Elizabeth Brownlie
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Joseph H. Beitchman
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Gloria Chaim
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - David A. Wolfe
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Centre for Prevention Science, Centre for Addiction and Mental Health, Toronto, Ontario
- Centre for Research and Education on Violence against Women and Children at the Faculty of Education, Western University, London, Ontario
| | - Brian Rush
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Joanna Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
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