Phenotypic factor analysis of psychopathology reveals a new body-related transdiagnostic factor

Transdiagnosis of alcohol use and psychopathologies: A systematic review

Multiple diagnoses are the rule in Mental Health and alcohol use disorder (AUD) is a psychopathology with many comorbidities, requiring interventions that consider common factors, which means using a transdiagnostic perspective. This study aimed to identify in the scientific literature the main common transdiagnostic factors that link AUD to other psychopathologies in people over 18 years of age. A systematic review of the literature was carried out in the portals of the databases Pubmed, PsychINFO and CAPES. 37 articles were selected for analysis, which resulted in 25 transdiagnostic factors linked to AUD and to several other related disorders and health conditions. The results emphasize the variety of disorders and health conditions related to AUD, which highlights the importance of transdiagnostic factors for these conditions as targets for both scientific research and therapeutic interventions for this population.

Reliability and validity of bifactor models of dimensional psychopathology in youth

Bifactor models are a promising strategy to parse general from specific aspects of psychopathology in youth. Currently, there are multiple configurations of bifactor models originating from different theoretical and empirical perspectives. We aimed to test the reliability, validity, measurement invariance, and the correlation of different bifactor models of psychopathology using the Child Behavior Checklist (CBCL). We used data from the Reproducible Brain Charts (RBC) initiative (N = 7,011, ages 5 to 22 years, 40.2% females). Factor models were tested using the baseline data. To address our aim, we (a) searched for the published item-level bifactor models using the CBCL; (b) tested their global model fit; (c) calculated model-based reliability indices; (d) tested associations with symptoms' impact in everyday life; (e) tested measurement invariance across many characteristics, and (f) analyzed the observed factor correlation across the models. We found 11 bifactor models ranging from 39 to 116 items. Their global model fit was broadly similar. Factor determinacy and H index were acceptable for the p-factors, internalizing, externalizing, and somatic specific factors in most models. However, only the p- and attention factors predicted daily life symptoms' impact in all models. Models were broadly invariant across different characteristics. P-factors were highly correlated across models (r = .88 to .99) and homotypic specific factors were highly correlated. These results suggest that regardless of item selection and strategy to compose CBCL bifactor models, they assess very similar constructs. Taken together, our results support the robustness of the p-factor across distinct bifactor models and studies of distinct characteristics. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Reintroducing Consciousness in Psychopathology: Review of the Literature and Conceptual Framework

Alterations in consciousness are among the most common transdiagnostic psychopathological symptoms. Therefore clinical practice would benefit from a clear conceptual framework that guides the recognition, comprehension, and treatment of consciousness disorders. However, contemporary psychopathology lacks such a framework. We describe how pathology of consciousness is currently being addressed in clinical psychology and psychiatry so far, and how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases, Tenth Edition (ICD-10) refer to this subject. A brief review of the literature on consciousness is then given. After describing psychological perspectives on consciousness and discussing theoretical issues involved in exploring consciousness, we offer a practical clinical working definition of consciousness and we illustrate its connections with a variety of diagnoses. Making use of Jean-Paul Sartre’s distinctions among: states, functions, qualities, and structure, provide a conceptual framework to understand consciousness, to refine diagnostics and to guide the development of therapeutic possibilities in clinical practice.

A Meta-Structural Model of Common Clinical Disorder and Personality Disorder Symptoms

A large and consistent research literature demonstrates the superiority of dimensional models of mental disorder. Factor analytic research has mapped the latent dimensions underlying separate sets of mental disorders (e.g., emotional disorders), but a common framework-unencumbered by arbitrary historical boundaries between disorder groups-requires additional research. Using empirically derived measures of three key domains of psychopathological variation, the overarching goal of the current study was to explicate dimensions connecting internalizing, externalizing, and personality disorders. Participants included 1,144 racially diverse undergraduates. Exploratory structural equation modeling analyses revealed seven latent dimensions: core internalizing, core externalizing, antagonism, impulsivity, dutifulness, detachment, and suspiciousness. This meta-structure reflects a more comprehensive model of the architecture of mental disorders than accounts derived from less inclusive assessment batteries. Future empirical work is needed to evaluate the utility of this structural model in etiological research, assessment, and treatment arenas.

Early symptom non-improvement and aggravation are associated with the treatment response to SSRIs in MDD: a real-world study

PURPOSE

Early improvement in major depressive disorder is defined as a reduction of ≥20% in the 17-item Hamilton Depression Rating Scale (HAM-D-17) score at the second week after initiation of treatment, predicting long-term treatment response. However, there remains no effective strategy for switching medications when a patient fails to reach early improvement at the second week. This study focused on the predictive value of early symptom changes in each item of the HAM-D-17 scale for treatment response to selective serotonin reuptake inhibitor (SSRI) monotherapy and to provide a reference for switching antidepressants to enhance early treatment efficacy.

PATIENTS AND METHODS

Our study was an observational, real-world study that enrolled 90 treatment-naïve patients experiencing their first episode of major depressive disorder in the outpatient department of Huashan Hospital. Patients who did not achieve the threshold of early improvement in the second week after starting treatment were switched to alternative SSRI monotherapy. Patient follow-up occurred at 2, 4, 8, and 12 weeks after the initiation of treatment. We analyzed the relationship between the change in each symptom on the HAM-D-17 scale and treatment efficacy.

RESULTS

Early improvement predicted the treatment response at 12 weeks (χ ²=19.249, P<0.001), whereas early non-improvement in insomnia and anxiety was associated with a poor response (OR =9.487, 95% CI: 1.312-68.588 and OR =12.947, 95% CI: 1.99-82.246, respectively). At week 2, general somatic symptom aggravation was associated with a poorer response (OR =73.337, 95% CI: 2.232->999.999); treatment-emergent headache and tremor were associated with treatment efficacy (t=-9.521, P<0.001 and t=3.660, P=0.001, respectively). In addition, the increase in suicidal thoughts, once treatment began, had no relationship with the treatment response (OR =0.821, P=0.872).

CONCLUSION

This study suggested that patients with early non-improvement in insomnia and anxiety were not suitable for switches in SSRI monotherapy. Patients with treatment-emergent symptoms, especially headaches and tremors, were not suitable for switching from monotherapy to another SSRI.