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Ferro MA, Chan CKY. P factor in children with chronic physical illness. J Psychosom Res 2024; 184:111863. [PMID: 39059044 DOI: 10.1016/j.jpsychores.2024.111863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/16/2024] [Accepted: 07/21/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND The p factor represents the overall liability for the development of mental illness. While evidence supporting the p factor in adults has been reported, studies in children are fewer, and none have examined the p factor in children with chronic physical illness (CPI). OBJECTIVE We aimed to model the p factor in a longitudinal sample of children with CPI using a parent-reported checklist and examine its construct validity against a structured diagnostic interview. METHODS We used data from 263 children aged 2-16 years diagnosed with a CPI who were enrolled in the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study. The p factor was modelled using the Emotional Behavioural Scales over 24 months using confirmatory factor analysis. Validation of the p factor was set against the Mini International Neuropsychiatric Interview for Children and Adolescents. RESULTS Factorial evidence supported the p factor, modelled using a bi-factor structure, compared to a standard correlated-factors (i.e., two-factor) structure [Δχ2 = 9.66(4), p = 0.047]. p factor scores were correlated with the number of different mental illness diagnoses (r = 0.71) and total number of diagnoses (r = 0.72). Dose-response relationships were shown for the number of different diagnoses (p < 0.001) and total number of diagnoses (p < 0.001). CONCLUSION In this first study of the p factor in children with CPI, we showed evidence of its bi-factor structure and associations with mental illness diagnoses. Mental comorbidity in children with CPI is pervasive and warrants transdiagnostic approaches to integrated pediatric care.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Christy K Y Chan
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
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2
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Haywood D, Kotov R, Krueger RF, Wright AGC, Forbes MK, Dauer E, Baughman FD, Rossell SL, Hart NH. Reconceptualizing mental health in cancer survivorship. Trends Cancer 2024; 10:677-686. [PMID: 38890021 DOI: 10.1016/j.trecan.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/20/2024]
Abstract
Mental health for cancer survivors in both research and clinical applications has strongly adopted a traditional nosological approach, involving the classification of psychopathology into discrete disorders. However, this approach has recently faced considerable criticism due to issues such as high comorbidity and within-disorder symptom heterogeneity across populations. Moreover, there are additional specific issues impacting the validity of traditional approaches in cancer survivorship populations, including the physiological effects of cancer and its treatments. In response, we provide the case for the hierarchical dimensional approach within psycho-oncology, in particular the Hierarchical Taxonomy of Psychopathology (HiTOP). We discuss not only the potential utility of HiTOP to research and clinical applications within psycho-oncology, but also its limitations, and what is required to apply this approach within cancer survivorship.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Aidan G C Wright
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA; Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Frank D Baughman
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Susan L Rossell
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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3
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Haywood D, Baughman FD, Dauer E, Haywood J, Rossell S, Hart NH. It's about time: mitigating cancer-related cognitive impairments through findings from computational models of the Wisconsin Card Sorting Task. BMC Cancer 2024; 24:798. [PMID: 38965483 PMCID: PMC11223404 DOI: 10.1186/s12885-024-12545-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/20/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Many cancer survivors experience cancer-related cognitive impairment (CRCI), often with significant negative consequences across various life domains. Emerging evidence suggests that allowing additional time to process information before acting may be a useful strategy for those with CRCI to mitigate some of its impacts. The Wisconsin Card Sorting Task (WCST), a measure of general cognition, has shown that for some cancer survivors, longer task completion time facilitates similar task performance outcomes to control populations concerning perseveration errors; a key performance metric of the WCST. However, assessing if this strategy may be useful, as well as determining for whom it may be useful, with regard to strengths and weaknesses among select cognitive domains, is challenging due to factors such as the problem of task impurity. Accordingly, this study provides an initial computational and experimental assessment of whether additional time to process information before acting is a useful strategy for those with CRCI. METHODS We simulated individual cognitive differences observed in humans by varying contributions of executive functioning components (updating, shifting, inhibition) to yield 48 distinct computational models of the WCST. Our main manipulation was then to provide these models with more or less time (at three levels of 20, 40 and 60 cycles) before models executed an action to sort a given card. We compared the number of perseveration errors on the WCST produced by the computational models. Additionally, we determined models that simulated the performance of cancer survivors on the WCST by comparing the number of perseveration errors produced by the models to human data. RESULTS Additional processing time resulted in the models producing significantly fewer perseveration errors, supporting our hypothesis. In addition, 8 unique models simulated the performance of cancer survivors on the WCST. Additional time appeared to have a positive influence on performance primarily by mitigating the impacts of severe inhibition impairments. For more severe global executive function impairments, a substantial amount of additional time was required to mitigate the impacts of the impairments. For the most severe impairments, additional time was unable to adequately mitigate the impact on performance. CONCLUSION Additional processing time may be a useful strategy to rectify perseveration errors among cancer survivors with CRCI. Our findings have implications for the development of practical strategies, such as workload and deadline management in occupational settings, which may mitigate the negative effects of CRCI.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia.
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
- Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - Frank D Baughman
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Jennifer Haywood
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Susan Rossell
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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4
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Haywood D, Henry M, Dauer E, Lederman O, Farley M, Henneghan AM, O'Connor M, Jefford M, Rossell SL, Hart NH. Cancer-related cognitive impairment as a key contributor to psychopathology in cancer survivors: implications for prevention, treatment and supportive care. Support Care Cancer 2024; 32:480. [PMID: 38954104 PMCID: PMC11219369 DOI: 10.1007/s00520-024-08696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
A significant proportion of cancer survivors will experience some form of mental health compromise across domains including mood, anxiety, psychosis, eating disorders, and substance use. This psychopathology within cancer survivors is related to a range of negative outcomes and can also have a substantial negative impact on quality of life. Along with psychopathology, cognitive impairments are also commonly experienced, resulting in deficits in memory, reasoning, decision-making, speed of processing, and concentration, collectively referred to as cancer-related cognitive impairment (CRCI). Within the non-oncology literature, cognitive deficits are consistently demonstrated to be a key transdiagnostic aetiological feature of psychopathology, functionally contributing to the development and perpetuation of symptoms. Whilst there is an acknowledgement of the role mental health concerns might play in the development of and perception of CRCI, there has been limited acknowledgement and research exploring the potential for CRCI to functionally contribute toward the development of transdiagnostic psychopathology in cancer survivors beyond simply psychosocial distress. Given the theoretical and empirical evidence suggesting cognitive deficits to be an aetiological factor in psychopathology, we provide a rationale for the potential for CRCI to be a factor in the development and perpetuation of transdiagnostic psychopathology in cancer survivors. This potential functional association has significant implications for risk identification, prevention, treatment, and supportive cancer care approaches regarding psychopathology in cancer survivorship. We conclude by providing directions for future research in this area.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia.
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
- Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - Melissa Henry
- Department of Otolaryngology-Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
- Department of Oncology, McGill University Health Centre, Montreal, QC, Canada
- Lady Davis Research Institute, McGill University, Montreal, QC, Canada
- Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Oscar Lederman
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia
- School of Health Science, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Morgan Farley
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia
| | - Ashley M Henneghan
- School of Nursing, University of Texas at Austin, Austin, TX, USA
- Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Moira O'Connor
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
| | - Susan L Rossell
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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5
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Feijs HME, van Aken L, van der Veld WM, van der Heijden PT, Egger JIM. No relations between executive functions and dimensional models of psychopathology or is time the missing link? PLoS One 2024; 19:e0288386. [PMID: 38466678 PMCID: PMC10927122 DOI: 10.1371/journal.pone.0288386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/26/2023] [Indexed: 03/13/2024] Open
Abstract
Impaired executive functions (EF) have been found within various mental disorders (e.g., attention deficit hyperactivity disorder, autism spectrum disorder, schizophrenia spectrum disorders) as described in DSM-5. However, although impaired EF has been observed within several categories of mental disorders, empirical research on direct relations between EF and broader dimension of psychopathology is still scarce. Therefore, in the current investigation we examined relations between three EF performance tasks and self-reported dimensions of psychopathology (i.e., the internalizing, externalizing, and thought disorder spectra) in a combined dataset of patients with a broad range of mental disorders (N = 440). Despite previously reported results that indicate impaired EF in several categories of mental disorders, in this study no direct relations were found between EF performance tasks and self-reported broader dimensions of psychopathology. These results indicate that relations between EF and psychopathology could be more complex and non-linear in nature. We evaluate the need for integration of EF and dimensional models of psychopathology and reflect on EF as a possible transdiagnostic factor of psychopathology.
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Affiliation(s)
- Hanneke M. E. Feijs
- Center of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Loes van Aken
- Center of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | | | - Paul T. van der Heijden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Center for Adolescent Psychiatry, Reinier van Arkel Mental Health Institute, ‘s-Hertogenbosch, The Netherlands
| | - Jos I. M. Egger
- Center of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Stevig Specialized and Forensic Care for People with Intellectual Disabilities, Dichterbij, Oostrum, The Netherlands
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6
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Harris JL, Swanson B, Petersen IT. A Developmentally Informed Systematic Review and Meta-Analysis of the Strength of General Psychopathology in Childhood and Adolescence. Clin Child Fam Psychol Rev 2024; 27:130-164. [PMID: 38112921 PMCID: PMC10938301 DOI: 10.1007/s10567-023-00464-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 12/21/2023]
Abstract
Considerable support exists for higher-order dimensional conceptualizations of psychopathology in adults. A growing body of work has focused on understanding the structure of general and specific psychopathology in children and adolescents. No prior meta-analysis has examined whether the strength of the general psychopathology factor (p factor)-measured by explained common variance (ECV)-changes from childhood to adolescence. The primary objective of this multilevel meta-analysis was to determine whether general psychopathology strength changes across development (i.e. across ages) in childhood and adolescence. Several databases were searched in November 2021; 65 studies, with 110 effect sizes (ECV), nested within shared data sources, were identified. Included empirical studies used a factor analytic modeling approach that estimated latent factors for child/adolescent internalizing, externalizing, and optionally thought-disordered psychopathology, and a general factor. Studies spanned ages 2-17 years. Across ages, general psychopathology explained over half (~ 56%) of the reliable variance in symptoms of psychopathology. Age-moderation analyses revealed that general factor strength remained stable across ages, suggesting that general psychopathology strength does not significantly change across childhood to adolescence. Even if the structure of psychopathology changes with development, the prominence of general psychopathology across development has important implications for future research and intervention.
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Affiliation(s)
- Jordan L Harris
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Avenue G60, Iowa City, IA, 52242, USA.
| | - Benjamin Swanson
- Department of Psychological Sciences, University of Arkansas, Fayetteville, AR, USA
| | - Isaac T Petersen
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Avenue G60, Iowa City, IA, 52242, USA
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7
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Haywood D, Dauer E, Baughman FD, Lawrence BJ, Rossell SL, Hart NH, O’Connor M. "Is My Brain Ever Going to Work Fully Again?": Challenges and Needs of Cancer Survivors with Persistent Cancer-Related Cognitive Impairment. Cancers (Basel) 2023; 15:5331. [PMID: 38001592 PMCID: PMC10669848 DOI: 10.3390/cancers15225331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Many cancer survivors experience cognitive impairments that impact memory, concentration, speed of information processing, and decision making. These impairments, collectively known as cancer-related cognitive impairments (CRCIs), are a key domain of unmet needs and can significantly impact a cancer survivor's identity and quality of life. However, there are no purpose-built, multi-domain, needs assessment tools specifically for CRCI. The development of such tools requires an in-depth understanding of cancer survivors' CRCI-specific challenges and associated needs. This study explored the challenges and associated needs of cancer survivors with persistent CRCI. An in-depth qualitative design using semi-structured interviews with (a) cancer survivors with perceived CRCI (n = 32) and (b) oncology health professionals (n = 19) was utilised. A reflexive thematic analysis of the interviews resulted in five overarching themes: (1) executing regular activities, (2) relational difficulties, (3) occupational functioning, (4) psychological distress, and (5) social functioning, as well as an additional informational needs domain. Ultimately, CRCI was found to directly produce a range of challenges that negatively, and persistently, impact cancer survivors' quality of life. Cancer survivors were also found to have a range of needs associated with these challenges. This research should be used to inform future challenges and needs assessment tools as well as treatment and supportive care priority areas directly relating to CRCI.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia
| | - Evan Dauer
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Blake J. Lawrence
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Susan L. Rossell
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Nicolas H. Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Park, SA 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane City, QLD 4000, Australia
- Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA 6160, Australia
| | - Moira O’Connor
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
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8
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Anning KL, Langley K, Hobson C, Van Goozen SHM. Dimensional associations between executive function processes and symptoms of ADHD, ASD, oppositional defiance and anxiety in young school-referred children. Cortex 2023; 167:132-147. [PMID: 37557009 DOI: 10.1016/j.cortex.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/28/2023] [Accepted: 06/20/2023] [Indexed: 08/11/2023]
Abstract
Executive function (EF) difficulties are implicated in Neurodevelopmental Disorders (NDDs), such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). Because NDDs are highly comorbid and frequently co-occur with additional clinical problems, it is unclear how specific EF problems are associated with symptoms of ASD and ADHD, whilst accounting for co-occurring anxiety or oppositional defiance disorder (ODD) symptoms. The current study utilised a large sample of young children (n = 438, aged 4-8) referred to Cardiff University's Neurodevelopment Assessment Unit (NDAU) by teachers for cognitive and/or socio-emotional problems. As part of the referral process, the teachers completed the Strengths and Difficulties Questionnaire (SDQ), which revealed that most children displayed moderate to high hyperactivity (86%) and prosocial (73%) problems, as well as high levels of symptoms in other clinical domains (41% emotional, 61% conduct and 68% peer problems). Children completed tasks to assess episodic memory, cognitive inhibition, cognitive flexibility and visuomotor control, whilst parents completed questionnaires to measure symptoms of ASD, ADHD, anxiety and ODD. Dimensional analyses showed that poorer cognitive inhibition and visuospatial episodic memory were significantly associated with ADHD symptoms, whereas cognitive flexibility was negatively associated with ODD symptoms. Having more ASD symptoms was associated with fewer cognitive inhibition problems, whereas anxiety was associated with better cognitive flexibility. Our approach to assessment and analysis shows that specific cognitive processes are associated with distinct neurodevelopmental and clinical symptoms, which is ultimately relevant to early identification of and intervention for young children at risk of cognitive and/or socio-emotional problems.
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Affiliation(s)
- Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK.
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Stephanie H M Van Goozen
- School of Psychology, Cardiff University, Cardiff, UK; Department of Clinical Neurodevelopmental Studies, Leiden University, Leiden, the Netherlands.
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9
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Haywood D, Baughman FD, Bosanac P, Johnston K, Gnatt I, Haywood J, Gullifer J, Rossell S. Research Directions for Leveraging and Supporting the Lived Experience of Mental Illness within Psychology. Healthcare (Basel) 2023; 11:2318. [PMID: 37628516 PMCID: PMC10454461 DOI: 10.3390/healthcare11162318] [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: 06/26/2023] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
This paper explores the lived experience of mental illness within the field of psychology across higher education and the mental health workforce. There is a high prevalence of mental health issues among psychology students and practitioners, and it is critical not only to provide support for these populations, but also to acknowledge the value of leveraging their lived experience within their education and practice. There has been increased interest in and advocacy for the involvement of those with lived experience of mental illness within mental healthcare service provision to improve patient experiences and outcomes. However, there have been limited acknowledgement and research regarding the role of psychologists with personal lived experiences of mental illness, and how to leverage this experience. Further, there are challenges faced by both psychology students and practising psychologists with lived experience that act as barriers to leveraging their unique skills and experiences. Psychology students with lived experience face stigma, inadequate support, and incongruence between the course material and their personal experiences. Similarly, practising psychologists with lived experience encounter stigma and isolation, indicating the need for a culture change that promotes transparency and understanding. The paper calls for research in five key directions to provide evidence that can be used to support and leverage lived experience in psychology.
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Affiliation(s)
- Darren Haywood
- School of Psychological Sciences, Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (P.B.)
- Department of Psychiatry, University of Melbourne, Parkville, VIC 3052, Australia
| | - Frank D. Baughman
- School of Population Health, Curtin University Western Australia, Bentley, WA 6102, Australia
| | - Peter Bosanac
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (P.B.)
- Department of Psychiatry, University of Melbourne, Parkville, VIC 3052, Australia
| | - Kim Johnston
- School of Psychological Sciences, Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Inge Gnatt
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (P.B.)
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Jennifer Haywood
- School of Population Health, Curtin University Western Australia, Bentley, WA 6102, Australia
| | - Judith Gullifer
- School of Psychological Sciences, Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Susan Rossell
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (P.B.)
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
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10
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Haywood D, Pantaleo A, Mullan BA, Heslop KR, Baughman FD. Do Dimensional Measures of Mental Health Symptoms Predict Level of Alcohol Involvement in the General Population? Subst Use Misuse 2023; 58:629-636. [PMID: 36790047 DOI: 10.1080/10826084.2023.2177962] [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] [Indexed: 02/16/2023]
Abstract
Background: There is a limited understanding of what specific mental health symptoms are associated to alcohol involvement. It is important to understand how the severity of different mental health dimensions may differ, and distinguish between, levels of alcohol involvement. Objectives: (a) explore for differences in severity of mental health symptoms between those with lower, and moderate/high alcohol involvement, (b) assess the degree to which mental health dimensions can distinguish between those with lower, and moderate/high alcohol involvement, and (c) examine what mental health dimensions are related to the highest risk of moderate/high alcohol involvement. Results: 400 participants representative of the general population in the USA were recruited online through Prolific and completed the Alcohol, Smoking and Substance Involvement Screening Test and Brief Symptom Inventory. Each of the nine mental health symptom dimensions significantly differed between lower and moderate/high alcohol involvement, with the moderate/high alcohol involvement group reporting greater severity symptoms. The nine symptom dimensions in combination also significantly distinguished lower and moderate/high alcohol involvement, however only somatization offered unique predictive utility. Lastly, global distress was also able to significantly distinguish the alcohol involvement groups, albeit to a lesser accuracy compared to the collection of individual symptom dimensions. Conclusions: These findings suggest that overall mental health distress may be important to understanding alcohol involvement, however individual symptom dimensions can add further explanatory variance. In particular, somatic symptoms may offer unique utility in understanding the relationship between mental health and alcohol involvement.
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Affiliation(s)
- Darren Haywood
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Australia.,Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Ashleigh Pantaleo
- School of Population Health, Curtin University, Perth, Australia.,WA Cancer Prevention Research Unit, Curtin University, Perth, Australia
| | - Barbara A Mullan
- School of Population Health, Curtin University, Perth, Australia.,WA Cancer Prevention Research Unit, Curtin University, Perth, Australia
| | - Karen R Heslop
- Curtin School of Nursing, Curtin University, Perth, Australia
| | - Frank D Baughman
- School of Population Health, Curtin University, Perth, Australia
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Mullan B, Liddelow C, Haywood D, Breare H. Behavior Change Training for Health Professionals: Evaluation of a 2-Hour Workshop. JMIR Form Res 2022; 6:e42010. [DOI: 10.2196/42010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Rates of noncommunicable diseases continue to rise worldwide. Many of these diseases are a result of engaging in risk behaviors. Without lifestyle and behavioral intervention, noncommunicable diseases can worsen and develop into more debilitating diseases. Behavioral interventions are an effective strategy to reduce the burden of disease. Behavior change techniques can be described as the “active ingredients” in behavior change and address the components that need to be altered in order for the target behavior to change. Health professionals, such as pharmacists and nurses, can engage in opportunistic behavior change with their patients, to encourage positive health behaviors.
Objective
We aimed to develop, implement, and evaluate a behavior change workshop targeted at health professionals in Australia, with the goal of increasing knowledge of behavior change techniques and psychological variables.
Methods
A prospective study design was used to develop and evaluate a 2-hour behavior change workshop targeted at health professionals. The workshop was developed based on the Capability, Opportunity, Motivation, and Behavior Model and had five core objectives: (1) to detail the role of health professionals in delivering optimal care, (2) to demonstrate opportunities to change behavior, (3) to describe principles of behavior change, (4) to explain behavior change techniques, and (5) to determine the most appropriate behavior change techniques to use and when to use them. A total of 10 workshops were conducted. To evaluate the workshops and identify any potential long-term changes in behavior, we collected pre- and postworkshop data on knowledge and psychological constructs from the attendees.
Results
A final sample of 41 health professionals comprising general practitioners, nurses, and pharmacists completed the pre- and postworkshop surveys. Following the workshops, there were significant improvements in knowledge of behavior change techniques (t40=–5.27, P<.001), subjective norms (t40=–3.49, P=.001), descriptive norms (t40=–3.65, P<.001), perceived behavioral control (t40=–3.30, P=.002), and intention (t36=–3.32, P=.002); each had a large effect size. There was no significant difference in postworkshop attitude (t40=0.78, P=.44). The participants also found the workshops to be highly acceptable.
Conclusions
A 2-hour, theoretically informed workshop designed to facilitate the use of behavior change techniques by health professionals was shown to be largely effective. The workshops resulted in increases in knowledge, descriptive and subjective norms, perceived behavioral control, and intention, but not in attitude. The intervention was also shown to be highly acceptable, with the large majority of participants deeming the intervention to be needed, useful, appropriate, and applicable, as well as interesting and worth their time. Future research should examine the lasting impacts of the workshop on health professionals’ practices.
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Haywood D, Baughman FD, Mullan BA, Heslop KR. Neurocognitive Artificial Neural Network Models Are Superior to Linear Models at Accounting for Dimensional Psychopathology. Brain Sci 2022; 12:1060. [PMID: 36009123 PMCID: PMC9405994 DOI: 10.3390/brainsci12081060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, there has been debate about the optimal conceptualisation of psychopathology. Structural models of psychopathology have been developed to counter issues, including comorbidity and poor diagnostic stability prevalent within the traditional nosological approach. Regardless of the conceptualisation of psychological dysfunction, deficits in neurocognitive abilities have been claimed to be an aetiological feature of psychopathology. Explorations of the association between neurocognition and psychopathology have typically taken a linear approach, overlooking the potential interactive dynamics of neurocognitive abilities. Previously, we proposed a multidimensional hypothesis, where within-person interactions between neurocognitive domains are fundamental to understanding the role of neurocognition within psychopathology. In this study, we used previously collected psychopathology data for 400 participants on psychopathological symptoms, substance use, and performance on eight neurocognitive tasks and compared the predictive accuracy of linear models to artificial neural network models. The artificial neural network models were significantly more accurate than the traditional linear models at predicting actual (a) lower-level and (b) high-level dimensional psychopathology. These results provide support for the multidimensional hypothesis: that the study of non-linear interactions and compensatory neurocognitive profiles are integral to understanding the functional associations between neurocognition and of psychopathology.
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Affiliation(s)
- Darren Haywood
- St. Vincent’s Hospital Melbourne, Mental Health, Fitzroy, VIC 3065, Australia
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
- EnAble Institute, Curtin University, Bentley, WA 6102, Australia
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Barbara A. Mullan
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
- EnAble Institute, Curtin University, Bentley, WA 6102, Australia
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Bentley, WA 6102, Australia
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Haywood D, Baughman FD, Mullan BA, Heslop KR. What Accounts for the Factors of Psychopathology? An Investigation of the Neurocognitive Correlates of Internalising, Externalising, and the p-Factor. Brain Sci 2022; 12:421. [PMID: 35447951 PMCID: PMC9030002 DOI: 10.3390/brainsci12040421] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/11/2022] [Accepted: 03/20/2022] [Indexed: 11/16/2022] Open
Abstract
Neurocognitive deficits have been consistently associated with a wide range of psychopathology and are proposed to not only be a consequence of the development of psychopathology but also directly involved in its aetiology. However, there is no clear understanding of what neurocognitive processes are particularly important to mental health. In this paper, we explored the association between neurocognitive abilities and the factors derived from structural models of psychopathology. Four hundred participants from a representative community sample completed measures of symptomology and substance use, as well as 8 neurocognitive tasks. We found a correlated-factors model, with internalising and externalising as the higher-order factors, and a single-factor model with only the p-factor, to be good fits for the data. Tasks that measured the speed of processing were significantly associated with internalising, externalising, and the p-factor, and accounted for significant amounts of unique variance in the factors after accounting for the common variance of the other tasks. Tasks that measured working memory, shifting, and inhibition were not significantly associated with psychopathology factors. Our findings suggest that neurocognitive abilities may not be differentially associated with psychopathology factors, but that speed of processing is a common correlate of the factors. We emphasise the importance of examining neurocognitive abilities and psychopathology on the individual level.
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Affiliation(s)
- Darren Haywood
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia or (D.H.); (F.D.B.)
- Mental Health, St. Vincent’s Hospital, Melbourne 3065, Australia
| | - Frank D. Baughman
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia or (D.H.); (F.D.B.)
| | - Barbara A. Mullan
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia or (D.H.); (F.D.B.)
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Perth 6845, Australia;
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Haeffel GJ, Jeronimus BF, Fisher AJ, Kaiser BN, Weaver LJ, Vargas I, Goodson JT, Soyster PD, Lu W. The Hierarchical Taxonomy of Psychopathology (HiTOP) Is Not an Improvement Over the DSM. Clin Psychol Sci 2022; 10:285-290. [PMID: 36299281 PMCID: PMC9596130 DOI: 10.1177/21677026211068873] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
In their response to our article (both in this issue), DeYoung and colleagues did not sufficiently address three fundamental flaws with the Hierarchical Taxonomy of Psychopathology (HiTOP). First, HiTOP was created using a simple-structure factor-analytic approach, which does not adequately represent the dimensional space of the symptoms of psychopathology. Consequently, HiTOP is not the empirical structure of psychopathology. Second, factor analysis and dimensional ratings do not fix the problems inherent to descriptive (folk) classification; self-reported symptoms are still the basis on which clinical judgments about people are made. Finally, HiTOP is not ready to use in real-world clinical settings. There is currently no empirical evidence demonstrating that clinicians who use HiTOP have better clinical outcomes than those who use the Diagnostic and Statistical Manual of Mental Disorders (DSM). In sum, HiTOP is a factor-analytic variation of the DSM that does not get the field closer to a more valid and useful taxonomy.
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Affiliation(s)
| | | | - Aaron J. Fisher
- Department of Psychology, University of California, Berkeley
| | - Bonnie N. Kaiser
- Department of Anthropology and Global Health Program, University of California, San Diego
| | | | - Ivan Vargas
- Department of Psychology, University of Arkansas
| | - Jason T. Goodson
- PTSD Clinical Team, VA Salt Lake City Health Care Systems, Salt Lake City, Utah
| | | | - Wei Lu
- Carver School of Medicine, University of Iowa Hospitals and Clinics
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Haywood D, Baughman FD, Mullan BA, Heslop KR. Going "Up" to Move Forward: S-1 Bifactor Models and the Study of Neurocognitive Abilities in Psychopathology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7413. [PMID: 34299862 PMCID: PMC8307957 DOI: 10.3390/ijerph18147413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
Recently, structural models of psychopathology, that address the diagnostic stability and comorbidity issues of the traditional nosological approach, have dominated much of the psychopathology literature. Structural approaches have given rise to the p-factor, which is claimed to reflect an individual's propensity toward all common psychopathological symptoms. Neurocognitive abilities are argued to be important to the development and maintenance of a wide range of disorders, and have been suggested as an important driver of the p-factor. However, recent evidence argues against p being an interpretable substantive construct, limiting conclusions that can be drawn from associations between p, the specific factors of a psychopathology model, and neurocognitive abilities. Here, we argue for the use of the S-1 bifactor approach, where the general factor is defined by neurocognitive abilities, to explore the association between neurocognitive performance and a wide range of psychopathological symptoms. We use simulation techniques to give examples of how S-1 bifactor models can be used to examine this relationship, and how the results can be interpreted.
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Affiliation(s)
- Darren Haywood
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, Perth 6845, Australia
- WA Cancer Prevention Research Unit, School of Population Health, Curtin University, Perth 6845, Australia
| | - Frank D. Baughman
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
| | - Barbara A. Mullan
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, Perth 6845, Australia
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Perth 6845, Australia;
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