Assessing the dimensions and structure of thwarted interpersonal needs

INTRODUCTION

The Interpersonal Needs Questionnaire-15 (INQ-15) assesses interpersonal needs comprising suicidal desire based on the Interpersonal Theory of Suicide (IPTS): Thwarted belongingness (TB) and perceived burdensomeness (PB). The IPTS is applied to many psychological-affective states and disorders, collectively showing state-specific pathways to suicidal features. Given the prevalent application of the IPTS, determining how the constructs are comprised and operate is critical. Consistent with the network perspective of psychological constructs, we used network and algorithmic methods to evaluate thwarted interpersonal needs.

METHODS

A sample (N = 863) aggregated from two independent studies (Sokol & Serper, 2019; Sokol et al., 2023) was used for analysis.

RESULTS

Network analysis identified three dimensions that were invariant by suicide-risk status: PB, and two dimensions from the TB items. Accounting for wording effects, one-dimensional structures presented in 9 %-23 % of replicates. The loadings comparison test algorithm suggested that the constructs were consistent with a network composition (over latent), and centrality indices identified meaningful strong and bridge features.

LIMITATIONS

The samples were demographically homogeneous, and more diverse samples in terms of sexuality, racial/ethnic identification, culture, and socioeconomic status might yield different findings.

CONCLUSION

Findings indicate that thwarted interpersonal needs are comprised of perceived burdensomeness, loneliness, and absence of reciprocal care dimensions and that loneliness-related experiences may be mechanisms by which PB and TB-related experiences co-occur. Additionally, results showed that the INQ-15 may have previously unquantified method effects, but the overall identified dimensions are stable. These results yield a nuanced conceptualization of interpersonal needs and their function.

Hierarchical network structure: A novel approach to conceptualising ICD-11 Complex PTSD using a general population sample from Africa

BACKGROUND

Investigations have sought to model the structure of ICD-11 Complex PTSD (CPTSD) using factor analytic models, finding support for higher-order domains representing PTSD and Disturbances in Self Organisation (DSO). Network analysis has alternatively modelled CPTSD through dimensional symptom associations.

METHODOLOGY

This study investigated the structure of CPTSD leveraging a novel approach, Hierarchical Exploratory Graph Analysis, using African general population samples (N = 2524).

RESULTS

The hierarchical graph model was estimated identifying a structure comprising six lower-order communities, indicative of ICD-11 CPTSD symptom domains, and two higher-order communities, indicative of PTSD and DSO. Results indicate the superiority of the hierarchical model, confirming the conceptualisation of ICD-11 PTSD and CPTSD symptom groupings.

LIMITATIONS

The cross-sectional nature of these data, and novelty of the methods used prompt calls for additional investigation to support these findings.

CONCLUSIONS

Hierarchical Exploratory Graph Analysis may offer a valuable means to better understanding the complexity of CPTSD symptomology through a novel network modelling approach. Relationships between Sense of Threat and Affect Dysregulation may serve as bridging symptoms between PTSD and DSO difficulties. These may be prioritised as the therapeutic targets for CPTSD. This pioneering approach using EGA, offers new insights into the intricate structure of CPTSD, potentially informing the use of assessments and interventions across diverse populations.

An exploratory graphical analysis of the Montgomery-Åsberg Depression Rating Scale pre- and post-treatment using pooled antidepressant trial secondary data

BACKGROUND

The 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) is a commonly used measure of depression in antidepressant clinical trials. Numerous studies have adopted classical test theory perspectives to assess the psychometric properties of this scale, finding generally positive results. However, its network configural structure and stability is unexplored across different time-points and treatment groups.

AIMS

To assess the network structure and stability of the MADRS in clinical settings pre- and post-treatment, and to determine a configurally invariant and stable model across time-points and treatment groups (placebo and intervention).

METHOD

Individual participant data for 6440 participants from 14 clinical trials of major depressive disorder was obtained from the data repository Vivli.org. Exploratory Graphical Analysis (EGA) was used to identify empirical models pre-treatment (baseline) and post-treatment (8-week outcome). Bootstrapping techniques were applied to obtain optimised configurally invariant models.

RESULTS

Empirical models presented with performance issues at baseline and for the placebo group at outcome. An abbreviated 8-item single-community model was found to be stable and configurally invariant across time-points and treatment groups. Symptoms such as low mood and lassitude showed most centrality across all models.

LIMITATIONS

Metric invariance could not be explored due to research environment limitations.

CONCLUSIONS

An 8-item one-community variant of the MADRS may provide optimal performance when conducting network analyses of antidepressant clinical trial outcomes. Findings suggest that interventions targeting low mood and lassitude might be most efficacious in treating depression among clinical trial participants. Further considerations of the potential impact on trial design and analysis should be explored.

Psychometric Evaluation of the Social Phobia Inventory (SPIN) in Algeria: A Comprehensive Approach Utilizing Network Analysis, Confirmatory Factor Analysis, and the Polytomous Rasch Model

This study aimed to evaluate the psychometric characteristics of the Social Phobia Inventory (SPIN) by employing network analysis, confirmatory factor analysis, and the Polytomous Rasch Model. A cross-sectional data set was collected comprising 1,530 participants, with 959 being women and 571 being men. The Bootstrap Exploratory Graph Analysis unveiled the presence of two dimensions, with Items 17, 15, 5, 14, 6, and 9 exhibiting the highest strength centrality index. Notably, the Network Comparison Test indicated no differences in Network Invariance and global strength between the networks of women and men. Furthermore, the confirmatory factor analysis results demonstrated that the two extracted dimensions displayed an acceptable goodness of fit. In addition, the reliability coefficient values were acceptable, exceeding the threshold of 0.70. The Rasch analysis results suggested an overall fit, but some items exhibited overlap, suggesting their potential removal. Furthermore, it was recommended to develop new items to address gaps between existing items, particularly for measuring the lower levels of Social Anxiety Disorder. In conclusion, these findings provide robust evidence supporting the reliability and validity of the SPIN as a tool for measuring Social Anxiety Disorder in Algeria.

Investigating the structure of disordered eating symptoms in adult men: A network analysis

OBJECTIVE

Eating disorders (EDs) increasingly emerge as a health risk in men, but there is concern that men's symptoms go unnoticed due to stereotypical perceptions and gender-related differences in symptom presentation. Novel assessments focused particularly on attitudes and behaviours towards increasing muscle size and definition. Using network analysis, this study aimed to corroborate and extend previous findings on disordered eating presentation in men by examining the role of muscularity concerns among an extended range of disordered eating symptoms.

METHOD

N = 294 adult men (18 years or older) completed muscularity-related and disordered eating assessments, among which we included assessments for orthorexic eating and Avoidant/Restrictive Food Intake Disorder for the first time. We selected symptoms empirically, estimated a regularised network, identified symptom communities, evaluated network loadings and bridge centrality estimates, and compared network structures between different groups of participants.

RESULTS

We identified five symptom communities related to muscularity-related concerns, features of core ED psychopathology, and selective eating. Symptoms regarding ruminating about healthy eating, guilt for unhealthy eating, weight overvaluation, concerns about muscularity, and selective eating emerged as highly central.

DISCUSSION

The results largely corroborate previous observations but suggest that muscle-building behaviours are part of a broader cluster of male body shaping and rule-based dieting behaviours.

The structure of motivation: Assessing readiness to change dimensions and their predictive value with the network validation of the Italian version of the Anorexia Nervosa Stages of Change Questionnarie

OBJECTIVE

Motivation to change is an important predictor for treatment outcomes in individuals with anorexia nervosa (AN), however, the existence and clinical relevance of distinct motivational dimensions are understudied. This study aimed to structurally validate the AN Stage of Change Questionnaire (ANSOCQ) in the Italian adult AN population to identify separate motivational dimensions and their association with clinical variables and outcomes.

METHOD

Inpatients and outpatients with AN (N = 300) completed the ANSOCQ and measures assessing eating and depressive psychopathology. Unique Variable Analysis and Exploratory Graph Analysis were employed to identify dimensions in the network structure of ANSOCQ. Cross-sectional associations with clinical variables were assessed in the whole sample. Predictive value on weight and psychopathology was assessed in inpatients.

RESULTS

Two dimensions were identified, one comprising items relative to weight gain, and the second items regarding attitudes towards eating, body, and emotional problems. Feelings associated with eating resulted as most central in the network. Higher scores in the first dimension and ANSOCQ total predicted weight gain during hospitalisation. No significant predictors emerged for changes in eating psychopathology.

DISCUSSION

These findings confirm the robust psychometric properties of ANSOCQ and provide support for the use of its subdimensions in clinical practice.

Dimensional Validation of the Italian Revised Version of the Children's Sleep Habits Questionnaire (CSHQ-r) for Children and Adolescents with ASD

Sleep problems are common in children with autism spectrum disorder (ASD), with potential repercussions on neurobehavioral functioning exacerbating socio-communicative impairments and aggressive behaviors. Parent reports are the most used method to assess sleep in pediatric populations and a modified 23-item of Children's Sleep Habits Questionnaire (CSHQ) for ASD has been proposed in the United States. The generalizability of the CSHQ for ASD has yet to be validated across countries, including Italy. To extend the CSHQ applicability to Italian youth with ASD, we back-translated to Italian and revised the 23-item CSHQ, validating its dimensional structure in a sample of children and adolescents with ASD using Explorative Graph Analysis. In addition, we compared the revised scale scores of the ASD group with a typically developing (TD) group. The revised Italian version of the CSHQ (CSHQ-r) consisted of a 15-item tool with a four-dimension structure (Sleep initiation/duration, Sleep anxiety/Co-sleeping, Night awakenings/Parasomnias, and Daytime alertness) with good structural stability. Group comparison indicated significantly higher scores in the ASD group than the TD group, suggesting greater prevalence of sleep disturbances in ASD. The four-dimensional CSHQ-r may represent a useful screening tool to assess sleep disorders in Italian children and adolescents with ASD, with potential implications for clinical practice.

A symptom-level perspective on irritability, PTSD, and depression in children and adults

BACKGROUND

Although irritability is a prominent clinical manifestation among traumatized populations, its relationships with other psychopathologies are rarely studied. Adopting a symptom-level perspective, this study aimed to explore how symptoms of irritability, posttraumatic stress disorder (PTSD), and depression are associated.

METHOD

The Brief Irritability Test, the PTSD Checklist for DSM-5, and the Patient Health Questionnaire-9 were used to measure irritability, PTSD, and depression, respectively, in a large sample of trauma-exposed children and adolescents (n = 5454), trauma-exposed adults (n = 4718), and children and adolescents with probable PTSD (n = 556). Exploratory graph analysis (EGA) and network analysis were conducted to examine potential communities and significant relations.

RESULTS

Although irritability, PTSD, and depression were highly correlated at the disorder level, EGA results indicated that, at the symptom level, they formed highly stable and dense communities, respectively. Relations across disorders mainly emerged at symptoms related to negative cognition, dysphoria, and suicidal thoughts. Especially, strong transdiagnostic relations across all samples were "negative beliefs" and "suicidal thoughts", "numbing" and "suicidal thoughts", "startle" and "moving slowly or restless", "bothering" and "moving slowly or restless". Furthermore, irritability symptoms seem more central than PTSD and depression symptoms, with "snap" being the most central node across all networks, especially in the child and adolescent sample.

CONCLUSION

Irritability, PTSD, and depression are relatively independent constructs when analyzed at the symptom level. Irritability symptoms emerged as core symptoms in trauma-exposed populations. Our findings highlight the importance of independent assessment of irritability in the diagnosis and treatment of PTSD.

Demoralization's link to depression and anxiety symptoms: A network analysis

Demoralization represents a clinical syndrome conceptualized as maladaptive coping to a stressor associated with discouragement, feelings of hopelessness, helplessness, and a loss of meaning in life. It is a prevalent comorbidity in individuals with severe physical illnesses and affects a substantial proportion of the general population when facing global stressors like the COVID-19 pandemic. The main aim of the study was to test whether demoralization and features of depression and anxiety might reflect distinct entities within the general population, specifically in older adults, and to explore symptom interconnections, using a network psychometrics approach. The revised demoralization scale (DS-II) and the patient health questionnaire 4 (PHQ-4) were applied to a representative sample (N = 2434) from the German general population. Network structures were analyzed using exploratory graph analysis (EGA) to identify the most distinct symptom groupings and their relationships. Stability of networks and symptom groupings was tested using bootstrap procedures. EGA revealed unidimensionality within younger adulthood and a four-factor solution within older adults, reliably distinguishing PHQ-4 and DS-II items. The most central features of the network were worthlessness, pointlessness, helplessness, feeling trapped and low mood. Suicidal ideation was more closely related to DS-II worthlessness than to PHQ-4 items. The cross-sectional design and using PHQ-4 instead of more comprehensive measures of depression and anxiety were limitations. In conclusion, in general population, demoralization symptoms can be distinguished from lack of interest or pleasure and low mood. It might represent a valid psychological construct beyond clinical populations. Further investigation of diagnostic implications is encouraged.

Detecting psychometric and diagnostic performance of the RU_SATED v2.0 multidimensional sleep health scale in community-dwelling adults combining exploratory graph analysis and ROC analysis

OBJECTIVE

The RU_SATED scale is increasingly used across the globe to measure sleep health. However, there is a lack of consensus around its psychometric and diagnostic performance. We conducted an empirical investigation into the psychometrics of the Chinese version of the RU_SATED (RU_SATED-C) scale, with a focus on structural validity and diagnostic performance.

METHODS

1171 adults were enrolled from three communities in Hangzhou, China in July 2022. The dataset was spilt in half, and we ran a bootstrapped exploratory graph analysis (bootEGA) in one half and a confirmatory factor analysis (CFA) in the other half to assess structural validity. Correlations with insomnia, wellness, anxiety, and depression symptoms were examined in order to assess concurrent validity; and Cronbach's α and McDonald's ω were calculated to assess internal consistency. Additionally, a Receiver Operating Characteristic (ROC) analysis established and externally validated the optimal score for identifying insomnia symptoms.

RESULTS

A one-dimensional structure, as identified by bootEGA, was corroborated in the CFA [comparative fit index = 0.934, root mean square error of approximation = 0.088, standardized root mean square residual = 0.051]. A moderate correlation was shown with insomnia symptoms, while weak correlations were observed with wellness, anxiety, and depression symptoms. The RU_SATED-C scale displayed sub-optimal internal consistency where coefficients dropped if any item was removed. A recommended cutoff score of ≤13 was derived for probable insomnia with a satisfactory diagnostic performance.

CONCLUSION

The RU_SATED-C scale displayed a one-dimensional model, along with adequate concurrent validity, internal consistency, and diagnostic performance. Further work necessitates multi-scenario testing and additional validation using objective sleep assessments.

Network structure of REM sleep behavior disorder symptoms in iRBD patients

OBJECTIVE

Employing the REM Sleep Behavior Disorder Questionnaire-Hong Kong (RBDQ-HK) to investigate symptoms and their severity in rapid eye movement (REM) sleep behavior disorder (RBD) patients, this study delves into the construct of RBD through the RBDQ-HK and its links to depression and sleep quality.

METHODS

Data from the RBDQ-HK, the Geriatric Depression Scale (GDS), and the Pittsburgh Sleep Quality Index (PSQI) were compiled from individuals with isolated RBD (iRBD) confirmed by polysomnography. We constructed a network analysis of the RBDQ-HK, measured the centrality of each symptom (node), conducted Exploratory Graph Analysis (EGA) to unveil the dimension structure of the questionnaire, and calculated bridge expected influence (BEI) to identifying critical bridge. Multivariate linear regression was also employed to discover relationships between RBDQ-HK dimensions and variables such as PSQI and GDS.

RESULTS

In our cohort of 455 iRBD patients (299 males), the items in the RBDQ-HK were divided into three dimensions: dream, movement, and SRI/violence. The symptoms identified as most central to RBD were 'shouting or yelling in sleep', 'dream-enacting movements', and 'talking during sleep'. The highest (BEI) was 'violent and aggressive dreams', which has the potential to bridge three dimensions within the symptom network. Depression was significantly correlated with the movement and dream dimensions of RBD, and sleep quality was predominantly related to the dream dimension score.

CONCLUSION

Our findings verify that the principal symptoms of the RBDQ-HK align with the established diagnostic criteria and reveal a three-dimensional structure within RBD symptoms. The relationships between the RBD symptoms, depression, and sleep quality need to be identified for the effective management of RBD patients.

Validation and structural exploration of the Chinese version of the Body Talk Scale

The Body Talk Scale (BTS) measures both negative body talk (including fat talk and muscle talk) and positive body talk across genders. In this study, we translated it into Chinese and assessed its structure, reliability and validity among mainland Chinese residents. Item analyses indicated that no item deletion was necessary for this study, and both exploratory factor analysis (n = 1853) and exploratory graph analysis (n = 1583) supported the three-factor structure of the original scale. Confirmatory factor analysis showed that the scale had a good model fit with CFI= 0.95, GFI= 0.93, TLI= 0.94, and RMSEA= 0.079(90 %CI [0.075, 0.084]). The results also showed that the Chinese version of the BTS had adequate criterion-related validity，internal consistency and six-week test-retest reliability. Meanwhile, the scale has good measurement invariance with respect to gender and can be tested for gender differences. In conclusion, the BTS showed sufficient psychometric properties in a Chinese sample, making it a valid instrument for studying body talk and health status in Chinese populations.

Evidence of validity of the Head-Toes-Knees-Shoulders Revised (HTKS-R) for Brazilian children

This study aims to examine the reliability and validity of the Head-Toes-Knees-Shoulders Revised (HTKS-R) as a measure of self-regulation in Brazilian children aged 3-5. The early childhood period is crucial for laying the foundations for personal, social and cognitive functioning, influencing development throughout life. Self-regulation, a malleable construct, plays a vital role in academic performance and behaviors throughout life. The HTKS-R, a widely used measure, assesses behavioral self-regulation, including cognitive flexibility, working memory and inhibitory control. The study included 379 children between the ages of 3 and 5 from a variety of backgrounds. Data were collected using the HTKS-R, a standardized self-report measure that integrates executive functions into a game to assess self-regulation. Exploratory Graphical Analysis (EGA) and Confirmatory Factor Analysis (CFA) were employed to analyze the data. The results of the EGA and BootEGA indicated a unidimensional structure for the HTKS-R, confirming its internal consistency and stability. The CFA supported the fit of the unidimensional model, demonstrating the test's construct validity. The HTKS-R showed factorial invariance between genders. The results suggest that the HTKS-R is a reliable and valid measure of self-regulation in Brazilian children aged 3-5. The applicability of the test in different age groups and environments provides valuable information about children's self-regulation skills. The study contributes to the literature by validating the HTKS-R in the Brazilian context and highlights its potential for assessing self-regulation in diverse populations.

PRONA: an R-package for Patient Reported Outcomes Network Analysis

SUMMARY

Network analysis (NA) has recently emerged as a new paradigm by which to model the symptom patterns of patients with complex illnesses such as cancer. NA uses graph theory-based methods to capture the interplay between symptoms and identify which symptoms may be most impactful to patient quality of life and are therefore most critical to treat/prevent. Despite NA's increasing popularity in research settings, its clinical applicability is hindered by the lack of a unified platform that consolidates all the software tools needed to perform NA, and by the lack of methods for capturing heterogeneity across patient cohorts. Addressing these limitations, we present PRONA, an R-package for Patient Reported Outcomes Network Analysis. PRONA not only consolidates previous NA tools into a unified, easy-to-use analysis pipeline, but also augments the traditional approach with functionality for performing unsupervised discovery of patient subgroups with distinct symptom patterns.

AVAILABILITY AND IMPLEMENTATION

PRONA is implemented in R. Source code, installation, and use instructions are available on GitHub at https://github.com/bbergsneider/PRONA.

The rubber hand illusion questionnaire: An exploratory graph analysis of ownership, referral of touch, and control statements

The rubber hand illusion is a well-known experiment that allows manipulation of one's own body experience. The original questionnaire gauges both the illusion experience and unforeseen experiences acting as control statements. In particular, two statements pertain to the referral of touch originating from the rubber hand (RoT), and one concerns the feeling of ownership of the rubber hand (SoO). Despite its prominence, the rubber hand illusion questionnaire has not undergone thorough examination of its psychometric properties. The literature reveals a tendency to use RoT and SoO statements interchangeably. In this study, we employed Exploratory Graph Analysis to explore the item structure and compared the correlation between SoO and RoT items in various conditions. While SoO and RoT are closely linked, our findings suggest potential separation. SoO and RoT statements consistently correlate, yet hints emerge that RoT might represent a distinct facet of the illusion. Correlations diminish beyond the perihand space, indicating a nuanced relationship. Additionally, moderate relationships between control statements and those measuring the illusion suggest that even control statements are modulated by the illusion experience. This study underscores the need for further exploration into the psychometric properties of body illusion questionnaires, prompting reflections on the interpretation in light of these results.

The Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale: Longitudinal psychometric syntheses with 10-year cohort multi-center evidence in an adult sample

OBJECTIVE

To evaluate cross-sectional (CMI), longitudinal (LMI), and cross-measurement invariance (C-LMI) of the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale (CES-D 8) and reconfirm other properties for measuring depression construct.

METHODS

11,479 Chinese adults from China Family Panel Studies were enrolled and randomly split into two halves. The exploratory half was used to reidentify the structures of the CES-D 8 by bootstrap exploratory graph analysis (bootEGA) and the confirmatory half was used to compare and choose the structure by confirmatory factor analysis (CFA).

RESULTS

The original two-factor model was found satisfactory as the solution for the Chinese CES-D 8 because of the relatively best fit. The CMI, LMI, and C-LMI were supported within groups of gender, age, marital status, and time with indices that have met the expectations. The Chinese CES-D 8 also showed sufficient internal consistencies with Cronbach's alpha valuing 0.795-0.868 and McDonald's omega valuing 0.850-0.870.

CONCLUSIONS

The CES-D 8 presents sufficient psychometric syntheses for assessing depressive symptoms to adulthood. These results demonstrate adequate measurement invariances and can be reliably used at different genders, ages, and long-term time points in Chinese cultural backgrounds.

A new way to conceptualize intolerance of uncertainty among adolescents: Embracing the network perspective

Intolerance of uncertainty (IU), a pivotal transdiagnostic risk factor in psychopathology, is defined as a dispositional incapacity to withstand uncertainty distress, driving maladaptive cognitive, emotional and behavioural reactions to uncertainty. However, the intricate interplay among these components, particularly in adolescents, remains underexplored; yet understanding this interplay is crucial for supporting mental health. To address this gap, we employed a network approach to conceptualize IU in 5672 non-clinical Chinese adolescents (Mage = 14.13 years, SDage = 1.96 years, range = 10-19 years, 46.6% boys), combining graphical Gaussian models (GGM) and directed acyclic graphs (DAG). Our analyses revealed a tripartite network comprising cognitive, behavioural and emotional components. Notably, 'frustration' and 'work with hindrance' emerged as key drivers, while 'catastrophizing belief' served as a critical bridge linking different components. These findings underscore the importance of alleviating uncertainty-induced frustration and enhancing coping skills for behavioural impediments to mitigate adolescent IU. Additionally, therapeutic interventions should prioritize modifying and re-evaluating catastrophizing beliefs related to uncertainty.

Acceptance as a possible link between past psychedelic experiences and psychological flexibility

Increased psychological flexibility (PF) may underlie the lasting positive effects of psychedelic experiences on mental well-being. The associations between different components of PF, psychological inflexibility (PI), and well-being with psychedelic use are not well understood. We conducted a cross-sectional internet survey of participants (N = 629) with experience of classical psychedelics. Using network analysis, we examined how aspects of a single psychedelic experience (mystical-type features and psychological insights) and the frequency of past psychedelic use, were associated with current PF and PI components, as well as with mental well-being and ill-being. Mediation analyses explored whether PF mediated the relationship between past psychedelic use and well-being or ill-being. The network analysis linked psychological insight to the PF component Acceptance, with no association found between the frequency of past use and PF. Mediation analyses showed PF mediates the association between past psychedelic use and well-being and ill-being. These results suggest that the quality and depth of the psychedelic experience, rather than the frequency of use, are primarily linked to psychological flexibility, particularly Acceptance, and overall well-being. This underscores the importance of treating PF as a multidimensional construct to better understand the long-term mental health benefits of psychedelics.

Network structure of symptomatology of adult attention-deficit hyperactivity disorder in patients with mood disorders

Patients with mood disorders commonly manifest comorbid psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated ADHD symptoms in this population. The current study aimed to explore the network structure of ADHD symptomology and identify central symptoms in patients with mood disorders. The Korean version of the Adult ADHD Self-Report Scale was used to assess the overall ADHD symptoms in 1,086 individuals diagnosed with mood disorders (major depressive disorder [n = 373], bipolar I disorder [n = 314], and bipolar II disorder [n = 399]). We used exploratory graph analysis to detect the number of communities, and the network structure was analyzed using regularized partial correlation models. We identified the central ADHD symptom using centrality indices. Network comparison tests were conducted with different subgroups of patients with mood disorders, including three mood diagnosis groups, between the patients who met the diagnostic criteria for ADHD [ADHD-suspected, n = 259] in their self-report and the others [ADHD-non-suspected, n = 827], and groups with high [n = 503] versus low [n = 252] levels of depressive state. The network analysis detected four communities: disorganization, agitation/restlessness, hyperactivity/impulsivity, and inattention. The centrality indices indicated that "feeling restless" was the core ADHD symptom. The result was replicated in the subgroup analyses within our clinically diverse population of mood disorders, encompassing three presentations: Patients with suspected ADHD, patients without suspected ADHD, and patients with a high depressive state. Our findings reveal that "feeling restless" is the central ADHD symptom. The treatment intervention for "feeling restless" may thus play a pivotal role in tackling ADHD symptoms in adult patients with mood disorders.

Deciphering the interplay between psychopathological symptoms, sensorimotor, cognitive and global functioning: a transdiagnostic network analysis

BACKGROUND

Understanding the relationship between psychopathology and major domains of human neurobehavioral functioning may identify new transdiagnostic treatment targets. However, studies examining the interrelationship between psychopathological symptoms, sensorimotor, cognitive, and global functioning in a transdiagnostic sample are lacking. We hypothesized a close relationship between sensorimotor and cognitive functioning in a transdiagnostic patient sample.

METHODS

We applied network analysis and community detection methods to examine the interplay and centrality [expected influence (EI) and strength] between psychopathological symptoms, sensorimotor, cognitive, and global functioning in a transdiagnostic sample consisting of 174 schizophrenia spectrum (SSD) and 38 mood disorder (MOD) patients. All patients (n = 212) were examined with the Positive and Negative Syndrome Scale (PANSS), the Heidelberg Neurological Soft Signs Scale (NSS), the Global Assessment of Functioning (GAF), and the Brief Cognitive Assessment Tool for Schizophrenia consisted of trail making test B (TMT-B), category fluency (CF) and digit symbol substitution test (DSST).

RESULTS

NSS showed closer connections with TMT-B, CF, and DSST than with GAF and PANSS. DSST, PANSS general, and NSS motor coordination scores showed the highest EI. Sensory integration, DSST, and CF showed the highest strength.

CONCLUSIONS

The close connection between sensorimotor and cognitive impairment as well as the high centrality of sensorimotor symptoms suggests that both domains share aspects of SSD and MOD pathophysiology. But, because the majority of the study population was diagnosed with SSD, the question as to whether sensorimotor symptoms are really a transdiagnostic therapeutic target needs to be examined in future studies including more balanced diagnostic groups.

Symptom Network Analysis and Unsupervised Clustering of Oncology Patients Identifies Drivers of Symptom Burden and Patient Subgroups With Distinct Symptom Patterns

BACKGROUND

Interindividual variability in oncology patients' symptom experiences poses significant challenges in prioritizing symptoms for targeted intervention(s). In this study, computational approaches were used to unbiasedly characterize the heterogeneity of the symptom experience of oncology patients to elucidate symptom patterns and drivers of symptom burden.

METHODS

Severity ratings for 32 symptoms on the Memorial Symptom Assessment Scale from 3088 oncology patients were analyzed. Gaussian Graphical Model symptom networks were constructed for the entire cohort and patient subgroups identified through unsupervised clustering of symptom co-severity patterns. Network characteristics were analyzed and compared using permutation-based statistical tests. Differences in demographic and clinical characteristics between subgroups were assessed using multinomial logistic regression.

RESULTS

Network analysis of the entire cohort revealed three symptom clusters: constitutional, gastrointestinal-epithelial, and psychological. Lack of energy was identified as central to the network which suggests that it plays a pivotal role in patients' overall symptom experience. Unsupervised clustering of patients based on shared symptom co-severity patterns identified six patient subgroups with distinct symptom patterns and demographic and clinical characteristics. The centrality of individual symptoms across the subgroup networks differed which suggests that different symptoms need to be prioritized for treatment within each subgroup. Age, treatment status, and performance status were the strongest determinants of subgroup membership.

CONCLUSIONS

Computational approaches that combine unbiased stratification of patients and in-depth modeling of symptom relationships can capture the heterogeneity in patients' symptom experiences. When validated, the core symptoms for each of the subgroups and the associated clinical determinants may inform precision-based symptom management.

A Network Analytic Approach to Dissociation: New Insights from Clinical Data

The transdiagnostic construct of dissociation, characterized by a disintegration of specific psychological functions such as consciousness, memory, identity, perception, body representation, and behavior, remains elusive to a unified conceptualization. Specifically, its dimensionality is a matter of ongoing controversy. Empirical approaches applying factor analyses to the Dissociative Experiences Scale (DES) have yielded inconsistent findings. This study adopts a novel methodological approach, utilizing Exploratory Graph Analysis (EGA) to address this issue. In a sample of 668 day-hospital patients undergoing psychotherapy for a variety of mental disorders, a Gaussian graphical model was estimated for the 28 items of the DES. Additionally, the stability of the results was ensured by bootstrap procedures. While both the original EGA and the bootstrap EGA suggested four dimensions, the structural consistency of this solution was low due to an instability of 12 items. After excluding 10 of these unstable items, re-analyses again revealed a four-factor structure, but boot EGA indicated that one factor had unsatisfactory structural consistency due to the multidimensionality of its two items. Upon removing these, our final network consisted of 16 items mapping onto 3 dimensions. Our study, using data from a diagnostically heterogeneous sample, replicates and extends previous findings on the dimensionality of dissociation as captured by the DES. The three dimensions identified correspond to segregated processes, derealization/depersonalization, and absorption. This solution aligns with a bipartite model of dissociation with two broader categories referring to either altered states of consciousness (often named detachment) or to non-integrated mental modules (labeled as compartmentalization).

Navigating Ambiguity: Adapting and Validating the Personal Need for Structure Scale in Spanish

The Personal Need for Structure (PNS) scale assesses individuals' tendency to seek out clarity and structured ways of understanding and interacting with their environment. The main aim of this study was to adapt the PNS scale to Spanish and assess its psychometric properties. There are two versions of the PNS scale being used, which vary in the number of dimensions (1 vs. 2), and in the number of items (12 vs. 11; because one version excludes Item 5). Therefore, an additional aim of this study was to compare the two existing versions of the PNS scale. This comparison aimed to address the debate regarding the inclusion of Item 5, and the number of dimensions that comprise the PNS scale. A sample of 735 individuals was collected. First, through an approach combining exploratory and confirmatory analyses, evidence was found in favor of the scale being composed of two related but distinguishable factors: Desire for Structure and Response to the Lack of Structure. Scores on these subscales showed acceptable internal consistency and test-retest reliability. Evidence supporting the invariance of the internal structure across sociodemographic variables such as gender and age was found. Validity evidence was also analyzed by examining the relationships with other relevant measures. The results indicated that Item 5 can be excluded without reducing scores validity or reliability, which supports preceding research in the literature. In conclusion, the PNS scale was satisfactorily adapted to and validated in Spanish and its use in this context is recommended.

The Common Structure of the Major Psychoses: More Similarities Than Differences in the Network Structures of Schizophrenia, Schizoaffective Disorder, and Psychotic Bipolar Disorder

BACKGROUND AND HYPOTHESIS

There has been a century-long debate about whether the major psychoses (eg, bipolar disorder, schizophrenia, and schizoaffective disorder) are one disorder with various manifestations or different disease entities. Traditional approaches using dimensional models have not provided decisive findings. Here, we address this question by examining the network constellation of affective and psychotic syndromes.

DESIGN

Comparable symptom data of 1882 patients with psychotic bipolar disorder, schizoaffective disorders, and schizophrenia were extracted from three datasets: B-SNIP 1, B-SNIP2, and PARDIP. Twenty-six items from the Positive and Negative Syndrome Scale, YMRS, and the Montgomery-Asberg Depression Rating Scale were selected for the analysis using a principled approach to eliminate overlapping/redundant items. Gaussian graphical models were estimated and assessed for stability, and their communities were identified using bootstrapped exploratory graph analysis. The structures and global densities of the networks were compared with network comparison tests.

RESULTS

The network structures were highly similar (r >. 80) across diagnostic groups. For all diagnoses, manic symptoms were more connected with positive symptoms while depressive symptoms were more linked with negative symptoms. The depressive and negative symptoms were the strongest indicators of depressive and psychotic communities. Theoretically interesting variability in network edge weights between symptoms was found relating to thought disorder and pessimistic thinking.

CONCLUSIONS

The same broad structure of psychopathology underlies the symptom expressions of bipolar disorder, schizoaffective disorder, and schizophrenia. Future studies should build on the present finding by comparing specific inter-relations between symptoms in the different diagnostic groups using methods capable of detecting causality.

Revisiting the Structure of the Chinese Version of the Questionnaire of Cognitive and Affective Empathy and Its Relationships with Schizotypy and Paranoia Using Network Approaches

Empathy is predominantly assessed with self-report questionnaires. However, their structural validities were not well-supported. This study aimed to re-explore and refine the factor structure of the Chinese version of the Questionnaire of Cognitive and Affective Empathy (QCAE) and investigate the pathways linked between dimensions of empathy and schizotypy. Data from a valid sample of 1,360 community-dwelling adults (aged 18-35) were subjected to the exploratory graph analysis (EGA) and bootstrap EGA for factor retention. A goodness-of-fit evaluation was conducted using confirmatory factor analysis (CFA). Lastly, a Gaussian graphical model with sum scores of the resultant empathy dimensions, positive, negative, and disorganized schizotypy, and paranoia as nodes was estimated. Results supported a three-factor structure for the revised 20-item QCAE, demonstrating a good model fit. The new Online simulation subscale was associated with reduced disorganized schizotypy, whereas the new Perspective-taking subscale was associated with decreased disorganized schizotypy and increased positive schizotypy. The composite Affective empathy subscale was associated with decreased negative schizotypy and increased positive and disorganized schizotypy and paranoia. Overall, the revised QCAE demonstrated good structural validity, measuring three separable and internally cohesive factors of empathy. Each factor possessed unique and differential relationships with schizotypy dimensions that merit research and clinical attention.

Dimensionality assessment in the presence of wording effects: A network psychometric and factorial approach

This study proposes a procedure for substantive dimensionality estimation in the presence of wording effects, the inconsistent response to regular and reversed self-report items. The procedure developed consists of subtracting an approximate estimate of the wording effects variance from the sample correlation matrix and then estimating the substantive dimensionality on the residual correlation matrix. This is achieved by estimating a random intercept factor with unit loadings for all the regular and unrecoded reversed items. The accuracy of the procedure was evaluated through an extensive simulation study that manipulated nine relevant variables and employed the exploratory graph analysis (EGA) and parallel analysis (PA) retention methods. The results indicated that combining the proposed procedure with EGA or PA achieved high accuracy in estimating the substantive latent dimensionality, but that EGA was superior. Additionally, the present findings shed light on the complex ways that wording effects impact the dimensionality estimates when the response bias in the data is ignored. A tutorial on substantive dimensionality estimation with the R package EGAnet is offered, as well as practical guidelines for applied researchers.

Assessment of psychometric performance for the Chinese version of the Brief Inventory of Perceived Stress integrating exploratory graph analysis and confirmatory factor analysis

OBJECTIVE

This study was to evaluate measurement properties of the Chinese version of the Brief Inventory of Perceived Stress (BIPS-C) and confirm possible solutions for measuring the constructs underlying perceived stress.

METHODS

A total of 1356 community residents enrolled and were randomly split into two halves. The first half was used to explore the underlying constructs of the BIPS-C by exploratory graph analysis (EGA) and the second half was used to compare and confirm the constructs by confirmatory factor analysis (CFA).

RESULTS

The EGA identified a one-factor model of the BIPS-C with an accuracy of 99.3%. One-factor, three-factor, second-order, and bifactor models were compared by CFAs. The bifactor model with one general and three specific factors was found to be the most adequate [comparative fit index (CFI) = 0.990; Tucker-Lewis index (TLI) = 0.979; root mean square error of approximation (RMSEA) = 0.058] and was superior to the other models. The related bifactor indices showed a stronger existence of the general factor. The bifactor model of the BIPS-C also showed adequate internal consistency with McDonald's omega and omega subscales ranging from moderate to strong (0.677-0.869).

CONCLUSION

The BIPS-C demonstrates sufficient measurement properties for assessing general perceived stress.

Linking social motivation, general motivation, and social cognition to interpersonal functioning in schizophrenia: insights from exploratory graph analysis

Motivation in general, and social motivation in particular are important for interpersonal functioning in individuals with schizophrenia. Still, their roles after accounting for social cognition, are not well understood. The sample consisted of 147 patients with schizophrenia. General motivation was measured using the Behavioral inhibition/activation scale (BIS/BAS). Social motivation was measured by Passive social withdrawal and Active social avoidance items from PANSS. Interpersonal functioning was evaluated with Birchwood's Social Functioning Scale (SFS). We used Exploratory Graph Analysis for network estimation and community detection. Active social avoidance, passive social withdrawal, and social withdrawal/engagement (from SFS) were the most important nodes. In addition, three distinct communities were identified: Social cognition, Social motivation, and Interpersonal functioning. Notably, the BIS and BAS measures of general motivation were not part of any community. BAS showed stronger links to functioning than BIS. Passive social withdrawal was more strongly linked to interpersonal functioning than social cognitive abilities. Results suggest that social motivation, especially social approach, is more closely related to interpersonal functioning in schizophrenia than general motivation. In contrast, we found that general motivation was largely unrelated to social motivation. This pattern highlights the importance of type of motivation for understanding variability in interpersonal difficulties in schizophrenia.

Personal Recovery With Bipolar Disorder: A Network Analysis

BACKGROUND

Personal recovery is valued by people with bipolar disorder (BD), yet its conceptualisation is unclear. Prior work conceptualising personal recovery has focussed on qualitative evidence or clinical factors without considering broader psychosocial factors. This study used a network analysis of Bipolar Recovery Questionnaire (BRQ) responses, aiming to identify (1) independent relationships between items to identify those most "central" to personal recovery and (2) how the relationships between items reflect themes of personal recovery.

METHODS

The model was developed from BRQ responses (36 items) from 394 people diagnosed with bipolar disorder. The undirected network was based on a partial correlation matrix and was weighted. Strength scores were calculated for each node. Community detection analysis identified potential themes. The accuracy of the network was assessed using bootstrapping.

RESULTS

Two consistent communities were identified: "Access to meaningful activity" and "Learning from experiences." "I feel confident enough to get involved in things in life that interest me" was the strongest item, although the strength stability coefficient (0.36) suggested strength should be interpreted with caution. The average edge weight was 0.02; however, stronger edges were identified.

LIMITATIONS

The network showed low stability, possibly due to sample heterogeneity. Future work could incorporate demographic variables, such as time since BD diagnosis or stage of personal recovery, into network estimation.

CONCLUSIONS

Network analysis can be applied to personal recovery, not only clinical symptoms of BD. Clinical applications could include tailoring recovery-focussed therapies towards encouraging important aspects of recovery, such as feeling confident to get involved with life.

The Broad Autism Phenotype-International Test (BAP-IT): A two-domain-based test for the assessment of the broad autism phenotype

LAY ABSTRACT

The broad autism phenotype refers to a group of behaviors related to autism spectrum disorder, but that appear to a lesser extent. Its assessment has been performed through outdated broad autism phenotype/autism spectrum disorder definitions and tests. To address this problem, this study presents the development of a new test, the Broad Autism Phenotype-International Test, a 20-item measure consisting of two dimensions, SOCIAL-BAP and RIRE-BAP, targeting the two-domain operationalization of autism spectrum disorder in Spain and the United Kingdom. Unlike the Broad Autism Phenotype Questionnaire, this test received empirical support as a quick and effective broad autism phenotype measure that can facilitate both broad autism phenotype/autism spectrum disorder research and interventions. This is the first step to studying the BAP in several Spanish and English-speaking countries.

Improving the Use of Parallel Analysis by Accounting for Sampling Variability of the Observed Correlation Matrix

Parallel analysis has been considered one of the most accurate methods for determining the number of factors in factor analysis. One major advantage of parallel analysis over traditional factor retention methods (e.g., Kaiser's rule) is that it addresses the sampling variability of eigenvalues obtained from the identity matrix, representing the correlation matrix for a zero-factor model. This study argues that we should also address the sampling variability of eigenvalues obtained from the observed data, such that the results would inform practitioners of the variability of the number of factors across random samples. Thus, this study proposes to revise the parallel analysis to provide the proportion of random samples that suggest k factors (k = 0, 1, 2, . . .) rather than a single suggested number. Simulation results support the use of the proposed strategy, especially for research scenarios with limited sample sizes where sampling fluctuation is concerning.

Assessing a measure for Quality of Life in patients with severe Alopecia Areata: a multicentric Italian study

Objective

The prevalence of anxiety and depression in patients diagnosed with Alopecia Areata (AA) is very high and this significant burden of psychological symptoms threatens the Health-Related Quality of Life (HRQoL) of affected patients. Indeed, AA often does not produce significant physical symptoms, but it nonetheless disrupts many areas of mental health. Clinical assessment of disease severity may not reliably predict patient's HRQoL, nor may it predict the patient's perception of illness. For this reason, considerable effort has been made to apply and develop measures that consider patient's perception and assess the HRQoL of individuals affected by AA. The aim of this multicentric study was to provide the Italian version of the Skindex-16AA and to evaluate its psychometric properties in a clinical sample of consecutive patients with moderate-to-severe AA.

Methods

This is a longitudinal, multicenter, observational study. Patients returned for follow-up visits at 4-, 12-, and 24-weeks. The analyses of the current work aimed to confirm the factorial structure of the Skindex-16AA. In the case of non-fit, an alternative structure for the model was proposed, using an Exploratory Graph Analysis and the Bayesian approach.

Results

The sample was composed of 106 patients with AA. Alopecia Universalis was the most frequently diagnosed type of alopecia at all time points. The analyses on the Skindex-16AA revealed that a two-factor structure with eight items fit the data best (Bayesian Posterior Predictive Checking using 95% Confidence Interval for the Difference Between the Observed and the Replicated Chi-Square values = -6.246/56.395, Posterior Predictive P-value = 0.06), and reported satisfactory psychometric properties (i.e., internal consistency and convergent validity).

Conclusion

The Skindex-8AA demonstrated optimal psychometric properties (i.e., convergent and construct validity, and test-retest reliability) measured in a sample of patients with AA, that may suggest that it is an appropriate tool to measure the HRQoL in AA patients. However, further studies are needed in order to confirm and tested other psychometric features of this tool.

Using exploratory graph analysis (EGA) in validating the structure of the Perth alexithymia questionnaire in Iranians with chronic pain

Background

Chronic pain's influence on emotional well-being can be significant. It may evoke feelings of despair, frustration, nervousness, and melancholy in individuals, which often manifest as reactions to enduring pain and disruptions in their daily lives. In this study, we seek to perform Bootstrap Exploratory Graph Analysis (EGA) on the Persian Version of the Perth Alexithymia Questionnaire (PAQ) in a cohort of people with chronic pain.

Methods

The research concentrated on the population of individuals encountering chronic pain within Tehran province from 2022 to 2023. Ultimately, the analysis comprised information from 234 male participants (with a mean age of 30.59, SD = 6.84) and 307 female participants (with a mean age of 30.16, SD = 6.65). After data collection, statistical analysis was conducted using the EGAnet2.0.4 package in R.4.3.2 software.

Results

The outcome of bootstrapped EGA unveiled a two-dimensional configuration of the PAQ comprising Factor 1 denoted as negative difficulty in describing and identifying feelings (N-DDIF) and Factor 2 characterized as general-externally orientated thinking (GEOT), representing robust structural integrity and item consistency (all items have stabilities > 0.70).

Conclusion

These findings endorse the validity of the PAQ, as evidenced by its confirmation in a broader sample using a novel methodology consistent with existing literature on two-factor decentering models.

The Network Structure of Cognitive Impairment: From Subjective Cognitive Decline to Alzheimer's Disease

It was proposed that a reorganization of the relationships between cognitive functions occurs in dementia, a vision that surpasses the idea of a mere decline of specific domains. The complexity of cognitive structure, as assessed by neuropsychological tests, can be captured by exploratory graph analysis (EGA). EGA was applied to the neuropsychological assessment of people (humans) with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer's disease (AD; total N = 638). Both sexes were included. In AD, memory scores detach from the other cognitive functions, and memory subdomains reduce their reciprocal relation. SCD showed a pattern of segregated neuropsychological domains, and MCI showed a noisy and less stable pattern. Results suggest that AD drives a reorganization of cognitive functions toward a less-fractionated architecture compared with preclinical conditions. Cognitive functions show a reorganization that goes beyond the performance decline. Results also have clinical implications in test interpretations and usage.

Confirmatory validation of the Mesothelioma Psychological Distress Tool-Patients: A brief patient-reported outcome measure assessing psychological distress in malignant mesothelioma patients

OBJECTIVE

Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool-Patients (MPDT-P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-P.

METHODS

The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT-P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach.

RESULTS

The two-factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three-factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future.

CONCLUSIONS

Integrating the MPDT-P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts.

Beyond sound irritation: cross-cultural evidence on the robustness of the five aspects of misophonic experience measured by the S-Five in a Polish sample

Misophonia is commonly associated with negative emotional or physiological responses to specific sounds. However, the consensus definition emphasizes that misophonia entails much more than that. Even in cases of subclinical misophonia, where individuals do not meet the disorder criteria, the experience can still be burdensome, despite not currently causing significant distress or impairment. The S-Five is a psychometric tool for comprehensive assessment of five aspects of misophonic experience: internalizing, externalizing, impact, threat, and outburst, and includes S-Five-T section to evaluate feelings evoked by triggering sounds and their intensity. We examined whether the five-factor structure developed in the UK could be replicated in a Polish sample, including individuals with and without self-identified misophonia. The Polish version of the S-Five was translated and tested on 288 Polish-speaking individuals. Comprehensive psychometric evaluation, including factor structure, measurement invariance, test-retest reliability, internal consistency, and concurrent validity evaluations, was conducted on the translated scale. Exploratory factor analysis suggested similar structure to the original English study, while bootstrap exploratory graph analysis showed the factor structure to be reproducible in other samples. The scale was found to be bias free with respect to gender, internally consistent and stable in time, and evidence of validity was provided using MisoQuest and Misophonia Questionnaire. These results offer support for the cross-cultural stability of the five factors and provide preliminary evidence for the suitability of the Polish version for clinical and research purposes. The study also investigated five facets of misophonia, triggering sounds, emotional responses, and their associations with symptoms of psychopathology across various cultures. It underscores the central role of anger, distress, and panic, while also highlighting the mixed role of irritation and disgust in misophonia across different cultural contexts. Mouth sounds evoked the most pronounced reactions compared to other repetitive sounds, although there were discernible cultural differences in the nature and intensity of reactions to various trigger sounds. These findings hold significant implications for future research and underscore the importance of considering cultural nuances in both research and the clinical management of misophonia.

The Network Structure of Relationship Obsessive-Compulsive Disorder Presentations: The Interplay between ROCD Symptoms with Maladaptive and Non-Maladaptive Personality Traits

INTRODUCTION

The current study aimed to utilize a network perspective to identify the core symptoms of Relationship Obsessive-Compulsive Disorder (ROCD), encompassing both partner-focused and relationship-centered presentations. Additionally, we examined the interaction between ROCD symptoms and personality traits.

METHOD

493 participants were included in the current study. The Personality Inventory for DSM-5 - short form (PID-5-SF), NEO Five-Factor Inventory, Partner-Related Obsessive-Compulsive Symptoms Inventory (PROCSI), and Relationship Obsessive-Compulsive Inventory (ROCI) were used to estimate the network structure. Specifically, we computed network structure, bridge expected influence (BEI), and Exploratory Graph Analysis (EGA) for ROCD scales.

RESULTS

In the ROCI network, items 1 and 11 (ROCI.1: "The idea that my affection for my partner is not genuine troubles me," ROCI.7: Thoughts that something is "off" in my relationship significantly disturb me.) emerged as the most important nodes (ROCI.1: Betweenness:1.777, Closeness:1.025, Strength: .872; ROCI.11" Betweenness: 1.097, Closeness:0.457, strength:.699). Additionally, ROCI.7 stands out with significant Betweenness and Expected Influence, emphasizing its importance in facilitating communication and influencing information flow. Conversely, in the PROCI network, item 2 (PROCI.2: "I am constantly questioning whether my partner is deep and intelligent enough") was identified as the most crucial node (Betweenness: 2.568, Closeness: 2.528, Strength: 1.905). Neuroticism is highly influential in the interaction of personality traits with the ROCI scale (BEI: .3781), connecting non-maladaptive traits, while Negative affect, a maladaptive trait, has a significant impact (Bridge Value: .283).

CONCLUSION

The present study provided a detailed examination of the psychological dynamics within romantic relationships, highlighting key cognitive processes and personality trait.

New Psychometric Evidence of the Grief Impairment Scale (GIS) in People Who Have Experienced the Death of a Loved One From a Network Psychometric Approach in Two Latin American Countries

This study aimed to evaluate the psychometric properties of the Grief Impairment Scale (GIS) using a network psychometric model. A total of 1048 individuals from Peru and El Salvador participated. A network psychometric model was used to determine internal structure, reliability, and cross-country invariance. The results indicate that the GIS items were grouped into a single network structure through Exploratory Graph Analysis. Reliability was estimated by structural consistency, and it was found that when replicating the network structure within an empirical dimension, a single network structure was consistently obtained, and all items remained stable. Furthermore, the network structure was invariant, thus functioning similarly across the different country groups. In conclusion, the GIS presented solid psychometric evidence of validity based on its internal structure, reliability, and cross-country invariance. Therefore, the GIS is a psychometrically sound measure of functional impairment symptoms due to grief for Peruvian and Salvadoran individuals.

Attitudes of autistic adults toward genetic testing for autism

Genetic testing for autism has been a controversial topic within the autistic community. Opinions regarding the benefits, risks, and limitations of genetic testing often differ between autistic people, researchers, and healthcare providers. The present study sought to understand the beliefs, attitudes, and intentions to pursue genetic testing of autistic adults and compare perspectives of autistic people who have had genetic testing with those who have not. An international sample of 173 autistic adults (19 [11%] who had previously undergone autism-related genetic testing) completed an online survey with questions assessing beliefs, attitudes, and intentions to pursue genetic testing. Beliefs and attitudes about genetic testing varied widely across the sample. Autistic individuals who had received prior genetic testing had much more positive beliefs about autism-related genetic testing (d = 0.87, 95% CI [0.37, 1.36]) and attitudes toward genetic testing (d = 1.14, 95% CI [0.66, 1.61]) compared to those who had not received such testing, although there were no meaningful differences between those same groups regarding beliefs about genetic testing unrelated to autism (d = 0.02, 95% CI [-0.45, 0.49], p = 0.93). Intention to genetically test oneself or one's (hypothetical) children was also significantly predicted by autism-specific beliefs, attitudes, and prior genetic testing status. A large majority of the sample (78.6%) also agreed that autistic individuals would benefit from contact with a genetic counselor in certain situations. These findings suggest that the autistic community does not have a singular view of genetic testing, and for those Autistic individuals who are interested in pursuing genetic testing for themselves or a family member, genetic counselors have the potential to play a key role in clinical care.

Burnout and depression in college students

Research on burnout has garnered considerable attention since its inception. However, the ongoing debate persists regarding the conceptual model of burnout and its relationship with depression. Thus, we conducted a network analysis to determine the dimensional structure of burnout and the burnout-depression overlap. The Maslach Burnout Inventory-Student Survey and Patient Health Questionnaire-9 were used to measure burnout and depression among 1096 college students. We constructed networks for burnout, depression, and a burnout-depression co-occurrence network. The results showed that cynicism symptom was the most central to the burnout network. In the co-occurrence network, depressive symptoms ("anhedonia", "fatigue") and burnout symptom ("doubting the significance of studies") were the most significant in causing burnout-depression comorbidity. Community detection revealed three communities within burnout symptoms, aligning closely with their three dimensions identified through factor analysis. Additionally, there was no overlap between burnout and depression. In conclusion, our findings support a multidimensional structure of burnout, affirming it as a distinct concept separate from depression. Cynicism, rather than exhaustion, plays the most important role in burnout and the burnout-depression comorbidity.

All the Same? Different Measures of Personality Functioning Are Similar but Distinct. A Comparative Study from a Psychodynamic Perspective Using Exploratory Graph Analysis

Personality functioning (PF) is a central construct in many theories of personality pathology. Based on psychodynamic theories, two screening questionnaires to assess PF are widely used: The Inventory of Personality Organization-16 item version and the Operationalized Psychodynamic Diagnosis-Structure Questionnaire Short Form. This study aimed to explore the similarities and differences of the two questionnaires in a large clinical sample of N = 1636 psychotherapeutic inpatients. Correlation analyses were conducted to examine the associations between the global scores and between the subscales. The study further used Exploratory Graph Analysis (EGA) to explore the dimensionality of the items. The stability of estimates was evaluated using a bootstrap version of EGA (bootEGA). The results indicated that the two questionnaires are highly correlated, yet not multicollinear, and moderate to large correlations were found between their subscales. EGA revealed six dimensions that fairly represented the original subscales. BootEGA showed that the dimensions and items were stable, except for one item that did not load sufficiently on any dimension. The findings suggest that although the questionnaires are highly correlated, their subscales tap into distinct domains of PF. We discuss implications stemming from these findings for clinical and scientific practice.

Psychometric network analysis of the Intuitive Eating Scale-2 in Chinese general adults

The Intuitive Eating Scale-2 (IES-2) is a measure of intuitive eating behaviors that has been extensively validated, with traditional latent variable modeling approaches, in youth and adults from many different populations, including college students in China. However, there is still a lack of research on the psychometric properties of the IES-2 in adults from the Chinese general population. Moreover, psychometric network analysis, as a complement to traditional latent variable modeling approaches, has not been used for examining the psychometric properties of the IES-2. Thus, the present study used a psychometric network approach to evaluate the psychometric properties of the IES-2 in Chinese adults from the general population. A sample of 700 Chinese general adults (50% women; Mage = 31.13 years, SD = 9.19) recruited online were included in the present study. Psychometric network analysis was performed. Exploratory graph analysis (EGA) identified four dimensions, which were well separated in the estimated network. The network structure showed excellent stability and metric measurement invariance (i.e., network loadings) across men and women. Furthermore, several items on the IES-2 were identified as key nodes in the network of the IES-2 that may be important for the development and maintenance of intuitive eating. For example, two items (i.e., "I trust my body to tell me when to eat," and "I trust my body to tell me when to stop eating") related to reliance on body cues were the most impactful nodes in the complete network. The findings of our study provide a greater understanding of the IES-2 from the perspective of network analysis and have implications for applications of intuitive eating interventions for general populations.

Accelerated epigenetic age is associated with whole-brain functional connectivity and impaired cognitive performance in older adults

While chronological age is a strong predictor for health-related risk factors, it is an incomplete metric that fails to fully characterize the unique aging process of individuals with different genetic makeup, neurodevelopment, and environmental experiences. Recent advances in epigenomic array technologies have made it possible to generate DNA methylation-based biomarkers of biological aging, which may be useful in predicting a myriad of cognitive abilities and functional brain network organization across older individuals. It is currently unclear which cognitive domains are negatively correlated with epigenetic age above and beyond chronological age, and it is unknown if functional brain organization is an important mechanism for explaining these associations. In this study, individuals with accelerated epigenetic age (i.e. AgeAccelGrim) performed worse on tasks that spanned a wide variety of cognitive faculties including both fluid and crystallized intelligence (N = 103, average age = 68.98 years, 73 females, 30 males). Additionally, fMRI connectome-based predictive models suggested a mediating mechanism of functional connectivity on epigenetic age acceleration-cognition associations primarily in medial temporal lobe and limbic structures. This research highlights the important role of epigenetic aging processes on the development and maintenance of healthy cognitive capacities and function of the aging brain.

Psychometric network analysis of the Patient Health Questionnaire-4 (PHQ-4) in Paraguayan general population

BACKGROUND

Depression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings.

OBJECTIVE

This study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics.

METHODS

A total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women.

RESULTS

The results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups.

CONCLUSION

The PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context.

Network Psychometrics of the 10-Item Perceived Stress Scale Among Patients With High Cardiovascular and Type 2 Diabetes Risk Using Exploratory Graph Analysis

BACKGROUND

No studies have explored the internal structure of the 10-item Perceived Stress Scale in patients with high cardiovascular and diabetes risk.

OBJECTIVE

We scrutinized the dimensionality of the scale in this patient group using exploratory graph analysis, a technique within the developing field of network psychometrics.

METHODS

Analyses were conducted on 200 primary care patients. A bootstrap version of exploratory graph analysis assessed the stability of the dimensions based on structural consistency, item stability, and network loadings.

RESULTS

Exploratory graph analysis revealed a 2-dimensional structure; structural consistency of the first dimension was high (0.863), whereas that for the second was low (0.667). Items belonging to the latter dimension did not cluster consistently with each other (ie, low item stability) and were not strongly associated with any particular dimension (ie, weak network loadings).

CONCLUSION

Exploratory graph analysis offers unique outputs, making it easy to assess the dimensional integrity of scales. Further research is warranted regarding the second dimension of the Perceived Stress Scale.

The Misinformation Susceptibility Test (MIST): A psychometrically validated measure of news veracity discernment

Interest in the psychology of misinformation has exploded in recent years. Despite ample research, to date there is no validated framework to measure misinformation susceptibility. Therefore, we introduce Verification done, a nuanced interpretation schema and assessment tool that simultaneously considers Veracity discernment, and its distinct, measurable abilities (real/fake news detection), and biases (distrust/naïvité-negative/positive judgment bias). We then conduct three studies with seven independent samples (Ntotal = 8504) to show how to develop, validate, and apply the Misinformation Susceptibility Test (MIST). In Study 1 (N = 409) we use a neural network language model to generate items, and use three psychometric methods-factor analysis, item response theory, and exploratory graph analysis-to create the MIST-20 (20 items; completion time < 2 minutes), the MIST-16 (16 items; < 2 minutes), and the MIST-8 (8 items; < 1 minute). In Study 2 (N = 7674) we confirm the internal and predictive validity of the MIST in five national quota samples (US, UK), across 2 years, from three different sampling platforms-Respondi, CloudResearch, and Prolific. We also explore the MIST's nomological net and generate age-, region-, and country-specific norm tables. In Study 3 (N = 421) we demonstrate how the MIST-in conjunction with Verification done-can provide novel insights on existing psychological interventions, thereby advancing theory development. Finally, we outline the versatile implementations of the MIST as a screening tool, covariate, and intervention evaluation framework. As all methods are transparently reported and detailed, this work will allow other researchers to create similar scales or adapt them for any population of interest.

Comparing community detection algorithms in psychometric networks: A Monte Carlo simulation

Identifying the correct number of factors in multivariate data is fundamental to psychological measurement. Factor analysis has a long tradition in the field, but it has been challenged recently by exploratory graph analysis (EGA), an approach based on network psychometrics. EGA first estimates a network and then applies the Walktrap community detection algorithm. Simulation studies have demonstrated that EGA has comparable or better accuracy for recovering the same number of communities as there are factors in the simulated data than factor analytic methods. Despite EGA's effectiveness, there has yet to be an investigation into whether other sparsity induction methods or community detection algorithms could achieve equivalent or better performance. Furthermore, unidimensional structures are fundamental to psychological measurement yet they have been sparsely studied in simulations using community detection algorithms. In the present study, we performed a Monte Carlo simulation using the zero-order correlation matrix, GLASSO, and two variants of a non-regularized partial correlation sparsity induction methods with several community detection algorithms. We examined the performance of these method-algorithm combinations in both continuous and polytomous data across a variety of conditions. The results indicate that the Fast-greedy, Louvain, and Walktrap algorithms paired with the GLASSO method were consistently among the most accurate and least-biased overall.

Designing and evaluating tasks to measure individual differences in experimental psychology: a tutorial

Experimental psychology is witnessing an increase in research on individual differences, which requires the development of new tasks that can reliably assess variations among participants. To do this, cognitive researchers need statistical methods that many researchers have not learned during their training. The lack of expertise can pose challenges not only in designing good, new tasks but also in evaluating tasks developed by others. To bridge the gap, this article provides an overview of test psychology applied to performance tasks, covering fundamental concepts such as standardization, reliability, norming and validity. It provides practical guidelines for developing and evaluating experimental tasks, as well as for combining tasks to better understand individual differences. To further address common misconceptions, the article lists 11 prevailing myths. The purpose of this guide is to provide experimental psychologists with the knowledge and tools needed to conduct rigorous and insightful studies of individual differences.

Cognitive restraint, uncontrolled eating, and emotional eating. The Italian version of the Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18): a three-step validation study

BACKGROUND

The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating.

OBJECTIVE

This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples.

METHOD

Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder).

RESULTS

In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders.

CONCLUSION

The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health.

LEVEL OF EVIDENCE

Level V, descriptive study.

A Novel, Network-Based Approach to Assessing Romantic-Relationship Quality

How should romantic-relationship quality be approached psychometrically? This is a complicated theoretical and methodological challenge that we begin to address through three studies. In Study 1a, we identified 25 distinct romantic-relationship categories among 754 items from 26 romantic-relationship-quality instruments with a weak Jaccard index (0.38), indicating that the scales' item content was extremely heterogeneous. Study 1b then demonstrated limited structure validity evidence in 43 scale-development-validation articles of 23 of these 26 instruments. Finally, Study 2 surveyed 587 French-speaking participants in a romantic relationship on romantic-relationship quality. Applying a network-based model, we identified four dimensions, three of which are central to relationship quality. The inferences were mostly limited to French-speaking, monogamous, heterosexual women. To resolve challenges detected in the literature, we recommend a multicountry qualitative approach, more diverse sampling, better definitions of romantic-relationship quality, and a dynamic-systems approach to measuring romantic-relationship quality.