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Cheli S, Lam WWT, Estapé T, Winterling J, Bahcivan O, Andritsch E, Weis J, Centeno I, Serpentini S, Farkas C, Wengström Y, Fioretto L, Baider L, Lam CCL, Goldzweig G. Risk perception, treatment adherence, and personality during COVID-19 pandemic: An international study on cancer patients. Psychooncology 2021; 31:46-53. [PMID: 34314560 PMCID: PMC8420575 DOI: 10.1002/pon.5775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/06/2021] [Accepted: 07/22/2021] [Indexed: 12/13/2022]
Abstract
Objective To explore the role of personality traits in moderating the relation between COVID‐19 risk perception and treatment adherence, and between risk perception and psychosocial distress in patients diagnosed with cancer. Methods An online survey (n = 1281) was conducted worldwide in seven countries (Austria, Germany, Hong Kong, Italy, Spain, Sweden, and Turkey). Inclusion criteria were to be 18 years of age or older, have received a cancer diagnosis, and be in treatment or follow‐up. A few moderated regression models were performed with both personality traits and Hierarchical Taxonomy of Psychopathology super‐spectra as moderators. Results Detachment, negative affectivity, psychoticism and all the super‐spectra significantly moderated the relation between coronavirus risk perception and psychosocial distress, after the adjusting effect of confidence in safeguards. Only negative affectivity moderated the association between coronavirus risk perception and treatment adherence. Conclusions Personality traits may foster the understanding of how a patient might adjust to cancer treatment and, more generically, to highly stressful events such as the COVID‐19 pandemic. Further research is needed to confirm the results in different cancer stages and types.
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Affiliation(s)
- Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy.,Center for Psychology and Health, Tages Charity, Florence, Italy
| | - Wendy W T Lam
- Faculty of Medicine, School of Public Health, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | | | - Jeanette Winterling
- Comprehensive Cancer Centre, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Ozan Bahcivan
- OZ Psychology Family Counselling Centre, Izmir, Turkey
| | | | - Joachim Weis
- Medical Faculty Comprehensive Cancer Center, University Clinic Centre, Freiburg, Germany
| | - Isabel Centeno
- Fundación Elisabeth Kübler-Ross, San Pedro Garza García, Mexico
| | | | | | - Yvonne Wengström
- Comprehensive Cancer Centre, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Luisa Fioretto
- Dipartimento Oncologico, USL Toscana Centro, Florence, Italy
| | - Lea Baider
- Assuta Medical Center, Oncology Institute, Tel-Aviv, Israel
| | - Cherry C L Lam
- Faculty of Medicine, School of Public Health, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Gil Goldzweig
- The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
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Dreier MJ, Coniglio K, Selby EA. Mapping features of pathological exercise using hierarchical-dimensional modeling. Int J Eat Disord 2021; 54:422-432. [PMID: 33185893 DOI: 10.1002/eat.23406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Pathological exercise is common among those with eating disorders and has typically been characterized as excessive, compulsive, or compensatory in nature. Little is known about how pathological exercise is associated with other eating disorder behaviors or personality traits, or whether these associations differ between men and women. METHOD We used hierarchical dimensional modeling in three samples, including college women (N = 205), women with eating psychopathology (N = 268), and college men (N = 235), to examine latent associations between pathological exercise and eating disorder psychopathology, namely compulsivity, emotion regulation, and body dissatisfaction. RESULTS Using Goldberg's (2006) "bass-ackwards" method, we identified separate 10-factor solutions (women) or an 11-factor solution (men). A distinct muscle building factor arose in the three-factor solution for men, and it also notably arose in the six- and eight-factor solutions for community and college women, respectively, highlighting an important understudied motivation factor in both healthy and pathological exercise. Each solution accounted for 64.8% (college women), 51.9% (women with eating psychopathology), and 43.9% (college men) of the variance in excessive exercise, respectively. DISCUSSION Findings indicate that pathological exercise is associated with different psychological traits (e.g., poor emotion regulation, compulsivity) across populations, and such differences may necessitate unique treatment approaches tailored accordingly.
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Affiliation(s)
- Melissa J Dreier
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kathryn Coniglio
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Edward A Selby
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
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Conway CC, Brown TA. Evaluating dimensional models of psychopathology in outpatients diagnosed with emotional disorders: A cautionary tale. Depress Anxiety 2018; 35:898-902. [PMID: 29637665 DOI: 10.1002/da.22740] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/10/2018] [Accepted: 02/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental disorders cluster together systematically. Through factor analysis of disorder comorbidity, investigators are establishing the latent dimensions that underlie the development of related syndromes. However, these dimensions have not been validated across diverse patient samples, in which comorbidity patterns vary widely. METHOD We assessed 4,928 outpatients seeking treatment for emotional disorders with a semistructured diagnostic interview. This was the largest patient sample as yet for an evaluation of the latent structure of mental disorders. We compared several competing dimensional models of common mental disorders via confirmatory factor analysis. RESULTS The hypothesized confirmatory factor model-anchored by internalizing and externalizing spectra-fit the diagnostic data poorly. Neither a one-factor model, reflecting a unitary liability to all mental disorders, nor a three-factor model, wherein the internalizing dimension bifurcated into distress and fear subfactors, fit appreciably better. CONCLUSIONS These data provide novel evidence that the internalizing and externalizing spectra are not structurally sound in all clinical contexts. We speculate about the causes of model misfit and advise additional research into the generalizability-with respect to sample, input data, developmental stage, and more-of dimensional models of mental disorder.
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Affiliation(s)
- Christopher C Conway
- Department of Psychological Sciences, College of William & Mary, Williamsburg, VA, USA
| | - Timothy A Brown
- Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA
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Lahey BB, Zald DH, Perkins SF, Villalta‐Gil V, Werts KB, Van Hulle CA, Rathouz PJ, Applegate B, Class QA, Poore HE, Watts AL, Waldman ID. Measuring the hierarchical general factor model of psychopathology in young adults. Int J Methods Psychiatr Res 2018; 27:e1593. [PMID: 28990308 PMCID: PMC5834349 DOI: 10.1002/mpr.1593] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/02/2017] [Accepted: 09/04/2017] [Indexed: 01/20/2023] Open
Abstract
There is evidence that models of psychopathology specifying a general factor and specific second-order factors fit better than competing structural models. Nonetheless, additional tests are needed to examine the generality and boundaries of the general factor model. In a selected second wave of a cohort study, first-order dimensions of psychopathology symptoms in 499 23- to 31-year-old twins were analyzed. Using confirmatory factor analysis, a bifactor model specifying a general factor and specific internalizing and externalizing factors fit better than competing models. Factor loadings in this model were sex invariant despite greater variances in the specific internalizing factor among females and greater variances in the general and specific externalizing factors among males. The bifactor structure was robust to the exclusion of any single first-order dimension of psychopathology. Furthermore, the results were essentially unchanged when all overlapping symptoms that define multiple disorders were excluded from symptom dimensions. Furthermore, the best-fitting bifactor model also emerged in exploratory structural equation modeling with freely estimated cross-loadings. The general factor of psychopathology was robust across variations in measurement and analysis.
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Affiliation(s)
- Benjamin B. Lahey
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - David H. Zald
- Departments of Psychology and PsychiatryVanderbilt UniversityNashvilleTennesseeUSA
| | - Scott F. Perkins
- Departments of Psychology and PsychiatryVanderbilt UniversityNashvilleTennesseeUSA
| | | | - Katherine B. Werts
- Departments of Psychology and PsychiatryVanderbilt UniversityNashvilleTennesseeUSA
| | - Carol A. Van Hulle
- Department of Biostatistics and Medical InformaticsUniversity of WisconsinMadisonWisconsinUSA
| | - Paul J. Rathouz
- Department of Biostatistics and Medical InformaticsUniversity of WisconsinMadisonWisconsinUSA
| | - Brooks Applegate
- Department of Educational Leadership, Research and TechnologyWestern Michigan UniversityKalamazooMichiganUSA
| | - Quetzal A. Class
- Department of Obstetrics and GynecologyUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Holly E. Poore
- Department of PsychologyEmory UniversityAtlantaGeorgiaUSA
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Forbes MK, Kotov R, Ruggero CJ, Watson D, Zimmerman M, Krueger RF. Delineating the joint hierarchical structure of clinical and personality disorders in an outpatient psychiatric sample. Compr Psychiatry 2017; 79:19-30. [PMID: 28495022 PMCID: PMC5643220 DOI: 10.1016/j.comppsych.2017.04.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND A large body of research has focused on identifying the optimal number of dimensions - or spectra - to model individual differences in psychopathology. Recently, it has become increasingly clear that ostensibly competing models with varying numbers of spectra can be synthesized in empirically derived hierarchical structures. METHODS AND MATERIALS We examined the convergence between top-down (bass-ackwards or sequential principal components analysis) and bottom-up (hierarchical agglomerative cluster analysis) statistical methods for elucidating hierarchies to explicate the joint hierarchical structure of clinical and personality disorders. Analyses examined 24 clinical and personality disorders based on semi-structured clinical interviews in an outpatient psychiatric sample (n=2900). RESULTS The two methods of hierarchical analysis converged on a three-tier joint hierarchy of psychopathology. At the lowest tier, there were seven spectra - disinhibition, antagonism, core thought disorder, detachment, core internalizing, somatoform, and compulsivity - that emerged in both methods. These spectra were nested under the same three higher-order superspectra in both methods: externalizing, broad thought dysfunction, and broad internalizing. In turn, these three superspectra were nested under a single general psychopathology spectrum, which represented the top tier of the hierarchical structure. CONCLUSIONS The hierarchical structure mirrors and extends upon past research, with the inclusion of a novel compulsivity spectrum, and the finding that psychopathology is organized in three superordinate domains. This hierarchy can thus be used as a flexible and integrative framework to facilitate psychopathology research with varying levels of specificity (i.e., focusing on the optimal level of detailed information, rather than the optimal number of factors).
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Affiliation(s)
- Miriam K. Forbes
- 2450 Riverside Ave, Suite F227, Departments of Psychiatry and Psychology, University of Minnesota—Twin Cities Campus, MN, 55454.
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, HSC, Level T-10, Room 060H, Stony Brook, NY 11794-8101, United States.
| | - Camilo J. Ruggero
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203,
| | - David Watson
- Department of Psychology, 118 Haggar Hall, University of Notre Dame, Notre Dame, IN 46556, United States.
| | - Mark Zimmerman
- 146 West River St, Suite 11b, Providence, RI 02904, United States..
| | - Robert F. Krueger
- N414 Elliot Hall, Department of Psychology, University of Minnesota—Twin Cities Campus, MN, 55455.
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Abstract
Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or "spectra"). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.
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Affiliation(s)
- Miriam K Forbes
- a Departments of Psychiatry and Psychology , University of Minnesota
| | - Andrew J Baillie
- b Centre for Emotional Health and Centre of Research Excellence in Mental Health and Substance Use , Macquarie University
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Hengartner MP, Lehmann SN. Why Psychiatric Research Must Abandon Traditional Diagnostic Classification and Adopt a Fully Dimensional Scope: Two Solutions to a Persistent Problem. Front Psychiatry 2017; 8:101. [PMID: 28638352 PMCID: PMC5461269 DOI: 10.3389/fpsyt.2017.00101] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Sandrine N Lehmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland
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