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The structure of adolescent psychopathology: a symptom-level analysis

Published online by Cambridge University Press:  01 December 2015

N. Carragher*
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia Office of Medical Education, University of New South Wales, Sydney, Australia
M. Teesson
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
M. Sunderland
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
N. C. Newton
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
R. F. Krueger
Affiliation:
Department of Psychology, University of Minnesota, MN, USA
P. J. Conrod
Affiliation:
Department of Psychiatry, Université de Montréal, Montréal, Canada
E. L. Barrett
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
K. E. Champion
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
N. K. Nair
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
T. Slade
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
*
*Address for correspondence: Dr N. Carragher, National Drug and Alcohol Research Centre, University of New SouthWales, NSW 2052, Australia. (Email: n.carragher@unsw.edu.au)

Abstract

Background

Most empirical studies into the covariance structure of psychopathology have been confined to adults. This work is not developmentally informed as the meaning, age-of-onset, persistence and expression of disorders differ across the lifespan. This study investigates the underlying structure of adolescent psychopathology and associations between the psychopathological dimensions and sex and personality risk profiles for substance misuse and mental health problems.

Method

This study analyzed data from 2175 adolescents aged 13.3 years. Five dimensional models were tested using confirmatory factor analysis and the external validity was examined using a multiple-indicators multiple-causes model.

Results

A modified bifactor model, with three correlated specific factors (internalizing, externalizing, thought disorder) and one general psychopathology factor, provided the best fit to the data. Females reported higher mean levels of internalizing, and males reported higher mean levels of externalizing. No significant sex differences emerged in liability to thought disorder or general psychopathology. Liability to internalizing, externalizing, thought disorder and general psychopathology was characterized by a number of differences in personality profiles.

Conclusions

This study is the first to identify a bifactor model including a specific thought disorder factor. The findings highlight the utility of transdiagnostic treatment approaches and the importance of restructuring psychopathology in an empirically based manner.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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References

Achenbach, TM, Edelbrock, CS (1984). Psychopathology of childhood. Annual Review of Psychology 35, 227256.CrossRefGoogle ScholarPubMed
Beesdo-Baum, K, Knappe, S, Pine, DS (2009). Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatric Clinics of North America 32, 483524.CrossRefGoogle Scholar
Birchwood, M (2003). Pathways to emotional dysfunction in first-episode psychosis. British Journal of Psychiatry 182, 373375.CrossRefGoogle ScholarPubMed
Blanco, C, Wall, MW, He, JP, Krueger, RF, Olfson, M, Jin, CJ, Burstein, M, Merikangas, KR (2015). The space of common psychiatric disorders in adolescents: comorbidity structure and individual latent liabilities. Journal of the American Academy of Child and Adolescent Psychiatry 54, 4552.CrossRefGoogle ScholarPubMed
Brown, TA (2006). Confirmatory Factor Analysis for Applied Research. Guilford Press: London.Google Scholar
Carragher, N, Krueger, RF, Eaton, NR, Slade, T (2015). Disorders without borders: current and future directions in the meta-structure of mental disorders. Social Psychiatry and Psychiatric Epidemiology 50, 339350.CrossRefGoogle ScholarPubMed
Caspi, A, Houts, RM, Belsky, DW, Goldman-Mellor, SJ, Harrington, H, Israel, S, Meier, MH, Ramrakha, S, Shalev, I, Poulton, R, Moffitt, TE (2014). The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science 2, 119137.CrossRefGoogle Scholar
Conrod, PJ, Castellanos, N, Mackie, C (2008). Personality-targeted interventions delay the growth of adolescent drinking and binge drinking. Journal of Child Psychology and Psychiatry 49, 181190.CrossRefGoogle ScholarPubMed
Costello, A, Edelbrock, C, Kalas, R, Kessler, M, Klaric, S (1982). Diagnostic Interview Schedule for Children: Child Version. National Institute of Mental Health: Rockville, MD.Google Scholar
Del Giudice, M (in press). The life history model of psychopathology explains the structure of psychiatric disorders and the emergence of the p factor: a simulation study. Clinical Psychological Science.Google Scholar
Derogatis, LR (1993). BSI: Administration, Scoring and Procedures Manual for the Brief Symptom Inventory. National Computer Systems: Minneapolis.Google Scholar
Derogatis, LR, Melisaratos, N (1983). The Brief Symptom Inventory: an introductory report. Psychological Medicine 13, 595605.CrossRefGoogle ScholarPubMed
Eaton, NR, Keyes, KM, Krueger, RF, Balsis, S, Skodol, AE, Markon, KE, Grant, BF, Hasin, DS (2012). An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample. Journal of Abnormal Psychology 121, 282288.CrossRefGoogle ScholarPubMed
Eaton, NR, Keyes, KM, Krueger, RF, Noordhof, A, Skodol, AE, Markon, KE, Grant, BF, Hasin, DS (2013). Ethnicity and psychiatric comorbidity in a national sample: evidence for latent comorbidity factor invariance and connections with disorder prevalence. Social Psychiatry and Psychiatric Epidemiology 48, 701710.CrossRefGoogle Scholar
Eaton, NR, Krueger, RF, Oltmanns, TF (2011). Aging and the structure and long-term stability of the internalizing spectrum of personality and psychopathology. Psychology and Aging 26, 987993.CrossRefGoogle ScholarPubMed
Fleming, S, Shevlin, M, Murphy, J, Joseph, S (2014). Psychosis within dimensional and categorical models of mental illness. Psychosis 6, 415.CrossRefGoogle Scholar
Franić, S, Dolan, CV, Borsboom, D, van Beijsterveldt, CE, Boomsma, DI (2014). Three-and-a-half-factor model? The genetic and environmental structure of the CBCL/6–18 internalizing grouping. Behavior Genetics 44, 254268.Google ScholarPubMed
Giannakopoulos, G, Dimitrakaki, C, Papadopoulou, K, Tzavara, C, Kolaitis, G, Ravens-Sieberer, U, Tountas, Y (2013). Reliability and validity of the Strengths and Difficulties Questionnaire in Greek adolescents and their parents. Health 5, 17741783.CrossRefGoogle Scholar
Goodman, A, Lamping, DL, Ploubidis, GB (2010). When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the Strengths and Difficulties Questionnaire (SDQ): data from British parents, teachers and children. Journal of Abnormal Child Psychology 38, 11791191.CrossRefGoogle ScholarPubMed
Goodman, R (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry 40, 13371345.CrossRefGoogle ScholarPubMed
Kendler, KS, Heath, AC, Martin, NG, Eaves, LJ (1987). Symptoms of anxiety and symptoms of depression. Same genes, different environments? Archives of General Psychiatry 44, 451457.CrossRefGoogle ScholarPubMed
Kendler, KS, Prescott, CA, Myers, J, Neale, MC (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry 60, 929937.CrossRefGoogle ScholarPubMed
Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617627.CrossRefGoogle ScholarPubMed
Keyes, KM, Eaton, NR, Krueger, RF, Skodol, AE, Wall, MW, Grant, BF, Siever, LJ, Hasin, DS (2013). Thought disorder in the meta-structure of psychopathology. Psychological Medicine 43, 16731683.CrossRefGoogle ScholarPubMed
Kotov, R, Chang, SW, Fochtmann, LJ, Mojtabai, R, Carlson, GA, Sedler, MJ, Bromet, EJ (2011 b). Schizophrenia in the internalizing-externalizing framework: a third dimension? Schizophrenia Bulletin 37, 11681178.CrossRefGoogle ScholarPubMed
Kotov, R, Ruggero, CJ, Krueger, RF, Watson, D, Yuan, Q, Zimmerman, M (2011 a). New dimensions in the quantitative classification of mental illness. Archives of General Psychiatry 68, 10031011.CrossRefGoogle ScholarPubMed
Krank, M, Stewart, SH, O'Connor, R, Woicik, PB, Wall, AM, Conrod, PJ (2011). Structural, concurrent, and predictive validity of the Substance use Risk Profile Scale in early adolescence. Addictive Behaviors 36, 3746.CrossRefGoogle ScholarPubMed
Krueger, RF, Caspi, A, Moffitt, TE, Silva, PA (1998). The structure and stability of common mental disorders (DSM-III-R): a longitudinal-epidemiological study. Journal of Abnormal Psychology 107, 216227.CrossRefGoogle ScholarPubMed
Krueger, RF, Chentsova-Dutton, YE, Markon, KE, Goldberg, D, Ormel, J (2003). A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting. Journal of Abnormal Psychology 112, 437447.CrossRefGoogle ScholarPubMed
Krueger, RF (1999). The structure of common mental disorders. Archives of General Psychiatry 56, 921926.CrossRefGoogle ScholarPubMed
Krueger, RF, Markon, KE (2011). A dimensional-spectrum model of psychopathology: progress and opportunities. Archives of General Psychiatry 68, 1011.CrossRefGoogle ScholarPubMed
Laceulle, OM, Vollebergh, WAM, Ormel, J (in press). The structure of psychopathology in adolescence: replication of a general psychopathology factor in the TRAILS Study. Clinical Psychological Science.Google Scholar
Lahey, BB, Applegate, B, Hakes, JK, Zald, DH, Hariri, AR, Rathouz, PJ (2012). Is there a general factor of prevalent psychopathology during adulthood? Journal of Abnormal Psychology 121, 971977.CrossRefGoogle Scholar
Lahey, BB, Rathouz, PJ, Keenan, K, Stepp, SD, Loeber, R, Hipwell, AE (2015). Criterion validity of the general factor of psychopathology in a prospective study of girls. Journal of Child Psychology and Psychiatry 56, 415422.CrossRefGoogle Scholar
Lahey, BB, Van Hulle, CA, Singh, AL, Waldman, ID, Rathouz, PJ (2011). Higher-order genetic and environmental structure of prevalent forms of child and adolescent psychopathology. Archives of General Psychiatry 68, 181189.CrossRefGoogle ScholarPubMed
Laurens, KR, Hobbs, MJ, Sunderland, M, Green, MJ, Mould, GL (2012). Psychotic-like experiences in a community sample of 8000 children aged 9 to 11 years: an item response theory analysis. Psychological Medicine 42, 14951506.CrossRefGoogle Scholar
Links, PS, Eynan, R (2013). The relationship between personality disorders and Axis I psychopathology: deconstructing comorbidity. Annual Review of Clinical Psychology 9, 529554.CrossRefGoogle ScholarPubMed
Markon, KE (2010). Modeling psychopathology structure: a symptom-level analysis of Axis I and II disorders. Psychological Medicine 40, 273288.CrossRefGoogle ScholarPubMed
Measelle, JR, Stice, E, Hogansen, JM (2006). Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents. Journal of Abnormal Psychology 115, 524538.CrossRefGoogle ScholarPubMed
Merikangas, KR, He, JP, Burstein, M, Swanson, SA, Avenevoli, S, Cui, L, Benjet, C, Georgiades, K, Swendsen, J (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry 49, 980989.CrossRefGoogle ScholarPubMed
Muthén, BO (2007). Factor scores in SPSS vs. Mplus (http://www.statmodel.com/discussion/messages/9/2528.html?1412177501). Accessed 28 April 2015.Google Scholar
Neal, DJ, Corbin, WR, Fromme, K (2006). Measurement of alcohol-related consequences among high school and college students: application of item response models to the Rutgers Alcohol Problem Index. Psychological Assessment 18, 402414.CrossRefGoogle Scholar
Newton, NC, Teesson, M, Barrett, EL, Slade, T, Conrod, PJ (2012). The CAP study, evaluation of integrated universal and selective prevention strategies for youth alcohol misuse: study protocol of a cluster randomized controlled trial. BMC Psychiatry 12, 118.CrossRefGoogle ScholarPubMed
Noordhof, A, Krueger, RF, Ormel, J, Oldehinkel, AJ, Hartman, CA (2015). Integrating autism-related symptoms into the dimensional internalizing and externalizing model of psychopathology. The TRAILS Study. Journal of Abnormal Child Psychology 43, 577587.CrossRefGoogle ScholarPubMed
Patalay, P, Fonagy, P, Deighton, J, Belsky, J, Vostanis, P, Wolpert, M (2015). A general psychopathology factor in early adolescence. British Journal of Psychiatry 207, 1522.CrossRefGoogle ScholarPubMed
Pettersson, E, Anckarsater, H, Gillberg, C, Lichtenstein, P (2013). Different neurodevelopmental symptoms have a common genetic etiology. Journal of Child Psychology and Psychiatry 54, 13561365.CrossRefGoogle ScholarPubMed
Raftery, AE (1995). Bayesian model selection in social research. Sociological Methodology 25, 11163.Google Scholar
Røysamb, E, Kendler, KS, Tambs, K, Orstavik, RE, Neale, MC, Aggen, SH, Torgersen, S, Reichborn-Kjennerud, T (2011). The joint structure of DSM-IV Axis I and Axis II disorders. Journal of Abnormal Psychology 120, 198209.CrossRefGoogle ScholarPubMed
Slade, T, Watson, D (2006). The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population. Psychological Medicine 36, 15931600.CrossRefGoogle ScholarPubMed
Tackett, JL, Lahey, BB, van Hulle, C, Waldman, I, Krueger, RF, Rathouz, PJ (2013). Common genetic influences on negative emotionality and a general psychopathology factor in childhood and adolescence. Journal of Abnormal Psychology 122, 11421153.CrossRefGoogle Scholar
van de Looij-Jansen, PM, Goedhart, AW, de Wilde, EJ, Treffers, PD (2011). Confirmatory factor analysis and factorial invariance analysis of the adolescent self-report Strengths and Difficulties Questionnaire: how important are method effects and minor factors? British Journal of Clinical Psychology 50, 127144.CrossRefGoogle ScholarPubMed
Vollebergh, WA, Iedema, J, Bijl, RV, de Graaf, R, Smit, F, Ormel, J (2001). The structure and stability of common mental disorders: the NEMESIS study. Archives of General Psychiatry 58, 597603.CrossRefGoogle ScholarPubMed
White, HR, Labouvie, EW (1989). Towards the assessment of adolescent problem drinking. Journal of Studies on Alcohol 50, 3037.CrossRefGoogle ScholarPubMed
Wittchen, HU, Beesdo-Baum, K, Gloster, AT, Höfler, M, Klotsche, J, Lieb, R, Beauducel, A, Bühner, M, Kessler, RC (2009). The structure of mental disorders re-examined: is it developmentally stable and robust against additions? International Journal of Methods in Psychiatric Research 18, 189203.CrossRefGoogle ScholarPubMed
Woicik, PA, Stewart, SH, Pihl, RO, Conrod, PJ (2009). The Substance Use Risk Profile Scale: a scale measuring traits linked to reinforcement-specific substance use profiles. Addictive Behaviors 34, 10421055.CrossRefGoogle Scholar
Wright, AG, Krueger, RF, Hobbs, MJ, Markon, KE, Eaton, NR, Slade, T (2013). The structure of psychopathology: toward an expanded quantitative empirical model. Journal of Abnormal Psychology 122, 281294.CrossRefGoogle ScholarPubMed
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