The adolescent developmental stage appears to be a sensitive period for the onset of several particular forms of mental disorder that are characterised by heightened emotionality and social ...sensitivity and are more common in females than males. We refer to these disorders (social anxiety disorder, generalised anxiety disorder, eating disorders, major depression) collectively as the social-emotional disorders. The aim of this paper is to address an important question in the understanding of social-emotional disorders – why do these disorders commonly begin during adolescence? We present a conceptual model that describes some of the key changes that occur during adolescence and that addresses some hypothesised ways in which these changes might increase risk for the development of social-emotional disorders. An overview of the extant empirical literature and some possible directions for future research are suggested. The model points to interesting links between psycho-social risk factors that should highlight potentially fruitful directions for both psychopathology research and early intervention programs.
•Adolescence is a sensitive period for development of several mental disorders.•These social-emotional disorders, include social and generalised anxieties, major depression, and eating disorders•We propose that developmental changes during adolescence increase risk for onset of these disorders.•Risks include pubertal changes and changes in emotion, sleep, self-concept, and peer relationships.•Interactions between pre-adolescent risk and adolescent developmental changes likely triggers onset of disorder.
Goldberg's (2006) bass-ackward approach to elucidating the hierarchical structure of individual differences data has been used widely to improve our understanding of the relationships among ...constructs of varying levels of granularity. The traditional approach has been to extract a single component or factor on the first level of the hierarchy, two on the second level, and so on, treating the correlations between adjoining levels akin to path coefficients in a hierarchical structure. This article proposes three modifications to the traditional approach with a particular focus on examining associations among
levels of the hierarchy: (a) identify and remove redundant elements that perpetuate through multiple levels of the hierarchy; (b) (optionally) identify and remove artefactual elements; and (c) plot the strongest correlations among the remaining elements to identify their hierarchical associations. Together these steps can offer a simpler and more complete picture of the underlying hierarchical structure among a set of observed variables. The rationale for each step is described, illustrated in a hypothetical example and three basic simulations, and then applied in real data. The results are compared with the traditional bass-ackward approach together with agglomerative hierarchical cluster analysis, and a basic tutorial with code is provided to apply the extended bass-ackward approach in other data. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Experiences of depression, anxiety, and peer victimization have each been found to predict one another, and to predict negative outcomes in the domains of school connectedness, social functioning, ...quality of life, and physical health. However, the common co-occurrence of depression, anxiety, and peer victimization experiences has made it difficult to disentangle their unique roles in these associations. The present study thus sought to characterize the precise nature of the bidirectional relationships between depressive symptoms, anxiety, and victimization over time, and to examine their unique sequelae during the transition from childhood to early adolescence. Longitudinal multi-informant (child-reported, parent-reported, and teacher-reported) data from a nationally representative sample were analyzed using path analysis when the study child was aged 10–11 (
n
=
4169;
M
age
= 10.3; 48.8% female) and aged 12–13 (
n
=
3956;
M
age
= 12.4; 48.2% female). Depressive symptoms, anxiety, and peer victimization had small but significant unique bidirectional relationships. All three constructs also uniquely and prospectively predicted poorer life functioning across all domains examined. These results demonstrate that current interventions should broaden their scope to simultaneously target depression, anxiety, and peer victimization, as each of these experiences independently act as additive risk factors for subsequent negative outcomes.
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a classification system that seeks to organize psychopathology using quantitative evidence - yet the current model was established by narrative ...review. This meta-analysis provides a quantitative synthesis of literature on transdiagnostic dimensions of psychopathology to evaluate the validity of the HiTOP framework.
Published studies estimating factor-analytic models from
(
diagnoses were screened. A total of 120,596 participants from 35 studies assessing 23
diagnoses were included in the meta-analytic models. Data were pooled into a meta-analytic correlation matrix using a random effects model. Exploratory factor analyses were conducted using the pooled correlation matrix. A hierarchical structure was estimated by extracting one to five factors representing levels of the HiTOP framework, then calculating congruence coefficients between factors at sequential levels.
Five transdiagnostic dimensions fit the
diagnoses well (comparative fit index = 0.92, root mean square error of approximation = 0.07, and standardized root-mean-square residual = 0.03). Most diagnoses had factor loadings >|0.30| on the expected factors, and congruence coefficients between factors indicated a hierarchical structure consistent with the HiTOP framework.
A model closely resembling the HiTOP framework fit the data well and placement of
diagnoses within transdiagnostic dimensions were largely confirmed, supporting it as valid structure for conceptualizing and organizing psychopathology. Results also suggest transdiagnostic research should (1) use traits, narrow symptoms, and dimensional measures of psychopathology instead of
diagnoses, (2) assess a broader array of constructs, and (3) increase focus on understudied pathologies.
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between ...psychopathology and normality, frequent disorder co‐occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma‐related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.
Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research ...and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.
There has been growing interest in studying attention-deficit/hyperactivity disorder (ADHD) in adulthood as a result of research indicating that ADHD often persists into adulthood and frequently is ...comorbid with other psychiatric disorders. Adult ADHD symptoms are most commonly assessed via self-report, but prior research examining the structure of self-reported adult ADHD symptoms has yielded discrepant results. Explicating the factor structure of ADHD symptom measures is essential to determine if such self-report measures assess symptom dimensions showing distinctive relations with other psychopathology and psychosocial functioning. Consequently, we examined the structure of adult ADHD symptoms in a large sample of adult outpatients (N = 1,094). Symptoms were assessed via the Adult ADHD Self-Report Scale (ASRS; Kessler et al., 2005), which has become the most widely used self-report ADHD measure. Additionally, we extended prior research by examining the relations for emergent ADHD dimensions with other psychopathology and psychosocial impairment. Results indicated that the ASRS's items define a bifactor structure with specific dimensions of inattentiveness, motor hyperactivity/impulsivity, and verbal hyperactivity/impulsivity. Our results indicate that specific ADHD factors show distinctive relations in some ways. For example, verbal hyperactivity/impulsivity showed negative relations with major depressive disorder, whereas inattentiveness showed positive relations with major depression. These results highlight the need for future research determining the extent to which making distinctions among various ADHD symptom types (i.e., distinguishing motor and verbal hyperactivity/impulsivity) is empirically warranted and clinically useful.
Public Significance Statement
This study using a sample of over 1,000 adults receiving treatment for psychological issues suggests that it may be important for researchers and clinicians to assess for related, but distinct, types of attention-deficit/hyperactivity disorder (ADHD) symptoms in adulthood. Specifically, ADHD symptom types may include poor attention, motor hyperactivity/impulsivity (e.g., being very fidgety), and verbal hyperactivity/impulsivity (e.g., being excessively talkative). Importantly, these different types of ADHD symptoms may overlap with other psychiatric diagnoses (e.g., depressive and anxiety disorders, bipolar disorder) to varying degrees.
This paper explores the concept that reducing general psychopathology early in the life course provides unprecedented opportunities to prevent the development of all forms of psychopathology later in ...life. We review empirical evidence for the existence of the general factor of psychopathology and theories regarding the psychological nature of the factor. We then highlight specific examples of environmental risk factors for general psychopathology and discuss translational implications for the transdiagnostic prevention of psychopathology beginning in early childhood. Ultimately, we propose a developmentally informed and transdiagnostic stepped care approach to intervention in which reduction of general psychopathology in early childhood represents the foundational step for prevention and intervention of subsequent psychopathology. This model heralds three key benefits over the current treatment zeitgeist: (1) Reducing the burden and confusion in healthcare and education systems by providing a coherent and systematic structure for early intervention across a child's development, (2) maximising the breadth of the impact of intervention by focusing on common shared risks across psychopathology, and (3) increasing the efficiency of intervention by corresponding with the development of psychopathology and leveraging the emergence of general psychopathology in early childhood.
•There is evidence for a general factor of psychopathology.•This factor captures the shared features common to all mental disorders.•It also highlights opportunities for transdiagnostic prevention of mental illness.•We propose a developmentally informed and stepped care approach to prevention.•In early childhood, the most efficient focus is on targeting the general factor.
Our consumer-driven culture has negative impacts for individuals who are vulnerable to clinical hoarding and compulsive shopping. Because of this, there is an ever-present need to have standardized ...tools to assess why we acquire and save things we might not need. In this article, we present the development of the Acquiring Motives Questionnaire (AMQ) and Saving Motives Questionnaire (SMQ), which were written based on a thorough literature review and consultation with 22 experts in the field. After piloting with two large nonclinical samples, we administered the measures to another large nonclinical sample (N = 535; Mage = 24.4, 74.2% female, 54.6% White) and then a community sample of individuals with hoarding disorder and/or compulsive buying-shopping disorder and controls without any mental health diagnoses (N = 159; Mage = 42.54, 85.5% female, 59.7% White). Confirmatory factor analyses supported a 14-factor model for the AMQ and a 14-factor model for the SMQ. All subscales demonstrated good internal consistency (ω = 0.81-0.96), 2-week test-retest reliability (intraclass correlation coefficient = 0.67-0.83), and convergent, divergent, and criterion validity. The measures also distinguished between controls and individuals with hoarding and/or compulsive buying diagnoses. Findings highlight that acquiring and saving behaviors are both motivated by the pursuit of positive emotions and the avoidance of negative emotions, which is consistent with our theoretical understanding of these clinical issues. Based on our findings, we make suggestions for psychological interventions.
Public Significance Statement
Current levels of overconsumption, particularly in capitalist societies, are environmentally unsustainable and have negative consequences for individuals vulnerable to compulsive shopping and hoarding. This is because many consumers buy too many nonessential products, often due to psychological reasons rather than actual needs. This article developed a new measure for the psychological motivations that drive the excessive acquisition and saving of possessions.
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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