Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T07:27:34.418Z Has data issue: false hasContentIssue false

Evidence for the continuous latent structure of mania in the Epidemiologic Catchment Area from multiple latent structure and construct validation methodologies

Published online by Cambridge University Press:  27 May 2010

J. J. Prisciandaro
Affiliation:
University at Buffalo, The State University of New York, Amherst, NY, USA
J. E. Roberts*
Affiliation:
University at Buffalo, The State University of New York, Amherst, NY, USA
*
*Address for correspondence: Dr J. E. Roberts, University at Buffalo, The State University of New York, Department of Psychology, Park Hall, Box 604110, Amherst, NY 14260-4110, USA. (Email: [email protected])

Abstract

Background

Although psychiatric diagnostic systems have conceptualized mania as a discrete phenomenon, appropriate latent structure investigations testing this conceptualization are lacking. In contrast to these diagnostic systems, several influential theories of mania have suggested a continuous conceptualization. The present study examined whether mania has a continuous or discrete latent structure using a comprehensive approach including taxometric, information-theoretic latent distribution modeling (ITLDM) and predictive validity methodologies in the Epidemiologic Catchment Area (ECA) study.

Method

Eight dichotomous manic symptom items were submitted to a variety of latent structural analyses, including factor analyses, taxometric procedures and ITLDM, in 10105 ECA community participants. In addition, a variety of continuous and discrete models of mania were compared in terms of their relative abilities to predict outcomes (i.e. health service utilization, internalizing and externalizing disorders, and suicidal behavior).

Results

Taxometric and ITLDM analyses consistently supported a continuous conceptualization of mania. In ITLDM analyses, a continuous model of mania demonstrated 6.52:1 odds over the best-fitting latent class model (LCM) of mania. Factor analyses suggested that the continuous structure of mania was best represented by a single latent factor. Predictive validity analyses demonstrated a consistent superior ability of continuous models of mania relative to discrete models.

Conclusions

The present study provided three independent lines of support for a continuous conceptualization of mania. The implications of a continuous model of mania are discussed.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aggen, SH, Neale, MC, Kendler, KS (2005). DSM criteria for major depression: evaluating symptom patterns using latent-trait item response models. Psychological Medicine 35, 475487.CrossRefGoogle ScholarPubMed
Akiskal, HS, Azorin, JM, Hantouche, EG (2003). Proposed multidimensional structure of mania: beyond the euphoric-dysphoric dichotomy. Journal of Affective Disorders 73, 7–18.CrossRefGoogle ScholarPubMed
APA (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. American Psychiatric Association: Washington, DC.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Boyd, JH, Burke, JD Jr., Gruenberg, E, Holzer, CE III, Rae, DS, George, LK, Karno, M, Stoltzman, R, McEvoy, L, Nestadt, G (1984). Exclusion criteria of DSM-III: a study of co-occurrence of hierarchy-free syndromes. Archives of General Psychiatry 41, 983989.CrossRefGoogle ScholarPubMed
Cassidy, F, Forest, K, Murry, E, Carroll, BJ (1998). A factor analysis of the signs and symptoms of mania. Archives of General Psychiatry 55, 2732.CrossRefGoogle ScholarPubMed
Cohen, J (1983). The cost of dichotomization. Applied Psychological Measurement 7, 249253.CrossRefGoogle Scholar
Depue, RA, Krauss, S, Spoont, MR (1987). A two-dimensional threshold model of seasonal bipolar affective disorder. In Psychopathology: An Interactional Perspective (ed. Magnusson, D. and Ohman, A.), pp. 95–123. Academic Press: Orlando, FL.Google Scholar
Eaton, WW, Kessler, LG (1985). Epidemiologic Field Method in Psychiatry: The NIMH Epidemiologic Catchment Area Program. Academic Press: Orlando, FL.Google Scholar
Grove, WM (1991). Validity of taxometric inferences based on cluster analysis stopping rules. In Thinking Clearly About Psychology: Essays in Honor of Paul E. Meehl, Vol. 2: Personality and Psychopathology (ed. Cicchetti, D. and Grove, W. M.), pp. 313329. University of Minnesota Press: Minneapolis, MN.Google Scholar
Haslam, N (2003). The dimensional view of personality disorders: a review of the taxometric evidence. Clinical Psychology Review 23, 7593.CrossRefGoogle ScholarPubMed
Helzer, JE, Robins, LN, McEvoy, LT, Spitznagel, EL, Stoltzman, RK, Farmer, A, Brockington, IF (1985). A comparison of clinical and diagnostic interview schedule diagnoses. Physician reexamination of lay-interviewed cases in the general population. Archives of General Psychiatry 42, 657666.CrossRefGoogle ScholarPubMed
Horn, JL (1965). A rationale and test for the number of factors in factor analysis. Psychometrika 30, 179185.CrossRefGoogle ScholarPubMed
Hu, L, Bentler, PM (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling 6, 155.CrossRefGoogle Scholar
Judd, LL, Akiskal, HS (2003). The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. Journal of Affective Disorders 73, 123131.CrossRefGoogle ScholarPubMed
Kallner, G, Lindelius, R, Petterson, U, Stockman, O, Tham, A (2000). Mortality in 497 patients with affective disorders attending a lithium clinic or after having left it. Pharmacopsychiatry 33, 8–13.CrossRefGoogle ScholarPubMed
Kessler, RC, Borges, G, Walters, EE (1999). Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry 56, 617626.CrossRefGoogle ScholarPubMed
Kessler, RC, Rubinow, DR, Holmes, C, Abelson, JM, Zhao, S (1997). The epidemiology of DSM-III-R bipolar I disorder in a general population survey. Psychological Medicine 27, 10791089.CrossRefGoogle Scholar
Kline, RB (2005). Principles and Practice of Structural Equation Modeling, 2nd edn. Guilford Press: New York.Google Scholar
Kraepelin, E (1921). Manic-Depressive Insanity and Paranoia. Livingstone: Edinburgh.CrossRefGoogle Scholar
Krueger, RF (1999). The structure of common mental disorders. Archives of General Psychiatry 56, 921926.CrossRefGoogle ScholarPubMed
Lenzenweger, MF (2004). Consideration of the challenges, complications, and pitfalls of taxometric analysis. Journal of Abnormal Psychology 113, 1023.CrossRefGoogle ScholarPubMed
Markon, KE, Krueger, RF (2006). Information-theoretic latent distribution modeling: distinguishing discrete and continuous latent variable models. Psychological Methods 11, 228243.CrossRefGoogle ScholarPubMed
Maxwell, SE, Delaney, HD (1993). Bivariate median splits and spurious statistical significance. Psychological Bulletin 113, 181190.CrossRefGoogle Scholar
McElroy, SL, Altshuler, LL, Suppes, T, Keck, PE Jr., Frye, MA, Denicoff, KD, Nolen, WA, Kupka, RW, Leverich, GS, Rochussen, JR, Rush, AJ, Post, RM (2001). Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. American Journal of Psychiatry 158, 420426.CrossRefGoogle ScholarPubMed
Meehl, PE (1973). MAXCOV-HITMAX: a taxometric search method for loose genetic syndromes. In Psychodiagnosis: Selected Papers (ed. Meehl, P. E.), pp. 200224. University of Minnesota Press: Minneapolis, MN.Google Scholar
Meehl, PE (1995). Bootstraps taxometrics: solving the classification problem in psychopathology. American Psychologist 50, 266275.CrossRefGoogle ScholarPubMed
Meehl, PE, Yonce, LJ (1994). Taxometric analysis: I. Detecting taxonicity with two quantitative indicators using means above and below a sliding cut (MAMBAC procedure). Psychological Reports 74, 10591274.Google Scholar
Meehl, PE, Yonce, LJ (1996). Taxometric analysis: II. Detecting taxonicity using covariance of two quantitative indicators in successive intervals of a third indicator (MAXCOV procedure). Psychological Reports 78, 10911227.CrossRefGoogle Scholar
Merikangas, KR, Akiskal, HS, Angst, J, Greenberg, PE, Hirschfeld, RMA, Petukhova, M, Kessler, RC (2007). Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Archives of General Psychiatry 64, 543552.CrossRefGoogle ScholarPubMed
Meyer, TD, Keller, F (2003). Is there evidence for a latent class called ‘hypomanic temperament’? Journal of Affective Disorders 75, 259267.CrossRefGoogle ScholarPubMed
Meyers, JK, Weissman, MM, Tischler, GL, Holzer, CE III, Leaf, PJ, Orvaschel, H, Anthony, JC, Boyd, JH, Burke, JD Jr., Kramer, M, Stoltzman, R (1984). Six-month prevalence of psychiatric disorders in three communities. Archives of General Psychiatry 41, 959967.CrossRefGoogle Scholar
Murphy, DL, Beigel, A (1974). Depression, elation, and lithium carbonate responses in manic patient subgroups. Archives of General Psychiatry 31, 643648.CrossRefGoogle ScholarPubMed
Muthén, BO (1989). Dichotomous factor analysis of symptom data. Sociological Methods and Research 18, 1965.CrossRefGoogle Scholar
Muthén, BO (2004). Mplus Technical Appendices. Muthén & Muthén: Los Angeles, CA.Google Scholar
Muthén, LK, Muthén, BO (2007). Mplus User's Guide, 5th edn. Muthén & Muthén: Los Angeles, CA.Google Scholar
Nichols, DS, Jones, RE Jr. (1985). Identifying schizoid-taxon membership with the Golden-Meehl MMPI items. Journal of Abnormal Psychology 94, 191194.CrossRefGoogle ScholarPubMed
Prisciandaro, JJ, Roberts, JE (2005). A taxometric investigation of unipolar depression in the National Comorbidity Survey. Journal of Abnormal Psychology 114, 718728.CrossRefGoogle ScholarPubMed
Prisciandaro, JJ, Roberts, JE (2009). A comparison of the predictive abilities of dimensional and categorical models of unipolar depression in the National Comorbidity Survey. Psychological Medicine 39, 10871096.CrossRefGoogle ScholarPubMed
R Development Core Team (2009). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna, Austria.Google Scholar
Raftery, AE (1995). Bayesian model selection in social research. Sociological Methodology 25, 111196.CrossRefGoogle Scholar
Robins, LN, Helzer, JE, Croughan, J, Ratcliff, KS (1981). National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Archives of General Psychiatry 38, 381389.CrossRefGoogle ScholarPubMed
Robins, LN, Helzer, JE, Ratcliff, KS, Seyfried, W (1982). Validity of the Diagnostic Interview Schedule, Version II: DSM-III diagnoses. Psychological Medicine 12, 855870.CrossRefGoogle ScholarPubMed
Ruscio, J (2000). Taxometric analysis with dichotomous indicators: the modified MAXCOV procedure and a case-removal consistency test. Psychological Reports 87, 929939.CrossRefGoogle Scholar
Ruscio, J (2009). Assigning cases to groups using taxometric results: an empirical comparison of classification techniques. Assessment 16, 5570.CrossRefGoogle ScholarPubMed
Ruscio, J, Haslam, N, Ruscio, AM (2006). Introduction to the Taxometric Method: A Practical Guide. Lawrence Erlbaum Associates: Mahwah, NJ.Google Scholar
Ruscio, J, Kaczetow, W (2008). Simulating multivariate nonnormal data using an iterative algorithm. Multivariate Behavioral Research 43, 355381.CrossRefGoogle ScholarPubMed
Ruscio, J, Marcus, DK (2007). Detecting small taxa using simulated comparison data: a reanalysis of Beach, Amir, and Bau's (2005) data. Psychological Assessment 19, 241246.CrossRefGoogle Scholar
Ruscio, J, Ruscio, AM (2000). Informing the continuity controversy: a taxometric analysis of depression. Journal of Abnormal Psychology 109, 473487.CrossRefGoogle ScholarPubMed
Ruscio, J, Ruscio, AM (2004 a). A nontechnical introduction to the taxometric method. Understanding Statistics 3, 151193.CrossRefGoogle Scholar
Ruscio, J, Ruscio, AM (2004 b). Clarifying boundary issues in psychopathology: the role of taxometrics in a comprehensive program of structural research. Journal of Abnormal Psychology 113, 2438.CrossRefGoogle Scholar
Ruscio, J, Ruscio, AM, Keane, TM (2004). Using taxometric analysis to distinguish a small latent taxon from a latent dimension with positively skewed indicators: the case of involuntary defeat syndrome. Journal of Abnormal Psychology 113, 145154.CrossRefGoogle ScholarPubMed
Ruscio, J, Ruscio, AM, Meron, M (2007 a). Applying the bootstrap to taxometric analysis: generating empirical sampling distributions to help interpret results. Multivariate Behavioral Research 42, 349386.CrossRefGoogle ScholarPubMed
Ruscio, J, Zimmerman, M, McGlinchey, JB, Chelminski, I, Young, D (2007 b). Diagnosing major depressive disorder: XI. A taxometric investigation of the categorical-dimensional debate on the structure underlying DSM-IV symptoms. Journal of Nervous and Mental Disease 195, 1019.CrossRefGoogle Scholar
SAS Institute Inc. (2002). %SREGSUB macro provides additional capabilities for PROC SURVEYREG (http://support.sas.com/kb/24/985.html#ref). Accessed 5 June 2008.Google Scholar
Sato, T, Bottlender, R, Kleindienst, N, Moller, H-J (2002). Syndromes and phenomenological subtypes underlying acute mania: a factor analytic study of 576 manic patients. American Journal of Psychiatry 159, 968974.CrossRefGoogle Scholar
Semler, G, Wittchen, H-U, Joschke, K, Zaudig, M, Vongeiso, T, Kaiser, S, von Cranach, M, Pfister, H (1987). Test-retest reliability of a standardized psychiatric interview (DIS/CIDI). European Archives of Psychiatry and Neurological Sciences 236, 214222.CrossRefGoogle ScholarPubMed
Shapiro, S, Tischler, GL, Cottler, L, George, LK, Amirkhan, JH, Kessler, LG, Skinner, EA (1985). Health services research questions. In Epidemiologic Field Method in Psychiatry: The NIMH Epidemiologic Catchment Area Program (ed. Eaton, W. W. and Kessler, L. G.), pp. 191208. Academic Press: Orlando, FL.CrossRefGoogle Scholar
Sharma, R, Markar, HR (1994). Mortality in affective disorder. Journal of Affective Disorders 31, 9196.CrossRefGoogle ScholarPubMed
Slade, T, Andrews, G (2005). Latent structure of depression in a community sample: a taxometric analysis. Psychological Medicine 35, 489497.CrossRefGoogle Scholar
Solomon, A, Ruscio, J, Seeley, JR, Lewinsohn, PM (2006). A taxometric investigation of unipolar depression in a large community sample. Psychological Medicine 36, 973985.CrossRefGoogle Scholar
Swann, AC, Janicak, PL, Calabrese, JR, Bowden, CL, Dilsaver, SC, Morris, DD, Petty, F, Davis, JM (2001). Structure of mania: depressive, irritable, and psychotic clusters with different retrospectively-assessed course patterns of illness in randomized clinical trial participants. Journal of Affective Disorders 67, 123132.CrossRefGoogle ScholarPubMed
Waldman, ID, Lilienfeld, SO (2001). Applications of taxometric methods to problems of comorbidity: perspectives and challenges. Clinical Psychology: Science and Practice 8, 520527.Google Scholar
Waller, NG, Meehl, PE (1998). Multivariate Taxometric Procedures: Distinguishing Types from Continua. Sage Publications, Inc.: Thousand Oaks, CA.Google Scholar
Walters, GD, Ruscio, J (2009). To sum or not to sum: taxometric analysis with ordered categorical assessment items. Psychological Assessment 21, 99–111.CrossRefGoogle ScholarPubMed
Watson, D (2003). Investigating the construct validity of the dissociative taxon: stability analyses of normal and pathological dissociation. Journal of Abnormal Psychology 112, 298305.CrossRefGoogle ScholarPubMed
Weissman, MA, Bruce, ML, Leaf, PJ, Florio, LP, Holzer, C III (1991). Affective disorders. In Psychiatric Disorders in America: The Epidemiologic Catchment Area Study (ed. Robins, L. N. and Regier, D. A.), pp. 5380. Free Press: New York, NY.Google Scholar
Wittchen, H-U, Semler, G, von Zerssen, D (1985). A comparison of two diagnostic methods: clinical ICD diagnoses vs. DSM-III and Research Diagnostic Criteria using the Diagnostic Interview Schedule (version 2). Archives of General Psychiatry 42, 677684.CrossRefGoogle ScholarPubMed