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The structure of psychopathology and association with poor sleep, self-harm, suicidality, risky sexual behavior, and low self-esteem in a population sample of adolescents

Published online by Cambridge University Press:  29 May 2020

Matthew Sunderland*
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Miriam K. Forbes
Affiliation:
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
Louise Mewton
Affiliation:
Centre for Healthy Brain Aging, School of Psychiatry, University of New South Wales, Sydney, Australia
Andrew Baillie
Affiliation:
Faculty of Health Sciences, The University of Sydney, Sydney, Australia
Natacha Carragher
Affiliation:
World Health Organisation, Geneva, Switzerland Office of Medical Education, University of New South Wales, Sydney, Australia
Samantha J. Lynch
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Philip J. Batterham
Affiliation:
Centre for Mental Health Research, Australian National University, Canberra, Australia
Alison L. Calear
Affiliation:
Centre for Mental Health Research, Australian National University, Canberra, Australia
Cath Chapman
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Nicola C. Newton
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Maree Teesson
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Tim Slade
Affiliation:
The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
*
Author for correspondence: Dr. Matthew Sunderland, The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building (G02), University of Sydney, Sydney, NSW2006, Australia; E-mail: [email protected].

Abstract

There is a growing body of evidence highlighting the presence of a single general dimension of psychopathology that can account for multiple associations across mental and substance use disorders. However, relatively little evidence has emerged regarding the validity of this model with respect to a range of factors that have been previously implicated across multiple disorders. The current study utilized a cross-sectional population survey of adolescents (n = 2,003) to examine the extent to which broad psychopathology factors account for specific associations between psychopathology and key validators: poor sleep, self-harm, suicidality, risky sexual behavior, and low self-esteem. Confirmatory factor models, latent class models, and factor mixture models were estimated to identify the best structure of psychopathology. Structural equation models were then estimated to examine the broad and specific associations between each psychopathology indicator and the validators. A confirmatory factor model with three lower-order factors, representing internalizing, externalizing, and psychotic-like experiences, and a single higher-order factor evidenced the best fit. The associations between manifest indicators of psychopathology and validators were largely nonspecific. However, significant and large direct effects were found between several pairwise associations. These findings have implications for the identification of potential targets for intervention and/or tailoring of prevention programs.

Type
Regular Articles
Copyright
Copyright © Cambridge University Press 2020

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References

Afzali, M. H., Sunderland, M., Carragher, N., & Conrod, P. (2017). The structure of psychopathology in early adolescence: Study of a Canadian sample. The Canadian Journal of Psychiatry, 63, 223230. https://doi.org/10.1177/0706743717737032CrossRefGoogle ScholarPubMed
Albott, C. S., Forbes, M. K., & Anker, J. J. (2018). Association of childhood adversity with differential susceptibility of transdiagnostic psychopathology to environmental stress in adulthood. JAMA Network Open, 1, e185354. https://doi.org/10.1001/jamanetworkopen.2018.5354CrossRefGoogle ScholarPubMed
Baglioni, C., Nanovska, S., Regen, W., Spiegelhalder, K., Feige, B., Nissen, C., … Riemann, D. (2016). Sleep and mental disorders: A meta-analysis of polysomnographic research. Psychological Bulletin, 142, 969990. https://doi.org/10.1037/bul0000053CrossRefGoogle ScholarPubMed
Borschmann, R., Stark, P., Prakash, C., & Sawyer, S. M. (2018). Risk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia. Journal of Paediatrics and Child Health, 54, 12131220. https://doi.org/10.1111/jpc.13938CrossRefGoogle ScholarPubMed
Carragher, N., Teesson, M., Sunderland, M., Newton, N. C., Krueger, R. F., Conrod, P. J., … Slade, T. (2016). The structure of adolescent psychopathology: A symptom-level analysis. Psychological Medicine, 46, 5. https://doi.org/10.1017/S0033291715002470CrossRefGoogle ScholarPubMed
Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., … Moffitt, T. E. (2014). The p factor: One general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science: A Journal of the Association for Psychological Science, 2, 119137. https://doi.org/10.1177/2167702613497473CrossRefGoogle Scholar
Caspi, A., & Moffitt, T. E. (2018). All for one and one for all: Mental disorders in one dimension. American Journal of Psychiatry, 175, 831844. https://doi.org/10.1176/appi.ajp.2018.17121383CrossRefGoogle ScholarPubMed
Castellanos-Ryan, N., Brière, F. N., O'Leary-Barrett, M., Banaschewski, T., Bokde, A., Bromberg, U., … IMAGEN Consortium. (2016). The structure of psychopathology in adolescence and its common personality and cognitive correlates. Journal of Abnormal Psychology, 125, 10391052. https://doi.org/10.1037/abn0000193CrossRefGoogle ScholarPubMed
Clark, S. L., Muthén, B., Kaprio, J., D'Onofrio, B. M., Viken, R., & Rose, R. J. (2013). Models and strategies for factor mixture analysis: An example concerning the structure underlying psychological disorders. Structural Equation Modeling: A Multidisciplinary Journal, 20, 681703. https://doi.org/10.1080/10705511.2013.824786CrossRefGoogle ScholarPubMed
Conway, C. C., Forbes, M. K., Forbush, K. T., Fried, E. I., Hallquist, M. N., Kotov, R., … Eaton, N. R. (2019). A hierarchical taxonomy of psychopathology can transform mental health research. Perspectives on Psychological Science, 14, 419436. https://doi.org/10.1177/1745691618810696CrossRefGoogle ScholarPubMed
Daraganova, G. (2017). Self-harm and suicidal behaviour of young people aged 14–15 years old. In K. Day (Ed), LSAC Annual Statistical Report 2016 (pp. 119144). Melbourne: Australian Institute of Family Studies.Google Scholar
Deville, J. C., & Särndal, C. E. (1992). Calibration estimators in survey sampling. Journal of the American Statistical Association, 87, 376382. https://doi.org/10.1080/01621459.1992.10475217CrossRefGoogle Scholar
Erskine, H. E., Moffitt, T. E., Copeland, W. E., Costello, E. J., Ferrari, A. J., Patton, G., … Scott, J. G. (2015). A heavy burden on young minds: The global burden of mental and substance use disorders in children and youth. Psychological Medicine, 45, 15611563. https://doi.org/10.1017/S0033291714002888CrossRefGoogle Scholar
Forbes, M. K., Rapee, R. M., & Krueger, R. F. (2019). Opportunities for the prevention of mental disorders by reducing general psychopathology in early childhood. Behaviour Research and Therapy, 119, 103411. https://doi.org/10.1016/j.brat.2019.103411CrossRefGoogle ScholarPubMed
Greene, A. L., Eaton, N. R., Li, K., Forbes, M. K., Krueger, R. F., Markon, K. E., … Kotov, R. (2019). Are fit indices used to test psychopathology structure biased? A simulation study. Journal of Abnormal Psychology, https://doi.org/10.1037/abn0000434CrossRefGoogle ScholarPubMed
Hafekost, J., Boterhoven de Haan, K., Lawrence, D., Sawyer, M. G., & Zubrick, S. R. (2017). Validation of the Adolescent self-esteem questionnaire: technical report. Perth, Western Australia.Google Scholar
Hafekost, J., Johnson, S., Lawrence, D., Sawyer, M., Ainley, J., Mihalopoulos, C., & Zubrick, S. R. (2016a). Introducing ‘Young Minds Matter.’. Australian Economic Review, 49, 503514. https://doi.org/10.1111/1467-8462.12163CrossRefGoogle Scholar
Hafekost, J., Lawrence, D., Boterhoven de Haan, K., Johnson, S. E., Saw, S., Buckingham, W. J., … Zubrick, S. R. (2016b). Methodology of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry, 50, 866875. https://doi.org/10.1177/0004867415622270CrossRefGoogle Scholar
Haltigan, J. D., Aitken, M., Skilling, T., Henderson, J., Hawke, L., Battaglia, M., … Andrade, B. F. (2018). “P” and “DP:” Examining symptom-level bifactor models of psychopathology and dysregulation in clinically referred children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 57, 384396. https://doi.org/10.1016/J.JAAC.2018.03.010CrossRefGoogle ScholarPubMed
Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., … Adams Hillard, P. J. (2015). National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health, 1, 4043. https://doi.org/10.1016/j.sleh.2014.12.010CrossRefGoogle ScholarPubMed
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 155.CrossRefGoogle Scholar
Jin, Y., Myers, N. D., Ahn, S., & Penfield, R. D. (2013). A comparison of uniform DIF effect size estimators under the MIMIC and rasch models. Educational and Psychological Measurement, 73, 339358. https://doi.org/10.1177/0013164412462705CrossRefGoogle Scholar
Keyes, K. M., Eaton, N. R., Krueger, R. F., McLaughlin, K. A., Wall, M. M., Grant, B. F., & Hasin, D. (2012). Childhood maltreatment and the structure of common psychiatric disorders. British Journal of Psychiatry, 200, 107115.CrossRefGoogle ScholarPubMed
Kim, H., & Eaton, N. R. (2015). The hierarchical structure of common mental disorders: Connecting multiple levels of comorbidity, bifactor models, and predictive validity. Journal of Abnormal Psychology, 124, 10641078. https://doi.org/10.1037/abn0000113CrossRefGoogle ScholarPubMed
Kotov, R., Waszczuk, M. A., Krueger, R. F., Forbes, M. K., Watson, D., Clark, L. A., … Zimmerman, M. (2017). The hierarchical taxonomy of psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126, 454477. https://doi.org/10.1037/abn0000258CrossRefGoogle ScholarPubMed
Krueger, R. F., Markon, K. E., Patrick, C. J., Benning, S. D., & Kramer, M. D. (2007). Linking antisocial behaviour, substance use, and personality: An integrative quantitative model of the adult externalizing spectrum. Journal of Abnormal Psychology, 116, 645666. https://doi.org/10.1037/0021-843X.116.4.645CrossRefGoogle ScholarPubMed
Laceulle, O. M., Vollebergh, W. A. M., & Ormel, J. (2015). The structure of psychopathology in adolescence. Clinical Psychological Science, 3, 850860. https://doi.org/10.1177/2167702614560750CrossRefGoogle Scholar
Lubke, G. H., & Muthén, B. (2005). Investigating population heterogeneity with factor mixture models. Psychological Methods, 10, 2139. https://doi.org/10.1037/1082-989X.10.1.21CrossRefGoogle ScholarPubMed
Lubman, D. I., Allen, N. B., Rogers, N., Cementon, E., & Bonomo, Y. (2007). The impact of co-occurring mood and anxiety disorders among substance-abusing youth. Journal of Affective Disorders, 103, 105112. https://doi.org/10.1016/j.jad.2007.01.011CrossRefGoogle ScholarPubMed
Mars, B., Heron, J., Crane, C., Hawton, K., Lewis, G., Macleod, J., … Gunnell, D. (2014). Clinical and social outcomes of adolescent self harm: Population based birth cohort study. BMJ (Clinical Research Ed.), 349, g5954. https://doi.org/10.1136/bmj.g5954Google ScholarPubMed
Masselink, M., Van Roekel, E., & Oldehinkel, A. J. (2018). Self-esteem in early adolescence as predictor of depressive symptoms in late adolescence and early adulthood: The mediating role of motivational and social factors. Journal of Youth and Adolescence, 47, 932946. https://doi.org/10.1007/s10964-017-0727-zCrossRefGoogle ScholarPubMed
Masyn, K. E., Henderson, C. E., & Greenbaum, P. E. (2010). Exploring the latent structures of psychological constructs in social development using the dimensional-categorical spectrum. Social Development (Oxford, England), 19, 470493. https://doi.org/10.1111/j.1467-9507.2009.00573.xGoogle ScholarPubMed
McElroy, E., Belsky, J., Carragher, N., Fearon, P., & Patalay, P. (2018). Developmental stability of general and specific factors of psychopathology from early childhood to adolescence: Dynamic mutualism or p-differentiation? Journal of Child Psychology and Psychiatry, 59, 667675. https://doi.org/10.1111/jcpp.12849CrossRefGoogle ScholarPubMed
Muthen, L. K., & Muthen, B. O. (2015). Mplus Users’ Guide. Los Angeles, CA: Muthen & Muthen.Google Scholar
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14, 535569. https://doi.org/10.1080/10705510701575396CrossRefGoogle Scholar
Paus, T., Keshavan, M., & Giedd, J. N. (2008). Why do many psychiatric disorders emerge during adolescence? Nature Reviews Neuroscience, 9, 947957. https://doi.org/10.1038/nrn2513CrossRefGoogle ScholarPubMed
Prendergast, L. E., Toumbourou, J. W., McMorris, B. J., & Catalano, R. F. (2019). Outcomes of early adolescent sexual behavior in Australia: Longitudinal findings in young adulthood. Journal of Adolescent Health, 64, 516522. https://doi.org/10.1016/J.JADOHEALTH.2018.10.006CrossRefGoogle ScholarPubMed
Raftery, A. E. (1995). Bayesian model selection in social research. Sociological Methodology, 25, 111163.CrossRefGoogle Scholar
Rodriguez-Seijas, C., Arfer, K. B., Thompson, R. G., Hasin, D. S., & Eaton, N. R. (2017). Sex-related substance use and the externalizing spectrum. Drug and Alcohol Dependence, 174, 3946. https://doi.org/10.1016/j.drugalcdep.2017.01.008CrossRefGoogle ScholarPubMed
Rodriguez, A., Reise, S. P., & Haviland, M. G. (2016). Evaluating bifactor models: Calculating and interpreting statistical indices. Psychological Methods, 21, 137150. https://doi.org/10.1037/met0000045CrossRefGoogle ScholarPubMed
Shaffer, D., Fisher, P., & Lucas, C. (2004). The diagnostic interview schedule for children (DISC). In Helsenroth, M. J., Segal, D. L., & Hersen, M. (Eds). Comprehensive handbook of psychological assessment (pp. 256270).Google Scholar
Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC- IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 2838. https://doi.org/10.1097/00004583-200001000-00014CrossRefGoogle ScholarPubMed
Slade, T., McEvoy, P. M., Chapman, C., Grove, R., & Teesson, M. (2015). Onset and temporal sequencing of lifetime anxiety, mood and substance use disorders in the general population. Epidemiology and Psychiatric Sciences, 24, 4553. https://doi.org/10.1017/S2045796013000577CrossRefGoogle ScholarPubMed
Starr, L. R., Conway, C. C., Hammen, C. L., & Brennan, P. A. (2014). Transdiagnostic and disorder-specific models of intergenerational transmission of internalizing pathology. Psychological Medicine, 44, 161172. https://doi.org/10.1017/S003329171300055XCrossRefGoogle ScholarPubMed
Sunderland, M., Carragher, N., Chapman, C., Mills, K., Teesson, M., Lockwood, E., … Slade, T. (2016). The shared and specific relationships between exposure to potentially traumatic events and transdiagnostic dimensions of psychopathology. Journal of Anxiety Disorders, 38, 102109. https://doi.org/10.1016/j.janxdis.2016.02.001CrossRefGoogle ScholarPubMed
Sunderland, M., & Slade, T. (2014). The relationship between internalizing psychopathology and suicidality, treatment seeking, and disability in the Australian population. Journal of Affective Disorders, 171, 612. https://doi.org/10.1016/j.jad.2014.09.012CrossRefGoogle ScholarPubMed
Tackett, J. L. (2006). Evaluating models of the personality–psychopathology relationship in children and adolescents. Clinical Psychology Review, 26, 584599. https://doi.org/10.1016/J.CPR.2006.04.003CrossRefGoogle ScholarPubMed
Teesson, M., Slade, T., & Mills, K. (2009). Comorbidity in Australia: Findings of the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, 43, 606614. https://doi.org/10.1080/00048670902970908CrossRefGoogle ScholarPubMed
Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3, 470. https://doi.org/10.1177/109442810031002CrossRefGoogle Scholar
Waldman, I. D., Poore, H. E., van Hulle, C., Rathouz, P. J., & Lahey, B. B. (2016). External validity of a hierarchical dimensional model of child and adolescent psychopathology: Tests using confirmatory factor analyses and multivariate behavior genetic analyses. Journal of Abnormal Psychology, 125, 10531066. https://doi.org/10.1037/abn0000183CrossRefGoogle ScholarPubMed
Wright, A. G. C., Krueger, R. F., Hobbs, M. J., Markon, K. E., Eaton, N. R., & 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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