13 research outputs found
In search of disorders: internalizing symptom networks in a large clinical sample.
Background
The coâoccurrence of internalizing disorders is a common form of psychiatric comorbidity, raising questions about the boundaries between these diagnostic categories. We employ network psychometrics in order to: (a) determine whether internalizing symptoms cluster in a manner reflecting DSM diagnostic criteria, (b) gauge how distinct these diagnostic clusters are and (c) examine whether this network structure changes from childhood to early and then late adolescence.
Method
Symptomâlevel data were obtained for service users in publicly funded mental health services in England between 2011 and 2015 (N = 37,162). A symptom network (i.e. Gaussian graphical model) was estimated, and a community detection algorithm was used to explore the clustering of symptoms.
Results
The estimated network was densely connected and characterized by a multitude of weak associations between symptoms. Six communities of symptoms were identified; however, they were weakly demarcated. Two of these communities corresponded to social phobia and panic disorder, and four did not clearly correspond with DSM diagnostic categories. The network structure was largely consistent by sex and across three age groups (8â11, 12â14 and 15â18 years). Symptom connectivity in the two older age groups was significantly greater compared to the youngest group and there were differences in centrality across the age groups, highlighting the ageâspecific relevance of certain symptoms.
Conclusions
These findings clearly demonstrate the interconnected nature of internalizing symptoms, challenging the view that such pathology takes the form of distinct disorders
Editorial Statement About JCCAPâs 2023 Special Issue on Informant Discrepancies in Youth Mental Health Assessments: Observations, Guidelines, and Future Directions Grounded in 60 Years of Research
Issue 1 of the 2011 Volume of the Journal of Clinical Child and Adolescent Psychology (JCCAP) included a Special Section about the use of multi-informant approaches to measure child and adolescent (i.e., hereafter referred to collectively as âyouthâ) mental health (De Los Reyes, 2011). Researchers collect reports from multiple informants or sources (e.g., parent and peer, youth and teacher) to estimate a given youthâs mental health. The 2011 JCCAP Special Section focused on the most common outcome of these approaches, namely the significant discrepancies that arise when comparing estimates from any two informantâs reports (i.e., informant discrepancies). These discrepancies appear in assessments conducted across the lifespan (Achenbach, 2020). That said, JCCAP dedicated space to understanding informant discrepancies, because they have been a focus of scholarship in youth mental health for over 60 years (e.g., Achenbach et al., 1987; De Los Reyes & Kazdin, 2005; Glennon & Weisz, 1978; Kazdin et al., 1983; Kraemer et al., 2003; Lapouse & Monk, 1958; Quay et al., 1966; Richters, 1992; Rutter et al., 1970; van der Ende et al., 2012). Thus, we have a thorough understanding of the areas of research for which they reliably appear when clinically assessing youth. For instance, intervention researchers observe informant discrepancies in estimates of intervention effects within randomized controlled trials (e.g., Casey & Berman, 1985; Weisz et al., 2017). Service providers observe informant discrepancies when working with individual clients, most notably when making decisions about treatment planning (e.g., Hawley & Weisz, 2003; Hoffman & Chu, 2015). Scholars in developmental psychopathology observe these discrepancies when seeking to understand risk and protective factors linked to youth mental health concerns (e.g., Hawker & Boulton, 2000; Hou et al., 2020; Ivanova et al., 2022). Thus, the 2011 JCCAP Special Section posed a question: Might these informant discrepancies contain data relevant to understanding youth mental health? Suppose none of the work in youth mental health is immune from these discrepancies. In that case, the answer to this question strikes at the core of what we produceâfrom the interventions we develop and implement, to the developmental psychopathology research that informs intervention development
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Cognitive appraisals in young people with obsessive-compulsive disorder
Background: A number of cognitive appraisals have been identified as important in the manifestation
of obsessive-compulsive disorder (OCD) in adults. There have, however, been few attempts to explore
these cognitive appraisals in clinical groups of young people. Method: This study compared young
people aged between 11 and 18 years with OCD (N Œ 28), young people with other types of anxiety
disorders (N Œ 28) and a non-clinical group (N Œ 62) on three questionnaire measures of cognitive
appraisals. These were inflated responsibility (Responsibility Attitude Scale; Salkovskis et al., 2000),
thoughtâaction fusion â likelihood other (ThoughtâAction Fusion Scale; Shafran, Thordarson & Rachman,
1996) and perfectionism (Multidimensional Perfectionism Scale; Frost, Marten, Luhart &
Rosenblate, 1990). Results: The young people with OCD had significantly higher scores on inflated
responsibility, thoughtâaction fusion â (likelihood other), and one aspect of perfectionism, concern over
mistakes, than the other groups. In addition, inflated responsibility independently predicted OCD
symptom severity. Conclusions: The results generally support a downward extension of the cognitive
appraisals held by adults with OCD to young people with the disorder. Some of the results, however,
raise issues about potential developmental shifts in cognitive appraisals. The findings are discussed in
relation to implications for the cognitive model of OCD and cognitive behavioural therapy for young
people with OCD. Keywords: Cognitive models, inflated responsibility, obsessive-compulsive disorder,
perfectionism, thoughtâaction fusion. Abbreviations: ADIS-C: Anxiety Disorders Interview Schedule
for Children; ADIS-P: Anxiety Disorders Interview Schedule for Parents; E/RP: Exposure/Response
Prevention; LOI-CV: Leyton Obsessional Inventory â Child Version; MPS: Multidimensional Perfectionism
Scale; OCD: Obsessive-Compulsive Disorder; RAS: Responsibility Attitude Scale; TAF-LO:
ThoughtâAction Fusion â (Likelihood Other)