In search of disorders: internalizing symptom networks in a large clinical sample.

Background The co‐occurrence 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 Symptom‐level 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 (8–11, 12–14 and 15–18 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 age‐specific 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

Callous-unemotional traits in a community sample of adolescents

This study examined the structure, distribution, and correlates of a new measure of self-reported callous-unemotional (CU) traits in 1,443 adolescents (774 boys, 669 girls) between the ages of 13 to 18 years. The Inventory of Callous-Unemotional Traits was sub-jected to exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis produced three factors: callousness, uncaring, and unemotional. Fit indexes sug-gested that the three-factor model, with a single higher-order factor, represented a satis-factory solution for the data. This factor structure fit well for both boys and girls. CU traits correlated significantly with measures of conduct problems and psychosocial impairment. Furthermore, the traits showed predicted associations with sensation seeking and the Big Five personality dimensions, supporting the construct validity of the measure of CU traits

Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Cypriot children and adolescents

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a 41-item self-report questionnaire that measures symptoms of DSM-IV anxiety disorders (panic/somatic, generalized anxiety, separation anxiety, social phobia) and school phobia in children and adolescents. This study examined the psychometric properties of the Greek translation of SCARED in a large community sample of children and adolescents (N = 1,072), aged 12 to 17 years, in the nonoccupied territory of Cyprus. A subsample of these participants (N = 108) was retested an average of 8 weeks after the initial assessment. The SCARED demonstrated high internal consistency (α = .92) and test-retest reliability (r = .84, over 8 weeks). The SCARED total scores correlated significantly with the internalizing factor of the Youth Self-Report, the Columbia Impairment Scale, and with the emotional subscale of the Strength and Difficulty Questionnaire. Confirmatory factor analyses revealed the same five-factor structure as the original SCARED. The SCARED proved to be a reliable and valid measure of anxiety symptoms in the Cypriot context