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Integrating Autism-Related Symptoms into the Dimensional Internalizing and Externalizing Model of Psychopathology. The TRAILS Study

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Abstract

Problems associated with Autism Spectrum Disorder (ASD) occur frequently in the general population and often co-occur with problems in other domains of psychopathology. In the research presented here these co-occurrence patterns were investigated by integrating a dimensional approach to ASDs into the more general dimensional framework of internalizing and externalizing psychopathology. Factor Analysis was used to develop hierarchical and bi-factor models covering multiple domains of psychopathology in three measurement waves of a longitudinal general population sample (N = 2,230, ages 10–17, 50.8 % female). In all adequately fitting models, autism related problems were part of a specific domain of psychopathology that could be distinguished from the internalizing and externalizing domains. Optimal model fit was found for a bi-factor model with one non-specific factor and four specific factors related to internalizing, externalizing, autism spectrum problems and problems related to attention and orientation. Autism-related problems constitute a specific domain of psychopathology that can be distinguished from the internalizing and externalizing domains. In addition, the co-occurrence patterns in the data indicate the presence of a strong general factor.

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Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. University Medical Center Groningen, Groningen, Netherlands

    Arjen Noordhof, Johan Ormel, Albertine J. Oldehinkel & Catharina A. Hartman

  2. University of Amsterdam, Weesperplein 4, Amsterdam, 1018, XA, The Netherlands

    Arjen Noordhof

  3. University of Minnesota, Minneapolis, USA

    Robert F. Krueger

  4. University of Groningen, Groningen, Netherlands

    Albertine J. Oldehinkel

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  1. Arjen Noordhof
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  2. Robert F. Krueger
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  3. Johan Ormel
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  4. Albertine J. Oldehinkel
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  5. Catharina A. Hartman
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Correspondence to Arjen Noordhof.

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Author Note

Arjen Noordhof, dep. Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen, dep. Clinical Psychology, University of Amsterdam; Robert F. Krueger, dep. Psychology, University of Minnesota; Johan Ormel, dep. Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen; Albertine J. Oldehinkel, dep. Interdisciplinary Center for Psychiatric Epidemiology University Medical Center Groningen, dep. Psychology, University of Groningen; Catharina A. Hartman, dep. Child and Adolescent Psychiatry, University Medical Center Groningen.

The Interdisciplinary Center for Psychiatric Epidemiology has been renamed as Interdisciplinary Center Psychopathology and Emotion regulation. Arjen Noordhof is no longer affiliated to the University Medical Center Groningen.

This research is part of the TRacking Adolescents’ Individual Lives Survey (TRAILS). Participating centers of TRAILS include various departments of the University Medical Center and University of Groningen, the Erasmus University Medical Center Rotterdam, the University of Utrecht, the Radboud Medical Center Nijmegen, and the Trimbos Institute, all in the Netherlands. Principal investigators are prof. dr. J. Ormel (University Medical Center Groningen) and prof. dr. F.C. Verhulst (Erasmus University Medical Center). TRAILS has been financially supported by various grants from the Netherlands Organization for Scientific Research NWO (Medical Research Council program grant GB-MW 940-38-011; ZonMW Brainpower grant 100-001-004; ZonMw Risk Behavior and Dependence grants 60-60600-98-018 and 60-60600-97-118; ZonMw Culture and Health grant 261-98-710; Social Sciences Council medium-sized investment grants GB-MaGW 480-01-006 and GB-MaGW 480-07-001; Social Sciences Council project grants GB-MaGW 457-03-018, GB-MaGW 452-04-314, an GB-MaGW 452-06-004; NWO large-sized investment grant 175.010.2003.005); the Sophia Foundation for Medical Research (projects 301 and 393), the Dutch Ministry of Justice (WODC), and the participating universities. We are grateful to all adolescents, their parents and teachers who participated in this research and to everyone who worked on this project and made it possible. The authors have no competing interests.

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Figure A.1

EXT = Externalizing problems; INT = Internalizing problems; AS+ =autism-related and attention-related problems; wdc = Withdrawn-depressed behavior (Wd) and Reduced Contact and Social Interest (Con); rbagg = Rule-breaking behavior (Rb) and Aggression (Agg); anx = Anxiety; sc = Somatic Complaints; agg* = specific items from the Aggression scale (Agg); ste = Stereotyped behavior; AS = Autism spectrum problems; AO = Attention and orientation problems; dif = Difficulties in Understanding Social Information; aggbeh = items from the Aggression and Behavioral problems scales; aggbeh1/ aggbeh2/ wdc1/ wdc2 = further subdivisions of these factors. (DOC 233 kb)

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Noordhof, A., Krueger, R.F., Ormel, J. et al. Integrating Autism-Related Symptoms into the Dimensional Internalizing and Externalizing Model of Psychopathology. The TRAILS Study. J Abnorm Child Psychol 43, 577–587 (2015). https://doi.org/10.1007/s10802-014-9923-4

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