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The Structure of Psychopathology in a Sample of Clinically Referred, Emotionally Dysregulated Early Adolescents

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Abstract

This investigation answers and amplifies calls to model the transdiagnostic structure of psychopathology in clinical samples of early adolescents and using stringent psychometric criteria. In 162 clinically referred, clinically evaluated 11–13-year-olds, we compared a correlated two-factor model, containing latent internalizing and externalizing factors, to a bifactor model, which added a transdiagnostic general factor. We also evaluated the bifactor model psychometrically, including criterion validity with broad indicators of psychosocial functioning. In doing so, we compared alternative approaches to defining and interpreting criterion validity: a recently proposed incremental definition based on amounts of variance in criterion factors explained, and the more typical definition based on the presence of conceptually meaningful relationships. While traditional fit statistics favored the bifactor model as expected, psychometric analyses added important nuance. Despite moderate reliability, the general factor was not fully transdiagnostic (i.e., was not informed by several externalizing scores), and was partially redundant with internalizing scores. Approaches to criterion validity yielded opposing results. Compared to the correlated two-factor model, the bifactor model redistributed, without incrementally increasing, the total variance explained in criterion indicators of psychosocial functioning. Yet, the bifactor model did improve the precision of clinically important relationships to psychosocial functioning, raising questions about meaningful tests of bifactor psychopathology models.

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Notes

  1. Coefficients for this unconditional model are in Supplement D. An alternative model loading all 6 indicators together on a factor, with residuals for parallel scores between reporters correlated, showed poor fit, χ2(6) = 29.79, p < .001, RMSEA = .16 [.11,.22], CFI = 0.78, TLI = 0.45.

  2. The initial model fit the data poorly, χ2(27) = 156.14, p < .001, RMSEA = .17 [.15,.20], CFI = 0.60, TLI = 0.47. Discrepancies between observed and model-implied correlations suggested several theoretically-consistent correlations, which were added to the model sequentially to determine whether fit could be improved (i.e., depression with BPD, depression with GAD, GAD with social phobia, GAD with separation anxiety, and separation anxiety with BPD, added in this order). Even after respecifications, fit remained weak, χ2(22) = 47.29, p = .001, RMSEA = .08 [.05,.12], CFI = 0.92, TLI = 0.87, and was significantly poorer than for the bifactor model, Δχ2(3) = 27.2, p < .001). Most internalizing pathologies would not load on the one-factor solution (Supplement C), and the density of correlations among error variances was suggestive of a separate latent factor.

  3. Tested separately in two models, psychosocial functioning and suicide risk produced the same patterns of relationships with bifactor model psychopathology factors as when tested together. All model fits were adequate.

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Preparation of this manuscript was aided by grants from the National Institute of Mental Health (R01 MH101088, PI: Stepp; T32 MH018951, PI: Brent; K01 MH119216, PI: Byrd; K01 MH101289, PI: Scott; K01 MH109859, PI: Beeney).

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  1. Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara St, Pittsburgh, PA, 15213, USA

    Vera Vine, Amy L. Byrd, Harmony Mohr, Lori N. Scott, Joseph E. Beeney & Stephanie D. Stepp

  2. Department of Psychology, University of Pittsburgh School of Arts and Sciences, Pittsburgh, PA, USA

    Stephanie D. Stepp

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Vine, V., Byrd, A.L., Mohr, H. et al. The Structure of Psychopathology in a Sample of Clinically Referred, Emotionally Dysregulated Early Adolescents. J Abnorm Child Psychol 48, 1379–1393 (2020). https://doi.org/10.1007/s10802-020-00684-x

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