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Comorbidity pp 221-239 | Cite as

Design, Statistical and Methodological Considerations: Comorbidity

  • Einar ThorsteinssonEmail author
  • Rhonda Brown
Chapter

Abstract

Research of disease comorbidity and symptom co-occurrence raises several issues relating to study design and analytical techniques that require careful consideration. In this chapter, we first address methodological issues that are of particular relevance in comorbidity research, including symptom overlap and the resultant double counting of symptoms; the pitfalls and advantages of removing overlapping scale items; and the utility of creating latent variables or ‘symptom groups’. We then discuss the advantages and limitations of employing various study designs in the context of comorbidity research and make recommendations for maximising the scientific rigour of statistical analyses whilst ensuring that ethical standards are met. Finally, we highlight analytical techniques that are relatively novel and/or less commonly utilised in studies of comorbidity, and how these techniques might advance research in this field.

References

  1. 1.
    Borsboom D, Cramer AOJ, Schmittmann VD, Epskamp S, Waldorp LJ. The small world of psychopathology. PLoS One. 2011;6(11):e27407.  https://doi.org/10.1371/journal.pone.0027407.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  3. 3.
    Mayo Clinic. Chronic fatigue syndrome. 2018; https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490. Accessed 31 May 2019.
  4. 4.
    Centre for Disease Control and Prevention [CDC]. Chronic fatigue syndrome. 2012; http://www.cdc.gov/cfs/. Accessed 31 May 2019.
  5. 5.
    Demyttenaere K, De Fruyt J, Stahl SM. The many faces of fatigue in major depressive disorder. The International Journal of Neuropsychopharmacology. 2005;8(1):93–105.  https://doi.org/10.1017/s1461145704004729.CrossRefPubMedGoogle Scholar
  6. 6.
    Aikens JE, Reinecke MA, Pliskin NH, et al. Assessing depressive symptoms in multiple sclerosis: Is it necessary to omit items from the original Beck Depression Inventory? Journal of Behavioral Medicine. 1999;22(2):127–142.  https://doi.org/10.1023/a:1018731415172.CrossRefPubMedGoogle Scholar
  7. 7.
    Sveinbjornsdottir S, Thorsteinsson EB. Psychometric properties of the Measure of Adolescent Coping Strategies (MACS). Psychology. 2014;5(2):142–147.  https://doi.org/10.4236/psych.2014.52022.CrossRefGoogle Scholar
  8. 8.
    Sveinbjornsdottir S, Thorsteinsson EB, Lingam GI. Model fit and comparisons for the Measure of Adolescent Coping Strategies (MACS): Fiji, Iceland, and Australia. Journal of Pacific Rim Psychology. 2017;11:e12.  https://doi.org/10.1017/prp.2017.20.CrossRefGoogle Scholar
  9. 9.
    Little TD, Schnabel KU, Jurgen Baumert J, eds. Modeling longitudinal and multilevel data: Practical issues, applied approaches, and specific examples. London, UK: Lawrence Erlbaum Associates; 2000.Google Scholar
  10. 10.
    Hayes AF. Introduction to mediation, moderation and conditional process analysis: A regression-based approach. 2nd ed. New York, NY: Guilford Press; 2018.Google Scholar
  11. 11.
    Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York, NY: Guilford Press; 2011.Google Scholar
  12. 12.
    Schmittmann VD, Cramer AOJ, Waldorp LJ, Epskamp S, Kievit RA, Borsboom D. Deconstructing the construct: A network perspective on psychological phenomena. New Ideas in Psychology. 2013;31(1):43–53.  https://doi.org/10.1016/j.newideapsych.2011.02.007.CrossRefGoogle Scholar
  13. 13.
    Shahar B, Britton WB, Sbarra DA, Figueredo AJ, Bootzin RR. Mechanisms of change in mindfulness-based cognitive therapy for depression: Preliminary evidence from a randomized controlled trial. International Journal of Cognitive Therapy. 2010;3(4):402–418.  https://doi.org/10.1521/ijct.2010.3.4.402.CrossRefGoogle Scholar
  14. 14.
    Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review. 2015;37:1–12.  https://doi.org/10.1016/j.cpr.2015.01.006.CrossRefPubMedGoogle Scholar
  15. 15.
    Kelly G. Body temperature variability (Part 1): A review of the history of body temperature and its variability due to site selection, biological rhythms, fitness, and aging. Alternative Medicine Review. 2006;11(4):278–293.PubMedGoogle Scholar
  16. 16.
    Lu S-H, Dai Y-T. Normal body temperature and the effects of age, sex, ambient temperature and body mass index on normal oral temperature: A prospective, comparative study. International Journal of Nursing Studies. 2009;46(5):661–668.  https://doi.org/10.1016/j.ijnurstu.2008.11.006.CrossRefPubMedGoogle Scholar
  17. 17.
    Danel T, Libersa C, Touitou Y. The effect of alcohol consumption on the circadian control of human core body temperature is time dependent. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2001;281(1):R52–R55.CrossRefGoogle Scholar
  18. 18.
    Roth GS, Lane MA, Ingram DK, et al. Biomarkers of caloric restriction may predict longevity in humans. Science. 2002;297(5582):811.  https://doi.org/10.1126/science.1071851.CrossRefPubMedGoogle Scholar
  19. 19.
    Redman LM, Martin CK, Williamson DA, Ravussin E. Effect of caloric restriction in non-obese humans on physiological, psychological and behavioral outcomes. Physiology & Behavior. 2008;94(5):643–648.  https://doi.org/10.1016/j.physbeh.2008.04.017.CrossRefGoogle Scholar
  20. 20.
    Soare A, Cangemi R, Omodei D, Holloszy JO, Fontana L. Long-term calorie restriction, but not endurance exercise, lowers core body temperature in humans. Aging. 2011;3(4):374–379.CrossRefGoogle Scholar
  21. 21.
    Kwok JSS, Chan TYK. Recurrent heat-related illnesses during antipsychotic treatment. Annals of Pharmacotherapy. 2005;39(11):1940–1942.  https://doi.org/10.1345/aph.1g130.CrossRefPubMedGoogle Scholar
  22. 22.
    Mellerup ET, Widding A, Wildschiødtz G, Rafaelsen OJ. Lithium effect on temperature rhythm in psychiatric patients. Acta Pharmacologica et Toxicologica. 1978;42(2):125–129.  https://doi.org/10.1111/j.1600-0773.1978.tb02179.x.CrossRefPubMedGoogle Scholar
  23. 23.
    Goldstein ER, Ziegenfuss T, Kalman D, et al. International society of sports nutrition position stand: Caffeine and performance. Journal of the International Society of Sports Nutrition. 2010;7(5).  https://doi.org/10.1186/1550-2783-7-5.CrossRefGoogle Scholar
  24. 24.
    Molnar GW. Body temperatures during menopausal hot flashes. Journal of Applied Physiology. 1975;38(3):499–503.CrossRefGoogle Scholar
  25. 25.
    Carmelli D, Swan GE, Bliwise DL. Relationship of 30-year changes in obesity to sleep-disordered breathing in the western collaborative group study. Obesity Research. 2000;8(9):632–637.  https://doi.org/10.1038/oby.2000.81.CrossRefPubMedGoogle Scholar
  26. 26.
    Byrne BM. Structural equation modelling with AMOS: Basic concepts, applications, and programming. 2nd ed. New York, NY: Routledge; 2010.Google Scholar

Copyright information

© The Author(s) 2020

Authors and Affiliations

  1. 1.University of New EnglandArmidaleAustralia
  2. 2.Australian National UniversityCanberraAustralia

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