A construct-network approach to bridging diagnostic and physiological domains: Application to assessment of externalizing psychopathology.

Abstract

A crucial challenge in efforts to link psychological disorders to neural systems, with the aim of developing biologically informed conceptions of such disorders, is the problem of method variance (Campbell & Fiske, 1959). Since even measures of the same construct in differing domains correlate only moderately, it is unsurprising that large sample studies of diagnostic biomarkers yield only modest associations. To address this challenge, a construct-network approach is proposed in which psychometric operationalizations of key neurobehavioral constructs serve as anchors for identifying neural indicators of psychopathology-relevant dispositions, and as vehicles for bridging between domains of clinical problems and neurophysiology. An empirical illustration is provided for the construct of inhibition-disinhibition, which is of central relevance to problems entailing deficient impulse control. Findings demonstrate that: (1) a well-designed psychometric index of trait disinhibition effectively predicts externalizing problems of multiple types, (2) this psychometric measure of disinhibition shows reliable brain response correlates, and (3) psychometric and brain-response indicators can be combined to form a joint psychoneurometric factor that predicts effectively across clinical and physiological domains. As a methodology for bridging between clinical problems and neural systems, the construct-network approach provides a concrete means by which existing conceptions of psychological disorders can accommodate and be reshaped by neurobiological insights.

Externalizing proneness and brain response during pre-cuing and viewing of emotional pictures

“…One potential concern is that participants were not patients diagnosed with externalizing disorders but rather college students varying in levels of disinhibitory tendencies as indexed by a self-report scale. However, this concern is mitigated by prior work demonstrating that externalizing psychopathology is continuous rather than discrete (Krueger et al, 2002 and that electrocortical response differences evident in clinical samples with severe externalizing problems (Venables and Patrick, 2014) are also observed in individuals from college or community samples who score high in disinhibitory tendencies Patrick et al, 2013). Further, the effect of reduced responsiveness to reward is consistent with data from patient populations (Barkley et al, 2001;Demurie et al, 2012;White et al, 2014).…”

“…Further, the effect of reduced responsiveness to reward is consistent with data from patient populations (Barkley et al, 2001;Demurie et al, 2012;White et al, 2014). Regarding the scale measure of disinhibition we used, this measure was carefully designed to index liability toward externalizing problems (Krueger et al, 2007;Patrick et al, 2013), and prior research has shown that scores on this scale covary substantially with interview-assessed externalizing symptoms-largely as a function of shared genetic influences that covary in turn with brain response . As such, this scale measure provides an effective vehicle for bridging between brain response measures and clinical problems .…”

“…This dispositional liability can be assessed in a number of ways, including through diagnostic interview, self-report questionnaire, lab task performance, and psychophysiological reactivity (Young et al, 2009;Patrick et al, 2012Patrick et al, , 2013. Indeed, recent research has demonstrated that general proneness to externalizing problems as operationalized by scores on a brief scale measure of trait disinhibitory tendencies indexes heritable variance in common with interview-assessed externalizing problems that in turn predicts aberrant brain response .…”

“…Externalizing proneness, or trait disinhibition 1 (Sher and Trull, 1994;Patrick et al, 2013), represents a prominently heritable liability for a number of dysfunctional behaviors of high societal and personal relevance, including conduct problems in childhood, impulsive-aggressive behavior in adulthood, and substance-related addictions (Krueger et al, 2002(Krueger et al, , 2007. This dispositional liability can be assessed in a number of ways, including through diagnostic interview, self-report questionnaire, lab task performance, and psychophysiological reactivity (Young et al, 2009;Patrick et al, 2012Patrick et al, , 2013.…”

The Research Domain Criteria framework: transitioning from dimensional systems to integrating neuroscience and psychopathology

“…Many paradigms have been developed that can provide measures both of behavioral performance and of related functional brain activity in different populations, providing some sense of the normal distribution of behavior; this capability, in turn, permits a quantitative specification of the extent to which various aspects of human functioning deviate from normality. Notably, these new developments are not confined only to laboratory tasks, but also to robust psychiatric scales and inventories that relate strongly to real-world functioning [7].…”