Delineating and validating higher-order dimensions of psychopathology in the Adolescent Brain Cognitive Development (ABCD) study

Abstract

Hierarchical dimensional systems of psychopathology promise more informative descriptions for understanding risk and predicting outcome than traditional diagnostic systems, but it is unclear how many major dimensions they should include. We delineated the hierarchy of childhood and adult psychopathology and validated it against clinically relevant measures. Participants were 9987 9- and 10-year-old children and their parents from the Adolescent Brain Cognitive Development (ABCD) study. Factor analyses of items from the Child Behavior Checklist and Adult Self-Report were run to delineate hierarchies of dimensions. We examined the familial aggregation of the psychopathology dimensions, and the ability of different factor solutions to account for risk factors, real-world functioning, cognitive functioning, and physical and mental health service utilization. A hierarchical structure with a general psychopathology (‘p’) factor at the apex and five specific factors (internalizing, somatoform, detachment, neurodevelopmental, and externalizing) emerged in children. Five similar dimensions emerged also in the parents. Child and parent p-factors correlated highly (r = 0.61, p < 0.001), and smaller but significant correlations emerged for convergent dimensions between parents and children after controlling for p-factors (r = 0.09−0.21, p < 0.001). A model with child p-factor alone explained mental health service utilization (R2 = 0.23, p < 0.001), but up to five dimensions provided incremental validity to account for developmental risk and current functioning in children (R2 = 0.03−0.19, p < 0.001). In this first investigation comprehensively mapping the psychopathology hierarchy in children and adults, we delineated a hierarchy of higher-order dimensions associated with a range of clinically relevant validators. These findings hold important implications for psychiatric nosology and future research in this sample.

Testing structural models of psychopathology at the genomic level

“…First, the HiTOP model, and indeed other phenotypic models of psychopathology (54,55), distinguish between disinhibited (e.g. substance use) and antagonistic (e.g.…”

“…Modeling higher-order psychopathology dimensions may have several advantages for genetic studies over studying individual diagnoses one at a time. These include a more parsimonious and accurate representation of psychopathology (8), higher heritability, capitalization on pleiotropy to increase genetic associations (56,57), greater genetic correlations with external variables, greater statistical power to detect genetic associations due to more information contained in latent continuous versus observed categorical phenotypes (54,55), and elimination of measurement error. These advantages, as well as GWAS of more fine-grained phenotypes (e.g., of distinct anxiety disorders), should increase the genetic signal and consequently the number of genome-wide significant associations found in GWAS (58).…”

Associations Between Resting State Functional Connectivity and a Hierarchical Dimensional Structure of Psychopathology in Middle Childhood

“…The hierarchical structure used in this study was delineated in the previous investigation through exploratory factor analysis with oblique (goemin) rotation, whereby the maximal number of factors was determined using parallel analyses and interpretability of factor solutions. 42 For more details of the creation of factor scores used in analyses, see (Michelini et al,2019). 12…”

“…The current study is based on 9,987 unrelated children (randomly selecting one child per Functional Connectivity and Dimensions of Psychopathology in Childhood 9 family when more than one participated) from the baseline ABCD 2.0.1 data release. 12 Participants were removed from analyses in the current study either for not having at least one resting state scan that passed quality assurance criteria (n=550) or being run on a Philips scanner (n=1208) due to an error in processing in the 2.01 ABCD data release, or in the case of missing data (n=631; Supplemental Table 1). Next, the remaining dataset was divided in discovery (n=3790) and replication (n=3791) datasets (Table 1).…”

“…[8][9][10][11] In particular, a study of the Child Behavioral Checklist (CBCL) 8 in Adolescent Brain Cognitive Development (ABCD) data found a hierarchical structure of psychopathology with a broad general "p-factor" at the apex, which progressively differentiates into narrower factors, with the most fine grained structure representing five lower-order major dimensions (internalizing, externalizing, neurodevelopmental, somatoform, and detachment). 12 The p-factor, also known as a general psychopathology factor, 13-16 has been hypothesized as critical to understanding mental disorders. 13 Alternatively, others suggested that p-factor may be too general and heterogeneous to reveal etiology, potentially representing functional consequences of psychopathology.…”