Factors of psychological distress: clinical value, measurement substance, and methodological artefacts

Abstract

Building on established insights, future research efforts should be more explicit about their theoretical understanding of psychopathology and how the analysis of a given indicator-respondent set informs this theoretical model. A coherent treatment of theoretical assumptions, indicators, and samples holds the key to building a comprehensive account of the latent structures of different types of psychopathology and mental health in general.

A comparison and integration of structural models of depression and anxiety in a clinical sample: Support for and validation of the tri-level model.

“…Numerous researchers have speculated on the interpretation of a p -factor; though prior studies were done in the context of the inclusion of externalizing and/or thought disorders, they have relevance for our General Distress factor as well. Most substantive interpretations focus on general psychopathology factors as indicators of a broad, non-specific state that arises from a general liability towards psychopathology (Bohnke & Croudace, 2015; Caspi et al, 2014; Lahey et al, 2012). Consistent with our findings, a p -factor should be linked to other indicators of severity, such as impairment, comorbidity, duration, and family history of psychopathology (Caspi et al, 2014).…”

“…Other interpretations are methodological in nature: General Distress could be reflective of response styles, such as an individual’s tendency to select extreme response options (Bohnke & Croudace, 2015) or to describe themselves in socially-(un)desirable terms (e.g., reporting poor functioning and negative emotions) (Lahey et al, 2012), perhaps as a “cry for help” among clinical participants. The latter is related to demoralization, or a non-specific unpleasant affect state that clinical internalizing samples frequently endorse and can account in part for the associations among affectively-laden personality traits (e.g., Noordhof et al, 2015).…”

Categories, continua and the growth of psychiatric knowledge

“…It may be, however, as Goldberg argues [2], that psychiatric syndromes are particularly insecure. The strong evidence for underlying dimensions presented by Eaton et al [3], Carragher et al [4], and Böhnke and Croudace [5] is a reflection of the central difficulties for classification, which are particularly salient in psychiatry: the boundary and threshold problems, and the artificiality of the distinction between Axis I and Axis II disorders. Nevertheless, it is generally appropriate to reject the theories developed in relation to a given syndrome before proceeding to jettison the syndrome itself as unhelpful.…”

“…a general factor plus the externalising/internalising dimensions) may be more appropriate, with the general factor capturing the shared variance in the dimensions. However, Böhnke and Croudace [5] sound a note of warning, providing detailed methodological caveats for this sort of research, in particular the possibility of inconsistent results arising from sample selection and the choice of models. It should be noted that the relationship between internalising and externalising dimensions may be non-reflexive: the behaviour picked up in the latter may arise from the mental symptoms that make up the former, whereas the reverse relationship may be much weaker.…”

Novel methods in psychiatric epidemiology

“…These reviews and commentaries highlight the rapid technological and subsequent scientific advances in psychiatry in uncovering mechanisms that underlie the epidemiological associations between adversity and illness that have been documented, since the advent of psychiatric epidemiology, yet also reveal a paradigm shift in its beginning stages of formation. In view of recent and impending revisions of the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases as well as movements towards non-binary classifications of psychiatric phenomena, the series then addressed current challenges in diagnostic classification in psychiatry [15–19], reviewing the enduring challenge of high comorbidity rates [19], methodological considerations in the use of latent variable models of psychopathology [16], and the evidence on transdiagnostic factors [17, 18] that may underlie individual common mental disorders [17, 18], personality disorders [18], and psychotic disorders [18, 20–22]. This was followed by reviews pulling together and discussing key findings from major epidemiological studies in the context of new challenges in the field and directions for future research [23–30].…”