Testing Structural Models of DSM-IV Symptoms of Common Forms of Child and Adolescent Psychopathology

Abstract

Confirmatory factor analyses were conducted of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) symptoms of common mental disorders derived from structured interviews of a representative sample of 4,049 twin children and adolescents and their adult caretakers. A dimensional model based on the assignment of symptoms to syndromes in DSM-IV fit better than alternative models, but some dimensions were highly correlated. Modest sex and age differences in factor loadings and correlations were found that suggest that the dimensions of psychopathology are stable across sex and age, but slightly more differentiated at older ages and in males. The dimensions of symptoms were found to be hierarchically organized within higher-order "externalizing" and "internalizing" dimensions, which accounted for much of their variance. Major depression and generalized anxiety disorder were substantially correlated with both the "externalizing" dimension and the "internalizing" dimension, however, suggesting the need to reconceptualize the nature of these higher-order dimensions.

Evaluation Of The Internal Structural Validity Of The Diagnostic And Statistical Manual Of Mental Disorders (Fourth Edition) Anxiety Disorders In Children And Adolescents

“…In contrast to findings from past studies that evaluated internal validity of symptoms of DSM-IV anxiety disorders and MDD using either the SCAS or RCADS (e.g., De Ross et al, 2002;Spence, 1997;, The findings of Lahey et al (2008) findings did not support the DSM's conceptualization of disorders using the CAPS as reported by either youth or their parents. Lahey et al (2008) also examined whether the internal structure of DSM-IV disorders in youth varied according to youth sex and age. Metric invariance tests of the best fitting factor models for both youth and parents were conducted to examine whether parameters of the models were invariant across youth sex and age (7 to 11 years vs. 12 to 17 years).…”

“…Shaffer et al, 1996) modified from a "yes" or "no" response format to a four point rating scale (Not At All to Very Much). In contrast to past studies that conducted CFAs on data based on only one informant (e.g., youth only or parent only), Lahey et al, (2008) conducted separate CFAs on both youth completed and parent completed data to test and compare a factor model based on the DSM and a number of alternative factor models that emerged in previous exploratory factor analyses (EFAs) conducted on CAPS data obtained from youths and parents, respectively (Lahey et al, 2004).…”

“…Seven factor models were tested and compared: (1) For the youth CAPS data, CFAs were conducted on CAPS items that assess symptoms of internalizing disorders and symptoms of CD to test and compare eight models (CD symptoms were the only set of externalizing symptoms that were assessed using the youth CAPS). The eight models were: (1) a correlated eight factor model that distinguished between CD and the same seven factors of anxiety and depression as in the correlated seven factor model for parents (model 1); (2) For the parent CAPS data, Lahey et al (2008) found that model (3) with five correlated factors fit significantly better than other factor models, including the seven correlated factor DSM model (model 1). For the child CAPS data, Lahey et al (2008) found that at model (3) with six correlated factors fit significantly better than other factor models, including the eight correlated factor DSM model (model 1).…”

“…Research on the internal validity of DSM anxiety disorders generally supports the distinctiveness of these disorders (e.g., Chorpita, Moffitt, & Gray, 2005;De Ross, Gullone, & Chorpita, 2002;Spence, 1997;, however, findings have been inconsistent (Higa-McMillan, Smith, Chorpita, & Hayashi, 2008;Lahey et al, 2008).…”

“…In addition, most past studies used samples of Caucasian youth (e.g., Lahey et al, 2008;Spence, 1997). The internal structure of DSM anxiety disorders in other ethnic and racial samples including Latino youth has not been investigated.…”