The generalizability of Older Adult Self‐Report (OASR) syndromes of psychopathology across 20 societies

Abstract

Objectives As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co‐occurring problems derived from self‐ratings of psychopathology by US elders would fit self‐ratings by elders in 19 other societies. Methods/design The Older Adult Self‐Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven‐syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes. Results In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies. Conclusions The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.

The generalizability of empirically derived syndromes of collateral‐reported elder psychopathology across 11 societies

“…When considered by syndrome, the median OABCL item loadings ranged from 0.47 for Worries to 0.77 for Functional Impairment, indicating large‐item loadings for each syndrome. Our findings were consistent with previous findings for the OASR, a parallel self‐report questionnaire, whose syndrome structure was supported in 19 societies, in addition to the United States (Ivanova et al, 2020).…”

“…As far as we know, this was only the second study in which the generalizability of syndromes of older adult psychopathology was tested across multiple societies. The first study was conducted by Ivanova et al (2020), who tested the fit of the United States 7‐syndrome model derived from self‐ratings on the OASR to self‐ratings by 12,826 60‐ to 102‐year‐olds in 19 societies. Their results supported the OASR syndrome structure across the tested societies.…”

Self-perceived and reported mental health in older adults

“…Despite this, as Mindt, et al (2019), there is currently a scarcity of assessment instruments that are common between cultures, linguistically diverse and that measure psychopathological constructs and psychosocial competencies in people specifically over 60 years of age. To overcome this limitation, the Achenbach questionnaires are instruments capable of evaluating the clinical, sociodemographic and psychosocial competencies of older people, and it has recently been reported that the empirical syndromes of the Older Adult Self-Report (OASR) questionnaire (Achenbach et al, 2004), are generalizable to 19 different societies in America, Europe and Asia (Ivanova et al, 2020). The existing correlations between the empirical syndromes measured by the questionnaire have a positive and high magnitude among them, the highest correlation being the irritability / disinhibition syndrome with thought problems (rxy = .90), thought problems with anxiety / depression (rxy = .86), and memory / cognition problems with functional impairment (rxy= .82) (Ivanova et al, 2017).…”

Hierarchical dimensional models of psychopathology: yes, but…

“…Second, the genetic architecture of psychopathology appears to consist of sets of genetic influences operating at different levels of specificity, across a multi-tiered hierarchy. For example, models using genetic loci identified in genome-wide association studies (GWAS) found that a significant proportion of genomic influences is common to numerous psychiatric disorders (e.g., schizophrenia, depression, attention-deficit/hyperactivity disorder) 4,5 . The remaining risk, which is considerable in size, is disorder-specific, indicating that genetic factors unique to narrow constructs also play a role in the etiology of psychopathology.…”

“…Nearly all of their references are based on Anglophone samples. Rather than being added as an afterthought, multicultural studies of the structure, prevalence, and other aspects of psychopathology should be fundamental components of ongoing research on hierarchical models 5,6 .…”