Factor Structure Of Symptoms Research Articles

Prevalence and correlates of ICD-11-based prolonged grief disorder in a representative Slovakian sample of recently bereaved adults

ABSTRACT Background: Prolonged Grief Disorder (PGD) has recently been included in both the ICD-11 and DSM-5-TR diagnostic manuals. Studying its prevalence and correlates across cultures is vital for more effective identification, treatment, and prevention. Objective: This study aimed to examine prevalence rates of ICD-11-based PGD, in a representative Slovakian sample in response to deaths of loved ones occurring during the previous year. Further aims were to examine the factor structure of PGD symptoms and correlates of summed PGD item scores and PGD ‘caseness’. Method: Self-reported data on PGD, depression, anxiety, alcohol use, and descriptive characteristics were gathered from a representative sample of the Slovak population (N = 319). Results: Data were gathered from N = 1853 people; 319 participants (17.2%) reported a loss in the past year. The prevalence of probable PGD among these bereaved participants was 1.99% for recent losses (<6 months, n = 151) and 7.75% for more distant losses (6–12 months, n = 130). The most frequently endorsed symptoms included longing/yearning for the deceased, sadness, denial/unrealness, and difficulty accepting the death. PGD symptoms had a unitary factor structure which was consistent for subsamples bereaved 1–5 and 6–12 months. The severity of PGD varied with kinship. Depression and anxiety, but not alcohol misuse, were associated with PGD severity and PGD caseness. Conclusions: These findings underscore that a significant group of people develop PGD between 6–12 months following a loss. This emphasises the need for targeted psychological interventions.

Postpartum acute stress disorder symptoms, social support, and quality of couple's relationship associations with childbirth PTSD.

We aimed to examine the hypothesized negative associations between childbirth post-traumatic stress disorder (PTSD) symptoms (using the two-factor model of birth-related and general symptoms), social support, and a couple's relationship quality at 8-12 weeks postpartum. This analysis considered the longitudinal positive shared variance with acute stress disorder (ASD) symptoms measured shortly after birth, while accounting for obstetric and demographic variables. Participants included 246 mothers who gave birth at the maternity ward of a tertiary healthcare center. Self-report questionnaires were used 1-4 days postpartum (T1): Demographic information, the Birth Satisfaction Scale-Revised (BSS-R), and the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS). At T2 (8-12 weeks postpartum), the Multidimensional Scale of Perceived Social Support (MSPSS), the Dyadic Adjustment Scale (DAS-7), and the City Birth Trauma Scale (BiTS). In partial support of our hypotheses, three hierarchical regression analyses revealed a significant positive contribution of ASD symptoms to childbirth PTSD general symptoms (β = .33, p <.001) and the total score (β=.29, p <.001), but not to birth-related symptoms. Social support (β = -.21, p = .003) and the quality of the couple's relationship (β=-.20, p = .003) showed negative associations with the BiTS general symptoms. Our study enhances understanding of the shared variance between childbirth ASD and PTSD, supporting the factor structure of general and birth-related symptoms as different aspects of childbirth PTSD and highlighting the negative association of social support and the quality of a couple's relationship with PTSD general symptoms, suggesting potential avenues for targeted interventions.

Factors associated with prolonged COVID-related PTSD-like symptoms among adults diagnosed with mild COVID-19 in Poland.

COVID-19 has been considered a possible cause of post-traumatic stress disorder (PTSD) or similar conditions. However, what specific disease symptoms may contribute most to prolonged PTSD-like symptoms in COVID-19 survivors is unclear. The study aimed to present the factor structure of COVID-19 symptoms and identify which symptoms of COVID-19 best explain the subsequent presence of PTSD-like symptoms in mild COVID-19 survivors. COVID-positive adults (n = 341) completed online self-report scales at the baseline assessment (T1) and after approximately 4 months (T2), including The Patient Health Questionnaire Anxiety-Depression Scale; The Scale of Psychosocial Experience Related to COVID-19, The Primary Care PTSD Screen for DSM-5; and self-designed questionnaires evaluating the severity of COVID-related medical and neurocognitive symptoms and pre-pandemic variables. Exploratory factor analysis revealed five factors of COVID-19 symptoms: flu-like, respiratory, cold, neurological, and neurocognitive. Hierarchical logistic regression showed that besides selected control variables (anxiety and depression, presence of PTSD-like symptoms, COVID-related stigma in T1), neurocognitive symptoms of COVID-19 in T1 but not other symptoms of the disease were a significant predictor of the presence of PTSD-like symptom in T2. Findings suggest a need for a comprehensive neurocognitive assessment of people diagnosed with COVID-19 and prompt interventions targeting the prevention of potential risks for long-term PTSD-like states at the community level.

Repurposing the K-10: The Factor Structure and Latent Profile of COVID-19 Pandemic-Anchored Psychological Distress Symptoms Among Filipino Teachers

The Kessler Psychological Distress Scale (K-10) is widely utilized to assess non-specific psychological distress. However, when applied to COVID-19 pandemic experiences, its psychometric properties have not been examined. This study investigated the factor structure, reliability, and latent profile of K-10 using data from 3032 Filipino teachers who reflected on their pandemic-related adversity prior to completing K-10. Confirmatory factor analyses were conducted to evaluate five extant models of the K-10’s structure, supporting the two-factor model (i.e., anxiety and depression) as best fitting the data. Both factors showed excellent internal reliability, and criterion-related validity was supported by correlations with anxiety and depression measures. Latent profile analysis revealed a four-class solution, identifying four distinct levels of distress severity. Overall, the contextualized K-10 demonstrated sound psychometric properties, which corroborates and extends its reliability and validity as a measure of pandemic-related distress. Further, the results offer insights into the dimensionality and distress profiles of the K-10 among teachers. Broadly, the findings highlight the importance of valid instruments in assessing contextualized psychological distress.

Comparing the distribution of neuropsychiatric symptoms among individuals with depression and mild cognitive impairment

AbstractBackgroundNeuropsychiatric symptoms (NPS) are common during the course of neurocognitive disorders. NPS have been previously reported in early and late stages of Alzheimer’s Disease. However, our understanding of NPS in high‐risk states for dementia such as mild cognitive impairment (MCI) and major depressive disorder (MDD) is poor. The purpose of this study was to compare the frequency and factor structure of neuropsychiatric symptoms among individuals with Mild Cognitive Impairment (MCI), Major Depressive Disorder (MDD) in remission, and comorbid MCI and MDD (in remission) (MCI‐D).MethodWe used baseline data from the Prevention of Alzheimer’s Dementia with Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression (PACt‐MD) study, a multicenter trial across five academic sites in Toronto, Canada (clinical trial No. NCT0238667). We used ANOVA or χ2‐test to compare frequency of NPS across groups. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI‐Q) items in the three groups.ResultWe included 374 participants with a mean age of 72.0 years (SD = 6.3). In the overall sample, at least one NPS was present in 64.2% participants, and 36.1% had at least moderate severity NPS (36.1%). Depression (54%, χ2 &lt; 0.001) and apathy (28.7%, χ2 = 0.002) were more prevalent in the MCI‐D group as compared to MCI and MDD groups. In factor analysis, NPS grouped differently in MCI, MDD, and MCI‐D groups. A “psychotic” subgroup emerged among MCI and MCI‐D, but not in MDD. Night‐time behaviors and disinhibition grouped differently across all three groups.ConclusionPrevalence of NPS seems higher in persons with MCI‐D as compared to those with only MCI or MDD. The factor structure of NPS differed between MCI, MDD, and MCI‐D groups. Future studies should investigate the association of NPS factors with cognition, function, and illness biomarkers.

Examining the Joint Factor Structure of Mania, Internalizing, and Thought Disorder Symptoms in a Large Online Sample

The optimal classification of mania symptoms within dimensional models of psychopathology remains unclear, due in part to most prior research using composite categorical ratings of mania/bipolar disorder rather than ratings of specific symptoms. We addressed this gap by examining the structure of self-reported symptom-level ratings of mania, internalizing, and thought disorder in adults (N = 1,112) recruited online who self-identified as having significant mental health histories. Although prior research suggests that mania symptoms overlap strongly with both internalizing and thought disorder, our results indicated much closer alignment with thought disorder than internalizing when examining a two-factor structure. Even when examining a three-factor structure, manic symptoms such as grandiosity loaded strongly onto a common factor with positive psychosis symptoms. However, symptoms such as racing thoughts and excessive energy loaded strongly onto a separate Agitation factor potentially representing a subspectrum within thought disorder. Agitation showed some unique correlates (e.g., with stimulant medication use), indicating heterogeneity within the broader thought disorder spectrum. Future directions extending this research include incorporating assessment of other psychopathology (e.g., externalizing), examining the cross-method consistency of results (e.g., when using interviews), and determining symptom course and interrelations using intensive longitudinal designs.

Factor Structure of ASD Symptoms in Russian 3-4-Year-Olds

The study aims to reveal autism vectors that are inherent in 3-4-year-olds with ASD. Three hundred eighty-three children with ASD took part in the research. An online questionnaire developed earlier by our research group was used. In the first stage, with the repeated use of exploratory factor analysis, the task of identifying the simplest factor structure was solved. As a result, a 7-factor system was obtained, including from 9 to 14 items in each factor (78 items in total): 1) "Persistence on sameness" (Sam); 2) "Emotional dysregulation" (Em); 3) "Alienation" (Al); 4) "Speech understanding" (SU); 5) "Disinhibition/Hyperactivity" (Hyp); 6) "Echolalia" (Ech); 7) "Sensory disintegration" (Sen). Next, a "parcel approach" was applied: binary items included in each factor were randomly distributed into 3 packages, from 3 to 5 items in each box. Thus, instead of 78 binary things, 21 quantitative variables were analyzed. At the second stage, a multi-group confirmatory factor analysis was applied to verify the factor validity and structural and measurement equivalence of the obtained 7-factor model to the parts of the sample that differ by gender (m, f) and age (3 and 4 years). The factor validity of the 7-factor model was confirmed: the factors Em, Al, Su, and Ech correlated with each other (correlations from 0.33 to 0.65), forming a group of communication disorders, the second group consisted of factors Sam and Sen (r = 0.66), the factor Hyp did not correlate with other elements. The equivalence of this 7-factor model was confirmed with respect to samples differing in gender (m, f) and age (3 and 4 years). According to all 7 calculated factors-scales, the example of children with ASD statistically significantly differed from other children with the magnitude of the Coen's d effect from 0.688 to 2.088. However, it can be supposed that the factor dimension of autism symptoms can be even more significant, because the revealed structure is based on 436 initial hypothetical symptoms of autism.

The structure of ICD-11 post traumatic stress disorder in a clinical sample of refugees based on the International Trauma Interview.

The ICD-11 proposes fundamental changes to the PTSD diagnostic criteria, prompting thorough validation. While this is ideally carried out based on diagnostic interviews, most-and in the case of transcultural psychiatry all-studies have relied on self-reported measures. In this study, we used the International Trauma Interview (ITI) to assess the factor structure of ICD-11 PTSD symptoms in a sample of trauma-affected refugees. The ITI was administered with a sample of refugees (n = 198), originating mainly from the Greater Middle East. The symptom ratings were subjected to a confirmatory factor analysis (CFA), comparing the ICD-11 concordant three-factor model with alternative two- and one-factor models. The overall fit was adequate for both the two- and three-factor models, but favored the two-factor model. Results for both models indicated local misspecifications and that item 5, hypervigilance, displayed a suboptimal loading. The results generally support the use of the ITI in a severely trauma-affected refugee population, albeit with particular attention needed in the administration of item 5. The superior fit of a two-factor model warrants further testing across populations.

A transdiagnostic approach to negative symptoms: exploring factor structure and negative symptoms in bipolar disorders.

Negative symptoms are increasingly recognized as transdiagnostic phenomena, linked to reduced quality of life and functioning, and often caused or worsened by amendable external factors such as depression, social deprivation, side-effects of antipsychotics or substance use. The structure of negative symptoms fits into two dimensions: diminished expression and apathy. These may differ in association with external factors that influence their severity and may thus require different treatment approaches. The dimensions are comprehensively established in non-affective psychotic disorders but are understudied in bipolar disorders. We conducted exploratory and confirmatory factor analyses in a sample of 584 individuals with bipolar disorder to assess the latent factor structure of negative symptoms as measured by the Positive and Negative Syndrome Scale (PANSS), and performed correlational analyses and multiple hierarchical regression analyses to investigate links between the two dimensions of negative symptoms and clinical and sociodemographic correlates. The latent factor structure of negative symptoms fits into two dimensions, i.e., diminished expression and apathy. A diagnosis of bipolar type I or a history of psychotic episodes predicted more severe levels of diminished expression. Depressive symptoms were associated with more severe negative symptoms across dimensions, yet 26.3% of euthymic individuals still displayed at least one mild or more severe negative symptom (PANSS score ≥ 3). The two-dimensional structure of negative symptoms seen in non-affective psychotic disorders reproduces in bipolar disorders indicating similarities in their phenomenology. Diminished expression was associated with a history of psychotic episodes and a diagnosis of BD-I, which may infer closer connections to psychosis liability. We found significantly less severe negative symptoms in euthymic than depressed participants. Nevertheless, more than a quarter of the euthymic individuals had at least one mild negative symptom, demonstrating some degree of persistence beyond depressed states.

The structure of apathy symptoms

ABSTRACT Introduction Apathy is common in many neurological, psychiatric, and medical disorders and is related to a number of important clinical outcomes. Nonetheless, research on apathy is hindered by different ways of defining and measuring it, which has led to heterogeneity in research findings. Method The current study aimed to investigate the factor structure of apathy symptoms using a novel item pool. We examined whether the use of this item pool has incremental validity above and beyond a widely used measure in predicting cognition and everyday functioning. Participants included 249 informants who reported on an individual with (n = 210) or without (n = 39) a neurological or psychiatric condition. Results Results showed the best fitting model of apathy symptoms was a bifactor model with apathy as a general dimension and three specific symptom factors including reduced interest and initiative, reduced emotional and verbal expression, and reduced social engagement. Incremental validity in predicting cognition was demonstrated for this more robust assessment of apathy symptoms. Conclusions Results are most aligned with one set of proposed diagnostic criteria for apathy which differs from other criteria in that it does not distinguish between cognitive and behavioral symptoms and includes a separate social dimension. Future research could aim to replicate this model in additional clinical samples and explore the incremental validity of the newly developed Apathy Symptom Inventory (ASI) in comparison to other recently developed measures.

Comparing the distribution of neuropsychiatric symptoms among individuals with depression and mild cognitive impairment

IntroductionNeuropsychiatric symptoms (NPS) are common during the course of neurocognitive disorders. NPS have been previously reported in early and late stages of Alzheimer’s Disease. However, our understanding of NPS in high-risk states for dementia such as mild cognitive impairment (MCI) and major depressive disorder (MDD) is poor.ObjectivesTo compare the frequency and factor structure of neuropsychiatric symptoms among individuals with Mild Cognitive Impairment (MCI), Major Depressive Disorder (MDD) in remission, and comorbid MCI and MDD (in remission) (MCI-D).MethodsWe used baseline data from the Prevention of Alzheimer’s Dementia with Cognitive Remediation Plus Transcranial Direct Current Stimulation in Mild Cognitive Impairment and Depression (PACt-MD) study, a multicenter trial across five academic sites in Toronto, Canada (clinical trial No. NCT0238667). We used ANOVA or χ2-test to compare frequency of NPS across groups. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI-Q) items in the three groups.ResultsWe included 374 participants with a mean age of 72.0 years (SD = 6.3). In the overall sample, at least one NPS was present in 64.2% participants, and 36.1 % had at least moderate severity NPS (36.1%). Depression (54%, χ2 &lt; 0.001) and apathy (28.7%, χ2=0.002) were more prevalent in the MCI-D group as compared to MCI and MDD groups. In factor analysis, NPS grouped differently in MCI, MDD, and MCI-D groups. A “psychotic” subgroup emerged among MCI and MCI-D, but not in MDD. Night-time behaviors and disinhibition grouped differently across all three groups.ConclusionsPrevalence of NPS seems higher in persons with MCI-D as compared to those with only MCI or MDD. The factor structure of NPS differed between MCI, MDD, and MCI-D groups. Future studies should investigate the association of NPS factors with cognition, function, and illness biomarkers.Disclosure of InterestNone Declared

Attachment, Autonomy-Connectedness, and Internalizing and Externalizing Personality Disorder Symptoms

The aim of this study was to analyze the higher order factor structure of Personality Disorders Symptoms (PDS), and to investigate sex differences in levels of PDS, attachment styles and autonomy-connectedness. Secondly we aimed to test a mediational path model, based upon attachment theory together with neo-analytical object relation theory, with internalizing and externalizing PDS as dependent variables and sex, attachment styles and autonomyconnectedness as explanatory variables. Our sample consisted of 202 psychology students. We used self-report questionnaires, independent t-tests, and factor- and regression analyses. Conform expectations a common two-factor solution of internalizing and externalizing was found for PDS. Men were, compared to women, less sensitive to others, more capable of managing new situation, less anxiously attached, more avoidant attached and more externalizing. Conform expectations attachment styles were related to autonomy in a specific way. The analyses of our path model showed that especially anxious attachment predicted internalizing PDS. When leaving out attachment styles in the regression analyses, the autonomy scales also predicted internalizing PDS, indicating spurious correlation effects. Sex and anxious attachment were significant predictors of externalizing pathology. Our results confirmed the existence of a two-order structure of internalizing and externalizing, sex-differences in levels of autonomy, attachment styles and internalizing and externalizing PDS. In addition, we think our theoretical model gives a good explanation of the specific relationships between sex, attachment, autonomy and internalizing and externalizing PDS.

Factor structure and item response of psychosis symptoms among Kenyan adults

BackgroundThe aim of this study was to evaluate the construct validity of the psychosis module of the Mini International Neuropsychiatric Interview version 7.0.2 (MINI-7). MethodWe utilized data collected from 2738 participants with a primary psychotic or bipolar disorder. Participants were drawn from two Kenyan sites of a large multi-center neuropsychiatric genetic study. The factor structure of the MINI-7 psychosis items were explored using confirmatory factor analyses (CFA) and Item Response Theory approach, for the full sample and by gender. ResultsThe CFA revealed that a 1-factor model provided adequate fit for the MINI-7 psychosis items for the full sample (x2 = 397.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.90) as well as for the female (x2 = 185.16.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.93; TLI = 0.91) and male groups (x2 = 242.09, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.89). Item thresholds for the full sample, and female and male groups were highest for ‘odd beliefs’ (−1.42, −1.33, and −1.51 respectively) and lowest for ‘visual hallucinations’ (−0.03, −0.04, and −0.01 respectively). LimitationsOur study used a hospital-based population, which may have excluded patients with milder psychotic symptoms. Findings may therefore not be generalizable to the community setting. ConclusionsOur findings indicate good construct validity of the MINI-7 psychosis module, and provides support for use of the tool in diagnosing psychotic disorders in clinical settings in Kenya.

Screening Tool for Mental Health Problems During COVID-19 Pandemic: Psychometrics and Associations With Sex, Grieving, Contagion, and Seeking Psychological Care.

BackgroundThe COVID-19 pandemic has created a public mental health crisis. Brief, valid electronic tools are required to evaluate mental health status, identify specific risk factors, and offer treatment when needed.ObjectiveTo determine the construct validity, reliability, and measurement invariance of a brief screening tool for mental health symptoms by sex, loss of loved ones, personal COVID-19 status, and psychological care-seeking during the COVID-19 pandemic. Furthermore, the aim involved establishing a predictive pattern between the mental health variables.MethodA total sample of 27,320 Mexican participants, with a mean age of 32 years (SD = 12.24, range = 18–80), 67% women (n = 18,308), 23.10% with a loss of loved ones (n = 6,308), 18.3% with COVID-19 status (n = 5,005), and 18.40% seeking psychological care (n = 5,026), completed a questionnaire through a WebApp, containing socio-demographic data (sex, loss of loved ones, COVID-19 status, and psychological care-seeking) and the dimensions from the Posttraumatic Checklist, Depression-Generalized Anxiety Questionnaires, and Health Anxiety-Somatization scales. We used the confirmatory factor analysis (CFA: through maximum likelihood to continuous variable data, as an estimation method), the invariance measurement, and the structural equational modeling (SEM) to provide evidence of the construct validity of the scale and the valid path between variables. We analyzed the measurement invariance for each dimension by comparison groups to examine the extent to which the items showed comparable psychometric properties.FindingsThe tool included eight dimensions: four posttraumatic stress symptoms -intrusion, avoidance, hyperactivation, and numbing, as well as depression, generalized anxiety, health anxiety, and somatization The tool’s multidimensionality, was confirmed through the CFA and SEM. The participants’ characteristics made it possible to describe the measurement invariance of scales because of the participants’ attributes. Additionally, our findings indicated that women reported high generalized anxiety, hyperactivation, and depression. Those who lost loved ones reported elevated levels of intrusion and health anxiety symptoms. Participants who reported having COVID-19 presented with high levels of generalized anxiety symptoms. Those who sought psychological care reported high levels of generalized anxiety, intrusion, hyperactivation, and health anxiety symptoms. Our findings also show that intrusion was predicted by the avoidance dimension, while health anxiety was predicted by the intrusion dimension. Generalized anxiety was predicted by the health anxiety and hyperactivation dimensions, and hyperactivation was predicted by the depression one. Depression and somatization were predicted by the health anxiety dimension. Last, numbing was predicted by the depression and avoidance dimensions.Discussion and OutlookOur findings indicate that it was possible to validate the factor structure of posttraumatic stress symptoms and their relationship with depression, anxiety, and somatization, describing the specific bias as a function of sociodemographic COVID-19-related variables. We also describe the predictive pattern between the mental health variables. These mental health problems were identified in the community and primary health care scenarios through the CFA and the SEM, considering the PCL, depression, generalized anxiety, health anxiety, and somatization scales adapted during the COVID-19 pandemic. Therefore, future studies should describe the diagnosis of mental health disorders, assessing the cut-off points in the tool to discriminate between the presence and absence of conditions and mental health cut-off points. Community and primary care screening will lead to effective early interventions to reduce the mental health risks associated with the current pandemic.LimitationsFuture studies should follow up on the results of this study and assess consistency with diagnoses of mental health disorders and evaluate the effect of remote psychological help. Moreover, in the future, researchers should monitor the process and the time that has elapsed between the occurrence of traumatic events and the development of posttraumatic stress and other mental health risks through brief electronic measurement tools such as those used in this study.

The factor structure of attention-deficit/hyperactivity disorder in schoolchildren

BackgroundMost studies support a bifactor model of childhood ADHD with two specific factors. However, several studies have not compared this model with a bifactor model with three specific factors, few have tested the actual strength of the factors, and none have examined whether “talks excessively” should be treated as a hyperactivity versus impulsivity symptom in children with ADHD. AimsTo examine the factor structure of ADHD symptoms and evaluate the relative strength of potential factors. MethodsParent-reports on the ADHD-Rating Scale (ADHD-RS-IV) were collected for 2044 schoolchildren from the general population and 147 children with ADHD from a clinical sample. Single-, two- and three-(correlated and bi-)factor models were tested using confirmatory factor analysis. ResultsMost models had a satisfactory fit. However, a correlated three-factor model where “talks excessively” was included as an indicator of impulsivity, and especially a bifactor model with one strong, well-defined general and two/three (ICD-10 defined) weak specific factors fit the data slightly better than the remaining models. ConclusionsThe factor structure is best characterized by a bifactor model with a strong general factor and two/three weaker specific factors. Therefore, we suggest emphasizing the ADHD-RS-IV total score rather than the subscale scores in clinical practice.

The Association of Self-Reported ADHD Symptoms and Sleep in Daily Life of a General Population Sample of School Children: An Inter- and Intraindividual Perspective.

Sleep and Attention-Deficit/Hyperactivity Disorder (ADHD) have repeatedly been found to be associated with each other. However, the ecological validity of daily life studies to examine the effect of sleep on ADHD symptoms is rarely made use of. In an ambulatory assessment study with measurement burst design, consisting of three bursts (each 6 months apart) of 18 days each, 70 German schoolchildren aged 10–12 years reported on their sleep quality each morning and on their subjective ADHD symptom levels as well as their sleepiness three times a day. It was hypothesized that nightly sleep quality is negatively associated with ADHD symptoms on the inter- as well as the intraindividual level. Thus, we expected children who sleep better to report higher attention and self-regulation. Additionally, sleepiness during the day was hypothesized to be positively associated with ADHD symptoms on both levels, meaning that when children are sleepier, they experience more ADHD symptoms. No association of sleep quality and ADHD symptoms between or within participants was found in multilevel analyses; also, no connection was found between ADHD symptoms and daytime sleepiness on the interindividual level. Unexpectedly, a negative association was found on the intraindividual level for ADHD symptoms and daytime sleepiness, indicating that in moments when children are sleepier during the day, they experience less ADHD symptoms. Explorative analyses showed differential links of nightly sleep quality and daytime sleepiness, with the core symptoms of inattention and hyperactivity/impulsivity, respectively. Therefore, future analyses should take the factor structure of ADHD symptoms into account.

Brazilian Portuguese Childhood Autism Spectrum Test: an investigation of the factor structure of autistic traits in school-aged children from Brazil.

There is limited evidence about the cross-cultural validity of autistic symptoms in school-aged children in Brazil. We used data from a large school survey to evaluate the factor structure of autism symptoms in community-dwelling children and adolescents. We translated the Childhood Autism Spectrum Test to Brazilian Portuguese and performed factor analyses to investigate the factor structure of parent-reported autistic symptoms in a large sample (n=8,571) of children/adolescents from a school survey in the metropolitan area of São Paulo. Autistic symptoms were best conceptualized under a correlated-factors model with two factors: one predominantly characterized by social-communication symptoms and the other by symptoms of inflexible/restricted language, behaviors, and interests. These findings provide evidence that the structure of autistic symptoms in Brazil is similar to that described in other countries, indicating the cross-cultural validity of autism in Brazil.

A Psychometric Investigation of Racial Trauma Symptoms Using a Semi-Structured Clinical Interview With a Trauma Checklist (UnRESTS)

The term racial trauma is used to describe the cumulative distressing and traumatizing effects of racism in all of its forms, and it closely resembles the construct of posttraumatic stress disorder (PTSD). This investigation aims to increase our understanding of racial trauma by comparing the characteristics of those with a clinically-relevant diagnosis of racial trauma to those without, based on the findings of a clinical semi-structured interview and symptom checklist for assessing racial trauma, the University of Connecticut Racial Ethnic Stress and Trauma Survey (UnRESTS), administered to a diverse group of adults (N = 97). This paper extends prior work on racial trauma by examining the correlations between racial trauma and validated self-report measures of discriminatory distress, controlling for racialization. We examine the correlation between a clinically-relevant diagnosis of racial trauma and racial/ethnic identity. We also compare racism-related PTSD symptoms in those with and without racial trauma to inform clinical assessment. Finally, we examine the factor structure of racial trauma symptoms using the 24 items from the UnRESTS PTSD symptom checklist and compare these to current DSM-5 models. The structure of racial trauma symptoms differed from the DSM-5 4-factor model, as do other PTSD models in the research literature. Clinical and research implications are discussed.

Does a unique co-occurring OCD and PTSD factor structure exist?: Examination of overlapping OCD and PTSD symptom clusters

OCD and PTSD share many commonalities, including phenotypic and functional overlap in symptoms. Specifically, both disorders are characterized by unwanted, intrusive, anxiety/distress-eliciting intrusive thoughts and evoking behaviors intended to control, neutralize, suppress, or outright avoid intrusive thoughts and associated anxiety/distress. Extant factor analytic research supports a model of PTSD at odds with current DSM-5 criteria, and no examination of the factor structure of comorbid OCD+PTSD currently exists despite the noted overlap in symptomatology and high rates of comorbidity. Using a sample of 4073 patients diagnosed with OCD and/or PTSD enrolled in intensive treatment programs for OCD or PTSD, multigroup confirmatory factor analysis (MGCFA) and measurement invariance tests were run to determine the best fitting model of OCD and PTSD symptoms in patients with OCD+PTSD. Four models were compared across patients with OCD, PTSD, and OCD+PTSD: DSM-5 and 7-factor hybrid PTSD models with OCD symptoms structured as either combined or comorbid constructs. The comorbid hybrid model proved the best fit, and both hybrid models evidenced better fit than DSM-5 models. The current study lends additional support for the hybrid model of PTSD and suggests that there is no existence of a unique factor structure of OCD and PTSD symptoms in individuals with the comorbid conditions.

Exploring Police-Initiated Post-Traumatic Stress Symptomatology, Depression, and Anxiety Using Factor Analysis

ABSTRACT Purpose Research suggests that police encounters can be a traumatic experience for youth. These experiences may result in trauma symptomatology and co-occurring mental health issues like depression and anxiety. However, studies exploring the relationships between trauma symptomatology, depression and anxiety do not typically focus on trauma that is rooted in experiences with the police. The present study utilizes exploratory and confirmatory factor analysis to examine the relationships among police-initiated post-traumatic stress symptoms, depression and anxiety. Method Exploratory and confirmatory factor analysis examines the factor structure of police-initiated post-traumatic stress symptoms, depression and anxiety. Results Results suggest that police-initiated post-traumatic stress symptomatology is two factors that are distinguishable from anxiety and depression. Discussion Our findings highlight the need to develop methods of disentangling the relationships between police-initiated post-traumatic stress symptomatology and co-occurring mental health symptoms, and advocating for policies and practices that can reduce negative police-youth interactions.