Models Of Psychopathology Research Articles

Advancing understanding of the relation between criterion a of the alternative model for personality disorders and hierarchical taxonomy of psychopathology: Insights from an external validity analysis.

Increasing interest surrounds the relation between Level of Personality Functioning (LPF), as defined by Criterion A of the Alternative Model for Personality Disorders, and the Hierarchical Taxonomy of Psychopathology (HiTOP) model. However, the integration of LPF within HiTOP remains unclear. Using bivariate correlation and linear regression analyses, this study assessed the associations between LPF and HiTOP spectra (externalizing antisocial, externalizing drug use, internalizing, antagonism, detachment, and psychoticism). A sample of 1,183 participants (46.2% female, Mage = 31.3 ± 14.8 years) from the Italian community completed various self-report measures to capture impairments in personality functioning, and several psychopathology symptoms. Bivariate correlations and regression analyses showed that the LPF facets were consistently associated with all HiTOP domains, even though the LPF measures used in this study appeared more reflective of internalizing symptoms than externalizing ones. The identity facet of LPF was uniquely associated with all outcome criteria, whereas no unique associations were evident for self-direction. Empathy facet had the highest association with antagonism while intimacy presented the highest relation with detachment. Overall, the evidence presented in this study partially supports the construct validity of Criterion A, highlighting its relevance across a wide range of psychopathological symptoms and its potential utility in clinical assessment beyond formal personality disorder diagnoses. Thus, this study may contribute to the understanding of LPF's role in the dimensional model of psychopathology and underscores the importance of considering personality functioning in the assessment and treatment of mental disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differential effects of trait-like emotion regulation use and situational emotion regulation ability across the affective and anxiety disorders spectrum: a transdiagnostic examination

Here, we investigated the association of different emotion regulation (ER) indices with symptom severity across a large transdiagnostic sample of patients with emotional disorders (cross-sectional approach) and the predictive validity these ER indices have for the outcome of routine care CBT (longitudinal approach). We assessed the trait-like use of adaptive (reappraisal) and maladaptive (suppression, externalizing behaviors) ER strategies via questionnaire as well as the situational ability to regulate emotions with an experimental ER paradigm. Psychopathology was assessed dimensionally using the depression, anxiety, and stress scale. Cross-sectionally symptom severity was predicted by less trait-like use of adaptive and more trait-like use of maladaptive ER strategies, but no associations were found for situational ER ability. This association was more pronounced for depression and stress symptoms rather than anxiety symptoms. In a striking dissociation, the longitudinal analyses revealed the reverse picture: Better situational ER ability, but not trait-like use of ER strategies was associated with less symptom severity after the CBT treatment. Our data argues in favor of a distinction between trait-like and situational ER abilities in individuals with emotional disorders, highlighting challenges in applying adaptive ER strategies in daily life despite demonstrating intact ER skills in experimental settings. Our findings also inform transdiagnostic models of psychopathology and suggest that distress/depression rather than anxiety symptomatology to be driving forces for the occurrence of ER deficits across the depression/anxiety disorders spectrum.

A Network Control Theory of Dynamic Systems Approach to Personalize Therapy

Contemporary latent disease models of psychopathology have shown limited clinical utility and the efficacy of conventional treatments have been disappointing. An alternative approach offers the network approach and a dynamic systems perspective to psychopathology and treatment change. To understand and modify dynamic systems, engineering and mathematics have been relying on principles of network control theory. This article will discuss the application of network control theory of dynamic systems approach to personalize therapy. Network control theory can be used as a guide for personalizing treatment by choosing the most promising intervention strategy targeting the change processes based on the network structure. A composit case illustration will demonstrate the principles and application of network control theory to therapy in practice within the framework of process-based therapy. In conclusion, a network control theory of dynamic systems approach is highly relevant and applicable to clinical science.

Targeting Higher-Order Dimensions of Personality in Treatment as a Parsimonious Means to Address Co-Occurring Psychopathology

People with borderline personality disorder (BPD) commonly have co-occurring mental health conditions that may be accounted for by higher-order factors in dimensional models of psychopathology. BPD Compass is a cognitive-behavioral treatment developed to target broad personality domains (i.e., negative affectivity, antagonism, disinhibition) associated with BPD and related conditions. The purpose of the present study was to explore the extent to which BPD Compass can serve as a transdiagnostic intervention for these comorbid conditions. Participants (N = 100; Mage = 28.13, 73.7% female, 79.6% White, 66% sexual minority) were assigned to either immediately begin treatment (randomized and naturalistic) or receive treatment after an 18-week waiting period. At baseline, participants met criteria for an average of 3.28 (SD = 2.02, range: 0-8) comorbid diagnoses ranging in clinical severity from 3.30 (for substance use disorder) to 4.91 (for persistent depressive disorder). Post-treatment clinical severity ratings (CSRs) for those randomized to receive BPD Compass were below clinical thresholds for all assessed conditions except premenstrual dysphoric disorder, whereas post-waitlist CSRs remained above clinical thresholds for all disorders except bipolar II, agoraphobia, and major depressive disorder. Collapsed across all patients who received BPD Compass, pre- to post-treatment improvements in were significant and large in magnitude for most disorders assessed. These results suggest that BPD Compass may be an efficacious transdiagnostic intervention, though our small sample and high rate of dropout warrant further study.

Shared principles for disentangling heterogeneity in neuroscience and psychopathology.

A primary goal of clinical neuroscience is to identify associations between individual differences in psychopathology and the brain. However, despite a significant amount of resources invested in this endeavor, few reliable neural correlates of psychopathology have been identified. A common suspect for this lack of success is the significant heterogeneity in symptoms observed in psychiatric disorders. However, this is not the only potential source of heterogeneity, as substantial heterogeneity is also observed in brain structure and function. Thus, for clinical neuroscience to identify reliable neural correlates of psychopathology, it will be necessary to better understand heterogeneity in both psychopathology and the brain. In this commentary, we suggest four shared principles that can help disentangle heterogeneity in both of these domains: (a) the brain and behavior should both be treated as complex measures, (b) a priori assumptions should be viewed with caution unless they can be replicated robustly in individuals, (c) complex models of individual differences require appropriate data to estimate them, and (d) the field would benefit from an increased focus on extensively measuring individuals, such as through the use of personalized models of psychopathology and neuroimaging data. Together, these shared principles can aid in better characterizing-and separating relevant and irrelevant-heterogeneity in measures of psychopathology and neuroimaging. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Emotional Dysregulation and Worry as Mediators between Stressful Life Events and Posttraumatic Stress Symptoms in Adult Mexican Women: A Cross-Sectional Study

Introduction. Women experience numerous episodes of adverse events, often linked to violence, which create emotional difficulties that contribute to the development of post-traumatic stress disorder. However, more research is required to understand the nature of post-traumatic reactions and the underlying psycho-emotional processes. Objective. To determine whether emotional dysregulation and worry mediate the relationship between the experience of stressful events and post-traumatic stress symptoms in a sample of adult Mexican women seeking online psychological treatment. Method. A cross-sectional study was conducted with a non-probabilistic sample of 687 women ages 18 to 76. Results. The data show that emotional dysregulation mediated the relationship between the type of trauma and post-traumatic stress symptoms for illness- and death-related events, but not for other types of stressors, whereas worry mediated the association between sexual and physical assault and post-traumatic stress symptoms. Discussion and conclusion. This study contributes to current psychopathology models focused on the transdiagnostic perspective. The findings may guide interventions targeting emotion regulation and worry as modifiable risk factors for the development of post-traumatic stress.

Prospective associations between early adolescent reward functioning and later dimensions of psychopathology.

Individual differences in reward functioning have been associated with numerous disorders in adolescence. Given relations with multiple forms of psychopathology, it is unclear whether these associations are disorder specific or reflective of shared variance across multiple disorders. In a sample of adolescents (N = 418), we examined associations between neural and self-reported indices of early reward functioning (age 12) with different levels of a hierarchical psychopathology model assessed later in adolescence (age 18). We examined whether prospective relationships between reward functioning are specific to individual disorders or better explained by transdiagnostic dimensions. We found modest results for prospective associations between reward indices and different dimensions of psychopathology, with most significant associations not surviving correction for multiple comparisons. We discuss the benefits and limitations of the modeling approach used to examine dimension-specific associations that future work can build on. Overall, more work is needed to better understand how reward functioning is specifically associated with different forms of and hierarchical levels of psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Adverse Childhood Experiences on Cognitive Control Across the Lifespan: A Systematic Review and Meta-analysis of Prospective Studies.

Adverse childhood experiences (ACEs) are strongly associated with impaired cognitive control, yet research on ACEs' effects across cognitive control domains-working memory, cognitive flexibility, and inhibitory control-remains sparse. This systematic review and meta-analysis evaluated the overall impact of ACEs on each of these cognitive control domains and explored moderating factors such as age, gender, cognitive control paradigms, and ACEs subtypes based on the dimensional model of adversity and psychopathology. A database search was conducted in SCOPUS, MedLine, PsycINFO, and Web of Science. Only prospective studies were included to ensure temporal order inferences, with at least two data collection points, assessing ACEs at baseline (T1) and cognitive control during follow-up (T2). Thirty-two studies (N = 26,863) producing 124 effect sizes were analyzed. Three-level meta-analyses revealed small-to-medium negative associations between ACEs and overall cognitive control (g = -0.32), and in each domain: working memory (g = -0.28), cognitive flexibility (g = -0.28), and inhibitory control (g = -0.32). The negative associations between ACEs and cognitive control were consistent across age, gender, and cognitive control paradigms. ACEs subtypes moderated the association with cognitive flexibility (p = .04) but not working memory or inhibitory control. Specifically, the deprivation subtype exhibited a stronger negative association with cognitive flexibility compared to threat and threat-and-deprivation subtypes. These findings highlight the pervasive negative impact of ACEs on cognitive control across ages and emphasize the need for targeted interventions. Implications, current gaps, limitations in research, and future study recommendations are discussed.

Characterizing the role of unpredictability within different dimensions of early life adversity.

Dimensional models of early life adversity highlight the distinct roles of deprivation and threat in shaping neurocognitive development and mental health. However, relatively little is known about the role of unpredictability within each dimension. We estimated both the average levels of, and the temporal unpredictability of deprivation and threat exposure during adolescence in a high-risk, longitudinal sample of 1354 youth (Pathways to Desistance study). We then related these estimates to later life psychological distress, and Antisocial and Borderline personality traits, and tested whether any effects are mediated by future orientation. High average levels of both deprivation and threat exposure were found to be associated with worse mental health on all three outcomes, but only the effects on Antisocial and Borderline personality traits were mediated by decreased future orientation, a pattern consistent with evolutionary models of psychopathology. Unpredictability in deprivation exposure proved to be associated with increased psychological distress and a higher number of Borderline traits, but with increased future orientation. There was some evidence of unpredictability in threat exposure buffering against the detrimental developmental effects of average threat levels. Our results suggest that the effects of unpredictability are distinct within different dimensions of early life adversity.

Testing a Conceptual Model of Early Adversity, Neural Function, and Psychopathology: Protocol for a Retrospective Observational Cohort Study.

Early adversity, broadly defined as a set of negative exposures during childhood, is extremely common and increases risk for psychopathology across the life span. Previous research suggests that separate dimensions of adversity increase risk through developmental plasticity mechanisms shaping unique neurobiological pathways. Specifically, research suggests that deprivation is associated with deficits in higher order cognition, while threat is associated with atypicality in fear learning and emotion dysregulation. However, most of this research has been conducted in adolescent and adult samples, long after exposure to adversity occurs and far from periods of peak developmental plasticity. The Wellness Health and Life Experiences (WHALE) study examines the neurobiological and behavioral mechanisms by which deprivation, threat, and unpredictability increase risk for psychopathology in early childhood (age 4-7 years) directly following periods of peak developmental plasticity. The objective of this study is to describe the study rationale and aims, the research design and procedures, and the analytical plan to test the study hypotheses. This is a retrospective cohort study that examines associations between exposure to deprivation and threat and their hypothesized neurobiological mechanisms, how these neurobiological mechanisms link early adversity and psychopathology, and associations between unpredictability, reward learning, and psychopathology. The sample was a convenience sample of children (aged 4-7 years) and their families, identified through flyers, email blasts to listserves, school-based advertising, and involvement in community events. Data were collected during a home visit, a subsequent laboratory visit, and a final neuroimaging visit. Planned analyses include linear regression, path analyses, and functional magnetic resonance imaging analyses to explore the role of neural function in the association between early adversity and psychopathology. Participants (N=301) have been recruited into the study, and data collection has commenced. The expected results will be available in 2024. The findings of this study will help elucidate the neurobiological mechanisms by which early adversity increases risk for psychopathology in early childhood. This study represents the earliest test of an influential theory of biological embedding of early adversity. DERR1-10.2196/59636.

Anger in social anxiety disorder

ABSTRACT The present study focused on the emotional experience of anger among individuals with and without social anxiety disorder (SAD). Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not meet criteria for SAD. Participants completed a 21-day experience sampling measurement (ESM) in which they reported on daily social interactions and emotions. Using multilevel linear modeling we found that individuals with SAD experienced more anger compared to individuals without SAD. We also found a Diagnosis × Social Context interaction such that interactions with distant others were associated with elevated anger compared to interactions with close others for individuals with SAD but not for individuals without SAD. Finally, we found that for individuals with SAD (but not those without SAD) anger on a given day (day t) was associated with elevated anxiety on the following day (day t + 1), above and beyond previous anxiety, sadness and guilt (i.e. anxiety, sadness and guilt reported on day t). This suggests that anger may play a unique role in maintaining or exacerbating anxiety among individuals with SAD. Additional implications of our findings for models of psychopathology and for treatment of SAD are discussed.

Models of Psychopathology and Religion: Suffering, Psychosis, and Neurodiversity

Models of Psychopathology and Religion: Suffering, Psychosis, and Neurodiversity

What Emotion Regulation Strategies are Associated with a General Psychopathology Factor (p) in Adolescence? Identifying Possible Transdiagnostic Targets for Intervention.

Mental health problems in adolescence are increasing and there is an urgent call for transdiagnostic interventions, as most adolescents experience problems across multiple domains. Research has identified a general psychopathology factor (p) capturing the shared variance across mental health problems. In parallel, there is empirical support for the transdiagnostic nature of emotion regulation. In the current study, we explore the associations between p and emotion regulation strategies to identify which strategies may be promising targets for intervention. Data from the population-based Youth and Mental Health Study (YAMHS) (N = 2,464, mean age 13.7years, SD 0.6) was used. The fit of different structural models of emotion regulation and psychopathology were compared, and latent factors from the final models were included in multiple regression analyses to explore the associations between p and emotion regulation strategies. A bifactor exploratory structural equation model (B-ESEM) showed best fit for modelling p. For emotion regulation strategies, an ESEM model showed best fit, including Rumination, Reactive Impulsivity, Distraction, Non-Acceptance, Problem Solving, Social Support, and Proactive Behavior. Results showed that a higher score on p was predicted by higher scores on the emotion regulation strategies Rumination (β = .38, p < .001) and Reactive Impulsivity (β = .35, p < .001), and lower scores on Problem Solving (β = -.15, p < .001). The results indicate that Rumination and Reactive Impulsivity have the strongest associations with p and may be promising targets for mental health interventions for adolescents.

Safety behaviors and positive emotions in social anxiety disorder

The present study examined contextual factors that affect safety behavior use as well as positive emotions when using safety behaviors among individuals with SAD. Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not meet criteria for SAD. Participants completed a 21-day experience sampling methodology (ESM) measurement in which they reported on daily social interactions, safety behavior use, and emotions. Using multilevel linear modeling we found that both individuals with and without SAD used more safety behaviors when interacting with distant others compared to close others, but this effect was greater for individuals with SAD compared to individuals without SAD. We also found that social anxiety significantly moderated the relationship between safety behaviors in social interactions and positive emotions. Specifically, our findings indicated that individuals with higher levels of social anxiety reported lower levels of positive emotions when using safety behaviors. Implications of our findings for models of psychopathology and for treatment of SAD are discussed.

Mapping the neurodevelopmental predictors of psychopathology.

Neuroimaging research has uncovered a multitude of neural abnormalities associated with psychopathology, but few prediction-based studies have been conducted during adolescence, and even fewer used neurobiological features that were extracted across multiple neuroimaging modalities. This gap in the literature is critical, as deriving accurate brain-based models of psychopathology is anessential steptowards understanding key neural mechanisms and identifying high-risk individuals. As such, we trained adaptive tree-boosting algorithms on multimodal neuroimaging features from the Lifespan Human Connectome Developmental (HCP-D) sample that contained 956 participants between the ages of 8 to 22 years old. Our feature space consisted of 1037 anatomical, 1090 functional, and 192 diffusion MRI features, which were used to derive models that separately predicted internalizing symptoms, externalizing symptoms, and the general psychopathology factor. We found that multimodal models were the most accurate, but all brain-based models of psychopathology yielded out-of-sample predictions that were weakly correlated with actual symptoms (r2 < 0.15). White matter microstructural properties, including orientation dispersion indices and intracellular volume fractions, were the most predictive of general psychopathology, followed by cortical thickness and functional connectivity. Spatially, the most predictive features of general psychopathology were primarily localized within the default mode and dorsal attention networks. These results were mostly consistent across all dimensions of psychopathology, except orientation dispersion indices and the default mode network were not as heavily weighted in the prediction of internalizing and externalizing symptoms. Taken with prior literature, it appears that neurobiological features are an important part of the equation for predicting psychopathology but relying exclusively on neural markers is clearly not sufficient, especially among adolescent samples with subclinical symptoms. Consequently, risk factor models of psychopathology may benefit from incorporating additional sources of information that have also been shown to explain individual differences, such as psychosocial factors, environmental stressors, and genetic vulnerabilities.

Life Course Models of Child Maltreatment: Effects on General Psychopathology Outcomes in a Longitudinal Sample.

The study compared life course models (LCM; accumulation, recency, and sensitive period) of child maltreatment and general psychopathology in a large, national longitudinal data set of 1354 youth ages birth-16years (657 boys, 53.2% Black, 59.7% <$40K caregiver income). Previous research has supported the accumulation and recency models, albeit with shorter or fewer time periods of outcome measurement. We extend this work by modeling the impact of combined abuse and neglect allegations on a general psychopathology factor (dysregulation profile). Cross-sectional structural equation models were constructed using LCMs and tested across two-year periods from 4-16years old and compared using Akaike Information Criterion weights. The recency variable generally explained the greatest proportion of variance in psychopathology. Notably, maltreatment more proximal to the time of outcome measurement had the strongest effect, suggesting that more recent maltreatment may have stronger effects on general psychopathology. These results lend support to a recency effect of maltreatment on psychopathology outcomes, although substantive overlaps with the accumulation model are noted.

Psychiatric Diagnosis: A Clinical Guide to Navigating Diagnostic Pluralism.

The controversies surrounding the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases have generated significant debate across the psy-sciences. This debate has been further fueled by the launch of the Research Domain Criteria as a framework to facilitate advances in neuroscientific research, a renewed emphasis on dimensional models of psychopathology, currently exemplified by the Hierarchical Taxonomy of Psychopathology, and development of the Psychodynamic Diagnostic Manual by the psychodynamic community. In this article, we provide a clinical overview of recent debates surrounding categorical and dimensional approaches to psychiatric diagnosis, offer a critical assessment of proposed alternatives, and discuss how clinicians can navigate a plurality of diagnostic frameworks. Our discussion emphasizes that diagnostic frameworks need to be contextualized within the process of a comprehensive clinical evaluation, and their advantages and disadvantages should be understood in relationship to the theoretical orientations and practical needs of clinicians.

Emotional Distress and Physical Activity Engagement in U.S. Veterans With Chronic Obstructive Pulmonary Disease: A Qualitative Study.

Physical activity is recommended as part of guideline-based care for managing chronic obstructive pulmonary disease (COPD) at all stages of the disease. However, physical activity interventions are less effective in individuals with co-occurring emotional distress (i.e., depression and/or anxiety symptoms). Interventions that dually promote improved physical and mental health in COPD are needed. The first step for intervention development is understanding individuals' experience of these factors. To understand the experience of emotional distress in U.S. Veterans diagnosed with COPD and to explore how emotional distress impacts physical activity engagement. Structured interviews informed by the cognitive and behavioral models of psychopathology were conducted with 29 United States Veterans with COPD (89.66% male, age 67.72 ± 6.55 years, 93.10% White) at the VA Boston Healthcare System. Interviews were audio recorded, transcribed, and underwent thematic analysis. Three major themes encapsulating 17 codes emerged through thematic analysis: (i) the experience of emotional distress in Veterans with COPD; (ii) the complex relationship between emotional distress, physical activity engagement, and COPD; (iii) contextual and personal factors. Veterans' interpretation of their COPD symptoms as unpredictable and uncontrollable and COPD-related physical limitations influenced their experience of emotional distress, while the experience of emotional distress both promoted and deterred physical activity engagement. Veterans were motivated to engage in physical activity despite experiencing emotional distress when they faced a responsibility in daily life. They identified motivational strategies and self-regulation techniques to manage emotional distress and to foster physical activity.

Major Problems in Clinical Psychological Science and How to Address them. Introducing a Multimodal Dynamical Network Approach

Abstract Background Despite impressive dissemination programs of best-practice therapies, clinical psychology faces obstacles in developing more efficacious treatments for mental disorders. In contrast to other medical disciplines, psychotherapy has made only slow progress in improving treatment outcomes. Improvements in the classification of mental disorders could enhance the tailoring of treatments to improve effectiveness. We introduce a multimodal dynamical network approach, to address some of the challenges faced by clinical research. These challenges include the absence of a comprehensive meta-theory, comorbidity, substantial diagnostic heterogeneity, violations of ergodicity assumptions, and a limited understanding of causal processes. Methods Through the application of multimodal dynamical network analysis, we describe how to advance clinical research by addressing central problems in the field. By utilizing dynamic network analysis techniques (e.g., Group Iterative Multiple Model Estimation, multivariate Granger causality), multimodal measurements (i.e., psychological, psychopathological, and neurobiological data), intensive longitudinal data collection (e.g., Ecological Momentary Assessment), and causal inference methods (e.g., GIMME), our approach could improve the comprehension and treatment of mental disorders. Under the umbrella of the systems approach and utilizing e.g., graph theory and control theory, we aim to integrate data from longitudinal, multimodal measurements. Results The multimodal dynamical network approach enables a comprehensive understanding of mental disorders as dynamic networks of interconnected symptoms. It dismantles artificial diagnostic boundaries, facilitating a transdiagnostic view of psychopathology. The integration of longitudinal data and causal inference techniques enhances our ability to identify influential nodes, prioritize interventions, and predict the impact of therapeutic strategies. Conclusion The proposed approach could improve psychological treatment by providing individualized models of psychopathology and by suggesting individual treatment angles.

Choose Wisely! – Considering the Perceived Threat in the Selection of Trauma Film Clips May Improve the Ecological Validity of the Trauma Film Paradigm

Abstract Background The trauma film paradigm (TFP) is the gold standard experimental psychopathology model of psychological trauma. However, different film clips with distinct effects on trauma-analogue symptoms are used across TFP studies, raising questions about the generalizability of study-specific results and the ecological validity of the TFP. Little is known about differences among film clips commonly used in the TFP regarding key features of psychological trauma (i.e., threat and anxiety) and their veridicality. Methods Thirty healthy participants watched eight trauma film clips in randomized order and subsequently rated each in view of perceived threat, anxiety, and realism. In addition to descriptive statistics, variance analyses and pairwise comparisons were performed to test for differences on these outcomes. Results The results indicated significant differences among the trauma film clips in terms of perceived threat and realism. However, nearly all trauma film clips evoked moderate anxiety levels. Conclusions This study stressed the importance of perceived threat as a key feature in selecting film clips for the TFP, as highly threatening film clips were also perceived as more realistic. When replicated using delayed outcomes (e.g., intrusive memories), choosing trauma film clips in view of their perceived threat might improve the ecological validity of the TFP.