Specific Dimensions Of Psychopathology Research Articles

Correlates of a general psychopathology factor in a clinical sample of childhood sexual abuse survivors

BackgroundChildhood sexual abuse (CSA) increases risk for most psychiatric disorders. There is evidence that the structure of psychopathology can be explained by a number of latent dimensions of psychopathology including a ‘General Psychopathology’ (P) factor. The objective of the current study was to provide the first assessment as to whether P is identifiable, and what its correlates might be in a clinical sample. MethodsAn adult, clinical sample of Danish CSA survivors (N = 420) was assessed using the Millon Clinical Multiaxial Inventory-III. Confirmatory factory analysis (CFA) was used to assess the latent structure of nine psychiatric disorders, and structural equation modelling (SEM) was used to determine correlates of the best-fitting dimensional model. ResultsCFA results favoured a bifactor model including three specific dimensions of psychopathology, “Internalizing”, “Externalizing”, and “Thought Disorder”, and a bi-factor “P”. A SEM model that included ten predictors was a good fit to the data and explained 55% of variance in ‘P’. The ‘P’ factor was significantly associated with emotional coping, negative self-worth, traumatic life events, and anxious attachments. LimitationsPsychiatric disorders were assessed using self-report measures, and the sample was predominately female. ConclusionsResults provide initial evidence of P in a clinical sample and several unique correlates of this factor were identified.

Common and dissociable regional cerebral blood flow differences associate with dimensions of psychopathology across categorical diagnoses.

The high comorbidity among neuropsychiatric disorders suggests a possible common neurobiological phenotype. Resting-state regional cerebral blood flow (CBF) can be measured noninvasively with MRI and abnormalities in regional CBF are present in many neuropsychiatric disorders. Regional CBF may also provide a useful biological marker across different types of psychopathology. To investigate CBF changes common across psychiatric disorders, we capitalized upon a sample of 1,042 youths (ages 11 to 23 years) who completed cross-sectional imaging as part of the Philadelphia Neurodevelopmental Cohort. CBF during a resting state was quantified on a voxelwise basis using arterial spin labeled perfusion MRI at 3T. A dimensional measure of psychopathology was constructed using a bifactor model of item-level data from a psychiatric screening interview, which delineated four factors (fear, anxious-misery, psychosis, and behavioral symptoms) plus a general factor: overall psychopathology. Overall psychopathology was associated with elevated perfusion in several regions including the right dorsal anterior cingulate cortex (ACC) and left rostral ACC. Furthermore, several clusters were associated with specific dimensions of psychopathology. Psychosis symptoms were related to reduced perfusion in the left frontal operculum and insula, whereas fear symptoms were associated with less perfusion in the right occipital/fusiform gyrus and left subgenual ACC. Follow-up functional connectivity analyses using resting-state fMRI collected in the same participants revealed that overall psychopathology was associated with decreased connectivity between the dorsal ACC and bilateral caudate. Together, the results of this study demonstrate common and dissociable CBF abnormalities across neuropsychiatric disorders in youth.

Role of 108 schizophrenia-associated loci in modulating psychopathological dimensions in schizophrenia and bipolar disorder.

The Schizophrenia Working Group of the Psychiatric Genomics Consortium (PGC) identified 108 loci associated with schizophrenia, but their role in modulating specific psychopathological dimensions of the disease is unknown. This study investigated which symptom dimensions may be affected by these loci in schizophrenia, and bipolar disorder. Positive, negative and depressive symptoms, suicidal ideation, cognition, violent behaviors, quality of life, and early onset were investigated in schizophrenia and bipolar disorder using the clinical antipsychotic trials of intervention effectiveness (CATIE) and systematic treatment enhancement program for bipolar disorder (STEP-BD) studies. Individual loci were investigated, then genes within 50 Kbp from polymorphisms with p < 0.10 were included in an enrichment analysis (Cytoscape GeneMania plugin) and used to estimate polygenic risk scores (PRS). Covariates were center, age, gender, ancestry-informative population, principal components, and for cognition, also years of education were considered. Eighty-nine polymorphisms were available, 479 and 810 white subjects were included from CATIE and STEP-BD, respectively. rs75059851 (IGSF9B gene) was associated with negative symptoms in CATIE (p = 0.00048). Genes within 50 Kbp from variants contributing to negative symptoms and suicide were enriched with GO terms involved in acetylcholine neurotransmission, cognition showed enrichment with GO terms involved in vitamin B6 and fucose metabolism while early onset with GO terms related to extracellular matrix structure. PRS showed nominal associations with violent behaviors and depressive symptoms. This study provided preliminary evidence that a schizophrenia-associated variant (rs75059851) may modulate negative symptoms. Multi-locus models may provide interesting insights about the biological mechanisms that mediate psychopathological dimensions.

The dimensional structure of psychopathology in 22q11.2 Deletion Syndrome

Background22q11.2 Deletion Syndrome (22q11.2DS) is one of the strongest known genetic risk factors for developing schizophrenia. Individuals with 22q11.2DS have high rates of neurodevelopmental disorders in childhood, while in adulthood ∼25% develop schizophrenia. Similar to the general population, high rates of comorbidity are common in 22q11.2DS. Employing a dimensional approach where psychopathology is examined at the symptom-level as complementary to diagnostic categories in a population at such high genetic risk for schizophrenia can help gain a better understanding of how psychopathology is structured as well as its genetic underpinnings. This is the first study to examine the dimensional structure of a wide spectrum of psychopathology in the context of a homogeneous genetic etiology like 22q11.2DS. MethodsWe evaluated 331 individuals with 22q11.2DS, mean age (SD) = 16.9(8.7); 51% males, who underwent prospective comprehensive phenotyping. We sought to replicate previous findings by examining a bi-factor model that derives a general factor of psychopathology in addition to more specific dimensions of psychopathology (i.e., internalizing, externalizing and thought disorder). ResultsPsychopathology in 22q11.2DS was divided into one ‘general psychopathology’ factor and four specific dimensions (i.e., ‘anxiety’, ‘mood’, ‘ADHD’ and ‘psychosis’). The ‘psychosis’ symptoms loaded strongly on the ‘general psychopathology’ factor. ConclusionsThe similarity of the symptom structure of psychopathology between 22q11.2DS and community and clinical populations without the deletion indicate that 22q11.2DS can provide a model to explore alternative approaches to our current nosology. Our findings add to a growing literature indicating the need to reorganize current diagnostic classification systems.

Dissociative symptoms in borderline personality disorder

ObjectiveTo study the association of dissociative symptoms and specific psychopathological dimensions in a sample of patients with Borderline Personality Disorder (BPD).MethodsAn observational analytic study was conducted. Patients with BPD were administered the Diagnostic Interview for Borderline (DIB-R) and Dissociative Experience Scale (DES–II).ResultsParticipants were 34 adult patients with BPD. The majority presented with dissociative symptoms (65.6%; n = 21). A statistical significant correlation was found between DES total score and DIB-R subscales: depression (P = 0.04), feeling of loneliness and emptiness (P = 0.005), sexual deviation (P = 0.002) and intolerance to loneliness (P = 0.01). Furthermore, depersonalization was statistically correlated with the severity of borderline psychopathology (DIB-R total score- P = 0.04), suicidal behavior (P = 0.001) and interpersonal problems (P = 0.04). Derealization was significantly correlated with cognition (P = 0.02), psychotic thought (P = 0.004) and intolerance to loneliness (P = 0.02).ConclusionsDissociative symptoms are not easy to detect in the clinical daily work. More than a half of patients with BPD presented with dissociative symptoms detected with a specific rating scale. Particularly, only some specific psychopathological dimensions are correlated with dissociation and need to be assessed in patients with BPD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

No relationship between baseline salivary alpha-amylase and State-Trait Anxiety Inventory Score in drug-naïve patients with short-illness-duration first episode major depressive disorder: An exploratory study.

BackgroundSalivary α-amylase (sAA) activity alternations are observed in major depressive disorder (MDD) being associated with depression severity and its specific psychopathological dimensions with anxiety being attributed to distress. No data is available on sAA in MDD according to Hamilton Rating Scale for Depression (HAMD-17) and State-Trait Anxiety Inventory (STAI). The exploratory study examines whether and to what extent baseline sAA level is interrelated to the psychopathological features including severity of symptoms and specific psychopathological dimensions.Material and MethodsThe basal, non-stimulated sAA activity was studied in 20 non-late-life adult, treatment-naïve MDD patients with short-illness-duration and in 20 age- and sex-matched healthy controls along with psychometric assessments with Hamilton Rating Scale for Depression (HAMD-17) and Spielberger State-Trait Anxiety Inventory (STAI).ResultsSignificantly lower (p=0.011) sAA activity was observed in MDD as compared to controls. No significant correlations were observed between sAA activity and the total HAMD-17 score as well as with regard to the specific core depression, insomnia, anxiety and somatic HAM-D psychopathological dimensions. No significant correlations were also found between sAA and STAIX-1 and STAIX-2 scores.ConclusionsLow baseline sAA levels in MDD with no correlations between sAA and psychopathological features including severity of symptoms and specific psychopathological dimensions was found. Key words:Salivary alpha-amylase, major depressive disorder, Spielberger State-Trait Anxiety Inventory, Hamilton Rating Scale for Depression.

Inflammation, neurotrophism and oxidative stress and childhood psychopathology in a large community sample.

To investigate the association between peripheral biomarkers and child psychopathology in a large community sample. A total of 625 aged 6- to 13-year old subjects were recruited from a community school-based study. Psychopathology was assessed using the Child Behaviour Checklist (CBCL). Psychiatric diagnosis was evaluated using the Development and Well-Being Assessment. The following biomarkers were examined in peripheral blood: brain-derived neurotrophic factor, cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, IFN-g, and TNF-α), chemokines (eotaxin/CCL11, IP-10, MCP-1), cytokine receptors (sTNFR1 and sTNFR2), and the oxidative stress marker TBARS. We found significant associations between sTNFR2, eotaxin/CCL11 and CBCL total score, as well as with specific dimensions of psychopathology. There were different patterns of association between these biomarkers and psychological and behavioural symptoms in children with and without a mental disorder. TBARS, IL-6 and MCP-1 were more specific to some clusters of symptoms in children with a psychiatric diagnosis. Our data support the potential use of biomarkers, especially those involved in immune-inflammatory pathways, in investigating neurodevelopmental psychopathology. Their association with different dimensions of symptoms might be of useful when analyzing illness severity and clusters of symptoms within specific disorders.

Mental disorders and risk of suicide attempt: a national prospective study.

Most mental disorders, when examined independently, are associated with an elevated risk for suicide attempt. However, mental disorders often co-occur, and that co-occurrence is well explained by models where specific mental disorders are understood as manifestations of latent dimensions of psychopathology. To date, it remains unclear whether the risk of suicide attempt is due to specific mental disorders, to specific dimensions of psychopathology (that is, internalizing and externalizing dimensions), to a general psychopathology factor or to a combination of these explanations. In a large nationally representative prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used structural equation modeling to examine the shared and specific effects of Axis I and Axis II disorders on the occurrence of suicide attempts in the general population and among individuals with a lifetime history of suicidal ideation. Effects of mental disorders on the risk of suicide attempt were exerted almost exclusively through a general psychopathology factor representing the shared effect across all mental disorders. Effects of remitted psychiatric disorders on the risk of suicide attempt were fully mediated by current mental disorders. Similar patterns of associations were found in individuals with suicidal ideation. These results held when using different approaches to modeling psychiatric comorbidity. Our findings underscore the importance of adopting dimensional approaches to comorbidity in the study of suicidal behavior. Because mental disorders increase the risk of suicide attempt through a general psychopathology liability, this dimension should be considered as an important therapeutic target to substantially advance suicide prevention.

A dimensional liability model of age differences in mental disorder prevalence: Evidence from a national sample

Recent theories have proposed a metastructure that organizes related mental disorders into broad dimensions of psychopathology (i.e., internalizing and externalizing dimensions). Prevalence rates of most mental disorders, when examined independently, are substantially lower in older than in younger adults, which may affect this metastructure. Within a nationally representative sample, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093), we developed a dimensional liability model of common psychiatric disorders to clarify whether aging affects specific disorders or general dimensions of psychopathology. Significant age differences existed across age groups (18–24, 25–34, 35–44, 45–54, 55–64, 65–75 and 75+), such that older adults showed lower prevalence rates of most disorders compared to younger adults. We next investigated patterns of disorder comorbidity for past-year psychiatric disorders and found that a distress-fear-externalizing liability model fit the data well. This model was age-group invariant and indicated that the observed lower prevalence of mental disorders with advancing age originates from lower average means on externalizing and internalizing liability dimensions. This unifying dimensional liability model of age and mental disorder comorbidity can help inform the role of aging on mental disorder prevalence for research and intervention efforts, and service planning for the impending crisis in geriatric mental health.

Plasma magnesium levels and treatment outcome in depressed patients

ObjectivesHigh, normal, or low plasma magnesium (Mg) levels have been observed in depressed patients. The aim of our study was to investigate the relationship of Mg levels with depression severity, specific psychopathological dimensions, and treatment outcome.MethodsA total of 123 outpatients during a major depressive episode were recruited. All patients showed at least two major depressive episodes and did not achieve remission in the former treatment trial. A blood sample was collected to determine total plasma Mg levels. The psychopathological status was assessed using Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Depression Retardation Rating Scale for psychomotor retardation, and Snaith–Hamilton Pleasure Scale for anhedonia. Hamilton Depression Rating Scale was repeated at 3 months after treatment.ResultsAll patients showed Mg levels mostly within the normal range. No association between Mg levels and psychopathological severity was reported. Patients who responded to antidepressant treatment showed higher Mg levels and higher retardation scores at basal evaluation in comparison with non-responders.DiscussionAlthough further studies investigating the relationship between hypomagnesaemia, depression, and treatment outcome are certainly necessary, we have hypothesized that hypomagnesaemia could be an epiphenomenic biochemical trait in less drug-responsive depressed patients. It is also plausible that lower Mg levels and hyperactive traits identify a biological subtype of patients with increased catecholaminergic functioning and a poorer response to aminergic drugs. Moreover, Mg depletion could partly account for the correlation between low Mg levels and poor outcome and this raises the question of Mg's possible therapeutic role in depression.

P02-20 - Predictive value of magnesium levels in depressed patients

Background and aimHigh, normal or low plasma magnesium (Mg) levels have been observed in depressed patients. The aim of our study was to investigate the relationship of plasma Mg levels with depression severity, specific psychopathological dimensions and treatment outcome.Materials and methods123 outpatients (M/F 60/63; mean age = 48 ± 15) during a Major Depressive Episode (MDE) were recruited. Most of them were affected by “difficult to treat” depression, that includes patients with history of at least two MDE, risk of chronicization and who did not achieve remission in previous treatments.The psychopathological status was assessed using HAM-D, HAM-A, DRRS for psychomotor retardation and SHAPS for anhedonia. HAM-D was repeated at 3 months. A blood sample was collected to determine total plasma Mg levels.ResultsWe observed an association between Mg levels and psychomotor retardation scores (p = 0.045). Moreover, subjects with residual symptoms after treatment (HAM-D at 3 months &gt; 15) have lower starting Mg values compared to treatment-responsive individuals (2.14 ± 0.2 vs. 2.25 ± 0.21, p = 0,039).ConclusionsConflicting data on plasma Mg levels in depression could be due to the isolation of brain Mg compartments from blood Mg compartments. As in a previous study, the association between high Mg levels and psychomotor retardation found in this larger sample strengthens the notion that high Mg levels play a part in the hypoactivity so often observed in depressed patients. Also, low Mg values in patients with poor treatment outcome suggest Mg could have a therapeutic potential in “difficult-to-treat” patients.

Relationship among psychopathological dimensions, coping mechanisms, and glycemic control in a Croatian sample of adolescents with diabetes mellitus type 1

Psychopathological factors associated with metabolic control in juvenile insulin-dependent diabetes mellitus (IDDM) deserve further investigation. This study assessed the relationship among specific psychopathological dimensions, coping mechanisms, and metabolic control in a Croatian clinical sample of adolescents with IDDM. One-hundred and one adolescents (aged 11-18) with IDDM filled out the youth self report (YSR) assessing psychopathological dimension and the scale of coping with stress (SCS). Glycemic control was estimated by the percentage of glycated hemoglobin (HbA1c). Subjects were divided into three groups according to HbA1C values: "optimal", "suboptimal control", and "at high risk". Subjects in optimal glycemic control presented with significantly lower scores in most of YSR scales compared to subjects at high risk. Moreover, they had significantly lower scores in avoidance and emotional reactivity and significantly higher scores in cognitive restructuring and problem solving SCS subscales. Regression models revealed that both internalizing and externalizing YSR scores, as well as emotional reactivity coping scores, independently contributed to explain variability of HbA1C values. Both internalizing and externalizing psychopathological dimensions, as well as emotion-oriented coping strategies, are independently associated with poor metabolic control in both boys and girls with IDDM, thus representing potential interest targets of psychotherapeutic interventions aimed at improving glycemic control in this population.

Insight, Global Functioning and Psychopathology Amongst In-patient Clients with Schizophrenia

To explore whether cognitive impairment and global functioning can predict the degree of insight into illness as well as whether insight is mediated by specific symptom dimensions of psychopathology in schizophrenia. A dimensional/cross sectional approach was used. A mixed group of clients (n = 36) were assessed as part of a routine clinical evaluation. The Wechsler Adult Intelligence Scale (WAIS) was used as a measure of intellectual performance, the Brief Symptom Inventory (BSI) was used as a measure of general psychopathology while the Global Assessment of Functioning (GAF) scale assessed clients' psychosocial functioning; insight was assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ). The correlation matrix of all outcome variables was examined; confounding effects of illness duration were tested by partial correlation analyses. GAF correlated with insight (rho = 0.41, P = 0.01) and the interpersonal sensitivity dimension of BSI (rho = -0.38, P = 0.03. Insight correlated positively with the anxiety (rho = 0.38, P = 0.03) and psychoticism (rho = 0.36, P = 0.04) dimensions of BSI. Our results suggest that insight is part of the phenomenology in schizophrenia, not being determined by neurocognitive disturbances. Improved insight was associated with more frequent psychotic symptoms endorsement, higher levels of anxiety and less severe psychopathological symptoms and difficulties in psychosocial functioning; clients with more pronounced difficulties in their personal and social interactions exhibited worse psychosocial functioning and more severe psychopathological symptoms.

The effect of change in clinical state on eye movement dysfunction in schizophrenia

Measures of eye movement dysfunction have been considered as candidate endophenotypes for the study of genetic liability in schizophrenia. In this respect it is crucial to confirm a clinical state independentce of these measures. Twenty people with DSM-IV schizophrenia were assessed using a battery of oculomotor tasks in the acute phase of their disorder without being treated with antipsychotic medication and then again in the remission phase under treatment with antipsychotic medication. The saccade latency in the saccade task, the error rate and antisaccade latency in the antisaccade task, and the frequency of unwanted saccades in the active fixation task were stable in time both at the group level and within each individual, showing no relation to the significant improvement in different psychopathological dimensions of these patients. The root mean square error, gain and saccade frequency in the pursuit task were not stable over time, although again this instability was not related to the changes in psychopathological status of these patients. Finally, the saccade frequency in the active fixation task with distracters was not stable in time and was correlated with changes in specific dimensions of psychopathology. These results provide further evidence that saccade and smooth eye pursuit dysfunction measures are not affected by the substantial change in the clinical state of schizophrenia from the acute phase to remission, and strengthen the current view that they can be used as endophenotypes. On the other hand, active fixation might be state-dependent adding to the evidence against its use as a candidate endophenotype in schizophrenia.

Removing Obstacles in Neuroscience Drug Discovery: The Future Path for Animal Models

Despite great advances in basic neuroscience knowledge, the improved understanding of brain functioning has not yet led to the introduction of truly novel pharmacological approaches to the treatment of central nervous system (CNS) disorders. This situation has been partly attributed to the difficulty of predicting efficacy in patients based on results from preclinical studies. To address these issues, this review critically discusses the traditional role of animal models in drug discovery, the difficulties encountered, and the reasons why this approach has led to suboptimal utilization of the information animal models provide. The discussion focuses on how animal models can contribute most effectively to translational medicine and drug discovery and the changes needed to increase the probability of achieving clinical benefit. Emphasis is placed on the need to improve the flow of information from the clinical/human domain to the preclinical domain and the benefits of using truly translational measures in both preclinical and clinical testing. Few would dispute the need to move away from the concept of modeling CNS diseases in their entirety using animals. However, the current emphasis on specific dimensions of psychopathology that can be objectively assessed in both clinical populations and animal models has not yet provided concrete examples of successful preclinical-clinical translation in CNS drug discovery. The purpose of this review is to strongly encourage ever more intensive clinical and preclinical interactions to ensure that basic science knowledge gained from improved animal models with good predictive and construct validity readily becomes available to the pharmaceutical industry and clinical researchers to benefit patients as quickly as possible.

Plasma magnesium level and psychomotor retardation in major depressed patients.

Numerous studies have been performed on magnesium (Mg) metabolism in patients with mood disorders but consistent results have not been obtained. To date, systematic clinical data about Mg levels in major depressed patients according to the psychopathological profile are not available. In the present study we have investigated the relationship between plasma Mg level severity of symptoms and specific psychopathological dimensions (anhedonia and retardation) in 53 mild-to-moderately depressed patients (M/F = 21/32; mean age 46.49 +/- 13.48). The psychopathological status was assessed using standard psychometric evaluation scales: HAM-D for severity of depression, HAM-A for severity of anxiety symptoms, DRRS for psychomotor retardation and SHAPS for anhedonia. We did not find any significant correlation between total plasma Mg levels (0.86 +/- 0.09 mmol/L), severity of depression (HAM-D = 17.13 +/- 6.76) and anxiety (HAM-A = 16.62 +/- 6.60). A statistically significant correlation between Mg levels and psychomotor retardation was observed. Patients with higher psychomotor retardation scores (DRRS = 20.41 +/- 7.72) showed higher plasma Mg levels (0.89 +/- 0.07 mmol/L), even though they remained in the normal range, in comparison to patients with lower retardation scores (DRRS = 7.29 +/- 3.80; Mg = 0.82 +/- 0.10 mmol/L). A relationship between catecholamines and Mg metabolism has been described and our results support the hypothesis that hypermagnesaemia might lead to hypoactivity and psychomotor retardation which is so often observed in depressed patients.

Psychopathology and Clinical Features in an Italian Sample of Patients with Myofascial and Temporomandibular Joint Pain: Preliminary Data

Aim of this study was to provide data on the relationships between psychopathological variables and temporomandibular disorders (TMD). Sixty-three TMD patients were investigated using clinical and anamnestical psychiatric informations and psychopathological measures. Three groups of TMD patients were recruited according to the Research Diagnostic Criteria for TMD guidelines: a group of patients presenting myofascial pain alone (RDC/TMD axis I group I), a group with temporomandibular joint (TMJ) pain alone (RDC/TMD axis I group IIIa, IIIb), and a group presenting both myofascial and TMJ pain. Two secondary groups were identified on the basis of the presence/absence of myofascial pain. The study design provided a psychiatric interview and psychometric assessment including the Symptom Check List-90-Revised (SCL-90-R), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS). --Psychiatric evaluation: Myofascial pain patients had higher scores for personal psychiatric history and a history of more frequent psychotropic drug use. --HDRS and HARS: The sample presented scores indicating mild depressive symptoms and moderate anxiety symptoms. --SCL-90-R: The global sample showed acute levels of psychological distress as measured by the GSI score (Global Severity Index). Myofascial pain patients scored higher than TMJ pain patients in the GSI (p = .028), PAR (paranoia; p = .015), PSY (psychoticism; p = .032), and HOS (hostility; p = .034) subscales. TMD patients showed elevated levels of depression, somatization, and anxiety. These characteristics did not differ significantly between patients with myofascial or TMJ pain. Other specific psychopathological dimensions, detected with SCL-90-R, appeared to be closely associated to the myofascial component.

Comorbidity and psychiatric diagnoses among women reporting child sexual abuse

Childhood sexual abuse (CSA) increases risk for most psychiatric disorders. There is evidence that the structure of psychopathology can be explained by a number of latent dimensions of psychopathology including a ‘General Psychopathology’ (P) factor. The objective of the current study was to provide the first assessment as to whether P is identifiable, and what its correlates might be in a clinical sample.An adult, clinical sample of Danish CSA survivors (N = 420) was assessed using the Millon Clinical Multiaxial Inventory-III. Confirmatory factory analysis (CFA) was used to assess the latent structure of nine psychiatric disorders, and structural equation modelling (SEM) was used to determine correlates of the best-fitting dimensional model.CFA results favoured a bifactor model including three specific dimensions of psychopathology, “Internalizing”, “Externalizing”, and “Thought Disorder”, and a bi-factor “P”. A SEM model that included ten predictors was a good fit to the data and explained 55% of variance in ‘P’. The ‘P’ factor was significantly associated with emotional coping, negative self-worth, traumatic life events, and anxious attachments.Psychiatric disorders were assessed using self-report measures, and the sample was predominately female.Results provide initial evidence of P in a clinical sample and several unique correlates of this factor were identified.

Symptom dimensions of the SCL-90-R: a test of the tripartite model of anxiety and depression.

To determine the extent to which the SCL-90-R assesses general distress or specific dimensions of psychopathology, two principal components analyses were conducted based on 900 outpatients diagnosed with mixed psychiatric disorders. The first component explained 30.5% of the total variance and was interpreted as reflecting overall symptom distress. Partialling the first component out of the correlations among the symptoms in a second principal components analysis, we found four specific residual components reflecting somatic anxiety, depression, irritability, and attention problems. The results were discussed as partially supporting Clark and Watson's (1991) tripartite model of anxiety and depression.