Locating eating pathology within an empirical diagnostic taxonomy: Evidence from a community-based sample.

Existing structural models of psychopathology need to be expanded to include additional diagnostic constructs beyond mood, anxiety, substance use, and antisocial behavior disorders. The goal of this study was to locate eating disorders within a hierarchical structural model of psychopathology that is anchored by broad Internalizing and Externalizing factors. Participants were female adolescent twins (N = 1,434) from the Minnesota Twin Family Study. The authors compared the fit of 4 models in which eating disorders (a) defined their own diagnostic class, (b) represented a subclass within Internalizing, (c) formed a subclass within Externalizing, and (d) were allowed to cross-load on both Internalizing and Externalizing. In the best fitting model, eating disorders formed a subfactor within Internalizing. These findings underscore the value of developing more comprehensive empirically based models of psychopathology to increase researchers' understanding of diverse mental disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Psychopathy Checklist: Youth Version and adolescent and adult recidivism: Considerations with respect to gender, ethnicity, and age.

The present study investigated the predictive accuracy of the Psychopathy Checklist: Youth Version (PCL: YV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003) for youth and adult recidivism, with respect to gender, ethnicity, and age, in a sample of 161 Canadian young offenders who received psychological services from an outpatient mental health facility. The PCL: YV significantly predicted any general, nonviolent, and violent recidivism in the aggregate sample over a 7-year follow-up; however, when results were disaggregated by youth and adult outcomes, the PCL: YV consistently appeared to be a stronger predictor of youth recidivism. The PCL: YV predicted youth recidivism for subsamples of female and Aboriginal youths, and very few differences in the predictive accuracy of the tool were observed for younger vs. older adolescent groups. Both the 13-item (i.e., D. J. Cooke & C. Michie, 2001, 3-factor) and the 20-item (i.e., R. D. Hare, 2003, 4-factor) models appeared to predict various recidivism criteria comparably across the aggregate sample and within specific demographic subgroups (e.g., female and Aboriginal youth). The Antisocial facet contributed the most variance in the prediction of adult outcomes, whereas the 3-factor model contributed significant incremental variance in the prediction of youth recidivism outcomes. Potential implications concerning the use of the PCL: YV in clinical and forensic assessment contexts are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hierarchical confirmatory factor analysis of the Child Behavior Checklist/4–18.

Hierarchical confirmatory factor analysis was used to evaluate the 2-factor 2nd-order structure of T. M. Achenbach's ( 1991 ) Child Behavior Checklist in a sample of 577 children who had been identified as having serious emotional disturbance. An alternative 1-factor 2nd-order model also was tested. Results supported T. M. Achenbach's model in which the broadband Internalizing factor was represented by the narrowband Withdrawn, Somatic, and Anxious/Depressed syndromes, and the broadband Externalizing factor was represented by the narrowband Delinquent and Aggressive syndromes. Consistent with T. M. Achenbach's model, the remaining narrowband syndromes (i.e., Social, Thought, Attention ) loaded equally on both broadband factors and should not be included in scoring either Internalizing or Externalizing. Fit of the 1-factor model also was good and only slightly poorer than the 2-factor model. Therefore, an overall score would be appropriate as a measure of global problem behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective differential prediction of adolescent alcohol use and problem use: Examining the mechanisms of effect.

This prospective study tested the assertion that psychopathology would predict both adolescent alcohol use and problem use, whereas socialization factors would predict only use, and explored mechanisms by which predictors led to problem use in a community sample of families (N?=?216). Externalizing symptoms, parental alcoholism, peer influences, and parental support were indirectly related to negative consequences through their effects on use level. Externalizing symptoms, internalizing symptoms, peer influences, and parental approval of use directly predicted consequences, controlling for the indirect effects through use level. Internalizing pathology potentiated the relation between consumption and consequences, whereas parental support and control mitigated this relation. Collectively, findings provided mixed support for the assertion that psychopathology would predict both use and problem use, whereas socialization factors would predict only use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The structure of personality disorders in individuals with posttraumatic stress disorder.

Research on the structure of personality disorders (PDs) has relied primarily on exploratory analyses to evaluate trait-based models of the factors underlying the covariation of these disorders. This study used confirmatory factor analysis to evaluate whether a model that included both PD traits and a general personality dysfunction factor would account for the comorbidity of the PDs better than a trait-only model. It also examined if the internalizing/externalizing model of psychopathology, developed previously through research on the structure of Axis I disorders, might similarly account for the covariation of the Axis II disorders in a sample of 245 veterans and nonveterans with posttraumatic stress disorder. Results indicated that the best fitting model was a modified bifactor structure composed of nine lower-order common factors. These factors indexed pathology ranging from aggression to dependency, with the correlations among them accounted for by higher-order Internalizing and Externalizing factors. Further, a general factor, reflecting a construct that we termed boundary disturbance, accounted for additional variance and covariance across nearly all the indicators. The Internalizing, Externalizing, and Boundary Disturbance factors evidenced differential associations with trauma-related covariates. These findings suggest continuity in the underlying structure of psychopathology across DSM–IV Axes I and II and provide empirical evidence of a pervasive, core disturbance in the boundary between self and other across the PDs. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Factor analysis of the Children's Depression Inventory in a community sample.

The factor structure of the Children's Depression Inventory (CDI; M. Kovacs, 1992) was evaluated in a large community sample of 1,777 children and 924 adolescents. There were 5 first-order factors (Externalizing, Dysphoria, Self-Deprecation, School Problems, and Social Problems) for the child group; the adolescent group yielded the same 5 factors plus a 6th factor (Biological Dysregulation). Confirmatory factor analyses supported the stability and replicability of the obtained factor structures. Both samples yielded 2 higher order factors—Internalizing and Externalizing. The factors were compared with previous CDI factors identified for clinical (B. Weiss et al., 1991) and community (M. Kovacs, 1992) samples. Other notable findings included more boys reporting high scores (17 and above) on the CDI among the child sample, whereas, among adolescents more girls reported high scores (17 and above) on the total CDI as well as higher scores on the biological dysregulation factor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal and adolescent ratings of psychopathology in young offender and non-clinical males.

Compared maternal and youth ratings of the youths' adjustment using the Child Behavior Checklist and Youth Self-Report with 50 young offenders and 51 non-clinical males (aged 12–16 yrs). While delinquent youths were in the clinical range only on the delinquent behavior subscale, maternal ratings were in the clinical range on most subscales. By contrast, maternal and youth reports in controls showed comparable ratings on Internalizing scales, with normal adolescents endorsing significantly more Externalizing behavior problems than their mothers. Maternal and youth ratings in the controls were in the normal range on all scales. Possible causes of these differences between young offenders' and their mothers' reporting of symptoms are discussed, and implications of these findings for forensic assessment of adolescents are presented. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Platelet MAO-B, personality, and psychopathology.

The article investigates the relationships between platelet monoamine oxidase-B (MAO-B) activity, personality, and psychopathology (Diagnostic and Statistical Manual of Mental Disorders [4th ed.; American Psychiatric Association, 1994] diagnoses. These relationships were assessed in 178 incarcerated male juvenile delinquents. Even after controlling for smoking, the authors found that both Internalizing and Externalizing Psychopathology were negatively related to MAO-B activity. In the final reduced model, novelty seeking fully mediated the relationships between MAO-B and Externalizing Psychopathology but not between MAO-B and Internalizing Psychopathology. It was hypothesized that low platelet MAO-B activity does not directly predispose individuals to psychopathology but is related to specific personality traits, which in turn represent a vulnerability factor for psychopathology. Future studies should help clarify the nature of the relationships between personality, biological markers, and psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective attention to affective stimuli and clinical depression among youths: Role of anxiety and specificity of emotion.

Cognitive models of psychopathology posit that the content or focus of information-processing biases (e.g., attentional biases) is disorder specific: Depression is hypothesized to be characterized by attentional biases specifically for depression-relevant stimuli (e.g., sad facial expressions), whereas anxiety should relate particularly to attentional biases to threat-relevant stimuli (e.g., angry faces). However, little research has investigated this specificity hypothesis and none with a sample of youths. The present study examined attentional biases to emotional faces (sad, angry, and happy compared with neutral) in groups of pure depressed, pure anxious, comorbid depressed and anxious, and control youths (ages 9–17 years; N = 161). Consistent with cognitive models, pure depressed and pure anxious youths exhibited attentional biases specifically to sad and angry faces, respectively, whereas comorbid youths exhibited attentional biases to both facial expressions. In addition, control youths exhibited attentional avoidance of sad faces, and comorbid boys avoided happy faces. Overall, findings suggest that cognitive biases and processing of particular emotional information are specific to pure clinical depression and anxiety, and results inform etiological models of potentially specific processes that are associated with internalizing disorders among youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress disorder and the genetic structure of comorbidity.

This study used structural equation modeling to examine the genetic and environmental architecture of latent dimensions of internalizing and externalizing psychiatric comorbidity and explored structural associations between posttraumatic stress disorder (PTSD) and these dimensions. Data were drawn from the Vietnam Era Twin Registry and included lifetime diagnoses for PTSD and a range of other psychiatric disorders for 3,372 male–male twin pairs. Examination of the phenotypic structure of these disorders revealed that PTSD cross-loaded on both Internalizing and Externalizing common factors. Biometric analyses suggested largely distinct genetic risk factors for the latent internalizing and externalizing comorbidity dimensions, with the total heritability of the Externalizing factor (69%) estimated to be significantly stronger than that for Internalizing (41%). Nonshared environment explained the majority of the remaining variance in the Internalizing (58%) and Externalizing (20%) factors. Shared genetic variance across the 2 dimensions explained 67% of their phenotypic correlation (r = .52). These findings have implications for conceptualizations of the etiology of PTSD and its location in an empirically based nosology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure of the Child Behavior Checklist/6-18 in a sample of girls adopted from China.

Confirmatory factor analysis with robust weighted least squares estimation of the 103 dichotomously scored items of the Child Behavior Checklist/6-18 (T. M. Achenbach & L. A. Rescorla, 2001) in a sample of 516 girls adopted from China (ages 6.0-15.7 years; M = 8.2, SD = 1.9) indicated that the fit of the 8-factor model was good (root-mean-square error of approximation = .047) and was slightly better than what T. M. Achenbach and L. A. Rescorla (2001) reported for the same model (.06). Support for the 2nd-order factor structure of Internalizing and Externalizing Problems also was provided. Comparisons of the mean scores for the syndromes and Internalizing, Externalizing, and Total Problems revealed mostly small differences between the sample of adopted Chinese girls and T. M. Achenbach and L. A. Rescorla's normative samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond neighborhood poverty: Family management, neighborhood disorder, and adolescents’ early sexual onset.

The authors examined how neighborhood disorder modifies associations between family management practices and youth transitions to sex among low-income African American and Latino urban families. The sample included 846 young adolescents and their mothers who participated in Welfare, Children and Families: A Three-City Study. Results from multilevel logistic regression models indicated no main effects of family management practices or neighborhood-level conditions on transitions to sex once accounting for demographics. However, higher levels of family routines and parental knowledge (i.e., awareness of youths’ friends, whereabouts, and activities) were more strongly associated with a lower probability of youth sexual onset as neighborhood disorder increased. Results provide further evidence for the contextually specific nature of parenting impacts on adolescent adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and Comorbidity in a Young Offender Sample: Taking A Closer Look At Psychopathy's Potential Importance Over Disruptive Behavior Disorders.

The authors examined the construct of psychopathy as applied to 130 adolescent offenders using 3 psychopathy measures and a broad range of DSM-TV Axis I diagnoses and psychosocial problems. Measures used in the study included the following: (a) Psychopathy Checklist-Youth Version (PCL- PCLYV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003), (b) Antisocial Process Screening Device (APSD; YV; P. J. Frick & R. D. Hare, 2002), (c) a modified version of the Self-Report Psychopathy-II scale (SRP-II; R. D. Hare, 1991b), and (d) the Adolescent Psychopathology Scale (APS; W. M. Reynolds, 1998). Results from this study offer incremental support for the construct validity of psychopathy in youth. Psychopathy evidenced better convergent and discriminant validity results than did the disruptive behavior disorders (DBDs) such as oppositional-defiant disorder (ODD) and conduct disorder (CD). Despite this finding, psychopathy scales nonetheless correlated with other forms of psychopathology at a higher rate than was expected, suggesting that comorbidity is high even when psychopathy is used as a classification scheme. Also, hierarchical multiple regression was used to determine whether psychopathy offered an improvement in the prediction of previous violent and nonviolent offenses. The results for the current study were mixed, with only the PCL-YV significantly predicting previous violent and nonviolent offenses beyond the DBDs. The findings indicate that psychopathy may offer incremental improvement over DBDs with regard to level of comorbidity and perhaps even prediction. However, simply extending the adult construct of psychopathy to youth without considering the array of psychopathology that may accompany adolescent psychopathy could be misleading. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital conflict and support seeking by parents in adolescence: Empirical support for the parentification construct.

Parentification, a parent-child dynamic wherein children come to provide ongoing emotional support for their parents, has been documented extensively in the clinical literature; however, it rarely has been studied systematically. Using a community sample of 83 couples and their adolescent children (mean age = 15.26 years; 52% male, 48% female), the authors linked adolescent self-report of parentification to specific youth and adult behaviors using multiple methods and examined its associations with youth adjustment problems. The parentification measure demonstrated strong internal consistency and 1-year stability. Parentification was associated with marital conflict, youth perceptions of threat, low warmth in the parent-child relationship, and the tendency for youths to intervene in marital conflict. Links were also found with youth reports of internalizing and externalizing behavior and poorer competency in close friendships. These findings thus support the parentification construct and provide evidence that parentification may contribute to poor youth outcomes by burdening children with developmentally inappropriate responsibilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depression, paternal psychopathology, and adolescent diagnostic outcomes.

The authors examined the relationship between maternal depression, paternal psychopathology, and adolescent diagnostic outcomes in a community sample of 522 Australian families. They also examined whether chronic family stress, father's expressed emotion, and parents' marital satisfaction mediated the relationship between parental psychopathology and adolescent outcomes. Mother's education, child's gender, and family income were covaried in all analyses. Results revealed that maternal depression and paternal depression had an additive effect on youth externalizing disorders. In addition, maternal depression interacted with both paternal depression and paternal substance abuse in predicting youth depression but not youth nondepressive disorders. Chronic family stress and father's expressed emotion appeared to mediate the relationship between parental psychopathology and youth depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure of the Hare Psychopathy Checklist: Youth version in German female and male detainees and community adolescents.

Substantial evidence exists for 3- and 4-factor models of psychopathy underlying patterns of covariation among the items of the Psychopathy Checklist—Revised (PCL–R) in diverse adult samples. Although initial studies conducted with the Psychopathy Checklist: Youth Version (PCL:YV) indicated reasonable fit for these models in incarcerated male adolescents in the United States and the United Kingdom, only one published study has addressed the factor structure of PCL:YV psychopathy in female adolescents, and no prior studies have addressed it outside of these countries. We used confirmatory factor analysis to investigate the factor structure underlying PCL:YV scores in 314 incarcerated (143 male, 171 female) and 193 in-school (99 male, 94 female) adolescents, ages 14 to 19 years. The 2-factor model provided adequate fit only for incarcerated male adolescents and the 4-factor model was problematic in all samples, but the 3-factor solution provided an adequate model in incarcerated and community male adolescents. None of the models provided consistently acceptable fit among female adolescents. Current findings provide evidence for the robustness of the 3-factor model of psychopathy in incarcerated and community male adolescent samples but raise doubts about the applicability of this model to female adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental evaluation of a modular approach to mobilizing antitobacco influences of peers and parents

The experimental evaluation of two components of a community intervention to prevent adolescent tobacco use are described. Youth antitobacco activities (e.g., peer quizzes, sidewalk art, poster and T-shirt giveaways, etc.) and family communications activities (pamphlets to parents and student quizzes of parents) were evaluated in two time-series experiments, each of which was conducted in two experimental and one control community. Students in Grades 6 and 8 and their parents were assessed in a series of four phone surveys in the first experiment and six phone surveys in the second. Implementation of the youth antitobacco and family communications activities led to significantly greater exposure of young people to antitobacco information. They led to increases in parent and youth knowledge about tobacco use and more negative attitudes toward tobacco. In Experiment 2, youths in intervention communities had significantly lower rated intentions to smoke. The findings suggest the value of a modular approach to community interventions for influencing the social context relevant to the onset of adolescent tobacco use.     

Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity.

A literature review on community studies of adolescent substance use, abuse, or dependence (SU/A/D) and psychiatric comorbidity yielded 22 articles from 15 studies with information on rates, specificity, timing, and differential patterns of comorbidity by gender, race/ethnicity, and other factors. Results revealed that 60% of youths with SU/A/D had a comorbid diagnosis, and conduct disorder (CD) and oppositional defiant disorder (not attention-deficit/hyperactivity disorder) were most commonly associated with SU/A/D, followed by depression. Child psychopathology (particularly CD) was associated with early onset of substance use and abuse in later adolescence. The authors suggest that available data relevant to SU/A/D and psychiatric comorbidity can be used to better address such questions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The structure of maladaptive personality traits in childhood: A step toward an integrative developmental perspective for DSM-V.

The present study describes the construction of a taxonomy of trait-related symptoms in childhood, the Dimensional Personality Symptom Item Pool (DIPSI), and examines the replicability of the taxonomy's higher order structure across maternal ratings of referred (N = 205) and nonreferred (N = 242) children and self-ratings of adolescents (N = 453). The DIPSI's 4 higher order factors--that is, Emotional Instability, Disagreeableness, Introversion, and Compulsivity--showed clear correspondence with the dimensions of personality pathology found in adulthood (Dimensional Assessment of Personality Pathology-Basic Questionnaire; W. J. Livesley, 1990; Schedule for Nonadaptive and Adaptive Personality; L. A. Clark, 1993). These 4 factors can be further organized into 2 superfactors, representing Internalizing and Externalizing Traits, demonstrating empirical and conceptual relationships with psychopathology models in childhood and adulthood. The implications for the assessment and conceptualization of early trait pathology are discussed in the context of an integrative developmental perspective on the construction of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent and child discrepancies in reporting severity of problem behaviors in three out-of-home settings.

This study compared scores on the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) for samples of youths in 3 out-of-home placements with varying levels of restrictiveness. Mean CBCL T scores were more than a standard deviation higher than mean YSR T scores on the broadband scales and about 2/3 of a standard deviation higher on the syndrome scales. The magnitude of the discrepancy varied between placements for several scales, with the least restrictive placements having the largest difference between CBCL and YSR ratings for the Externalizing scale. For the Internalizing scale, the discrepancy was larger for older youths (ages 15–18) than for younger youths (ages 11–14). These results support previous findings that in clinical samples, adults rate children's behavioral and emotional problems as more severe than do children themselves. This study extends prior research by demonstrating the occurrence of this discrepancy across a continuum of care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)