A Developmentally Informed Systematic Review and Meta-Analysis of the Strength of General Psychopathology in Childhood and Adolescence

Considerable support exists for higher-order dimensional conceptualizations of psychopathology in adults. A growing body of work has focused on understanding the structure of general and specific psychopathology in children and adolescents. No prior meta-analysis has examined whether the strength of the general psychopathology factor (p factor)-measured by explained common variance (ECV)-changes from childhood to adolescence. The primary objective of this multilevel meta-analysis was to determine whether general psychopathology strength changes across development (i.e. across ages) in childhood and adolescence. Several databases were searched in November 2021; 65 studies, with 110 effect sizes (ECV), nested within shared data sources, were identified. Included empirical studies used a factor analytic modeling approach that estimated latent factors for child/adolescent internalizing, externalizing, and optionally thought-disordered psychopathology, and a general factor. Studies spanned ages 2-17 years. Across ages, general psychopathology explained over half (~ 56%) of the reliable variance in symptoms of psychopathology. Age-moderation analyses revealed that general factor strength remained stable across ages, suggesting that general psychopathology strength does not significantly change across childhood to adolescence. Even if the structure of psychopathology changes with development, the prominence of general psychopathology across development has important implications for future research and intervention.

Associations Between Maladaptive Personality Traits and General Psychopathology in Female and Male Adolescents

Adolescence is a period of rapid physical, psychological, and neural maturation that makes youth vulnerable to emerging psychopathology, highlighting the need for improved identification of psychopathology risk indicators. Recently, a higher-order latent psychopathology factor (p-factor) was identified that explains latent liability for psychopathology beyond internalizing and externalizing difficulties. However, recent proposals suggest reconceptualizing the p-factor model in terms of impairments in personality encompassing difficulties in both self-regulation (borderline features) and self-esteem (narcissistic features), but this remains untested. To address this, this study examined the p-factor structure and the contribution of borderline and narcissistic features using two cross-sectional data collections. In Study 1, 974 cisgender adolescents (63% assigned females at birth; age range: 13-19; Mage = 16.68, SD = 1.40) reported on internalizing and externalizing problems (YSR) to test via structural equation models (SEM) different theoretical models for adolescent psychopathology. In Study 2, 725 cisgender adolescents (64.5% assigned females at birth; age range: 13-19; Mage = 16.22, SD = 1.32) reported internalizing and externalizing problems (YSR), borderline personality features (BPFSC-11), and narcissistic personality traits (PNI), to explore, via SEM, the contribution of borderline and narcissistic traits to the p-factor and accounting for gender differences. Results confirmed the utility of a bi-factor model in adolescence. Furthermore, findings highlighted the contribution of borderline features and narcissistic vulnerability to general psychopathology. The study provides the first evidence supporting a p-factor model reconceptualized in terms of personality impairments encompassing difficulties in self-regulation and self-esteem in adolescents.

Examining the association between deficits in self-concept clarity and eating disorder severity

OBJECTIVE

We sought to (1) compare self-concept clarity (SCC; the degree to which a person possesses a confidently defined, internally consistent, and stable sense of self) between female participants with and without eating disorders, (2) examine associations between SCC deficits and severity of eating disorder specific and related psychopathology in individuals with eating disorders, and (3) determine if there is a unique association between SCC deficits and eating disorder severity, controlling for related psychopathology.

METHOD

Participants (M age = 23.16 years) with eating disorders (n = 121) and controls (n = 63) completed semi-structured clinical interviews and self-report assessments.

RESULTS

SCC deficits were significantly greater in the eating disorder compared to the control group. In the eating disorder group, greater SCC deficits were significantly associated with greater severity of eating pathology, depression, impulsivity, and trait anxiety. In a hierarchical regression analysis, significant associations between SCC deficits and Eating Disorder Examination (EDE) Global scores were better accounted for by shared variance with anxiety.

DISCUSSION

SCC deficits may reflect a transdiagnostic feature related to the severity of a range of mental health problems, suggesting potential benefit of transdiagnostic interventions.

Transdiagnostic biomarkers of mental illness across the lifespan: A systematic review examining the genetic and neural correlates of latent transdiagnostic dimensions of psychopathology in the general population

This systematic review synthesizes evidence from research investigating the biological correlates of latent transdiagnostic dimensions of psychopathology (e.g., the p-factor, internalizing, externalizing) across the lifespan. Eligibility criteria captured genomic and neuroimaging studies investigating general and/or specific dimensions in general population samples across all age groups. MEDLINE, Embase, and PsycINFO were searched for relevant studies published up to March 2023 and 46 studies were selected for inclusion. The results revealed several biological correlates consistently associated with transdiagnostic dimensions of psychopathology, including polygenic scores for ADHD and neuroticism, global surface area and global gray matter volume. Shared and unique associations between symptom dimensions are highlighted, as are potential age-specific differences in biological associations. Findings are interpreted with reference to key methodological differences across studies. The included studies provide compelling evidence that the general dimension of psychopathology reflects common underlying genetic and neurobiological vulnerabilities that are shared across diverse manifestations of mental illness. Substantive interpretations of general psychopathology in the context of genetic and neurobiological evidence are discussed.

The P3 ERP in Relation to General Versus Specific Psychopathology in Early Childhood

There is considerable covariation between externalizing and internalizing problems across the lifespan. Partitioning general and specific psychopathology is crucial to identify (a) processes that confer specific risk for externalizing versus internalizing problems and (b) transdiagnostic processes that confer risk for the covariation between externalizing and internalizing problems. The oddball P3 event-related potential (ERP) component, thought to reflect attentional orienting, has been widely examined in relation to psychopathology. However, prior studies have not examined the P3-or other aspects of neural functioning-in relation to general versus specific psychopathology in children. The present study examined whether children's (N = 124, ages 3-7 years) P3 amplitudes were associated with general versus specific psychopathology. Children's electroencephalography data were recorded during an oddball task. Parents rated their children's externalizing and internalizing problems. Using bifactor models to partition variance in parents' ratings of children's psychopathology symptoms, we examined children's P3 amplitudes in relation to three latent factors: (1) the general factor of psychopathology-the covariation of externalizing and internalizing psychopathology, (2) unique externalizing problems-the variance in externalizing problems after controlling for the general factor, and (3) unique internalizing problems. Results indicated that smaller P3 amplitudes were associated with unique externalizing problems at ages 3-5, and with general psychopathology at ages 6-7. Findings suggest that smaller P3 amplitudes may be associated with externalizing problems from a very young age. Moreover, there may be a developmental shift in the functional significance of the P3 in relation to general and specific psychopathology in childhood.

The 3-year effects of a personality-targeted prevention program on general and specific dimensions of psychopathology

This study aimed to examine the effect of a personality-targeted prevention program (Preventure) on trajectories of general and specific dimensions of psychopathology from early- to mid-adolescence. Australian adolescents (N = 2190) from 26 schools participated in a cluster randomized controlled substance use prevention trial. This study compared schools allocated to deliver Preventure (n = 13 schools; n = 466 students; Mage = 13.42 years), a personality-targeted selective intervention, with a control group (n = 7 schools; n = 235 students, Mage = 13.47 years). All participants were assessed for psychopathology symptoms at baseline, 6-, 12-, 24- and 36-months post-baseline. Outcomes were a general psychopathology factor and four specific factors: fear, distress, alcohol use/harms and conduct/inattention), extracted from a higher-order model. Participants who screened as 'high-risk' on at least one of four personality traits (negative thinking, anxiety sensitivity, impulsivity and sensation seeking) were included in intention-to-treat analyses. Intervention effects were examined using multi-level mixed models accounting for school-level clustering. Among high-risk adolescents, growth in general psychopathology was slower in the Preventure group compared to the control group (b = -0.07, p = 0.038) across the three years. After controlling for effects on general psychopathology, there were no significant, additional effects on the lower order factors. This study provides evidence for the effectiveness of a selective personality-targeted intervention in altering trajectories of general psychopathology during adolescence. This finding represents impacts on multiple symptom domains and highlights the potential for general psychopathology as an intervention target.

Processing Speed is Related to the General Psychopathology Factor in Youth

The relationship between the p factor and cognition in youth has largely focused on general cognition (IQ) and executive functions (EF). Another cognitive construct, processing speed (PS), is dissociable from IQ and EF, but has received less research attention despite being related to many different mental health symptoms. The present sample included 795 youth, ages 11-16 from the Colorado Learning Disabilities Research Center (CLDRC) sample. Confirmatory factor analyses tested multiple p factor models, with the primary model being a second-order, multi-reporter p factor. We then tested the correlation between the p factor and a latent PS factor. There was a significant, negative correlation between the p factor and PS (r(87) = -0.42, p < .001), indicating that slower processing speed is associated with higher general mental health symptoms. This association is stronger than previously reported associations with IQ or EF. This finding was robust across models that used different raters (youth and caregiver) and modeling approaches (second-order vs. bifactor). Our findings indicate that PS is related to general psychopathology symptoms. This research points to processing speed as an important transdiagnostic construct that warrants further exploration across development.

A meta-analytic review of transcranial direct current stimulation (tDCS) on general psychopathology symptoms of schizophrenia; immediate improvement followed by a return to baseline

Transcranial direct current stimulation (tDCS) is a promising tool for alleviating positive and negative symptoms of schizophrenia, but its role in functional outcome remains uncertain. This meta-analysis examined the effects of tDCS on general psychopathology symptoms (GPS) from the Positive and Negative Syndrome Scale (PANSS) because GPS are closely associated with daily functioning. Literature search using Medline and PsycINFO identified 8 randomized controlled trials with tDCS and PANSS. The GPS were significantly reduced after tDCS but there was no evidence for long-term treatment effects. Further research is needed to optimize the dosing of tDCS and to understand individual differences in treatment response.

Is executive dysfunction a risk marker or consequence of psychopathology? A test of executive function as a prospective predictor and outcome of general psychopathology in the adolescent brain cognitive development study®

A general psychopathology ('p') factor captures shared variation across mental disorders. One hypothesis is that poor executive function (EF) contributes to p. Although EF is related to p concurrently, it is unclear whether EF predicts or is a consequence of p. For the first time, we examined prospective relations between EF and p in 9845 preadolescents (aged 9-12) from the Adolescent Brain Cognitive Development Study® longitudinally over two years. We identified higher-order factor models of psychopathology at baseline and one- and two-year follow-up waves. Consistent with previous research, a cross-sectional inverse relationship between EF and p emerged. Using residualized-change models, baseline EF prospectively predicted p factor scores two years later, controlling for prior p, sex, age, race/ethnicity, parental education, and family income. Baseline p factor scores also prospectively predicted change in EF two years later. Tests of specificity revealed that bi-directional prospective relations between EF and p were largely generalizable across externalizing, internalizing, neurodevelopmental, somatization, and detachment symptoms. EF consistently predicted change in externalizing and neurodevelopmental symptoms. These novel results suggest that executive dysfunction is both a risk marker and consequence of general psychopathology. EF may be a promising transdiagnostic intervention target to prevent the onset and maintenance of psychopathology.

Genome-wide DNA methylation patterns associated with general psychopathology in children

Psychiatric symptoms are interrelated and found to be largely captured by a general psychopathology factor (GPF). Although epigenetic mechanisms, such as DNA methylation (DNAm), have been linked to individual psychiatric outcomes, associations with GPF remain unclear. Using data from 440 children aged 10 years participating in the Generation R Study, we examined the associations of DNAm with both general and specific (internalizing, externalizing) factors of psychopathology. Genome-wide DNAm levels, measured in peripheral blood using the Illumina 450K array, were clustered into wider co-methylation networks ('modules') using a weighted gene co-expression network analysis. One co-methylated module associated with GPF after multiple testing correction, while none associated with the specific factors. This module comprised of 218 CpG probes, of which 198 mapped onto different genes. The CpG most strongly driving the association with GPF was annotated to FZD1, a gene that has been implicated in schizophrenia and wider neurological processes. Associations between the probes contained in the co-methylated module and GPF were supported in an independent sample of children from the Avon Longitudinal Study of Parents and Children (ALSPAC), as evidenced by significant correlations in effect sizes. These findings might contribute to improving our understanding of dynamic molecular processes underlying complex psychiatric phenotypes.

General and Eating Disorder Psychopathology in Relation to Short- and Long-Term Weight Change in Treatment-Seeking Children: A Latent Profile Analysis

BACKGROUND

Concurrent general psychopathology (GP) and eating disorder psychopathology (EDP) are commonly reported among youth with overweight/obesity and may impact weight change.

PURPOSE

We identified patterns of GP and EDP in children with overweight/obesity and examined the impact on weight change following family-based behavioral obesity treatment (FBT) and maintenance interventions.

METHODS

Children (N = 172) participated in 4 month FBT and subsequent 8 month weight maintenance interventions. GP and EDP were assessed prior to FBT (baseline). Child percentage overweight was assessed at baseline, post-FBT (4 months), and post-maintenance (12 months). Latent profile analysis identified patterns of baseline GP and EDP. Linear mixed-effects models examined if profiles predicted 4- and 12-month change in percentage overweight and if there were two-way and three-way interactions among these variables, adjusting for relevant covariates.

RESULTS

Results indicated a three-profile structure: lower GP and EDP (LOWER); subclinically elevated GP and EDP without loss of control (LOC; HIGHER); and subclinically elevated GP and EDP with LOC (HIGHER + LOC). Across profiles, children on average achieved clinically meaningful weight loss (i.e., ≥9 unit change in percentage overweight) from baseline to 4 month FBT and sustained these improvements at 12 month maintenance. There was no evidence that latent profiles were related to percentage overweight change from baseline to FBT (p > .05) or baseline to maintenance (p > .05). There was no evidence for two-way or three-way interactions (p > .05).

CONCLUSION

Concurrent GP and EDP do not portend differential short- or long-term weight change following FBT and maintenance. Future research is warranted on the durability of weight change among youth with GP and EDP.

TRIAL REGISTRATION

NCT00759746.

Regulatory focus and the p factor: Evidence for self-regulatory dysfunction as a transdiagnostic feature of general psychopathology

A general psychopathology ('p') factor captures transdiagnostic features of mental illness; however, the meaning of the p factor remains unclear. Regulatory focus theory postulates that individuals regulate goal pursuit either by maximizing gains (promotion) or minimizing losses (prevention). As maladaptive goal pursuit has been associated with multiple categorical disorders, we examined whether individual differences in promotion and prevention goal pursuit are associated with p as well as internalizing- and externalizing-specific factors using structural equation modeling of data from 1330 volunteers aged 18-22. Unsuccessful attainment of promotion and prevention goals was related to increased levels of p. Over and above relations with the p factor, unsuccessful attainment of promotion goals was associated with higher internalizing-specific psychopathology, whereas unsuccessful attainment of prevention goals was related to higher externalizing-specific psychopathology. These associations also were separable from related personality traits. After controlling for sex differences in the composition of the psychopathology factors, there were no sex differences in the relations between promotion and prevention goal pursuit and p and specific internalizing and externalizing factors. These findings suggest higher general psychopathology reflects poorer overall self-regulation of goal pursuit and that maladaptive promotion and prevention orientations also are associated with internalizing- and externalizing-specific psychopathology, respectively.

Transdiagnostic neuroimaging markers of psychiatric risk: A narrative review

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We review the literature on neural correlates of a general psychopathology factor

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General psychopathology relates to structural and functional neurodevelopment

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Disrupted network connectivity maturation may underlie psychiatric vulnerability

Several decades of neuroimaging research in psychiatry have shed light on structural and functional neural abnormalities associated with individual psychiatric disorders. However, there is increasing evidence for substantial overlap in the patterns of neural dysfunction seen across disorders, suggesting that risk for psychiatric illness may be shared across diagnostic boundaries. Gaining insights on the existence of shared neural mechanisms which may transdiagnostically underlie psychopathology is important for psychiatric research in order to tease apart the unique and common aspects of different disorders, but also clinically, so as to help identify individuals early on who may be biologically vulnerable to psychiatric disorder in general. In this narrative review, we first evaluate recent studies investigating the functional and structural neural correlates of a general psychopathology factor, which is thought to reflect the shared variance across common mental health symptoms and therefore index psychiatric vulnerability. We then link insights from this research to existing meta-analytic evidence for shared patterns of neural dysfunction across categorical psychiatric disorders. We conclude by providing an integrative account of vulnerability to mental illness, whereby delayed or disrupted maturation of large-scale networks (particularly default-mode, executive, and sensorimotor networks), and more generally between-network connectivity, results in a compromised ability to integrate and switch between internally and externally focused tasks.

A Family Socialization Model of Transdiagnostic Risk for Psychopathology in Preschool Children

This longitudinal study examined the presence of general (P) and specific internalizing (INT) and externalizing (EXT) psychopathology factors in a community sample of preschool children. We assessed child and contextual correlates of P, INT, and EXT, and tested a model connecting socioeconomic risk to these factors through family socialization processes and child cognitive abilities. Participants were 501 children recruited at birth and followed up at 18 months and 3 years. Child and family functioning were measured using parental reports, observation, and standardized assessments. Both mothers and their partners reported on children's mental health, permitting the estimation of a trifactor model of psychopathology that captured caregivers' shared and unique perspectives with respect to P, INT, and EXT. Results revealed several transdiagnostic correlates of the common-perspective P factor, including family income, maternal education, maternal depression, and maternal responsiveness, as well as marginal associations with sibling negativity and children's language and theory of mind abilities. Several shared and unique correlates of INT and EXT were also observed. Structural equation modelling revealed that the effects of family income and maternal education on P operated indirectly through maternal responsiveness, while the effects of maternal education on INT and EXT operated through maternal reflective capacity, albeit in opposite directions. Together, these results suggest that the effects of socioeconomic disadvantage on general psychopathology are organized in a temporal cascade from distal to proximal risk.

Exposure to Bullying and General Psychopathology: A Prospective, Longitudinal Study

Although there is mounting evidence that the experience of being bullied associates with both internalizing and externalizing symptoms, it is not known yet whether the identified associations are specific to these symptoms, or shared between them. The primary focus of this study is to assess the prospective associations of bullying exposure with both general and specific (i.e., internalizing, externalizing) factors of psychopathology. This study included data from 6,210 children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Child bullying was measured by self-report at ages 8 and 10 years. Child psychopathology symptoms were assessed by parent-interview, using the Development and Well-being Assessment (DAWBA) at ages 7 and 13 years. Bullying exposure significantly associated with the general psychopathology factor in early adolescence. In particular, chronically victimized youth exposed to multiple forms of bullying (i.e., both overt and relational) showed higher levels of general psychopathology. Bullying exposure also associated with both internalizing and externalizing factors from the correlated-factors model. However, the effect estimates for these factors decreased considerably in size and dropped to insignificant for the internalizing factor after extracting the shared variance that belongs to the general factor of psychopathology. Using an integrative longitudinal model, we found that higher levels of general psychopathology at age 7 also associated with bullying exposure at age 8 which, in turn, associated with general psychopathology at age 13 through its two-year continuity. Findings suggest that exposure to bullying is a risk factor for a more general vulnerability to psychopathology.

Pica behaviors in a German community-based online adolescent and adult sample: an examination of substances, triggers, and associated pathology

PURPOSE

To examine self-reported pica substances, situational triggers for, and associated psychosocial burden of pica eating in adolescents and adults in a Western European population.

METHODS

A total of 78 individuals aged 16 years and over, who indicated consuming a substance that in their opinion is not considered as food, participated in an online survey. Two questionnaires assessed eating disorder and general psychopathology, and a third asked about the substances consumed, duration and frequency of consumption, triggers for consumption, emotions thereafter, and interest in treatment.

RESULTS

The most frequently reported substances included foods in an uncooked or non-edible form, body parts/fluids, grass, leaves, paper, and earth-like substances, with 54 (69.23%) participants reporting a substance that would qualify as pica substance according to DSM-5. The main triggers for consumption were taste of the substance/indulgence, boredom, curiosity, and release of internal tension. The most common emotion after consumption was relief. Pica eating frequency was not significantly related to eating disorder and general psychopathology (both p > 0.05). A total of 24 individuals considered their pica eating as disruptive, of whom only eight declared an interest in treatment.

CONCLUSIONS

The kind of substances consumed is in line with the previous reports in other populations. Pica eating does not seem to be associated with significant psychosocial burden; only a subgroup indicated that they experience it as disruptive and expressed interest in treatment. Nevertheless, for these individuals, triggers for pica eating and emotions thereafter might provide first hints for the development of interventions.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Opportunities for the prevention of mental disorders by reducing general psychopathology in early childhood

This paper explores the concept that reducing general psychopathology early in the life course provides unprecedented opportunities to prevent the development of all forms of psychopathology later in life. We review empirical evidence for the existence of the general factor of psychopathology and theories regarding the psychological nature of the factor. We then highlight specific examples of environmental risk factors for general psychopathology and discuss translational implications for the transdiagnostic prevention of psychopathology beginning in early childhood. Ultimately, we propose a developmentally informed and transdiagnostic stepped care approach to intervention in which reduction of general psychopathology in early childhood represents the foundational step for prevention and intervention of subsequent psychopathology. This model heralds three key benefits over the current treatment zeitgeist: (1) Reducing the burden and confusion in healthcare and education systems by providing a coherent and systematic structure for early intervention across a child's development, (2) maximising the breadth of the impact of intervention by focusing on common shared risks across psychopathology, and (3) increasing the efficiency of intervention by corresponding with the development of psychopathology and leveraging the emergence of general psychopathology in early childhood.

Age-Normative Pathways of Striatal Connectivity Related to Clinical Symptoms in the General Population

BACKGROUND

Altered striatal development contributes to core deficits in motor and inhibitory control, impulsivity, and inattention associated with attention-deficit/hyperactivity disorder and may likewise play a role in deficient reward processing and emotion regulation in psychosis and depression. The maturation of striatal connectivity has not been well characterized, particularly as it relates to clinical symptomatology.

METHODS

Resting-state functional connectivity with striatal subdivisions was examined for 926 participants (8-22 years of age, 44% male) from the general population who had participated in two large cross-sectional studies. Developing circuits were identified and growth charting of age-related connections was performed to obtain individual scores reflecting relative neurodevelopmental attainment. Associations of clinical symptom scales (attention-deficit/hyperactivity disorder, psychosis, depression, and general psychopathology) with the resulting striatal connectivity age-deviation scores were then tested using elastic net regression.

RESULTS

Linear and nonlinear developmental patterns occurred across 231 striatal age-related connections. Both unique and overlapping striatal age-related connections were associated with the four symptom domains. Attention-deficit/hyperactivity disorder severity was related to age-advanced connectivity across several insula subregions, but to age-delayed connectivity with the nearby inferior frontal gyrus. Psychosis was associated with advanced connectivity with the medial prefrontal cortex and superior temporal gyrus, while aberrant limbic connectivity predicted depression. The dorsal posterior insula, a region involved in pain processing, emerged as a strong contributor to general psychopathology as well as to each individual symptom domain.

CONCLUSIONS

Developmental striatal pathophysiology in the general population is consistent with dysfunctional circuitry commonly found in clinical populations. Atypical age-normative connectivity may thereby reflect aberrant neurodevelopmental processes that contribute to clinical risk.

Prevalence of pica and rumination behaviors in German children aged 7-14 and their associations with feeding, eating, and general psychopathology: a population-based study

Despite potentially severe medical consequences of pica and rumination disorder (RD), little is known about their prevalence and association with other psychopathology in childhood. As a part of a larger population-based study, 804 children aged 7-14 years and their parents were asked about their experience of pica and RD behaviors, and associated eating, feeding and general psychopathology. A total of 12.31 and 11.49% of the participants reported having engaged in pica or RD behaviors, respectively, at least once. Recurring pica or RD behaviors had been experienced by 4.98 and 1.49% of the participants, respectively. The behaviors showed a significant but small correlation with one another (r = 0.28, p < 0.01). Correlations with symptoms of avoidant/restrictive food intake disorder (ARFID) were significant but small (pica: r = 0.18, RD: r = 0.27, both p < 0.01). Prevalence rates of recurring pica behavior were significantly increased if recurring RD was present (58.33%), and also vice versa (17.50%). The prevalence rates of recurrent pica and RD behaviors were also increased in the presence of an ARFID diagnosis (both behaviors 12.0%). However, correlations with restraint and eating, weight, and shape concern were non-significant (all p > 0.05). Additionally, RD behavior was positively correlated with emotional and conduct problems (r = 0.15 and 0.22, both p < 0.01), and both behaviors were negatively correlated with prosocial behavior (r = -  0.10 and - 0.09, both p < 0.05). Our findings underscore the clinical significance of pica and RD behaviors. More research is warranted on both disorders and their association and relation with ARFID to deepen the understanding of their presentation and to ascertain diagnostic validity.

Polygenic Risk Score associated with specific symptom dimensions in first-episode psychosis

Recent Genome-Wide Association Studies (GWAS) have provided evidence for the involvement of a number of genetic variants in schizophrenia (SCZ). The objective of the current study was to examine the association between these variants and symptom dimensions, evaluated prospectively over a period of 24months, in a clinically well-characterized sample of individuals (n=241) with first-episode psychosis (FEP). The genetic variants were analyzed collectively as captured through a Polygenic Risk Score (PRS), calculated for each individual. At each evaluation time point (baseline, 1, 2, 6 and 24months), correlation analysis was conducted with PRS and symptom dimension scores assessed by the Positive and Negative Syndrome Scale (PANSS). We also examined the association of PRS with global symptom rating, depression, anxiety, social and occupational functioning as measured by widely used and well validated scales. At baseline, significant positive correlation was observed between PRS and the general psychopathology dimension of the PANSS but no associations were observed with the positive or negative symptom dimensions. Anxiety, assessed using the Hamilton Anxiety Rating Scale, was also significantly correlated with the PRS. No significant correlation was observed with other symptom dimensions or with the PANSS score at the later evaluations. These results provide novel evidence of an association between general psychopathology and PRS in young people with first episode psychosis. They also demonstrate that it is important to note the dynamic changes of symptoms over time when trying to refine the relationship between genetic factors and phenotypes.

Social stratification of general psychopathology trajectories and young adult social outcomes: A second-order growth mixture analysis over the early life course

BACKGROUND

Research has documented heterogeneous developmental trajectories of specific symptoms, such as anxiety and depression, in late childhood and adolescence. Few studies, however, have examined the heterogeneity of general psychopathology (GPP) trajectories considering symptoms of anxiety, depression, and hostility in adolescence simultaneously. Identifying antecedents for distinct trajectory groups of GPP, and their respective consequences, may provide insight into the etiological underpinnings of social antecedents of different symptoms and inform the targets and timing of intervention.

METHODS

European American target adolescents (N=444, 53% female) evaluated three domain specific symptoms (i.e., symptoms of anxiety, depression, and hostility) as well as psychosocial risks and social consequences over 10 years (from 1990 [Wave 2] to 2001 [Wave 13]). First- and second-order growth mixture models (SOGMMs) were used to identify trajectories of GPP and specific symptoms from mid-adolescence through young adulthood, as well as their predictors and consequences.

RESULTS

A three-class model consisting of high and escalating (10.1%), high and decreasing (23.2%), and consistently low (66.7%) GPP emerged as the preferred solution. More predictors and outcomes were associated with membership in both the high and escalating and the high and declining classes of GPP compared to corresponding classes of the specific symptoms trajectories.

LIMITATIONS

Self-reported information regarding three symptoms may be a source of bias within the current study.

CONCLUSION

Our findings suggest that unified interventions and/or prevention efforts are needed to not only assess specific symptoms, but also to treat GPP in adolescence.