The structure of psychopathology: toward an expanded quantitative empirical model

Abstract

There has been substantial recent interest in the development of a quantitative, empirically based model of psychopathology. However, the majority of pertinent research has focused on analyses of diagnoses, as described in current official nosologies. This is a significant limitation because existing diagnostic categories are often heterogeneous. In the current research, we aimed to redress this limitation of the existing literature, and to directly compare the fit of categorical, continuous, and hybrid (i.e., combined categorical and continuous) models of syndromes derived from indicators more fine-grained than diagnoses. We analyzed data from a large representative epidemiologic sample (the 2007 Australian National Survey of Mental Health and Wellbeing; N = 8,841). Continuous models provided the best fit for each syndrome we observed (distress, obsessive compulsivity, fear, alcohol problems, drug problems, and psychotic experiences). In addition, the best fitting higher-order model of these syndromes grouped them into three broad spectra: Internalizing, Externalizing, and Psychotic Experiences. We discuss these results in terms of future efforts to refine emerging empirically based, dimensional-spectrum model of psychopathology, and to use the model to frame psychopathology research more broadly.

Figure 1

Graphical depiction of hypothetical distributions associated with the estimated model types.

Figure 2

The best fitting higher-order model of psychopathology. Note that portions of the model were estimated in isolation. Coefficients represent standardized parameter estimates. DEP = Depression criteria; MAN = Manic episode criteria; GAD = Generalized anxiety disorder criterion; PAN = Panic attacks; SOC = Social phobia criterion; AGO = Agoraphobia; OCD = Obsessive-compulsive criteria; PSY = Psychosis criteria; ALC = Alcohol use criteria; DRG = Drug use criteria.