Is Poor Working Memory a Transdiagnostic Risk Factor for Psychopathology?

Abstract

In contrast to historical conceptualizations that framed psychological disorders as distinct, categorical conditions, it is now widely understood that co- and multi-morbidities between disorders are extensive. As a result, there has been a call to better understand the dimensional liabilities that are common to and influence the development of multiple psychopathologies, as supported and exemplified by the National Institutes of Mental Health (NIMH) Research Domain Criteria (RDoC) framework. We use a latent variable SEM approach to examine the degree to which working memory deficits represent a cognitive liability associated with the development of common and discrete dimensions of psychopathology. In a sample of 415 community recruited children aged 8-12 (n = 170 girls), we fit a bi-factor model to parent reports of behavior from the DISC-4 and BASC-2, and included a latent working memory factor as a predictor of the internalizing, externalizing, and general "p-factor." We found that both the general "p-factor" and externalizing (but not internalizing) latent factor were significantly associated with working memory. When a bi-factor model of externalizing symptomology was fit to further explore this relationship, working memory was only correlated with the general externalizing dimension; correlation with specific inattention, hyperactive/impulsive, and oppositional factors did not survive once the general externalizing dimension was taken into consideration. These findings held regardless of the sex of the child. Our results suggest that working memory deficits represent both a common cognitive liability for mental health disorders, and a specific liability for externalizing disorders.

Keywords: Bifactor; Executive function; Externalizing; P-factor; Working memory.

Figure 1

Model 1b, bifactor model of psychopathology. Non-significant paths shown as dotted lines. Int Prob = BASC-2 Internalizing problems composite; GAD = Generalized Anxiety Disorder; MDD/DD = Major Depressive/Dysthymic disorder; Ext Prob = BASC-2 Externalizing problems composite; ODD = Oppositional Defiant Disorder; IN = Inattention; HI = Hyperactivity/Impulsivity

Figure 2

Model 2, working memory (WM) as latent liability for general psychopathology (p) and externalizing (Ext) but not internalizing symptomology (Int). Non-significant paths shown as dotted lines. Int Prob = BASC-2 internalizing problems composite; GAD = Generalized Anxiety Disorder; MDD/DD = Major Depressive/Dysthymic Disorders; Ext Prob = BASC-2 Externalizing problems composite; ODD = Oppositional Defiant Disorder; IN = Inattention; HI = Hyperactivity/Impulsivity

Figure 3

Model 3, bifactor model of externalizing disorders (Ext), comprised of inattention (IN), hyperactivity/impulsivity (HI) and Oppositional Defiant Disorder (ODD) symptoms. Nonsignificant paths shown as dotted lines

Figure 4

Model 4, working memory (WM) as a latent liability for general externalizing psychopathology (Ext) but not the specific inattentive (IN) or hyperactive/impulsive (HI) factors. Nonsignificant paths shown as dotted lines