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Internalizing and externalizing psychopathology in middle age: genetic and environmental architecture and stability of symptoms over 15 to 20 years

Published online by Cambridge University Press:  01 July 2019

Daniel E. Gustavson Open the ORCID record for Daniel E. Gustavson [Opens in a new window] ,
Carol E. Franz ,
Matthew S. Panizzon ,
Michael J. Lyons  and
William S. Kremen
Daniel E. Gustavson*
Affiliation:
Department of Psychiatry, Center for Behavioral Genetics of Aging, University of California, La Jolla, USA
Carol E. Franz
Affiliation:
Department of Psychiatry, Center for Behavioral Genetics of Aging, University of California, La Jolla, USA
Matthew S. Panizzon
Affiliation:
Department of Psychiatry, Center for Behavioral Genetics of Aging, University of California, La Jolla, USA
Michael J. Lyons
Affiliation:
Department of Psychological and Brain Sciences, Boston University, Boston, USA
William S. Kremen
Affiliation:
Department of Psychiatry, Center for Behavioral Genetics of Aging, University of California, La Jolla, USA Veterans Affairs San Diego Healthcare System, La Jolla, USA
*
Author for correspondence: Daniel E. Gustavson, E-mail: dgustavson@ucsd.edu
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Abstract

Background

Internalizing and externalizing psychopathology factors explain much of the covariance among psychiatric conditions, especially at the level of genetic risk. However, few studies have examined internalizing and externalizing factors in middle-aged samples, especially their ability to predict later symptoms across midlife. The goals of the current study were (i) to quantify the genetic and environmental influences on internalizing and externalizing psychopathology in individuals in their early 40s, and (ii) examine the extent to which these genetic and environmental influences predict self-reported measures of internalizing and externalizing symptoms 15–20 years later.

Method

1484 male twins completed diagnostic interviews of psychopathology at mean age 41 and self-reported measures of anxiety, depression, substance use, and related variables at up to two time-points in late middle age (mean ages 56 and 62).

Results

Structural equation modeling of the diagnostic interviews confirmed that internalizing and externalizing factors accounted for most of the genetic variance in individual disorders, with substantial genetic (ra = 0.70) and environmental (re = 0.77) correlations between the factors. Internalizing psychopathology at age 41 was correlated with latent factors capturing anxiety, depression, and/or post-traumatic stress symptoms at ages 56 (r = 0.51) and 62 (r = 0.43). Externalizing psychopathology at age 41 was correlated r = 0.67 with a latent factor capturing aggression, tobacco use, and alcohol use at age 56. Stability of both factors was driven by genetic influences.

Conclusions

These findings demonstrate the considerable stability of internalizing and externalizing psychopathology symptoms across middle age, especially their genetic influences. Diagnostic interviews effectively predict self-reported symptoms and behaviors 15–20 years later.

Keywords

Antisocial personality disorderanxietydepressiondrug useheritabilitystructural equation modelingtwin study
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 9 , July 2020 , pp. 1530 - 1538
Copyright
Copyright © Cambridge University Press 2019

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders, 3rd Edn, revised. Washington, DC: American Psychiatric Association.Google Scholar
Bergen, SE, Gardner, CO and Kendler, KS (2007) Age-related changes in heritability of behavioral phenotypes over adolescence and young adulthood: a meta-analysis. Twin Research and Human Genetics 10, 423–433.10.1375/twin.10.3.423CrossRefGoogle Scholar
Blonigen, DM, Hicks, BM, Krueger, RF, Patrick, CJ and Iacono, WG (2005) Psychopathic personality traits: heritability and genetic overlap with internalizing and externalizing psychopathology. Psychological Medicine 35, 637–648.10.1017/S0033291704004180CrossRefGoogle ScholarPubMed
Bornovalova, MA, Hicks, BM, Iacono, WG and McGue, M (2009) Stability, change, and heritability of borderline personality disorder traits from adolescence to adulthood: a longitudinal twin study. Development and Psychopathology 21, 1335–1353.10.1017/S0954579409990186CrossRefGoogle ScholarPubMed
Bulik-Sullivan, B, Finucane, HK, Anttila, V, Gusev, A, Day, FR, Loh, PR, ReproGen, C, Psychiatric Genomics, C, Genetic Consortium for Anorexia Nervosa of the Wellcome Trust Case Control, C, Duncan, L, Perry, JR, Patterson, N, Robinson, EB, Daly, MJ, Price, AL and Neale, BM (2015) An atlas of genetic correlations across human diseases and traits. Nature Genetics 47, 1236–1241.CrossRefGoogle ScholarPubMed
Burt, SA, McGue, M, Krueger, RF and Iacono, WG (2005) Sources of covariation among the child-externalizing disorders: informant effects and the shared environment. Psychological Medicine 35, 1133–1144.CrossRefGoogle ScholarPubMed
Caspi, A, Houts, RM, Belsky, DW, Goldman-Mellor, SJ, Harrington, H, Israel, S, Meier, MH, Ramrakha, S, Shalev, I, Poulton, R and Moffitt, TE (2014) The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science 2, 119–137.10.1177/2167702613497473CrossRefGoogle Scholar
Chantarujikapong, SI, Scherrer, JF, Xian, H, Eisen, SA, Lyons, MJ, Goldberg, J, Tsuang, M and True, WR (2001) A twin study of generalized anxiety disorder symptoms, panic disorder symptoms and post-traumatic stress disorder in men. Psychiatry Research 103, 133–145.CrossRefGoogle ScholarPubMed
Derks, EM, Dolan, CV and Boomsma, DI (2004) Effects of censoring on parameter estimates and power in genetic modeling. Twin Research 7, 659–669.CrossRefGoogle ScholarPubMed
Duncan, LE, Ratanatharathorn, A, Aiello, AE, Almli, LM, Amstadter, AB, Ashley-Koch, AE, Baker, DG, Beckham, JC, Bierut, LJ, Bisson, J, Bradley, B, Chen, CY, Dalvie, S, Farrer, LA, Galea, S, Garrett, ME, Gelernter, JE, Guffanti, G, Hauser, MA, Johnson, EO, Kessler, RC, Kimbrel, NA, King, A, Koen, N, Kranzler, HR, Logue, MW, Maihofer, AX, Martin, AR, Miller, MW, Morey, RA, Nugent, NR, Rice, JP, Ripke, S, Roberts, AL, Saccone, NL, Smoller, JW, Stein, DJ, Stein, MB, Sumner, JA, Uddin, M, Ursano, RJ, Wildman, DE, Yehuda, R, Zhao, H, Daly, MJ, Liberzon, I, Ressler, KJ, Nievergelt, CM and Koenen, KC (2018) Largest GWAS of PTSD (N = 20 070) yields genetic overlap with schizophrenia and sex differences in heritability. Molecular Psychiatry 23, 666–673.CrossRefGoogle ScholarPubMed
Eaton, NR, Krueger, RF, Keyes, KM, Skodol, AE, Markon, KE, Grant, BF and Hasin, DS (2011) Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders. Psychological Medicine 41, 1041–1050.10.1017/S0033291710001662CrossRefGoogle ScholarPubMed
Eley, TC, Lichtenstein, P and Moffitt, TE (2003) A longitudinal behavioral genetic analysis of the etiology of aggressive and nonaggressive antisocial behavior. Development and Psychopathology 15, 383–402.CrossRefGoogle ScholarPubMed
Friedman, NP, Miyake, A, Altamirano, LJ, Corley, RP, Young, SE, Rhea, SA and Hewitt, JK (2016) Stability and change in executive function abilities from late adolescence to early adulthood: a longitudinal twin study. Developmental Psychology 52, 326–340.10.1037/dev0000075CrossRefGoogle ScholarPubMed
Fu, Q, Heath, AC, Bucholz, KK, Lyons, MJ, Tsuang, MT, True, WR and Eisen, SA (2007) Common genetic risk of major depression and nicotine dependence: the contribution of antisocial traits in a United States veteran male twin cohort. Twin Research and Human Genetics 10, 470–478.10.1375/twin.10.3.470CrossRefGoogle Scholar
Ginzburg, K, Ein-Dor, T and Solomon, Z (2010) Comorbidity of posttraumatic stress disorder, anxiety and depression: a 20-year longitudinal study of war veterans. Journal of Affective Disorders 123, 249–257.10.1016/j.jad.2009.08.006CrossRefGoogle ScholarPubMed
Gjone, H and Stevenson, J (1997) The association between internalizing and externalizing behavior in childhood and early adolescence: genetic or environmental common influences? Journal of Abnormal Child Psychology 25, 277–286.10.1023/A:1025708318528CrossRefGoogle ScholarPubMed
Gustavson, DE, du Pont, A, Hatoum, AS, Rhee, SH, Kremen, WS, Hewitt, JK and Friedman, NP (2017) Genetic and environmental associations between procrastination and internalizing/externalizing psychopathology. Clinical Psychological Science 5, 798–815.10.1177/2167702617706084CrossRefGoogle ScholarPubMed
Hink, LK, Rhee, SH, Corley, RP, Cosgrove, VE, Hewitt, JK, Schulz-Heik, RJ, Lahey, BB and Waldman, ID (2013) Personality dimensions as common and broadband-specific features for internalizing and externalizing disorders. Journal of Abnormal Child Psychology 41, 939–957.10.1007/s10802-013-9730-3CrossRefGoogle ScholarPubMed
Hollingshead, AB (1975) Four Factor index of Social status. New Haven, CT: Yale University.Google Scholar
Hu, LT and Bentler, PM (1998) Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychological Methods 3, 424–453.10.1037/1082-989X.3.4.424CrossRefGoogle Scholar
Kendler, KS and Myers, J (2014) The boundaries of the internalizing and externalizing genetic spectra in men and women. Psychological Medicine 44, 647–655.10.1017/S0033291713000585CrossRefGoogle ScholarPubMed
Kendler, KS, Prescott, CA, Myers, J and Neale, MC (2003) The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry 60, 929–937.10.1001/archpsyc.60.9.929CrossRefGoogle ScholarPubMed
Kilpatrick, DG, Resnick, HS, Milanak, ME, Miller, MW, Keyes, KM and Friedman, MJ (2013) National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. Journal of Traumatic Stress 26, 537–547.CrossRefGoogle ScholarPubMed
King, SM, Iacono, WG and McGue, M (2004) Childhood externalizing and internalizing psychopathology in the prediction of early substance use. Addiction 99, 1548–1559.CrossRefGoogle ScholarPubMed
Koenen, KC, Fu, QJ, Ertel, K, Lyons, MJ, Eisen, SA, True, WR, Goldberg, J and Tsuang, MT (2008) Common genetic liability to major depression and posttraumatic stress disorder in men. Journal of Affective Disorders 105, 109–115.CrossRefGoogle ScholarPubMed
Kotov, R, Krueger, RF, Watson, D, Achenbach, TM, Althoff, RR, Bagby, M and Zimmerman, M (2017) The hierarchical taxonomy of psychopathology (HiTOP): a dimensional alternative to traditional nosologies. Journal of Abnormal Psychology 126, 454–477.CrossRefGoogle ScholarPubMed
Kremen, WS, Thompson-Brenner, H, Leung, YM, Grant, MD, Franz, CE, Eisen, SA, Jacobson, KC, Boake, C and Lyons, MJ (2006) Genes, environment, and time: the Vietnam Era twin study of aging (VETSA). Twin Research and Human Genetics 9, 1009–1022.10.1375/twin.9.6.1009CrossRefGoogle Scholar
Kremen, WS, Franz, CE and Lyons, MJ (2013 a) VETSA: the Vietnam Era twin study of aging. Twin Research and Human Genetics 16, 399–402.CrossRefGoogle Scholar
Kremen, WS, Franz, CE and Lyons, MJ (2013 b) VETSA: the Vietnam Era twin study of aging - ADDENDUM. Twin Research and Human Genetics 16, 403.CrossRefGoogle ScholarPubMed
Krueger, RF (1999) The structure of common mental disorders. Archives of General Psychiatry 56, 921–926.CrossRefGoogle ScholarPubMed
Krueger, RF, Caspi, A, Moffitt, TE, Silva, PA and McGee, R (1996) Personality traits are differentially linked to mental disorders: a multitrait-multidiagnosis study of an adolescent birth cohort. Journal of Abnormal Psychology 105, 299–312.10.1037/0021-843X.105.3.299CrossRefGoogle ScholarPubMed
Krueger, RF, Hicks, BM, Patrick, CJ, Carlson, SR, Iacono, WG and McGue, M (2002) Etiologic connections among substance dependence, antisocial behavior, and personality: modeling the externalizing spectrum. Journal of Abnormal Psychology 111, 411–424.10.1037/0021-843X.111.3.411CrossRefGoogle ScholarPubMed
Lilienfeld, SO (2003) Comorbidity between and within childhood externalizing and internalizing disorders: reflections and directions. Journal of Abnormal Child Psychology 31, 285–291.CrossRefGoogle ScholarPubMed
Lo, M-T, Hinds, DA, Tung, JY, Franz, C, Fan, C-C, Wang, Y, Smeland, OB, Schork, A, Holland, D and Kauppi, K (2017) Genome-wide analyses for personality traits identify six genomic loci and show correlations with psychiatric disorders. Nature genetics 49, 152–156.CrossRefGoogle ScholarPubMed
Logue, MW, Solovieff, N, Leussis, MP, Wolf, EJ, Melista, E, Baldwin, C, Koenen, KC, Petryshen, TL and Miller, MW (2013) The ankyrin-3 gene is associated with posttraumatic stress disorder and externalizing comorbidity. Psychoneuroendocrinology 38, 2249–2257.10.1016/j.psyneuen.2013.04.013CrossRefGoogle ScholarPubMed
Martin, NG, Eaves, LJ, Kearsey, MJ and Davies, P (1978) The power of the classical twin study. Heredity (Edinb) 40, 97–116.CrossRefGoogle ScholarPubMed
Martin, J, Taylor, MJ and Lichtenstein, P (2018) Assessing the evidence for shared genetic risks across psychiatric disorders and traits. Psychological Medicine 48, 1759–1774.CrossRefGoogle ScholarPubMed
Miller, MW, Kaloupek, DG, Dillon, AL and Keane, TM (2004) Externalizing and internalizing subtypes of combat-related PTSD: a replication and extension using the PSY-5 scales. Journal of Abnormal Psychology 113, 636–645.CrossRefGoogle ScholarPubMed
Muthén, LK and Muthén, BO (2010–2012) Mplus Version 7 User's Guide. Los Angeles, CA: Muthén & Muthén.Google Scholar
Petkus, AJ, Gatz, M, Reynolds, CA, Kremen, WS and Wetherell, JL (2016) Stability of genetic and environmental contributions to anxiety symptoms in older adulthood. Behavior Genetics 46, 492–505.10.1007/s10519-015-9772-0CrossRefGoogle ScholarPubMed
Plomin, R, Asbury, K and Dunn, J (2001) Why are children in the same family so different? Nonshared environment a decade later. The Canadian Journal of Psychiatry 46, 225–233.CrossRefGoogle ScholarPubMed
Radloff, LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401.10.1177/014662167700100306CrossRefGoogle Scholar
Robins, L, Helzer, J, Cottler, L and Goldring, E (1988) National Institute of Mental Health Diagnostic Interview Schedule: Version III Revised (DIS-III-R). St Louis, MO: Department of Psychiatry, Washington University Medical School.Google Scholar
Schoenborn, CA and Heyman, KM (2009) Health characteristics of adults aged 55 years and over: United States, 2004–2007. National Health Statistics Report 16, 1–31.Google Scholar
Spielberger, CD (1983) Manual for the State-Trait Anxiety Inventory (form Y)(” self-evaluation questionnaire”). Palo Alto, CA: Consulting Psychologists Press.CrossRefGoogle Scholar
Tackett, JL, Lahey, BB, van Hulle, C, Waldman, I, Krueger, RF and Rathouz, PJ (2013) Common genetic influences on negative emotionality and a general psychopathology factor in childhood and adolescence. Journal of Abnormal Psychology 122, 1142–1153.10.1037/a0034151CrossRefGoogle Scholar
Tellegen, A (1985) Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In Tuma, AH & Maser, JD (eds), Anxiety and the anxiety disorders. Hillsdale, NJ, US: Lawrence Erlbaum Associates, Inc., pp. 681–706.Google Scholar
True, WR, Heath, AC, Scherrer, JF, Xian, H, Lin, N, Eisen, SA, Lyons, MJ, Goldberg, J and Tsuang, MT (1999a) Interrelationship of genetic and environmental influences on conduct disorder and alcohol and marijuana dependence symptoms. American Journal of Medical Genetics 88, 391–397.3.0.CO;2-L>CrossRefGoogle Scholar
True, WR, Xian, H, Scherrer, JF, Madden, PA, Bucholz, KK, Heath, AC, Eisen, SA, Lyons, MJ, Goldberg, J and Tsuang, M (1999b) Common genetic vulnerability for nicotine and alcohol dependence in men. Archives of General Psychiatry 56, 655–661.10.1001/archpsyc.56.7.655CrossRefGoogle Scholar
Tsuang, MT, Bar, JL, Harley, RM and Lyons, MJ (2001) The harvard twin study of substance abuse: what we have learned. Harvard Review of Psychiatry 9, 267–279.CrossRefGoogle ScholarPubMed
Visscher, PM, Wray, NR, Zhang, Q, Sklar, P, McCarthy, MI, Brown, MA and Yang, J (2017) 10 years of GWAS discovery: biology, function, and translation. The American Journal of Human Genetics 101, 5–22.10.1016/j.ajhg.2017.06.005CrossRefGoogle Scholar
Ware, JE Jr and Sherbourne, CD (1992) The MOS 36-item short-form health survey (SF-36): i. Conceptual framework and item selection. Medical Care 30, 473–483.CrossRefGoogle ScholarPubMed
Weathers, FW, Litz, BT, Herman, DS, Huska, JA and Keane, TM (1993) The PTSD checklist (PCL): reliability, validity, and diagnostic utility. The 9th Annual Meeting of the International Society for Traumatic Stress Studies.Google Scholar
Weiss, B, Susser, K and Catron, T (1998) Common and specific features of childhood psychopathology. Journal of Abnormal Psychology 107, 118–127.CrossRefGoogle ScholarPubMed
Whiteside, SP and Lynam, DR (2003) Understanding the role of impulsivity and externalizing psychopathology in alcohol abuse: application of the UPPS impulsive behavior scale. Experimental Clinical Psychopharmacology 11, 210–217.CrossRefGoogle ScholarPubMed
Xian, H, Chantarujikapong, SI, Scherrer, JF, Eisen, SA, Lyons, MJ, Goldberg, J, Tsuang, M and True, WR (2000) Genetic and environmental influences on posttraumatic stress disorder, alcohol and drug dependence in twin pairs. Drug and Alcohol Dependence 61, 95–102.CrossRefGoogle ScholarPubMed
Young, SE, Friedman, NP, Miyake, A, Willcutt, EG, Corley, RP, Haberstick, BC and Hewitt, JK (2009) Behavioral disinhibition: liability for externalizing spectrum disorders and its genetic and environmental relation to response inhibition across adolescence. Journal of Abnormal Psychology 118, 117–130.CrossRefGoogle ScholarPubMed
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