Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T07:26:03.456Z Has data issue: false hasContentIssue false
  • English
  • Français

The structure of common and uncommon mental disorders

Published online by Cambridge University Press:  21 May 2012

K. T. Forbush  and
D. Watson
K. T. Forbush*
Affiliation:
Purdue University, West Lafayette, IN, USA
D. Watson
Affiliation:
University of Notre Dame, South Bend, IN, USA
*
*Address for correspondence: K. T. Forbush, Ph.D., Purdue University, Department of Psychological Sciences, 703 Third Street, West Lafayette, IN 47907, USA. (Email: kforbush@purdue.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Co-morbidity patterns in epidemiological studies of mental illness consistently demonstrate that a latent internalizing factor accounts for co-morbidity patterns among unipolar mood and anxiety disorders, whereas a latent externalizing factor underlies the covariation of substance-use disorders and antisocial behaviors. However, this structure needs to be extended to include a broader range of disorders.

Method

Exploratory and confirmatory factor analyses were used to examine the structure of co-morbidity using data from the Collaborative Psychiatric Epidemiological Surveys (n = 16 233).

Results

In the best-fitting model, eating and bipolar disorders formed subfactors within internalizing, impulse control disorders were indicators of externalizing, and factor-analytically derived personality disorder scales split between internalizing and externalizing.

Conclusions

This was the first large-scale nationally representative study that has included uncommon mental disorders with sufficient power to examine their fit within a structural model of psychopathology. The results of this study have important implications for conceptualizing myriad mental disorders.

Keywords

Bipolar disordersco-morbidityeating disordersimpulse control disorderspersonality disorders
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 1 , January 2013 , pp. 97 - 108
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2011). DSM-5 development: substance use and addictive disorders. (http://www.dsm5.org/proposedrevision/Pages/SubstanceUseandAddictiveDisorders.aspx). Accessed 10 September 2011.Google Scholar
Black, DW, Repertinger, S, Gaffney, GR, Gabel, J (1998). Family history and psychiatric comorbidity in persons with compulsive buying: preliminary findings. American Journal of Psychiatry 155, 960–963.CrossRefGoogle ScholarPubMed
Black, DW, Shaw, M, Blum, N (2010). Pathological gambling and compulsive buying: do they fall within an obsessive–compulsive spectrum? Dialogues in Clinical Neuroscience 12, 175–185.CrossRefGoogle ScholarPubMed
Blanco, C, Alegria, AA, Petry, NM, Grant, JE, Simpson, HB, Liu, SM, Grant, BF, Hasin, DS (2010). Prevalence and correlates of fire-setting in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Journal of Clinical Psychiatry 71, 1218–1225.CrossRefGoogle ScholarPubMed
Blanco, C, Myers, J, Kendler, KS (2012). Gambling, disordered gambling and their association with major depression and substance use: a web-based cohort and twin-sibling study. Psychological Medicine 42, 497–508.CrossRefGoogle ScholarPubMed
Bollen, KA (1989). The consequences of measurement error. In Structural Equations with Latent Variables (ed. Bollen, K. A.), pp. 151–178. Wiley-Interscience: New York.CrossRefGoogle Scholar
Broadhead, WE, Blazer, DG, George, LK, Tse, CK (1990). Depression, disability days, and days lost from work in a prospective epidemiologic survey. Journal of the American Medical Association 264, 2524–2528.CrossRefGoogle Scholar
Brown, TA (2006 a). CFA model revision and comparison. In Confirmatory Factor Analysis for Applied Research (ed. Brown, T. A.), pp. 157–211. Guilford Press: New York.Google Scholar
Brown, TA (2006 b). Data issues in CFA: missing, non-normal, and categorical data. In Confirmatory Factor Analysis for Applied Research (ed. Brown, T. A.), pp. 363–411. Guilford: New York.Google Scholar
Cachelin, FM, Maher, BA (1998). Is amenorrhea a critical criterion for anorexia nervosa? Journal of Psychosomatic Research 44, 435–440.CrossRefGoogle ScholarPubMed
Collaborative Psychiatric Epidemiology Surveys (2011). FAQs (http://www.icpsr.umich.edu/icpsrweb/CPES/support/faqs). Accessed 10 September 2011.Google Scholar
Corrigan, PW (2004). Don't call me nuts: an international perspective on the stigma of mental illness. Acta Psychiatrica Scandinavica 109, 403–404.CrossRefGoogle Scholar
Crisp, AH, Gelder, MG, Rix, S, Meltzer, HI, Rowlands, OJ (2000). Stigmatisation of people with mental illnesses. British Journal of Psychiatry 177, 4–7.CrossRefGoogle ScholarPubMed
Cunningham-Williams, RM, Cottler, LB, Compton, WM 3rd, Spitznagel, EL (1998). Taking chances: problem gamblers and mental health disorders – results from the St. Louis Epidemiologic Catchment Area Study. American Journal of Public Health 88, 1093–1096.CrossRefGoogle ScholarPubMed
De Clercq, B, De Fruyt, F, Van Leeuwen, K, Mervielde, I (2006). The structure of maladaptive personality traits in childhood: a step toward an integrative developmental perspective for DSM-V. Journal of Abnormal Psychology 115, 639–657.CrossRefGoogle ScholarPubMed
Eaton, NR, Keyes, KM, Krueger, RF, Balsis, S, Skodol, AE, Markon, KE, Grant, BF, Hasin, DS (2012). An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample. Journal of Abnormal Psychology 121, 282–288.CrossRefGoogle ScholarPubMed
Eaton, NR, Krueger, RF, Oltmanns, TF (2011). Aging and the structure and long-term stability of the internalizing spectrum of personality and psychopathology. Psychology and Aging 26, 987–993.CrossRefGoogle ScholarPubMed
Eaton, NR, South, SC, Krueger, RF (2010). The meaning of comorbidity among common mental disorders. In Contemporary Directions in Psychopathology (ed. Millon, T., Krueger, R. F. and Simonsen, E.), pp. 223–241. Guilford Publications: New York.Google Scholar
Fincham, D, Grimsrud, A, Corrigall, J, Williams, DR, Seedat, S, Stein, DJ, Myer, L (2009). Intermittent explosive disorder in South Africa: prevalence, correlates and the role of traumatic exposures. Psychopathology 42, 92–98.CrossRefGoogle ScholarPubMed
Forbush, KT, South, SC, Krueger, RF, Iacono, WG, Clark, LA, Keel, PK, Legrand, LN, Watson, D (2010). Locating eating pathology within an empirical diagnostic taxonomy: evidence from a community-based sample. Journal of Abnormal Psychology 119, 282–292.CrossRefGoogle ScholarPubMed
Garfinkel, PE, Lin, E, Goering, P, Spegg, C, Goldbloom, D, Kennedy, S, Kaplan, AS, Woodside, DB (1996). Should amenorrhoea be necessary for the diagnosis of anorexia nervosa? Evidence from a Canadian community sample. British Journal of Psychiatry 168, 500–506.CrossRefGoogle ScholarPubMed
Grant, JE, Potenza, MN, Weinstein, A, Gorelick, DA (2010). Introduction to behavioral addictions. American Journal of Drug and Alcohol Abuse 36, 233–241.CrossRefGoogle ScholarPubMed
Hayton, JC, Allen, DG, Scarpello, V (2004). Factor retention decisions in exploratory factor analysis: a tutorial on parallel analysis. Organizational Research Methods 7, 191–205.CrossRefGoogle Scholar
Heeringa, SG, Wagner, J, Torres, M, Duan, NH, Adams, T, Berglund, P (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research 13, 221–240.CrossRefGoogle Scholar
Henriksson, MM, Aro, HM, Marttunen, MJ, Heikkinen, ME, Isometsä, ET, Kuoppasalmi, KI, Lönnqvist, JK (1993). Mental disorders and comorbidity in suicide. American Journal of Psychiatry 150, 935–940.Google ScholarPubMed
Hettema, JM, Neale, MC, Myers, JM, Prescott, CA, Kendler, KS (2006). A population-based twin study of the relationship between neuroticism and internalizing disorders. American Journal of Psychiatry 163, 857–864.CrossRefGoogle ScholarPubMed
Hu, L-t, Bentler, PM (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling 6, 1–55.CrossRefGoogle Scholar
Kendler, KS, Prescott, CA, Myers, J, 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.CrossRefGoogle ScholarPubMed
Kessler, RC, Chiu, WT, Demler, O, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617–627.CrossRefGoogle ScholarPubMed
Kessler, RC, Foster, CL, Saunders, WB, Stang, PE (1995). Social consequences of psychiatric disorders I: Educational attainment. American Journal of Psychiatry 152, 1026–1032.Google ScholarPubMed
Kessler, RC, Frank, RG (1997). The impact of psychiatric disorders on work loss days. Psychological Medicine 27, 861–873.CrossRefGoogle ScholarPubMed
Kessler, RC, Hwang, I, LaBrie, R, Petukhova, M, Sampson, NA, Winters, KC, Schaffer, HJ (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine 38, 1351–1360.CrossRefGoogle ScholarPubMed
Kessler, RC, Ormel, J, Petukhova, M, McLaughlin, KA, Green, JG, Russo, LJ, Stein, DJ, Zaslavsky, AM, Aguilar-Gaxiola, S, Alonso, J, Andrade, L, Benjet, C, de Girolamo, G, de Graaf, R, Demyttenaere, K, Fayyad, J, Haro, JM, Hu, Cy, Karam, A, Lee, S, Lepine, J-P, Matchsinger, H, Mihaescu-Pintia, C, Posada-Villa, J, Sagar, R, Üstün, TB (2011). Development of lifetime comorbidity in the World Health Organization World Mental Health Surveys. Archives of General Psychiatry 68, 90–100.CrossRefGoogle ScholarPubMed
Kessler, RC, Üstün, TB (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.CrossRefGoogle ScholarPubMed
Kessler, RC, Walters, EE, Forthofer, MS (1998). The social consequences of psychiatric disorders, III: probability of marital stability. American Journal of Psychiatry 155, 1092–1096.CrossRefGoogle ScholarPubMed
Kotov, R, Ruggero, CJ, Krueger, RF, Watson, D, Yuan, Q, Zimmerman, M (2011). New dimensions in the quantitative classification of mental illness. Archives of General Psychiatry 68, 1003–1011.CrossRefGoogle ScholarPubMed
Krishnan, KR (2005). Psychiatric and medical comorbidities of bipolar disorder. Psychosomatic Medicine 67, 1–8.CrossRefGoogle ScholarPubMed
Krueger, RF, Caspi, A, Moffitt, TE, Silva, PA (1998). The structure and stability of common mental disorders (DSM-III-R): a longitudinal–epidemiological study. Journal of Abnormal Psychology 107, 216–227.CrossRefGoogle ScholarPubMed
Krueger, RF, Eaton, NR, Clark, LA, Watson, D, Markon, KE, Derringer, J, Skodol, A, Livesley, WJ (2011). Deriving an empirical structure of personality pathology for DSM-5. Journal of Personality Disorders 25, 170–191.CrossRefGoogle ScholarPubMed
Kushner, SC, Quilty, LC, Tackett, JL, Bagby, RM (2011). The hierarchical structure of the Dimensional Assessment of Personality Pathology (DAPP-BQ). Journal of Personality Disorders 25, 504–516.CrossRefGoogle ScholarPubMed
Lesage, AD, Boyer, R, Grunberg, F, Vanier, C, Morissette, R, Ménard-Buteau, C, Lover, M (1994). Suicide and mental disorders: a case–control study of young men. American Journal of Psychiatry 151, 1063–1068.Google ScholarPubMed
Loranger, AW (1999). International Personality Disorder Examination: DSM-IV and ICD-10 Interviews. Psychological Assessment Resources, Inc.: Odessa, FL.Google Scholar
Markon, KE (2010). Modeling psychopathology structure: a symptom-level analysis of Axis I and II disorders. Psychological Medicine 40, 273–288.CrossRefGoogle ScholarPubMed
Measelle, JR, Stice, E, Hogansen, JM (2006). Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents. Journal of Abnormal Psychology 115, 524–538.CrossRefGoogle ScholarPubMed
Merikangas, KR, Akiskal, HS, Angst, J, Greenberg, PE, Hirschfeld, RM, Petukhova, M, Kessler, RC (2007). Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Archives of General Psychiatry 64, 543–552.CrossRefGoogle ScholarPubMed
Merikangas, KR, Jin, R, He, JP, Kessler, RC, Lee, S, Sampson, NA, Viana, MC, Andrade, LH, Hu, C, Karam, EG, Ladea, M, Medina-Mora, ME, Ono, Y, Posada-Villa, J, Sagar, R, Wells, JE, Zarkov, Z (2011). Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Archives of General Psychiatry 68, 241–251.CrossRefGoogle ScholarPubMed
Mitchell, JE, Cook-Myers, T, Wonderlich, SA (2005). Diagnostic criteria for anorexia nervosa: looking ahead to DSM-V. International Journal of Eating Disorders 37, S95–S97.CrossRefGoogle ScholarPubMed
Muthén, LK, Muthén, BO (2007). Mplus User's Guide, 5th edn.Muthén & Muthén: Los Angeles, CA.Google Scholar
O'Connor, BP (2002). The search for dimensional structure differences between normality and abnormality: a statistical review of published data on personality and psychopathology. Journal of Personality and Social Psychology 83, 962–982.CrossRefGoogle ScholarPubMed
Ohaeri, JU (2003). The burden of caregiving in families with a mental illness: a review of 2002. Current Opinion in Psychiatry 16, 457–465.CrossRefGoogle Scholar
Raftery, AE (1995). Bayesian model selection in social research. Sociological Methodology 25, 111–163.CrossRefGoogle Scholar
Regier, DA, Kaelber, CT, Rae, DS, Farmer, ME, Knauper, B, Kessler, RC, Norquist, GS (1998). Limitations of diagnostic criteria and assessment instruments for mental disorders: implications for research and policy. Archives of General Psychiatry 55, 109–115.CrossRefGoogle ScholarPubMed
Skodol, AE, Oldham, JM, Hyler, SE, Stein, DJ, Hollander, E, Gallaher, PE, Lopez, AE (1995). Patterns of anxiety and personality disorder comorbidity. Journal of Psychiatric Research 29, 361–374.CrossRefGoogle ScholarPubMed
Slade, T, Watson, D (2006). The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population. Psychological Medicine 13, 1593–1600.CrossRefGoogle Scholar
Slutske, WS, Eisen, S, True, WR, Lyons, MJ, Goldberg, J, Tsuang, M (2000). Common genetic vulnerability for pathological gambling and alcohol dependence in men. Archives of General Psychiatry 57, 666–673.CrossRefGoogle ScholarPubMed
Slutske, WS, Eisen, S, Xian, H, True, WR, Lyons, MJ, Goldberg, J, Tsuang, M (2001). A twin study of the association between pathological gambling and antisocial personality disorder. Journal of Abnormal Psychology 110, 297–308.CrossRefGoogle ScholarPubMed
Thomas, JJ, Vartanian, LR, Brownell, KD (2009). The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: meta-analysis and implications for DSM. Psychological Bulletin 135, 407–433.CrossRefGoogle Scholar
Vollebergh, WAM, Iedema, J, Bijl, RV, de Graaf, R, Smit, F, Ormel, J (2001). The structure and stability of common mental disorders: the NEMESIS Study. Archives of General Psychiatry 6, 597–603.CrossRefGoogle Scholar
Watson, T, Andersen, A (2003). A critical examination of the amenorrhea and weight criteria for diagnosing anorexia nervosa. Acta Psychiatrica Scandinavica 108, 175–182.CrossRefGoogle ScholarPubMed
Wolf, AW, Schubert, DSP, Patterson, MB, Grande, TP, Brocco, KJ, Pendleton, L (1988). Associations among major psychiatric diagnoses. Journal of Consulting and Clinical Psychology 56, 292–294.CrossRefGoogle ScholarPubMed
Yoshimasu, K, Kawakami, N (2011). Epidemiological aspects of intermittent explosive disorder in Japan; prevalence and psychosocial comorbidity: findings from the World Mental Health Japan Survey 2002–2006. Psychiatry Research 186, 384–389.CrossRefGoogle ScholarPubMed