Publications by authors named "Kristian E Markon"

111 Publications

Les progrès dans la réalisation de la classification quantitative de la psychopathologie.

Ann Med Psychol (Paris) 2021 Jan 8;179(1):95-106. Epub 2021 Jan 8.

Department of Psychology, University of Iowa, Iowa City, IA, USA.

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.
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http://dx.doi.org/10.1016/j.amp.2020.11.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8309948PMC
January 2021

Post-traumatic disorder symptom severity in the perspective of hierarchical taxonomy of psychopathology spectra and dysfunctional personality domains among trauma-exposed community-dwelling women.

Personal Ment Health 2021 Jul 9. Epub 2021 Jul 9.

School of Psychology, Vita-Salute San Raffaele, Milan, Italy.

To assess the relationships between post-traumatic stress disorder (PTSD) components, Hierarchical Taxonomy of Psychopathology (HiTOP) spectra, and dysfunctional personality domains, the Post-Traumatic Checklist for DSM-5 (PCL-5); the Personality Inventory for DSM-5-Brief Form+ (PID-5BF+); and self-report measures of HiTOP Internalizing, Thought Disorders, and Externalizing spectra were administered to 387 trauma-exposed Italian community-dwelling women. Before structural equation modeling (SEM), measurement components of models were assessed using confirmatory factor analyses. Both taxometric and Gaussian mixture analysis results were consistent with a dimensional representation of the PCL-5 scores. SEM results showed that PTSD components, at least as they were operationalized by the PCL-5 scores, were positively, significantly, and substantially associated with HiTOP Internalizing and Thought Disorder Spectra latent dimensions, as well as with Negative Affectivity, Detachment, and Psychoticism personality domains.
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http://dx.doi.org/10.1002/pmh.1525DOI Listing
July 2021

A nine-month study on the course of COVID-19 related perceived post-traumatic stress disorder among Italian community-dwelling adults.

J Psychiatr Res 2021 09 15;141:146-151. Epub 2021 Jun 15.

Vita-Salute San Raffaele University, Milan, Italy. Electronic address:

The present study aimed to evaluate base rate estimates, course of, and psychopathology and personality risk factors for COVID-19-related post-traumatic stress disorder (PTSD) in community-dwelling adults during the pandemic. 203 participants from a sample of 811 Italian community-dwelling adults agreed to participate in a nine-month, three-wave (Wave 1: March 2020; Wave 2: June 2020; Wave 3: December 2020) longitudinal study. Participants in the longitudinal study did not differ from the cross-sectional original sample on age, gender, civil status, educational level, occupation, and Italian area of residence. At each wave, participants were administered the PTSD scale of the International Trauma Questionnaire (ITQ), DSM-5 measures of acute stress, dissociation, depression and anxiety, as well as a maladaptive personality domain measure at Wave 1. Participants were instructed to answer to the ITQ items based only on COVID-19 pandemic and related containment measures. The point prevalence estimates of COVID-19 related PTSD at each wave ranged from 11% to 13%; however, up to roughly 23% of our participants experienced clinically relevant PTSD features during nine months of the COVID-19 pandemic in Italy. Multiple logistic regression results showed that experiencing internalizing symptoms (i.e., mostly acute stress) and selected personality features (i.e., Negative Affectivity and Psychoticism) at Wave 1 represent risk factors for PTSD symptoms at later waves. These findings extend previous knowledge on COVID-19 related PTSD and support the need for preventive and treatment interventions for PTSD during the COVID-19 pandemic.
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http://dx.doi.org/10.1016/j.jpsychires.2021.06.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579247PMC
September 2021

Mood during pregnancy: Trends, structure, and invariance by gestational day.

J Psychiatr Res 2021 08 7;140:260-266. Epub 2021 Jun 7.

Department of Psychological and Brain Sciences, University of Iowa, United States.

Mood dynamics during pregnancy are important in understanding a critical period of human development, and also as a model for biopsychosocial stress processes. Here, in four large samples of smartphone app respondents (differentiated by time period and number of responses), we modeled mood for each gestational day during the pregnancy period. We aimed to delineate patterns of changes in mood across pregnancy, as well as potential changes in measurement properties across the period. Results indicated that three prominent mood factors - positivity, distress, and irritability - could account for responses in this period, and that changes in measurement properties of mood items across pregnancy were small in magnitude. Mean irritability increased, and positivity decreased, in the first trimester before reversing in direction; there was also some evidence for previously reported U-shaped trends in mood, where negative mood is greatest early in pregnancy, decreases, and then increases again. Results help characterize mood processes at a detailed level during a critical period, and point to directions for future research to explicate causes and effects of mood changes during this time.
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http://dx.doi.org/10.1016/j.jpsychires.2021.06.006DOI Listing
August 2021

HiTOP Assessment of the Somatoform Spectrum and Eating Disorders.

Assessment 2022 Jan 9;29(1):62-74. Epub 2021 Jun 9.

University of Mainz, Mainz, Germany.

We report on Phase 1 efforts of the Hierarchical Taxonomy of Psychopathology (HiTOP) measurement subgroup tasked with developing provisional scales for the somatoform spectrum and eating disorders. In Study 1, items were written to assess five somatoform spectrum constructs (bodily distress symptoms, conversion symptoms, health anxiety, disease conviction, and somatic preoccupation). Scale development analyses were conducted on 550 university students. The conversion symptom items were too infrequently endorsed and were set aside for Phase 2. Analyses of the other items yielded four scales corresponding closely to their hypothesized structure. In Study 2, we delineated 15 specific feeding and eating disorder constructs. A sample of 400 university students were administered candidate items and several eating disorder questionnaires for criterion validity. Analyses yielded six scales capturing previously described constructs, tapping content related to body image and weight concerns, restricting and purging, cognitive restraint, binging, excessive exercise, and muscle building. Two scales representing additional constructs deemed to be of high clinical import-negative attitude towards obesity and avoidant/restrictive food intake disorder-were retained for Phase 2, for a total of eight scales. Overall, we concluded that Phase 1 had been successful at generating a comprehensive set of provisional scales for inclusion in Phase 2.
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http://dx.doi.org/10.1177/10731911211020825DOI Listing
January 2022

The Inter-Rater Reliability and Validity of the Italian Translation of the Structured Clinical Interview for Alternative Model for Personality Disorders Module I and Module II: A Preliminary Report on Consecutively Admitted Psychotherapy Outpatients.

J Pers Disord 2020 12;34(Suppl C):95-123

From School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.

To evaluate the reliability and convergent validity of the Structured Clinical Interview for Alternative Model for Personality Disorders (SCID-5-AMPD) Module I and Module II, 88 adult psychotherapy participants were administered the Italian translations of the SCID-5-AMPD Module I and Module II, Level of Personality Functioning Scale-Brief Form (LPFS-BF), Level of Personality Functioning Scale-Self Report (LPFS-SF), Personality Inventory for (PID-5), Personality Diagnostic Questionnaire-4+ (PDQ-4+), and Structured Clinical Interview for Personality Disorders (SCID-5-PD) relying on a Williams crossover design. SCID-5-AMPD Module I and Module II showed excellent inter-rater reliability. In terms of convergent validity, meaningful associations were observed between SCID-5-AMPD Module I scores and self-report measures of Criterion A; similarly, SCID-5-AMPD Module II trait scores were meaningfully related to PID-5 trait scores. As a whole, our preliminary findings supported the clinical utility of 5 AMPD.
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http://dx.doi.org/10.1521/pedi_2020_34_511DOI Listing
December 2020

On Unreplicable Inferences in Psychopathology Symptom Networks and the Importance of Unreliable Parameter Estimates.

Multivariate Behav Res 2021 Mar-Apr;56(2):368-376. Epub 2021 Feb 18.

Department of Psychology, University of Minnesota.

We recently wrote an article comparing the conclusions that followed from two different approaches to quantifying the reliability and replicability of psychopathology symptom networks. Two commentaries on the article have raised five core criticisms, which are addressed in this response with supporting evidence. 1) We did not over-generalize about the replicability of symptom networks, but rather focused on interpreting the contradictory conclusions of the two sets of methods we examined. 2) We closely followed established recommendations when estimating and interpreting the networks. 3) We also closely followed the relevant tutorials, and used examples interpreted by experts in the field, to interpret the bootnet and NetworkComparisonTest results. 4) It is possible for statistical control to increase reliability, but that does not appear to be the case here. 5) Distinguishing between statistically significant versus substantive differences makes it clear that the differences between the networks affect the inferences we would make about symptom-level relationships (i.e., the basis of the purported utility of symptom networks). Ultimately, there is an important point of agreement between our article and the commentaries: All of these applied examples of cross-sectional symptom networks are demonstrating unreliable parameter estimates. While the commentaries propose that the resulting differences between networks are not genuine or meaningful because they are not statistically significant, we propose that the unreplicable inferences about the symptom-level relationships of interest fundamentally undermine the utility of the symptom networks.
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http://dx.doi.org/10.1080/00273171.2021.1886897DOI Listing
October 2021

Three recommendations based on a comparison of the reliability and validity of the predominant models used in research on the empirical structure of psychopathology.

J Abnorm Psychol 2021 Apr 4;130(3):297-317. Epub 2021 Feb 4.

Department of Psychology.

The present study compared the primary models used in research on the structure of psychopathology (i.e., correlated factor, higher-order, and bifactor models) in terms of structural validity (model fit and factor reliability), longitudinal measurement invariance, concurrent and prospective predictive validity in relation to important outcomes, and longitudinal consistency in individuals' factor score profiles. Two simpler operationalizations of a general factor of psychopathology were also examined-a single-factor model and a count of diagnoses. Models were estimated based on structured clinical interview diagnoses in two longitudinal waves of nationally representative data from the United States ( = 43,093 and = 34,653). Models that included narrower factors (fear, distress, and externalizing) were needed to capture the observed multidimensionality of the data. In the correlated factor and higher-order models these narrower factors were reliable, largely invariant over time, had consistent associations with indicators of adaptive functioning, and had moderate stability within individuals over time. By contrast, the fear- and distress-specific factors in the bifactor model did not show good reliability or validity throughout the analyses. Notably, the general factor of psychopathology ( factor) performed similarly well across tests of reliability and validity regardless of whether the higher-order or bifactor model was used; the simplest (single factor) model was also comparable across most tests, with the exception of model fit. Given the limitations of categorical diagnoses, it will be important to repeat these analyses using dimensional measures. We conclude that when aiming to understand the structure and correlates of psychopathology it is important to (a) look beyond model fit indices to choose between different models, (b) examine the reliability of latent variables directly, and (c) be cautious when isolating and interpreting the unique effects of specific psychopathology factors, regardless of which model is used. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/abn0000533DOI Listing
April 2021

Evaluating the Viability of Neurocognition as a Transdiagnostic Construct Using Both Latent Variable Models and Network Analysis.

Res Child Adolesc Psychopathol 2021 06 3;49(6):697-710. Epub 2021 Feb 3.

Department of Psychological and Brain Sciences, G60 Psychological and Brain Sciences Bldg, University of Iowa, Iowa City, IA, US.

The relational structure of psychological symptoms and disorders is of crucial importance to mechanistic and causal research. Methodologically, factor analytic approaches (latent variable modeling) and network analyses are two dominant approaches. Amidst some debate about their relative merits, use of both methods simultaneously in the same data set has rarely been reported in child or adolescent psychopathology. A second issue is that the nosological structure can be enriched by inclusion of transdiagnostic constructs, such as neurocognition (e.g., executive functions and other processes). These cut across traditional diagnostic boundaries and are rarely included even though they can help map the mechanistic architecture of psychopathology. Using a sample enriched for ADHD (n = 498 youth ages 6 to 17 years; M = 10.8 years, SD = 2.3 years, 55% male), both approaches were used in two ways: (a) to model symptom structure and (b) to model seven neurocognitive domains hypothesized as important transdiagnostic features in ADHD and associated disorders. The structure of psychopathology domains was similar across statistical approaches with internalizing, externalizing, and neurocognitive performance clusters. Neurocognition remained a distinct domain according to both methods, showing small to moderate associations with internalizing and externalizing domains in latent variable models and high connectivity in network analyses. Overall, the latent variable and network approaches yielded more convergent than discriminant findings, suggesting that both may be complementary tools for evaluating the utility of transdiagnostic constructs for psychopathology research.
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http://dx.doi.org/10.1007/s10802-021-00770-8DOI Listing
June 2021

On hierarchically-informed measures of psychopathology.

World Psychiatry 2021 Feb;20(1):66-67

Department of Psychology, University of Iowa, Iowa City, IA, USA.

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http://dx.doi.org/10.1002/wps.20812DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801835PMC
February 2021

A longitudinal study on clinically relevant self-reported depression, anxiety and acute stress features among Italian community-dwelling adults during the COVID-19 related lockdown: Evidence of a predictive role for baseline dysfunctional personality dimensions.

J Affect Disord 2021 03 29;282:364-371. Epub 2020 Dec 29.

Vita-Salute San Raffaele University, Milan, Italy. Electronic address:

Background: Although necessary for public health, quarantine has been documented to cause post-traumatic stress symptoms, anxiety, and depression. We designed the present longitudinal study to evaluate the psychological impact of quarantine in Italian community-dwelling adult participants.

Methods: A sample of 304 Italian community-dwelling adult participants (75.7% female; mean age = 35.28 years) was administered self-reported measures of depression, anxiety and acute stress symptoms at the beginning and at the end of the lockdown. Potential predictors of clinically relevant symptoms at the end of the lockdown were assessed. Specifically, data on gender, civil status, education level, occupation, and area of residence, as well as maladaptive personality domains were collected.

Results: More than 43% of participants suffered from the early impact of the lockdown; at the end of the lockdown roughly 32% of participants still reported any clinically relevant depression anxiety, and/or acute stress disorder condition. Clinically relevant acute stress reaction at the beginning of lockdown was a particularly important risk factor for experiencing clinically relevant acute stress, depression, and anxiety at the end of the lockdown. Maladaptive personality domains represent non-trivial predictors of participants' self-reports of clinically relevant depression, anxiety, and acute stress conditions at the end of the lockdown.

Limitations: Excess of female participants and the impossibility of evaluating if participants suffered from any internalizing disorder before the COVID-19 quarantine represent major limitations of our study.

Conclusions: Our findings suggest assessment of internalizing disorder symptoms during quarantine may be helpful in identifying people who may benefit from early treatment interventions.
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http://dx.doi.org/10.1016/j.jad.2020.12.165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834264PMC
March 2021

The relationship between obsessive-compulsive spectrum disorders and DSM-5 dysfunctional personality domains in a nonclinical sample of Italian women.

Personal Ment Health 2021 05 3;15(2):147-156. Epub 2021 Jan 3.

Vita-Salute San Raffaele University, Milan, Italy.

To evaluate the usefulness of the DSM-5 maladaptive personality domains in explaining the similarities and differences among four disorders included in the obsessive-compulsive spectrum, 428 Italian community-dwelling women (mean age = 31.96 years, SD = 12.30 years) were administered the Obsessive-Compulsive Spectrum Disorder Scales and the Personality Inventory for DSM-5-Short Form as part of an ongoing online survey on women's health. Multiple Indicators Multiple Causes (MIMIC) confirmatory bifactor analysis results showed that the OCSD general factor (i.e., obsessive-compulsive spectrum factor) was positively associated with Negative Affectivity, whereas Body Dysmorphic Disorder (BDD), Hoarding Disorder (HD), and Skin-Picking Disorder (SPD) specific factors showed significant and substantial differential relationships with dysfunctional personality domains. Specifically, BDD was positively associated with Negative Affectivity, Detachment and Psychoticism domains; HD was associated with high Negative Affectivity and Psychoticism; and SPD was associated with Detachment. © 2020 John Wiley & Sons, Ltd.
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http://dx.doi.org/10.1002/pmh.1502DOI Listing
May 2021

The distinction between symptoms and traits in the Hierarchical Taxonomy of Psychopathology (HiTOP).

J Pers 2020 Sep 26. Epub 2020 Sep 26.

Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirically and quantitatively derived dimensional classification system designed to describe the features of psychopathology and, ultimately, to replace categorical nosologies. Among the constructs that HiTOP organizes are "symptom components" and "maladaptive traits," but past HiTOP publications have not fully explicated the distinction between symptoms and traits. We propose working definitions of symptoms and traits and explore challenges, exceptions, and remaining questions. Specifically, we propose that the only systematic difference between symptoms and traits in HiTOP is one of time frame. Maladaptive traits are dispositional constructs that describe persistent tendencies to manifest features of psychopathology, whereas symptoms are features of psychopathology as they are manifest during any specific time period (from moments to days to months). This has the consequence that almost every HiTOP dimension, at any level of the hierarchy, can be assessed as either a trait or a symptom dimension, by adjusting the framing of the assessment. We discuss the implications of these definitions for causal models of the relations between symptoms and traits and for distinctions between psychopathology, normal personality variation, and dysfunction.
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http://dx.doi.org/10.1111/jopy.12593DOI Listing
September 2020

Body Dysmorphic Disorder in the Perspective of the Alternative DSM-5 Model for Personality Disorder: A Study on Italian Community-Dwelling Women.

J Nerv Ment Dis 2020 12;208(12):974-981

School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.

To evaluate the relationships between body dysmorphic disorder (BDD) and Alternative DSM-5 Model for Personality Disorder (AMPD) criterion A and dysfunctional personality trait (i.e., criterion B) measures, 420 Italian community-dwelling women were administered three measures of BDD (i.e., the Body Dysmorphic Disorder Questionnaire, the Body Dysmorphic Disorder-Dimensional Scale, and the Appearance Anxiety Inventory), as well as the Level of Personality Functioning Scale-Brief Form (LPFS-BF) and the Personality Inventory for DSM-5-Short Form (PID-5-SF). The three BDD measures showed substantial convergent validity correlations and could be reliably cumulated to obtain the BDD Cumulative Index (BDDCI). Several significant, nonnegligible correlations were observed between the BDDCI as well as the LPFS-BF scale scores and PID-5-SF personality trait scale scores. Relative importance weight analysis results showed that LPFS-BF scale scores and PID-5-SF trait scale scores were substantial predictors of the BDDCI scores (R = 0.42, f = 0.72). In particular, AMPD criterion A impairment in self-functioning and AMPD criterion B depressivity, anhedonia, perseveration, separation insecurity, and cognitive and perceptual dysregulation were core components of the dysfunctional personality profile associated with BDD.
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http://dx.doi.org/10.1097/NMD.0000000000001239DOI Listing
December 2020

Dysfunctional personality features, non-scientifically supported causal beliefs, and emotional problems during the first month of the COVID-19 pandemic in Italy.

Pers Individ Dif 2020 Oct 26;165:110139. Epub 2020 May 26.

Vita-Salute San Raffaele University, Milan, Italy.

The present study aimed at assessing the impact of demographic characteristics, maladaptive personality traits and causal beliefs about COVID-19 on perceived emotional problems in a sample of Italian community-dwelling adults ( = 1043) in the first month of the social distancing period due to the COVID-19 pandemic in Italy. Hierarchical logistic regression analysis results showed that dysfunctional personality domains and non-scientifically supported causal beliefs explained all the variance that was originally explained by demographic variables (i.e., age and gender). In particular, negative affectivity and detachment represented relevant risk factors for reduced emotional well-being in our sample. A significant positive association was observed also between emotional problems and supernatural causal beliefs on the COVID-19 infection. Our data supported the importance of considering the impact of quarantine measures on psychological well-being, while suggesting possible risk factors related to individual differences in personality and causal beliefs.
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http://dx.doi.org/10.1016/j.paid.2020.110139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247995PMC
October 2020

Assessing dark triad dimensions from the perspective of moral disengagement and DSM-5 alternative model of personality disorder traits.

Personal Disord 2020 03 9;11(2):100-107. Epub 2020 Jan 9.

Faculty of Psychology, Vita-Salute San Raffaele University.

The present study aimed to test the relationships of Dark Triad constructs with propensity toward moral disengagement and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Alternative Model of Personality Disorder (AMPD) maladaptive personality traits. A total of 279 community-dwelling adult participants (41.6% male; Mage = 32.27 years) were administered the Two-Dimensional Mach-IV Scale, Five-Factor Narcissism Inventory-Short Form, Triarchic Psychopathy Measure, Personality Inventory for DSM-5, and Moral Disengagement Scale. Multiple regression results showed differential associations between Dark Triad construct traits and propensity toward moral disengagement. Correlation analyses showed that all Dark Triad trait dimensions could be substantially described in terms of AMPD maladaptive trait profile. When the effect of Moral Disengagement Scale scores was taken into account in relative importance weights analysis (Radjusted2 = .66), DSM-5 AMPD maladaptive trait profile explained 27% of the variance in the "Dark Triad" latent factor over and above the effect of moral disengagement. As a whole, our findings supported the idea that the Dark Triad personality constructs are likely to share a common core of antagonistic maladaptive personality traits. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/per0000388DOI Listing
March 2020

Redefining phenotypes to advance psychiatric genetics: Implications from hierarchical taxonomy of psychopathology.

J Abnorm Psychol 2020 Feb 5;129(2):143-161. Epub 2019 Dec 5.

Department of Psychology.

Genetic discovery in psychiatry and clinical psychology is hindered by suboptimal phenotypic definitions. We argue that the hierarchical, dimensional, and data-driven classification system proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium provides a more effective approach to identifying genes that underlie mental disorders, and to studying psychiatric etiology, than current diagnostic categories. Specifically, genes are expected to operate at different levels of the HiTOP hierarchy, with some highly pleiotropic genes influencing higher order psychopathology (e.g., the general factor), whereas other genes conferring more specific risk for individual spectra (e.g., internalizing), subfactors (e.g., fear disorders), or narrow symptoms (e.g., mood instability). We propose that the HiTOP model aligns well with the current understanding of the higher order genetic structure of psychopathology that has emerged from a large body of family and twin studies. We also discuss the convergence between the HiTOP model and findings from recent molecular studies of psychopathology indicating broad genetic pleiotropy, such as cross-disorder SNP-based shared genetic covariance and polygenic risk scores, and we highlight molecular genetic studies that have successfully redefined phenotypes to enhance precision and statistical power. Finally, we suggest how to integrate a HiTOP approach into future molecular genetic research, including quantitative and hierarchical assessment tools for future data-collection and recommendations concerning phenotypic analyses. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/abn0000486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6980897PMC
February 2020

The network approach to psychopathology: promise versus reality.

World Psychiatry 2019 Oct;18(3):272-273

Department of Psychology, University of Minnesota, Minneapolis, MN, USA.

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http://dx.doi.org/10.1002/wps.20659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732676PMC
October 2019

The network approach to psychopathology: promise versus reality.

World Psychiatry 2019 Oct;18(3):272-273

Department of Psychology, University of Minnesota, Minneapolis, MN, USA.

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http://dx.doi.org/10.1002/wps.20659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732676PMC
October 2019

Are fit indices used to test psychopathology structure biased? A simulation study.

J Abnorm Psychol 2019 Oct 18;128(7):740-764. Epub 2019 Jul 18.

Department of Psychiatry.

Structural models of psychopathology provide dimensional alternatives to traditional categorical classification systems. Competing models, such as the bifactor and correlated factors models, are typically compared via statistical indices to assess how well each model fits the same data. However, simulation studies have found evidence for probifactor fit index bias in several psychological research domains. The present study sought to extend this research to models of psychopathology, wherein the bifactor model has received much attention, but its susceptibility to bias is not well characterized. We used Monte Carlo simulations to examine how various model misspecifications produced fit index bias for 2 commonly used estimators, WLSMV and MLR. We simulated binary indicators to represent psychiatric diagnoses and positively skewed continuous indicators to represent symptom counts. Across combinations of estimators, indicator distributions, and misspecifications, complex patterns of bias emerged, with fit indices more often than not failing to correctly identify the correlated factors model as the data-generating model. No fit index emerged as reliably unbiased across all misspecification scenarios. Although, tests of model equivalence indicated that in one instance fit indices were not biased-they favored the bifactor model, albeit not unfairly. Overall, results suggest that comparisons of bifactor models to alternatives using fit indices may be misleading and call into question the evidentiary meaning of previous studies that identified the bifactor model as superior based on fit. We highlight the importance of comparing models based on substantive interpretability and their utility for addressing study aims, the methodological significance of model equivalence, as well as the need for implementation of statistical metrics that evaluate model quality. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/abn0000434DOI Listing
October 2019

Assessing the relationships between self-reports of childhood adverse experiences and DSM-5 alternative model of personality disorder traits and domains: A study on Italian community-dwelling adults.

Personal Ment Health 2019 08 24;13(3):180-189. Epub 2019 Jun 24.

Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy.

A body of research suggests that child maltreatment may not represent an uncommon phenomenon. Adverse childhood experiences have been consistently linked to a variety of mental disorders, including personality disorder. Starting from these considerations, we aimed at testing the associations between retrospective self-reports of childhood abuse and Personality Inventory for DSM-5 (PID-5) traits and domains in a sample of community-dwelling adult participants (N = 369; 41.2% male). PID-5 scales yielded 63 (52.5%) rank-order correlations with self-reports of childhood abuse that were significant at Bonferroni-corrected p level (i.e. p < 0.00042), with values ranging from 0.18 to 0.36. According to Fisher's z-test for correlation coefficient homogeneity, the wide majority of the correlations were reproduced across male participants and female participants. Partial rank-order correlation analyses highlighted specific personality profiles that were uniquely, albeit modestly associated with memories of childhood abuse. Confirming and extending previous findings, our results showed that retrospective reports of childhood abuse are significantly, albeit moderately associated with different dysfunctional personality traits, at least in Italian community-dwelling adults. As a whole, our data seemed to stress the importance of PID-5 traits and domains in improving our understanding of the relationships between self-reports of childhood abuse and dysfunctional personality dimensions in adulthood. © 2019 John Wiley & Sons, Ltd.
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http://dx.doi.org/10.1002/pmh.1456DOI Listing
August 2019

Alternative Model of Personality Disorder Dysfunctional Personality Traits as Predictors of Self-Reported Aggression in an Italian Sample of Consecutively Admitted, Personality-Disordered Psychotherapy Patients.

J Pers Disord 2019 Jun 17:1-20. Epub 2019 Jun 17.

Vita-Salute San Raffaele University, Milan, Italy.

In order to assess the relationships between Alternative Model of Personality Disorder (AMPD) maladaptive personality traits and self-reports of aggression, 508 Italian adult participants who met at least one Axis II/ Section II personality disorder (PD) diagnosis were administered the Personality Inventory for (PID-5) and the Aggression Questionnaire (AQ). Analysis results showed that multiple regression results, PID-5 Hostility, Callousness, and Risk Taking trait scale scores explained a large amount of variance in AQ Physical Aggression (PA) scores. Moreover, PID-5 Hostility, Callousness, and Risk Taking explained more than 20% of the variance in the AQ Physical Aggression scale scores that was left unexplained by selected continuously scored Axis II/ Section II PDs, whereas SCID-II Paranoid, Narcissistic, Borderline, and Antisocial PDs added only 4% of variance to the amount of variance in AQ Physical Aggression scores that was already explained by the PID-5 trait scale scores.
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http://dx.doi.org/10.1521/pedi_2019_33_430DOI Listing
June 2019

Quantifying the Reliability and Replicability of Psychopathology Network Characteristics.

Multivariate Behav Res 2021 Mar-Apr;56(2):224-242. Epub 2019 May 29.

Department of Psychology, University of Minnesota, Minneapolis, MN, USA.

Pairwise Markov random field networks-including Gaussian graphical models (GGMs) and Ising models-have become the "state-of-the-art" method for psychopathology network analyses. Recent research has focused on the reliability and replicability of these networks. In the present study, we compared the existing suite of methods for maximizing and quantifying the stability and consistency of PMRF networks (i.e., lasso regularization, plus the and packages in ) with a set of metrics for directly comparing the detailed network characteristics interpreted in the literature (e.g., the presence, absence, sign, and strength of each individual edge). We compared GGMs of depression and anxiety symptoms in two waves of data from an observational study ( = 403) and reanalyzed four posttraumatic stress disorder GGMs from a recent study of network replicability. Taken on face value, the existing suite of methods indicated that overall the network edges were stable, interpretable, and consistent between networks, but the direct metrics of replication indicated that this was not the case (e.g., 39-49% of the edges in each network were unreplicated across the pairwise comparisons). We discuss reasons for these apparently contradictory results (e.g., relying on global summary statistics versus examining the detailed characteristics interpreted in the literature) and conclude that the limited reliability of the detailed characteristics of networks observed here is likely to be common in practice, but overlooked by current methods. Poor replicability underpins our concern surrounding the use of these methods, given that generalizable conclusions are fundamental to the utility of their results.
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http://dx.doi.org/10.1080/00273171.2019.1616526DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6883148PMC
October 2021

Measurement of pathological personality traits according to the DSM-5: A Polish adaptation of the PID-5. Part II - empirical results.

Psychiatr Pol 2019 Feb 28;53(1):23-48. Epub 2019 Feb 28.

University of Minnesota.

Objectives: This paper presents results of a study on the Polish adaptation of the Personality Inventory for DSM-5 (PID-5), which was developed to measure pathological traits under a new, dimensional model proposed in Section III of the DSM-5 as part of a hybrid alternative system of personality disorder diagnosis.

Methods: The study involved a clinical sample (N = 129 individuals with a mean age of M = 32.40; SD = 9.08; 84.5% with a personality disorder diagnosis) and a non-clinical one (N = 1,043 individuals with a mean age of M = 34.98; SD = 15.71). Two questionnaires: the PID-5 and the MMPI-2 (Minnesota MultiphasicPersonality Inventory - 2) were use in the study.

Results: The results showed the Polish adaptation of the PID-5 to be reliable and valid (the internal consistency coefficients for the PID-5 scales and subscales were high in clinical sample and at satisfactory level in non-clinical sample). All scales and almost all subscales of the PID-5 turned out to differentiate between clinical and non-clinical samples. The PID-5 scales and subscales exhibited a consistent pattern of relationships with the Personality Psy-chopathology Five (PSY-5) dimensions and with the clinical scales of the MMPI-2.

Conclusions: Obtained data demonstrate the PID-5 to be a satisfactory operationalization of the pathological personality trait model, and at the same time corroborate the scientific value of the DSM-5 model itself.
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http://dx.doi.org/10.12740/PP/OnlineFirst/86478DOI Listing
February 2019

Measurement of pathological personality traits according to the DSM-5: A Polish adaptation of the PID-5. Part I - theoretical foundations.

Psychiatr Pol 2019 Feb 28;53(1):7-22. Epub 2019 Feb 28.

University of Minnesota.

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes a novel hybrid system of personality disorder diagnosis in addition to the one pre-viously laid down in the DSM-IV-TR. This alternative diagnostic system, published within Section III of the DSM-5, was hoped to overcome the inherent limitations of categorical diagnosis by integrating the categorical and dimensional approaches to personality disorders. As such, it constitutes a bridge between psychiatric pathology classifications and findings from psychological research on the structure of normal personality.At the core of the hybrid DSM-5 system lies a new model of pathological personality traits, operationalized using the Personality Inventory for DSM-5 (PID-5). This paper outlines the background and main features of the DSM-5 hybrid system of personality disorder diagnosis with a focus on the dimensional model of pathological traits and definitions thereof. The cur-rent status, application potential and limitations of the DSM-5 diagnostic system and the pathological traits model are also discussed. In another paper, the authors present the PID-5 inventory and report on a study investigating a Polish adaptation of this instrument.
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http://dx.doi.org/10.12740/PP/OnlineFirst/86477DOI Listing
February 2019

The replicability of the personality inventory for DSM-5 domain scale factor structure in U.S. and non-U.S. samples: A quantitative review of the published literature.

Psychol Assess 2019 Jul 18;31(7):861-877. Epub 2019 Mar 18.

Faculty of Psychology.

The present study aimed at quantitatively synthesizing published studies on the replicability of the Personality Inventory for , fifth edition (; PID-5) domain factor structure in U.S. and non-U.S. cultural contexts. A literature search was conducted, and 23 studies based on 25 samples ( = 24,240) were included. Seven studies provided data on the factor replicability of the PID-5 in the U.S. and 16 studies yielded PID-5 factor replicability data in non-U.S. countries. The majority ( = 17, 68.0%) of the studies were based on community/student samples. Median congruence coefficient (CC) values ranged from .92 to .98 in U.S. studies, and from .91 to .97 in non-U.S. studies. No significant effect of sample type, translation, and geographic area on CC values was observed. Meta-analytic structural equation modeling results supported the homogeneity of the PID-5 scale correlation matrices across both U.S. studies, root mean square error of approximation (RMSEA) = .039, and non-U.S. studies, RMSEA = .045. Dimensionality analyses of the pooled correlation matrix provided evidence for a 5-factor structure of the PID-5 scales in both U.S. and non-U.S. studies; the resulting factor loading matrices were highly similar to the normative U.S. factor loading matrix. As a whole, our findings support the generalizability of the PID-5 factor structure, suggesting the replicability of Negative Affectivity, Detachment, Antagonism, and Psychoticism factors across different samples, translations, age groups, and nations. Further studies on samples from non-Western Europe countries, as well as from specific population, are needed before drawing definitive conclusions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/pas0000711DOI Listing
July 2019

A correlated traits, correlated methods model for thin-slice child personality assessment.

Psychol Assess 2019 Apr 14;31(4):545-556. Epub 2019 Mar 14.

Department of Psychology.

Recent research has illustrated the utility and accuracy of a thin-slice (TS) approach to child personality assessment, whereby unacquainted observers provide personality ratings of children after exposure to brief behavioral episodes. The current study sought to expand on this approach by exploring formal multitrait-multimethod (MTMM) models for child TS data comprising ratings from a comprehensive set of TS situations. Results using data from a sample of 326 community children 9-10 years of age indicated that a correlated traits, correlated methods (CTCM) model can be used to represent individual differences in children's behavior as manifest across different situations. Indicator variables derived from a CTCM differentially correlated with traditional parental ratings of behavior, moreover, and provide predictive and incremental validity regarding child competencies and behavior. Results illustrate the utility of a TS approach in the assessment of childhood personality and inform understanding of issues encountered in applying different MTMM models to these types of empirical data. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/pas0000635DOI Listing
April 2019

Psychology's Replication Crisis and Clinical Psychological Science.

Annu Rev Clin Psychol 2019 05 23;15:579-604. Epub 2019 Jan 23.

Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa 52242, USA.

Despite psychological scientists' increasing interest in replicability, open science, research transparency, and the improvement of methods and practices, the clinical psychology community has been slow to engage. This has been shifting more recently, and with this review, we hope to facilitate this emerging dialogue. We begin by examining some potential areas of weakness in clinical psychology in terms of methods, practices, and evidentiary base. We then discuss a select overview of solutions, tools, and current concerns of the reform movement from a clinical psychological science perspective. We examine areas of clinical science expertise (e.g., implementation science) that should be leveraged to inform open science and reform efforts. Finally, we reiterate the call to clinical psychologists to increase their efforts toward reform that can further improve the credibility of clinical psychological science.
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http://dx.doi.org/10.1146/annurev-clinpsy-050718-095710DOI Listing
May 2019

Bifactor and Hierarchical Models: Specification, Inference, and Interpretation.

Annu Rev Clin Psychol 2019 05 16;15:51-69. Epub 2019 Jan 16.

Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa 52242, USA; email:

Bifactor and other hierarchical models have become central to representing and explaining observations in psychopathology, health, and other areas of clinical science, as well as in the behavioral sciences more broadly. This prominence comes after a relatively rapid period of rediscovery, however, and certain features remain poorly understood. Here, hierarchical models are compared and contrasted with other models of superordinate structure, with a focus on implications for model comparisons and interpretation. Issues pertaining to the specification and estimation of bifactor and other hierarchical models are reviewed in exploratory as well as confirmatory modeling scenarios, as are emerging findings about model fit and selection. Bifactor and other hierarchical models provide a powerful mechanism for parsing shared and unique components of variance, but care is required in specifying and making inferences about them.
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http://dx.doi.org/10.1146/annurev-clinpsy-050718-095522DOI Listing
May 2019
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