All for One and One for All: Mental Disorders in One Dimension

American Journal of Psychiatry, Journal Year: 2018, Volume and Issue: 175(9), P. 831 - 844

Published: April 6, 2018

In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able measure person’s liability mental disorder, comorbidity among disorders, persistence of disorders over time, severity symptoms. This general psychopathology been termed “p,” because it conceptually parallels already familiar behavioral scientists clinicians: the “g” factor intelligence. As g reflects low high ability, p represents severity, with thought disorder at extreme. The unites all disorders. It influences present/absent status on hundreds psychiatric symptoms, which modern nosological systems typically aggregate into dozens distinct diagnoses, in turn three overarching domains, namely, externalizing, internalizing, psychotic experience finally one from high: p. Studies show higher person scores p, worse fares measures family history illness, brain function, childhood developmental history, life impairment. A may help account for ubiquitous nonspecificity psychiatry: multiple share same risk factors biomarkers often respond therapies. Here, authors summarize unidimensional idea, review research demystify statistical models, articulate some implications prevention clinical practice, outline transdiagnostic agenda. [AJP AT 175: Remembering Our Past We Envision Future October 1910: Study Association Insanity Grace Helen Kent A.J. Rosanoff:

Language: Английский

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The gut microbiota in anxiety and depression – A systematic review

Clinical Psychology Review, Journal Year: 2020, Volume and Issue: 83, P. 101943 - 101943

Published: Oct. 29, 2020

Language: Английский

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Transdiagnostic approaches to mental health problems: Current status and future directions.

Journal of Consulting and Clinical Psychology, Journal Year: 2020, Volume and Issue: 88(3), P. 179 - 195

Published: Feb. 18, 2020

Despite a longstanding and widespread influence of the diagnostic approach to mental ill health, there is an emerging growing consensus that such psychiatric nosologies may no longer be fit for purpose in research clinical practice.In their place, gathering support "transdiagnostic" cuts across traditional boundaries or, more radically, sets them aside altogether, provide novel insights into how we might understand health difficulties.Removing distinctions between proposed taxa at level classification opens up new ways classifying problems, suggests alternative conceptualizations processes implicated provides platform thinking about onset, maintenance, treatment recovery from experiences disabling distress.In this Introduction Special Section on Transdiagnostic Approaches Psychopathology, narrative review transdiagnostic literature order situate articles context.We begin with brief history outline several challenges it currently faces arguably limit its applicability current science practice.We then recent approaches classification, biopsychosocial processes, interventions, highlighting promising developments.Finally, present some key facing make suggestions way forward. What public significance article?Traditional systems facilitating understanding core underlying nor driving developments.Here propose 'transdiagnostic' have potential better represent scientific reality reflecting complexity, dimensionality comorbidity norm practice.

Language: Английский

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Supervised Machine Learning: A Brief Primer

Behavior Therapy, Journal Year: 2020, Volume and Issue: 51(5), P. 675 - 687

Published: May 16, 2020

Language: Английский

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Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study

JAMA Network Open, Journal Year: 2020, Volume and Issue: 3(4), P. e203221 - e203221

Published: April 21, 2020

Importance

Mental health professionals typically encounter patients at 1 point in patients’ lives. This cross-sectional window understandably fosters focus on the current presenting diagnosis. Research programs, treatment protocols, specialist clinics, and journals are oriented to diagnoses, assumption that diagnosis informs about causes prognosis. study tests an alternative hypothesis: people with mental disorders experience many different kinds of across diagnostic families, when followed for 4 decades.

Objective

To describe disorder life histories first half course.

Design, Setting, Participants

cohort involved participants born New Zealand from 1972 1973 who were enrolled population-representative Dunedin Study. Participants observed birth age 45 years (until April 2019). Data analyzed May 2019 January 2020.

Main Outcomes Measures

Diagnosed impairing assessed 9 times ages 11 years. Brain function was through neurocognitive examinations conducted 3 years, neuropsychological testing during childhood adulthood, midlife neuroimaging-based brain age.

Results

Of 1037 original (535 male [51.6%]), 1013 had data available. The proportions meeting criteria a as follows: 35% (346 975) 15 50% (473 941) 18 51% (489 961) 21 48% (472 977) 26 46% (444 969) 32 45% (429 955) 38 44% (407 927) onset occurred by adolescence 59% (600 1013), eventually affecting 86% (869 1013) midlife. By 85% (737 869) accumulated comorbid diagnoses. adolescent-onset subsequently presented more past-year assessments (r = 0.71; 95% CI, 0.68 0.74;P < .001) met diverse 0.64; 0.60 0.67;P .001). Confirmatory factor analysis summarizing decades identified general psychopathology, p-factor. Longitudinal analyses showed high p-factor scores (indicating extensive histories) antedated poor functioning −0.18; −0.24 −0.12;P .001), accompanied childhood-to-adulthood cognitive decline −0.11; −0.17 −0.04;P associated older 0.14; 0.07 0.20;P

Conclusions Relevance

These findings suggest shift among successive disorders. present study, alongside nationwide Danish registers, inform life-course perspective cautions against overreliance diagnosis-specific research clinical protocols.

Language: Английский

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Controversies in Narcissism

Annual Review of Clinical Psychology, Journal Year: 2017, Volume and Issue: 13(1), P. 291 - 315

Published: March 16, 2017

There has been a surge in interest and research on narcissism narcissistic personality disorder (NPD). Despite or because of this increased attention, there are several areas substantial debate that surround the construct, including descriptions grandiose vulnerable dimensions variants, questions regarding existence consensual description, central versus peripheral features narcissism, distinctions between normal pathological possible etiological factors, role self-esteem where should be studied, how it can assessed, its representation diagnostic nosologies. We suggest failure to distinguish (i.e., overtly immodest, self-centered, entitled, domineering) (e.g., distrustful, neurotic, introverted) presentations led less cohesive coherent literature trait-based models bring greater clarity many these important debates.

Language: Английский

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Exploring Comorbidity Within Mental Disorders Among a Danish National Population

JAMA Psychiatry, Journal Year: 2019, Volume and Issue: 76(3), P. 259 - 259

Published: Jan. 16, 2019

Individuals with mental disorders often develop comorbidity over time. Past studies of have restricted analyses to a subset and few provided absolute risks later comorbidity.To undertake comprehensive study within disorders, by providing temporally ordered age- sex-specific pairwise estimates between the major groups an interactive website visualize all results guide future research clinical practice.This population-based cohort included individuals born in Denmark January 1, 1900, December 31, 2015, living country 2000, 2016. The were conducted June 2017 May 2018.Danish health registers used identify which examined broad 10-level International Statistical Classification Diseases Related Health Problems, 10th Revision, subchapter (eg, codes F00-F09 F10-F19). For each pair overall lagged hazard ratios 95% CIs calculated using Cox proportional hazards regression models. Absolute estimated competing survival analyses. Estimates for sex generated.A total 5 940 778 persons this (2 958 293 men 2 982 485 women; mean [SD] age at beginning follow-up, 32.1 [25.4] years). They followed up 83.9 million person-years. All associated increased risk other when adjusting sex, age, calendar time (hazard ranging from 2.0 [95% CI, 1.7-2.4] prior intellectual disabilities eating 48.6 46.6-50.7] developmental disabilities). patterned, higher during first year after onset disorder, but persistently elevated rates entire observation period. Some substantial developing specific 30.6% 29.3%-32.0%] 38.4% 37.5%-39.4%] women diagnosis mood before 20 years developed neurotic following years).Comorbidity is pervasive, persists This provides disorder-, sex-, age-specific relative disorders. Web-based data visualization tools are utility.

Language: Английский

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Progress in achieving quantitative classification of psychopathology

World Psychiatry, Journal Year: 2018, Volume and Issue: 17(3), P. 282 - 293

Published: Sept. 7, 2018

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

Language: Английский

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The Hierarchical Taxonomy of Psychopathology (HiTOP): A Quantitative Nosology Based on Consensus of Evidence

Annual Review of Clinical Psychology, Journal Year: 2021, Volume and Issue: 17(1), P. 83 - 108

Published: Feb. 13, 2021

Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research utility clinicalpractice are therefore limited. The Hierarchical Taxonomy Psychopathology (HiTOP) consortium proposed a model based structural evidence. It addresses problems heterogeneity, comorbidity, unreliability. We review HiTOP model, supporting evidence, conceptualization this hierarchical dimensional framework. system is yet comprehensive, we describe processes for improving expanding it. summarize data ability to predict explain etiology (genetic, environmental, neurobiological), risk factors, outcomes, treatment response. progress development HiTOP-based measures clinical implementation system. Finally, outstanding challenges agenda. practical already, its ongoing will produce transformative map psychopathology.

Language: Английский

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Mental Health During the First Year of the COVID-19 Pandemic: A Review and Recommendations for Moving Forward

Perspectives on Psychological Science, Journal Year: 2022, Volume and Issue: 17(4), P. 915 - 936

Published: Jan. 19, 2022

COVID-19 has infected millions of people and upended the lives most humans on planet. Researchers from across psychological sciences have sought to document investigate impact in myriad ways, causing an explosion research that is broad scope, varied methods, challenging consolidate. Because policy practice aimed at helping live healthier happier requires insight robust patterns evidence, this article provides a rapid thorough summary high-quality studies available through early 2021 examining mental-health consequences living pandemic. Our review evidence indicates anxiety, depression, distress increased months Meanwhile, suicide rates, life satisfaction, loneliness remained largely stable throughout first year In response these insights, we present seven recommendations (one urgent, two short-term, four ongoing) support mental health during pandemic beyond.

Language: Английский

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