Should Clinicians Split or Lump Psychiatric Symptoms? The Structure of Psychopathology in Two Large Pediatric Clinical Samples from England and Norway

TY - JOUR

T1 - Should Clinicians Split or Lump Psychiatric Symptoms?

T2 - The Structure of Psychopathology in Two Large Pediatric Clinical Samples from England and Norway

AU - Fernández de la Cruz, Lorena

AU - Vidal-Ribas, Pablo

AU - Zahreddine, Nada

AU - Mathiassen, Børge

AU - Brøndbo, Per Håkan

AU - Simonoff, Emily

AU - Goodman, Robert

AU - Stringaris, Argyris

PY - 2017/12/14

Y1 - 2017/12/14

N2 - It has been suggested that the structure of psychiatric phenomena can be reduced to a few symptom dimensions. These proposals, mainly based on epidemiological samples, may not apply to clinical populations. We tested the structure of psychiatric symptoms across two pediatric clinical samples from England (N = 8434) and Norway (N = 5866). Confirmatory factor analyses of the parent-reported Strengths and Difficulties Questionnaire (SDQ) evaluated the relative fit of several models, including a first-order model, a second-order model with the widely-established broad symptom dimensions of internalizing-externalizing, and two bi-factor models capturing a general psychopathology factor. Predictive value of the SDQ subscales for psychiatric disorders was examined. A first-order five-factor solution better fit the data. The expected SDQ subscale(s) related best to the corresponding psychiatric diagnosis. In pediatric clinical samples, a granular approach to psychiatric symptoms where several dimensions are considered seems to fit the data better than models based on lumping symptoms into internalizing/externalizing dimensions.

AB - It has been suggested that the structure of psychiatric phenomena can be reduced to a few symptom dimensions. These proposals, mainly based on epidemiological samples, may not apply to clinical populations. We tested the structure of psychiatric symptoms across two pediatric clinical samples from England (N = 8434) and Norway (N = 5866). Confirmatory factor analyses of the parent-reported Strengths and Difficulties Questionnaire (SDQ) evaluated the relative fit of several models, including a first-order model, a second-order model with the widely-established broad symptom dimensions of internalizing-externalizing, and two bi-factor models capturing a general psychopathology factor. Predictive value of the SDQ subscales for psychiatric disorders was examined. A first-order five-factor solution better fit the data. The expected SDQ subscale(s) related best to the corresponding psychiatric diagnosis. In pediatric clinical samples, a granular approach to psychiatric symptoms where several dimensions are considered seems to fit the data better than models based on lumping symptoms into internalizing/externalizing dimensions.

KW - Construct validity

KW - Factor structure

KW - Nosology

KW - Predictive value

KW - Strengths and Difficulties Questionnaire

UR - http://www.scopus.com/inward/record.url?scp=85038117790&partnerID=8YFLogxK

U2 - 10.1007/s10578-017-0777-1

DO - 10.1007/s10578-017-0777-1

M3 - Article

AN - SCOPUS:85038117790

SN - 0009-398X

JO - Child Psychiatry and Human Development

JF - Child Psychiatry and Human Development

ER -