In search of disorders: internalizing symptom networks in a large clinical sample.

E McElroy, P Patalay

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)
1 Downloads (Pure)

Abstract

Background
The co-occurrence of internalizing disorders is a common form of psychiatric comorbidity, raising questions about the boundaries between these diagnostic categories. We employ network psychometrics in order to: (a) determine whether internalizing symptoms cluster in a manner reflecting DSM diagnostic criteria, (b) gauge how distinct these diagnostic clusters are and (c) examine whether this network structure changes from childhood to early and then late adolescence.

Method
Symptom-level data were obtained for service users in publicly funded mental health services in England between 2011 and 2015 (N = 37,162). A symptom network (i.e. Gaussian graphical model) was estimated, and a community detection algorithm was used to explore the clustering of symptoms.

Results
The estimated network was densely connected and characterized by a multitude of weak associations between symptoms. Six communities of symptoms were identified; however, they were weakly demarcated. Two of these communities corresponded to social phobia and panic disorder, and four did not clearly correspond with DSM diagnostic categories. The network structure was largely consistent by sex and across three age groups (8–11, 12–14 and 15–18 years). Symptom connectivity in the two older age groups was significantly greater compared to the youngest group and there were differences in centrality across the age groups, highlighting the age-specific relevance of certain symptoms.

Conclusions
These findings clearly demonstrate the interconnected nature of internalizing symptoms, challenging the view that such pathology takes the form of distinct disorders.
Original languageEnglish
Pages (from-to)897-906
Number of pages10
JournalJournal of Child Psychology and Psychiatry
Volume60
Issue number8
Early online date21 Mar 2019
DOIs
Publication statusPublished - 17 Jul 2019

Keywords

  • Nosology
  • depression
  • anxiety
  • comorbidity
  • developmental psychopathology
  • network analysis

Fingerprint

Dive into the research topics of 'In search of disorders: internalizing symptom networks in a large clinical sample.'. Together they form a unique fingerprint.

Cite this