بررسی ساختار آسیب شناسی روانی با استفاده از تجزیه و تحلیل کلاس پنهان

Several recent studies using factor analytic methods find that the structure of psychopathology reflects broad internalizing and externalizing dimensions, with the internalizing dimension being further divided into fear and distress disorders. Although these variable-centered studies have provided important insights into the structure of psychopathology, they provide limited information about the classification of individual cases. The present study examines patterns of lifetime internalizing and externalizing psychopathology in participants from the Oregon Adolescent Depression Project using latent class analysis that classifies individuals rather than variables. A 4-class solution best fits the data. The largest class (62.5%) included individuals with relatively little psychopathology; 1 class (16.4%) was largely characterized by internalizing disorders, 1 class (16.9%), largely characterized by externalizing disorders; and the final class (4.2%), characterized by both internalizing and externalizing disorders. The validity of the classes was further examined using data on psychiatric morbidity, temperament, and family aggregation of psychopathology. Classes differed on indices of positive, negative, and disinhibited temperament in ways that were consistent with theoretical predictions. Patterns of familial aggregation of psychopathology demonstrated relative specificity of transmission of different disorders. Overall, the findings support conclusions from studies of dimensional models of internalizing and externalizing disorders, and extend them to person-centered approaches to classification.

Several studies on the structure of internalizing and externalizing psychopathology conducted over the last decade have largely relied on variable-centered methodologies such as factor analysis for investigating structural associations among various forms of psychopathology [1], [2], [3], [4], [5] and [6]. In many of these studies, the authors concluded that the best fitting model was a higher order internalizing factor with 2 facets, reflecting distress and fear disorders, and a single externalizing factor [1], [2], [3] and [5]. Exceptions to this general pattern, however, have been reported. In 1 instance, the best-fitting model included distress, fear, and externalizing factors but not a higher order internalizing factor [6], whereas another study found that the best-fitting model included single factors for internalizing and externalizing disorders [4]. Similar findings have also been reported in studies of children and adolescents [7] and [8], suggesting continuity in structure across development. In each of the studies that reported higher order internalizing and externalizing factors, moderate associations between factors were noted, suggesting significant covariation among internalizing disorders, among externalizing disorders, and across internalizing and externalizing disorders.