The structure and short-term stability of the emotional disorders: a dimensional approach
The structure and short-term stability of the emotional disorders: a dimensional approach
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DOI：
10.1017/s0033291714002815
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发表时间：
2015-06-01
影响因子：
6.9
通讯作者：
Watson, D.
中科院分区：
文献类型：
--
作者：
Kotov, R.;Perlman, G.;Watson, D.
背景因素分析研究发现，抑郁症、躁郁症、创伤后精神障碍、强迫症和焦虑症--统称为情绪障碍--形成了一个包括痛苦和恐惧子因素的内化谱。然而，一些疾病的位置是不确定的。此外，先前的研究分析了基于二分访谈的诊断或维度自我报告措施。我们使用第三代测量-情绪和焦虑症状访谈（IMAS）-结合临床访谈与维度评估的优势来调查这种结构。访谈进行了385名学生和288精神科门诊病人。参与者在2个月后再次接受采访。探索性和验证性因素分析确定了三个因素：痛苦（抑郁，广泛性焦虑，创伤后应激，易怒和恐慌综合征）;恐惧（社交焦虑，广场恐怖症，特定恐怖症和强迫症）;和双相情感障碍（躁狂和强迫症）。结构是一致的，随着时间的推移和样本，除了恐慌和广场恐怖症有较高的因素负荷的患者。纵向分析揭示了高的时间稳定性的因素（重测r = 0.72至0.87），但也实质性的疾病特异性的稳定性。这项调查--它连接了诊断研究和自我报告研究--发现了内化精神病理学的三个子因素。它为一个新的子因素提供了支持，澄清了强迫症和双相情感障碍的位置，并证明了该模型在人群中的普遍性。越来越多的研究表明，需要正式认识到情绪障碍之间的密切联系，以及在这一范围内的经验集群。IMAS表现出较强的心理测量特性，并可用于各种研究和临床应用，通过提供维度，访谈为基础的评估情绪障碍。
Background. Factor-analytic studies have found that depressive, bipolar, post-traumatic, obsessive-compulsive, and anxiety disorders - jointly referred to as the emotional disorders - form an internalizing spectrum that includes distress and fear subfactors. However, placement of some disorders is uncertain. Also, prior research analysed dichotomous interview-based diagnoses or dimensional self-report measures. We investigated this structure using a third-generation measure - the Interview for Mood and Anxiety Symptoms (IMAS) - that combines strengths of a clinical interview with dimensional assessment.Method. The interview was administered to 385 students and 288 psychiatric out-patients. Participants were reinterviewed 2 months later.Results. Exploratory and confirmatory factor analyses identified three factors: distress (depression, generalized anxiety, post-traumatic stress, irritability, and panic syndrome); fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive); and bipolar (mania and obsessive-compulsive). The structure was consistent over time and across samples, except that panic and agoraphobia had higher factor loadings in patients. Longitudinal analyses revealed high temporal stability of the factors (test-retest r = 0.72 to 0.87), but also substantial disorder-specific stability.Conclusions. This investigation - which bridges diagnostic and self-report studies - found three subfactors of internalizing psychopathology. It provided support for a new subfactor, clarified the placement of obsessive-compulsive and bipolar disorders, and demonstrated that this model generalizes across populations. The accumulating research suggests the need to recognize formally the close links among the emotional disorders, as well as empirical clusters within this spectrum. The IMAS demonstrated strong psychometric properties and can be useful for various research and clinical applications by providing dimensional, interview-based assessment of the emotional disorders.