The General Factor of Psychopathology in Psychosis and Severe Mental Illness

精神病和严重精神疾病的精神病理学一般因素

• 批准号: 10413229
• 负责人: STEPHAN HECKERS
• 金额: $ 91.35万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10413229
• 关键词: Address; Adult; Age; Anterior; Area; Categories; Characteristics; Child; Clinical; Clinical assessments; Cognitive; Communities; Data; Diagnosis; Dimensions; Disease; Etiology; Functional Magnetic Resonance Imaging; Impaired cognition; Individual; Individual Differences; Influentials; Interview; Literature; Manic; Measures; Medical; Mental disorders; Meta-Analysis; Methodology; Modeling; Neuropsychology; Patients; Population; Prognosis; Properdin; Psychopathology; Psychoses; Psychotic Disorders; Recovery; Research; Risk; Risk Factors; Sampling; Schizophrenia; Schizotypal Personality Disorder; Sensory; Severities; Shared Paranoid Disorder; Structural Models; Structure; Symptoms; Temporal Lobe; Testing; Thalamic structure; Work; Youth; base; cognitive function; experience; first episode psychosis; first episode schizophrenia; longitudinal design; neural correlate; neuropathology; novel; prognostic assays; prognostic significance; psychotic symptoms; risk variant; schizophrenia-spectrum disorder; severe mental illness

An increasing body of evidence on the structure of psychopathology indicates the presence of a general factor of psychopathology (GF), also referred to as a P-factor, that explains a significant amount of the common variance in the expression of multiple psychopathological symptoms and disorders. The presence of a GF has substantial implications for understanding psychopathology because it suggests that a comprehensive understanding of mental illness requires an untangling of nonspecific risk factors from more narrow, dimension- specific risk factors or features. Caspi et al., (2014) suggest that schizophrenia symptoms are so highly correlated with the GF, that they are mostly an expression of the GF. However, methodological limitations, such as the use of community and youth samples, limit conclusions from the existing literature. We propose to test the hypothesis that schizophrenia spectrum (SS) symptoms load heavily on both a GF AND a separate higher-order psychosis factor using a sample of 1000 adult psychiatric and medical treatment seeking subjects that includes a substantial group of patients with SS disorders as well as patients with significant externalizing and internalizing symptoms. The potential utility of this hierarchical dimensional approach is that it allows quantification of the extent to which each individual possesses a high GF score (reflected in the overall breadth of symptoms), or symptoms that are more narrowly constrained to a specific 2nd order factor (such as externalizing, internalizing, and psychosis factors) or even more narrow, first-order symptom dimensions. Using this quantitative approach, we will test the extent to which neuropsychological and structural and functional MRI measures that have previously been observed in patients with schizophrenia are more strongly related to the GF versus a psychosis factor. This will allow us to test the hypothesis that some neural correlates, such as the volume of the anterior cingulate area, are nonspecific correlates of the GF, while others, such as temporal cortical sensory processing abnormalities, are specific to the psychosis, and remain even after controlling for the GF. In order to test the prognostic significance of the GF, we will additionally test whether scores on the GF are predictive of course of illness in 50 SS patients experiencing first-episode psychosis. Taken together, the study will provide the most comprehensive test to date of the relevance of GF model to understanding the expression and neural correlates of severe psychopathology,

越来越多的关于精神病理学结构的证据表明存在一个普遍因素 精神病理学（GF），也被称为P因子，它解释了大量的常见的 多种精神病理学症状和障碍的表达差异。一个GF的存在 这对理解精神病理学具有重大意义，因为它表明， 理解精神疾病需要从更狭窄的维度解开非特异性风险因素， 特定的风险因素或特征。Caspi等人，（2014）表明精神分裂症症状与GF高度相关，它们主要是GF的表达。然而，方法上的局限性，如使用社区和青年样本，限制了现有文献的结论。我们建议使用1000名成年精神病和寻求药物治疗的受试者样本来检验精神分裂症谱（SS）症状在GF和单独的高阶精神病因素上负荷很大的假设， 患有SS障碍的患者以及具有显著的外化和内化症状的患者。的 这种分层维度方法的潜在效用在于，它允许量化 每个人都有一个高的GF分数（反映在症状的整体广度），或症状， 更狭义地限制于特定的二阶因素（如外化、内化和精神病 因素）或甚至更窄的一阶症状维度。使用这种定量方法，我们将测试 神经心理学、结构和功能MRI测量的程度， 与精神病因素相比，精神分裂症患者中观察到的与GF的相关性更强。这将 允许我们测试一些神经相关的假设，例如前扣带区的体积， 是GF的非特异性相关性，而其他相关性，如颞叶皮层感觉处理异常， 是精神病特有的，即使在控制GF后仍然存在。为了检验预后 GF的显著性，我们将另外测试GF上的分数是否可以预测50例患者的病程。 SS患者出现首次精神病发作。总的来说，这项研究将提供最 迄今为止，GF模型与理解表达和神经相关性的相关性的综合测试 严重的精神病态