The structure and predictive validity of the internalizing disorders.

Area of Science:

• Psychiatry and Psychology
• Behavioral Science
• Epidemiology

Background:

• Multivariate comorbidity research suggests shared underlying factors for mood and anxiety disorders.
• Previous research has not directly compared categorical, dimensional, and hybrid models of these shared liabilities.
• Understanding these common liabilities is crucial for accurate diagnosis and treatment of internalizing disorders.

Purpose of the Study:

• To compare different models of shared liabilities for seven internalizing disorders.
• To identify the best-fitting model for these common vulnerabilities.
• To examine the predictive validity of identified liabilities for future psychopathology and physical health outcomes.

Main Methods:

• Utilized confirmatory factor, latent class, exploratory factor mixture, and exploratory structural equation modeling.
• Analyzed data from a large, nationally representative sample (N=43,093).
• Modeled seven internalizing disorders, considering gender, assessment waves, and lifetime/12-month diagnoses.

Main Results:

• A two-dimensional liability structure (distress-fear) provided the best fit for the data.
• This distress-fear structure demonstrated robustness, replicating across various demographic and diagnostic parameters.
• The identified liabilities, rather than disorder-specific factors, significantly predicted future internalizing pathology, suicide attempts, angina, and ulcer.

Conclusions:

• The distress-fear model represents a robust framework for understanding the common liabilities underlying internalizing disorders.
• These shared liabilities are significant predictors of future internalizing psychopathology and adverse physical health outcomes.
• Findings underscore the importance of targeting these transdiagnostic vulnerabilities in clinical interventions.