Joint factor structure of self-reported cognitive and affective problems in a help-seeking population

Self-reported cognitive and affective complaints are crucial in diagnosing neuropsychiatric conditions like adult attention-deficit/hyperactivity disorder (ADHD). While common, these complaints often reflect factors beyond measurable cognitive deficits, highlighting the need for validated assessment tools. This study uses a transdiagnostic approach to (1) explore factor models underlying self-reported cognitive and affective problems and (2) examine how these complaints relate to objective neuropsychological performance, aiming to improve clinical assessment and understanding.

Data were collected from 808 adolescents and adults seeking support for self-perceived learning and co-occurring mental health challenges from the Finnish Rehabilitation Foundation between 2014 and 2021. Self-reported cognitive and affective (depression and anxiety) complaints were assessed with the Questionnaire of Learning and Mental Health Problems (KOMO), and neuropsychological test data were additionally obtained from a subgroup of 70 participants. The structure of cognitive and affective complaints and their correlations with neuropsychological test performance were examined using exploratory and confirmatory factor analyses.

The model best explaining the data included a general factor for affective complaints but correlated factors for cognitive complaints. In that model, transdiagnostic affective symptoms correlated more strongly with cognitive complaints (r = .36‒.72) than specific depressive symptoms (r = .05‒.10). Mathematics and visuospatial-visuomotor complaints showed the strongest negative associations with neuropsychological test performance, while attention-executive function complaints had unexpected positive associations with performance in several cognitive domains.

This study replicates the transdiagnostic structure of affective problems and suggests that cognitive complaints do not fit a comparable general factor structure. Findings highlight the complexity of self-reported cognitive issues - particularly those related to attention and executive function - and underscore the need for comprehensive assessments that go beyond self-report measures.