Establishing a transdiagnostic dimension of early childhood depressive symptoms using the Preschool Feelings...

Young child depressive symptoms are associated with various concurrent and future psychiatric problems, indicating early transdiagnostic risk for psychopathology. We now need studies that identify and test the robustness, reliability, and validity of early emerging depressive symptom dimensions, examining them relative to wide-ranging forms of psychopathology. Psychometric methods are suitable for such investigations.

In a sample of 547 young children (ages 3-7 years) enriched for internalizing problems, preregistered analyses on the psychometric properties of the Preschool Feelings Checklist-Scale (PFC-S) investigated the robustness and interpretation of young child depressive symptom dimensions using exploratory structural equation models (ESEMs) and correlations alongside related constructs. We also tested the accuracy with which the PFC-S distinguished children based on broadband psychiatric diagnostic profiles and clinical concern.

A bifactor ESEM with three group factors (Social and Behavioral Anhedonia, Emotional and Behavioral Dysregulation, and Excessive Guilt and Sadness) and residual correlations accounting for item wording similarities was the most valid PFC-S model (comparative fit index/Tucker-Lewis index = 0.98; root mean squared error of approximation = 0.06; standardized root mean squared residual = 0.03). Only the general factor emerged as reliable (ω _H = 0.91; H = 0.96; factor determinacy = 0.99). The general factor evidenced correlations with measures of child anhedonia severity, executive dysfunction, and emotion dysregulation (|rs| > .60) a well as correlations with child reward responsiveness, driven goal pursuit, inhibited behavior, sex assigned at birth, and caregiver depressive symptom severity (0 < |rs| ≤ .37), but was not significantly correlated with child guilt, approach behavior, or fun-seeking (|rs| ≤ .07). The general factor most accurately distinguished children with multiple co-occurring diagnoses, including depression, and those with no diagnoses, as well as children with versus without clinical levels of general psychopathology.

Findings support a PFC-S general factor characterized by reward and executive dysfunction with both depression-specific and transdiagnostic psychopathology risk relevance in young children.