Department of Psychology, The Ohio State University.
Department of Psychology, Stony Brook University.
J Abnorm Psychol. 2018 Apr;127(3):326-337. doi: 10.1037/abn0000339. Epub 2018 Feb 26.
Despite nonoverlapping criterion sets, conduct disorder and depression co-occur at much higher rates than expected by chance. Contemporary model-based approaches to explaining use factor analysis and its variants to evaluate interrelations among symptoms in large population-based and twin samples. These analyses invariably yield broadband internalizing and externalizing factors, which load on a higher-order general liability factor-findings that are robust across age and informant. Although model-based approaches elucidate structural aspects of comorbidity, they are variable-centered, and usually cross-sectional. Most therefore do not assess of comorbidity, or whether noncomorbid individuals are prospectively vulnerable to heterotypic comorbidity. We use an accelerated longitudinal design to evaluate growth in parent-reported conduct problems (CPs) and depression among children, ages 8-15 years, who were recruited at study entry into depressed only (n = 27), CPs only (n = 28), comorbid (n = 81), and control (n = 70) groups based on levels of symptoms. Consistent with normative developmental trends across this age range, steep growth in depression was exhibited by all groups, including those who reported only CPs at study entry. In contrast, growth in CPs was restricted to those who reported high symptoms at intake (with or without comorbid depression), compared with low and stable among depressed only and control participants. To our knowledge, this is the first study to demonstrate, using carefully ascertained "pure" versus comorbid groups who were followed naturalistically, that comorbid depression is likely to develop among those with pure CPs, but comorbid CPs are not likely to develop among those with pure depression. (PsycINFO Database Record
尽管标准不重叠，但品行障碍和抑郁症的同时发生率远高于随机预期。当代基于模型的解释方法使用因素分析及其变体来评估大型基于人群和双胞胎样本中症状之间的相互关系。这些分析无一例外地产生宽带内化和外化因素，这些因素加载在更高阶的一般责任因素上——这些发现在年龄和信息提供者方面都是稳健的。尽管基于模型的方法阐明了共病的结构方面，但它们是变量为中心的，通常是横断面的。因此，大多数方法都不能评估共病的进展，或者非共病个体是否有前瞻性易患异质共病。我们使用加速纵向设计来评估父母报告的行为问题（CPs）和抑郁在儿童中的增长，年龄在 8-15 岁之间，他们在研究开始时根据症状水平被招募到仅抑郁组（n=27）、仅 CPs 组（n=28）、共病组（n=81）和对照组（n=70）。与这个年龄范围内的正常发展趋势一致，所有组都表现出抑郁的急剧增长，包括那些在研究开始时只报告 CPs 的组。相比之下，CPs 的增长仅限于那些在摄入时报告高症状的人（无论是否伴有共病抑郁），而仅在抑郁组和对照组中，CPs 的增长受到限制，并且稳定。据我们所知，这是第一项使用精心确定的“纯”与共病组进行自然随访的研究，证明共病抑郁很可能在那些有单纯 CPs 的人中发展，但在那些有单纯抑郁的人中，共病 CPs 不太可能发展。
