Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA.
Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
J Child Psychol Psychiatry. 2021 Mar;62(3):289-298. doi: 10.1111/jcpp.13243. Epub 2020 Apr 18.
There is converging evidence that mental disorders are more optimally conceptualized in a hierarchical framework (i.e., the Hierarchical Taxonomy of Psychopathology, HiTOP) that transcends the categorical boundaries of the Diagnostic and Statistical Manual of Mental Disorders (DSM). However, the majority of this evidence comes from studies that draw upon predominantly European American or Caucasian populations. Whether a hierarchical conceptualization of mental disorders generalizes across racial-ethnic groups, including for African American (AA) populations, is unclear.
We tested multidimensional and bifactor models of 15 DSM diagnoses and psychiatric traits in two groups, including AA (n = 3,088) and European American (EA; n = 5,147) youths aged 8-21 from the Philadelphia Neurodevelopmental Cohort (PNC). We also conducted multigroup confirmatory factor analyses to test for factorial invariance between the best fitting AA and EA multidimensional and bifactor models.
In the multidimensional model tests, a three-factor model, specifying internalizing, externalizing, and thought dimensions, emerged as the best fitting model for AAs and EAs. In the bifactor model tests, a three-factor model (i.e., internalizing, externalizing, and thought dimensions) that also specified a general factor emerged as the optimal for both AAs and EAs. The general factor accounted for a significant proportion of the covariation between the secondary factors and the individual disorders and traits. Furthermore, both models were factorially invariant, indicating no significant difference in the factor structure of mental disorders between AAs and EAs in PNC.
Results suggest that the hierarchical factor structure of mental disorders may be racial-ethnically robust. This finding has implications for etiological and epidemiological studies focused on racial-ethnic subgroup comparisons, particularly with respect to identifying similarities and differences in prevalence rates or sociodemographic risk factors for mental disorders.
越来越多的证据表明，精神障碍在一个超越《精神障碍诊断与统计手册》（DSM）分类界限的层级框架（即心理病理学层级分类，HiTOP）中得到了更优化的概念化。然而，这些证据主要来自于主要依赖欧洲裔或白种人群体的研究。一个分层的精神障碍概念是否适用于包括非裔美国人（AA）在内的不同种族-民族群体，目前尚不清楚。
我们在费城神经发育队列（PNC）中，对 8-21 岁的 AA（n=3088）和 EA（n=5147）青少年进行了两个组别的研究，测试了 15 种 DSM 诊断和精神特质的多维和双因素模型。我们还进行了多组验证性因子分析，以检验 AA 和 EA 多维和双因素模型中因子的不变性。
在多维模型检验中，一个指定内在化、外在化和思维维度的三因素模型，成为 AA 和 EA 的最佳拟合模型。在双因素模型检验中，一个指定内在化、外在化和思维维度，同时指定一个一般因素的三因素模型，成为 AA 和 EA 的最佳模型。一般因素解释了次要因素和个体障碍与特质之间的大部分协方差。此外，这两个模型在因子结构上是不变的，这表明 PNC 中非裔美国人与欧洲裔美国人的精神障碍结构没有显著差异。
结果表明，精神障碍的层级因素结构可能具有种族-民族上的稳健性。这一发现对以种族-民族亚组比较为重点的病因学和流行病学研究具有影响，特别是在确定精神障碍的患病率或社会人口风险因素的相似性和差异性方面。
