Department of Psychology.
J Psychopathol Clin Sci. 2022 Apr;131(3):235-252. doi: 10.1037/abn0000737. Epub 2022 Feb 7.
Like diagnostic status, clinically relevant thought remains overwhelmingly conceptualized in terms of discrete categories (e.g., worry, rumination, obsessions). However, definitions can vary widely. The area of perseverative thought (or clinically relevant thought more broadly) would benefit substantially from a consensus-based, empirically grounded taxonomy similar to the Hierarchical Taxonomy of Psychopathology (Kotov et al., 2017) or the Big Five for personality. This article addresses three major barriers to establishing such a taxonomy: (a) a lack of research explicitly comparing categorical (subtype) versus dimensional models, (b) primary reliance on between-person measures rather than modeling at the level of the thought (within person), and (c) insufficient emphasis on replication and refinement. Participants included an unselected crowdsourced sample (790 observations from 286 participants) and an independent anxious-depressed replication sample (808 observations from 277 participants). Participants made dimensional ratings for three idiographic clinically relevant thoughts on a range of features. Multilevel latent class analysis and multilevel exploratory factor analysis were applied to identify and extract natural patterns of covariation among features at the level of the thought, controlling for person-level tendencies. A consistent five-dimension solution emerged across both samples and reliably outperformed the best-fitting categorical solution in terms of fit, replicability, and explanatory power. Identified dimensions were dyscontrol, self-focus, valence, interpersonal, and uncertainty. Findings support a five-factor latent structure of perseverative thought. Theoretical, empirical, and clinical implications and future directions are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
与诊断状况一样，临床上相关的思维在很大程度上仍然被概念化为离散的类别（例如，担忧、沉思、强迫观念）。然而，定义可能有很大差异。持续思维（或更广泛的临床上相关思维）领域将从基于共识和经验基础的分类法中受益匪浅，类似于精神病理学的层次分类法（Kotov 等人，2017 年）或人格的五大因素。本文解决了建立这种分类法的三个主要障碍：（a）缺乏明确比较类别（亚型）与维度模型的研究，（b）主要依赖于个体间的测量而不是思维水平上的建模（个体内），以及（c）对复制和细化的重视不够。参与者包括一个未选择的众包样本（来自 286 名参与者的 790 个观察结果）和一个独立的焦虑抑郁复制样本（来自 277 名参与者的 808 个观察结果）。参与者对一系列特征的三个个体化临床上相关思维进行了维度评分。多层次潜在类别分析和多层次探索性因素分析用于识别和提取思维水平上特征之间的自然变化模式，同时控制个体水平的倾向。在两个样本中都出现了一致的五因素解决方案，并且在拟合度、可重复性和解释力方面可靠地优于最佳拟合的类别解决方案。确定的维度是失控、自我关注、效价、人际关系和不确定性。研究结果支持持续思维的五因素潜在结构。讨论了理论、经验和临床意义以及未来方向。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
