Zoupou Eirini, Moore Tyler M, Calkins Monica E, Gur Raquel E, Gur Ruben C, Scott J Cobb
Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA.
Psychol Med. 2024 Aug;54(11):3145-3155. doi: 10.1017/S0033291724001302. Epub 2024 Jun 3.
Neurocognitive dysfunction is a transdiagnostic finding in psychopathology, but relationships among cognitive domains and general and specific psychopathology dimensions remain unclear. This study aimed to examine associations between cognition and psychopathology dimensions in a large youth cohort.
The sample ( = 9350; age 8-21 years) was drawn from the Philadelphia Neurodevelopmental Cohort. Data from structured clinical interviews were modeled using bifactor confirmatory factor analysis (CFA), resulting in an overall psychopathology ('p') factor score and six orthogonal psychopathology dimensions: dysphoria/distress, obsessive-compulsive, behavioral/externalizing, attention-deficit/hyperactivity, phobias, and psychosis. Neurocognitive data were aggregated using correlated-traits CFA into five factors: executive functioning, memory, complex cognition, social cognition, and sensorimotor speed. We examined relationships among specific and general psychopathology dimensions and neurocognitive factors.
The final model showed both overall and specific associations between cognitive functioning and psychopathology, with acceptable fit (CFI = 0.91; TLI = 0.90; RMSEA = 0.024; SRMR = 0.054). Overall psychopathology and most psychopathology dimensions were negatively associated with neurocognitive functioning (phobias [ < 0.0005], behavioral/externalizing [ < 0.0005], attention-deficit/hyperactivity [ < 0.0005], psychosis [ < 0.0005 to < 0.05]), except for dysphoria/distress and obsessive-compulsive symptoms, which were positively associated with complex cognition ( < 0.05 and < 0.01, respectively).
By modeling a broad range of cognitive and psychopathology domains in a large, diverse sample of youth, we found aspects of neurocognitive functioning shared across clinical phenotypes, as well as domain-specific patterns. Findings support transdiagnostic examination of cognitive performance to parse variability in the link between neurocognitive functioning and clinical phenotypes.
神经认知功能障碍是精神病理学中的一项跨诊断性发现,但认知领域与一般及特定精神病理学维度之间的关系仍不明确。本研究旨在探讨一个大型青年队列中认知与精神病理学维度之间的关联。
样本(n = 9350;年龄8 - 21岁)取自费城神经发育队列。来自结构化临床访谈的数据使用双因素验证性因素分析(CFA)进行建模,得出一个总体精神病理学(“p”)因素得分以及六个正交的精神病理学维度:烦躁/痛苦、强迫、行为/外化、注意力缺陷/多动、恐惧症和精神病。神经认知数据使用相关特质CFA汇总为五个因素:执行功能、记忆、复杂认知、社会认知和感觉运动速度。我们研究了特定和一般精神病理学维度与神经认知因素之间的关系。
最终模型显示认知功能与精神病理学之间存在总体和特定关联,拟合度可接受(CFI = 0.91;TLI = 0.90;RMSEA = 0.024;SRMR = 0.054)。总体精神病理学和大多数精神病理学维度与神经认知功能呈负相关(恐惧症[p < 0.0005]、行为/外化[p < 0.0005]、注意力缺陷/多动[p < 0.0005]、精神病[p < 0.0005至p < 0.05]),但烦躁/痛苦和强迫症状与复杂认知呈正相关(分别为p < 0.05和p < 0.01)。
通过对一个大型、多样化的青年样本中的广泛认知和精神病理学领域进行建模,我们发现了跨临床表型共享的神经认知功能方面以及特定领域模式。研究结果支持对认知表现进行跨诊断检查,以剖析神经认知功能与临床表型之间联系的变异性。