ADHD and the Externalizing Spectrum: Direct Comparison of Categorical, Continuous, and Hybrid Models of Liability in a Nationally Representative Sample

Overview

Journal Soc Psychiatry Psychiatr Epidemiol

Specialties Psychiatry
Public Health
Social Sciences

Date 2013 Oct 2

PMID 24081325

Citations 35

Authors

Natacha Carragher

Robert F Krueger

Nicholas R Eaton

Kristian E Markon

Katherine M Keyes

Carlos Blanco

Tulshi D Saha

Deborah S Hasin

Affiliations

Soon will be listed here.

Abstract

Purpose: Alcohol use disorders, substance use disorders, and antisocial personality disorder share a common externalizing liability, which may also include attention-deficit hyperactivity disorder (ADHD). However, few studies have compared formal quantitative models of externalizing liability, with the aim of delineating the categorical and/or continuous nature of this liability in the community. This study compares categorical, continuous, and hybrid models of externalizing liability.

Method: Data were derived from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (N = 34,653). Seven disorders were modeled: childhood ADHD and lifetime diagnoses of antisocial personality disorder (ASPD), nicotine dependence, alcohol dependence, marijuana dependence, cocaine dependence, and other substance dependence.

Results: The continuous latent trait model provided the best fit to the data. Measurement invariance analyses supported the fit of the model across genders, with females displaying a significantly lower probability of experiencing externalizing disorders. Cocaine dependence, marijuana dependence, other substance dependence, alcohol dependence, ASPD, nicotine dependence, and ADHD provided the greatest information, respectively, about the underlying externalizing continuum.

Conclusions: Liability to externalizing disorders is continuous and dimensional in severity. The findings have important implications for the organizational structure of externalizing psychopathology in psychiatric nomenclatures.

Citing Articles

Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum.

Michelini G, Carlisi C, Eaton N, Elison J, Haltigan J, Kotov R World Psychiatry. 2024; 23(3):333-357.

PMID: 39279404 PMC: 11403200. DOI: 10.1002/wps.21225.

Using rodent data to elucidate dopaminergic mechanisms of ADHD: Implications for human personality.

Tripp G, Wickens J Personal Neurosci. 2024; 7:e2.

PMID: 38384667 PMC: 10877278. DOI: 10.1017/pen.2023.12.

The validity of transdiagnostic factors in predicting homotypic and heterotypic continuity of psychopathology symptoms over time.

Jung B, Kim H Front Psychiatry. 2023; 14:1096572.

PMID: 37275971 PMC: 10235495. DOI: 10.3389/fpsyt.2023.1096572.

Genetic and shared environmental factors explain the association between adolescent polysubstance use and high school noncompletion.

Davis C, Gizer I, Agrawal A, Statham D, Heath A, Martin N Psychol Addict Behav. 2023; 38(1):114-123.

PMID: 36913302 PMC: 10497723. DOI: 10.1037/adb0000915.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum.

Watson D, Levin-Aspenson H, Waszczuk M, Conway C, Dalgleish T, Dretsch M World Psychiatry. 2022; 21(1):26-54.

PMID: 35015357 PMC: 8751579. DOI: 10.1002/wps.20943.

References

Clark S, Muthen B, Kaprio J, DOnofrio B, Viken R, Rose R . Models and Strategies for Factor Mixture Analysis: An Example Concerning the Structure Underlying Psychological Disorders. Struct Equ Modeling. 2013; 20(4). PMC: 3844130. DOI: 10.1080/10705511.2013.824786. View

Bentler P . Comparative fit indexes in structural models. Psychol Bull. 1990; 107(2):238-46. DOI: 10.1037/0033-2909.107.2.238. View

Grant B, Dawson D, Stinson F, Chou P, Kay W, Pickering R . The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug Alcohol Depend. 2003; 71(1):7-16. DOI: 10.1016/s0376-8716(03)00070-x. View

Steiger J . Structural Model Evaluation and Modification: An Interval Estimation Approach. Multivariate Behav Res. 2016; 25(2):173-80. DOI: 10.1207/s15327906mbr2502_4. View

Stinson F, Dawson D, Goldstein R, Chou S, Huang B, Smith S . Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2008; 69(7):1033-45. PMC: 2669224. DOI: 10.4088/jcp.v69n0701. View

Helzer J, Bucholz K, Gossop M . A dimensional option for the diagnosis of substance dependence in DSM-V. Int J Methods Psychiatr Res. 2007; 16 Suppl 1:S24-33. PMC: 6879089. DOI: 10.1002/mpr.210. View

Forbush K, WATSON D . The structure of common and uncommon mental disorders. Psychol Med. 2012; 43(1):97-108. DOI: 10.1017/S0033291712001092. View

Eaton N, Krueger R, Keyes K, Skodol A, Markon K, Grant B . Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders. Psychol Med. 2010; 41(5):1041-50. PMC: 3193799. DOI: 10.1017/S0033291710001662. View

Hasin D, Carpenter K, McCloud S, Smith M, Grant B . The alcohol use disorder and associated disabilities interview schedule (AUDADIS): reliability of alcohol and drug modules in a clinical sample. Drug Alcohol Depend. 1997; 44(2-3):133-41. DOI: 10.1016/s0376-8716(97)01332-x. View

10.

Krueger R . The structure of common mental disorders. Arch Gen Psychiatry. 1999; 56(10):921-6. DOI: 10.1001/archpsyc.56.10.921. View

11.

Eaton N, Krueger R, Markon K, Keyes K, Skodol A, Wall M . The structure and predictive validity of the internalizing disorders. J Abnorm Psychol. 2012; 122(1):86-92. PMC: 3755742. DOI: 10.1037/a0029598. View

12.

Krueger R, Markon K, Patrick C, Iacono W . Externalizing psychopathology in adulthood: a dimensional-spectrum conceptualization and its implications for DSM-V. J Abnorm Psychol. 2005; 114(4):537-50. PMC: 2242352. DOI: 10.1037/0021-843X.114.4.537. View

13.

Charach A, Yeung E, Climans T, Lillie E . Childhood attention-deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses. J Am Acad Child Adolesc Psychiatry. 2010; 50(1):9-21. DOI: 10.1016/j.jaac.2010.09.019. View

14.

Ruan W, Goldstein R, Chou S, Smith S, Saha T, Pickering R . The alcohol use disorder and associated disabilities interview schedule-IV (AUDADIS-IV): reliability of new psychiatric diagnostic modules and risk factors in a general population sample. Drug Alcohol Depend. 2007; 92(1-3):27-36. PMC: 2246381. DOI: 10.1016/j.drugalcdep.2007.06.001. View

15.

Hasin D, Kilcoyne B . Comorbidity of psychiatric and substance use disorders in the United States: current issues and findings from the NESARC. Curr Opin Psychiatry. 2012; 25(3):165-71. PMC: 3767413. DOI: 10.1097/YCO.0b013e3283523dcc. View

16.

Beesdo-Baum K, Hofler M, Gloster A, Klotsche J, Lieb R, Beauducel A . The structure of common mental disorders: a replication study in a community sample of adolescents and young adults. Int J Methods Psychiatr Res. 2009; 18(4):204-20. PMC: 6878418. DOI: 10.1002/mpr.293. View

17.

Witkiewitz K, King K, McMahon R, Wu J, Luk J, Bierman K . Evidence for a multi-dimensional latent structural model of externalizing disorders. J Abnorm Child Psychol. 2012; 41(2):223-37. PMC: 3557529. DOI: 10.1007/s10802-012-9674-z. View

18.

Markon K, Krueger R . Categorical and continuous models of liability to externalizing disorders: a direct comparison in NESARC. Arch Gen Psychiatry. 2005; 62(12):1352-9. PMC: 2242348. DOI: 10.1001/archpsyc.62.12.1352. View

19.

Almansa J, Vermunt J, Forero C, Vilagut G, de Graaf R, de Girolamo G . Measurement and description of underlying dimensions of comorbid mental disorders using Factor Mixture Models: results of the ESEMeD project. Int J Methods Psychiatr Res. 2011; 20(2):116-33. PMC: 6878289. DOI: 10.1002/mpr.334. View

20.

Arcos-Burgos M, Velez J, Solomon B, Muenke M . A common genetic network underlies substance use disorders and disruptive or externalizing disorders. Hum Genet. 2012; 131(6):917-29. PMC: 3351604. DOI: 10.1007/s00439-012-1164-4. View