Youth Comorbidity Patterns and Research Domain Criteria (RDoC)-Informed Factors: A Scoping Review of Person-Centered Psychopathology Research.

Abstract

Purpose: High rates of comorbid psychopathology have driven a growing body of person-centered research to understand the grouping structure of youth comorbidity by identifying meaningful comorbidity patterns and validating them with neurobehavioral factors. The National Institute of Mental Health's Research Domain Criteria (RDoC) offers an etiological framework for systematically identifying constructs organized around major functioning domains. This scoping review study mapped person-centered comorbidity studies and synthesized the RDoC-informed factors of comorbidity patterns.

Materials and methods: We followed Arksey and O'Malley's methodological framework. Five databases (e.g. PubMed and CINAHL) were searched. Twenty-five peer-reviewed studies examining comorbidity patterns in youth up to age 17 were included.

Results: One normative pattern was consistently identified, along with one general psychopathology pattern with a higher probability of all symptoms. Additionally, specific patterns, such as internalizing and externalizing patterns, reflecting unique covariances among assessed symptoms, were identified. Of the 43 extracted RDoC-informed factors, systems for social processes (33%) emerged as the most widely examined domains, followed by cognitive (26%), negative valence (19%), and arousal and regulatory (14%) systems. Most factors were differentially associated with comorbidity patterns.

Discussion: The identified comorbidity patterns supported a conceptualization of psychopathology with broader factors, such as one general and other specific psychopathology factors, reflecting underlying liability for a range of symptoms. Definitive conclusions about the effects of RDoC-informed factors require further studies, given limited evidence of positive valence (5%) and sensorimotor (5%) systems.

Conclusion: More rigorous incorporation of novel RDoC-informed factors into comorbidity studies may inform evidence-based preventive strategies.