Joint factor structure of self-reported cognitive and affective problems in a help-seeking population.

Abstract

Introduction: Self-reported cognitive and affective complaints are crucial in diagnosing neuropsychiatric conditions like adult attention-deficit/hyperactivity disorder (ADHD). While common, these complaints often reflect factors beyond measurable cognitive deficits, highlighting the need for validated assessment tools. This study uses a transdiagnostic approach to (1) explore factor models underlying self-reported cognitive and affective problems and (2) examine how these complaints relate to objective neuropsychological performance, aiming to improve clinical assessment and understanding.

Method: Data were collected from 808 adolescents and adults seeking support for self-perceived learning and co-occurring mental health challenges from the Finnish Rehabilitation Foundation between 2014 and 2021. Self-reported cognitive and affective (depression and anxiety) complaints were assessed with the Questionnaire of Learning and Mental Health Problems (KOMO), and neuropsychological test data were additionally obtained from a subgroup of 70 participants. The structure of cognitive and affective complaints and their correlations with neuropsychological test performance were examined using exploratory and confirmatory factor analyses.

Results: The model best explaining the data included a general factor for affective complaints but correlated factors for cognitive complaints. In that model, transdiagnostic affective symptoms correlated more strongly with cognitive complaints (r = .36‒.72) than specific depressive symptoms (r = .05‒.10). Mathematics and visuospatial-visuomotor complaints showed the strongest negative associations with neuropsychological test performance, while attention-executive function complaints had unexpected positive associations with performance in several cognitive domains.

Conclusion: This study replicates the transdiagnostic structure of affective problems and suggests that cognitive complaints do not fit a comparable general factor structure. Findings highlight the complexity of self-reported cognitive issues - particularly those related to attention and executive function - and underscore the need for comprehensive assessments that go beyond self-report measures.