Structure of Psychopathology in Romanian Preschool-Aged Children in an Epidemiological and a High-Risk Sample

Katherine L. Guyon-Harris PhD , André Plamondon PhD , Kathryn L. Humphreys PhD, EdM , Mark Wade PhD , Mary Margaret Gleason MD , Florin Tibu PhD , Charles A. Nelson PhD , Nathan A. Fox PhD , Charles H. Zeanah MD
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Abstract

Objective

Research on bifactor models of psychopathology in early childhood is limited to community samples with little longitudinal follow-up. We examined general and specific forms of psychopathology within 2 independent samples of preschool-aged Romanian children. Within a sample with children exposed to psychosocial deprivation, we also examined antecedents and longitudinal outcomes of the general factor.

Method

One sample consisted of 350 Romanian children (mean age = 39.7 months, SD = 10.9) from an epidemiological study; the second sample consisted of 170 Romanian children (mean age = 55.6 months, SD = 1.9) exposed to severe early-life deprivation, as well as community comparison children, with longitudinal follow-up at 8 and 12 years. Psychopathology symptoms were assessed through caregiver-reported structured clinical interviews.

Results

An SI-1 bifactor model of psychopathology was supported in both samples and included specific factors for externalizing, internalizing, and disturbed relatedness symptoms. In the second sample, longer duration of psychosocial deprivation and lower-quality caregiving were associated with higher scores on the general and all specific factors. Higher scores on the general factor were associated with later cognitive function, competence, and psychopathology symptoms. Considering all factors together, only the general factor explained variance in later childhood outcomes and was slightly stronger compared to a total symptom count for some, but not all, outcomes.

Conclusion

General psychopathology in early childhood explains meaningful variance in child outcomes across multiple domains of functioning in later childhood. However, important questions remain regarding its clinical utility and usefulness, given complex measurement and limited explanatory power beyond the more accessible approach of a total symptom count.

Clinical trial registration information

The Bucharest Early Intervention Project; https://clinicaltrials.gov/; NCT00747396.

罗马尼亚学龄前儿童的流行病学和高危样本的心理病理学结构
目的对儿童早期精神病理双因素模型的研究仅限于社区样本,且缺乏纵向随访。我们在罗马尼亚学龄前儿童的2个独立样本中检查了一般和特定形式的精神病理学。在一个暴露于心理社会剥夺的儿童样本中,我们还检查了一般因素的前因和纵向结果。方法样本为来自流行病学研究的350名罗马尼亚儿童(平均年龄= 39.7个月,SD = 10.9);第二个样本包括170名早期生活严重剥夺的罗马尼亚儿童(平均年龄= 55.6个月,SD = 1.9),以及社区比较儿童,在8岁和12岁时进行纵向随访。通过护理人员报告的结构化临床访谈评估精神病理症状。结果两组样本均支持SI-1精神病理学双因素模型,该模型包含外化、内化和干扰相关症状的特定因素。在第二个样本中,较长的社会心理剥夺持续时间和较低质量的护理与一般和所有特定因素的较高得分相关。一般因素得分越高,其认知功能、能力和精神病理症状越晚。综合考虑所有因素,只有一般因素解释了儿童后期结果的差异,并且与某些(但不是全部)结果的总症状数相比略强。结论儿童早期的一般精神病理学解释了儿童后期在多个功能领域的结果有意义的差异。然而,由于复杂的测量和有限的解释力超出了更容易获得的总症状计数方法,关于其临床效用和有用性的重要问题仍然存在。临床试验注册信息布加勒斯特早期干预项目;https://clinicaltrials.gov/;NCT00747396。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JAACAP open
JAACAP open Psychiatry and Mental Health
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