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Modeling psychopathology structure: a symptom-level analysis of Axis I and II disorders

Published online by Cambridge University Press:  11 June 2009

K. E. Markon
K. E. Markon*
Affiliation:
Department of Psychology, University of Iowa, Iowa City, IA, USA
*
*Address for correspondence: K. E. Markon, Ph.D., Department of Psychology, University of Iowa, 11 Seashore Hall E., Iowa City, IA 52242, USA. (Email: [email protected])
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Abstract

Background

Analyses of co-morbidity patterns among common mental disorders have repeatedly indicated that relationships among disorders can be understood in terms of broad superordinate dimensions. However, these analyses have been based on syndromal-level indicators, which are often heterogeneous, rather than on symptoms, which are presumably more homogeneous.

Method

Symptom-level exploratory and confirmatory analyses were used to explore the joint hierarchical organization of Axis I and II psychopathology, using data on 8405 individuals from the 2000 British Psychiatric Morbidity Survey.

Results

Analyses indicated that 20 identified subordinate dimensions of psychopathology could be organized into four broad superordinate dimensions: Internalizing, Externalizing, Thought Disorder, and Pathological Introversion.

Conclusions

These results extend existing model frameworks ‘downward’ as well as ‘outward’, by analyzing symptoms rather than diagnoses, and by integrating symptoms from Axis I and II disorders in a common framework. This model demonstrates the importance of hierarchy in psychopathology structure, comprises replicable features of psychopathology structure, and has important implications for understanding the nature and organization of mental disorders.

Keywords

Axis IAxis IIfactor analysispsychopathologystructural equation model
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 2 , February 2010 , pp. 273 - 288
Copyright
Copyright © Cambridge University Press 2009

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