The General Factor of Psychopathology in Psychosis and Severe Mental Illness

精神病和严重精神疾病的精神病理学一般因素

• 批准号: 10260599
• 负责人: STEPHAN HECKERS
• 金额: $ 93.83万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10260599
• 关键词: Address; Adult; Age; Anterior; Area; Categories; Characteristics; Child; Clinical; Clinical assessments; Cognitive; Communities; Data; Diagnosis; Dimensions; Disease; Etiology; Functional Magnetic Resonance Imaging; Impaired cognition; Individual; Individual Differences; Influentials; Interview; Literature; Manic; Measures; Medical; Mental disorders; Meta-Analysis; Methodology; Modeling; Neuropsychology; Patients; Population; Prognosis; Properdin; Psychopathology; Psychoses; Psychotic Disorders; Recovery; Research; Risk; Risk Factors; Sampling; Schizophrenia; Schizotypal Personality Disorder; Sensory; Severities; Shared Paranoid Disorder; Structural Models; Structure; Symptoms; Temporal Lobe; Testing; Thalamic structure; Work; Youth; base; cognitive function; experience; first episode psychosis; first episode schizophrenia; longitudinal design; neural correlate; neuropathology; novel; prognostic assays; prognostic significance; psychotic symptoms; risk variant; schizophrenia-spectrum disorder; severe mental illness

An increasing body of evidence on the structure of psychopathology indicates the presence of a general factor of psychopathology (GF), also referred to as a P-factor, that explains a significant amount of the common variance in the expression of multiple psychopathological symptoms and disorders. The presence of a GF has substantial implications for understanding psychopathology because it suggests that a comprehensive understanding of mental illness requires an untangling of nonspecific risk factors from more narrow, dimension- specific risk factors or features. Caspi et al., (2014) suggest that schizophrenia symptoms are so highly correlated with the GF, that they are mostly an expression of the GF. However, methodological limitations, such as the use of community and youth samples, limit conclusions from the existing literature. We propose to test the hypothesis that schizophrenia spectrum (SS) symptoms load heavily on both a GF AND a separate higher-order psychosis factor using a sample of 1000 adult psychiatric and medical treatment seeking subjects that includes a substantial group of patients with SS disorders as well as patients with significant externalizing and internalizing symptoms. The potential utility of this hierarchical dimensional approach is that it allows quantification of the extent to which each individual possesses a high GF score (reflected in the overall breadth of symptoms), or symptoms that are more narrowly constrained to a specific 2nd order factor (such as externalizing, internalizing, and psychosis factors) or even more narrow, first-order symptom dimensions. Using this quantitative approach, we will test the extent to which neuropsychological and structural and functional MRI measures that have previously been observed in patients with schizophrenia are more strongly related to the GF versus a psychosis factor. This will allow us to test the hypothesis that some neural correlates, such as the volume of the anterior cingulate area, are nonspecific correlates of the GF, while others, such as temporal cortical sensory processing abnormalities, are specific to the psychosis, and remain even after controlling for the GF. In order to test the prognostic significance of the GF, we will additionally test whether scores on the GF are predictive of course of illness in 50 SS patients experiencing first-episode psychosis. Taken together, the study will provide the most comprehensive test to date of the relevance of GF model to understanding the expression and neural correlates of severe psychopathology,

关于心理病理结构的越来越多的证据表明存在一个普遍因素 精神病理学（GF）也称为P因子，这解释了大量共同 多种心理病理症状和疾病表达的差异。 GF的存在 对理解心理病理学的实质性含义，因为它暗示了一个全面的 对精神疾病的了解需要从更狭窄，维度 - 特定的风险因素或特征。 Caspi等人（2014年）表明，精神分裂症症状与GF非常相关，以至于它们主要是GF的表达。但是，方法论上的局限性（例如使用社区和青年样本）限制了现有文献的结论。我们建议检验以下假设，即精神分裂症谱（SS）症状使用1000个成人精神病和医疗寻求受试者的样本在GF和单独的高级精神病因素上都大大负担。 SS疾病的患者以及具有重大外在化和内在症状的患者。这 这种层次维度方法的潜在效用是，它允许量化 每个人的GF得分很高（反映在症状的整体广度上）或 更狭义地限制在特定的第二阶因子（例如外部化，内在化和精神病） 因素），甚至更狭窄的一阶症状维度。使用这种定量方法，我们将测试 神经心理学，结构和功能性MRI测量的程度 在精神分裂症患者中观察到的与GF与精神病因素相关。这会 允许我们检验某些神经相关的假设，例如前扣带回区域的体积， 是GF的非特异性相关性，而其他人，例如时间皮质感觉处理异常， 特定于精神病，即使在控制了GF之后也保持不变。为了测试预后 GF的重要性，我们还将测试GF上的分数是否可以预测50中的疾病 SS患者患有第一集精神病。综上所述，这项研究将提供最多的 GF模型与理解表达和神经相关的相关性的综合测试 严重的心理病理学，