Advancing understanding of the classification of broad autism phenotype and attention‐deficit/hyperactivity disorder symptom dimensions within the Hierarchical Taxonomy of Psychopathology

Abstract

Research on personality and psychopathology associations has informed the classification of many symptom dimensions within the Hierarchical Taxonomy of Psychopathology (HiTOP). However, classification of symptom dimensions defining autism and attention-deficit/hyperactivity disorder (ADHD) within the HiTOP framework remains unclear in many ways. To address this issue, we examined the joint factor structure of (a) measures assessing characteristics relevant to ADHD and autism and (b) normal range personality traits in a sample of 547 adults recruited from Amazon Mechanical Turk, many of whom reported elevated autism-relevant and ADHD-relevant characteristics. We also examined how factors identified in these analyses correlated with measures of internalizing symptoms and select externalizing traits. Our results indicated that some measures assessing autism-relevant and ADHD-relevant characteristics (e.g. communication issues, hyperactivity/impulsivity) defined a distinct Attention and Communication Difficulties factor, with scores on this factor correlating strongly with internalizing symptom ratings. However, other relevant characteristics such as aloofness may be indicators of existing HiTOP spectra such as detachment. We discuss how these findings inform classification of autism-relevant and ADHD-relevant characteristics within the HiTOP, as well as key future directions for extending the limited research in this area.Basic personality dimensions are linked strongly to many disorders from the Diagnostic and Statistical Manual of Mental Disorders (currently fifth edition; DSM-5 1 ). For example, neuroticism shows notable associations with many disorders, associating strongly with symptoms defining 'internalizing' disorders such as major depressive disorder and generalized anxiety disorder. Other personality traits such as conscientiousness also show noteworthy negative associations with many internalizing disorders and with externalizing disorders such as substance use disorders. [2][3][4] These robust associations for core personality dimensions with many DSM disorders may help to account for why different disorders covary strongly and frequently are comorbid. In addition to challenges associated with diagnostic comorbidity, other issues with the DSM framework include poor

An Initial Investigation of the Joint Classification of Hypomania- and Neurodevelopmental Disorder-Relevant Dimensions Within the Hierarchical Taxonomy of Psychopathology

“…Regardless, overlap for these NDD indicators with disinhibited externalizing indicators was substantial in models with three of fewer factors, with these indicators overlapping meaningfully in these more basic models (e.g., ADHD and internalizing measures loading strongly onto Instability factors in three-factor models). Furthermore, both (a) the online community Disinhibited Externalizing factor and (b) the undergraduate Disinhibition/Communication factor showed notable correlates with internalizing symptoms and related past week ratings reflecting emotion dysregulation, distress, and fear (e.g., perceived panic attacks), underscoring previously identified links between internalizing, disinhibited externalizing, and some NDD features (Forbes et al, 2021; Stanton et al, 2021).…”

“…Across samples, all three ADHD indicators and BAPQ Pragmatic Language Difficulties loaded most strongly onto joint factors with indicators of disinhibited externalizing in models with the greatest number of factors. Specifically, the emergence of a Disinhibition/Communication factor marked by inattention, hyperactivity, communication difficulties, and non-perseverance parallels a distinct NDD factor identified in other recent studies (e.g., Michelini et al, 2019; Stanton et al, 2021). However, with the exception of ASRS Inattentiveness, loadings for other ADHD indicators and BAPQ Pragmatic Language Difficulties were substantially weaker in magnitude on the closest parallel factor in four- and five-factor models from the online community data, which we instead labeled Disinhibited Externalizing due to specific patterns of loadings (e.g., CAT-PD Irresponsibility loading very strongly on this factor in the online community data).…”

“…Notably, recent calls for reforming ASD diagnosis argue against conceptualizing ASD and other NDDs dimensionally, based in part on concerns that use of dimensional frameworks complicates categorical determinations of the presence or absence of ASD in research and practice, among other reasons (e.g., hindering research on mechanisms; Mottron, 2021). Acknowledging these perspectives, several recent studies indicate that some NDD-relevant features such as communication difficulties may be distinct from well-established HiTOP spectra (e.g., internalizing, detachment; Michelini et al, 2019; Stanton et al, 2021). However, other features described as characteristic of ASD (e.g., social withdrawal) overlap closely with existing HiTOP spectra such as detachment (Michelini et al, 2019; Zimmerman et al, 2021).…”

“…. Acknowledging these perspectives, several recent studies indicate that some NDD-relevant features such as communication difficulties may be distinct from well-established HiTOP spectra (e.g., internalizing, detachment; Michelini et al, 2019;Stanton et al, 2021). However, other features described as characteristic of ASD (e.g., social withdrawal) overlap closely with existing HiTOP spectra such as detachment (Michelini et al, 2019;Zimmerman et al, 2021).…”

Hierarchische Taxonomie der Psychopathologie (HiTOP): Ein neues Modell zur Beschreibung psychischer Probleme

“…Relevant sind insbesondere strukturelle Analysen zur "dunklen Materie der Psychopathologie" (Kotov et al, 2021) also zu Phänomenen, deren Platzierung im HiTOP-Modell als unsicher gilt. Hierzu gehören neben vorläufig platzierten Konstrukten wie Manie (Forbes, Baillie, et al, 2023;Stanton et al, 2023) und Somatoformes Spektrum (Hartmann et al, 2022) Stanton et al, 2021;Stanton et al, 2023). Beispielsweise zeigte sich in mehreren Studien ein von den bisher im HiTOP-Modell berücksichtigten Spektren abgrenzbarer Faktor zu Aufmerksamkeits-und Kommunikationsschwierigkeiten (Forbes, Baillie, et al, 2023;Michelini et al, 2019;Stanton et al, 2021;Stanton et al, 2023).…”