Heterotypic and homotypic continuity in psychopathology: a narrative review

Abstract

Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as “continuity,” “psychopathology,” “infancy,” “childhood,” “adolescence,” “adulthood,” “homotypic,” and “heterotypic” were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.

Regulatory problems and developmental psychopathology within the first 2 years of living—a nested in cohort population-based study

“…Also, a tendency of heterotypic association was seen among children with RP of sleeping and ICD-10 disorders of feeding and eating, overall indicating a transdiagnostic impact of having any RP. Homotypic continuity is characterized by consistency, similarity, and predictability of behaviors or internal states across different developmental phases, whereas heterotypic continuity does not imply longitudinal consistency of specific problems or symptoms, but rather an unspecific predictability across domains of mental health (48). Our findings based on data from very early childhood thus add to the knowledge on homotypic and heterotypic stability of psychopathology, which hitherto mostly have been explored in older ages.…”

The catcher in the mind: validation of the brief-mentalized affectivity scale for adolescents in the Italian population

“…Furthermore, the ability to reflect on one’s affective states and attribute meaning to them appears to be a protective factor against the development of externalizing symptomatology, as all dimensions of MA exhibited significant negative associations with this factor. Once again, this underscores the importance of fostering this capacity in adolescents within the context of psychotherapy, as the presence of externalizing disorders during adolescence has a strong continuity into adulthood (Petersen et al ., 2015 ; Speranza et al ., 2023 ) and is linked to various issues, including difficulties in academic and work settings (Cherkasova et al ., 2021 ), alcohol and substance use (Englund & Siebenbruner, 2012 ; Meque et al ., 2019 ), personality disorders, particularly antisocial disorder (Copeland et al ., 2009 ), and suicidal tendencies (Cherkasova et al ., 2021 ; Verona et al ., 2004 ). Taken together, our findings underscore the complexity of emotional development during adolescence, as well as the need to consider it within a broader context, always referring to the interplay between other mental abilities, such as the one to develop intimate and trusting relationships, the use of defense mechanisms, and overall mentalization abilities, as suggested by the PDM-2 (Lingiardi & McWilliams, 2017 ; Tanzilli et al ., 2021 ).…”

Reexamining developmental continuity and discontinuity in the 21st century: Better aligning behaviors, functions, and mechanisms.

“…Most studies asserting heterotypic continuity find a predictive association of one behavior or syndrome at T1 in predicting another behavior or syndrome at T2 (e.g., Ferdinand et al, 2007; Lahey et al, 2014; Lavigne et al, 2014; Miller et al, 2009; Nagin & Tremblay, 2001; Putnam et al, 2008; Richards et al, 2022; Shevlin et al, 2017; Snyder et al, 2017; Speranza et al, 2023; Wichstrøm et al, 2017). Such studies document interesting associations among seemingly disparate processes.…”