Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research.

Co-occurrence of mental disorders including severe PTSD, somatic symptoms, and dissociation in the aftermath of trauma is common and sometimes associated with poor treatment outcomes. However, the interrelationships between these conditions at symptom level are not well understood. In the present study, we aimed to explore direct connections between PTSD, somatic symptoms, and dissociation to gain a deeper insight into the pathological processes underlying their comorbidity that can inform future treatment plans. In a sample of 655 adult inpatients with a diagnosis of severe PTSD following childhood abuse (85.6% female; mean age = 47.57), we assessed symptoms of PTSD, somatization, and dissociation. We analyzed the comorbidity structure using a partial correlation network with regularization. Mostly positive associations between symptoms characterized the network structure. Muscle or joint pain was among the most central symptoms. Physiological reactivation was central in the full network and together with concentrations problems acted as bridge between symptoms of PTSD and somatic symptoms. Headaches connected somatic symptoms with others and derealization connected dissociative symptoms with others in the network. Exposure to traumatic events has a severe and detrimental effect on mental and physical health and these consequences worsen each other trans-diagnostically on a symptom level. Strong connections between physiological reactivation and pain with other symptoms could inform treatment target prioritization. We recommend a dynamic, modular approach to treatment that should combine evidence-based interventions for PTSD and comorbid conditions which is informed by symptom prominence, readiness to address these symptoms and preference.

/pdf/co-occurrence-of-severe-ptsd-somatic-symptoms-and-1kuue1cmye.pdf

Co-occurrence of severe PTSD, somatic symptoms and dissociation in a large sample of childhood trauma inpatients: a network analysis.

In their response to our article (both in this issue), DeYoung and colleagues did not sufficiently address three fundamental flaws with the Hierarchical Taxonomy of Psychopathology (HiTOP). First, HiTOP was created using a simple-structure factor-analytic approach, which does not adequately represent the dimensional space of the symptoms of psychopathology. Consequently, HiTOP is not the empirical structure of psychopathology. Second, factor analysis and dimensional ratings do not fix the problems inherent to descriptive (folk) classification; self-reported symptoms are still the basis on which clinical judgments about people are made. Finally, HiTOP is not ready to use in real-world clinical settings. There is currently no empirical evidence demonstrating that clinicians who use HiTOP have better clinical outcomes than those who use the Diagnostic and Statistical Manual of Mental Disorders (DSM). In sum, HiTOP is a factor-analytic variation of the DSM that does not get the field closer to a more valid and useful taxonomy.

/pdf/the-hierarchical-taxonomy-of-psychopathology-hitop-is-not-an-2stx9gxg.pdf

The Hierarchical Taxonomy of Psychopathology (HiTOP) Is Not an Improvement Over the DSM

In this commentary, we discuss questions and misconceptions about the Hierarchical Taxonomy of Psychopathology (HiTOP) raised by Haeffel et al. We explain what the system classifies and why it is d...

/pdf/answering-questions-about-the-hierarchical-taxonomy-of-4y6pj44sod.pdf

Answering Questions About the Hierarchical Taxonomy of Psychopathology (HiTOP): Analogies to Whales and Sharks Miss the Boat:

Post-stroke Everything.

The Hierarchical Taxonomy of Psychopathology (HiTOP) uses factor analysis to group self-reported symptoms of mental illness (i.e., like goes with like). It is hailed as a significant improvement ov...

Folk Classification and Factor Rotations: Whales, Sharks, and the Problems With the Hierarchical Taxonomy of Psychopathology (HiTOP):

http://www.archives-pmr.org/article/S0003999322002878/pdf

Effects of Transcranial Direct Durrent Stimulation on Post-stroke Dysphagia: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

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Folk Classification and Factor Rotations: Whales, Sharks, and the Problems With the Hierarchical Taxonomy of Psychopathology (HiTOP):

The Hierarchical Taxonomy of Psychopathology (HiTOP) Is Not an Improvement Over the DSM

Effects of Transcranial Direct Durrent Stimulation on Post-stroke Dysphagia: A Systematic Review and Meta-analysis of Randomized Controlled Trials.