Comorbidity occurs when an individual has symptoms of more than one psychological condition. These symptoms can manifest simultaneously, appear at different times, or even overlap in occurrence. Depressive and anxious conditions are among the most commonly comorbid mental health problems. One method of classifying these comorbid events is confirmatory factor analysis (CFA), which has produced a consistent classification of three particular types of comorbid states. They include anxious misery and fear, both of which are internalizing states, and externalizing. Symptoms of posttraumatic stress, anxiety, and depression fall under the anxious-misery category, while symptoms of phobia fall under the fear category.
Although CFA is widely accepted, it does not account for personality factors involved in multiple comorbidity. Therefore, Philip Spinhoven of the Institute of Psychology and the Department of Psychiatry at Leiden University Medical Center in the Netherlands theorized that latent class analyses (LCA) might be a fruitful alternative to CFA in the assessment of comorbid psychiatric conditions. Spinhoven used a person-centered approach when he led a recent study on comorbidity. He examined the Big Five personality factors in a sample of 2,566 adults using both LCA and latent transition analysis (LTA) over a 2-year period. Spinhoven found a new classification of comorbidity based on traits and five classes based on personality.
Spinhoven evaluated panic disorders, depression, and social anxiety and was able to classify the participants as falling into one of the following classes: few disorders, distress disorders, fear disorders, or comorbid fear and distress disorders. He also discovered that the participants fell into unique categories of resilience and control. Those with the highest levels of control and the lowest levels of conscientiousness were the least likely to see symptoms decrease throughout the study period. Spinhoven believes that these findings imply that conscientiousness may be a factor that warrants further LCA and LTA research with respect to comorbidity of anxious or depressive conditions. He added, “These results suggest that factor analytic and latent class analysis may be complementary approaches for modeling a set of disorders as latent dimensions or as clusters or groups.”
Spinhoven, P., de Rooij, M., Heiser, W., Smit, J. H., Penninx, B. W. (2012). Personality and changes in comorbidity patterns among anxiety and depressive disorders. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0028234
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