Psychopathology is often classified according to diagnostic categories or scale scores. These ignore potentially important information about associations between specific symptoms and, consequently, lead to heterogeneous constructs that may mask relevant individual differences. Network analyses focus on these specific symptom associations, providing the opportunity to explore the complex structure of psychopathology in more detail. We examined the empirical network structure of 95 emotional and behavioral problems of the Youth Self-Report (YSR) to explore how well this structure reflected the predefined YSR domains. The study was conducted in a large community sample (N = 2,175) of preadolescents (mean age = 11.1, SD = 0.6 years), and the network structure was determined by means of the recently developed network analysis technique, eLasso. Although problems within the same domain, in general, showed more and stronger connections than problems belonging to different domains, some problems showed substantially more or stronger associations than others; consequently, problems cannot be considered interchangeable indicators of their domain. Furthermore, no sharp boundaries were found between the domains as specific symptom pairs of different domains showed strong connections. Taken together, our findings indicate that network models provide a promising addition to the more traditional way of distinguishing diagnoses or scale scores.
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Alterations in physiological reactivity to stress are argued to be central mechanisms linking adverse childhood environmental experiences to internalizing and externalizing psychopathology. Childhood trauma exposure may influence physiological reactivity to stress in distinct ways from other forms of childhood adversity. This study applied a novel theoretical model to investigate the impact of childhood trauma on cardiovascular stress reactivity - the biopsychosocial model of challenge and threat. This model suggests that inefficient cardiovascular responses to stress - a threat as opposed to challenge profile - are characterized by blunted cardiac output (CO) reactivity and increased vascular resistance. We examined whether childhood trauma exposure predicted an indicator of the threat profile of cardiovascular reactivity and whether such a pattern was associated with adolescent psychopathology in a population-representative sample of 488 adolescents (M=16.17years old, 49.2% boys) in the TRacking Adolescents' Individual Lives Survey (TRAILS). Exposure to trauma was associated with both internalizing and externalizing symptoms and a pattern of cardiovascular reactivity consistent with the threat profile, including blunted CO reactivity during a social stress task. Blunted CO reactivity, in turn, was positively associated with externalizing, but not internalizing symptoms and mediated the link between trauma and externalizing psychopathology. None of these associations varied by gender. The biopsychosocial model of challenge and threat provides a novel theoretical framework for understanding disruptions in physiological reactivity to stress following childhood trauma exposure, revealing a potential pathway linking such exposure with externalizing problems in adolescents.
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