Abstract:
We reevaluated HiTOP\'s existing factor analytic evidence-base for a Psychosis (P) superspectrum as encompassing two psychosis-relevant subfactors (\"spectra\")-Thought Disorder (TD) and Detachment (D). We found that their data did not support P as a superspectrum with TD and D subfactors. Instead, TD contained both positive and negative symptoms of psychosis and emerged at the subfactor level. D did not target negative symptoms but, largely, disorders unrelated to psychosis and should not be placed under P. Determining if P is truly a superspectrum with psychosis TD and D subfactors will require factor analyses whose items are symptom-based and span the full range of psychopathology. Secondly, HiTOP authors state that TD and D provide a \"nearly 2-fold\" improvement in reliability over schizophrenia diagnoses but, after aligning the comparative study methodologies, this 2-fold improvement disappears. Finally, HiTOP\'s use of the term thought disorder is inconsistent with the ICD-11 and psychosis literature, in which it refers to formal thought disorder. We recommend that HiTOP (a) refer to P as a subfactor with positive and negative symptoms of psychosis until research indicates otherwise, (b) regularly rely on formal systematic reviews, (c) use appropriate reliability comparisons, (d) deconflate D with negative symptoms, and (e) rename TD.
摘要:
我们重新评估了HiTOP的精神病(P)超频谱的现有因素分析证据基础,包括两个与精神病相关的子因素(“频谱”)-思想障碍(TD)和脱离(D)。我们发现他们的数据不支持P作为TD和D子因子的超谱。相反,TD包含精神病的阳性和阴性症状,并在亚因子水平出现。D没有针对阴性症状,但是,很大程度上,与精神病无关的疾病,不应将其置于P下。确定P是否真的是精神病TD和D亚因素的超谱系,需要进行因子分析,其项目基于症状,涵盖精神病理学的全部范围。其次,HiTOP的作者指出,TD和D在精神分裂症诊断的可靠性方面提供了“近2倍”的改善,但是,在调整了比较研究方法之后,这种2倍的改善消失了。最后,HiTOP对思维障碍一词的使用与ICD-11和精神病文献不一致,它指的是形式上的思维障碍。WerecommendthatHiTOP(a)refertoPasasubfactorwithpositiveandnegativesymptomsofpsychosisuntilresearchindicatedotherwise,(b)定期依赖正式的系统审查,(c)使用适当的可靠性比较,(d)消除D的阴性症状,和(e)重命名TD。