Dimensional Views of Childhood Adversity and Psychopathology: Insights from Growing Up in New Zealand

Abstract

Background: The dose-response relationship demonstrated by the cumulative risk approach has helped identify which children are in need for intervention and is univocal in the transdiagnostic risk that childhood adversity poses for psychopathology. However, the homogenization of different types of experiences and reliance on stress-based explanations, are key limitations of this approach. As such, different frameworks such as the Dimensional Model of Adversity and Psychopathology (DMAP) and the Harshness-Unpredictability framework, have focused on categorising distinct forms of adverse experiences into core dimensions based on their neurobiological and evolutionary consequences on development. Similarly, many have argued for dimensional views of psychopathology through the use of: a) symmetrical bi-factor models, where each symptom loads onto its specific factor and a general factor; and b) bi-factor S-1 models, consisting of specific factors and a general factor that is defined a priori by a reference domain. Further investigation is required to integrate these dimensional approaches to better understand the relationship between childhood adversity and psychopathology. Aims: The aim of this study was to investigate the factor structure and reliability of common models of psychopathology using the Total Difficulties Score (TDS) of the Strengths and Difficulties Questionnaire (SDQ). Another aim was to construct different adversity dimensions and test their association with the SDQ and the mediating role of executive control in this relationship. Methods: Using Growing Up in New Zealand data, the structure of the TDS was assessed for 4632 children as well as its association with sociodemographic and behavioural correlates. Adversity dimensions (threat, deprivation, and unpredictability) were measured using various mother-reported data from the child’s first 4.5 years of life. Direct and indirect effects of these adversity dimensions were examined with the SDQ at age 8 years and through the Luria Handclap Task (executive control) measured at age 4.5 years. Results: Confirmatory factor analyses and ancillary statistics revealed anomalous results across most models tested. The bi-factor S-1 model emerged as the most suitable structure for the TDS and showed correlations with lower prosocial behaviour using the SDQ. All adversity dimensions were associated with greater TDS; however, only deprivation showed significant indirect effects through poorer executive control in a combined mediation model. Conclusions: Bi-factor S-1 models represent a theoretically superior alternative to symmetrical bi-factor models, and present an opportunity to leverage the SDQ in transdiagnostic research. Further, this is the first study to highlight the utility in integrating multiple adversity dimensions from different frameworks, and show the transdiagnostic role of executive control as a target for intervention and prevention.