Abstract
Sexual dysfunctions have not been included in research on the broad structure of psychopathology to date, despite their high prevalence and impact on quality of life. Preliminary research has shown that they may fit well in an internalizing spectrum, alongside depressive and anxiety disorders. This study compared dimensional and categorical models of the relationships between depression, anxiety, and sexual problems with “hybrid” models (i.e., factor mixture analyses), which combine dimensional and categorical components simultaneously. Participants (n = 1000) were selectively recruited to include a range of symptom levels, and completed a series of self-report measures online. A hybrid model that combined dimensional and categorical components fit best for men and women. Taken together, the results are consistent with a nosology that explicitly recognizes the relationships between the diagnostic chapters of depressive and anxiety disorders and sexual dysfunctions, but still maintains discrete diagnoses, which is compatible with the structure of the DSM-5 and upcoming ICD-11.
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Notes
LPA does not allow for varying severity within categories, and relies on a conditional independence assumption (i.e., the assumption that disorders are completely unrelated to each other within each class; Masyn, Henderson, & Greenbaum, 2010); neither of these rigid assumptions is compatible with what is known about the nature of psychopathology. FAs rely on the assumptions that all individuals are from the same homogeneous population (i.e., share the same patterns of relationships), and that individual differences arise purely from differences on an underlying factor, which are both unlikely to be true in the real world.
In this type of FMA, the means of the continuous disorder scores are allowed to vary across classes, as a variety of symptom severity levels are expected between groups. Factor loadings are held invariant across classes, which suggests that the disorders are being measured the same way across all classes; but factor variances and covariances and the factor covariance matrix are freely estimated in each class, which allows for a range of severity levels within and between classes. This will allow us to determine if there are categorically different groups in the sample, or if the same underlying structure is appropriate for all groups.
The BLRT p-values did not reach nonsignificance in any of the analyses, and so the p-values are not included in the tables (all ps < .0001). Models were selected according to the VLMR and LMR p-values, as well as the information criteria and substantive model interpretation (Nylund, Asparouhov, & Muthén, 2007).
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Forbes, M.K., Baillie, A.J. & Schniering, C.A. Where Do Sexual Dysfunctions Fit into the Meta-Structure of Psychopathology? A Factor Mixture Analysis. Arch Sex Behav 45, 1883–1896 (2016). https://doi.org/10.1007/s10508-015-0613-2
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DOI: https://doi.org/10.1007/s10508-015-0613-2