| Modeling and treating internalizing psychopathology in a clinical trial: a latent variable structural equation modeling approach. | |
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MedLine Citation:
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PMID: 23298776 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Clinical trials are typically designed to test the effect of a specific treatment on a single diagnostic entity. However, because common internalizing disorders are highly correlated ('co-morbid'), we sought to establish a practical and parsimonious method to characterize and quantify changes in a broad spectrum of internalizing psychopathology targeted for treatment in a clinical trial contrasting two transdiagnostic psychosocial interventions. Method Alcohol dependence treatment patients who had any of several common internalizing disorders were randomized to a six-session cognitive-behavioral therapy (CBT) experimental treatment condition or a progressive muscle relaxation training (PMRT) comparison treatment condition. Internalizing psychopathology was characterized at baseline and 4 months following treatment in terms of the latent structure of six distinct internalizing symptom domain surveys. RESULTS: Exploratory structural equation modeling (ESEM) identified a two-factor solution at both baseline and the 4-month follow-up: Distress (measures of depression, trait anxiety and worry) and Fear (measures of panic anxiety, social anxiety and agoraphobia). Although confirmatory factor analysis (CFA) demonstrated measurement invariance between the time-points, structural models showed that the latent means of Fear and Distress decreased substantially from baseline to follow-up for both groups, with a small but statistically significant advantage for the CBT group in terms of Distress (but not Fear) reduction. CONCLUSIONS: The approach demonstrated in this study provides a practical solution to modeling co-morbidity in a clinical trial and is consistent with converging evidence pointing to the dimensional structure of internalizing psychopathology. |
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Authors:
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M G Kushner; R F Krueger; M M Wall; E W Maurer; J S Menk; K R Menary |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-9 |
Journal Detail:
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Title: Psychological medicine Volume: - ISSN: 1469-8978 ISO Abbreviation: Psychol Med Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1254142 Medline TA: Psychol Med Country: - |
Other Details:
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Languages: ENG Pagination: 1-13 Citation Subset: - |
Affiliation:
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Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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