Work

Investigating the hierarchical structure of psychopathology and prospective associations between cognitive dysfunction and transdiagnostic symptom dimensions in 112,694 older adults from the UK Biobank.

Year: 2026

Type: article

Abstract: This study aimed to characterize the structure of psychopathology in older adults and determine whether cognitive dysfunction predicts transdiagnostic symptom dimensions throughout later life.Competing models of psychopathology (i.e., one-factor, correlated-factors, bi-factor, and higher-order models) were examined using confirmatory factor analysis (CFA) in participants aged 55-78 years old from the UK Biobank (N 5 112,694, male 5 44.6%, M 5 65.05 years).Multigroup CFA was used to examine measurement invariance of the optimal model across four age groups (i.e., 55-59, 60-64, 65-69, and 70-78 years).Structural equation modelling was used to examine cognitive dysfunction as a predictor of transdiagnostic symptom dimensions in the full sample and across age-stratified subsamples.A higher-order model was selected as the optimal model of psychopathology, including a general factor and three lower-order factors (i.e., internalizing, externalizing/substance use, thought disorder).This model demonstrated acceptable model-fit (CFI 5 .932,TLI 5 .928,RMSEA 5 0.047) and reliability of the lower-order factors (H 5 .850-.974).This model also demonstrated configural, lower-order metric/scalar, and higher-order metric/scalar invariance across age groups (change in CFI values # .002).Cognitive dysfunction predicted greater general psychopathology and uniquely predicted internalizing and thought disorder in the full sample (bs 5 .066-.154, ps < .01)and across age-stratified subsamples (bs 5 .052-.143, ps < .01).There was no association with externalizing/substance use.Findings support the hierarchical organization of psychopathology throughout older adulthood and indicate that cognitive dysfunction is prospectively associated with general psychopathology and emotionallyfocused (internalizing) and psychosis-like (thought disorder) symptom dimensions. General Scientific SummaryA growing body of evidence suggests that mental health symptoms can be organized into a hierarchy of dimensions that cut across traditional diagnostic categories, with a broad general dimension at the top and increasingly specific groups of symptoms at lower levels.This hierarchical organization has not been well studied in older adults, and it remains unclear whether cognitive difficulties are related to these general and specific symptom dimensions later in life.Using a large sample of older adults, the current study shows that this hierarchical structure extends into older adulthood and that poorer cognitive functioning is associated with both general mental health problems and more specific emotional and psychosis-like symptom dimensions, but not with substance-related problems.

Source: Journal of Psychopathology and Clinical Science

DOI: 10.1037/abn0001115

Authors: Nicholas Hoy, Miriam K. Forbes, Monika A. Waszczuk, Matthew Sunderland, Simone Reppermund, Louise Mewton