University of Leicester
Homotypic and heterotypic psychopathological continuity: a child cohort study.pdf (1.01 MB)
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Homotypic and heterotypic psychopathological continuity: a child cohort study.

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journal contribution
posted on 2019-08-12, 13:21 authored by Mark Shevlin, Eoin McElroy, Jamie Murphy
BACKGROUND: Heterotypic psychopathological continuity (i.e. one disorder predicting another at a later time point) contradicts the conventional view that psychiatric disorders are discrete, static entities. Studying this phenomenon may help to tease out the complex mechanisms that underpin psychiatric comorbidity. To date, no studies have explicitly compared heterotypic effects within and across higher order dimensions of psychopathology. METHODS: Patterns of homotypic and heterotypic psychopathological continuity were examined using cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 4815). Eight common psychiatric disorders were assessed at age 7.5 and again at age 14 years using the maternal report version of the Development and Well-Being Assessment (DAWBA). Cross-lagged models were used to compare patterns of homotypic and heterotypic continuity within and across three higher order dimensions of psychopathology; internalizing-fear, internalizing-distress, and externalizing. RESULTS: Homotypic continuity was universal. Considerable heterotypic continuity was observed even after controlling for homotypic continuity and the presence of all disorders at baseline. Heterotypic continuity was more common within higher order dimensions, but a number of significant cross-dimension effects were observed, with ADHD acting as a strong predictor of subsequent internalizing disorders. CONCLUSIONS: Heterotypic continuity may reflect elements of shared aetiology, or local-level interactions between disorders.


We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The UK Medical Research Council and the Wellcome Trust (Grant ref.: 092731) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and the corresponding author will serve as guarantor for the contents of this paper. This research received no specific funding.



Social Psychiatry and Psychiatric Epidemiology, 2017, 52 (9), pp. 1135-1145

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/Organisation/COLLEGE OF LIFE SCIENCES/Biological Sciences/Neuroscience, Psychology and Behaviour


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Social Psychiatry and Psychiatric Epidemiology


Springer Verlag (Germany)



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