Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 7/2007

01-07-2007 | ORIGINAL PAPER

The descriptive epidemiology of internalizing and externalizing psychiatric dimensions

Author: Tim Slade, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 7/2007

Login to get access

Abstract

Background

There is a growing recognition that comorbidity among individual mental disorders is best explained by the broad, psychiatric dimensions of internalization (sub-divided into distress and fear) and externalization. The aims of the current study were to examine the descriptive epidemiology of these psychiatric dimensions.

Methods

Continuous measures of distress, fear and externalization dimensions were obtained from principal components analysis of 11 common ICD-10 mental disorders in a large (N = 10,641) community sample. The relationships between these three dimensions and sociodemographic, physical illness and personality disorder characteristics were determined using multivariate linear regression analyses.

Results

The results suggest that the distress dimension is more strongly related to disadvantageous sociodemographic characteristics and physical health conditions than either the fear or externalizing dimensions. The results also demonstrate some specificity in profiles particularly with regard to the personality disorders.

Conclusions

Greater emphasis should be placed on continuous psychiatric dimensions that are thought to underlie the expression of putatively independent mental disorders.
Literature
1.
Achenbach TM, Edelbrock CS (1978) The classification of child psychopathology: a review and analysis of empirical efforts. Psychol Bull 85:1275–1301PubMedCrossRef
2.
Andrews G, Henderson S, Hall W (2001) Prevalence, comorbidity, disability and service utilisation. Overview of the Australian National Mental Health Survey. Brit J Psychiatry 178:145–153CrossRef
3.
Andrews G, Peters L (1998) The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry Psychiatr Epidemiol 33:80–88CrossRef
4.
Anonymous (2000) Cross-national comparisons of the prevalences and correlates of mental disorders. WHO International Consortium in Psychiatric Epidemiology. Bull World Health Organ 78:413–426
5.
Bijl RV, Ravelli A, van Zessen G (1998) Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 33:587–595PubMedCrossRef
6.
Carmody TP (1992) Affect regulation, nicotine addiction, and smoking cessation. J Psychoactive Drugs 24:111–122PubMed
7.
Casillas A, Clark LA (2002) Dependency, impulsivity, and self-harm: traits hypothesized to underlie the association between cluster B personality and substance use disorders. J Personal Disord 16:424–436PubMedCrossRef
8.
Costa PT Jr, Widiger TA (eds) (2002) Personality disorders and the five-factor model of personality, 2nd edn. American Psychological Association, Washington DC
9.
Goodwin RD, Jacobi F, Thefeld W (2003) Mental disorders and asthma in the community. Arch Gen Psychiatry 60:1125–1130PubMedCrossRef
10.
Goodwin RD, Stein MB (2002) Generalized anxiety disorder and peptic ulcer disease among adults in the United States. Psychosom Med 64:862–866PubMedCrossRef
11.
Hasler G, Gergen PJ, Kleinbaum DG, Ajdacic V, Gamma A, Eich D, Rossler W, Angst J (2005) Asthma and panic in young adults: a 20-year prospective community study. Am J Respir Crit Care Med 171:1224–1230PubMedCrossRef
12.
Helzer JE, Kraemer HC, Krueger RF (2007) The feasibility and need for dimensional psychiatric diagnoses. Psychol Med 36:1671–1680CrossRef
13.
Kendler KS, Prescott CA, Myers J, Neale MC (2003) The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry 60:929–937PubMedCrossRef
14.
Kessler RC, Chiu WT, Demler, Walters EE (2005) Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:617–627
15.
Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19PubMed
16.
Kish L, Frankel MR (1974) Inference from complex surveys. J Roy Stat Soc Ser B 36:1–37
17.
18.
Krueger RF, Caspi A, Moffitt TE, Silva PA (1998) The structure and stability of common mental disorders (DSM-III-R): a longitudinal-epidemiological study. J Abnorm Psychol 107:216–227PubMedCrossRef
19.
Krueger RF, Markon KE (2006) Reinterpreting comorbidity: a model-based approach to understanding and classifying psychopathology. Annu Rev Clin Psychol 2:111–133CrossRef
20.
Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610PubMedCrossRef
21.
Lenzenweger MF, Loranger AW, Korfine L, Neff C (1997) Detecting personality disorders in a nonclinical population. Application of a 2-stage procedure for case identification. Arch Gen Psychiatry 54:345–351PubMed
22.
Levenstein S, Ackerman S, Kiecolt-Glaser JK, Dubois A (1999) Stress and peptic ulcer disease. JAMA 281:10–11PubMedCrossRef
23.
Lewin TJ, Slade T, Andrews G, Carr VJ, Hornabrook CW (2005) Assessing personality disorders in a national mental health survey. Soc Psychiatry Psychiatr Epidemiol 40:87–98PubMedCrossRef
24.
Loranger AW, Janca A, Sartorius N (1997) Assessment and diagnosis of personality disorders: the ICD-10 international personality disorder examination (IPDE). Cambridge University Press, Cambridge
25.
Patten SB (2000) The specificity of epidemiological correlates of major depression. Compr Psychiatry 41:92–96PubMedCrossRef
26.
Skodol AE, Gunderson JG, Pfohl B, Widiger TA, Livesley WJ, Siever LJ (2002) The borderline diagnosis I: psychopathology, comorbidity, and personality structure. [see comment]. Biol Psychiatry 51:936–950PubMedCrossRef
27.
Slade T, Peters L, Schneiden V, Andrews G (1998) The International Personality Disorder Examination Questionnaire (IPDEQ): preliminary data on its utility as a screener for anxious personality disorder. Int J Methods Psychiatr Res 7:84–88CrossRef
28.
Slade T, Watson D (2006) The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population. Psychol Med 36:1593–1600PubMedCrossRef
29.
Teasdale JD, Russell ML (1983) Differential effects of induced mood on the recall of positive, negative and neutral words. Br J Clin Psychol 22(Pt 3):163–171PubMed
30.
Vollebergh WA, Iedema J, Bijl RV, de Graaf R, Smit F, Ormel J (2001) The structure and stability of common mental disorders: the NEMESIS study. Arch Gen Psychiatry 58:597–603PubMedCrossRef
31.
WHO (1997) Composite International Diagnostic Interview, 2.0 edn. World Health Organization, Geneva
32.
Wagner FA, Anthony JC (2002) Into the world of illegal drug use: exposure opportunity and other mechanisms linking the use of alcohol, tobacco, marijuana, and cocaine. Am J Epidemiol 155:918–925PubMedCrossRef
33.
Widiger TA, Simonsen E, Krueger RF, Livesley WJ, Verheul R (2005) Personality disorder research agenda for DSM-V. J Personal Disord 19:315–338PubMedCrossRef
34.
Wittchen HU (1994) Reliability and validity studies of the WHO–Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28:57–84PubMedCrossRef
Metadata
Title
The descriptive epidemiology of internalizing and externalizing psychiatric dimensions
Author
Tim Slade, PhD
Publication date
01-07-2007
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 7/2007
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-007-0200-5

Other articles of this Issue 7/2007

Social Psychiatry and Psychiatric Epidemiology 7/2007 Go to the issue

ORIGINAL PAPER

Social determinants of self-reported emotional and behavioral problems in Greek adolescents

ORIGINAL PAPER

Lifetime risk and age-of-onset of mental disorders in the Belgian general population

ORIGINAL PAPER

Self-harm in England: a tale of three cities

ORIGINAL PAPER

Diagnostic concordance of neurasthenia spectrum disorders in Pune, India

ORIGINAL PAPER

The mental health effects of multiple work and family demands

ORIGINAL PAPER

Perceived social justice, long-term unemployment and health