Familial Aggregation of Externalizing Psychopathology

Abstract

Objective Understanding familial aggregation (FA) of psychopathology in a latent variable framework allows for an understanding of shared risk for maladaptive traits and disorders in parents and their children, and improves clinical utility or risk models. Previously, FA has been investigated using bivariate approaches, providing a piecemeal understanding of risk. This study investigates 1) how externalizing disorders in parents impact risk for a broad range of internalizing and externalizing disorders in offspring, 2) if risk shared between parents and offspring is best conceptualized as general risk for a group of disorders or specific to particular disorders, and 3) how this might vary as a function of parent and offspring gender. Methods Data for sample one were collected as part of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) in 2001-2002 on 43,093 individuals 18 years or older living in the US. A replication sample used the Minnesota Twin and Family Study sample of twins, siblings, and their parents using parallel analyses to attempt to replicate results in an independent sample which used direct assessment of parent psychopathology. Using confirmatory factor analysis, parental externalizing disorders were investigated as a risk factor for externalizing, fear, and distress disorders in offspring, in a latent variable structural equation model. Results Externalizing in parents was most predictive of externalizing in offspring, followed by distress and finally fear disorders. However, in female offspring, externalizing in mothers in particular was as strong a predictor of distress disorders as it was of externalizing disorders. Risk for offspring disorders associated with parent disorders was well-explained by a latent variable framework, with residual correlations for ASPD in parents associated with specific risk for offspring ASPD. Conclusions Results indicate that familial psychopathology aggregation follows a pattern that suggests risk is aggregated generally (transdiagnostically across similar disorders), not specifically. Additionally, externalizing in mothers is associated with increased risk for distress disorders in female offspring, and possibly also in male offspring.