Cross-Cultural Validation of Transdiagnostic Symptom Dimensions and Their Relationship with Hierarch
Poster No:
760
Submission Type:
Abstract Submission
Authors:
Xiaofang Li1, Qun Ye1
Institutions:
1Zhejiang Normal University, Jinhua, Zhejiang
First Author:
Co-Author:
Introduction:
Psychiatric disorders rarely occur in isolation, and symptom dimensions often transcend traditional diagnostic boundaries (Wise et al., 2023). Recent advancements in large-scale studies and computational factor modeling (Hopkins et al., 2022) have supported transdiagnostic approaches to psychiatric symptoms, identifying three key dimensions: anxiety-depression, compulsive and intrusive thoughts, and social withdrawal. However, the applicability of these symptom dimensions in Eastern cultural contexts, where factors suMASch as lower prevalence of substance addiction differ from Western contexts, remains underexplored. This study aimed to investigate the cross-cultural generalizability of these transdiagnostic dimensions in an Eastern sample. Additionally, we examined the associations between these symptom dimensions and metacognitive functioning (Seow et al., 2021), a hierarchical construct encompassing global and specific metacognitive processes, to better understand individual differences in psychiatric symptomatology.
Methods:
In Study 1 (Figure 1A), 400 participants were recruited based on the epidemiology of mental disorders in China (Huang et al., 2019) and findings from prior research (Seow et al., 2024). Participants completed nine clinical scales comprising 197 items to identify transdiagnostic symptom dimensions. Factor analysis was conducted using Maximum Likelihood Estimation (MLE) with oblique oblimin rotation. Cross-validation was employed to derive an optimized item pool of 85 items for Study 2. In Study 2 (Figure 1B), 279 participants completed the 85-item reduced set, a metamemory experimental task, and five scales assessing global metacognition. Relationships between symptom dimensions and metacognition were analyzed through regression models and hierarchical analyses.
Results:
Factor analysis in Study 1 revealed a three-factor structure consistent with prior findings: Anxiety-Depression (AD), Social Withdrawal (SW), and Compulsive Behaviour and Intrusive Thoughts (CIT). The reduced 85-item set demonstrated robust predictive validity for the three symptom dimensions based on cross-validation metrics. In Study 2, metamemory task results showed that confidence ratings for correct trials (M = 86.06%, SD = 6.48%) were significantly higher than those for incorrect trials (M = 74.52%, SD = 10.48%, p < 0.001). Regression analyses revealed distinct associations between confidence and symptom dimensions: higher AD scores were associated with lower confidence (β = -0.19, SE = 0.06, p = 0.002), SW scores showed a weaker and nonsignificant negative association (β = -0.03, SE = 0.06, p = 0.55), while higher CIT scores were linked to greater confidence (β = 0.14, SE = 0.06, p = 0.02). When global metacognitive metrics were introduced, differences in AD were primarily driven by lower self-esteem and impaired global metacognitive abilities (β = -0.67, SE = 0.05, p < 0.001). In contrast, CIT variations were influenced by both local task performance (β =0.15, SE=0.06, p =0.020) and global metacognitive parameters (self-esteem: β = -0.14, SE = 0.05, p = 0.002).
Conclusions:
This study highlights the feasibility of extracting transdiagnostic symptom dimensions in an Eastern cultural context, aligning with Gillan et al.'s (2016) findings of AD, CIT, and SW as robust, replicable dimensions. Importantly, these dimensions exhibited specific relationships with hierarchical metacognitive functioning. These findings underscore the role of metacognitive biases in shaping psychiatric symptoms and suggest that hierarchical metacognitive models provide valuable insights for clinical interventions targeting depression and obsessive-compulsive tendencies. Future research should explore the dynamic interplay between global and domain-specific metacognition and symptom dimensions to refine transdiagnostic models and intervention strategies across cultures.
Higher Cognitive Functions:
Higher Cognitive Functions Other 1
Learning and Memory:
Learning and Memory Other 2
Keywords:
Other - mental health; transdiagnostic; computational psychiatry; metacognition; eastern culture
1|2Indicates the priority used for review
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Hopkins, A. K., Gillan, C., Roiser, J. P., Wise, T., & Sidarus, N. (2022, September 29). Optimising the measurement of anxious-depressive, compulsivity and intrusive thought and social withdrawal transdiagnostic symptom dimensions. https://doi.org/10.31234/osf.io/q83sh
Huang, Y., Wang, Y., Wang, H., Liu, Z., Yu, X., Yan, J., Yu, Y., Kou, C., Xu, X., Lu, J., Wang, Z., He, S., Xu, Y., He, Y., Li, T., Guo, W., Tian, H., Xu, G., Xu, X., . . . Wu, Y. (2019). Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry, 6(3), 211-224.
Wise, T., Robinson, O. J., & Gillan, C. M. (2023). Identifying Transdiagnostic Mechanisms in Mental Health Using Computational Factor Modeling. Biological Psychiatry, 93(8), 690-703.
Seow, T. X. F., Fleming, S. M., & Hauser, T. U. (2024, April 16). Metacognitive biases in anxious-depression and compulsivity extend across perception and memory. https://doi.org/10.31234/osf.io/avyph
Seow, T. X. F., Rouault, M., Gillan, C. M., & Fleming, S. M. (2021). How Local and Global Metacognition Shape Mental Health. Biological Psychiatry, 90(7), 436-446.