The Dimensional Structure of Internalizing Psychopathology: Relation to Diagnostic Categories

Recent approaches have aimed to represent the dimensional structure of psychopathology, but relatively little research has rigorously tested subdimensions within internalizing psychopathology. Using adult samples harmonized across three sites (N = 427), this study tested preregistered models of the dimensional structure of internalizing psychopathology and their relations with current and lifetime depressive and anxiety disorders diagnostic data. Across S-1 bifactor and hierarchical models, we found converging evidence for both general and specific internalizing dimensions. Depression, generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic attacks were all associated with a general internalizing factor that we posit primarily represents motivational anhedonia. GAD was also associated with a specific anxious apprehension factor, and SAD was associated with specific anxious apprehension and low positive affect factors. We suggest that dimensional approaches capturing shared and specific internalizing symptom facets more accurately describe the structure of internalizing psychopathology and provide useful alternatives to categorical diagnoses to advance clinical science.