Journal of affective disorders · 2026
Dimensional and categorical approaches to behavioral-emotional problems in children and adolescents with mental disorders: A cross-sectional study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Peyvandi Aida, Delvecchio Giuseppe, Colli Chiara, Bonivento Carolina, Garzitto Marco, Mauri Maddalena, Nobile Maria, Brambilla Paolo
Аннотация
INTRODUCTION: Many psychiatric disorders emerge during adolescence, but their manifestations show only partial overlaps with adult disorders. Child and adolescent mental disorders have long-term implications for adult functioning, underscoring the need for early intervention. Effective treatment strategies require accurate diagnostic approaches and consideration of potential confounders. Therefore, this study aims to compare dimensional and categorical assessment methods to identify emotional-behavioral differences across different disorder categories.
METHODS: In a multi-center cross-sectional study, 1466 Italian children and adolescents, who referred to mental health services (aged 3-18) were categorized into 10 DSM-based diagnostic groups. Participants completed the Wechsler Intelligence Scale for Children-Revised, while parents completed the Child Behavior Checklist and the Barratt Simplified Measure of Social Status.
RESULTS: Individuals with communication disorders showed fewer internalizing, externalizing, and attentional problems compared to other diagnostic categories. In addition, similar to individuals with intellectual developmental disorders, those with mixed neurodevelopmental disorders demonstrated greater IQ problems compared to several other groups. Furthermore, participants with disruptive disorders exhibited more internalizing symptoms than those with ADHD. Finally, the dimensional perspective proved more informative, revealing a broader pattern of between-group differences than the categorical approach. For example, when examining attentional differences in ADHD, the dimensional approach proved more efficient, identifying attentional challenges in ADHD compared to more diagnostic groups than the categorical approach did.
DISCUSSION: These findings support using dimensional approaches for more comprehensive trans-diagnostic assessments and highlighting group differences in emotional-behavioral symptoms. Understanding these group differences can improve differential diagnosis and help to design tailored treatment plans.
METHODS: In a multi-center cross-sectional study, 1466 Italian children and adolescents, who referred to mental health services (aged 3-18) were categorized into 10 DSM-based diagnostic groups. Participants completed the Wechsler Intelligence Scale for Children-Revised, while parents completed the Child Behavior Checklist and the Barratt Simplified Measure of Social Status.
RESULTS: Individuals with communication disorders showed fewer internalizing, externalizing, and attentional problems compared to other diagnostic categories. In addition, similar to individuals with intellectual developmental disorders, those with mixed neurodevelopmental disorders demonstrated greater IQ problems compared to several other groups. Furthermore, participants with disruptive disorders exhibited more internalizing symptoms than those with ADHD. Finally, the dimensional perspective proved more informative, revealing a broader pattern of between-group differences than the categorical approach. For example, when examining attentional differences in ADHD, the dimensional approach proved more efficient, identifying attentional challenges in ADHD compared to more diagnostic groups than the categorical approach did.
DISCUSSION: These findings support using dimensional approaches for more comprehensive trans-diagnostic assessments and highlighting group differences in emotional-behavioral symptoms. Understanding these group differences can improve differential diagnosis and help to design tailored treatment plans.