Skip to main content

Advertisement

SpringerLink
Log in

The descriptive epidemiology of internalizing and externalizing psychiatric dimensions

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Achenbach TM, Edelbrock CS (1978) The classification of child psychopathology: a review and analysis of empirical efforts. Psychol Bull 85:1275–1301

    Article  PubMed  CAS  Google Scholar 

  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 178:145–153

    Article  CAS  Google Scholar 

  3. Andrews G, Peters L (1998) The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry Psychiatr Epidemiol 33:80–88

    Article  CAS  Google Scholar 

  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

    Google Scholar 

  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 33:587–595

    Article  PubMed  CAS  Google Scholar 

  6. Carmody TP (1992) Affect regulation, nicotine addiction, and smoking cessation. J Psychoactive Drugs 24:111–122

    PubMed  CAS  Google Scholar 

  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 16:424–436

    Article  PubMed  Google Scholar 

  8. Costa PT Jr, Widiger TA (eds) (2002) Personality disorders and the five-factor model of personality, 2nd edn. American Psychological Association, Washington DC

    Google Scholar 

  9. Goodwin RD, Jacobi F, Thefeld W (2003) Mental disorders and asthma in the community. Arch Gen Psychiatry 60:1125–1130

    Article  PubMed  Google Scholar 

  10. Goodwin RD, Stein MB (2002) Generalized anxiety disorder and peptic ulcer disease among adults in the United States. Psychosom Med 64:862–866

    Article  PubMed  Google Scholar 

  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 171:1224–1230

    Article  PubMed  Google Scholar 

  12. Helzer JE, Kraemer HC, Krueger RF (2007) The feasibility and need for dimensional psychiatric diagnoses. Psychol Med 36:1671–1680

    Article  Google Scholar 

  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 60:929–937

    Article  PubMed  Google Scholar 

  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 51:8–19

    PubMed  CAS  Google Scholar 

  16. Kish L, Frankel MR (1974) Inference from complex surveys. J Roy Stat Soc Ser B 36:1–37

    Google Scholar 

  17. Krueger RF (1999) The structure of common mental disorders. Arch Gen Psychiatry 56:921–926

    Article  PubMed  CAS  Google Scholar 

  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 107:216–227

    Article  PubMed  CAS  Google Scholar 

  19. Krueger RF, Markon KE (2006) Reinterpreting comorbidity: a model-based approach to understanding and classifying psychopathology. Annu Rev Clin Psychol 2:111–133

    Article  Google Scholar 

  20. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610

    Article  PubMed  CAS  Google Scholar 

  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 54:345–351

    PubMed  CAS  Google Scholar 

  22. Levenstein S, Ackerman S, Kiecolt-Glaser JK, Dubois A (1999) Stress and peptic ulcer disease. JAMA 281:10–11

    Article  PubMed  CAS  Google Scholar 

  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 40:87–98

    Article  PubMed  Google Scholar 

  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

    Google Scholar 

  25. Patten SB (2000) The specificity of epidemiological correlates of major depression. Compr Psychiatry 41:92–96

    Article  PubMed  CAS  Google Scholar 

  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 51:936–950

    Article  PubMed  Google Scholar 

  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 7:84–88

    Article  Google Scholar 

  28. Slade T, Watson D (2006) The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population. Psychol Med 36:1593–1600

    Article  PubMed  Google Scholar 

  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):163–171

    PubMed  Google Scholar 

  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 58:597–603

    Article  PubMed  CAS  Google Scholar 

  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 155:918–925

    Article  PubMed  Google Scholar 

  33. Widiger TA, Simonsen E, Krueger RF, Livesley WJ, Verheul R (2005) Personality disorder research agenda for DSM-V. J Personal Disord 19:315–338

    Article  PubMed  Google Scholar 

  34. Wittchen HU (1994) Reliability and validity studies of the WHO–Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28:57–84

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Psychiatry, University of New South Wales at St Vincent’s Hospital, 299 Forbes Street, Darlinghurst, NSW, 2010, Australia

    Tim Slade PhD

Authors
  1. Tim Slade PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tim Slade PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Slade, T. The descriptive epidemiology of internalizing and externalizing psychiatric dimensions. Soc Psychiat Epidemiol 42, 554–560 (2007). https://doi.org/10.1007/s00127-007-0200-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-007-0200-5

Keywords

Search

Navigation