Threat sensitivity, an individual difference construct reflecting variation in responsiveness to threats of various types, predicts physiological reactivity to aversive stimuli and shares heritable variance with anxiety disorders in adults. However, no research has been conducted yet with youth to examine the heritability of threat sensitivity or evaluate the role of genetic versus environmental influences in its relations with mental health problems. The current study addressed this gap by evaluating the psychometric properties of a measure of this construct, the 20-item Trait Fear scale (TF-20), and examining its phenotypic and genotypic correlations with different forms of psychopathology in a sample of 346 twin pairs (121 monozygotic), aged 9-14 years. Analyses revealed high internal consistency and test-retest reliability for the TF-20. Evidence was also found for its convergent and discriminant validity in terms of phenotypic and genotypic correlations with measures of fear-related psychopathology. By contrast, the TF-20's associations with depressive conditions were largely attributable to environmental influences. Extending prior work with adults, current study findings provide support for threat sensitivity as a genetically-influenced liability for phobic fear disorders in youth.

The triarchic model was advanced as an integrative, trait-based framework for investigating psychopathy using different assessment methods and across developmental periods. Recent research has shown that the triarchic traits of boldness, meanness, and disinhibition can be operationalized effectively in youth, but longitudinal research is needed to realize the model's potential to advance developmental understanding of psychopathy. We report on the creation and validation of scale measures of the triarchic traits using questionnaire items available in the University of Southern California Risk Factors for Antisocial Behavior (RFAB) project, a large-scale longitudinal study of the development of antisocial behavior that includes measures from multiple modalities (self-report, informant rating, clinical-diagnostic, task-behavioral, physiological). Using a construct-rating and psychometric refinement approach, we developed triarchic scales that showed acceptable reliability, expected intercorrelations, and good temporal stability. The scales showed theory-consistent relations with external criteria including measures of psychopathy, internalizing/externalizing psychopathology, antisocial behavior, and substance use. Findings demonstrate the viability of measuring triarchic traits in the RFAB sample, extend the known nomological network of these traits into the developmental realm, and provide a foundation for follow-up studies examining the etiology of psychopathic traits and their relations with multimodal measures of cognitive-affective function and proneness to clinical problems.

Dopamine degeneration in Parkinson's disease (PD) dysregulates the striatal neural network and causes motor deficits. However, it is unclear how altered striatal circuits relate to dopamine-acetylcholine chemical imbalance and abnormal local field potential (LFP) oscillations observed in PD. We perform a multimodal analysis of the dorsal striatum using cell-type-specific calcium imaging and LFP recording. We reveal that dopamine depletion selectively enhances LFP beta oscillations during impaired locomotion, supporting beta oscillations as a biomarker for PD. We further demonstrate that dynamic cholinergic interneuron activity during locomotion remains unaltered, even though cholinergic tone is implicated in PD. Instead, dysfunctional striatal output arises from elevated coordination within striatal output neurons, which is accompanied by reduced locomotor encoding of parvalbumin interneurons and transient pathological LFP high-gamma oscillations. These results identify a pathological striatal circuit state following dopamine depletion where distinct striatal neuron subtypes are selectively coordinated with LFP oscillations during locomotion.

Neuropsychiatric symptoms are common, comorbid, and often disabling for patients with traumatic brain injury (TBI). Identifying transdiagnostic symptom dimensions post-TBI may help overcome limitations of traditional psychiatric diagnoses and advance treatment development. We characterized the dimensional structure of neuropsychiatric symptoms at 2-weeks postinjury in n = 1,732 TBI patients and n = 238 orthopedic-injured trauma controls (OTC) from the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Symptoms were reported on the Brief Symptom Inventory-18, Patient Health Questionnaire-9 Depression checklist, PTSD Checklist for DSM-5, PROMIS Pain Intensity scale, and Insomnia Severity Index. We established a novel factor model of neuropsychiatric symptoms and evaluated how 3 TBI severity strata and OTC patients differed in symptom severity. The final factor model had 6 first-order factors subsumed by 2 second-order factors: Internalizing (encompassing Depression, Anxiety, and Fear) and Somatic symptoms (Sleep, Physical, Pain). Somatic symptoms fit better as a correlated factor of (vs. a lower-order factor within) Internalizing. All symptom dimensions except for Pain were more severe in 1 or more TBI subgroups, as compared to the OTC group. Milder brain injury was generally associated with more severe symptoms, whereas more general injury severity (higher level of care, e.g., emergency department, intensive care unit) was associated with more pain. The findings indicate a broad factor resembling the internalizing factor of general psychopathology in traumatically injured patients, alongside a distinct somatic symptom factor. Brain injury, especially milder brain injury, may exacerbate liabilities toward these symptoms. These neuropsychiatric dimensions may help advance more precision medicine research for TBI. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

This study aimed to elucidate the structure of the Rivermead Postconcussion Symptoms Questionnaire (RPQ) and evaluate its longitudinal and group variance. Factor structures were developed and compared in 1,011 patients with mild traumatic brain injury (mTBI; i.e., Glasgow Coma Scale score 13-15) from the Transforming Research and Clinical Knowledge in TBI study, using RPQ data collected at 2 weeks, and 3, 6, and 12 months postinjury. A bifactor model specifying a general factor and emotional, cognitive, and visual symptom factors best represented the latent structure of the RPQ. The model evinced strict measurement invariance over time and across sex, age, race, psychiatric history, and mTBI severity groups, indicating that differences in symptom endorsement were completely accounted for by these latent dimensions. While highly unidimensional, the RPQ has multidimensional features observable through a bifactor model, which may help differentiate symptom expression patterns in the future.

Our objective was to examine the construct validity of the Brief Test of Adult Cognition by Telephone (BTACT) and its relationship to traumatic brain injury (TBI) of differing severities. Data were analyzed on 1422 patients with TBI and 170 orthopedic trauma controls (OTC) from the multi-center Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Participants were assessed at 6 months post-injury with the BTACT and an in-person neuropsychological battery. We examined the BTACT's factor structure, factorial group invariance, convergent and discriminant validity, and relationship to TBI and TBI severity. Confirmatory factor analysis supported both a 1-factor model and a 2-factor model comprising correlated Episodic Memory and Executive Function (EF) factors. Both models demonstrated strict invariance across TBI severity and OTC groups. Correlations between BTACT and criterion measures suggested that the BTACT memory indices predominantly reflect verbal episodic memory, whereas the BTACT EF factor correlated with a diverse range of cognitive tests. Although the EF factor and other BTACT indices showed significant relationships with TBI and TBI severity, some group effect sizes were larger for more comprehensive in-person cognitive tests than the BTACT. The BTACT is a promising, brief, phone-based cognitive screening tool for patients with TBI. Although the BTACT's memory items appear to index verbal Episodic Memory, items that purport to assess EFs may reflect a broader array of cognitive domains. The sensitivity of the BTACT to TBI severity is lower than domain-specific neuropsychological measures, suggesting it should not be used as a substitute for comprehensive, in-person cognitive testing at 6 months post-TBI.

We critique Roy et al.'s (2020; this issue) approach to characterizing the item-level factor structure of the three scales of the Triarchic Psychopathy Measure (TriPM), in light of the manner in which the TriPM scales were developed, the purposes they were designed to serve, and the growing body of evidence supporting their construct validity. We focus on three major points: (1) The TriPM scales are item-based factor scales - i.e., item sets designed to index broad factors of larger multi-scale (parent) inventories; (2) item-level structural analysis can be useful for representing broad dimensions tapped by such scales, but it cannot be expected to provide an accurate picture of narrower subdimensions (facets) assessed by their parent inventories; and (3) it is critical to consider the nomological networks of the TriPM scales (and other triarchic scale measures) in appraising their effectiveness as operationalizations of the triarchic model constructs. We illustrate the first and second of these points by applying Roy et al.'s analytic approach to the trait scales of the NEO-FFI, which were developed to index broad personality dimensions of the multi-scale NEO-PI-R. We address the third point with reference to the growing body of literature supporting the construct validity of the TriPM scales and demonstrating their utility for advancing an integrative understanding of psychopathy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

IMPORTANCE Heterogeneity across patients with traumatic brain injury (TBI) presents challenges for clinical care and intervention design. Identifying distinct clinical phenotypes of TBI soon after injury may inform patient selection for precision medicine clinical trials. OBJECTIVE To investigate whether distinct neurobehavioral phenotypes can be identified 2 weeks after TBI and to characterize the degree to which early neurobehavioral phenotypes are associated with 6-month outcomes. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study included patients presenting to 18 US level 1 trauma centers within 24 hours of TBI from 2014 to 2019 as part of the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Data were analyzed from January 28, 2020, to January 11, 2021. EXPOSURES TBI. MAIN OUTCOMES AND MEASURES Latent profiles (LPs) were derived from common dimensions of neurobehavioral functioning at 2 weeks after injury, assessed through National Institutes of Health TBI Common Data Elements (ie, Brief Symptom Inventory-18, Patient Health Questionnaire-9 Depression checklist, Posttraumatic Stress Disorder Checklist for DSM-5, PROMIS Pain Intensity scale, Insomnia Severity Index, Rey Auditory Verbal Learning Test, Wechsler Adult Intelligence Scale-Fourth Edition Coding and Symbol Search subtests, Trail Making Test, and NIH Toolbox Cognitive Battery Pattern Comparison Processing Speed, Dimensional Change Card Sort, Flanker Inhibitory Control and Attention, and Picture Sequence Memory subtests). Six-month outcomes were the Satisfaction With Life Scale (SWLS), Quality of Life after Brain Injury-Overall Scale (QOLIBRI-OS), Glasgow Outcome Scale-Extended (GOSE), and Rivermead Post-Concussion Symptoms Questionnaire (RPQ). RESULTS Among 1757 patients with TBI included, 1184 (67.4%) were men, and the mean (SD) age was 39.9 (17.0) years. LP analysis revealed 4 distinct neurobehavioral phenotypes at 2 weeks after injury: emotionally resilient (419 individuals [23.8%]), cognitively impaired (368 individuals [20.9%]), cognitively resilient (620 individuals [35.3%]), and neuropsychiatrically distressed (with cognitive weaknesses; 350 individuals [19.9%]). Adding LP group to models including demographic characteristics, medical history, Glasgow Coma Scale score, and other injury characteristics was associated with significantly improved estimation of association with 6-month outcome (GOSE R-2 increase = 0.09-0.19; SWLS R-2 increase = 0.12-0.22; QOLIBRI-OS R-2 increase = 0.14-0.32; RPQ R-2 = 0.13-0.34). CONCLUSIONS AND RELEVANCE In this cohort study of patients with TBI presenting to US level-1 trauma centers, qualitatively distinct profiles of symptoms and cognitive functioning were identified at 2 weeks after TBI. These distinct phenotypesmay help optimize clinical decision-making regarding prognosis, as well as selection and stratification for randomized clinical trials.

The Multidimensional Personality Questionnaire (MPQ) is a normal range inventory for assessing a variety of empirically derived primary traits. These trait scores can be differentially weighted to estimate higher-order broad dimensions such as Positive Emotionality (PEM), Negative Emotionality (NEM), and Constraint (CON). However, broad trait scores are estimated using proprietary regression equations and necessitate near complete administration of the inventory. We aimed to increase measurement efficiency by creating abbreviated item-based approximations of these weighted scores. To parsimoniously delineate and differentiate the broad traits, classical test theory and item response theory approaches were used to identify five items from each primary trait scale approximating the weighted estimates while also maintaining the breadth of MPQ content coverage. Initial scale development relied on the MPQ-276 (standard form) normative sample (n = 1,237), which was followed by cross-validation using two samples of twins and cotwins from the Minnesota Twin Family Study (n = 1,304, n = 1,305). Additional validation was conducted using a third sample of undergraduate students (n = 201).The resulting item-based scales (PEM-20, NEM-15, CON-15) demonstrated strong convergence with the established proprietary broad trait estimates. Furthermore, these abbreviated scales exhibited similar associations with the external measures of personality and psychopathology. Abbreviated item-based scales may have utility for efficient estimation of the same broadband personality dimensions assessed by longer forms of the MPQ. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Research Domain Criteria initiative aims to reorient the focus of psychopathology research toward biobehavioral constructs that cut across different modalities of measurement, including self-report and neurophysiology. Constructs within the Research Domain Criteria framework are intentionally transdiagnostic, with the construct of "acute threat," for example, broadly relevant to clinical problems and associated traits involving fearfulness and stress reactivity. A potentially valuable referent for research on the construct of acute threat is a structural model of fear/fearlessness questionnaires known to predict variations in physiological threat reactivity as indexed by startle potentiation. The aim of the current work was to develop an efficient, item-based scale measure of the general factor of this structural model for use in studies of dispositional threat sensitivity and its relationship to psychopathology. A self-report scale consisting of 44 items from a conceptually relevant, nonproprietary questionnaire was first developed in a sample of 1,307 student participants, using the general factor of the fear/fearlessness model as a direct referent. This new Trait Fear scale was then evaluated for convergent and discriminant validity with measures of personality and psychopathology in a separate sample (n = 213) consisting of community adults and undergraduate students. The strong performance of the scale in this criterion-validation sample suggests that it can provide an effective means for indexing variations along a dispositional continuum of fearfulness reflecting variations in sensitivity to acute threat.

The Multidimensional Personality Questionnaire (MPQ) is a self-report inventory that assesses personality in terms of 11 lower-order (“primary”) trait scales, which load onto three higher-order factors reflecting temperament dimensions. The full-length version of the inventory is 276 items; shorter standard-wording and simplified-wording forms (155 items and 157 items, respectively) are also available. Each item of the MPQ is answered either “true” or “false.” The inventory also contains validity scales that assess for random responding, acquiescence versus “nay-saying,” and social desirability. The MPQ has proven particularly useful for clarifying how temperamentrelated psychological dispositions relate to normative and maladaptive behavior.

In recent years there has been increasing interest in applying network science tools to EEG data. At the 2018 American Epilepsy Society conference in New Orleans, LA, the yearly session of the Engineering and Neurostimulation Special Interest Group focused on emerging, translational technologies to analyze seizure networks. Each speaker demonstrated practical examples of how network tools can be utilized in clinical care and provide additional data to help care for patients with intractable epilepsy. The groups presented advances using tools from functional connectivity, control theory, and graph theory to analyze human EEG data. These tools have great potential to augment clinical interpretation of EEG signals.

Serious mental health conditions peak in prevalence and incidence during the transition to adulthood (approximately ages 16–25). Young adults are at high risk for discontinuation of care when no longer eligible for child mental health services. This study uses state administrative data to examine service continuation among those aging out of child system services in Texas (N = 3135). Most (63.5%) did not enroll in adult services following their 18th birthday. Binary logistic regression analyses found that significant predictors of child-to-adult service continuation included (1) a serious primary mental health diagnosis (i.e., schizophrenia, bipolar disorder, major depressive disorder), (2) risks to self and others, and (3) number of prior-year mental health services received. These findings suggest that historical mental health policies and practices may contribute to service disconnection at age 18 in Texas. Implications for mental health policy and system reform locally and nationally are discussed.

Background: Identifying separate dimensions of concussion symptoms may inform a precision medicine approach to treatment. It was previously reported that a bifactor model identified distinct acute postconcussion symptom dimensions. Purpose: To replicate previous findings of a bifactor structure of concussion symptoms in the Concussion Assessment Research and Education (CARE) Consortium sample, examine measurement invariance from pre- to postinjury, and evaluate whether factors are associated with other clinical and biomarker measures. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Collegiate athletes were prospectively evaluated using the Sport Concussion Assessment Tool–3 (SCAT-3) during preseason (N = 31,557); 2789 were followed at <6 hours and 24 to 48 hours after concussion. Item-level SCAT-3 ratings were analyzed using exploratory and confirmatory factor analyses. Bifactor and higher-order models were compared for their fit and interpretability. Measurement invariance tested the stability of the identified factor structure across time. The association between factors and criterion measures (clinical and blood-based markers of concussion severity, symptom duration) was evaluated. Results: The optimal structure for each time point was a 7-factor bifactor model: a General factor, on which all items loaded, and 6 specific factors—Vestibulo-ocular, Headache, Sensory, Fatigue, Cognitive, and Emotional. The model manifested strict invariance across the 2 postinjury time points but only configural invariance from baseline to postinjury. From <6 to 24-48 hours, some dimensions increased in severity (Sensory, Fatigue, Emotional), while others decreased (General, Headache, Vestibulo-ocular). The factors correlated with differing clinical and biomarker criterion measures and showed differing patterns of association with symptom duration at different time points. Conclusion: Bifactor modeling supported the predominant unidimensionality of concussion symptoms while revealing multidimensional properties, including a large dominant General factor and 6 independent factors: Headache, Vestibulo-ocular, Sensory, Cognitive, Fatigue, and Emotional. Unlike the widely used SCAT-3 symptom severity score, which declines gradually after injury, the bifactor model revealed separable symptom dimensions that have distinct trajectories in the acute postinjury period and different patterns of association with other markers of injury severity and outcome. Clinical Relevance: The SCAT-3 total score remains a valuable, robust index of overall concussion symptom severity, and the specific factors identified may inform management strategies. Because some symptom dimensions continue to worsen in the first 24 to 48 hours after injury (ie, Sensory, Fatigue, Emotional), routine follow-up in this time frame may be valuable to ensure that symptoms are managed effectively.

We describe efforts to formulate a quantitative measurement model for boldness, a construct that has been intensively discussed and investigated in the psychopathy literature in recent years. Although the Fearless Dominance factor of the Psychopathic Personality Inventory (PPI-FD) has served as a major referent for studying this dispositional construct, boldness was not explicitly targeted in developing the PPI, creating the need for a formal measurement model for this construct. Using an exploratory approach to test construction and multiple waves of data collection and analysis involving 1,791 participants, we created nine unidimensional scales (comprising a total of 130 items) for assessing correlated but thematically distinct facets of boldness, and characterized their higher-order structure. Overall scores on this new Boldness Inventory correlated highly with PPI-FD (positively) and dispositional fear (negatively), and negligibly with disinhibitory proclivities, in validation samples consisting of undergraduates (N = 767) and male prisoners (N = 326). The structural model of this new inventory, encompassing a general factor on which all facet scales loaded and two subordinate factors defined by residual variances of certain scales, effectively accommodated the constituent scales of PPI-FD. The model development work reported here establishes a valuable foundation for further, more fine-grained investigation of boldness as it relates to psychopathy and other clinical conditions as well as to adaptive functioning and performance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).