Psychopathology depression super factors measured in the clinical analysis questionnaire.

Transcription

1 Psychopathology depression super factors measured in the clinical analysis questionnaire. by Gregory J. Boyle Department of Education, University of Melbourne, Parkville, Victoria 3052, Australia ABSTRACT In the area of psychometric measurement of depression, the most comprehensive multidimensional instrument is the Clinical Analysis Questionnaire (CAQ). This selfreport inventory is purported to measure some 28 normal and abnormal personality source traits. In particular, seven separate depression primaries are claimed to have a measurement basis in the CAQ. Clearly, despite the apparent comprehensiveness of the instrument, there are too many primary factors in the CAQ for practical use in many contexts. In order to simplify interpretation of CAQ scores, it seems desirable to utilise a smaller number of more reliable super factors wherever possible. The present investigation explores this issue and findings suggest that depression is a complex phenomenon even at the super factor level. Findings also suggest that traditional psychiatric labels may need to be reworked in the light of the present evidence on super factors within the psychopathological domain. INTRODUCTION Of all the areas of psychopathology, depression is perhaps the most pervasive (Boyd, Weissman, Thompson and Myers, 1982). However, the lack of agreed definition in empirical investigations of the phenomenon has resulted in many discrepant findings (Shapiro, 1981). In an attempt to clarify some of the issues pertaining to depression measurement, Boyle (1985b) critically reviewed many of the extant self-report measures of depression in terms of the psychometric characteristics and empirical research underpinning the construction of such instruments. In the light of that review, it appears desirable to develop new measures of depression within a multivariate psychometric context. Such an approach has the obvious advantage of providing simultaneous measurement on a number of other relevant constructs in addition to depression, per se, enabling the researcher or the clinician to quantify the complexity of psychological effects of various treatments. The most comprehensive multivariate instrument which measures depression phenomena is the Clinical Analysis Questionnaire (CAQ) (Cattell and Sells, 1974; Krug, 1980). This multidimensional instrument is basically an extension of the Sixteen Personality Factor Questionnaire (16PF-Cattell, Eber and Tatsuoka, 1970) to the abnormal personality trait domain. Thus the 16 normal personality trait dimensions from the 16PF as well as an additional 12 pathological trait factors are included in the CAQ. In particular, there are seven depression subscales, along with factors measuring Paranoia, Psychopathic Deviation, Schizophrenia, Psychasthenia, and Psychological Inadequacy. Joint factoring of the 16PF with the MMPI (e.g. Cattell and Bolton, 1969) served as the basis for including the five additional psychopathological factors in the CAQ apart from the depression factors. As is apparent, when the principles of sound factor analytic methodology advocated by Cattell (1973b, pp , 1978) are adhered to, the factors derived from the MMPI

2 item pool differ somewhat from those typically purported to be measured in that instrument. More importantly for the present investigation, it is clear that depression is not a unitary psychopathological dimension, but rather is a complex multidimensional phenomenon (cf. Boyle, 1983a, b, 1984a, b, 1985b, c, 1986b; Cattell, 1979, pp ; Price, Cattell and Patrick, 1981). The seven primary depression factors purported to be measured in the CAQ (Krug, 1980) have been labelled: Hypochondriasis, Suicidal Depression, Agitated Depression (brooding discontent), Anxious Depression, Low Energy Depression, Guilt and Resentment, and Bored Depression. Several factor analyses of items and item parcels have provided tentative support for the primary factor structure of the CAQ (e.g. Cattell, 1973a; Cattell and Bjerstedt, 1967; Cattell and Bolton, 1969; Cattell and Sells, 1974; Cattell and Kameoka, 1985; Delhees and Cattell, 1971; Kameoka, 1986; Schwartz, 1976). As for the few reports of second-order factors measured in the CAQ, the results have been conflicting (e.g. Krug and Laughlin, 1977; Schwartz, 1976). Thus in the study by Schwartz, 10 secondaries were extracted and rotated to oblique simple structure. Three of these second-order factors exhibited appreciable loadings on the various depression primaries in the CAQ. Likewise Krug and Laughlin extracted and rotated to oblique simple structure 10 second-order factors, but they obtained only a single major depression secondary, in separate analyses for males and females. For males, Agitated Depression (D1) lined up with Psychopathic Deviation in a higher-order factor labelled by Krug and Laughlin as Socialization. While this also was observed for the female data, both Anxious Depression (D3) as well as Guilt and Resentment (Dh) exhibited loadings on the second-order Neuroticism dimension in addition to significant loadings on the Depression super factor itself. Seemingly, the complexity of depression structures was more articulated in the female sample than in the male sample. This finding accords with previous research (e.g. Abramson and Andrews, 1982; King and Buchwald, 1982; Scott, Hannum and Ghrist, 1982) which suggests that females more readily admit to depression symptomatology than do males in general. Schwartz (1976) contended that when comparing samples of normal college students with combined normal-pathological samples on the CAQ, a different structuring of secondary factors seems evident. According to Schwartz (p. 172) Although perhaps not originally intended for administration to normal Ss, the CAQ secondaries seem to have a great deal of additional information to offer which has not been found in the l6pf when administered alone. Future higher-order factorings are anticipated with great interest. In her analysis of primary factors in the CAQ, Kameoka (I 986) factored a combination of CAQ item parcels (each subscale was split into two separate parcels). as well as a further pool of 62 depression items from the Comprehensive Problem Behavior Checklist (CPBC-Marsella and Sanborn, l975), on a normal sample of 214 undergraduates enrolled at the University of Hawaii. Kameoka included the additional depression items in her analysis of the CAQ item parcels in order to provide further refinement of the seven depression primaries. Kameoka (p. 120) observed that there was a tendency for the depression primaries to collapse among themselves (raising) questions about their strata status. She argued therefore, that further refinement was necessary to establish the independence of the depression primaries in the CAQ. Given the high intercorrelations of the seven depression factors, the call by both Schwartz (1976) and Kameoka (1986) for further studies into the higher-order factor structure of the CAQ seems particularly germane.

3 In view of the complexity of interpreting scores on all 28 CAQ primaries, along with the concomitant instability of regression weights in prediction equations (Eysenck, 1984, p. 333), it is clearly desirable to simplify the CAQ model of abnormal and normal personality traits by seeking super factors as broad as those in Eysenck s typological system (cf. Boyle, 1986d). Cattell s system of numerous primary source factors is just too complex for the vast majority of main-stream psychologists to deal with effectively. Boyle (e.g. 1983c, 1985a, l986a, c, e) has previously shown the feasibility of scoring multidimensional psychological instruments for a considerably smaller number of more parsimonious super factors (meta-psychological factors). As for the psychometric characteristics of the CAQ. McNair (1978, p. 746) commented that, one-day test-retest stabilities for 100 largely normal young adults ; the coefficients, ranging from 0.67 to 0.90 are not especially impressive considering the short interval. Clearly for trait measures, short-interval stabilities should be particularly high (about 0.90 or higher) if the measures are in fact highly reliable, as pointed out by Boyle (1979, p. 78). For the first part of the CAQ (which measures normal personality traits on the 16PF model), the test-retest stabilities ranged from 0.51 to 0.74 (cf. Krug, 1980, p. 27) suggesting that the instrument is less than optimally reliable. The difference in numbers of items in each subscale for Part I (eight items) as compared with Part II (12 items) may indeed account for the diminished stability coefficients in the first part of the instrument. Even so, Guthrie (1985. p. 341) has contended that, Each clinical scale has only 12 items, (and) that must inevitably limit the degree that scales correlate with external variables such as diagnosis. Evidently, the CAQ subscales need lengthening in terms of number of items, in accord with the Spearman-Brown prophecy formula (cf. Cracker and Algina, 1986, pp. 118-l 19). Alternatively, the instrument should be scored at the second-order level. Accordingly, the present paper investigates further the question of higher-order factors measured in the CAQ. METHOD Procedure and results The table of intercorrelations for the 31 primary factors extracted by Kameoka (1986, p. 119) was subjected to a higher-order iterative principal factoring procedure (initial communality estimates were the maximum off-diagonal correlations), together with rotation to oblique simple structure via the direct Oblimin method as provided in the SPSS package (Nie, Hull, Jenkins, Steinbrenner and Bent, 1975). Both the Kaiser- Guttman (K-G) criterion of eigen values greater than unity, and the Scree test (Cattell and Vogelmann, 1977; Hakstian, Rogers and Cattell, 1982) agreed in showing that nine second-order CAQ factors should be extracted (this refutes McNair s, 1978, p. 746 claim regarding the number of CAQ secondaries). As Child (1970, pp ) has indicated, the K-G and Scree test criteria for determining the appropriate factor extraction number tend to provide similar estimates when the number of variables in the analysis is between 20 and 50, as in the present instance. While objective computer algorithms have been devised for interpreting the Scree test (e.g. Barrett and Kline, 1982; Gorsuch, 1983, ) these were not used in the present analysis as the appropriate number of factors was clearly indicated. The results of the second-

4 order factoring of the CAQ and CPBC primaries are presented in Table 1. The thirdorder results are shown in Table 3. Factor 1 (which accounted for 15.3% of the unrotated variance) exhibited significant (20.30) loadings on Affectia/Warmth (negatively), Hypochondriasis, Suicidal Depression, Low Energy Depression, Guilt and Resentment, Paranoia, Schizophrenia, and Psychasthenia. Taken together, these loadings give an interpretation of Psychotic and Schizophrenic Depression, with no less than four of the depression primaries (D,, D,, D,, D6) being involved. Factor 2 (11.9% of variance) had significant loadings on Dominance as well as Psychopathic Deviation, along with smaller loadings on Agitated Depression, Impulsivity/Autia, and a negative loading on Schizophrenia. The loadings of this super factor are suggestive of Psychopathic Dominance. Factor 3 (8.2% of variance) loaded mainly on General Psychosis and

5 Suspiciousness/Pretension. The putative interpretation of this factor is Psychotic Inadequacy. Factor 4 (6.6% of variance) exhibited significant loadings on Affectia/Warmth, Surgency/Impulsivity, Parmia/Boldness, Radicalism, and negatively on Anxious Depression, and Premsia/Sensitivity. The interpretation of this super factor is Extraversion- Introversion. This is the first of the super factors in the present analysis which is primarily a normal personality dimension (cf. Eysenck, 1981, 1983; Eysenck and Eysenck, 1984). As for Factor 5 (6.2% of variance), significant loadings on Intelligence, Ego Strength/Stability, Super Ego/Conscientiousness, Autia/Good Memory/Concentration, give an interpretation of Intelligent Independence. Again, this is a normal secondary in the 16PF (or at least two purported secondaries collapsed into a single dimension). Factor 6 (5.0% of the variance) loaded positively on Bored Depression and Paranoia, and negatively on Autia and Security/Lack of Guilt. Hence Factor 6 might be described as Paranoid Depression. Factor 7 (4.8% of variance) exhibited significant loadings on Helplessness, Irritability and Attachment to the Self (Egocentricity/Low Self- Sentiment), as well as on Low Energy Depression. These loadings were all negative, while in contrast, a positive loading occurred for Intelligence. Taken together, these loadings suggest that this super factor might best be described as Helpless Depression. Factor 8 (4.1% of the variance) had significant loadings on Ego Strength as well as on Ergic Tension (negatively), indicative of the stability-instability continuum (cf. Meites, Lovallo and Pishkin, 1980). Clearly, this super factor represents an emotionality dimension which is part of the normal personality composition of Neuroticism. As for Factor 9 (3.6% of variance), significant loadings occurred for Sensitivity (Threctia and Premsia), Agitated Depression, Anxious Depression, Hypochondria, and negatively for Ego Strength. The putative interpretation of this factor might be described as Anxious Depression. This super factor appears to comprise the psychopathological component of neuroticism.

6 DISCUSSION AND CONCLUSIONS Overall, the present findings clearly suggest that previous higher-order factorings of the CAQ have not provided a definitive answer to the question of normal and abnormal personality trait super factors. The results of the present analysis confirm that depression is a complex phenomenon with major types being Psychotic Depression, Paranoid Depression, Helpless Depression (cf. Seligman, Abramson, Semmel and von Baeyer, 1979, regarding learned helplessness), and Anxious Depression. Investigation of multifaceted depression phenomena within the framework of such depression super factors is likely to yield more fruitful outcomes than by attempting to interpret findings in terms of seven separate primaries simultaneously. The present findings provide support for only three (possibly four) of the eight second-order factors purported to be measurable within the normal 16PF personality trait domain (cf. Cattell et al., 1970). While the reduced number of items in the first part of the CAQ (in comparison with the number of items in the 16PF subscales) may partly account for this finding, nevertheless, it remains likely that only about five 16PF secondaries have been well substantiated in the research literature. In contrast, the present findings suggest at least six psychopathological personality trait super factors which might have important implications for clinical research and practice. Seemingly, the traditional psychiatric syndrome labels will need to be revised in the light of heuristic evidence, such as provided in this paper. Instruments such as the MMPI which have been designed in an ad hoc criterion-keyed fashion, have only served to rationalise the continued use of psychiatric labels, which may have no inherent validity, irrespective of facile interpretations such as those included in the DSM-III. The factor structure of the CAQ clearly demonstrates the inadequacy of the psychiatric syndrome dimensions claimed to be measured in the MMPI. As Holden, Reddon, Jackson and Helmes (1983, p. 37) have pointed out, factor analyses of the entire MMPI item pool... not only fail to support the original scoring keys but also suggest a different number of scales with largely different interpretations. (cf. Reddon, Marceau and Jackson, 1982). On this evidence therefore, psychiatric practice is based on outmoded stereotypical concepts of mental illness, which have little if any basis in empirical psychometric research. The present findings regarding psychopathological super factors, albeit still tentative and requiring further crossvalidational research, may ultimately open the way for a more realistic understanding of psychopathology and concomitantly facilitate treatment modalities which may be more appropriate in many clinical situations. REFERENCES Abramson and Andrews, L.Y. Abramson and D.E. Andrews, Cognitive models of depression: Implications for sex differences in vulnerability to depression. Int. J. Ment. Hlth. 11 (1982), pp Barrett and Kline, P.T. Barrett and P. Kline, Factor extraction: An examination of three methods. Person. Stud. Group Behav. 2 (1982), pp Boyd et al., J.H. Boyd, M.M. Weissman, W.D. Thompson and J.K. Myers, Screening for depression in a community sample: Understanding the discrepancies

7 between depression symptom and diagnostic scales. Arch. gen. Psychiat. 39 (1982), pp Boyle, G.J. Boyle, Delimitation of state-trait curiosity in relation to state anxiety and learning task performance. Aust. J. Educ. 23 (1979), pp Boyle, 1983a. G.J. Boyle, Effects of depressive mood and the premenstrual factor on processing of high and low content structure text in American and Australian college women. In: Ph.D. Dissertation, University of Delaware (1983a). Boyle, 1983b. G.J. Boyle, Effects on academic learning of manipulating emotional states and motivational dynamics. Br. J. educ. Psychol. 53 (1983b), pp Boyle, 1983c. G.J. Boyle, Higher-order factor structure of Cattell's MAT and 8SQ. Multivar. Exp. Clin. Res. 6 (1983c), pp Boyle, 1984a. G.J. Boyle, A cross-cultural investigation of the effects of depressive mood on processing of high and low content structure text. In: Paper presented at the 19th Annual Conference, Australian Psychological Society, University of Western Australia, Perth (1984a). Boyle, 1984b. G.J. Boyle, Effects on academic learning of manipulating mood states and motivational dynamics in relation to ability and personality factors. In: Ph.D. Dissertation, University of Melbourne (1984b). Boyle, 1985a. G.J. Boyle, A reanalysis of the higher-order factor structure of the Motivation Analysis Test and the Eight State Questionnaire. Person. individ. Diff. 6 (1985a), pp Boyle, 1985b. G.J. Boyle, Self-report measures of depression: Some psychometric considerations. Br. J. clin. Psychol. 24 (1985b), pp Boyle, 1985c. G.J. Boyle, The paramenstruum and negative moods in normal young women. Person. individ. Diff. 6 (1985c), pp Boyle, 1986a. G.J. Boyle, Analysis of typological factors across the Eight State Questionnaire and the Differential Emotions Scale. Psychol. Rep. 59 (1986a), pp Boyle, 1986b. G.J. Boyle, Depressed mood effects on processing of high- and lowcontent structure text in American and Australian college women. J. Struct. Learning. 9 (1986b), pp Boyle, 1986c. G.J. Boyle, Higher-order factors in the Differential Emotions Scale (DES-III). Person. Individ. Diff. 7 (1986c), pp Boyle, 1986d. G.J. Boyle, Super factors in Cattell's Sixteen Personality Factor Questionnaire, Eight State Battery and Objective Motivation Analysis Test. Person. individ. Diff. 7 (1986d), pp

8 Boyle, 1986e. G.J. Boyle, Typological mood-state factors measured in the Eight State Questionnaire. Person. individ. Diff. 7 (1986e), pp Cattell, 1973a. R.B. Cattell, A check on the 28 factor Clinical Analysis Questionnaire structure on normal and pathological subjects. J. Multivar. exp. Person. Clin. Psychol. 1 (1973a), pp Cattell, 1973b. R.B. Cattell, Personality and Mood by Questionnaire., Jossey-Bass, San Francisco (1973b). Cattell, R.B. Cattell, The Scientific use of Factor Analysis in Behavioral and Life Sciences., Plenum Press, New York (1978). Cattell, R.B. Cattell In: The Structure of Personality in its EnvironmentPersonality and Learning Theory Vol. 1, Springer, New York (1979). Cattell and Bjerstedt, R.B. Cattell and A. Bjerstedt, The structure of depression, by factoring Q-data in relation to general personality source traits. Scand. J. Psychol. 8 (1967), pp Cattell and Bolton, R.B. Cattell and L.S. Bolton, What pathological dimensions lie beyond the normal dimensions of the 16PF? A comparison of MMPI and 16PF factor domains. J. consult. Clin. Psychol. 33 (1969), pp Cattell and Kameoka, R.B. Cattell and V.A. Kameoka, Psychological states measured in the Clinical Analysis Questionnaire (CAQ). Multivar. Exp. Clin. Res. 7 (1985), pp Cattell and Sells, R.B. Cattell and S. Sells, The Clinical Analysis Questionnaire (CAQ)., Institute for Personality and Ability Testing, Champaign, Illinois (1974). Cattell and Vogelmann, R.B. Cattell and S. Vogelmann, A comprehensive trial for the scree and KG criteria for determining the number of factors. Multivar. Behav. Res. 12 (1977), pp Cattell et al., R.B. Cattell, H.W. Eber and M.M. Tatsuoka, Handbook for the 16PF., Institute for Personality and Ability Testing, Champaign, Illinois (1970). Child, D. Child, The Essentials of Factor Analysis., Holt, Rinehart & Winston, London (1970). Crocker and Algina, L. Crocker and J. Algina, Introduction to Classical and Modern Test Theory., Holt, Rinehart & Winston, New York (1986). Delhees and Cattell, K.H. Delhees and R.B. Cattell, The dimensions of pathology: Proof of their projection beyond the normal 16PF source traits. Personality 2 (1971), pp Eysenck, H.J. Eysenck, A Model for Personality., Springer, New York (1981).

9 Eysenck, H.J. Eysenck, Personality as a fundamental concept in scientific psychology. Aust. J. Psychol. 35 (1983), pp Eysenck, H.J. Eysenck, Cattell and the theory of personality. Multivar. Behav. Res. 19 (1984), pp Eysenck and Eysenck, H.J. Eysenck and M.W. Eysenck, Personality and Individual Differences: A Natural Science Approach., Plenum Press, New York (1984). Gorsuch, R.L. Gorsuch, Factor Analysis. (2nd Edn. ed.),, Plenum Press, New York (1983). Guthrie, G. Guthrie, Review of the Clinical Analysis Questionnaire. In: J.V. Mitchell, Jr, Editor, The Ninth Mental Measurements Yearbook, Buros Institute of Mental Measurements, University of Nebraska Press, Lincoln, Nebraska (1985). Hakstian et al., A.R. Hakstian, W.T. Rogers and R.B. Cattell, The behavior of number-of-factors rules with simulated data. Multivar. Behav. Res. 17 (1982), pp Holden et al., R.R. Holden, J.R. Reddon, D.N. Jackson and E. Helmes, The construct heuristic applied to the measurement of psychopathology. Multivar. Behav. Res. 18 (1983), pp Kameoka, V.A. Kameoka, The structure of the Clinical Analysis Questionnaire and depression symptomatology. Multivar. Behav. Res. 21 (1986), pp King and Buchwald, D.A. King and A.M. Buchwald, Sex differences in subclinical depression: Administration of the Beck Depression Inventory in public and private disclosure situations. J. Person. Soc. Psychol. 42 (1982), pp Krug, S.E. Krug, Clinical Analysis Questionnaire manual., Institute for Personality and Ability Testing, Champaign, Ill. (1980). Krug and Laughlin, S.E. Krug and J.E. Laughlin, Second-order factors among normal and pathological primary personality traits. J. consult. Psychol. 45 (1977), pp Marsella and Sanborn, A. Marsella and K. Sanborn, The comprehensive problem behavior/feeling checklist: A new self-report depression scale. (1975) Unpublished manuscript. McNair, D.M. McNair, Review of the Clinical Analysis Questionnaire. In: O.K. Buros, Editor, The Eight Mental Measurements Yearbook, Highland Park Gryphon, New Jersey (1978). Meites et al., K. Meites, W. Lovallo and V. Pishkin, A comparison of four scales for anxiety, depression, and neuroticism. J. clin. Psychol. 36 (1980), pp

10 Nie et al., N.H. Nie, C.H. Hull, J.G. Jenkins, K. Steinbrenner and D.H. Bent, Statistical Package for the Social Sciences., McGraw-Hill, New York (1975). Price et al., P.L. Price, R.B. Cattell and S.V. Patrick, A check on the factoranalytic structure of four O-A kit source traits, independence, Evasiveness, Realism and Dissofrustance found diagnostic of depression. Multivar. Exp. clin. Res. 5 (1981), pp Reddon et al., J.R. Reddon, R. Marceau and D.N. Jackson, An application of singular value decomposition to the factor analysis of MMPI items. Appl. Psychol. Measurement 6 (1982), pp Schwartz, S.A. Schwartz, Second order factors of the CAQ in a normal population. Multivar. exp. Clin. Res. 2 (1976), pp Scott et al., N.A. Scott, T.E. Hannum and S.L. Ghrist, Assessment of depression among incarcerated females. J. Person. Assessment 46 (1982), pp Seligman et al., M.E.P. Seligman, L.Y. Abramson, A. Semmel and C. von Baeyer, Depressive attributional style. J. abnorm. Psychol. 88 (1979), pp Shapiro, M.B. Shapiro, Assessing feelings reported by depressives in research investigations. Br. J. med. Psychol. 54 (1981), pp Skinner, N.F. Skinner, Personality characteristics of volunteers for painful experiments. Bull. Psychonom. Soc. 20 (1982), pp Wardell and Yeudall, D. Wardell and L.T. Yeudall, A multidimensional approach to criminal disorders: The assessment of impulsivity and its relation to crime. Adv. Behav. Res. Ther. 2 (1980), pp