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Moving from Structure to Function: Assessing a Hierarchy of Psychopathology in Daily Life
Quantitative empirical models of psychopathology address many of the structural problems of classical diagnostic schemes (e.g., non-binary distributions, excessive comorbidity, diagnostic heterogeneity). However, they are largely based on the structure of individual differences in the experience of psychopathology. In contrast, many clinical theories, which also inform intervention efforts, are based on the function of maladaptive behavior. This distinction is akin to the difference between morphology and physiology in the broader biological sciences. A structure-function divide in the focus of empirical and clinical work contributes to a lack of integration and difficulties with translation. In an effort to bridge this divide, the current project sought to measure indicators of spectra identified in structural models using daily diaries in naturalistic settings, in order to examine the within-person structure and develop scales that would be suitable for studying dynamic processes and the function of these behaviors in daily life. A mixed psychiatric/community sample (person N=300) reported on 81 daily markers of psychopathology for 14 days (day N= 3,735). Multilevel structural equation modeling was used to assess the psychometrics of scales and their hierarchy at both the within and between-person levels. These scales provide useful tools for studying dynamic processes associated with quantitative empirically derived domains of psychopathology. These include variability across contexts, reactivity to daily stress, and predictors of daily functioning, among others.