Examining the factor structure of the DSM‐5 Level 1 cross‐cutting symptom measure

• Published in: International journal of methods in psychiatric research Vol. 32; no. 2; pp. e1953 - n/a
• Main Authors: Gibbons, Alison B., Farmer, Cristan, Shaw, Jacob S., Chung, Joyce Y.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.06.2023; John Wiley and Sons Inc; Wiley
• Subjects: Anxiety; Anxiety - diagnosis; Anxiety Disorders - diagnosis; Clinical medicine; clinical research; COVID-19; COVID-19 - diagnosis; Drug abuse; Drug use; factor analysis; Factor Analysis, Statistical; Health care industry; Health services; Human subjects; Humans; Medical research; Mental depression; Mental disorders; Mental Health; Mental health care; Mood; Original; Personality; Psychopathology; Psychosis; Quantitative psychology; Substance use; Surveys and Questionnaires; transdiagnostic; COVID-19; factor analysis; transdiagnostic; clinical research; mental health
• ISSN: 1049-8931; 1557-0657; 1557-0657
• DOI: 10.1002/mpr.1953

Objectives The DSM‐5 Level 1 Cross‐Cutting Symptom Measure (DSM‐XC) was developed by the American Psychiatric Association as a transdiagnostic mental health symptom survey. Despite its promise as a screening tool, few studies have assessed its latent dimensionality or provided guidance on interpreting responses. We examined the factor structure of the DSM‐XC in a convenience sample of participants with varying degrees of psychopathology. Methods Participants (n = 3533) were enrolled in an online study on the mental health impact of COVID‐19 (NCT04339790). We used a factor analytic framework with exploratory and confirmatory analyses to evaluate candidate factor solutions. Convergent validity analysis with concurrent study measures was also performed. Results Six‐factor and bifactor candidate solutions both had good fit and full measurement invariance across age, sex, and enrollment date. The six‐factor solution resulted in constructs labeled as: mood, worry, activation, somatic, thought, and substance use. A general psychopathology factor and two residual factors (mood and anxiety constructs) explained the variance of the bifactor solution. Conclusions Our analysis supports that the DSM‐XC is a multidimensional instrument spanning many mental health symptoms. We provide scoring solutions for two factor structures that capture broader constructs of psychopathology. Use of a convenience sample may limit generalizability of findings.