PMID- 30768420
OWN - NLM
STAT- MEDLINE
DCOM- 20200723
LR  - 20240214
IS  - 1527-5418 (Electronic)
IS  - 0890-8567 (Print)
IS  - 0890-8567 (Linking)
VI  - 58
IP  - 9
DP  - 2019 Sep
TI  - Quantifying the Optimal Structure of the Autism Phenotype: A Comprehensive 
      Comparison of Dimensional, Categorical, and Hybrid Models.
PG  - 876-886.e2
LID - S0890-8567(18)31894-X [pii]
LID - 10.1016/j.jaac.2018.09.431 [doi]
AB  - OBJECTIVE: The two primary-seemingly contradictory-strategies for classifying 
      child psychiatric syndromes are categorical and dimensional; conceptual 
      ambiguities appear to be greatest for polythetic syndromes such as autism 
      spectrum disorder (ASD). Recently, a compelling alternative has emerged that 
      integrates both categorical and dimensional approaches (ie, a hybrid model), 
      thanks to the increasing sophistication of analytic procedures. This study aimed 
      to quantify the optimal phenotypic structure of ASD by comprehensively comparing 
      categorical, dimensional, and hybrid models. METHOD: The sample comprised 3,825 
      youth, who were consecutive referrals to a university developmental disabilities 
      or child psychiatric outpatient clinic. Caregivers completed the Child and 
      Adolescent Symptom Inventory-4R (CASI-4R), which includes an ASD symptom rating 
      scale. A series of latent class analyses, exploratory and confirmatory factor 
      analyses, and factor mixture analyses was conducted. Replication analyses were 
      conducted in an independent sample (N = 2,503) of children referred for 
      outpatient evaluation. RESULTS: Based on comparison of 44 different models, 
      results indicated that the ASD symptom phenotype is best conceptualized as 
      multidimensional versus a categorical or categorical-dimensional hybrid 
      construct. ASD symptoms were best characterized as falling along three dimensions 
      (ie, social interaction, communication, and repetitive behavior) on the CASI-4R. 
      CONCLUSION: Findings reveal an optimal structure with which to characterize the 
      ASD phenotype using a single, parent-report measure, supporting the presence of 
      multiple correlated symptom dimensions that traverse formal diagnostic boundaries 
      and quantify the heterogeneity of ASD. These findings inform understanding of how 
      neurodevelopmental disorders can extend beyond discrete categories of development 
      and represent continuously distributed traits across the range of human 
      behaviors.
CI  - Copyright (c) 2018 American Academy of Child and Adolescent Psychiatry. Published 
      by Elsevier Inc. All rights reserved.
FAU - Kim, Hyunsik
AU  - Kim H
AD  - Stony Brook University, NY. Electronic address: hyunsik.kim2@gmail.com.
FAU - Keifer, Cara
AU  - Keifer C
AD  - Stony Brook University, NY.
FAU - Rodriguez-Seijas, Craig
AU  - Rodriguez-Seijas C
AD  - Stony Brook University, NY.
FAU - Eaton, Nicholas
AU  - Eaton N
AD  - Stony Brook University, NY.
FAU - Lerner, Matthew
AU  - Lerner M
AD  - Stony Brook University, NY.
FAU - Gadow, Kenneth
AU  - Gadow K
AD  - Stony Brook University, NY.
LA  - eng
GR  - UL1 RR024153/RR/NCRR NIH HHS/United States
GR  - R01 MH077907/MH/NIMH NIH HHS/United States
GR  - R01 MH077676/MH/NIMH NIH HHS/United States
GR  - M01 RR010710/RR/NCRR NIH HHS/United States
GR  - R01 MH077997/MH/NIMH NIH HHS/United States
GR  - R01 MH077750/MH/NIMH NIH HHS/United States
GR  - R01 MH110585/MH/NIMH NIH HHS/United States
GR  - R01 MH073967/MH/NIMH NIH HHS/United States
GR  - UL1 TR000005/TR/NCATS NIH HHS/United States
GR  - UL1 TR000090/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20181029
PL  - United States
TA  - J Am Acad Child Adolesc Psychiatry
JT  - Journal of the American Academy of Child and Adolescent Psychiatry
JID - 8704565
SB  - IM
CIN - J Am Acad Child Adolesc Psychiatry. 2019 Oct;58(10):1019-1021. PMID: 31561830
CIN - J Am Acad Child Adolesc Psychiatry. 2019 Oct;58(10):1021-1025. PMID: 31561831
MH  - Adolescent
MH  - Autism Spectrum Disorder/*diagnosis/*psychology
MH  - Child
MH  - Communication
MH  - Female
MH  - Humans
MH  - Interpersonal Relations
MH  - Male
MH  - *Models, Psychological
MH  - *Phenotype
MH  - Young Adult
PMC - PMC6488452
MID - NIHMS1511033
OTO - NOTNLM
OT  - ASD phenotype
OT  - Child and Adolescent Symptom Inventory
OT  - autism spectrum disorder
OT  - classification
OT  - dimensional models
COIS- Author Conflicts of Interest/Disclosures Authors report no conflicts of interest, 
      except Kenneth D. Gadow, PhD, of Stony Brook University, who is a shareholder in 
      Checkmate Plus, publisher of the Child and Adolescent Symptom Inventory-4R. 
      Disclosure: Dr. Gadow is a shareholder in Checkmate Plus, publisher of the Child 
      and Adolescent Symptom Inventory-4R. Drs. Eaton and Lerner, Mr. Kim, Ms. Keifer, 
      and Mr. Rodriguez-Seijas report no biomedical financial interests or potential 
      conflicts of interest.
EDAT- 2019/02/16 06:00
MHDA- 2020/07/24 06:00
PMCR- 2020/09/01
CRDT- 2019/02/16 06:00
PHST- 2018/02/16 00:00 [received]
PHST- 2018/09/22 00:00 [revised]
PHST- 2018/10/18 00:00 [accepted]
PHST- 2019/02/16 06:00 [pubmed]
PHST- 2020/07/24 06:00 [medline]
PHST- 2019/02/16 06:00 [entrez]
PHST- 2020/09/01 00:00 [pmc-release]
AID - S0890-8567(18)31894-X [pii]
AID - 10.1016/j.jaac.2018.09.431 [doi]
PST - ppublish
SO  - J Am Acad Child Adolesc Psychiatry. 2019 Sep;58(9):876-886.e2. doi: 
      10.1016/j.jaac.2018.09.431. Epub 2018 Oct 29.