Diversity in Mental Health from a HiTOP Perspective

The prevalence of mental health conditions are well-known to vary by race and ethnicity. A fundamental question is whether these important differences reflect actual (e.g., etiological) differences or biases in measurement. Problematically, existing clinical measures for mental health conditions are often assumed to exhibit measurement invariance (i.e., the degree to which a construct is measured with equivalence in different groups). Yet, there are few studies that have systematically tested for measurement invariance in psychopathology across these sociodemographic domains. The few in existence have focused on one dimension at a time (e.g., race-ethnicity or sexual orientation), without consideration of other sociodemographic domains. More commonly, studies will treat these domains as statistical covariates despite the important role they play in our clinical decision making and clinical interventions. As the field advances towards statistically driven systems to characterize externalizing outcomes (i.e., HiTOP, see figure here), there is an increasing need to systematically interrogate for measurement bias in our clinical measures of externalizing across race-ethnicity, SGM status, and SES. In fact, a recent review of all studies published in a premier clinical psychology journal found fewer than 5% of all published studies since its inception discussed the race-ethnicity of its participants (Rodriguez-Seijas, Li, et al., 2023).

This line of our research utilizes data from diverse, population-based datasets, including Neurodevelopmental Genomics: Trajectories of Complex Phenotypes (i.e., PNC), the National Longitudinal Study of Adolescent to Adult Health (Add Health), and the Adolescent Brain Cognitive Development Study (ABCD) to study the dimensionality of mental health outcomes across a diversity of populations. We are especially interested in the issue of measurement invariance of HiTOP mental health dimensions.

Our lab is associated with the HiTOP Consortium’s Diversity, Equity, and Inclusion (DEI) Workgroup (Dr. Li serves as co-chair). We offer several opportunities to collaborate with members of the consortium.

Representative articles:

  • Rodriguez-Seijas, C., Li, J. J., Balling, C., Brandes, C., Bernat, E., Boness, C., Forbes, M., Forbush, K., Joyner, K., Krueger, R., Levin-Aspenson, H., Michelini, G., Ro, E., Rutter, L., Stanton, K., Tackett, J., Waszczuk, M., Eaton, N. (2023). Diversity and the Hierarchical Taxonomy of Psychopathology (HiTOP). Nature Reviews Psychology. doi: 10.1038/s44159-023-00200-0
  • Waszczuk, M. A., Jonas, K. G., Bornovalova, M., Breen, G., Bulik, C. M., Docherty, A. R., Eley, T. C., Hettema, J. M., Kotov, R., Krueger, R. F., Lencz, T., Li, J. J., Vassos, E., Waldman, I. D. (accepted). Dimensional and Transdiagnostic Phenotypes in Psychiatric Genome-wide Association Studies. Molecular Psychiatry. Preprint doi: https://osf.io/52qvj/
  • He, Q.* & Li, J. J. (2020). The factor structure of mental disorders in African American and European American youths: Evidence of invariance. Preprint doi: 10.31234/osf.io/bw2gy