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Categorical versus dimensional structure of autism spectrum
disorder: A multi‐method investigation
acamh.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jcv2.12142
Abstract
Background: A key question for any psychopathological diagnosis is whether the
condition is continuous or discontinuous with typical variation. The primary
objective of this study was to use a multi‐method approach to examine the broad
latent categorical versus dimensional structure of autism spectrum disorder (ASD).
Method: Data were aggregated across seven independent samples of participants
with ASD, other neurodevelopmental disorders (NDD), and non‐ASD/NDD controls
(aggregate Ns = 512–16,755; ages 1.5–22). Scores from four distinct phenotype
measures formed composite “indicators” of the latent ASD construct. The primary
indicator set included eye gaze metrics from seven distinct social stimulus paradigms. Logistic regressions were used to combine gaze metrics within/across paradigms, and derived predicted probabilities served as indicator values. Secondary
indicator sets were constructed from clinical observation and parent‐report measures of ASD symptoms. Indicator sets were submitted to taxometric‐ and latent
class analyses.
Results: Across all indicator sets and analytic methods, there was strong support for
categorical structure corresponding closely to ASD diagnosis. Consistent with notions of substantial phenotypic heterogeneity, the ASD category had a wide range of
symptom severity. Despite the examination of a large sample with a wide range of
IQs in both genders, males and children with lower IQ were over‐represented in the
ASD category, similar to observations in diagnosed cases.
Conclusions: Our findings provide strong support for categorical structure corresponding closely to ASD diagnosis. The present results bolster the use of well‐
diagnosed and representative ASD groups within etiologic and clinical research,
motivating the ongoing search for major drivers of the ASD phenotype. Despite the
categorical structure of ASD, quantitative symptom measurements appear more
useful for examining relationships with other factors.
KEYWORDS
autism, categorical, dimensional, latent, taxometric
disorder: A multi‐method investigation
acamh.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jcv2.12142
Abstract
Background: A key question for any psychopathological diagnosis is whether the
condition is continuous or discontinuous with typical variation. The primary
objective of this study was to use a multi‐method approach to examine the broad
latent categorical versus dimensional structure of autism spectrum disorder (ASD).
Method: Data were aggregated across seven independent samples of participants
with ASD, other neurodevelopmental disorders (NDD), and non‐ASD/NDD controls
(aggregate Ns = 512–16,755; ages 1.5–22). Scores from four distinct phenotype
measures formed composite “indicators” of the latent ASD construct. The primary
indicator set included eye gaze metrics from seven distinct social stimulus paradigms. Logistic regressions were used to combine gaze metrics within/across paradigms, and derived predicted probabilities served as indicator values. Secondary
indicator sets were constructed from clinical observation and parent‐report measures of ASD symptoms. Indicator sets were submitted to taxometric‐ and latent
class analyses.
Results: Across all indicator sets and analytic methods, there was strong support for
categorical structure corresponding closely to ASD diagnosis. Consistent with notions of substantial phenotypic heterogeneity, the ASD category had a wide range of
symptom severity. Despite the examination of a large sample with a wide range of
IQs in both genders, males and children with lower IQ were over‐represented in the
ASD category, similar to observations in diagnosed cases.
Conclusions: Our findings provide strong support for categorical structure corresponding closely to ASD diagnosis. The present results bolster the use of well‐
diagnosed and representative ASD groups within etiologic and clinical research,
motivating the ongoing search for major drivers of the ASD phenotype. Despite the
categorical structure of ASD, quantitative symptom measurements appear more
useful for examining relationships with other factors.
KEYWORDS
autism, categorical, dimensional, latent, taxometric