In this study, we examined the unique associations between functional impairment and different psychopathology domains across childhood and adolescence. We examined whether functional impairment’s associations with psychopathological domains can offer important insights to understanding direct and indirect pathways for the co-occurrence among mental health difficulties across childhood and adolescence. From the population-based study Spit for Science, we included 5163 participants between the ages of 6 and 18.97 years (Mean age = 9.98, SD = 2.89) with parent/self-rated quantitative measures of psychopathology. We used network estimation to examine the unique associations among ratings of functional impairment, inattention, hyperactivity, autism, obsessions and compulsions, depression, anxiety, and irritability, while accounting for age effects. Bootstrapped difference tests of edges (partial correlations between two domains in a network) and node (domains/variable within a network) influence on network connectivity were conducted. In addition to domain specific associations, functional impairment-irritability and functional impairment-depression ratings were two of the strongest connections in the network. Overall, functional impairment and depression ratings had some of the highest centrality indices, in terms of their strength and number of direct and indirect connections. Age effects varied in the network with the positive age-depressive ratings connection being the strongest. This study demonstrates the importance of examining associations among psychopathology domains together with functional impairment to delineate important direct and indirect pathways for co-occurrence. We offer data driven hypotheses for impairment-related pathways and suggest important targets for intervention that can be examined in clinical research to mitigate comorbidities.

在这项研究中，我们研究了儿童期和青春期功能障碍与不同精神病理学领域之间的独特关联。我们研究了功能障碍与精神病理学领域的关联是否可以为理解儿童期和青春期心理健康困难同时发生的直接和间接途径提供重要见解。根据以人群为基础的研究 Spit for Science，我们纳入了 5163 名年龄在 6 岁至 18.97 岁之间的参与者（平均年龄 = 9.98，SD = 2.89），并进行了家长/自评的精神病理学定量测量。我们使用网络估计来研究功能障碍、注意力不集中、多动、自闭症、强迫观念和强迫行为、抑郁、焦虑和易怒的评级之间的独特关联，同时考虑年龄影响。对边（网络中两个域之间的部分相关性）和节点（网络中的域/变量）对网络连接性的影响进行了引导差异测试。除了特定领域的关联之外，功能障碍-易怒和功能障碍-抑郁评级是网络中最强的两个联系。总体而言，功能障碍和抑郁评级在直接和间接联系的强度和数量方面具有最高的中心性指数。网络中的年龄效应各不相同，其中积极的年龄抑郁评级联系最强。这项研究证明了检查精神病理学领域与功能障碍之间的关联以描绘共现的重要直接和间接途径的重要性。我们为损伤相关途径提供数据驱动的假设，并建议重要的干预目标，这些目标可以在临床研究中进行检查，以减轻合并症。