SCL-90-R emotional distress ratings in substance use and impulse control disorders: One-factor, oblique first-order, higher-order, and bi-factor models compared

To fully understand the dimensionality of an instrument in a certain population, rival bi-factor models should be routinely examined and tested against oblique first-order and higher-order structures. The present study is among the very few studies that have carried out such a comparison in relation to the Symptom Checklist-90-R. In doing so, it utilized a sample comprising 2593 patients with substance use and impulse control disorders. The study also included a test of a one-dimensional model of general psychological distress. Oblique first-order factors were based on the original a priori 9-dimensional model advanced by Derogatis (1977); and on an 8-dimensional model proposed by Arrindell and Ettema (2003)—Agoraphobia, Anxiety, Depression, Somatization, Cognitive-performance deficits, Interpersonal sensitivity and mistrust, Acting-out hostility, and Sleep difficulties. Taking individual symptoms as input, three higher-order models were tested with at the second-order levels either (1) General psychological distress; (2) ‘Panic with agoraphobia’, ‘Depression’ and ‘Extra-punitive behavior’; or (3) ‘Irritable-hostile depression’ and ‘Panic with agoraphobia’. In line with previous studies, no support was found for the one-factor model. Bi-factor models were found to fit the dataset best relative to the oblique first-order and higher-order models. However, oblique first-order and higher-order factor models also fit the data fairly well in absolute terms. Higher-order solution (2) provided support for R.F. Krueger's empirical model of psychopathology which distinguishes between fear, distress, and externalizing factors (Krueger, 1999). The higher-order model (3), which combines externalizing and distress factors (Irritable-hostile depression), fit the data numerically equally well. Overall, findings were interpreted as supporting the hypothesis that the prevalent forms of symptomatology addressed have both important common and unique features. Proposals were made to improve the Depression subscale as its scores represent more of a very common construct as is measured with the severity (total) scale than of a specific measure that purports to measure what it should assess―symptoms of depression.