Integrating Autism-Related Symptoms into the Dimensional Internalizing and Externalizing Model of Psychopathology. The TRAILS Study

Arjen Noordhof, Robert F. Krueger, Johan Ormel, Albertine J. Oldehinkel, Catharina A. Hartman

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Problems associated with Autism Spectrum Disorder (ASD) occur frequently in the general population and often co-occur with problems in other domains of psychopathology. In the research presented here these co-occurrence patterns were investigated by integrating a dimensional approach to ASDs into the more general dimensional framework of internalizing and externalizing psychopathology. Factor Analysis was used to develop hierarchical and bi-factor models covering multiple domains of psychopathology in three measurement waves of a longitudinal general population sample (N = 2,230, ages 10–17, 50.8 % female). In all adequately fitting models, autism related problems were part of a specific domain of psychopathology that could be distinguished from the internalizing and externalizing domains. Optimal model fit was found for a bi-factor model with one non-specific factor and four specific factors related to internalizing, externalizing, autism spectrum problems and problems related to attention and orientation. Autism-related problems constitute a specific domain of psychopathology that can be distinguished from the internalizing and externalizing domains. In addition, the co-occurrence patterns in the data indicate the presence of a strong general factor.

Original languageEnglish (US)
Pages (from-to)577-587
Number of pages11
JournalJournal of Abnormal Child Psychology
Issue number3
StatePublished - Apr 2015

Bibliographical note

Funding Information:
This research is part of the TRacking Adolescents’ Individual Lives Survey (TRAILS). Participating centers of TRAILS include various departments of the University Medical Center and University of Groningen, the Erasmus University Medical Center Rotterdam, the University of Utrecht, the Radboud Medical Center Nijmegen, and the Trimbos Institute, all in the Netherlands. Principal investigators are prof. dr. J. Ormel (University Medical Center Groningen) and prof. dr. F.C. Verhulst (Erasmus University Medical Center). TRAILS has been financially supported by various grants from the Netherlands Organization for Scientific Research NWO (Medical Research Council program grant GB-MW 940-38-011; ZonMW Brainpower grant 100-001-004; ZonMw Risk Behavior and Dependence grants 60-60600-98-018 and 60-60600-97-118; ZonMw Culture and Health grant 261-98-710; Social Sciences Council medium-sized investment grants GB-MaGW 480-01-006 and GB-MaGW 480-07-001; Social Sciences Council project grants GB-MaGW 457-03-018, GB-MaGW 452-04-314, an GB-MaGW 452-06-004; NWO large-sized investment grant 175.010.2003.005); the Sophia Foundation for Medical Research (projects 301 and 393), the Dutch Ministry of Justice (WODC), and the participating universities. We are grateful to all adolescents, their parents and teachers who participated in this research and to everyone who worked on this project and made it possible. The authors have no competing interests.

Publisher Copyright:
© 2014, Springer Science+Business Media New York.


  • Autism spectrum disorder
  • Comorbidity
  • Confirmatory factor analysis
  • Externalizing psychopathology
  • Internalizing psychopathology


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