title: Exposure to environmental factors increases connectivity between symptom domains in the psychopathology network.
abstract: We investigated to what degree environmental exposure (childhood trauma, urbanicity, cannabis use, and discrimination) impacts symptom connectivity using both continuous and categorical measures of psychopathology.
  
  
  
  Outcomes were continuous symptom dimensions of self-reported psychopathology using the Self-report Symptom Checklist-90-R in 3021 participants from The Early Developmental Stages of the Psychopathology (EDSP) study and binary DSM-III-R categories of mental disorders and a binary measure of psychotic symptoms in 7076 participants from The Netherlands Mental Health Survey and Incidence Study (NEMESIS-1). For each symptom dimension in the EDSP and mental disorder in the NEMESIS-1 as the dependent variable, regression analyses were carried out including each of the remaining symptom dimensions/mental disorders and its interaction with cumulative environmental risk load (the sum score of environmental exposures) as independent variables.
  
  
  
  All symptom dimensions in the EDSP and related diagnostic categories in the NEMESIS-1 were strongly associated with each other, and environmental exposures increased the degree of symptom connectivity in the networks in both cohorts.
  
  
  
  Our findings showing strong connectivity across symptom dimensions and related binary diagnostic constructs in two independent population cohorts provide further evidence for the conceptualization of psychopathology as a contextually sensitive network of mutually interacting symptoms.
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Sinan
authors.initials: S
authors.lastname: Guloksuz
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Martine
authors.initials: M
authors.lastname: van Nierop
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Bak
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Ten Have
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: van Dorsselaer
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands.|School of Psychology, Open University, Heerlen, The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Gunther
authors.affiliation: Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland.
authors.forename: Roselind
authors.initials: R
authors.lastname: Lieb
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands.|University Psychiatric Center Katholieke Universiteit Leuven, campus Kortenberg, Leuvensesteenweg, Kortenberg, Belgium.
authors.forename: Ruud
authors.initials: R
authors.lastname: van Winkel
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.|Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands. vanosj@gmail.com.|King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK. vanosj@gmail.com.
authors.forename: Jim
authors.initials: J
authors.lastname: van Os
mesh_terms: D000293:Adolescent; D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D063189:Symptom Assessment; D055815:Young Adult
keywords: Depression; Environment; Epidemiology; Psychopathology; Psychosis