Conceptualization of the latent structure of autism: further evidence and discussion of dimensional and hybrid models

Research output: Contribution to journalResearch articleContributedpeer-review


  • Sarah Wittkopf - , University of Marburg (Author)
  • Anika Langmann - , University of Marburg (Author)
  • Veit Roessner - , Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • Stefan Roepke - , Charité – Universitätsmedizin Berlin (Author)
  • Luise Poustka - , University of Göttingen (Author)
  • Igor Nenadić - , University of Marburg (Author)
  • Sanna Stroth - , University of Marburg (Author)
  • Inge Kamp-Becker - , University of Marburg (Author)


Autism spectrum disorder (ASD) might be conceptualized as an essentially dimensional, categorical, or hybrid model. Yet, current empirical studies are inconclusive and the latent structure of ASD has explicitly been examined only in a few studies. The aim of our study was to identify and discuss the latent model structure of behavioral symptoms related to ASD and to address the question of whether categories and/or dimensions best represent ASD symptoms. We included data of 2920 participants (1–72 years of age), evaluated with the Autism Diagnostic Observation Schedule (Modules 1–4). We applied latent class analysis, confirmatory factor analysis, and factor mixture modeling and evaluated the model fit by a combination of criteria. Based on the model selection criteria, the model fits, the interpretability as well as the clinical utility we conclude that the hybrid model serves best for conceptualization and assessment of ASD symptoms. It is both grounded in empirical evidence and in clinical usefulness, is in line with the current classification system (DSM-5) and has the potential of being more specific than the dimensional approach (decreasing false positive diagnoses).


Original languageEnglish
Pages (from-to)2247-2258
Number of pages12
JournalEuropean Child and Adolescent Psychiatry
Issue number11
Publication statusPublished - Nov 2023

External IDs

PubMed 36006478


Sustainable Development Goals


  • Autism classification, Autism spectrum disorder, Factor mixture modeling, Latent structure hybrid model, Diagnostic and Statistical Manual of Mental Disorders, Autistic Disorder, Humans, Factor Analysis, Statistical, Autism Spectrum Disorder/diagnosis, Concept Formation