Sociodemographic Reporting and Sample Composition Over Three Decades of Psychopathology Research: A Systematic Review and Quantitative Synthesis

Abstract

Although researchers seek to understand psychological phenomena in a population, quantitative research studies are conducted in smaller samples meant to represent the larger population of interest. To understand the phenomenology of psychopathology and ensure generalizability, careful consideration of sample sociodemographic makeup and other participant characteristics is critical. This systematic review and quantitative synthesis considers reporting of sociodemographic characteristics and sample composition in the Journal of Abnormal Psychology (now the Journal of Psychopathology and Clinical Science) over the past 3 decades. Across k = 1,244 empirical studies, there were high and increasing rates of reporting of participant age/developmental stage and sex/gender, low but increasing reporting of socioeconomic status/income, and moderate and stable reporting of educational attainment. Rates of reporting of sexual orientation remained low and reporting of gender identity was essentially nonexistent. There were low to moderate but increasing rates of reporting of participant race and ethnicity. Approximately three-quarters of participants in studies over the past 3 decades were White, while the proportion of participants who were Asian, Black or African American, American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, or Hispanic/Latino was much lower. Approximately two-thirds of participants were female, with this proportion increasing over time. There were also notable differences in the proportion of study participants as a function of race and sex/gender for different forms of psychopathology. Basic science and theoretical research on the etiology, development, symptomatology, and course of psychopathology must include sociodemographically diverse samples that are representative of and generalizable to the larger human population, while seeking to decrease the stigma of psychopathology and increase mental health equity. Recommendations are made to increase sociodemographic diversity in psychopathology research and the scientific review and publication process.

General Scientific Summary:

Basic science and theoretical research on the etiology, development, symptomatology, and course of psychopathology must include sociodemographically diverse samples, while seeking to decrease the stigma of psychopathology and increase mental health equity.

Although researchers seek to understand psychological phenomena in a population, quantitative research studies are, in practice, conducted in smaller samples of individuals meant to represent the larger population of interest (Bornstein et al., 2013; Rad et al., 2018). To understand the phenomenology of various forms of psychopathology and ensure research findings for study samples are generalizable, careful consideration of the sociodemographic makeup of the sample and other participant characteristics is critical. Various forms of psychopathology are prevalent in the general population worldwide (Global Burden of Disease Collaborative Network, 2019), and prevalence rates vary across sociodemographic characteristics, including socioeconomic status, sex/gender, sexual orientation and gender identity, and race/ethnicity. Accurate and equitable psychopathology research seeks to understand psychopathology phenomenology in context, ensures inclusion of and generalizability to all populations without perpetuating historical and contemporary harms, and considers how the etiology, development, symptomatology, and course of psychopathology may be differently influenced by sociocultural factors and manifested differently among individuals within the larger population. However, multiple systematic reviews of empirical research published over the past several decades in major psychology journals report samples that are predominantly from the United States and Western Europe, are non-Hispanic/Latino White, and skew more highly educated and high-income (Arnett, 2009; Bornstein et al., 2013; Iwamasa et al., 2002; Nielsen et al., 2017; Pedersen et al., 2022; Rad et al., 2018; Roberts et al., 2020; Sears, 1986; Thalmayer et al., 2021). As such, broad claims about human psychology and behavior, including psychopathology, are made based on research that has relied largely on samples that are mostly or entirely Western, Educated, Industrialized, Rich, and Democratic (WEIRD; Henrich et al., 2010).

Many clinical features of psychopathology, such as age of onset, severity, and course, may vary as a function of sociodemographic characteristics. There is abundant evidence that socioeconomic disadvantage, including lower income and educational attainment, is associated with varied forms of psychopathology in adults and children, both as a risk and exacerbating factor and as a factor relevant for diagnosis and access to treatment (Evans-Lacko et al., 2018; Kohn et al., 1998; Peverill et al., 2021; Santiago et al., 2011; Van Oort et al., 2011; Villatoro et al., 2018). However, most psychological research is conducted in a small number of wealthier countries, and with participants with higher incomes and education (Arnett, 2009; Henrich et al., 2010), meaning most of our psychopathology research may not generalize to the “modal” human.

There are also well-established sex/gender differences in prevalence for many forms of psychopathology, though less well-established explanations (e.g., biological, sociocultural; Kuehner, 2017). For example, although the prevalence of any mental disorder is higher among women than men (Seedat et al., 2009), rates of substance use disorders are approximately two times higher in men than in women, (Brady & Randall, 1999; McHugh et al., 2018), while rates of depression and anxiety disorders are approximately two times higher in women than in men (Dalsgaard et al., 2020; Kuehner, 2017; McLean et al., 2011). There is also increasing recognition that individuals who identify as sexual/gender diverse are disproportionately exposed to discrimination and victimization, experience high rates of various forms of psychopathology, including depression, trauma-related symptoms, and substance use, and are at increased risk for suicidal ideation/behaviors and death by suicide (de Vries et al., 2011; Graham et al., 2011; Rice et al., 2019). Despite this clear need, there has been a stark, almost complete absence of their description in psychopathology research (Pedersen et al., 2022). The estimated prevalence rates of children, adolescents, and adults in the general population in the United States and worldwide who identify as sexual/gender diverse range widely, from 1% to 20% (Cáceres et al., 2006; Calzo & Blashill, 2018; Mayer et al., 2008; Shields et al., 2013), highlighting the need for even basic descriptive research that promotes psychological well-being.

There are also some differences in prevalence rates as a function of race/ethnicity, though this literature is considerably more nuanced and influenced by aspects of intersectionality (e.g., sexual orientation, immigrant status; Anderson & Mayes, 2010; Georgiades et al., 2018; Rodriguez-Seijas et al., 2019). Race and ethnicity are socially constructed categories—but categories that nonetheless signify social meaning and stratification. In the United States and the world, race/ethnicity acts as a proxy measure for exposure to shared experiences of structural and systemic, as well as individual experiences of, discrimination and racism (Lett, Asabor, et al., 2022; Nketia et al., 2021; Oakes & Rossi, 2003). Although racial/ethnic categories are not biologically meaningful, they have become markers of racialization over centuries of structural and systemic oppression, generational socioeconomic disadvantage, and disproportionate rates of incarceration, lack of access to quality mental health and medical care, environmental exposures, and exclusion from educational opportunities. Thus, although there are no plausible biological or genetic explanations for differences in prevalence rates across racial/ethnic groups for any form of psychopathology, there are structural and systemic contributors to the development, manifestation, course, and outcomes of varied forms of psychopathology as a function of race/ethnicity.

The Present Study

Because the phenomenology of psychopathology may be influenced by sociodemographic characteristics, and because psychopathology research is enriched by inclusion of participants with varied lived experiences, backgrounds, and identities, it is important that our samples reflect the full human population to which most psychopathology research intends to generalize. In this systematic review and quantitative synthesis, I considered reporting of sociodemographic characteristics and sample composition in psychopathology research studies published over the past 3 decades (in the 1990s, 2000s, and 2010s). I selected the Journal of Abnormal Psychology (now the Journal of Psychopathology and Clinical Science, with the name of the journal changed in 2022) as a representative psychopathology research journal that publishes studies of basic research and theory in the broad field of psychopathology. I considered rates of reporting over time, as well as the proportion of participants in samples as a function of sex/gender, race, and ethnicity over time, and as a function of form of psychopathology.

Methods

Literature Search

Database search.

A systematic search in the PsycINFO database identified all articles published in the Journal of Abnormal Psychology in three sampling time frames in the 1990s (January 1, 1995, to December 31, 1999), 2000s (January 1, 2005, to December 31, 2009), and 2010s (January 1, 2015, to December 31, 2019). These 5-year time frames were selected to provide a sampling of the total number of publications over the past 3 decades (including the most recent publications at the time the systematic search was conducted in 2020).

Inclusion and exclusion criteria.

Empirical studies were included if they reported on a sample of human participants. Studies were excluded if they were nonempirical (e.g., reviews, editorials, commentaries) or if they reported on a nonhuman sample (e.g., animal studies, simulations). See Figure 1 for the PRISMA flow diagram for the literature search.

Figure 1.

PRISMA flow diagram of the literature search. A total of 1,233 articles were published in the Journal of Abnormal Psychology during the three sampling time frames, of which 117 were excluded because they were nonempirical or nonhuman. The remaining 1,116 articles reported on 1,244 independent samples that were included in this systematic review and quantitative synthesis.

Study coding.

All included studies were coded for whether they reported (0 = not reported, 1 = reported) on relevant sample sociodemographic characteristics (continent of study sample, participant age/developmental stage, sex/gender¹, sexual orientation², gender identity³, socioeconomic status/income, educational attainment, race, ethnicity). Studies were coded for continent of sample, participant age/developmental stage, sex/gender, race, and ethnicity, as well as the total number of participants in the sample. Age/developmental stage was coded as infancy/preschool (≤ 5 yr), childhood (6 – 12 yr), adolescence (13 – 17 yr), emerging adulthood (18 – 24 yr), adulthood (25 – 59 yr), and older adulthood (≥ 60 yr). In studies that included psychopathology and comparison groups, participant sex/gender, race, and ethnicity, and the total number of participants in the psychopathology and comparison groups were coded. According to the standards on race and ethnicity followed in the 2020 United States Census (Office of Management and Budget, 1997), “American Indian or Alaska Native”⁴ included participants categorized as having origins in the original peoples of North, Central, and South America, “Asian” included participants categorized as having origins in the original peoples of Eastern Asia, Southeast Asia, and South Asia, “Black or African American”⁵ included participants categorized as having origins in the original peoples of Africa, “Native Hawaiian or Other Pacific Islander”⁶ included participants categorized as having origins in the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands, and “White” included participants categorized as having origins in the original peoples of Europe, the Middle East, or North Africa; “Hispanic or Latino” included participants categorized as people of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race⁷. Form of psychopathology examined in each study was coded according to Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) chapters^{8, 9} (American Psychiatric Association, 2013b). All studies were coded and second coded by trained research assistants under the supervision of the author, and any discrepancies in coding were identified and resolved by discussion and consensus. Preparation of the final dataset, including standardization across studies of race/ethnicity into United States Census categories, was completed by the author.

Data Analysis

I first examined rates of reporting on relevant sample sociodemographic characteristics within each sampling time frame to determine whether there were changes in reporting practices over the past 3 decades. Next, I examined participant sex/gender within each sampling time frame to determine whether there were changes in the proportion of female participants in study samples, and whether there were changes in the proportion of female participants as a function of form of psychopathology. Finally, I examined participant race and ethnicity within each sampling time frame to determine whether there were changes in the proportion of participants by race/ethnicity in study samples, and whether there were changes in the proportion of participants by race as a function of form of psychopathology. All analyses were conducted using the “metaprop” function in the “meta” package (Schwarzer, 2022) in R (version 4.2.1), so that, for each set of studies (k is the number of studies), each analysis yielded an overall mean (pooled) point estimate (presented as percentages) with a 95% confidence interval (CI) within each sampling time frame (the 95% CIs around each point estimate indicate that these are meta-analytic syntheses that estimate the population proportion given sampling from the observed proportions in the included studies, so that we are 95% confident that the true population proportion falls within that interval). The Q_B statistic and was used to examine whether were significant differences in pooled point estimates across sampling time frames; point estimates for one sampling time frame or sociodemographic characteristic that fell outside the 95% CI for another were considered to be meaningfully different from one another. Although I set the significance level at p < .050 (and did not correct for multiple comparisons), I present point estimates with 95% CIs for all analyses, to provide an indication of the precision and robustness of effects, and present p values to 3 digits, to allow researchers to consider different significance levels. Although analyses of reporting of sociodemographic characteristics could be conducted with k = 0 in a sampling time frame (i.e., no studies reported on that sociodemographic characteristic during that sampling time frame, which is meaningful information), I required k > 0 in all sampling time frames to conduct analyses of pooled sample proportions (i.e., the estimated percentage of sample participants in that sampling time frame by sex/gender or race/ethnicity).

Transparency and openness.

Study coding and data, and analysis code, for this review are available at https://osf.io/mgsba/?view_only=fd886e7bdf29401b8e3cf31d0e98db56. This study was not preregistered.

Results

Overview

A total of 1,233 articles were published in the Journal of Abnormal Psychology during the three sampling time frames (1990s: k = 319, 2000s: k = 429, 2010s: k = 485), of which 117 were excluded because they were nonempirical (1990s: k = 17, 2000s: k = 37, 2010s: k = 56) or nonhuman (1990s: k = 2, 2000s: k = 3, 2010s: k = 2). The remaining 1,116 articles reported on 1,244 independent samples that were included in this systematic review and quantitative synthesis (1990s: k = 374, 2000s: k = 417, 2010s: k = 453). All statistics for reporting and proportion of sample sociodemographic characteristics within each sampling time frame are presented in Table 1 and for sample sex/gender and race as a form of psychopathology in Supplemental Tables S1 and S2. The majority of study samples were from North America or Europe (90.08% to 95.16% to 92.90%) in all three decades and this increased significantly over time (see Figure 2).

Table 1.

Sample Sociodemographic Characteristics

Sociodemographic characteristic	1990s		2000s		2010s
	k	% (95% CI)	k	% (95% CI)	k	% (95% CI)
Continent	373/374	99.73% (97.95%, 99.97%)	413/417	99.04% (97.47%, 99.64%)	451/453	99.56% (98.25%, 99.89%)
Proportion of studies reporting						QB(2) = 1.63, p = .442
Proportion Africa	1	0.27% (0.04%, 1.88%)	1	0.24% (0.03%, 2.06%)	1	0.22% (0.03%, 1.75%)
					QB(2) = 0.02, p = .992
Proportion Asia	8	2.14% (1.08%, 4.23%)	7	1.69% (0.81%, 3.51%)	10	2.22% (1.20%, 4.08%)
					QB(2) = 0.34, p = .845
Proportion Europe	48	12.87% (9.84%, 16.67%)	84	20.34% (16.73%, 24.50%)	89	19.73% (16.30%, 23.69%)
					QB(2) = 8.98, p = .011
Proportion North America	288	77.21% (71.64%, 81.97%)	309	74.82% (70.30%, 78.86%)	330	73.17% (68.67%, 77.24%)
					QB(2) = 1.40, p = .497
Proportion Oceania	28	7.51% (5.16%, 10.79%)	11	2.66% (1.48%, 4.74%)	19	4.21% (2.70%, 6.51%)
					QB(2) = 9.65, p = .008
Proportion South America	0	0.00% (0.00%, 100.00%)	1	0.24% (0.03%, 1.70%)	2	0.44% (0.11%, 1.76%)
					QB(2) = 0.23, p = .892
Age/developmental stage	338/374	90.37% (86.94%, 92.98%)	400/417	95.92% (93.54%, 97.45%)	442/453	97.57% (95.66%, 98.65%)
Proportion of studies reporting					QB(2) = 20.73, p < .001
Proportion infancy/preschool	8	2.52% (1.27%, 4.97%)	7	1.87% (0.89%, 3.87%)	12	2.83% (1.60%, 4.96%)
					QB(2) = 0.78, p = .679
Proportion childhood	31	9.78% (6.90%, 13.69%)	31	8.29% (5.89%, 11.55%)	60	14.15% (10.73%, 18.44%)
					QB(2) = 6.42, p = .040
Proportion adolescence	26	8.20% (5.46%, 12.14%)	51	13.64% (10.52%, 17.50%)	45	10.61% (8.02%, 13.92%)
					QB(2) = 4.77, p = .092
Proportion emerging adulthood	62	19.56% (13.32%, 27.78%)	58	15.51% (12.18%, 19.54%)	60	14.15% (11.14%, 17.81%)
					QB(2) = 2.04, p = .361
Proportion adulthood	186	58.68% (52.65%, 64.46%)	222	59.36% (54.30%, 64.23%)	245	57.78% 53.023%, 62.40%)
					QB(2) = 0.20, p = .903
Proportion older adulthood	4	1.26% (0.47%, 3.32%)	5	1.34% (0.48%, 3.63%)	2	0.47% (0.08%, 2.74%)
					QB(2) = 1.09, p = .579
Sex/gender	341/374	91.18% (87.85%, 93.66%)	387/417	92.81% (89.90%, 94.92%)	439/453	96.91% (94.85%, 98.16%)
Proportion of studies reporting					QB(2) = 11.78, p = .003
Proportion female	341	48.49% (40.15%, 56.92%)	387	46.13% (37.74%, 54.74%)	439	62.14% (55.14%, 68.66%)
					QB(2) = 9.96, p = .007
Psychopathology group	154	29.91% (18.99%, 43.72%)	161	52.56% (43.19%, 61.75%)	171	55.07% (46.27%, 63.57%)
					QB(2) = 9.32, p = .009
Comparison group	154	33.59% (22.27%, 47.18%)	161	53.60% (44.61%, 62.36%)	171	56.54% (48.23%, 64.51%)
					QB(2) = 8.16, p = .017
Sexual orientation	6/374	1.60% (0.72%, 3.52%)	3/417	0.72% (0.23%, 2.21%)	7/453	1.55% (0.75%, 3.14%)
Proportion of studies reporting					QB(2) = 1.52, p = .467
Gender identity	0/374	0.00% (0.00%, 100.00%)	0/417	0.00% (0.00%, 100.00%)	1/453	0.22% (0.03%, 1.55%)
Proportion of studies reporting					QB(2) = 0.00, p = .999
Socioeconomic status	65/374	17.38% (13.87%, 21.56%)	96/417	23.02% (19.23%, 27.31%)	109/453	24.06% (20.35%, 28.21%)
Proportion of studies reporting					QB(2) = 5.98, p = .050
Educational attainment	177/374	47.33% (42.31%, 52.40%)	213/417	51.08% (46.27%, 55.87%)	202/453	44.59% (40.03%, 49.24%)
Proportion of studies reporting					QB(2) = 3.63, p = .163
Race	157/374	41.98% (36.91%, 47.22%)	254/417	60.91% (56.14%, 65.48%)	288/453	63.58% (58.87%, 68.04%)
Proportion of studies reporting					QB(2) = 40.93, p < .001
Proportion reporting American Indian	14/157	8.92% (5.35%, 14.50%)	38/254	14.96% (10.57%, 20.74%)	51/289	17.65% (13.67%, 22.48%)
					QB(2) = 5.99, p = .050
Proportion American Indian	13	1.23% (0.72%, 2.08%)	38	0.96% (0.72%, 1.29%)	49	0.62% (0.46%, 0.85%)
					QB(2) = 6.26, p = .044
Psychopathology group	1	2.50% (0.35%, 15.73%)	5	1.12% (0.41%, 3.05%)	11	1.60% (0.86%, 2.94%)
					QB(2) = 0.62, p = .733
Comparison group	1	0.00% (0.00%, 100.00%)	5	0.73% (0.14%, 3.64%)	11	0.27% (0.04%, 1.87%)
					QB(2) = 0.58, p = .747
Proportion reporting Asian	38/157	24.20% (18.13%, 31.53%)	79/254	31.10% (25.70%, 37.07%)	111/289	38.41% (32.95%, 44.17%)
					QB(2) = 9.57, p = .008
Proportion Asian	37	6.31% (3.78%, 10.35%)	76	3.83% (2.60%, 5.61%)	110	4.60% (3.89%, 5.43%)
					QB(2) = 2.35, p = .309
Psychopathology group	5	3.23% (0.67%, 14.16%)	15	5.86% (2.33%, 13.96%)	25	5.12% (3.31%, 7.84%)
					QB(2) = 0.43, p = .806
Comparison group	5	2.49% (0.36%, 15.18%)	15	4.38% (1.57%, 11.65%)	25	7.88% (5.25%, 11.64%)
					QB(2) = 2.36, p = .307
Proportion reporting Black	74/157	47.13% (39.45%, 54.95%)	167/254	65.75% (59.70%, 71.33%)	205/289	70.93% (65.42%, 75.89%)
					QB(2) = 22.37, p < .001
Proportion Black	71	13.87% (10.40%, 18.26%)	164	13.61% (11.24%, 16.38%)	202	16.03% (13.56%, 18.86%)
					QB(2) = 1.87, p = .393
Psychopathology group	10	7.97% (2.34%, 23.82%)	26	15.27% (10.30%, 22.04%)	46	21.39% (15.20%, 29.22%)
					QB(2) = 3.74, p = .154
Comparison group	10	22.00% (4.01%, 65.59%)	26	12.78% (8.26%, 19.26%)	46	18.42% (11.78%, 27.64%)
					QB(2) = 1.61, p = .447
Proportion reporting Pacific Islander	1/157	0.64% (0.09%, 4.47%)	4/254	1.57% (0.59%, 4.12%)	18/289	6.23% (3.96%, 9.67%)
					QB(2) = 10.44, p = .054
Proportion Pacific Islander	1	6.89% (5.18%, 9.11%)	4	1.04% (0.34%, 3.13%)	17	0.76% (0.52%, 1.11%)
					QB(2) = 86.21, p < .001
Psychopathology group	0	-	0	-	2	-
Comparison group	0	-	0	-	2	-
Proportion reporting White	144/157	91.72% (76.84%, 97.37%)	243/254	95.67% (92.27%, 97.61%)	269/289	93.08% (89.52%, 95.49%)
					QB(2) = 1.94, p = .379
Proportion White	130	83.72% (79.92%, 86.92%)	237	78.75% (75.54%, 81.65%)	261	73.87% (71.09%, 76.47%)
					QB(2) = 17.57, p < .001
Psychopathology group	27	89.16% (81.27%, 93.97%)	55	75.74% (68.85%, 81.52%)	71	67.27% (63.47%, 70.87%)
					QB(2) = 19.73, p < .001
Comparison group	27	89.30% (80.94%, 94.25%)	55	77.92% (70.83%, 83.68%)	71	66.82% (62.10%, 71.23%)
					QB(2) = 19.72, p < .001
Ethnicity	60/347	16.04% (12.66%, 20.12%)	121/417	29.02% (24.86%, 33.56%)	138/453	30.46% (26.40%, 34.85%)
Proportion of studies reporting					QB(2) = 25.29, p < .001
Proportion Hispanic/Latino	56	6.93% (5.02%, 9.49%)	121	6.37% (5.09%, 7.94%)	135	7.77% (6.70%, 8.99%)
					QB(2) = 2.25, p = .324
Psychopathology group	7	3.59% (1.00%, 12.03%)	14	3.62% (1.68%, 7.62%)	24	9.37% (7.62%, 11.48%)
					QB(2) = 7.84, p = .020
Comparison group	7	3.39% (0.69%, 15.07%)	14	4.39% (1.98%, 9.44%)	25	7.78% (5.75%, 10.45%)
					QB(2) = 2.72, p = .257

Note. Statistics for reporting and proportion of sample sociodemographic characteristics within each sampling time frame. For each set of studies, each analysis yielded an overall mean point estimate (presented as percentages) with a 95% confidence interval (CI) within each sampling time frame. k is the number of studies included in each analysis. k/k indicates the number of studies that reported on the sociodemographic characteristic out of the total number of studies, and k indicates the number of studies that reported on the proportion of participants for the sociodemographic characteristic. The Q_B statistic indicated whether were significant differences in point estimates across sampling time frames; point estimates for one sampling time frame or sociodemographic characteristic that fell outside the 95% CI for another were considered to be meaningfully different from one another.

Figure 2.

Percentage of samples in studies published in the (A) 1990s, (B) 2000s, and (C) 2010s by continent.

Reporting of Sociodemographic Characteristics Over Time

Rates of reporting of sample sociodemographic characteristics across sampling time frames are illustrated in Figure 3 Panel A and presented in Table 1. Figure 3 Panel A illustrates the proportion of studies that reported on participant age/developmental stage, sex/gender, sexual orientation, socioeconomic status/income, educational attainment, race, and ethnicity. Because studies may have reported on all, some, or none of these sociodemographic characteristics, rates of reporting reflect the proportion of studies that reported on each sociodemographic characteristic. That is, the upper bound for each, if each were consistently reported by all studies, would be 100% (i.e., all studies reported on each sociodemographic characteristic). There were high and significantly increasing rates of reporting of participant age/developmental stage over time (90.37% to 95.92% to 97.57%) and, among the studies that reported on participant age/developmental stage, approximately half of samples were in adulthood (58.68% to 59.36% to 57.78%) in all three decades, with a smaller proportion of samples in childhood (9.78% to 8.29% to 14.15%), adolescence (8.20% to 13.64% to 10.61%), and emerging adulthood (19.56% to 15.51% to 14.15%), and only a very small proportion in infancy/preschool (2.52% to 1.87% to 2.83%) or older adulthood (1.26% to 1.34% to 0.47%). There were high and significantly increasing rates of reporting of participant sex/gender over time (91.18% to 92.81% to 96.91%), though it was almost always unclear whether studies were referring to participants’ assigned sex at birth or gender identity. Rates of reporting of participant sexual orientation (1.60% to 0.72% to 1.55%) were very low in all three decades, and rates of reporting of participant gender identity (0.00% to 0.00% to 0.22%) were essentially nonexistent, reported in only a single study in the 2010s. There were low but significantly increasing rates of reporting of socioeconomic status/income over time (17.38% to 23.02% to 24.06%) and moderate and stable rates of reporting of educational attainment (47.33% to 51.08% to 44.59%) in all three decades. There were moderate but significantly increasing rates of reporting of participant race over time (41.98% to 60.91% to 63.58%) and low but significantly increasing rates of reporting of participant ethnicity over time (16.04% to 29.02% to 30.46%). Rates of reporting of participant race across sampling time frames are illustrated in Figure 3 Panel B and presented in Table 1. Figure 3 Panel B illustrates the proportion of studies that reported on each coded race category among the studies that reported on participant race (note that only about half of the included studies reported on participant race; see Table 1). Because these studies may have reported on all or only some of these race categories, rates of reporting reflect the proportion of studies that reported on each race category. That is, the upper bound for each race category, if each were consistently reported by all of these studies, would be 100% (i.e., all of the studies that reported on participant race reported on each race category). Among the studies that reported on participant race, there were very high and stable rates of reporting of the proportion of participants who were White over time (91.72% to 95.67% to 93.08%), moderate to high and significantly increasing rates of reporting of the proportion of participants who were Black over time (47.13% to 65.75% to 70.93%), low to moderate but significantly increasing rates of reporting of the proportion of participants who were Asian over time (24.20% to 31.10% to 38.41%), and low but significantly increasing rates of reporting of the proportion of participants who were American Indian over time (8.92% to 14.96% to 17.65%) and very low but significantly increasing rates of the reporting of participants who were Pacific Islander over time (0.64% to 1.57% to 6.23%).

Figure 3.

Rates of reporting of (A) sample sociodemographic characteristics and (B) participant race. Because studies may have reported on all, some, or none of the sociodemographic characteristics considered in this review, including participant race in different categories, rates of reporting illustrated in the figure reflect the proportion of studies that reported on each sociodemographic characteristic and race category (i.e., if all studies consistently reported on all sociodemographic characteristics and race categories, the proportion for each would be 100%). The size of points corresponds to the number of studies (k) within each time sampling frame.

Taken together, results for reporting of sociodemographic characteristics over time indicated considerable variation in rates of reporting of specific sample sociodemographic characteristics. There were consistently high rates of reporting of participant age/developmental stage and participant sex/gender (though not whether participants’ assigned sex at birth or gender identity was being reported), moderate rates of reporting of educational attainment but lower rates of reporting of socioeconomic status/income, lower but increasing rates of reporting of participant race and ethnicity, and very low rates of reporting of participant sexual orientation and gender identity. Moreover, when studies did report on participant race (which was only about half of the time), the proportion of participants who were White was almost always reported (~94% of the studies that reported on participant race reported on the proportion of participants who were White across all three decades). In contrast, the proportion of participants who were races other than White was far less frequently reported (ranging from ~ 3% for Pacific Islander to ~64% for Black across all three decades). Although the reporting of races other than White increased over the past three decades, and the proportion of participants who were Black or Asian was increasingly reported, rates of reporting of American Indian and Pacific Islander remained very low.

Proportion of Female Participants Over Time

A total of 1,167 (94%) studies reported on participant sex/gender across the three sampling time frames (1990s: k = 341, 2000s: k = 387, 2010s: k = 439). All statistics for the proportion of female participants within each sampling time frame are presented in Table 1. Among the studies that reported on participant sex/gender, there was a significant increase across the three decades to almost two-thirds female (48.49% to 46.13% to 62.14%).

The proportion of female participants in studies that reported on a form of psychopathology coded within the DSM-5 classification system is illustrated in Figure 4 Panel A and all statistics for the proportion of female participants within each sampling time frame are presented in Supplemental Table S1. Among the studies that reported on participant sex/gender as a function of form of psychopathology (i.e., almost all of the included studies reported on participant sex/gender; see Table 1), studies of eating disorders (99.94% to 99.98% to 99.98%) had the highest proportion of female participants, with this remaining stable over time, followed by studies of depressive disorders (77.90% to 74.00% to 93.52%), with this increasing, though not significantly, over time. The proportion of female participants in studies of anxiety disorders (68.27% to 59.46% to 55.48%) and bipolar disorders (57.38% to 59.07% to 70.54%) was moderate and stable over time. Studies of disruptive disorders (0.29% to 0.00% to 2.25%) had the lowest proportion of female participants, though this increased significantly over time, followed by studies of neurodevelopmental disorders (0.01% to 16.42% to 34.70%), with this increasing, though not significantly, over time. The proportion of female participants in studies of psychotic disorders (29.34% to 40.62% to 40.79%) and substance use disorders (14.39% to 42.66% to 50.96%) increased significantly from low to moderate over time. The proportion of female participants in studies of personality disorders (38.62% to 69.13% to 88.49%) increased from moderate to high over time, whereas the proportion of female participants in studies of trauma disorders (77.17% to 33.26% to 11.09%) decreased from high to low over time, though neither change over time was significant (likely reflecting the relatively smaller number of studies broad confidence intervals). Examination of point estimates and 95% CIs indicated that, in studies with a psychopathology and comparison group, the proportion of female participants in the psychopathology and comparison groups were comparable for all disorders over time.

Figure 4.

Proportion of (A) female participants and (B) participants who are White as a function of form of psychopathology. The size of points corresponds to the number of studies (k) within each time sampling frame.

Taken together, the proportion of samples was approximately two-thirds female across forms of psychopathology. However, there was considerable variation in the proportion of female participants as a function of form of psychopathology. Studies of eating disorders were almost exclusively female (~100% of participants were female across all three decades), as were studies of depressive disorders (~81% of participants were female across all three decades), whereas studies of disruptive disorders were almost exclusively male (<1% of participants were female across all three decades). Studies of psychotic disorders and substance use disorders shifted from largely male to approximately half female (from ~30% to ~41% female participants for psychotic disorders over time and ~14% to ~51% female participants for substance use disorders over time), studies of personality disorders shifted to almost exclusively female (from ~39% to ~88% female participants over time), and studies of trauma disorders decreased from largely female to almost exclusively male (from ~77% to ~11% female participants over time). Notably, the proportion of female participants in psychopathology and comparison groups was comparable across all forms of psychopathology.

Proportion of Participants by Race/Ethnicity Over Time

A total of 699 (56%) studies reported on participant race across the three sampling time frames (1990s: k = 157, 2000s: k = 254, 2010s: k = 288). All statistics for the proportion of study participants who were American Indian, Asian, Black, Pacific Islander, and White within each sampling time frame are presented in Table 1. Among the studies that reported on participant race, approximately three-quarters of participants were White (83.72% to 78.75% to 73.87%), though this reflected a significant decrease over time, the proportion of study participants who were Black (13.87% to 13.61% to 16.03%) or Asian (6.31% to 3.83% to 4.60%) was low and remained stable over time, and the proportion of study participants who were American Indian (1.23% to 0.96% to 0.62%) or Pacific Islander (6.89% to 1.04% to 0.76%) was very low and decreased significantly over time; the proportion of study participants who were Hispanic/Latino (6.93% to 6.37% to 7.77%) was low and stable over time.

The proportion of participants who were White in studies that reported on a form of psychopathology coded within the DSM-5 classification system is illustrated in Figure 4 Panel B, and all statistics for the proportion of participants by race/ethnicity within each sampling time frame are presented in Supplemental Table S1. Among the studies that reported on the proportion of participants who were White (i.e., almost all of the studies reported on the proportion of White participants; see Table 1), the proportion of participants who were White in studies of anxiety disorders (86.23% to 65.43% to 80.20%), depressive disorders (87.19% to 78.46% to 78.52%), eating disorders (78.90% to 76.06% to 84.07%), and personality disorders (84.21% to 76.58% to 75.05%) was very high and stable over time. The proportion of participants who were White in studies of bipolar disorders (93.90% to 81.25% to 69.28%), neurodevelopmental disorders (99.84% to 83.55% to 63.44%), psychotic disorders (87.06% to 71.38% to 61.60%), and substance use disorders (89.06% to 86.53% to 71.64%) decreased significantly from very high to moderate over time. The proportion of participants who were White in studies of disruptive disorders (65.12% to 86.24% to 66.16%) and trauma disorders (66.99% to 53.12% to 68.82%) was moderate and stable over time. Examination of point estimates and 95% CIs indicated that, in studies with a psychopathology and comparison group, the proportion of participants who were White in the psychopathology and comparison groups was comparable for all disorders over time.

Among the studies that reported on the proportion of participants who were races other than White (i.e., ranging from approximately half of studies for reporting of Black participants, approximately one-third for Asian, very rarely for American Indian, to almost no studies for Pacific Islander; see Table 1), the proportion of participants who were American Indian, Asian, and Black in studies of anxiety disorders (American Indian: 0.00% to 0.18% to 0.83%; Asian: 3.08% to 3.88% to 4.35%; Black: 19.18% to 7.44% to 8.97%), bipolar disorders (American Indian: not reported; Asian: 7.69% to 5.24% to 4.37%; Black: 7.10% to 17.17% to 19.15%), depressive disorders (American Indian: 0.54% to 0.91% to 0.55%; Asian: 7.35% to 6.60% to 7.22%; Black: 9.71% to 18.50% to 13.48%), disruptive disorders (American Indian: 0.99% to 1.35% to 0.80%; Asian: 0.40% to 10.33% to 2.78%; Black: 28.64% to 14.56% to 20.32%), personality disorders (American Indian: not reported; Asian: 0.00% to 4.17% to 4.20%; Black: 1.39% to 10.47% to 17.46%), psychotic disorders (American Indian: not reported; Asian: 6.37% to 4.12% to 5.88%; Black: 19.32% to 17.96% to 26.63%), substance use disorders (American Indian: 0.00% to 1.11% to 1.27%; Asian: 0.83% to 1.82% to 4.35%; Black: 3.72% to 13.52% to 21.24%), and trauma disorders (American Indian: 0.98% to 1.54% to 2.16%; Asian: 2.20% to 2.93% to 3.25%; Black: 14.81% to 26.22% to 22.13%) was very low to low and stable over time. The proportion of participants who were Black in studies of bipolar disorders (7.10% to 17.17% to 19.15%), eating disorders (4.19% to 6.84% to 7.57%), neurodevelopmental disorders (14.04% to 8.27% to 18.79%), and personality disorders (1.39% to 10.47% to 17.46%) increased significantly over time, whereas the proportion of participants who were American Indian (4.44% to 0.81% to 0.31%) and Asian (8.65% to 8.75% to 2.70%) in studies of eating disorders decreased significantly over time, as did the proportion of participants who were Asian (12.28% to 1.03% to 5.21%) in studies of neurodevelopmental disorders. There were not enough studies that reported on the proportion of participants who were Pacific Islander to examine proportions in studies over time, and there were not enough studies that reported on the proportion of participants who were American Indian, Asian, Black, or Pacific Islander in studies with a psychopathology and comparison group to examine proportions in the psychopathology and comparison groups over time.

Taken together, there were consistently high rates of reporting of the proportion of participants who were White and samples were predominantly White across forms of psychopathology (~77% of participants were White across all three decades). There was little variation in the proportion of participants who were White as a function of form of psychopathology, so that samples were predominantly White across all disorders. However, there was evidence of shifts toward a greater proportion of participants who were Black in studies of bipolar disorders, eating disorders, neurodevelopmental disorders, and personality disorders, though the proportion was still low (ranging from ~8% to ~19% of participants who were Black, depending on the disorder), whereas the proportion of participants who were American Indian or Asian decreased in studies of eating disorders and neurodevelopmental disorders (ranging from <1% to 5% of participants who were American Indian or Asian). Notably, the proportion of participants who were Pacific Islander was so rarely reported it could not be included in analyses.

Discussion

The adequacy of our sampling strategies and sociodemographic diversity of our samples in psychopathology research is rarely explicitly interrogated and sample characteristics are inconsistently reported, if at all (Arnett, 2009; Bornstein et al., 2013; Iwamasa et al., 2002; Nielsen et al., 2017; Pedersen et al., 2022; Rad et al., 2018; Roberts et al., 2020; Sears, 1986; Thalmayer et al., 2021). Previous systematic reviews on this issue have largely focused on rates of reporting. By also conducting a quantitative synthesis of those sample sociodemographic characteristics that were reported consistently—sex/gender and race/ethnicity—this review of psychopathology research published over the past 3 decades in the Journal of Psychopathology and Clinical Science (formerly the Journal of Abnormal Psychology) found that most (about two-thirds) participants in psychopathology research are female and this has increased over time, and that most participants are non-Hispanic/Latino and White, though this has decreased over time—but remains high, at about three-quarters White. This review also found notable gaps in reporting across the 3 decades, including inconsistent reporting of socioeconomic status, whether reported sex/gender was participants’ assigned sex at birth or gender identity, and low rates of reporting of participant sexual orientation and gender identity, and participant race/ethnicity. Appropriate sampling in psychopathology research is crucial because it determines whether findings are generalizable—or not—and to which populations. Below, I first provide an overview of key findings from this review and implications for generalizable psychopathology research. I then make several recommendations to increase sociodemographic diversity in and generalizability of psychopathology research and in the scientific review and publication process, building upon previous important work on sampling, publishing, and funding in psychology research (Auelua-Toomey & Roberts, 2022; Bornstein et al., 2013; Buchanan, Perez, Prinstein, & Thurston, 2021; Pedersen et al., 2022; Rad et al., 2018; Roberts & Mortenson, 2023; Roberts, Bareket-Shavit, Dollins, Goldie, & Mortenson, 2020).

Implications for Generalizable Psychopathology Research

Much of the psychopathology research published in this journal over the past 3 decades has been conducted in the United States and with female, non-Hispanic, White samples. Moreover, key sociodemographic characteristics have been inconsistently reported (socioeconomic status), infrequently reported (race other than White, ethnicity) or not reported at all (sexual orientation, gender identity), meaning the adequacy of sampling for these aspects of participants’ lived experiences, backgrounds, and identities cannot be evaluated, though we know that many clinical features, such as age of onset, severity, and course, vary as a function of sociodemographic characteristics.

Socioeconomic status.

Although it was possible in this review to consider rates of reporting of socioeconomic status and education in psychopathology research samples, it was not possible to quantitatively synthesize across studies to determine socioeconomic status in samples. As found in other reviews (Kachmar et al., 2019; Oakes & Rossi, 2003), there was too much variation across studies in how socioeconomic status, income, and education were reported. Studies reported idiosyncratic income ranges, coding of occupational status (e.g., Hollingshead), or other indicators of income (e.g., percentage of participants below the federal poverty level). Educational attainment was often reported as number of years of (participant or parent) education or degree (e.g., high school), but many reported idiosyncratic educational attainment ranges (e.g., some college, college or higher degree). Given the relatively small proportion of individuals worldwide who are from highly resourced countries or socioeconomically advantaged, and the implications of socioeconomic disadvantage for mental health and well-being, it is critical that psychopathology research not be conducted exclusively in socioeconomically advantaged samples, as doing so will miss important opportunities to understand the contextual and experiential processes that influence the development, course, and severity of psychopathology, and to develop prevention-intervention efforts and public policies that will help those who need it most.

Sex/gender.

This review found high rates of reporting of participant sex/gender in psychopathology research samples over the past 3 decades (though whether reported sex/gender was participants’ assigned sex at birth or gender identity was almost never reported), and quantitative synthesis across studies indicated that psychopathology research samples included approximately two-thirds female participants, with the proportion of female participants increasing significantly over time, and there were notable differences in the proportion female as a function of form of psychopathology. Some of these proportions mapped onto expected rates in the general population. For example, studies of anxiety disorders had proportionately higher numbers of female participants, whereas studies of psychotic disorders had proportionately lower numbers of female participants, mapping onto prevalence estimates of these disorders in the general population (Jongsma et al., 2019; McLean et al., 2011). Others showed changes over time that appear to map onto increasing recognition among researchers and clinicians that the form of psychopathology occurs among women/girls or men/boys. For example, the proportion of female participants in studies of substance use and neurodevelopmental disorders increased over the past 3 decades, with the recognition that women/girls may be affected by these forms of psychopathology and concerted efforts to increase female participants (Burrows et al., 2022; Meyer et al., 2019). Clearly, we cannot understand or identify potential differences in the phenomenology of psychopathology among a subset of the population if research is not conducted in that population. For example, the almost homogenous female samples in studies of eating disorders in this review means that we are limited in our understanding of relevant risk factors that may be common across or specific to women/girls and men/boys, even though men and boys are affected by eating pathology (Lydecker & Grilo, 2018; Striegel-Moore et al., 2009).

Sexual orientation and gender identity.

There were very low rates of reporting of participant sexual orientation (~2%) and almost nonexistent reporting of participant gender identity—in only a single study published in 2019 in the time sampling frames considered here, which collectively spanned 15 years of publications over 3 decades¹⁰. It is presumably not the case that psychopathology research samples do not include sexual/gender diverse participants (though it is not possible to know if that information is not reported), but instead that this information is only rarely assessed and even less frequently reported (or required to be reported by journal editors or reviewers). Due to this lack of reporting, it was not possible to quantitatively synthesize across studies to determine the proportion of participants who identify as sexual/gender diverse. This presents a critical absence in psychopathology research as rates of psychopathology and other adverse experiences are disproportionately high among individuals who identify as sexual/gender diverse, and there are economic, regional, and legislative barriers to their mental health and medical treatment access (Lett, Abrams, et al., 2022; Ronan, 2021). In order to understand the contextual and experiential risk and protective factors for psychopathology and well-being among individuals that identify as sexual/gender diverse, they must be included in psychopathology research.

Race/ethnicity.

This review found consistently high reporting of the proportion of participants who were White (i.e., although only about half of studies reported on participant race, almost all studies that reported on participant race reported on the proportion of participants who were White). In contrast, rates of reporting for other races and for ethnicity were considerably lower, though there were increases in reporting over time. Quantitative synthesis across studies that reported on race/ethnicity indicated that psychopathology research samples were predominantly (about three-quarters) White and (almost all) non-Hispanic/Latino. The United States and the world is increasingly racially/ethnically diverse (Jensen et al., 2021; United Nations Department of Economic and Social Affairs, 2022), and to the extent psychopathology phenomena are influenced by and reflect differential inequitable exposures, psychopathology research samples that are majority and homogenously non-Hispanic/Latino White will be limited in capturing these influences. Differing experiences and inequities in exposure to adversity, as well as clinical bias, can lead to both overdiagnosis and underdiagnosis among racial/ethnic groups. For example, Black or Hispanic/Latino individuals are disproportionately diagnosed with psychotic disorders relative to White individuals (Olbert et al., 2018; Schwartz & Blankenship, 2014). Children who are Black experience considerable delays in diagnosis of autism spectrum disorder—on average almost 4 years after their parents first raise concerns with their medical providers (Constantino et al., 2020), with critical implications for prognosis, to the extent early intervention may improve developmental outcomes. Clinicians may be less likely to detect eating pathology among Black or Hispanic/Latino individuals (Gordon et al., 2006), and those who are Black and Hispanic/Latino are less likely to seek treatment for eating disorders (Coffino et al., 2019). Again, it is critical to emphasize that differences in the prevalence of psychopathology among different racial/ethnic groups do not reflect innate biological differences, cultural inferiority, or maladaptive choices—it is the sociocultural influences linked to racial identities and categories reflect factors that themselves confer risk for psychopathology.

Recommendations for Generalizable Psychopathology Research

Although recommendations for sampling and reporting in psychology research have been made (Bornstein et al., 2013; Pedersen et al., 2022; Rad et al., 2018; Roberts & Mortenson, 2023; Roberts et al., 2020), movement toward following these recommendations has been relatively slow, and will require continued and increased efforts by researchers, journal editors and reviewers, and funding agencies. Psychopathology researchers should consider the larger population to which the sample is intended to generalize and determine what the most appropriate sample composition should be in terms of the research question and relevant psychopathology and sociodemographic features. Sociodemographically diverse samples are necessary in psychopathology research that is intended to generalize to the larger human population, because the larger human population is sociodemographically diverse. Researchers should justify the study sample and larger population it is intended to generalize to, and explicitly link study conclusions to the population sampled, so that it is clear how well findings are likely to generalize to that population (with limitations to generalizability also explicitly noted). Researchers should also gauge the adequacy of their study sample and evaluate sample composition during and after data collection, making adjustments during the enrollment stage, as needed, and report relevant psychopathology and sociodemographic characteristics of the sample, including nonrespondents during enrollment or participants who attrite to follow-up. In particular, this review indicates a dire need for reporting on participant race/ethnicity (beyond White and “non-White”), as well as more consistent reporting of socioeconomic status, including income and education. Reporting on (and presumably assessment of) participant sexual orientation and gender identity (including whether reported sex was assigned sex at birth), essentially nonexistent in this review, is critical as the field moves forward. The National Institutes of Health (NIH)-funded PhenX Toolkit provides recommended standard data collection measures for assessing participant sociodemographic characteristics, including age, sex/gender, sexual orientation, gender identity, race, ethnicity, and socioeconomic status. As the field has and will continue to advance in our understanding, recommended reporting practices for sociodemographic characteristics and identities will change. Researchers working with existing datasets that used outdated terms or categories during data collection, or that did not assess all relevant sociodemographic characteristics, can simply note that when reporting (and replace previously used terms with racist underpinnings, such as “Caucasian” (Mukhopadhyay, 2018), with more appropriate terms).

Publication of Psychopathology Research

It is critical to recognize and acknowledge that many of the limitations and gaps in reporting and sample composition identified in this review reflect systems-level issues in psychopathology research and publishing. These systems-level issues uphold exclusionary practices that maintain the predominant focus on majority and/or privileged populations in psychopathology research and, whether made explicit or not, consider research with diverse, minority, and socially marginalized populations as “niche,” relegated to specialty journals. These practices reflect and reify epistemic exclusion, the devaluation of research outside of the dominant discourse, and implies that research with, for example, samples of people who are socioeconomically disadvantaged, non-White and Hispanic/Latino, or who identify as sexual/gender diverse, does not contribute to the production of “general” knowledge about the human population (Settles et al., 2020), while research with samples that are non-Hispanic, White, cisgender, and heterosexual are seen as “neutral” or “the norm” (Roberts & Mortensen, 2023).

As is also the case in other institutions and systems, power in publication is not equitably distributed across its roles and members, meaning different aspects of institutional- and systems-level change will come from different stakeholders. It will require that prestigious journals, editors, reviewers, and funding agencies make explicit that generalizable psychopathology research that includes sociodemographically diverse samples is valued, seek it out, publish it, and fund it. Diversification at all levels in psychopathology research is likely to further these efforts. Racial/ethnic minorities make up less than one-quarter of psychology faculty in the United States (Syed et al., 2018), which necessarily limits racial/ethnic diversity in who is conducting the research. Yet journal editors, editorial boards, and reviewers also play critical roles as the “gatekeepers” that determine what is ultimately published (and what is not) and in which journals (see Roberts preprint). Editors and editorial boards of psychology journals are predominantly White and male (Hartmann et al., 2013; Liu et al., 2023; Roberts et al., 2020), yet the racial/ethnic and gender composition of editorial boards signal to researchers what research may be valued, influencing their likelihood of submitting their work there (Auelua-Toomey et al., 2022). Moreover, the type of research published varies as a function of the editor, with a large, systematic review of cognitive, developmental, and social psychology journals finding not only that the vast majority editors (93%) were White, but also that having White editors and a higher proportion of the editorial board that was White negatively predicted the percentage of articles that focused on race (Roberts et al., 2020).

Editors and reviewers play a fundamental role in what is ultimately published. Although independent peer review is one of the hallmarks of the scientific process, it is not always impartial, objective, or fair. Biases may be subtle and unrecognized. Editors and reviewers with explicit or implicit biases or without relevant expertise may not see the merit in some psychopathology research, or not be willing to work with authors through the revision process. One notable systematic review of manuscript submissions to a management journal found that manuscripts focusing on diversity were 12 times more likely to be rejected than accepted, and 15 times more likely to be invited to revise than accepted (King et al., 2018). Peer review also plays a key role in funding decisions, a critical determinant of the psychopathology research that is conducted and ultimately submitted for publication. Significant disparities in grant selection processes and funding are well documented for race and gender, with, for example, Black researchers 10% less likely than White researchers to receive National Institutes of Health R01 funding, even after accounting for relevant factors (Ginther et al., 2011; see also Dzirasa et al., 2020; Erosheva et al., 2020).

Recommendations for the Publication of Generalizable Psychopathology Research

Extending beyond recommendations aimed toward individual psychopathology researchers are broader, institutional- and systemic-level recommendations. Recommendations focus on multiple aspects of the scientific review and publication process and build upon other critical reviews (Auelua-Toomey & Roberts, 2022; Buchanan, Perez, Prinstein, & Thurston, 2021; Roberts & Mortenson, 2023; Roberts, Bareket-Shavit, Dollins, Goldie, & Mortenson, 2020). Journals should recruit editorial board members from diverse identities and backgrounds by having broad calls that indicate the importance of diversity in its editorial board, asking editorial board members or experts in the field who themselves identify as members of sociodemograpically diverse groups to identify potential recruits to the board, inviting guest editors for manuscripts or special issues, and using formal mentoring systems to train more junior researchers as editors. Similarly, editors should strive to select reviewers with relevant expertise with diverse lived experiences, backgrounds, and identities. Journals should consider training the editorial board and reviewers in equitable, fair, and constructive reviewing that identifies systemic issues and biases in scientific review and publishing and provides guidance. Of course, journals must support their editorial board members and reviewers, recognizing that many researchers identify as members of sociodemographically diverse groups take on additional burdens (e.g., serving on committees, mentoring students). Editors and reviewers should require that authors report relevant psychopathology and sociodemographic characteristics of their samples, and encourage consistency in reporting. Journals should also make clear to their editorial boards and psychopathology researchers more broadly that they value psychopathology research in sociodemographically diverse samples. This can be done in the journal’s mission statement, special issues highlighting relevant work, and by spotlighting and promoting relevant publications. To evaluate these efforts and identify ongoing areas of needed change and solutions, journals should also assess, evaluate, and publicly report progress using quantitative metrics, including the sociodemographic composition of the editorial board, reviewers, and, when possible, authors, as well as data on acceptance, revision, and rejection rates as a function of author and sample sociodemographic characteristics.

Equitable Sampling and Reporting in Psychopathology Research

Although the field of psychopathology research stands to gain tremendously from the diversification of its samples, this must be done thoughtfully and with care. Inclusive recruitment and community engagement requires recognition that scientific research is neither neutral nor apolitical. It is critical that psychopathology researchers carefully consider how their research and its publication may cause or perpetuate harm to research participants and their communities, take steps to minimize harm as much as possible, and partner directly with researchers already working within these spaces, as well as with members of the community who will be participating in and affected by the research (Bonevski et al., 2014). There is extensive and well-documented history of harms in psychopathology and other mental health and medical research of marginalized and oppressed communities (Nketia et al., 2021; Scharff et al., 2010; Washington, 2006), as well as opportunistic “safari research” and “health equity tourism” (Lett, Adekunle, et al., 2022; A. R. Martin et al., 2022). In particular, although the 2020s saw a rapid shift by journals and funding agencies toward recognition of the need for equity informed and informative psychopathology research, this does not mean that this important work had not already been conducted for decades before being “discovered” (Lett, Adekunle, et al., 2022). Researchers must take the time to learn about previous and ongoing research efforts with communities in order to foster the genuine trust necessary to work within and further develop in partnership the necessary infrastructure required for sustainable research that benefits its participating communities—in the same way that inclusion of members of the community benefit the research.

Psychopathology researchers working within sociodemographically diverse samples must also carefully consider the potential implications of analyses focused on group differences and their potential for misinterpretation. Centuries of structural and systemic injustices in the United States and the world have resulted in disproportionate exposure to both acute and chronic stressors by individuals and families who are lower-income, racial/ethnic minorities, and sexual/gender diverse. Statistical analyses conducted at the “group” level (e.g., racialized group classification within socially constructed categories) must be conducted and interpreted within this historical and contemporary context. Assessing and reporting on sociodemographic characteristics is important for characterizing the samples included in psychopathology research, but samples that include only a small percentage of participants in a particular identity group can introduce complications about whether and how they should be included in analyses, and “controlling for” race or sexual orientation/gender identity or conducting group-level comparisons can perpetuate harmful beliefs or interpretations. Great care must be taken to minimize biased interpretations of group differences as biological essentialism, cultural inferiority, or maladaptive choices when instead they are a reflection of these social inequities (e.g., race as a proxy for exposure to racism; Lett, Asabor, et al., 2022; Nketia et al., 2021), as so doing is not only inaccurate but also further perpetuates and exacerbates existing structural and systemic injustices. Psychopathology researchers must be mindful of and do their best to anticipate the ethical, legal, social, and policy contexts in which their findings will be received, both within and outside of academia, as we bear the responsibility of taking every measure possible when developing our research questions, designing our studies, conducting the research, and interpreting and disseminating the findings to do so in ways that minimize the potential for harm as much as possible.

Strengths and Limitations

This systematic review and quantitative synthesis considered sociodemographic characteristics in over 1,200 psychopathology research samples in empirical articles published in one of the “top” psychopathology journals, the Journal of Psychopathology and Clinical Science. By including studies published over a relatively extended time period (in sampling time frames over the past 3 decades), this review identified overall trends that reflect evolving psychiatric nosologies, sociocultural shifts, and changes in psychopathology research practices over time. This review also had some limitations that prompt caution in interpreting the findings. Although this review extended beyond most previous reviews by quantitatively synthesizing across studies to determine sample composition in terms of sex/gender and race/ethnicity over time, other relevant sociodemographic features were inconsistently reported (socioeconomic status) or rarely reported at all (sexual orientation, gender identity), precluding quantitative synthesis across studies. Participant race/ethnicity was also inconsistently reported in studies, reflecting both shifts in categorization of race/ethnicity over the past 30 years and a notable lack of standardized reporting across studies. This review relied on coding of socially constructed categories, following the 2020 United States Census, for sample race/ethnicity. This approach has important limitations, as many studies did not report on race/ethnicity following Census categories (e.g., studies reported information in a single group for participants who were Asian, American Indian, and Pacific Islander, or studies reported on race/ethnicity together, rather than as separate constructs). Moreover, this approach does not consider evolving race/ethnicity categories or include individuals who identify with multiple races and fails to consider changes over time and across contexts in racial or ethnic self-identification (Goldstein & Morning, 2000; Liebler et al., 2017). For example, the current United States Census ethnicity category of Hispanic or Latino was first introduced in 1997, and there is currently a proposed addition of the race category of Middle Eastern or North African¹¹. Some forms of psychopathology were infrequently studied, leading to relatively few studies included in the review, and some forms of psychopathology had so few studies they could not be included at all. Other studies were excluded from the psychopathology review because the form of psychopathology could not be readily coded, especially those commonly studied together (comorbid forms of psychopathology, e.g., depression and anxiety). Although the Journal of Psychopathology and Clinical Science is a well-regarded psychopathology journal, the generalizability of findings from this review to other psychopathology journals, or to psychology journals more generally, has not yet been evaluated. An important next step will be to take a broader, more comprehensive approach that samples across multiple journals.

Conclusions

Basic science and theoretical research on the etiology, development, symptomatology, and course of psychopathology must include sociodemographically diverse samples. In order to understand the phenomenology of various forms of psychopathology and ensure research findings for study samples are generalizable, careful consideration of sample sociodemographic makeup and other participant characteristics is critical. The adequacy of our sampling strategies, resulting sample characteristics, and publication of generalizable psychopathology research has fundamental implications for our understanding of psychopathology and its phenomenology, and, in turn, the efficacy and effectiveness of our preventions and treatments, and our efforts to decrease the stigma of psychopathology and increase mental health equity.