The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders?
The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders?
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DOI：
10.1177/2167702613497473
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Moffitt TE
中科院分区：
文献类型：
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作者：
Caspi A;Houts RM;Belsky DW;Goldman-Mellor SJ;Harrington H;Israel S;Meier MH;Ramrakha S;Shalev I;Poulton R;Moffitt TE
精神障碍传统上被视为独特的、偶发的和绝对的状况。这一观点受到了一些证据的挑战，这些证据表明，许多疾病是顺序共病、复发/慢性的，并且存在于一个连续体中。利用达尼丁多学科健康与发展研究，我们检查了精神病理学的结构，考虑了从青春期到中年20年间精神障碍的维度、持久性、共发性和顺序共病。精神疾病最初由三个高阶因素（内化、外化和思维障碍）来解释，但用一个普通精神病理学维度来解释甚至更好。我们把这个维度称为p因素，因为它在概念上与心理科学中一个熟悉的维度相似：一般智力的g因素。p值越高，生活障碍越严重，熟悉程度越高，发育史越差，早期大脑功能越受损。p因子解释了为什么很难找到针对个体精神障碍的原因、后果、生物标志物和治疗方法。跨诊断方法可以改善研究。
Mental disorders traditionally have been viewed as distinct, episodic, and categorical conditions. This view has been challenged by evidence that many disorders are sequentially comorbid, recurrent/chronic, and exist on a continuum. Using the Dunedin Multidisciplinary Health and Development Study, we examined the structure of psychopathology, taking into account dimensionality, persistence, co-occurrence, and sequential comorbidity of mental disorders across 20 years, from adolescence to midlife. Psychiatric disorders were initially explained by three higher-order factors (Internalizing, Externalizing, and Thought Disorder) but explained even better with one General Psychopathology dimension. We have called this dimension the p factor because it conceptually parallels a familiar dimension in psychological science: the g factor of general intelligence. Higher p scores are associated with more life impairment, greater familiality, worse developmental histories, and more compromised early-life brain function. The p factor explains why it is challenging to find causes, consequences, biomarkers, and treatments with specificity to individual mental disorders. Transdiagnostic approaches may improve research.