The p factor: One general psychopathology factor in the structure of psychiatric disorders?

Avshalom Caspi, Renate M. Houts, Daniel W. Belsky, Sidra J. Goldman-Mellor, Honalee Harrington, Salomon Israel, Madeline H. Meier, Sandhya Ramrakha, Idan Shalev, Richie Poulton, Terrie E. Moffitt

Research output: Contribution to journalArticlepeer-review

1569 Scopus citations

Abstract

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.

Original languageAmerican English
Pages (from-to)119-137
Number of pages19
JournalClinical Psychological Science
Volume2
Issue number2
DOIs
StatePublished - Mar 2014
Externally publishedYes

Bibliographical note

Funding Information:
This research received support from the National Institute on Aging (NIA; Grant G032282) and the Medical Research Council (Grant MRK00381X). Additional support was provided by the National Institute of Child Health and Human Development (NICHD; Grant HD061298) and the Jacobs Foundation. D. W. Belsky was supported by a postdoctoral fellowship from the NIA (T32 AG000029). S. J. Goldman-Mellor was supported by a postdoctoral fellowship from the NICHD (T32 HD07376). S. Israel was supported by a Rothschild Fellowship from the Yad Hanadiv Rothschild Foundation. M. H. Meier was supported by a postdoctoral fellowship from the National Institute on Drug Abuse (P30 DA023026). The Dunedin Multidisciplinary Health and Development Research Unit is supported by the New Zealand Health Research Council.

Keywords

  • DSM
  • Developmental psychopathology
  • Psychiatric epidemiology

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