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 language | English |
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Pages (from-to) | 119-137 |
Number of pages | 19 |
Journal | Clinical Psychological Science |
Volume | 2 |
Issue number | 2 |
DOIs | |
State | Published - Mar 2014 |
Externally published | Yes |
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