- Bibtex: @cervin2021a
- Bibliography: Cervin, M., Norris, L. A., Ginsburg, G., Gosch, E. A., Compton, S. N., Piacentini, J., Albano, A. M., Sakolsky, D., Birmaher, B., Keeton, C., Storch, E. A., & Kendall, P. C. (2021). The p Factor Consistently Predicts Long-Term Psychiatric and Functional Outcomes in Anxiety-Disordered Youth. Journal of the American Academy of Child & Adolescent Psychiatry, 60(7), 902-912.e5. https://doi.org/10.1016/j.jaac.2020.08.440
They used SEM for modeling the p-factor (
Child Behavior Checklist (CBCL) was used to establish p
Aggressive behavior and rule-breaking behavior had strong positive correlations beyond p
Withdrawn/depressed was negatively associated with attention problems and aggressive behavior after accounting for shared p variance.
Lots of strong correlations between p and clinical outcomes in the direction you would expect.
They suggest that youth high in p may need treatment for broader outcomes instead of disorder-specific CBT. Another suggestion is to include core processes (emotion dysregulation, emotional impulsivity) in CBT
…higher p at baseline was associated with lower functioning/more impairment at all follow-up assessments.
Importantly, p was the only predictor consistently associated with outcomes across time and measures, also when controlling for baseline diagnostic comorbidity, indicating that p is related not only to a narrow set of outcomes but to broad outcomes, and that it is not simply a proxy for diagnostic comorbidity.
Objective Pediatric anxiety disorders can have a chronic course and are considered gateway disorders to adult psychopathology, but no consistent predictors of long-term outcome have been identified. A single latent symptom dimension that reflects features shared by all mental health disorders, the p factor, is thought to reflect mechanisms that cut across mental disorders. Whether p predicts outcome in youth with psychiatric disorders has not been examined. We tested whether the p factor predicted long-term psychiatric and functional outcomes in a large, naturalistically followed-up cohort of anxiety-disordered youth. Method Children and adolescents enrolled in a randomized controlled treatment trial of pediatric anxiety were followed-up on average 6 years posttreatment and then annually for 4 years. Structural equation modeling was used to estimate p at baseline. Both p and previously established predictors were modeled as predictors of long-term outcome. Results Higher levels of p at baseline were related to more mental health disorders, poorer functioning, and greater impairment across all measures at all follow-up time points. p Predicted outcome above and beyond previously identified predictors, including diagnostic comorbidity at baseline. Post hoc analyses showed that p predicted long-term anxiety outcome, but not acute treatment outcome, suggesting that p may be uniquely associated with long-term outcome. Conclusion Children and adolescents with anxiety disorders who present with a liability toward broad mental health problems may be at a higher risk for poor long-term outcome across mental health and functional domains. Efforts to assess and to address this broad liability may enhance long-term outcome. PDF: cervin_2021_the_p_factor_consistently_predicts_long-term_psychiatric_and_functional.pdf