title: The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders?
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.
authors.affiliation: Department of Psychology and Neuroscience, Duke University ; Institute for Genome Sciences and Policy, Duke University ; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center ; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London.
authors.forename: Avshalom
authors.initials: A
authors.lastname: Caspi
authors.affiliation: Department of Psychology and Neuroscience, Duke University.
authors.forename: Renate M
authors.initials: RM
authors.lastname: Houts
authors.affiliation: Center for the Study of Aging and Human Development, Duke University Medical Center.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Belsky
authors.affiliation: Center for Developmental Science, University of North Carolina at Chapel Hill.
authors.forename: Sidra J
authors.initials: SJ
authors.lastname: Goldman-Mellor
authors.affiliation: Department of Psychology and Neuroscience, Duke University.
authors.forename: HonaLee
authors.initials: H
authors.lastname: Harrington
authors.affiliation: Department of Psychology and Neuroscience, Duke University.
authors.forename: Salomon
authors.initials: S
authors.lastname: Israel
authors.affiliation: Department of Psychology and Neuroscience, Duke University.
authors.forename: Madeline H
authors.initials: MH
authors.lastname: Meier
authors.affiliation: Dunedin Multidisciplinary Health and Development Research Unit, Department, of Preventive and Social Medicine, School of Medicine, University of Otago.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Ramrakha
authors.affiliation: Department of Psychology and Neuroscience, Duke University.
authors.forename: Idan
authors.initials: I
authors.lastname: Shalev
authors.affiliation: Dunedin Multidisciplinary Health and Development Research Unit, Department, of Preventive and Social Medicine, School of Medicine, University of Otago.
authors.forename: Richie
authors.initials: R
authors.lastname: Poulton
authors.affiliation: Department of Psychology and Neuroscience, Duke University ; Institute for Genome Sciences and Policy, Duke University ; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center ; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London.
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Moffitt
keywords: DSM; developmental psychopathology; psychiatric epidemiology