Clinical implications of a general psychopathology factor: A cognitive–behavioral transdiagnostic group treatment for community mental health.

Meier, Matthew A.

doi:10.1037/int0000095

Cited by 19 publications

(21 citation statements)

References 69 publications

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“…In addition, dual harmers often experience psychiatric comorbidity. Transdiagnostic approaches that target self-regulation (e.g., mindfulness-based approaches for emotion-regulation) may reduce harmful behaviors and co-occurring psychopathology (38). Lastly, our findings recommend application of available interventions to prevent childhood maltreatment (39) as well as implementation of exposure-reduction strategies (e.g., education on self-protective measures) and evidence-based programs (40,41) to prevent revictimization in adolescence.…”

Section: Discussionmentioning

confidence: 99%

Adolescents Who Self-Harm and Commit Violent Crime: Testing Early-Life Predictors of Dual Harm in a Longitudinal Cohort Study

Richmond‐Rakerd

Caspi

Arseneault

et al. 2019

AJP

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Objective. Self-harm is associated with violent offending. However, little is known about young people who engage in “dual-harm” behavior. We investigated antecedents, clinical features, and life characteristics distinguishing dual-harming adolescents from those who self-harm only. Method. Participants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative UK cohort of 2,232 twins born in 1994–1995. Self-harm in adolescence was assessed through interviews at age 18. Violent offending was assessed using a computer questionnaire at age 18 and police records through age 22. Risk factors were assessed between ages 5–12. Adolescent mental health, victimization, personality functioning, and use of support services were measured at age 18. Results. Self-harm was associated with violent crime (OR=3.50, 95% CI=2.61–4.70), even after accounting for familial risk factors. Dual-harmers had been victims of violence from childhood, and exhibited lower childhood self-control and lower childhood IQ than self-only harmers. Dual-harmers experienced higher rates of concurrent psychotic symptoms and substance dependence. They also exhibited distinct personality styles characterized by resistance to change and by emotional and interpersonal lability. However, dual-harmers were not more likely than self-only harmers to have contact with mental health services. Conclusions. Dual-harmers have self-control difficulties and are immersed in violence from a young age. A treatment- rather than punishment-oriented approach is indicated to meet these individuals’ needs. Connecting self-harming adolescents with delinquency-reduction programs and transdiagnostic approaches that target self-regulation may reduce harmful behaviors. Preventing childhood maltreatment and implementing strategies to reduce victimization exposure could mitigate risk for both internalized and externalized violence.

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Section: Discussionmentioning

confidence: 99%

Adolescents Who Self-Harm and Commit Violent Crime: Testing Early-Life Predictors of Dual Harm in a Longitudinal Cohort Study

Richmond‐Rakerd

Caspi

Arseneault

et al. 2019

AJP

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“…Instead, we suggest that specific causes will be challenging to find because if a disorder’s causes covary in a dose-response fashion with the disorder’s severity, then the same causes may characterize other disorders too because it is severe disorder that tends to be comorbid, concurrently and sequentially, reflecting p . The hypothesis of shared pathogenesis raised by p extends to other kinds of variables studied in psychiatry--including biomarkers(61), consequences(52), and treatments(62). We think the absence of causal nonspecificity invites researchers in genetics, neuroscience, and developmental psychopathology to focus on p itself.…”

Section: The Quixotic Pursuit Of Specificity and The Promise Of Non-smentioning

confidence: 98%

All for One and One for All: Mental Disorders in One Dimension

Caspi

Moffitt

2018

AJP

732

686

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In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able to measure a person's liability to mental disorder, comorbidity among disorders, persistence of disorders over time, and severity of symptoms. This single dimension of general psychopathology has been termed "p," because it conceptually parallels a dimension already familiar to behavioral scientists and clinicians: the "g" factor of general intelligence. As the g dimension reflects low to high mental ability, the p dimension represents low to high psychopathology severity, with thought disorder at the extreme. The dimension of p unites all disorders. It influences present/absent status on hundreds of psychiatric symptoms, which modern nosological systems typically aggregate into dozens of distinct diagnoses, which in turn aggregate into three overarching domains, namely, the externalizing, internalizing, and psychotic experience domains, which finally aggregate into one dimension of psychopathology from low to high: p. Studies show that the higher a person scores on p, the worse that person fares on measures of family history of psychiatric illness, brain function, childhood developmental history, and adult life impairment. A dimension of p may help account for ubiquitous nonspecificity in psychiatry: multiple disorders share the same risk factors and biomarkers and often respond to the same therapies. Here, the authors summarize the history of the unidimensional idea, review modern research into p, demystify statistical models, articulate some implications of p for prevention and clinical practice, and outline a transdiagnostic research agenda. [AJP AT 175: Remembering Our Past As We Envision Our Future October 1910: A Study of Association in Insanity Grace Helen Kent and A.J. Rosanoff: "No sharp distinction can be drawn between mental health and mental disease; a large collection of material shows a gradual and not an abrupt transition from the normal state to pathological states."(Am J Psychiatry 1910; 67(2):317-390 )].

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“…Practically, bifactor analyses aimed at assessing the reliability and external validity of the general and group factors can help guide the level of focus in assessment and treatment planning (17,88,89). Can we predict treatment outcomes based on the general factor alone, or do we need an assessment of group factors?…”

Section: Biological Psychiatrymentioning

confidence: 99%

Appropriate Use of Bifactor Analysis in Psychopathology Research: Appreciating Benefits and Limitations

Bornovalova

Choate

Fatimah

et al. 2020

Biological Psychiatry

145

129

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Co-occurrence of psychiatric disorders is welldocumented. Recent quantitative efforts have moved toward an understanding of this phenomenon, with the 'general psychopathology' or p-factor model emerging as the most prominent characterization. Over the past decade, bifactor model analysis has become increasingly popular as a statistical approach to describe common/shared and unique elements in psychopathology. However, recent work has highlighted potential problems with common approaches to evaluating and interpreting bifactor models. Here, we argue that, when properly applied and interpreted, bifactor models can be useful for answering some important questions in psychology and psychiatry research. We review problems with evaluating bifactor models based on global model fit statistics. We then describe more valid approaches to evaluating bifactor models and highlight three types of research questions for which bifactor models are wellsuited to answer. We also discuss the utility and limits of bifactor applications in genetic and neurobiological research. We close by comparing advantages and disadvantages of bifactor models to other analytic approaches and noting that no statistical model is a panacea to rectify limitations of the research design used to gather data. 1 Sometimes, group factors are called "specific factors." However, "specific factor" more correctly refers to an item's reliable (non-error) variance that is not shared with other items (5).

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Clinical implications of a general psychopathology factor: A cognitive–behavioral transdiagnostic group treatment for community mental health.

Cited by 19 publications

References 69 publications

Adolescents Who Self-Harm and Commit Violent Crime: Testing Early-Life Predictors of Dual Harm in a Longitudinal Cohort Study

Adolescents Who Self-Harm and Commit Violent Crime: Testing Early-Life Predictors of Dual Harm in a Longitudinal Cohort Study

All for One and One for All: Mental Disorders in One Dimension

Appropriate Use of Bifactor Analysis in Psychopathology Research: Appreciating Benefits and Limitations

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