Recent research suggests that comorbidity in child and adolescent psychiatric symptoms can be explained by a single general psychopathology (“p”) factor and more specific factors summarizing clusters of symptoms. This study investigated within- and between-person changes in general and specific psychopathology factors over a psychosocial intervention.
A secondary analysis was conducted of the Systemic Therapy for At-Risk Teens study, a pragmatic randomized controlled trial that compared the effects of multisystemic therapy with those of management as usual for decreasing antisocial behavior in 684 adolescents (82% boys; 11–18 years old at baseline) over an 18-month period. The general p factor and specific antisocial, attention, anxiety, and mood factors were estimated from a symptom-level analysis of a set of narrowband symptom scales measured repeatedly during the study. General and specific psychopathology factors were assessed for reliability, validity, and within- and between-person change using a parallel process multilevel growth model.
A revised bi-factor model that included a general p factor and specific anxiety, mood, antisocial, and attention factors with cross-loadings fit the data best. Although the factor structure was multidimensional, p accounted for most of the variance in total scores. The p, anxiety, and antisocial factors predicted within-person variation in external outcomes. Furthermore, the p and antisocial factors showed within-person declines, whereas anxiety showed within-person increases, over time. Despite individual variation in baseline factor scores, adolescents showed similar rates of change.
The bi-factor model is useful for teasing apart general and specific therapeutic changes that are conflated in standard analyses of symptom scores.
|Number of pages||11|
|Journal||Journal of the American Academy of Child and Adolescent Psychiatry|
|Early online date||14 Jan 2019|
|Publication status||Published - 1 Aug 2019|
- general psychopathology
- p factor