Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Ontario, Canada; Hospital for Sick Children, Toronto, Ontario, Canada.
Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 2018 Jun;57(6):384-396. doi: 10.1016/j.jaac.2018.03.010. Epub 2018 Apr 10.
This study examined cross-informant evidence for a general factor of psychopathology ("P") and a narrower, clinically oriented dysregulation general factor based on the Dysregulation Profile ("DP") in a large clinical sample of children and adolescents. We also compared the magnitude of P and DP general factor associations with self-harm and suicidal ideation as an indicator of criterion validity.
Itemwise data from the Child Behavior Checklist (N = 2,934; 4-18 years of age) were analyzed using confirmatory bifactor modeling and replicated in a supplementary analysis using Youth Self Report data (N = 2,395).
General P and DP bifactor models fit the data better than single-factor and correlated factor models. Cross-informant criterion analyses on a subset of youth (n = 1,552) suggested that whether modeled as latent P or DP, associations with a brief composite index of self-harm and suicidal ideation are essentially of the same magnitude.
Our findings provide novel, large-sample support for the existence of general factors of psychopathology and dysregulation in clinically referred children and adolescents using a standardized rating system of psychopathology symptoms. Moreover, our results provide preliminary evidence that general psychopathology and dysregulation factors are clinically meaningful constructs. In addition, our findings raise the possibility that the DP general factor may serve as an efficient proxy for the general psychopathology factor in future clinical applications. Further efforts are necessary to understand the core empirical meaning of the P factor and to determine how it can be applied to clinical assessment and intervention.
本研究在一个大型临床儿童和青少年样本中，考察了基于失调特征（DP）的精神病症状（“P”）和更窄的、临床导向的失调一般因素的跨报告者证据，并比较了 P 和 DP 一般因素与自我伤害和自杀意念的关联程度，以此作为效标效度的指标。
使用验证性双因素模型分析了来自儿童行为检查表（N=2934；4-18 岁）的项目数据，并在使用青少年自我报告数据（N=2395）的补充分析中进行了复制。
与单因素和相关因素模型相比，一般 P 和 DP 双因素模型更适合数据。在对一部分青少年（n=1552）进行的跨报告者效标分析中，无论以潜在 P 还是 DP 形式建模，与自我伤害和自杀意念的简短综合指标的关联程度基本相同。
我们的研究结果为使用标准化精神病症状评定系统，为临床转诊的儿童和青少年的精神病症状和失调的一般因素的存在提供了新的、大样本支持。此外，我们的结果提供了初步证据，表明一般精神病和失调因素是具有临床意义的构念。此外，我们的研究结果表明，DP 一般因素可能在未来的临床应用中作为一般精神病因素的有效替代。需要进一步努力来理解 P 因素的核心实证意义，并确定如何将其应用于临床评估和干预。
