University of Toronto, The Centre for Addiction and Mental Health (CAMH), and The Hospital for Sick Children, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 2019 Aug;58(8):751-753. doi: 10.1016/j.jaac.2019.03.005. Epub 2019 Mar 7.
There exists widespread dissatisfaction with current categorical approaches to mental disorders, in particular the DSM, along with considerable quantitative empirical evidence that mental disorders are more accurately understood as continuously distributed dimensions of psychopathology. This has resulted in an increasing shift toward a dimensional organization of psychopathology in contemporary psychiatry. Factor-analytic modeling of symptom data derived from numerous measures of mental illness and psychopathology has provided consistent evidence for a transdiagnostic general factor model of psychopathology. In the most basic general factor model, classic diagnostic phenotypes, such as anxiety and depression, are thought to be reflected by a specific internalizing psychopathology dimension, whereas conduct and attention/hyperactivity disorders most often are reflected by a specific externalizing psychopathology dimension. In addition, a general psychopathology, or a "p" factor, reflects both the common variation among all symptoms of psychopathology, as well as low to high psychopathology severity, thus cutting across diverse mental disorder categories. This shared variation reflects the high rates of comorbidity commonly observed across most classic mental disorder categories.
目前，人们普遍对精神障碍的分类方法（尤其是 DSM）感到不满，同时也有大量定量实证证据表明，精神障碍更准确地被理解为心理病理学的连续分布维度。这导致了当代精神病学中精神病理学的维度组织的日益转变。从众多精神疾病和心理病理学测量中得出的症状数据的因子分析模型为心理病理学的跨诊断一般因素模型提供了一致的证据。在最基本的一般因素模型中，经典的诊断表型，如焦虑和抑郁，被认为反映了特定的内化心理病理学维度，而行为和注意力/多动障碍通常反映了特定的外化心理病理学维度。此外，一般心理病理学或“p”因素反映了心理病理学所有症状之间的共同变异，以及从低到高的心理病理学严重程度，因此跨越了不同的精神障碍类别。这种共同变异反映了在大多数经典精神障碍类别中常见的高共病率。
