Pettersson Erik, Larsson Henrik, D'Onofrio Brian M, Bölte Sven, Lichtenstein Paul
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
School of Medical Sciences, Örebro University, Örebro, Sweden.
World Psychiatry. 2020 Jun;19(2):206-213. doi: 10.1002/wps.20763.
In recent years, there has been a surge of interest in the general factor of psychopathology ("p"), which is intended to summarize broad psychiat-ric comorbidity into a single index. In this study, rather than attempting to validate this model using statistical techniques, we compared the magnitude (as indicated by the variance explained in the respective indicators) and the predictive validity of the "p" factor with those of the gen-eral factor of intelligence ("g"). To compare the magnitude, for "g", we analyzed fifteen Wechsler Adult Intelligence Scale subtests (N=1,200). For "p", we analyzed fourteen psychiatric diagnoses in Swedish adults (N=909,699), eight self- and parent-rated psychopathology scales in Swedish adolescents (N=2,069), and sixteen parent-rated psychopathology scales in Swedish children (N=14,589). To compare the predictive validity, we analyzed Swedish male military conscripts (N=414,595, mean age: 18.3 years) with measures on both "g" and "p" (derived from eight psychiatric diagnoses). We then examined their unique associations with three intelligence-related outcomes (annual income, highest education, and university entrance exam scores), and sixteen adverse outcomes (e.g., suicidal behavior, psychotropic medication prescription, and criminality) retrieved from registers (mean age at follow-up = 29.2 years). Results indicated that the magnitudes of "g" and "p" were very similar. Controlling for "p", "g" significantly predicted later education (standardized beta, β=0.38, SE=0.01) and university entrance exam scores (β=0.48, SE=0.01). Controlling for "g", "p" significantly predicted all adverse outcomes (mean β=0.32; range: 0.15 to 0.47). These findings support the notion that psychopathology indicators can be combined into a single score, similar to how intelligence subtests are combined into a general intelligence score. This "p" score might supplement specific diagnoses when formulating a management plan and predicting prognosis.
近年来,人们对精神病理学的一般因素(“p”)兴趣激增,该因素旨在将广泛的精神疾病共病归纳为一个单一指标。在本研究中,我们并未尝试使用统计技术来验证该模型,而是将“p”因素与智力一般因素(“g”)的大小(以各指标所解释的方差表示)和预测效度进行了比较。为比较大小,对于“g”,我们分析了15项韦氏成人智力量表子测验(N = 1200)。对于“p”,我们分析了瑞典成年人的14种精神疾病诊断(N = 909699)、瑞典青少年的8种自评和家长评定的精神病理学量表(N = 2069)以及瑞典儿童的16种家长评定的精神病理学量表(N = 14589)。为比较预测效度,我们分析了瑞典男性应征入伍者(N = 414595,平均年龄:18.3岁),他们同时接受了“g”和“p”的测量(来自8种精神疾病诊断)。然后,我们考察了它们与三种智力相关结果(年收入、最高学历和大学入学考试成绩)以及从登记处获取的16种不良结果(如自杀行为、精神药物处方和犯罪)之间的独特关联(随访时的平均年龄 = 29.2岁)。结果表明,“g”和“p”的大小非常相似。在控制“p”的情况下,“g”显著预测了后期教育(标准化β,β = 0.38,标准误 = 0.01)和大学入学考试成绩(β = 0.48,标准误 = 0.01)。在控制“g”的情况下,“p”显著预测了所有不良结果(平均β = 0.32;范围:0.15至0.47)。这些发现支持了这样一种观点,即精神病理学指标可以像智力子测验被组合成一般智力分数那样,被组合成一个单一分数。这个“p”分数在制定管理计划和预测预后时可能会补充具体诊断。