Abramovitch Amitai, Short Tatiana, Schweiger Avraham
Department of Psychology, Texas State University, USA.
Department of Psychology, Texas State University, USA.
Clin Psychol Rev. 2021 Jun;86:102007. doi: 10.1016/j.cpr.2021.102007. Epub 2021 Mar 26.
Research into cognitive functions across psychological disorders suggests that cognitive deficiencies may be present across multiple disorders, potentially pointing to a transdiagnostic phenomenon. More recently, a single dimension model of psychopathology, the p factor, has been proposed, in which cognitive deficits are thought to be an intrinsic construct, assumed to be transdiagnostic. However, no systematic investigation to date tested this hypothesis. The aim of the present study was to systematically review meta-analyses to assess the hypothesis that the C factor (cognitive dysfunction) is transdiagnostic in psychopathology and review potential moderators that may account for such a phenomenon. We conducted a systematic review of meta-analyses examining cognitive function across all disorders for which data were available. Included meta-analyses (n = 82), comprising 97 clinical samples, yielded 1,055 effect sizes. Twelve major disorders/categories (e.g., bipolar disorder, substance use disorders) were included, comprising 29 distinct clinical entities (e.g., euthymic bipolar disorder; alcohol use disorder). Results show that all disorders reviewed are associated with underperformance across cognitive domains, supporting the hypothesis that the C factor (or cognitive dysfunction) is a transdiagnostic factor related to p. To examine moderators that may explain or contribute to c, we first consider important interpretative limitations of neuropsychological data in psychopathology. More crucially, we review oft-neglected motivational and emotional transdiagnostic constructs of p, as prominent contributing constructs to the C factor. These constructs are offered as a roadmap for future research examining these constructs related to p, that contribute, and may account for cognitive dysfunctions in psychopathology.
对各类心理障碍认知功能的研究表明，认知缺陷可能存在于多种障碍中，这可能指向一种跨诊断现象。最近，有人提出了一种心理病理学的单维度模型——p因子，其中认知缺陷被认为是一种内在结构，假定具有跨诊断性。然而，迄今为止尚无系统研究验证这一假设。本研究的目的是系统回顾荟萃分析，以评估C因子（认知功能障碍）在心理病理学中具有跨诊断性这一假设，并回顾可能解释这种现象的潜在调节因素。我们对所有有数据可用的障碍的认知功能进行了荟萃分析的系统回顾。纳入的荟萃分析（n = 82），包含97个临床样本，得出1055个效应量。纳入了12种主要障碍/类别（如双相情感障碍、物质使用障碍），包括29个不同的临床实体（如心境正常的双相情感障碍；酒精使用障碍）。结果表明，所有被回顾的障碍都与认知领域的表现不佳有关，支持了C因子（或认知功能障碍）是与p相关的跨诊断因素这一假设。为了研究可能解释或促成C因子的调节因素，我们首先考虑心理病理学中神经心理学数据的重要解释局限性。更关键的是，我们回顾了p中常被忽视的动机和情感跨诊断结构，它们是C因子的突出促成结构。这些结构为未来研究这些与p相关的结构提供了路线图，这些结构促成并可能解释心理病理学中的认知功能障碍。
