Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA.
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
Res Child Adolesc Psychopathol. 2024 Nov;52(11):1753-1764. doi: 10.1007/s10802-024-01223-8. Epub 2024 Jun 13.
Accumulating evidence supports the presence of a general psychopathology dimension, the p factor ('p'). Despite growing interest in the p factor, questions remain about how p is assessed. Although multi-informant assessment of psychopathology is commonplace in clinical research and practice with children and adolescents, almost no research has taken a multi-informant approach to studying youth p or has examined the degree of concordance between parent and youth reports. Further, estimating p requires assessment of a large number of symptoms, resulting in high reporter burden that may not be feasible in many clinical and research settings. In the present study, we used bifactor multidimensional item response theory models to estimate parent- and adolescent-reported p in a large community sample of youth (11-17 years) and parents (N = 5,060 dyads). We examined agreement between parent and youth p scores and associations with assessor-rated youth global functioning. We also applied computerized adaptive testing (CAT) simulations to parent and youth reports to determine whether adaptive testing substantially alters agreement on p or associations with youth global functioning. Parent-youth agreement on p was moderate (r =.44) and both reports were negatively associated with youth global functioning. Notably, 7 out of 10 of the highest loading items were common across reporters. CAT reduced the average number of items administered by 57%. Agreement between CAT-derived p scores was similar to the full form (r =.40) and CAT scores were negatively correlated with youth functioning. These novel results highlight the promise and potential clinical utility of a multi-informant p factor approach.
越来越多的证据支持一般精神病理学维度(p 因子)的存在。尽管人们对 p 因子越来越感兴趣,但仍有一些问题需要解决,例如如何评估 p 因子。尽管在儿童和青少年的临床研究和实践中,多来源评估精神病理学是很常见的,但几乎没有研究采用多来源方法来研究青少年 p 因子,也没有研究父母和青少年报告之间的一致性程度。此外,估计 p 因子需要评估大量症状,这会导致报告者负担过重,在许多临床和研究环境中可能不可行。在本研究中,我们使用双因子多维项目反应理论模型来估计大量社区青少年(11-17 岁)及其父母(n=5060 对)的父母和青少年报告的 p 因子。我们考察了父母和青少年 p 因子得分之间的一致性,并与评估者评定的青少年整体功能相关联。我们还对父母和青少年报告进行了计算机化自适应测试(CAT)模拟,以确定自适应测试是否会显著改变 p 因子的一致性或与青少年整体功能的相关性。父母和青少年在 p 因子上的一致性适中(r=0.44),且两者均与青少年整体功能呈负相关。值得注意的是,10 个最高负荷项目中有 7 个在报告者之间是共有的。CAT 减少了 57%的平均施测项目数。CAT 衍生的 p 因子得分之间的一致性与完整形式相似(r=0.40),且 CAT 得分与青少年功能呈负相关。这些新的结果突出了多来源 p 因子方法的前景和潜在临床应用价值。