P-factor in children Flashcards
Dunedin Study & Comorbidit
(1) Comorbidity is the rule, not the exception.
(2) Also very high associations between diff forms of psychopathology. Lot of overlap
Dunedin Study & Risk Factors
(1) Risk Factors are largely nonspecific
=> Multifinality: e.g. childhood maltreatment is a risk factor for almost every form of disorder (same for low SES)
=> Some factors increase risk for specific dimensions of psychopathology AND general psychopathology
Data from Caspi et al., 24 – nonspecific risk X types of disorders, Results?
(1) Each risk factor has basically equal association with externalizing, internalizing, and thought disorders.
Petterson et al., 2016:
- Study of EVERY adults in Sweden: N=3.4 million
- National registry data
- Specific genes vs diagnosis
Results?
(1) Genetic risk is specific AND general
-> Even genes don’t provide a lot of risk for specific disorders vs others.
=> Heredity of psychopathology and parental psychopathology = risk factor (but BROADER risk not specific)
… continuity is common in psychopathology
Heterotypic
Different construals of psychopathology
(1) Correlated factors approach
(2) Single Factor Model
(3) Hierarchical model (HiTOP model)
(4) Bifactor model
Correlated factors approach
- See picture
- Orange box (class of disorders) related to blue boxes (specific disorder)
- Orange boxes related to each others
Single Factor Model
- Green box (General risk of psychopathology) explain all subtypes
- P explains all disorders, no subtypes
Hierarchical model (HiTOP model)
Green -> Orange -> Blue
Bifactor model
Green -> blue (General psychopathology directly causes disorders)
Orange -> blue (Specific factors cause specific disorders)
(double arrows see picture)
-> This is the model Caspi and Moffet’s research supports
Meta-analytic evidence for P? (Ringwald et al., 2023)
- 35 studies, 120k participants, 23 DSM diagnoses
- Good evidences
- What they found: YES
Which model of P is right?
-> Unclear and research shows it doesn’t rly matter!!
=> Scores of p correlated at .95+ regardless of how you model it
What is P?
(1) P is empirically based (= a result of statistical modelling, not directly observed). Therefore, we interpret what it means
Different theories of P (4)
(1) Dispositional/trait level negative emotionality
(2) Emotion regulation difficulties/impulsive responsitivity to emotion
(3) Low cognitive functioning -Not just intelligence - attention & concentration, processing speed, higher level thinking
(4) Thought dysfunction/aberrant thought processes
-> Thought disorder, we think it’s very extreme (e.g. schizophrenia)
-> But research find smaller/more subtle levels of thought dysfunction are present in a lot of diff disorders
Challenges to P-factor (4)
(1) Symptom networks
(2) P might not be a CAUSE of psychopathology, we might be assessing a COMMON RESULT of many forms of psychopathology (P=impairment?)
(3) Autism doesn’t fit in that
(4) Different studies find very different strengths of correlations between a disorder and P (e.g. panic: from 0 to 0.80)
Challenges to P-factor: Symptom Networks
=> Symptoms across different disorders cause each other
-> There is no underlying p or risk for general psychopathology that explains everything
=> Implication: intervening on central symptom (circled) leads to domino effect of symptom reduction in related symptoms
Challenges to P-factor: P=impairment?
Maybe P factor isn’t an underlying cause, maybe it’s just the result of BEING HIGH in a lots of diff forms of psychopathology (flipped arrows)
Challenges to P-factor: Autism (3)
ASD have very high HOMOTYPIC continuity.
=> P-factor theory does not mesh well with our understanding of ASD
(1) -> High homotypic continuity - it endures over time
(2) -> ASD doesn’t ‘morph’ to other disorders
(3) -> Genetic risk for autism not associated with p (characterized by dysregulation) in 36 months old
Is P factor incompatible with DSM?
P-factor is NOT incompatible with DSM, just says disorders have similar underlying cause
=> Idea of P doesn’t mean categories don’t exist/aren’t important, it means these categories have common cause
Long-term implications for aging: promoting healthy childhood development
P factor strongly associated with faster biological aging (cells maturing at a quicker rate)
Implications for Psychotherapy
-> If psychopathology has a common cause, can we have a common treatment?
=> Transdiagnostic Treatment
Transdiagnostic Treatments
- Unified protocol for transdiagnostic treatment of emotional disorders
Transdiagnostic Treatments: PROS (4)
- Can be trained with ‘just’ this and help with GAS, SAD, SD, DMDD…
- Effective
- Cost and time efficient
- Meta analysis 19 RCTs 13 uncontrolled pre-post trials: Moderate to large effects = effects across anxiety and depression!
=> Most evidence for internalizing symptoms
Modular Treatment
Match-ADTC – modular tx for
=> ADTC = Anxiety, depression, trauma, conduct problems
=> Pick a starting point based on presenting problems, then follow the flowchart
