Editorial: Putting Practicality Into "p": Leveraging General Factor Models of Psychopathology in Clinical Intervention

Abstract

There exists widespread dissatisfaction with current categorical approaches to mental disorders, in particular the DSM,^1,2 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.³ 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,⁴ 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.