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The p Factor Consistently Predicts Long-Term Psychiatric and Functional Outcomes in Anxiety-Disordered Youth

Cervin, Matti LU ; Norris, Lesley ; Ginsburg, Golda ; Gosch, Elizabeth ; Compton, Scott N. ; Piacentini, John ; Albano, Anne Marie ; Sakolsky, Dara ; Birmaher, Boris and Keeton, Courtney , et al. (2021) In Journal of the American Academy of Child and Adolescent Psychiatry 60(7). p.902-912
Abstract
Objective
Pediatric anxiety disorders can have a chronic course and are considered gateway disorders to adult psychopathology, but no consistent predictors of long-term outcome have been identified. A single latent symptom dimension that reflects features shared by all mental health disorders, the p factor, is thought to reflect mechanisms that cut across mental disorders. Whether p predicts outcome in youth with psychiatric disorders has not been examined. We tested whether the p factor predicted long-term psychiatric and functional outcomes in a large naturalistically followed-up cohort of anxiety-disordered youth.

Method
Youth enrolled in a randomized controlled treatment trial of pediatric anxiety during... (More)
Objective
Pediatric anxiety disorders can have a chronic course and are considered gateway disorders to adult psychopathology, but no consistent predictors of long-term outcome have been identified. A single latent symptom dimension that reflects features shared by all mental health disorders, the p factor, is thought to reflect mechanisms that cut across mental disorders. Whether p predicts outcome in youth with psychiatric disorders has not been examined. We tested whether the p factor predicted long-term psychiatric and functional outcomes in a large naturalistically followed-up cohort of anxiety-disordered youth.

Method
Youth enrolled in a randomized controlled treatment trial of pediatric anxiety during childhood/adolescence were followed-up on average six years posttreatment and then annually for four years. Structural equation modeling was used to estimate p at baseline. p and previously established predictors were modeled as predictors of long-term outcome.

Results
Higher levels of p at baseline were related to more mental health disorders, poorer functioning, and greater impairment across all measures at all follow-up time points. p predicted outcome above and beyond previously identified predictors, including diagnostic comorbidity at baseline. Post hoc analyses showed that p predicted long-term anxiety outcomes, but not acute treatment outcome, suggesting that p may be uniquely associated with long-term outcome.

Conclusion
Youth with anxiety disorders who present with a liability towards broad mental health problems may be at a higher risk for poor long-term outcome across mental health and functional domains. Efforts to assess and address this broad liability may enhance long-term outcome. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the American Academy of Child and Adolescent Psychiatry
volume
60
issue
7
pages
11 pages
publisher
Elsevier
external identifiers
  • pmid:32950650
  • scopus:85097868330
ISSN
0890-8567
DOI
10.1016/j.jaac.2020.08.440
language
English
LU publication?
yes
id
56866706-b1bb-4d3e-a8b4-57e4477bbad5
date added to LUP
2020-09-18 10:35:02
date last changed
2022-04-19 00:44:38
@article{56866706-b1bb-4d3e-a8b4-57e4477bbad5,
  abstract     = {{Objective<br/>Pediatric anxiety disorders can have a chronic course and are considered gateway disorders to adult psychopathology, but no consistent predictors of long-term outcome have been identified. A single latent symptom dimension that reflects features shared by all mental health disorders, the p factor, is thought to reflect mechanisms that cut across mental disorders. Whether p predicts outcome in youth with psychiatric disorders has not been examined. We tested whether the p factor predicted long-term psychiatric and functional outcomes in a large naturalistically followed-up cohort of anxiety-disordered youth.<br/><br/>Method<br/>Youth enrolled in a randomized controlled treatment trial of pediatric anxiety during childhood/adolescence were followed-up on average six years posttreatment and then annually for four years. Structural equation modeling was used to estimate p at baseline. p and previously established predictors were modeled as predictors of long-term outcome.<br/><br/>Results<br/>Higher levels of p at baseline were related to more mental health disorders, poorer functioning, and greater impairment across all measures at all follow-up time points. p predicted outcome above and beyond previously identified predictors, including diagnostic comorbidity at baseline. Post hoc analyses showed that p predicted long-term anxiety outcomes, but not acute treatment outcome, suggesting that p may be uniquely associated with long-term outcome.<br/><br/>Conclusion<br/>Youth with anxiety disorders who present with a liability towards broad mental health problems may be at a higher risk for poor long-term outcome across mental health and functional domains. Efforts to assess and address this broad liability may enhance long-term outcome.}},
  author       = {{Cervin, Matti and Norris, Lesley and Ginsburg, Golda and Gosch, Elizabeth and Compton, Scott N. and Piacentini, John and Albano, Anne Marie and Sakolsky, Dara and Birmaher, Boris and Keeton, Courtney and Storch, Eric A. and Kendall, Philip C.}},
  issn         = {{0890-8567}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{7}},
  pages        = {{902--912}},
  publisher    = {{Elsevier}},
  series       = {{Journal of the American Academy of Child and Adolescent Psychiatry}},
  title        = {{The p Factor Consistently Predicts Long-Term Psychiatric and Functional Outcomes in Anxiety-Disordered Youth}},
  url          = {{http://dx.doi.org/10.1016/j.jaac.2020.08.440}},
  doi          = {{10.1016/j.jaac.2020.08.440}},
  volume       = {{60}},
  year         = {{2021}},
}