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All for One and One for All: Mental Disorders in One Dimension.

Publication ,  Journal Article
Caspi, A; Moffitt, TE
Published in: The American journal of psychiatry
September 2018

In both child and adult psychiatry, empirical evidence has now accrued to suggest that a single dimension is able to measure a person's liability to mental disorder, comorbidity among disorders, persistence of disorders over time, and severity of symptoms. This single dimension of general psychopathology has been termed "p," because it conceptually parallels a dimension already familiar to behavioral scientists and clinicians: the "g" factor of general intelligence. As the g dimension reflects low to high mental ability, the p dimension represents low to high psychopathology severity, with thought disorder at the extreme. The dimension of p unites all disorders. It influences present/absent status on hundreds of psychiatric symptoms, which modern nosological systems typically aggregate into dozens of distinct diagnoses, which in turn aggregate into three overarching domains, namely, the externalizing, internalizing, and psychotic experience domains, which finally aggregate into one dimension of psychopathology from low to high: p. Studies show that the higher a person scores on p, the worse that person fares on measures of family history of psychiatric illness, brain function, childhood developmental history, and adult life impairment. A dimension of p may help account for ubiquitous nonspecificity in psychiatry: multiple disorders share the same risk factors and biomarkers and often respond to the same therapies. Here, the authors summarize the history of the unidimensional idea, review modern research into p, demystify statistical models, articulate some implications of p for prevention and clinical practice, and outline a transdiagnostic research agenda. [AJP AT 175: Remembering Our Past As We Envision Our Future October 1910: A Study of Association in Insanity Grace Helen Kent and A.J. Rosanoff: "No sharp distinction can be drawn between mental health and mental disease; a large collection of material shows a gradual and not an abrupt transition from the normal state to pathological states."(Am J Psychiatry 1910; 67(2):317-390 )].

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Published In

The American journal of psychiatry

DOI

EISSN

1535-7228

ISSN

0002-953X

Publication Date

September 2018

Volume

175

Issue

9

Start / End Page

831 / 844

Related Subject Headings

  • Psychopathology
  • Psychiatry
  • Models, Psychological
  • Mental Disorders
  • Humans
  • 5203 Clinical and health psychology
  • 3202 Clinical sciences
  • 17 Psychology and Cognitive Sciences
  • 11 Medical and Health Sciences
 

Citation

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ICMJE
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Caspi, A., & Moffitt, T. E. (2018). All for One and One for All: Mental Disorders in One Dimension. The American Journal of Psychiatry, 175(9), 831–844. https://doi.org/10.1176/appi.ajp.2018.17121383
Caspi, Avshalom, and Terrie E. Moffitt. “All for One and One for All: Mental Disorders in One Dimension.The American Journal of Psychiatry 175, no. 9 (September 2018): 831–44. https://doi.org/10.1176/appi.ajp.2018.17121383.
Caspi A, Moffitt TE. All for One and One for All: Mental Disorders in One Dimension. The American journal of psychiatry. 2018 Sep;175(9):831–44.
Caspi, Avshalom, and Terrie E. Moffitt. “All for One and One for All: Mental Disorders in One Dimension.The American Journal of Psychiatry, vol. 175, no. 9, Sept. 2018, pp. 831–44. Epmc, doi:10.1176/appi.ajp.2018.17121383.
Caspi A, Moffitt TE. All for One and One for All: Mental Disorders in One Dimension. The American journal of psychiatry. 2018 Sep;175(9):831–844.
Journal cover image

Published In

The American journal of psychiatry

DOI

EISSN

1535-7228

ISSN

0002-953X

Publication Date

September 2018

Volume

175

Issue

9

Start / End Page

831 / 844

Related Subject Headings

  • Psychopathology
  • Psychiatry
  • Models, Psychological
  • Mental Disorders
  • Humans
  • 5203 Clinical and health psychology
  • 3202 Clinical sciences
  • 17 Psychology and Cognitive Sciences
  • 11 Medical and Health Sciences