期刊
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
卷 60, 期 7, 页码 902-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jaac.2020.08.440
关键词
anxiety disorders; outcome; p factor; children; adolescents
资金
- National Institute of Mental Health (NIMH) [U01 MH064089, U01 MH64092, U01 MH64003, U01 MH63747, U01 MH64088, U01 MH064003]
- US National Institutes of Health (NIH) [F31MH123038]
- NATIONAL INSTITUTE OF MENTAL HEALTH [F31MH123038] Funding Source: NIH RePORTER
This study examined the long-term outcomes of children and adolescents with anxiety disorders, finding that the p factor at baseline predicted more mental health disorders, poorer functioning, and greater impairment across all follow-up time points. The p factor predicted outcomes beyond previously identified predictors such as diagnostic comorbidity.
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: Children and adolescents enrolled in a randomized controlled treatment trial of pediatric anxiety were followed-up on average 6 years posttreatment and then annually for 4 years. Structural equation modeling was used to estimate p at baseline. Both 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 outcome, but not acute treatment outcome, suggesting that p may be uniquely associated with long-term outcome. Conclusion: Children and adolescents with anxiety disorders who present with a liability toward 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 to address this broad liability may enhance long-term outcome.
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