@article{bc6356d6e8c8488d8d392e7c6d11f32e,
title = "The p Factor Consistently Predicts Long-Term Psychiatric and Functional Outcomes in Anxiety-Disordered Youth",
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: 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.",
keywords = "adolescents, anxiety disorders, children, outcome, p factor",
author = "Matti Cervin and Norris, {Lesley A.} and Golda Ginsburg and Gosch, {Elizabeth A.} and Compton, {Scott N.} and John Piacentini and Albano, {Anne Marie} and Dara Sakolsky and Boris Birmaher and Courtney Keeton and Storch, {Eric A.} and Kendall, {Philip C.}",
note = "Funding Information: The Child and Adolescent Anxiety Multimodal Study (CAMS) and the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS) were supported by grants from the National Institute of Mental Health (NIMH; U01 MH064089 to Dr. Walkup; U01 MH64092 to Dr. Albano; U01 MH64003 to Dr. Birmaher; U01 MH63747 to Dr. Kendall; U01 MH64088 to Dr. Piacentini; and U01 MH064003 to Dr. Compton). Funding for this study was provided from the US National Institutes of Health (NIH) awarded to Ms. Norris [F31MH123038]. Views expressed within this article represent those of the authors and are not intended to represent the position of NIMH, NIH, or the US Department of Health and Human Services. Funding Information: Disclosure: Dr. Cervin has received research support from Region Sk{\aa}ne, Lions Sk{\aa}ne, Stiftelsen Lindhaga, and Bror Gadelius Minnesfond. Dr. Ginsburg has received funding from NIMH and the US Department of Education and has served as a paid consultant for Syneos Health. Dr. Compton has received research support from NIH and the NC GlaxoSmithKline Foundation. He has consulted for Mursion, Inc., Luminopia, Inc., and Shire. He has received honoraria from the Journal of Consulting and Clinical Psychology, the Nordic Long-Term OCD Treatment Study Research Group, and the Centre for Child and Adolescent Mental Health, Eastern and Southern Norway. He has served on the scientific advisory board of the Tourette Association of America (TAA), the Anxiety and Depression Association of America (ADAA), and Mursion, Inc. He has given expert testimony for Duke University. Dr. Piacentini has received research support from NIMH, the TLC Foundation for BFRBs, and Pfizer Pharmaceuticals ; book royalties from Guilford Press and Oxford University Press; and speaking honoraria and travel expenses from the International OCD Foundation and TAA. Dr. Albano has received grant support from NIMH and Duke University; royalties from Oxford University Press and Lynn Sonberg Books; and honoraria from the American Psychological Association (APA) and Brackett Global. Dr. Sakolsky has received funding from NIMH. She has received an honorarium from Northwell Health for a child and adolescent lecture at Zucker Hillside Hospital in 2018 and has served as an editorial board member of Child and Adolescent Psychopharmacology News. Dr. Birmaher has received research funding from NIMH and royalties for publications from UpToDate, APA, and Random House. Dr. Storch has consulted for Levo Therapeutics. He has received grant funding from the Greater Houston Community Foundation , the Red Cross, Rebuild Texas, NIH, and the Texas Higher Education Coordinating Board. He has received book royalties from Springer, Elsevier, Wiley, APA, and Lawrence Erlbaum and honorarium for training from the International OCD Foundation. Dr. Kendall has received author royalties from the sales of treatment materials (Guilford, Oxford University Press, and Workbook Publishing); his spouse has a financial interest in and is affiliated with Workbook Publishing. Drs. Gosch and Keeton and Ms. Norris have reported no biomedical financial interests or potential conflicts of interest. ",
year = "2020",
doi = "10.1016/j.jaac.2020.08.440",
language = "English (US)",
journal = "Journal of the American Academy of Child and Adolescent Psychiatry",
issn = "0890-8567",
publisher = "Elsevier Limited",
}