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Predictors of p factor scores in children with chronic physical illness
Mark A Ferro1, Christy K Y Chan1
1School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
Insights
Predictors of the p factor, representing mental illness liability in children with chronic physical illness, include child age, disability, parent psychopathology, and community factors. Female sex and immigrant parents were associated with lower liability.
Area of Science:
- Child and Adolescent Mental Health
- Chronic Physical Illness
- Psychopathology Research
Background:
- The p factor quantifies general liability for mental illness.
- A bi-factor model of the p factor has been validated in children with chronic physical illness.
Purpose of the Study:
- To identify predictors of the p factor in children with chronic physical illness.
- To explore multilevel factors influencing mental illness liability in this population.
Main Methods:
- Utilized data from the Multimorbidity in Children and Youth Across the Life-course study (n=263).
- Employed a parent-reported Emotional Behavioural Scales to develop a bi-factor model for the p factor.
- Used analysis of variance and multiple regression to identify predictors of p factor scores.
Main Results:
- No significant differences in p factor scores were found across different physical illnesses.
- Predictors of elevated p factor scores included older child age, higher disability, parent psychopathology and stress, and specific community characteristics (older age, lower labor force participation, higher racialized/newcomer populations).
- Lower p factor scores were associated with female sex and immigrant parents.
Conclusions:
- Psychopathology predictors in children with physical illness operate at multiple levels.
- Fixed characteristics can guide targeted screening, while modifiable factors offer intervention opportunities.
- Integrated physical-mental health services, with a family-centered approach, are recommended for upstream interventions.
Background:
The p factor represents the overall liability for the development of mental illness within individuals and we have previously validated a bi-factor model of the p factor in children with chronic physical illness.
Objective:
In this next phase, we modelled predictors of the p factor in this sample of children.
Methods:
Data come from the ongoing Multimorbidity in Children and Youth Across the Life-course study. Data from 263 children with a chronic physical illness aged 2-16 years and their parents were collected over 24 months. The parent-reported Emotional Behavioural Scales was used to develop a bi-factor model of the p factor. Subsequently, p factor scores were extracted from the model and standardized (Mean = 100, SD = 15). Analysis of variance compared p factor scores across different physical illnesses. Multiple regression was used to identify multilevel baseline predictors of p scores.
Results:
There was no significant difference in p scores across categories of physical illness (F = 0.44, p = 0.849). Factors predictive of elevated p scores were older child age (B = 0.44), higher level of disability (B = 1.03), elevated parent psychopathology (B = 0.22) and stress (B = 0.21), and living in communities with older age and lower labor force participation (B = 1.66) and higher concentrations of racialized/newcomer populations (B = 2.05). Lower p scores were associated with being female (B = -3.85) and having immigrant parents (B = -5.43).
Conclusion:
Factors predicting psychopathology, measured using p scores, in children with physical illness are multilevel. Fixed characteristics can inform targeted screening efforts, whereas modifiable characteristics are opportunities for upstream intervention in the context of family-centered integrated physical-mental health services.
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