OBJECTIVE Recent research suggests that comorbidity in child and adolescent psychiatric symptoms can be summarized by a single latent dimension known as the p factor and more specific factors summarizing clusters of symptoms. This study investigated within- and between-person changes in general and specific psychopathology factors over a psychosocial intervention. METHOD A secondary analysis was conducted of the Systemic Therapy for At-Risk Teens study, a pragmatic randomized controlled trial that compared the effects of multisystemic therapy with those of management as usual for decreasing antisocial behavior in 684 adolescents (82% boys; 11-18 years old at baseline) over an 18-month period. The general p factor and specific antisocial, attention, anxiety, and mood factors were estimated from a symptom-level analysis of a set of narrowband symptom scales measured repeatedly during the study. General and specific psychopathology factors were assessed for reliability, validity, and within- and between-person change using a parallel process multilevel growth model. RESULTS A revised bi-factor model that included a general p factor and specific anxiety, mood, antisocial, and attention factors with cross-loadings fit the data best. Although the factor structure was multidimensional, the p factor accounted for most of the variance in total scores. The p factor, anxiety, and antisocial factors predicted within-person variation in external outcomes. Furthermore, the p factor and antisocial factors showed within-person declines, whereas anxiety showed within-person increases, over time. Despite individual variation in baseline factor scores, adolescents showed similar rates of change. CONCLUSION The bi-factor model is useful for teasing apart general and specific therapeutic changes that are conflated in standard analyses of symptom scores. CLINICAL TRIAL REGISTRATION INFORMATION START (Systemic Therapy for At Risk Teens): A National Randomised Controlled Trial to Evaluate Multisystemic Therapy in the UK Context; http://www.isrctn.com; ISRCTN77132214.

中文翻译：

---

心理社会干预中一般和特定心理病理因素的变化。

目的最近的研究表明，儿童和青少年精神病症状的合并症可以通过称为p因子的单个潜在维度来概括，而更具体的因素可以概括症状群。这项研究调查了在社会心理干预下一般和特定心理病理因素在人内和人际之间的变化。方法对风险青少年进行系统治疗的研究进行了二次分析，该研究是一项实用的随机对照试验，比较了多系统治疗与常规治疗对减少684名青少年（82％的男孩； 11-18岁）的反社会行为的影响在18个月内）。一般的p因子和特定的反社交，注意，焦虑，通过对一组窄带症状量表的症状水平分析，在研究过程中反复测量，评估情绪和情绪因素。使用并行过程多级增长模型评估一般和特定的心理病理因素的可靠性，有效性以及人与人之间和人与人之间的变化。结果修正后的双因素模型包括一般的p因素和特定的焦虑，情绪，反社会和注意因素，并且交叉负荷最适合该数据。尽管因子结构是多维的，但p因子占总得分的大部分差异。p因子，焦虑和反社会因素预测了人与人之间外部结局的差异。此外，随着时间的推移，p因子和反社会因素显示出人际关系下降，而焦虑则显示出人际关系上升。尽管基线因素评分存在个体差异，但青少年的变化率相似。结论双因子模型可用于区分症状评分的标准分析中混和的一般和特定治疗改变。临床试验注册信息开始（针对处于危险中的青少年的系统疗法）：一项评估英国背景下多系统疗法的国家随机对照试验；http://www.isrctn.com; ISRCTN77132214。一项国家随机对照试验，以评估英国背景下的多系统疗法；http://www.isrctn.com; ISRCTN77132214。一项国家随机对照试验，以评估英国背景下的多系统疗法；http://www.isrctn.com; ISRCTN77132214。