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Abstract
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Aims: 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. In this next phase, we modelled predictors of the p factor in this longitudinal 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 to 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, Standard Deviation = 15). Analysis of variance was used to compare p factor scores across different physical illnesses. Multiple regression was used to identify multilevel baseline predictors of the p factor. Results and Conclusions: Analysis of variance suggested no significant difference in p factor scores across categories of physical illness (F = 0.44, p = 0.849). Factors predictive of elevated p factor scores were child age (B = 0.44, p = 0.033), level of disability (B = 1.03, p < 0.001), parent psychopathology (B = 0.22, p = 0.005) and stress (B = 0.21, p = 0.0443), and community characteristics related to age and labor force (B = 1.66, p = 0.014) and racialized/newcomer populations (B = 2.05, p = 0.009). Lower p factor scores were associated with being female (B = -3.85, p = 0.015) and having immigrant parents (B = -5.43, p = 0.021). Overall predisposition for psychopathology, as characterized by the p factor, is consistent across children with different physical illnesses and factors predicting elevated psychopathology in this vulnerable population are multilevel. Replication of these findings using child-reported measures and in different populations of children and youth is warranted. Multisectoral collaboration is needed to address the multilevel determinants of physical-mental comorbidity with broad upstream prevention efforts and individualized care plans that implement transdiagnostic approaches for children.
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