The Co-Occurrence of Externalizing and Internalizing Problems from the p Factor Perspective: A Literature Review

Ma Yuxin; Zhang Liang; Cai Qingyu; Liu Lin; Zhang Wenxin

doi:10.16719/j.cnki.1671-6981.20230610

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Journal of Psychological Science ›› 2023, Vol. 46 ›› Issue (6) : 1352-1359. DOI: 10.16719/j.cnki.1671-6981.20230610

Developmental & Educational Psychology

The Co-Occurrence of Externalizing and Internalizing Problems from the p Factor Perspective: A Literature Review

Ma Yuxin, Zhang Liang, Cai Qingyu, Liu Lin, Zhang Wenxin

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Abstract

The co-occurrence of externalizing and internalizing psychopathology problems is the norm rather than the exception. Understanding the externalizing-internalizing co-occurrence depends on theories of psychopathology structure. The splitting-oriented theory treats each internalizing and externalizing problems as relatively separated entity. This theoretical perspective leads to problems in the externalizing-internalizing co-occurrence research, the most problematic of which is that almost every psychopathology problem co-occurs with each other. Thus, it is difficult to ensure whether an observed co-occurrence represents an authentic functional connection between psychopathology problems, or if it is just a spurious relation derived from methodological fallacies.

The p factor theory breaks this logjam. As an innovative theory about the structure of psychopathology, it proposes that an unobserved propensity to psychopathology, the p factor, gives rise to all forms of psychopathology problems, thus leading to the co-occurring phenomenon. Additionally, there are also propensities specific to certain clusters of problems, which are the specific internalizing factor and externalizing factor. Compared to former psychopathology structure theories, the p factor provides a direct theoretical representation of the co-occurrence phenomenon. In terms of methodology, the bi-factor model serves as the statistical representation of the p factor theory. The bi-factor model is characterized by all indicators loading onto a general factor (g factor); meanwhile, certain clusters of indicators also load onto their specific factors (s factors) respectively.

In recent years, there has been an increasing number of empirical studies investigating the externalizing-internalizing co-occurrence from the perspective of p factor theory and utilizing the bi-factor paradigm. When comparing the bi-factor model with other competing models, researchers have consistently found that the bi-factor model best fits psychopathology data, providing strong support for the validity of the p factor theory in delineating psychopathology structure. By integrating predictors into the bi-factor model, researchers have identified important etiology factors. Specifically, the p factor has a solid genetic basis and is related with neurobiological characteristics. Additionally, there is a significant link between the p factor and the temperament of negative emotionality. Individuals with stronger negative emotionality tend to experience the co-occurrence between internalizing and externalizing problems. Contextual factors also contribute to the p factor. For example, adverse family factors, such as poverty, parental substance use, and maternal depression, can place children and adolescents at elevated risks of externalizing-internalizing co-occurrence. Harsh parenting could be a risk factor, while positive parenting practices may protect children from developing psychopathology. Studies on peer and social factors have also revealed that peer victimization and peer rejection play significant roles as etiology factors of the p factor, which in turn may contribute to the development of both externalizing and internalizing problems. Furthermore, by evaluating relations between the outcome variable and the p factor, researchers found that the p factor of children and adolescents correlated with a much wider range of negative outcomes in the future.

Future research should focus on improving the research design and statistical modeling when using the bi-factor paradigm to ensure the reliability and validity of the findings. For instance, employing a multi-informant design can be important and even necessary to prevent potential biases caused by the common-method issue. Additionally, given that general and specific psychopathology factors are theorized as orthogonal to each other, caution should be exercised in allowing correlations among these factors in bi-factor modeling. Furthermore, to enhance the validation of the p factor theory and to develop a comprehensive etiological framework of psychopathology, future research from the p factor perspective should aim to integrate with the perspective of developmental psychopathology. By incorporating developmental perspectives, researchers can gain a more holistic understanding of the development and expression of psychopathology over time.

Key words

psychopathology / externalizing and internalizing problems / co-occurrence / p factor / bi-factor model

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Ma Yuxin, Zhang Liang, Cai Qingyu, Liu Lin, Zhang Wenxin. The Co-Occurrence of Externalizing and Internalizing Problems from the p Factor Perspective: A Literature Review[J]. Journal of Psychological Science. 2023, 46(6): 1352-1359 https://doi.org/10.16719/j.cnki.1671-6981.20230610

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