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May 24, 2026Journal of Psychopathology and Clinical Science0 citations

The value of focusing on psychosocial dysfunction rather than categorical disorders: Commentary on Caspi et al. (2026).

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EAEmily AtkinsonJOJoshua R. OltmannsGSGregory C. Smith

Key Points

  • This commentary discusses the importance of focusing on psychosocial dysfunction as opposed to categorical disorders in understanding psychopathology.
  • Critiques the use of categorical diagnoses from the DSM in detecting common patterns of dysfunction.
  • Evaluates findings from Caspi et al. on psychopathology across generations.
  • Analyzes the impact of sample homogeneity on study generalizability.
  • Caspi et al. provided strong evidence for assortative mating and cross-generational transmission of psychiatric dysfunction.
  • The recognition of a general factor of psychopathology could enhance clinical understanding and practices.
  • Effects reported by Caspi et al. should be considered probabilistic rather than deterministic.

Abstract

Caspi et al. (see record 2026-80066-001) conducted an ambitious population-level investigation that provided robust support for assortative mating and the transfer of psychiatric dysfunction across generations. These findings are key to our understanding of the nature and clinical utility of the general factor of psychopathology "p" and support the possibility that "p" reflects a nonspecific index of psychosocial dysfunction, where common dysfunction associated with multiple specific behaviors drives psychiatric comorbidity and cross-generational transmissibility. In addition, we argue the following. First, categorical Diagnostic and Statistical Manual of Mental Disorders diagnoses hinder the recognition of these patterns, as they arbitrarily divide shared dysfunction into distinct disorders. Second, recognition of "p" can have direct clinical value. Third, though Caspi et al. report striking odds ratios, these effects should be interpreted as probabilistic, rather than deterministic, and should not be misinterpreted as inevitable outcomes. Fourth, while the population-level scope of this investigation is a major strength, the racial and ethnic homogeneity of the sample may limit global generalizability. The target article provides a critical contribution to psychological science and can facilitate significant improvements in our understanding of psychopathology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

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Cite This Study

Atkinson et al. (2026) studied this question.

synapsesocial.com/papers/6a12955d48a0ea16656717f6https://doi.org/10.1037/abn0001088
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