2 6 2 7Hierarchical dimensional systems of psychopathology promise more informative descriptions for 2 8 understanding risk and predicting outcome than traditional diagnostic systems, but it is unclear how many 2 9 major dimensions they should include. We delineated the hierarchy of childhood and adult 3 0 psychopathology and validated it against clinically-relevant measures. Participants were 4,524 9-and 10-3 1year-old children and their parents from the Adolescent Brain Cognitive Development (ABCD) study.
2Factor analyses on items from the Child Behavior Checklist and Adult Self-Report characterized a 3 3 dimensional hierarchy. We examined the familial aggregation of the psychopathology dimensions, and 3 4 the ability of different factor solutions to account for risks factors, social, educational and cognitive 3 5 functioning, and physical and mental health service utilization. A hierarchical structure with a general 3 6 psychopathology ('p') factor at the apex and five specific factors (internalizing, somatoform, detachment, 3 7 neurodevelopmental, and externalizing) emerged in children. Adult factors were similar, but externalizing 3 8 behaviors separated into disinhibited and antagonistic factors. Child and parent p-factors correlated highly 3 9 (r=.61, P<.001), and smaller but significant correlations emerged for convergent dimensions between 4 0 parents and children after controlling for p-factors (r=.10-20, P<.001). A model with childhood p-factor 4 1 alone explained mental health service utilization (R 2 =.13, P<.001), but up to five dimensions provided 4 2 incremental validity to account for developmental risk and current functioning (R 2 =.03-.20, P<.001). In 4 3 this first investigation comprehensively mapping the psychopathology hierarchy in children and adults, 4 4we delineated a hierarchy of higher-order dimensions associated with a range of clinically-relevant 4 5 validators. These findings hold important implications for psychiatric nosology and future research in this 4 6 sample. 4 7 4 8 3