Configurations of common childhood psychosocial risk factors.
BACKGROUND
Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors.


METHODS
Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class structure was retested in a representative population sample of 1420 children aged 9 to 13. In each sample, the child and one parent were interviewed with the Child and Adolescent Psychiatric Assessment. Concurrent psychiatric status was used to validate class membership.


RESULTS
LCA identified five latent classes in both samples: two low risk classes; two moderate risk classes both involving family poverty configured with various other risk factors; and a high risk class characterized by family relational dysfunction and parental risk characteristics. Of the primary sample, 48.6% were categorized as low risk, 42.8% as moderate risk, and 8.6% as high risk. Moderate risk classes differed in their prediction of disruptive and emotional disorders depending on their specific risk factor configurations. High risk youth had the highest levels of both emotional and disruptive disorders. Combining our latent classes with a cumulative risk approach best accounted for the effects of risk factors on psychopathology in our primary sample.


CONCLUSIONS
Particular risk configurations have specific associations with psychiatric disorders. Configurational approaches are an important asset for large-scale epidemiological studies that integrate information about patterns of risk and disorders.
Copeland
William
W
Developmental Epidemiology Program, Duke University Medical Center, Durham, NC 27710, USA. william.copeland@duke.edu
Shanahan
Lilly
L
Costello
E Jane
EJ
Angold
Adrian
A
D000293:Adolescent; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000209:etiology / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D019964:Mood Disorders / Q000209:etiology / Q000523:psychology; D009657:North Carolina; D010290:Parents; D018570:Risk Assessment; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires