title: Empirically derived subtypes of serious emotional disturbance in a large adolescent sample.
abstract: OBJECTIVE
  The heterogeneity of serious emotional disturbance has been thoroughly documented among adolescents with nationally representative data derived from structured interviews, although use of these interviews may not be feasible within the context of brief and self-administered school surveys. This study seeks to identify distinct subtypes of serious emotional disturbance in a large school-based sample.
  
  
  METHODS
  A total of 108,736 students fully completed the K6 scale that was included on the 2012 Kentucky Incentives for Prevention Survey. Latent class analysis was used to derive subtypes of serious emotional disturbance among students receiving a positive screen (n = 15,147). To determine significant predictors of class membership, adjusted rate ratios and 95 % confidence intervals were calculated using multinomial logistic regression.
  
  
  RESULTS
  A four-class model was the most parsimonious, with four distinct subtypes emerging that varied by both symptom type and severity: comorbid moderate severity, comorbid high severity, anxious moderate severity, and depressed high severity. Age, gender, race/ethnicity, family structure, substance use, antisocial behavior, role impairments, and peer victimization were significant predictors of class membership, although the magnitude of these effects was stronger for the two high severity groups.
  
  
  CONCLUSIONS
  Our results suggest heterogeneity of serious emotional disturbance by both symptom type and severity. Prevention programs may benefit by shifting focus from specific disorders to the core features of serious emotional disturbance, including psychological distress, high comorbidity, and role impairments.
authors: Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, USA, npeiper@gmail.com.
authors: Nicholas
authors: N
authors: Peiper
authors: Richard
authors: R
authors: Clayton
authors: Richard
authors: R
authors: Wilson
authors: Robert
authors: R
authors: Illback
authors: Elizabeth
authors: E
authors: O'Brien
authors: Richard
authors: R
authors: Kerber
authors: Richard
authors: R
authors: Baumgartner
authors: Carlton
authors: C
authors: Hornung
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D000987:Antisocial Personality Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D058445:Bullying; D002648:Child; D015897:Comorbidity; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D012574:Schools; D012720:Severity of Illness Index; D013334:Students / Q000523:psychology*; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires
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