Empirically derived patterns of psychiatric symptoms in youth: A latent profile analysis.
By conceptualizing domains of behavior transdiagnostically, the National Institute of Mental Health Research Domain Criteria (NIMH RDoC) initiative facilitates new ways of studying psychiatric symptoms. In this study, latent profile analysis (LPA) was used to empirically derive classes or patterns of psychiatric symptoms in youth that transect traditional nosologic boundaries.



Data were drawn from 509 children and adolescents (ages 7-18 years; mean age =12.9 years; 54% male) who were evaluated in the NIMH Emotion and Development Branch and were heterogeneous with respect to presenting diagnoses and symptoms. Youth and/or their parents completed measures of several core symptom dimensions: irritability, anxiety, depression, and attention deficit hyperactivity disorder (ADHD). LPA was used to parse response patterns into distinct classes, based on the levels of, and interrelations among, scores on the different measures.



Five classes emerged: low levels of symptomatology (52% of sample); anxiety and mild depressive symptoms (17%); parent-reported irritability and ADHD (16%); irritability and mixed comorbid symptoms (10%); and high levels of irritability, anxiety, depression, and ADHD (5%). Importantly, these latent classes cut across informants and the clinical conditions for which youth were initially evaluated. Further, the classes characterized by irritability exhibited the poorest overall functioning.



These data were cross-sectional. Examination of external validators, including neurobiological correlates and symptom course, is warranted.



Results inform our understanding of the structure of psychiatric symptoms in youth and suggest new ways to operationalize psychopathology and examine it in relation to neurobiology.
Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA. Electronic address: kircanskik@mail.nih.gov.
Katharina
K
Kircanski
Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Susan
S
Zhang
Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Argyris
A
Stringaris
Department of Psychology, San Diego State University, University of California, San Diego, USA; Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, USA.
Jillian Lee
JL
Wiggins
Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Kenneth E
KE
Towbin
Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Daniel S
DS
Pine
Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Ellen
E
Leibenluft
Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
Melissa A
MA
Brotman
D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D010290:Parents; D011599:Psychopathology
Children; Comorbidity; Latent profile analysis; Symptoms; Transdiagnostic
J Am Acad Child Adolesc Psychiatry. 2016 Feb;55(2):93-8
26802775
Bipolar Disord. 2013 Sep;15(6):669-79
23799945
J Abnorm Psychol. 2015 Nov;124(4):1079-91
26301974
J Am Acad Child Adolesc Psychiatry. 1999 Oct;38(10):1230-6
10517055
Biol Psychiatry. 2006 Nov 1;60(9):991-7
17056393
J Am Acad Child Adolesc Psychiatry. 2013 Dec;52(12):1304-13
24290463
JAMA Psychiatry. 2014 Sep;71(9):1015-24
25006969
Am J Psychiatry. 2012 Jan;169(1):47-54
22193524
J Abnorm Child Psychol. 2008 Feb;36(2):187-206
17912624
J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):841-850.e2
23880494
J Am Acad Child Adolesc Psychiatry. 2016 Jul;55(7):556-70
27343883
Psychophysiology. 2016 Mar;53(3):351-4
26877125
Am J Psychiatry. 2013 Feb;170(2):173-9
23377638
Depress Anxiety. 2015 May;32(5):364-72
25504765
Psychiatry Res. 2010 Aug 15;178(3):550-5
20510462
Biol Psychiatry. 2006 Nov 1;60(9):903-11
16650832
J Child Psychol Psychiatry. 2009 Oct;50(10):1291-300
19486226
J Abnorm Psychol. 2010 Nov;119(4):631-9
20939653
J Child Psychol Psychiatry. 1999 Nov;40(8):1273-82
10604405
J Am Acad Child Adolesc Psychiatry. 1994 Oct;33(8):1158-64
7982866
J Am Acad Child Adolesc Psychiatry. 2015 May;54(5):377-84
25901774
Arch Gen Psychiatry. 1983 Nov;40(11):1228-31
6639293
J Abnorm Psychol. 2004 Aug;113(3):358-85
15311983
Child Adolesc Psychiatr Clin N Am. 2012 Jul;21(3):501-25
22800991
J Child Psychol Psychiatry. 2001 Oct;42(7):933-42
11693588
Am J Psychiatry. 2016 Jul 1;173(7):722-30
26892942
Arch Gen Psychiatry. 2003 Aug;60(8):837-44
12912767
J Am Acad Child Adolesc Psychiatry. 1997 Jul;36(7):980-8
9204677
Biol Psychiatry. 2005 Oct 1;58(7):562-8
16239161
Depress Anxiety. 2014 Jul;31(7):559-65
23798350
Psychol Bull. 2005 Jul;131(4):483-509
16060799
J Anxiety Disord. 2016 Jan;37:21-9
26590429
Compr Psychiatry. 2012 May;53(4):323-32
21757192
Am J Psychiatry. 2011 Feb;168(2):129-42
21123313
Depress Anxiety. 2014 Jul;31(7):566-73
23818321
Psychol Med. 2010 Sep;40(9):1453-66
19939326
J Abnorm Psychol. 2014 Nov;123(4):841-51
25314267
J Am Acad Child Adolesc Psychiatry. 2013 Apr;52(4):389-400.e1
23582870
Compr Psychiatry. 2011 Sep-Oct;52(5):527-35
21111407
Am J Psychiatry. 2010 Jul;167(7):748-51
20595427
Biol Psychiatry. 2014 Sep 1;76(5):350-3
25103538
Br J Psychol. 2010 Aug;101(Pt 3):383-99
19321035
Soc Cogn Affect Neurosci. 2016 Jan;11(1):78-88
26137973
Am J Psychiatry. 2015 Jul;172(7):603-5
26130199
Psychiatry Res. 2015 Feb 28;231(2):120-5
25544024
J Am Acad Child Adolesc Psychiatry. 2015 Aug;54(8):635-42
26210332
J Child Psychol Psychiatry. 2012 Nov;53(11):1109-17
22574736
Am J Psychiatry. 2003 Mar;160(3):430-7
12611821
J Am Acad Child Adolesc Psychiatry. 2016 Jan;55(1):54-61
26703910
Psychol Med. 2014 Sep;44(12):2603-15
24468022
J Abnorm Child Psychol. 1986 Mar;14(1):25-39
3950219