title: Characterising the latent structure and organisation of self-reported thoughts, feelings and behaviours in adolescents and young adults.
abstract: Little is known about the underlying relationships between self-reported mental health items measuring both positive and negative emotional and behavioural symptoms at the population level in young people. Improved measurement of the full range of mental well-being and mental illness may aid in understanding the aetiological substrates underlying the development of both mental wellness as well as specific psychiatric diagnoses. A general population sample aged 14 to 24 years completed self-report questionnaires on anxiety, depression, psychotic-like symptoms, obsessionality and well-being. Exploratory and confirmatory factor models for categorical data and latent profile analyses were used to evaluate the structure of both mental wellness and illness items. First order, second order and bifactor structures were evaluated on 118 self-reported items obtained from 2228 participants. A bifactor solution was the best fitting latent variable model with one general latent factor termed 'distress' and five 'distress independent' specific factors defined as self-confidence, antisocial behaviour, worry, aberrant thinking, and mood. Next, six distinct subgroups were derived from a person-centred latent profile analysis of the factor scores. Finally, concurrent validity was assessed using information on hazardous behaviours (alcohol use, substance misuse, self-harm) and treatment for mental ill health: both discriminated between the latent traits and latent profile subgroups. The findings suggest a complex, multidimensional mental health structure in the youth population rather than the previously assumed first or second order factor structure. Additionally, the analysis revealed a low hazardous behaviour/low mental illness risk subgroup not previously described. Population sub-groups show greater validity over single variable factors in revealing mental illness risks. In conclusion, our findings indicate that the structure of self reported mental health is multidimensional in nature and uniquely finds improved prediction to mental illness risk within person-centred subgroups derived from the multidimensional latent traits.
authors.affiliation: Department of Psychology, University of Bath, Bath, United Kingdom.
authors.forename: Michelle C
authors.identifier: http://orcid.org/0000-0003-4015-7435
authors.initials: MC
authors.lastname: St Clair
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Sharon
authors.initials: S
authors.lastname: Neufeld
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.affiliation: Division of Psychology and Language Sciences, University College London, London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Fonagy
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Edward T
authors.initials: ET
authors.lastname: Bullmore
authors.affiliation: Max Planck UCL Centre for Computational Psychiatry and Ageing, University College London, London, United Kingdom.
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Dolan
authors.affiliation: Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Moutoussis
authors.affiliation: Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom.
authors.forename: Umar
authors.initials: U
authors.lastname: Toseeb
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Goodyer
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004644:Emotions; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D009770:Obsessive Behavior / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D057566:Self Report; D011795:Surveys and Questionnaires; D013850:Thinking; D055815:Young Adult