Latent class analysis (LCA) is a statistical procedure used to identify qualitatively different subgroups within populations who often share certain outward characteristics. The assumption underlying LCA is that membership in unobserved groups (or classes) can be explained by patterns of scores across survey questions, assessment indicators, or scales. The application of LCA is an active area of research and continues to evolve. As more researchers begin to apply the approach, detailed information on key considerations in conducting LCA is needed. In the present article, we describe LCA, review key elements to consider when conducting LCA, and provide an example of its application.

Objective Little is known about the patterns among individuals in the long-term course of suicidal thoughts and behaviors (STBs). The objective of this study was to identify developmental trajectories of STBs from adolescence through young adulthood, as well as risk and protective covariates, and nonsuicidal outcomes associated with these trajectories. Method 180 adolescents (ages 12–18 at recruitment) were repeatedly assessed over an average of 13.6 years (2,273 assessments) since their psychiatric hospitalization. Trajectories were based on ratings of STBs at each assessment. Covariates included psychiatric risk factors (proportion of time in episodes of psychiatric disorders, hopelessness, trait anxiety, impulsivity, and aggression in adulthood, sexual and physical abuse, parental history of suicidal behavior), protective factors (survival and coping beliefs, social support in adulthood, parenthood), and nonsuicidal outcomes (social adjustment and functional impairment in adulthood, school drop-out, incarcerations). Results Using a Bayesian group-based trajectory model, four trajectories of STBs were identified: (1) an Increasing Risk class (11%), (2) a Highest Overall Risk class (12%), (3) a Decreasing Risk class (33%), and (4) a Low Risk class (44%). The four classes were associated with distinct patterns of correlates in risk and protective factors and nonsuicidal outcomes. Conclusion Adolescents and young adults have heterogeneous developmental trajectories of STBs. These trajectories and their covariates may inform strategies for predicting STBs and targeting interventions for individuals at risk for suicidal behavior.

Objectives This study was designed to examine escalation in repeat suicide attempts from adolescence through adulthood, as predicted by sensitization models (and reflected in increasing intent and lethality with repeat attempts, decreasing amount of time between attempts, and decreasing stress to trigger attempts) Method In a prospective study of 180 adolescents followed through adulthood after a psychiatric hospitalization, suicide attempts and antecedent life events were repeatedly assessed (M = 12.6 assessments, SD = 5.1) over an average of 13 years, 6 months (SD = 4 years, 5 months). Multivariate logistic, multiple linear, and negative binomial regression models were used to examine patterns over time. Results After age 17-18, the majority of suicide attempts were repeat attempts (i.e., made by individuals with prior suicidal behavior). Intent increased both with increasing age, and with number of prior attempts. Medical lethality increased as a function of age but not recurrent attempts. The time between successive suicide attempts decreased as a function of number of attempts. The amount of precipitating life stress was not related to attempts. Conclusions Adolescents and young adults show evidence of escalation of recurrent suicidal behavior, with increasing suicidal intent and decreasing time between successive attempts. However, evidence that sensitization processes account for this escalation was inconclusive. Effective prevention programs that reduce the likelihood of individuals attempting suicide for the first time (and entering this cycle of escalation), and relapse prevention interventions that interrupt the cycle of escalating suicidal behavior among individuals who already have made attempts are critically needed.

Objective The purpose of this article was to systematically review literature on the impact of patients’ psychiatric hospitalizations on caregivers. Implications for practice and research are presented. Methods A systematic search of Web of Knowledge, PsychInfo, and Medline (PubMed) was conducted for peer-reviewed articles published before August 31, 2013. Qualitative, quantitative, and mixed method studies were included if they focused on caregiver outcomes and contained data collected directly from caregivers of patients who had been psychiatrically hospitalized. Results Twenty-nine articles met the inclusion criteria. Caregivers are heterogeneous in their reaction to the psychiatric hospitalization; however, many report distress. Caregivers also often report that they experience stigma, disruptions in daily life, worse physical health, economic strain, and changes in relationships following hospitalization. Negative reactions to the hospitalization may decrease over time, but can remain elevated when compared to the general population. Nonetheless, many caregivers also experience positive changes as a result of the hospitalization. The reaction of caregivers may be influenced by the severity of the patient’s psychiatric problems as well as the caregiver’s demographics and style of coping. Conclusions Caregivers experience a range of reactions to the psychiatric hospitalizations and providing caregivers with psychoeducation on their possible reaction as well as techniques to assist them may improve clinical outcomes for patients. Future research is needed to understand the heterogeneity in caregiver’s reactions to the patient’s psychiatric hospitalization.

ObjectiveTo better understand Black mothers' and White mothers' qualitative reactions to their adolescents' hospitalizations due to suicide attempts.BackgroundCaregivers of youth with suicidal behaviors play a vital role in youth's subsequent treatment and recovery. Yet little attention has been paid to how they are affected by youth's psychiatric hospitalizations or how their reactions may be influenced by race.MethodTwenty Black mothers (Mage = 42.50; SD = 8.48) and 20 White mothers (Mage = 44.85; SD = 6.86) were randomly selected from data originally collected for a larger longitudinal, mixed method, multisite study. Data analysis was informed by grounded theory methodology.ResultsFour themes emerged from the data: mothers' emotional distress; mothers' coping, needs, and supports; mothers' perceived need for increased monitoring; and improved mother–child relationships.ConclusionsBlack mothers and White mothers largely had similar reactions to youth's hospitalizations; however, nuanced differences also were noted regarding how they described their experiences and what they emphasized.ImplicationsDuring discharge planning, mothers need additional support (beyond referrals) in their roles as caregivers and for their own coping. Additional clinical and research implications are discussed.