Background: Latent class analysis (LCA) can be used to identify subgroups of children with similar patterns of mental health symptoms and/or strengths. The method is becoming more commonly used in child mental health research, but there are reservations about the replicability, reliability, and validity of findings. Objective: A systematic literature review was conducted to investigate the extent to which LCA has been used to study population mental health in children, and whether replicable, reliable and valid findings have been demonstrated. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A search of literature, published between January 1998 and December 2017, was carried out using MEDLINE, EMBASE, PsycInfo, Scopus, ERIC, ASSIA, and Google Scholar. A total of 2,748 studies were initially identified, of which 23 were eligible for review. The review examined the methods which studies had used to choose the number of mental health classes, the classes that they found, and whether there was evidence for the validity and reliability of the classes. Results: Reviewed studies used LCA to investigate both disparate mental health symptoms, and those associated with specific disorders. The corpus of studies using similar indicators was small. Differences in the criteria used to select the final LCA model were found between studies. All studies found meaningful or useful subgroups, but there were differences in the extent to which the validity and reliability of classes were explicitly demonstrated. Conclusions : LCA is a useful tool for studying and classifying child mental health at the population level. Recommendations are made to improve the application and reporting of LCA and to increase confidence in findings in the future, including use of a range of indices and criteria when enumerating classes, clear reporting of methods for replicability, and making efforts to establish the validity and reliability of identified classes.
In the current study, data collected from Wave 6 of the Millennium Cohort Study ( n = 11,872), a nationally representative sample survey of youth aged 14 years in the UK, are used to examine the prevalence of loneliness among this age-group, investigate the feelings associated with the experience of loneliness among youth, explore the risk factors for loneliness among young people, and learn how they coped with loneliness. Given recent findings that youth are vulnerable to loneliness, the study assesses the prevalence of loneliness among adolescents across some important sociodemographic characteristics, such as nation of residence, gender, and ethnicity. We also identify the kinds of social experiences that accompany loneliness during adolescence, exploring friendship, relations with parents, social support, and bullying. Our key finding is that, in addition to the absence of desired social relationships, which has been typically identified as the ultimate source of loneliness, the presence of undesirable and even harmful social relationships is a major source of loneliness. This study uniquely brings together psychological and sociological perspectives to understand the experience of youth loneliness.
Almost all measures of loneliness have been developed without discussing how to best conceptualize and assess the severity of loneliness. In the current study, we adapted the four-item UCLA, so that it continued to measure frequency of loneliness, but also assessed intensity and duration, providing a measure of other aspects of loneliness severity. Using data from participants resident in the UK who completed the BBC Loneliness Experiment (N = 36,767; F = 69.6%) and Latent Class Profile Analyses, we identified four groups of people who scored high on loneliness on at least one of the three severity measures. Duration of loneliness often over months or years seemed to be particularly important in distinguishing groups. Further, group membership was predicted by important demographic and psychological variables. We discuss the findings in terms of implications for research and practice. We highlight the need to explore these profiles longitudinally to investigate how membership predicts later mental and physical health, and well-being.
Mental health is complex, comprising both mental distress and well-being. This study used latent class analysis to identify common combinations of mental distress and well-being ('mental health classes') among schoolchildren aged 8-9 years (N = 3340). Thirteen items, measuring a range of conduct problems, emotional symptoms, and subjective well-being, were included in the analysis. Four mental health classes were identified: (1) complete mental health (n = 1895, 57%), (2) vulnerable (n = 434, 13%), (3) emotional symptoms but content (n = 606, 18%), and (4) conduct problems but content (n = 404, 12%). The classes were reliably identified across different datasets, and for males and females. Differential relations with covariates indicated that mental health classes were distinct and externally valid. The results supported the dual-factor model of mental health, suggesting that mental distress and subjective well-being are separate continua. Three of the four possible combinations of high and low distress and subjective well-being posited by the dual-factor model were found using this inductive statistical method. Importantly, our analysis also revealed two 'symptomatic but content' groups, differentiated by symptom domain (internalising/externalising). The covariate analyses between mental health classes and sociodemographic factors, prior academic attainment, school connectedness, and peer support, indicated that there are nuanced relations between those variables and particular constellations of mental distress and well-being. As one of the few dual-factor studies to focus on middle childhood, the current study adds important new evidence that contributes to our understanding of the complexities of mental health among schoolchildren.
The dual-factor model of mental health indicates the importance of simultaneously assessing symptoms and subjective wellbeing, but there is limited understanding of how dual-factor mental health changes during the transition from childhood to early adolescence and factors associated with change. The current study investigated dual-factor mental health over a 2-year period from when children were 8–9 years old to 10–11 years old (N = 2402; 48% female), using latent transition analysis. Further analyses determined whether sex and peer support were associated with initial mental health status or specific transitions during this period. Following class enumeration procedures, a 5-class model was selected at both timepoints. Classes were: (1) complete mental health, (2) vulnerable, (3) emotional symptoms but content, (4) conduct problems but content, and (5) troubled. Half of the sample changed mental health status during the study period. Sex and peer support were associated with specific mental health statuses and subsequent transitions. The findings have implications for mental health screening practice and identifying those in need of targeted interventions.
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