Latent classes of emotional and behavioural problems in epidemiological and referred samples and their relations to DSM-IV diagnoses

Abstract

Researchers’ interest have recently moved toward the identification of recurrent psychopathological profiles characterized by concurrent elevations on different behavioural and emotional traits. This new strategy turned to be useful in terms of diagnosis and outcome prediction. We used a person-centred statistical approach to examine whether different groups could be identified in a referred sample and in a general-population sample of children and adolescents, and we investigated their relation to DSM-IV diagnoses. A latent class analysis (LCA) was performed on the Child Behaviour Checklist (CBCL) syndrome scales of the referred sample (N = 1225), of the general-population sample (N = 3418), and of the total sample. Models estimating 1-class through 5-class solutions were compared and agreement in the classification of subjects was evaluated. Chi square analyses, a logistic regression, and a multinomial logistic regression analysis were used to investigate the relations between classes and diagnoses. In the two samples and in the total sample, the best-fitting models were 4-class solutions. The identified classes were Internalizing Problems (15.68%), Severe Dysregulated (7.82%), Attention/Hyperactivity (10.19%), and Low Problems (66.32%). Subsequent analyses indicated a significant relationship between diagnoses and classes as well as a main association between the severe dysregulated class and comorbidity. Our data suggested the presence of four different psychopathological profiles related to different outcomes in terms of psychopathological diagnoses. In particular, our results underline the presence of a profile characterized by severe emotional and behavioural dysregulation that is mostly associated with the presence of multiple diagnosis.

Clinical Effects of an ACT-Group Training in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

“…The significance level was set at p < 0.05 and effect size was expressed as Cohen's d or Wilcoxon's r, as required. We aimed to control these analyses for possible confounding variables such as medication (The MTA Cooperative Group, 1999), social economic status (Nobile et al 2010, Biederman et al 2002 and comorbidity (Frigerio et al 2006, Bianchi et al 2017, which were found to be associated with severity of symptoms and different response to treatment. Gender and age were not included in our list of covariates, because we analysed CPRS T-scores, which are already weighed for age and gender.…”

Associations between infant and toddler regulatory problems, childhood co‐developing internalising and externalising trajectories, and adolescent depression, psychotic and borderline personality disorder symptoms

“…Within this theoretical framework, early RPs are viewed as the starting point of a trajectory of self‐regulatory problems (Winsper & Wolke, ), which may manifest as daytime co‐occurring internalising and externalising behaviour problems (Williams, Berthelsen, Walker, Nicholson, ). These problems, in turn, can increase the risk of a range of psychopathological outcomes including personality disorders (Halperin, Rucklidge, Powers, Miller, & Newcorn, ), DSM‐IV diagnoses (mood, anxiety, ADHD) and comorbidity (Bianchi et al., ).…”

The relationship between profiles and transitions of internalizing and externalizing symptoms in children and suicidal thoughts in early adolescence

“…The finding that the majority of children stayed in the ‘Low’ group from ages 6/7–10/11 years is consistent with other research (Luby et al ., 2003; Althoff et al ., 2006, 2010 b ; Basten et al ., 2013, Bonadio et al ., 2016; Weeks et al ., 2016; Bianchi et al ., 2017). The largest proportion of individuals who were in the ‘Moderate’ or the ‘Hyperactivity/internalizing’ profiles at age 6/7 years also ended up in the ‘Low’ profile by age 10/11 years.…”

“…Additionally, constructs of co-occurring internalizing/externalizing, such as the Child Behavior Checklist (CBCL) Dysregulation profile have also been identified (Biederman et al ., 1995). This is a widely replicated profile of problem behavior in which children score high on symptoms of emotional and behavioral self-regulation (De Caluwé et al ., 2013; Masi et al ., 2015; Bianchi et al ., 2017). Beyond the types of symptoms exhibited, there has also been variation in severity, where mild, moderate, and severe levels of internalizing, externalizing, and co-occurrence between the two has been observed, supporting nuance beyond diagnostic thresholds (DiStefano and Kamphaus, 2006; Ostrander et al ., 2008; Mindrila, 2016).…”