Latent class analysis of anxiety and depressive symptoms of the Youth Self-Report in a general population sample of young adolescents

Department of Child and Adolescent Psychiatry, Erasmus Medical Center Rotterdam/Sophia Children's Hospital, Dr. Molewaterplein 60/PO Box 2060, 3000 CB Rotterdam, The Netherlands.
Behaviour Research and Therapy (Impact Factor: 3.85). 07/2006; 44(6):849-60. DOI: 10.1016/j.brat.2005.06.004
Source: PubMed


This study examined whether distinct groups of young adolescents with mainly anxiety or mainly depression could be identified in a general population sample. Latent class analysis was used on self-report ratings of DSM-IV symptoms of anxiety and depressive disorders, because it was hypothesized that these ratings provide a bigger chance to identify distinct groups than parent ratings of symptoms that are poorly associated with DSM-IV. Results from exploratory and confirmatory latent class analysis showed that only very small numbers of young adolescents had mainly anxiety or mainly depressive symptoms. Instead, a five-group model fitted the data best. These five groups contained young adolescents who either had a high, intermediate, or low probability to have comorbid symptoms of anxiety and depression. It was concluded that symptoms of DSM-IV anxiety and depressive disorders co-occur in young adolescents, and that latent class analysis on items that capture also severe symptoms like suicidal thoughts are needed to derive groups with specific comorbidity patterns in a general population sample.


Available from: Johan Ormel
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    • "LCA is increasingly used in public health studies to identify metabolic syndrome (Boyko et al., 2012), immunological patterns (Figueiredo et al., 2013) and incidence of respiratory symptoms in children (Spycher et al., 2008), and has proven to be an efficient method for disentangling groups and creating more homogeneous subgroups. In relation to instrument consistency , LCA has been used to identify the subtypes of Antisocial Personality Disorder (Bucholz et al., 2000), Attention Deficit/ Hyperactivity Disorder (Rasmussen et al., 2002), and patterns of problem behaviour (Lang et al., 2006). These studies aim to improve diagnostic validity by relying on empirical evidence, and moving towards more valid and useful classification criteria. "
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    ABSTRACT: Different instruments have been used to measure social support in epidemiological studies of which the most widely used is the Medical Outcomes Study Social Support Scale (SSS-MOS). However, these studies lack measures of the level of social support on health risks. We used Latent Class Analysis (LCA) to distinguish subgroups with different levels of perceived social support and tested the consistency of these subgroups by their associations with the prevalence of Common Mental Disorders (CMD). This is a cross-sectional study of 1013 mothers living in the city of Salvador, Brazil in which psychosocial data were collected through home visits using the SSS-MOS and the Self Reporting Questionnaire-20. For each dimension of social support analysed here, we selected models with two classes using LCA. Multivariate logistic regression models were used to estimate the association between participants’ perceived social support and the prevalence of CMD to verify the consistency of the groups defined by LCA. There was a clear difference in the reporting of perceived social support between those classified as high or low using LCA. The probability of perceiving several types of social support was lower in the subgroup classified as low level of social support (13.7% to 59.8%), and it was much higher in the group classified as high level of social support (84.3% to 98%). A greater prevalence of CMD was found among mothers with lower levels of social support. LCA seems to be a useful tool to improve measurement of perceived social support by separation into two levels in which the lower level is associated with an increased prevalence of CMD.
    Social Science Research 11/2014; 50. DOI:10.1016/j.ssresearch.2014.11.009 · 1.27 Impact Factor
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    • "Because the majority of youth in previous LCA studies do not meet diagnostic criteria for anxiety, the degree of variability in clinical levels of anxiety remains unclear. Third, although some studies suggest that the structure of anxiety disorders may differ by youth sex and age (Beesdo-Baum et al., 2009; Marmorstein, 2006; Wittchen, Beesdo-Baum, et al., 2009), most work has not examined how anxiety disorders may aggregate differently across these demographic groups, or instead has treated them as covariates in analyses (Ferdinand et al., 2006; Muris et al., 2002; van Lang et al., 2006). Finally, most studies that have examined the degree of overlap among the anxiety disorders have acquired information using relatively narrow assessment periods (e.g., 2 weeks, 1-month, 12-months) rather than a lifetime assessment approach. "
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    ABSTRACT: The current study examined the sex- and age-specific structure and comorbidity of lifetime anxiety disorders among U.S. adolescents. The sample consisted of 2,539 adolescents (1,505 females and 1,034 males) from the National Comorbidity Survey-Adolescent Supplement who met criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. [DSM-IV-TR]) lifetime anxiety disorders (American Psychiatric Association, 2000). Adolescents ranged in age from 13 to 18 years (M = 15.2 years, SE = 0.08 years) and were 39% non-White. Multiple-group latent class analysis was conducted by adolescent sex and age to identify subgroups of adolescents with similar anxiety disorder profiles. Developmental and clinical correlates of empirically derived classes were also examined to assess the nomological validity of identified subgroups. A 7-class solution provided the best fit to the data, with classes defined primarily by one rather than multiple anxiety disorders. Results also indicated that classes displayed similar diagnostic profiles across age, but varied by sex. Classes characterized by multiple anxiety disorders were consistently associated with a greater degree of persistence, clinical severity, impairment, and comorbidity with other DSM-IV-TR psychiatric disorders. The presentation of lifetime anxiety disorders among adolescents and the observation of unique correlates of specific classes provide initial evidence for the utility of individual DSM-IV-TR anxiety disorder categories. Although findings of the present study should be considered preliminary, results emphasize the potential value of early intervention and gender-specific conceptualization and treatment of anxiety disorders.
    Journal of Consulting and Clinical Psychology 11/2011; 80(1):102-15. DOI:10.1037/a0026069 · 4.85 Impact Factor
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    • "However, only a few studies have investigated patterns of joint MDD and GAD symptom occurrence. Using clinical convenience samples of adolescents, three studies have found that anxiety symptoms tended to be more prevalent than depression symptoms (Ferdinand et al, 2005; van Lang et al, 2005; Wadsworth et al, 2001). "
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    ABSTRACT: Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly comorbid and, as diagnoses, problematic because they are heterogeneous, may impair functioning even in subclinical manifestations, and may not predict important external criteria as well as empirically-derived classifications. The present study employed a latent class analysis using data from National Comorbidity Survey (1990-1992) and focused on respondents who endorsed at least 1 screening question for MDD and 1 for GAD (N = 1009). Results revealed 4 symptom domains (somatic anxiety, somatic depression, psychological anxiety, and psychological depression) reflecting the heterogeneity of MDD and GAD, and 7 respondent classes. Analysis revealed that people in classes with a high prevalence of either somatic anxiety or somatic depression symptoms presented with the highest levels of disability, distress, and service utilization. Evidence also was found for clinically meaningful subthreshold comorbid conditions. Anxiety-related and depression-related symptoms can be meaningfully differentiated, but differentiating between somatic and psychological symptoms has the greatest practical significance.
    The Journal of nervous and mental disease 05/2009; 197(4):215-24. DOI:10.1097/NMD.0b013e31819d954f · 1.69 Impact Factor
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