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.

Fig 1

A. Standard Error of Measurement for the general factor and specific factors. B. Standard Error of Measurement for each Narrow Band measurement* Factor Score. *MFQ = Moods and Feelings Questionnaire; RCMAS = Revised Children’s Manifest Anxiety Scale; r-LOI = revised Leyton Obsessional Inventory; ABQ = Antisocial Behaviour Questionnaire; RSE = Rosenberg Self Esteem Scale; SPQ = Schizotypal Personality Questionnaire; WB = Warwick-Edinburgh Mental Well-Being Scale.

Fig 2. Bar chart showing general factor (distress), self-confidence, antisocial, worry, aberrant thoughts, and mood levels for girls and boys* at ages 14–15, 16–17, 18–19, 20–21 and 22–24.

* Females: N = 224 for 14–15 year olds; N = 257 for 16–17 year olds; N = 234 for 18–19 year olds; N = 228 for 20–21 year olds; N = 261 for 22–24 year olds. Males: N = 199 for 14–15 year olds; N = 222 for 16–17 year olds; N = 200 for 18–19 year olds; N = 199 for 20–21 year olds; N = 204 for 22–24 year olds.

Fig 3. Latent trait levels for the six subgroups from the latent profile analysis.