Multi-morbid developmental trajectories: A multi-trajectory analysis of common mental health issues across childhood and adolescence

• In Event: Extensions to Group Based Trajectory Modeling

Abstract

Summarising heterogeneity of mental health symptom trajectories in terms of a small number of developmental subtypes can be useful for identifying common developmental patterns with potentially different etiologies, outcomes, and other clinically relevant characteristics. However, despite the fact that mental health symptoms frequently cluster within individuals, symptom trajectories tend to be considered in isolation. In this study we evaluated combined developmental trajectories of ADHD, internalising and externalising symptoms in a normative sample of youth with data at ages 7,8,9,10,11,12,13 and 15. Using group-based multi-trajectory modelling, our optimal model included six trajectory groups, labelled ‘low’, ‘normative maturing’, ‘internalising’, ‘multimorbid late onset’, ‘remitting ADHD and externalising’, and ‘persistent ADHD/remitting externalising’. Examining covariates of group membership suggested a potential etiological dissociation between individuals affected solely by internalising problems and those affected by externalising and ADHD, with or without comorbid internalising problems. In addition, covariate associations depended on the developmental course of symptoms – not just concurrent symptom levels - underlining the need to consider developmental trajectories when seeking to illuminate the antecedents and outcomes of mental health issues including conduct disorder and delinquency.

Authors

• Aja Murray, University of Edinburgh

• Manuel Eisner, University of Cambridge

• Daniel Nagin, Carnegie Mellon University