Poster #22 - Psychosocial Developmental Trajectory Profiles and Psychiatric Hospitalization Among Transition-Age Youth Receiving Mental Health Services

• In Event: Poster Session 13

Abstract

Transition-age youth, ages 16-24, with serious emotional disturbance/serious mental illness (SED/SMI), have a diagnosed mental health disorder that has significantly interfered with their home or community functioning in the past year. Impaired functioning places youth at risk for poor educational achievement, lack of self-sufficiency, and mental health problems (Davis & Stoep, 1997; Teich et al., 2003). Although psychiatric problems during this age increase the risk of poor outcomes, many youth recover and flourish (Bello et al., 2017; Liang et al., 2021). The developmental psychopathology concepts of equifinality and multifinality explain how interactions between a person and their environmental factors influence how youth with common traits/experiences (e.g., trauma) and develop a SED/SMI (equifinality). Youth with SED/ SMI may experience different treatment outcomes (multifinality) (Cicchetti & Rogosch, 1996). Research indicates that several predictors (trauma symptoms, family support, self-regulation, optimism, self-efficacy, and peer relationships) may influence divergent developmental trajectories (Andretta & McKay, 2020; Marques et al., 2017; McClelland et al., 2013; Morrow & Villodas, 2018; Moses & Villodas, 2017; Thompson et al., 2019). Examining developmental growth trajectories during mental health treatment adds nuance to our understanding of how youth with SMI/ SED respond differently to intervention.
The current study examined clinical assessment and Medicaid billing data for 2,135 transition-age youth with SED/SMI receiving mental health treatment over one-year across three-time points (enrollment, six months, and 12 months) to identify and validate psychosocial developmental trajectory profiles. Using latent class growth curve analysis (LCGA) and latent curve analysis (LCA), the current study identified five profiles of youth on three developmental outcomes (educational attainment, knowledge to manage a mental health condition, and living skills) based on six psychosocial factors (trauma symptoms, family support, self-regulation, optimism, self-efficacy, peer relationships) at three-time points, adjusting for youth characteristics. See Table 1 for the BIC values used to guide model selection. Youth somewhat clustered into groups representing a linear range of psychosocial and developmental trajectories (from greater psychosocial strengths and developmental outcomes to youth with the greatest needs); however, youth characteristics were associated with profile membership. This resulted in an interaction of profile patterns. Younger-aged, Black Youth of Color (BYOC), females, and youth with a learning strength clustered into profiles with stronger developmental trajectories than older, White, male youth, and youth with learning challenges. Moreover, females and younger youth had stronger developmental trajectories compared to males and older youth despite having worse psychosocial factor scores. See Figure 1 for an example profile illustration. Also, profiles with the highest psychosocial and developmental needs experienced the greatest gains during a year of treatment with a rate of change from -0.17 to -0.22 (SE = 0.03 - 0.05, p < .001). Under 10% (n = 197) of youth experienced psychiatric hospitalization (M =1.96, SD = 11.07). Profiles with the strongest psychosocial factors predicted psychiatric hospitalizations, partially validating the profiles. Findings have several implications for mental health treatment planning with transition-age youth with SED/SMI based on baseline assessment scores and youth characteristics.

Authors

• Deborah Layman, Other (New York Office of Mental Health)
  Presenting Author

• Celia B Fisher, Fordham University