(PS8-C70) Latent Transdiagnostic Profiles of Children with Severe Psychopathology: Implications for Personalized Intensive Treatment

Saturday, November 19, 2022

12:00 PM – 1:00 PM EST

Location: Westside Ballroom, 5th Floor

Author(s)

AG

Ariel Gianukakis, B.A.

Research Assistant
Lifespan Bradley Hospital
Providence, Rhode Island
AW

Anne S. Walters, ABPP, Ph.D.

Clinical Professor
Brown University
East Providence, Rhode Island
JP

Justin Parent, Ph.D.

Assistant Professor (Research)
Alpert Medical School of Brown University
Providence, Rhode Island

Background: Children who require intensive hospital-based intervention often experience severe psychopathology in multiple diagnostic domains and substantial functional impairment across settings. Given that these children most often present with concurrent symptoms in many different DSM-based diagnostic categories (e.g., impulsivity, attention problems, emotion dysregulation), determining optimal intervention targets and strategies is challenging to determine – a decision that has high stakes, given common concerns with suicidal ideation, aggressive behaviors, or both. Measurement based care (MBC) involves the routine collection of patient and caregiver reports to inform clinical decision making throughout treatment and has shown evidence of improved patient outcomes in hospital programs. Despite ample research investigating several single variable-centered factors that could impact treatment efficacy, there is limited MBC research that has explored person-centered profiles, especially ones that focus on transdiagnostic factors, such as emotional competence. In the current study, we present a latent profile analysis of emotional competence of children presenting for partial hospitalization services.

Method: The study included a total of 301 children (7–12-years-old) with severe psychopathology who presented for intensive hospital-based treatment. Children and their primary caregivers completed a comprehensive assessment using standardized measures at admission. Latent profile analysis was used to explore if there are distinct clusters of children based on interconnected transdiagnostic emotional competence domains of emotional inhibition, emotion reactivity, and emotion regulation. Following latent profile analyses, predictors of profile membership were explored across internalizing, externalizing, family, school, and peer domains.

Results: A three-profile model represented the best fit to the data. The Reactive group profile is characterized by children who have low emotional inhibition and limited emotion regulation skills, especially for worry and anger. Predictors of the Reactive profile included chronic irritability and impulsivity paired with low school functioning and the highest levels of parental internalizing symptoms. The Suppression profile was characterized by very high emotion inhibition paired with high attempts at emotional regulation, especially for sadness. Predictors of the Suppression profile were those suggesting overcontrol of emotional experiences, such as the lowest levels of impulsivity and the highest levels of anxiety, depression, and suicidal ideation. Children in the Suppressor profile were reported to have the lowest school and social functioning. Finally, the Moderate profile fits those who show moderate levels of emotion inhibition and have relatively strong emotion regulation coping skills compared to the Suppressor and Reactive profiles.

Discussion: We propose that focusing on transdiagnostic factors in parallel with person-centered analytic approaches will facilitate application of MBC to drive precision and personalized treatment tailored to a patient’s specific needs, ultimately resulting in improved treatment outcomes.