Stratification of adolescents across mental phenomena emphasizes the importance of transdiagnostic distress: a replication in two general population cohorts

Jan Stochl*, Hannah Jones, Emma Soneson, Adam P. Wagner, Golam M. Khandaker, Stanley Zammit, Jon Heron, Gemma Hammerton, Edward T. Bullmore, Ray Dolan, Peter Fonagy, Ian M. Goodyer, J. Perez, Peter B. Jones

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Characterizing patterns of mental phenomena in epidemiological studies of adolescents can provide insight into the latent organization of psychiatric disorders. This avoids the biases of chronicity and selection inherent in clinical samples, guides models of shared aetiology within psychiatric disorders and informs the development and implementation of interventions. We applied Gaussian mixture modelling to measures of mental phenomena from two general population cohorts: the Avon Longitudinal Study of Parents and Children (ALSPAC, n = 3018) and the Neuroscience in Psychiatry Network (NSPN, n = 2023). We defined classes according to their patterns of both positive (e.g. wellbeing and self-esteem) and negative (e.g. depression, anxiety, and psychotic experiences) phenomena. Subsequently, we characterized classes by considering the distribution of diagnoses and sex split across classes. Four well-separated classes were identified within each cohort. Classes primarily differed by overall severity of transdiagnostic distress rather than particular patterns of phenomena akin to diagnoses. Further, as overall severity of distress increased, so did within-class variability, the proportion of individuals with operational psychiatric diagnoses. These results suggest that classes of mental phenomena in the general population of adolescents may not be the same as those found in clinical samples. Classes differentiated only by overall severity support the existence of a general, transdiagnostic mental distress factor and have important implications for intervention.

Original languageEnglish
JournalEuropean Child and Adolescent Psychiatry
Early online date18 Nov 2021
Publication statusE-pub ahead of print - 18 Nov 2021

Bibliographical note

Funding Information:
JS, APW, JP and PBJ received support from the NIHR Applied Research Collaboration (ARC) East of England (EoE). JH is supported by the MRC and Alcohol Research UK (MR/L022206/1). GH is supported by a Sir Henry Wellcome Postdoctoral Fellowship (209138/Z/17/Z). GMK acknowledges funding support from the Wellcome Trust (201486/Z/16/Z), MRC (MC_PC_17213), and MQ: Transforming Mental Health (MQDS17/40). ES is supported by a Gates Cambridge Trust Scholarship (OP1144). PF is in receipt of a National Institute for Health Research (NIHR) Senior Investigator Award (NF-SI-0514-10157), and was in part supported by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Barts Health NHS Trust. The NSPN study was supported by a Wellcome Trust Strategic Award (095844/Z/11/Z) to IMG, EB, PBJ, RD and PF. The UK Medical Research Council and Wellcome (Grant Ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This study was also supported by MRC Grants (MR/M006727/1 and G0701503/85179) and the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2021, The Author(s).


  • Psychopathology
  • Classification
  • Adolescence
  • Transdiagnostic approach


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