A transdiagnostic approach to understanding psychopathology in late adolescents: parent-adolescent relationship dynamics discriminate latent classes of psychological adjustment

Comorbidity is a significant problem for current classification systems of psychopathology (i.e., DSM-V). One issue is that the underlying mechanisms shared among comorbid disorders are poorly understood, especially potential psychosocial mechanisms such as family dynamics. The current study used latent class analysis to empirically classify patterns of psychopathology within a large community sample of late adolescents (age 18-19) based on their lifetime psychological adjustment measured using the World Health Organization Composite International Diagnostic Interview. Videotaped family interactions of adolescents (age 16-17) and their parents were micro and macro coded and the resulting family dynamics were compared across the three empirically defined groups of psychological adjustment which emerged from the latent class analysis: 1) an early onset, persistent antisocial behavior class; 2) an emotionally distressed and substance using class; and 3) a typically developing class. It was found that some directly observed family dynamics, including parental monitoring, dyadic positive engagement and coercive engagement discriminated among empirically derived classes. It was also found that particular tasks better discriminated among classes with regard to specific family dynamics (e.g., family activity task best discriminated among classes on dyadic positive engagement). Overall, findings suggest that novel methodologies like latent class analysis can be useful in attempting to map underlying transdiagnostic mechanisms onto the current diagnostic framework. The findings also highlight the importance of taking many variables into consideration when attempting to understand how family dynamics are associated with psychological adjustment.