Journal of Abnormal Child Psychology

, Volume 36, Issue 1, pp 95–104

A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

  • Kevin A. Yoder
  • Susan L. Longley
  • Les B. Whitbeck
  • Dan R. Hoyt
Article

Abstract

The present study examined associations among dimensions of suicidality and psychopathology in a sample of 428 homeless adolescents (56.3% female). Confirmatory factor analysis results provided support for a three-factor model in which suicidality (measured with lifetime suicidal ideation and suicide attempts), internalizing disorders (assessed with lifetime diagnoses of major depressive episode and post-traumatic stress disorder), and externalizing disorders (indicated by lifetime diagnoses of conduct disorder, alcohol abuse, and drug abuse) were positively intercorrelated. The findings illustrate the utility of a dimensional approach that integrates suicidality and psychopathology into one model.

Keywords

Psychopathology Suicidality Internalizing Externalizing Homeless adolescents 

References

  1. Achenbach, T. M., & McConaughy, S. H. (1997). Empirically based assessment of child and adolescent psychopathology: Practical applications (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
  2. Ahrens, B., & Linden, M. (1996). Is there a suicidality syndrome independent of specific major psychiatric disorder? Results of a split half multiple regression analysis. Acta Psychiatrica Scandinavica, 94, 79–86.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington, DC: American Psychiatric Association.Google Scholar
  4. Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87.PubMedCrossRefGoogle Scholar
  5. Apter, A., & Ofek, H. (2001). Personality constellations and suicidal behaviour. In K. Van Heeringen (Ed.), Understanding suicidal behaviour: The suicidal process approach to research, treatment, and prevention (pp. 94–119). Chichester, England: Wiley.Google Scholar
  6. Bank, L., Dishion, T., Skinner, M., & Patterson, G. R. (1990). Method variance in structural equation modeling: Living with “glop”. In G. R. Patterson (Ed.), Depression and aggression in family interaction (pp. 247–279). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  7. Bonett, D. G., & Price, R. M. (2005). Inferential methods for the tetrachoric correlation coefficient. Journal of Educational and Behavioral Statistics, 30, 213–225.CrossRefGoogle Scholar
  8. Booth, R. E., & Zhang, Y. (1996). Severe aggression and related conduct problems among runaway and homeless adolescents. Psychiatric Services, 47, 75–80.PubMedGoogle Scholar
  9. Brent, D. A., & Mann, J. J. (2005). Family genetic studies, suicide, and suicidal behavior. American Journal of Medical Genetics Part C, 133, 13–24.CrossRefGoogle Scholar
  10. Breton, J.-J., Tousignant, M., Bergeron, L., & Berthiaume, C. (2002). Informant-specific correlates of suicidal behavior in a community survey of 12- to 14-year-olds. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 723–730.PubMedCrossRefGoogle Scholar
  11. Brezo, J., Paris, J., Tremblay, R., Vitaro, F., Zoccolillo, M., Hérbert, M., et al. (2006). Personality traits as correlates of suicide attempts and suicidal ideation in young adults. Psychological Medicine, 36, 191–202.PubMedCrossRefGoogle Scholar
  12. Bridge, J. A., Goldstein, T. R., & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, 47, 372–394.PubMedCrossRefGoogle Scholar
  13. Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: Guilford.Google Scholar
  14. Brown, G. K., Beck, A. T., Steer, R. A., & Grisham, J. R. (2000). Risk factors for suicide in psychiatric outpatients: A 20-year prospective study. Journal of Consulting and Clinical Psychology, 68, 371–377.PubMedCrossRefGoogle Scholar
  15. Cox, B. J., Clara, I. P., & Enns, M. W. (2002). Posttraumatic stress disorder and the structure of common mental disorders. Depression and Anxiety, 15, 168–171.PubMedCrossRefGoogle Scholar
  16. Esposito, C. L., & Clum, G. A. (2003). The relative contribution of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Journal of Clinical Child and Adolescent Psychology, 32, 386–395.PubMedCrossRefGoogle Scholar
  17. Evans, E., Hawton, K., & Rodham, K. (2004). Factors associated with suicidal phenomena in adolescents: A systematic review of population-based studies. Clinical Psychology Review, 24, 957–979.PubMedCrossRefGoogle Scholar
  18. Evans, E., Hawton, K., Rodham, K., & Deeks, J. (2005). The prevalence of suicidal phenomena in adolescents: A systematic review of population-based studies. Suicide and Life-Threatening Behavior, 35, 239–250.PubMedCrossRefGoogle Scholar
  19. Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4, 272–299.CrossRefGoogle Scholar
  20. Feitel, B., Margetson, N., Chamas, J., & Lipman, C. (1992). Psychosocial background and behavioral and emotional disorders of homeless and runaway youth. Hospital and Community Psychiatry, 43, 155–159.PubMedGoogle Scholar
  21. Fergusson, D. M., Horwood, L. J., & Boden, J. M. (2006). Structure of internalising symptoms in early adulthood. British Journal of Psychiatry, 189, 540–546.PubMedCrossRefGoogle Scholar
  22. Foley, D. L., Goldston, D. B., Costello, E. J., & Angold, A. (2006). Proximal psychiatric risk factors for suicidality in youth. Archives of General Psychiatry, 63, 1017–1024.PubMedCrossRefGoogle Scholar
  23. Giaconia, R. M., Reinherz, H. Z., Silverman, A. B., Pakiz, B., Frost, A. K., & Cohen, E. (1995). Traumas and posttraumatic stress disorder in a community population of older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1369–1380.PubMedCrossRefGoogle Scholar
  24. Haber, M. G., & Toro, P. A. (2004). Homelessness among families, children, and adolescents: An ecological-developmental perspective. Clinical Child and Family Psychology Review, 7, 123–164.PubMedCrossRefGoogle Scholar
  25. Hills, A. L., Cox, B. J., McWilliams, L. A., & Sareen, J. (2005). Suicide attempts and externalizing psychopathology in a nationally representative sample. Comprehensive Psychiatry, 46, 334–339.PubMedCrossRefGoogle Scholar
  26. Hoyert, D. L., Heron, M. P., Murphy, S. L., & Kung, H.-C. (2006). Deaths: Final data for 2003. National Vital Statistics Report, 54. Hyattsville, MD: National Center for Health Statistics.Google Scholar
  27. Isacsson, G. (2006). Depression is the core of suicidality—its treatment is the cure. Acta Psychiatrica Scandinavica, 114, 149–150.PubMedCrossRefGoogle Scholar
  28. Jöreskog, K. G., & Sörbom, D. (2001). LISREL 8: User’s reference guide. Lincolnwood, IL: Scientific Software International.Google Scholar
  29. Jöreskog, K. G., & Sörbom, D. (2002). PRELIS 2: User’s reference guide. Lincolnwood, IL: Scientific Software International.Google Scholar
  30. Kamieniecki, G. W. (2001). Prevalence of psychological distress and psychiatric disorders among homeless youth in Australia: A comparative review. Australian and New Zealand Journal of Psychiatry, 35, 352–358.PubMedCrossRefGoogle Scholar
  31. Karabanow, J., & Clement, P. (2004). Interventions with street youth: A commentary on the practice-based research literature. Brief Treatment and Crisis Intervention, 4, 93–108.CrossRefGoogle Scholar
  32. Kipke, M. D., O’Connor, S., Nelson, B., & Anderson, J. E. (1998). A probability sampling for assessing the effectiveness of outreach for street youth. In J. B. Greenberg & M. S. Neumann (Eds.), What we have learned from the AIDS evaluation of street outreach projects: A summary document (pp. 17–28). Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  33. Krueger, R. F. (1999). The structure of common mental disorders. Archives of General Psychiatry, 56, 921–926.PubMedCrossRefGoogle Scholar
  34. Krueger, R. F., & Markon, K. E. (2006). Reinterpreting comorbidity: A model-based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111–133.PubMedCrossRefGoogle Scholar
  35. Lahey, B. B., Applegate, B., Waldman, I. D., Loft, J. D., Hankin, B. L., & Rick, J. (2004). The structure of child and adolescent psychopathology: Generating new hypotheses. Journal of Abnormal Psychology, 113, 358–385.PubMedCrossRefGoogle Scholar
  36. Leboyer, M., Slama, F., Siever, L., & Bellivier, F. (2005). Suicidal disorders: A nosological entity per se? American Journal of Medical Genetics Part C, 133, 3–7.CrossRefGoogle Scholar
  37. Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1996). Adolescent suicidal ideation and attempts: Prevalence, risk factors, and clinical implications. Clinical Psychology: Science and Practice, 3, 25–46.CrossRefGoogle Scholar
  38. Marsh, H. W., Hau, K.-T., & Grayson, D. (2005). Goodness of fit in structural equation models. In A. Maydeu-Olivares & J. J. McArdle (Eds.), Contemporary psychometrics: A festschrift for Roderick P. McDonald (pp. 275–340). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  39. Newton, R. R., & Rudestam, K. E. (1999). Your statistical consultant: Answers to your data analysis questions. Thousand Oaks, CA: Sage.Google Scholar
  40. Piacentini, J., Shaffer, D., Fisher, P., Schwab-Stone, M., Davies, M., & Gioia, P. (1993). The diagnostic interview schedule for children—Revised version (DISC-R): III. Concurrent criterion validity. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 658–665.PubMedCrossRefGoogle Scholar
  41. Schwab-Stone, M., Fisher, P., Piacentini, J., Shaffer, D., Davies, M., & Briggs, M. (1993). The diagnostic interview schedule for children—Revised version (DISC-R): II. Test–retest reliability. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 651–657.PubMedCrossRefGoogle Scholar
  42. Shaffer, D., Schwab-Stone, M., Fisher, P., Cohen, P., Piacentini, J., Davies, M., et al. (1993). The diagnostic interview schedule for children—Revised version (DISC-R): I. Preparation, field testing, interrater reliability, and acceptability. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 643–650.PubMedCrossRefGoogle Scholar
  43. Shahar, G., Bareket, L., Rudd, M. D., & Joiner, T. E. (2006). In severely suicidal young adults, hopelessness, depressive symptoms, and suicidal ideation constitute a single syndrome. Psychological Medicine, 36, 913–922.PubMedCrossRefGoogle Scholar
  44. Slade, T., & Watson, D. (2006). The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population. Psychological Medicine, 36, 1593–1600.PubMedCrossRefGoogle Scholar
  45. Sleegers, J., Spijker, J., van Limbeek, J., & van Engeland, H. (1998). Mental health problems among homeless adolescents. Acta Psychiatrica Scandinavica, 97, 253–259.PubMedCrossRefGoogle Scholar
  46. Smart, R. G., & Ogborne, A. C. (1994). Street youth in substance abuse treatment: Characteristics and treatment compliance. Adolescence, 29, 733–745.PubMedGoogle Scholar
  47. Thompson, S. J., Maguin, E., & Pollio, D. E. (2003). National and regional differences among runaway youth using federally-funded crisis services. Journal of Social Science Research, 30, 1–17.Google Scholar
  48. Turecki, G. (2001). Suicidal behavior: Is there a genetic predisposition? Bipolar Disorders, 3, 335–349.PubMedCrossRefGoogle Scholar
  49. Unger, J. B., Kipke, M. D., Simon, T. R., Montgomery, S. B., & Johnson, C. J. (1997). Homeless youths and young adults in Los Angeles: Prevalence of mental health problems and the relationship between mental health and substance abuse disorders. American Journal of Community Psychology, 25, 371–394.PubMedCrossRefGoogle Scholar
  50. U.S. Department of Health and Human Services. (2001). Protection of human subjects. Code of Federal Regulations (45 CFR § 46 et seq.). National Institutes of Health, Office of Protection from Research Risks.Google Scholar
  51. Van Heeringen, K. (2001). The suicidal process and related concepts. In K. Van Heeringen (Ed.), Understanding suicidal behaviour: The suicidal process approach to research, treatment, and prevention (pp. 3–14). Chichester, England: Wiley.Google Scholar
  52. Verona, E., Sachs-Ericsson, N., & Joiner, T. E. (2004). Suicide attempts associated with externalizing psychopathology in an epidemiological sample. American Journal of Psychiatry, 161, 444–451.PubMedCrossRefGoogle Scholar
  53. Whitbeck, L. B., & Hoyt, D. R. (1999). Nowhere to grow: Homeless and runaway adolescents and their families. New York: Aldine de Gruyter.Google Scholar
  54. Whitbeck, L. B., Johnson, K. D., Hoyt, D. R., & Cauce, A. M. (2004a). Mental disorder and comorbidity among runaway and homeless adolescents. Journal of Adolescent Health, 35, 132–140.PubMedGoogle Scholar
  55. Whitbeck, L. B., Johnson, K. D., Hoyt, D. R., & Cauce, A. M. (2004b). The missing psychotic disorders: Response. Journal of Adolescent Health, 35, 433.CrossRefGoogle Scholar
  56. Wittchen, H.-U. (1994). Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical review. Journal of Psychiatric Research, 28, 57–84.PubMedCrossRefGoogle Scholar
  57. Wittchen, H.-U., & Kessler, R. C. (1994). Modifications of the CIDI in the National Comorbidity Survey: The development of the UM-CIDI (NCS Working Paper #2). Ann Arbor: Institute for Social Research, The University of Michigan.Google Scholar
  58. Yates, G. L., MacKenzie, R., Pennbridge, J., & Cohen, E. (1988). A risk profile comparison of runaway and non-runaway youth. American Journal of Public Health, 78, 820–821.PubMedCrossRefGoogle Scholar
  59. Yoder, K. A., Whitbeck, L. B., & Hoyt, D. R. (2007). Dimensionality of thoughts of death and suicide: Evidence from a study of homeless adolescents. Social Indicators Research (in press) DOI 10.1007/s11205-007-9095-5.

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Kevin A. Yoder
    • 1
  • Susan L. Longley
    • 2
  • Les B. Whitbeck
    • 3
  • Dan R. Hoyt
    • 3
  1. 1.Department of SociologyUniversity of North TexasDentonUSA
  2. 2.Veterans Administration Medical CenterSyracuseUSA
  3. 3.Department of SociologyUniversity of Nebraska–LincolnLincolnUSA

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