Like Parent, Like Child? Mapping Transmission Patterns of Psychopathology in Lebanese Parent-Child Dyads Using Latent Class Analysis

Abstract

Background: Familial aggregation of psychopathology is well established, with children of affected parents showing elevated risk for both internalizing and externalizing disorders. Yet, most studies rely on variable-centered analytic approaches that overlook the complexity of comorbidity and heterogeneity in child symptom presentations. Objectives: Using a person-centered approach, this study (1) identifies typologies or classes of psychopathology among Lebanese children and adolescents and (2) examines how parental mental health predicts child class membership. Methods: Data were drawn from the Psychopathology in Children and Adolescents in Lebanon Study (PALS), a national household survey conducted between February and November 2018. The sample included 1,283 Arabic-speaking children and adolescents aged 8–17 years (56.4% aged 8–11; 50.1% female) and their primary caregivers (81.9% biological mothers). Child mental health symptoms spanned depression, anxiety, emotional and peer problems, conduct problems, and hyperactivity/inattention. Parental mental health spanned somatic symptoms, anxiety/insomnia, social dysfunction, and severe depression. Latent class analysis identified child psychopathology profiles, and multinomial logistic regression tested associations between parental mental health and child class membership, adjusting for sociodemographic and clinical covariates. Results: LCA suggests three distinct classes of child psychopathology: an anxiety- predominant class (n=250; 19.5%) defined by near-universal anxiety (99.9%) with minimal comorbidity, an internalizing–externalizing comorbidity class (n=52; 4.1%) characterized by high probabilities of symptoms across all domains (53–81%), and finally a healthy class (n=981; 76.7%). After adjusting for a number of potential confounders (child age, socioeconomic status, academic difficulties, chronic illness, and family psychiatric history), parental severe depression was a strong predictor of child psychopathology, increasing odds of membership in both the anxiety-predominant class (aOR=2.62, 95% CI [1.64–4.19]) and comorbidity class (aOR=3.16, 95% CI [1.42– 7.04]). Conclusions: Child psychopathology in a sample of children/adolescents from Lebanon displays meaningful heterogeneity, with parental severe depression exerting broad transdiagnostic influence on offspring symptom profiles. These findings underscore the importance of screening for—and treating—parental depression in pediatric and primary care settings. Family-centered interventions targeting parental mental health may offer an efficient strategy to disrupt intergenerational transmission of psychopathology.