Transdiagnostic emotional profiles in at-risk Spanish adolescents: A latent profile analysis

The transdiagnostic approach to psychopathology offers an alternative to traditional nosology by focusing on shared dimensions across emotional disorders. The Multidimensional Emotional Disorders Inventory (MEDI) operationalizes a prominent transdiagnostic model, yet evidence in adolescent community samples remains limited. This study aimed to identify latent transdiagnostic profiles of emotional symptomatology in at-risk adolescents using MEDI and to test their external validity with indicators of mental health and psychosocial functioning. A total of 582 adolescents (73.4% female; M = 13.8 years, SD = 1.4, range 11-18) were selected from a community screening of 8746 students. Latent profile analysis (LPA) was conducted on the nine MEDI dimensions, and the Bolck-Croon-Hagenaars (BCH) method compared profiles on depressive and anxiety symptoms, emotional/behavioral difficulties, suicidal behavior, self-esteem, social support, and quality of life. Two complementary solutions emerged: a three-profile solution (Low Risk, Mild Risk, High Risk) reflecting severity gradients, and a five-profile solution (Low Risk, Mild Risk, Anxious-Traumatic, Socially Inhibited-Depressed, High Comorbid Risk) capturing more differentiated phenotypic configurations. Both solutions showed significant between-profile differences on all external indicators. In the three-profile model, High and Mild Risk groups reported lower self-esteem and quality of life than Low Risk. In the five-profile model, High Comorbid Risk and Socially Inhibited-Depressed showed the highest distress and suicidality, whereas Anxious-Traumatic preserved positive affect and relatively better functioning. Findings support the utility of MEDI for deriving clinically meaningful transdiagnostic profiles in adolescents, with implications for early detection, risk stratification, and the development of modular transdiagnostic interventions tailored to subgroup needs.