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Predicting psychopathology symptom trajectories using machine learning

A 33‐year prospective study

Bibliographic Data

ID21344870
AuthorsSeda Sacu (0000-0003-4734-9835, Department of Child and Adolescent Psychiatry and Psychotherapy Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg Mannheim Germany, corresponding author), F Streit (0000-0003-1080-4339, Heidelberg University), Stephanie H Witt (German Center for Mental Health (DZPG), partner site Mannheim‐Heidelberg‐Ulm Mannheim Germany), S de Witt (Heidelberg University), Tobias Banaschewski (0000-0003-4595-1144, Department of Child and Adolescent Psychiatry and Psychotherapy Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg Mannheim Germany), Nathalie Holz (0000-0002-6225-9267, Heidelberg University, corresponding author), Nathalie E Holz (Department of Child and Adolescent Psychiatry and Psychotherapy Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg Mannheim Germany), Katharina Schultebraucks (0000-0001-5085-8249, Department of Psychiatry NYU Grossman School of Medicine New York NY USA)
Year2026
Publication date2026-06-15
Open AccessYes
TypeARTICLE
VenueJournal of Child Psychology and Psychiatry (JOURNAL)
Journal identifiersISSN: 0021-9630 • E-ISSN: 1469-7610
PublisherWiley (PUBLISHER • GB)
DOI10.1111/jcpp.70180
PMID42294587
OpenAlexW7164831084
LanguageEN
References cited40

BACKGROUND: While previous literature has established a link between psychopathology symptom trajectories and psychosocial risk, most studies have not extended into adulthood or incorporated comprehensive risk measures. We aimed to identify symptom trajectories for externalizing and internalizing symptoms over a 25-year span and predict them using machine learning. METHODS: We used data from a longitudinal birth cohort study (N = 317, 171 females). Psychopathology symptoms were measured between age 8 and 33. Symptom trajectories were identified using growth mixture models. An extensive battery of risk and protective measures over the lifespan (e.g., polygenic scores, psychosocial risk factors, temperament) was used to train machine learning-based classification models. RESULTS: We identified three trajectories for both externalizing and internalizing symptoms (entropy > 0.8, likelihood ratio test p < .05): Low, increasing (late-adolescent emergence), and decreasing (childhood-limited) symptoms classes. Both genetic (e.g., polygenic scores for cognition and mental disorders) and environmental factors (e.g., adverse family characteristics, poor social functioning) predicted symptom trajectories. For externalizing symptoms trajectories, random forest achieved fair discriminatory power with a multiclass macro-average AUC of 0.77 and a multiclass micro-average of 0.88. For internalizing symptoms trajectories, logistic regression achieved modest discriminatory power with a multiclass macro-average AUC of 0.75 and a multiclass micro-average of 0.83. CONCLUSIONS: Psychopathology risk trajectories vary across development and are influenced by diverse risk factors. Understanding these risk factors can support early identification of at-risk individuals and inform targeted prevention and intervention efforts

Cognition · Cohort · Logistic regression · Longitudinal study · Prospective cohort study · Psychopathology · Psychosocial · Digital Mental Health Interventions · Mental Health Research Topics · Personality Disorders and Psychopathology

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