Background: Data based on general population studies of exposure-to-risk factors is not adequate to describe the mental health of children living in the most extreme "high-risk" environments.
Methods: Data were collected in a longitudinal prospective study of two cohorts of 9 and 13 year-old socially at-risk children. Cluster analysis was used to classify youths based on the reports about potential areas of risk. The psychopathological structure of empirical clusters was compared through cross-sectional and longitudinal epidemiological indexes and through multiple regression and multivariate analysis of variance.
Results: Cluster analysis provided eight binary high-low risk classifications. Exposure to risk was highly prevalent. In preadolescence, broken family, parenting style and contextual profiles were the highest risk factors for psychopathology. In adolescence, they were psychological variables, verbal comprehension, pre-peri-postnatal history, physical health and family characteristics. Cumulative risk followed a linear trend for psychopathology and functional impairment. The child's perception of low marital discord and good school achievement were protective factors.
Conclusions: Extreme socially at-risk populations have specific profiles of risk that can be identified through a person-centered approach and may be amenable to selective preventive interventions.