Internalising or Externalising? Latent Profile Identification and Longitudinal Transitions of Severe Psychological Crisis and Mental Health Problems in College Students: The Influence of Underlying Psychological Distress

Stress Health. 2026 Aug;42(4):e70196. doi: 10.1002/smi.70196.

ABSTRACT

College student mental health issues are receiving increasing attention from various stakeholders. However, research on the longitudinal trends of college student mental health remains scarce. This study enrolled 5479 college students from a Chinese university. Using Latent Profile Analysis (LPA), it identified distinct classes characterising comorbid patterns of severe psychological crisis with internalising and externalising psychological problems during the period from 2022 to 2024. Latent Transition Analysis (LTA) was then employed to examine the stability of these classes across the three-year period. For the comorbid pattern of severe psychological crisis and internalising problems, the LPA yielded four distinct mental health classes: Secure Group, Low Internalising Problems Group, Low Crisis-High Internalising Problems Group, and High-Risk Group. Similarly, for the comorbid pattern of severe psychological crisis and externalising problems, four classes emerged: Secure Group, Low Crisis Group, Sub-High-Risk Group, and High-Risk Group. Longitudinal analysis via the LTA model revealed that, within both comorbid patterns, the Secure Group exhibited the highest stability, while the remaining classes demonstrated varying degrees of change. These findings underscore the need for stakeholders to prioritise college student mental health concerns and develop timely intervention strategies to accurately guide mental health promotion, prevention, and intervention efforts.

PMID:42400164 | DOI:10.1002/smi.70196