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Translating multilevel theory into multilevel research: Challenges and opportunities for understanding the social determinants of psychiatric disorders

机译：将多层次理论转化为多层次研究：理解精神疾病的社会决定因素的挑战和机遇

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The observation that features of the social environment, including family, school, and neighborhood characteristics, are associated with individual-level outcomes has spurred the development of dozens of multilevel or ecological theoretical frameworks in epidemiology, public health, psychology, and sociology, among other disciplines. Despite the widespread use of such theories in etiological, intervention, and policy studies, challenges remain in bridging multilevel theory and empirical research. This paper set out to synthesize these challenges and provide specific examples of methodological and analytical strategies researchers are using to gain a more nuanced understanding of the social determinants of psychiatric disorders, with a focus on children’s mental health. To accomplish this goal, we begin by describing multilevel theories, defining their core elements, and discussing what these theories suggest is needed in empirical work. In the second part, we outline the main challenges researchers face in translating multilevel theory into research. These challenges are presented for each stage of the research process. In the third section, we describe two methods being used as alternatives to traditional multilevel modeling techniques to better bridge multilevel theory and multilevel research. These are: (1) multilevel factor analysis and multilevel structural equation modeling; and (2) dynamic systems approaches. Through its review of multilevel theory, assessment of existing strategies, and examination of emerging methodologies, this paper offers a framework to evaluate and guide empirical studies on the social determinants of child psychiatric disorders as well as health across the lifecourse.
机译：社会环境的特征（包括家庭，学校和邻里特征）与个人水平的结果相关的观察结果刺激了流行病学，公共卫生，心理学和社会学等数十个多层次或生态理论框架的发展学科。尽管这些理论在病因，干预和政策研究中得到了广泛的应用，但是在将多层次理论和实证研究联系起来方面仍然存在挑战。本文着手综合这些挑战，并提供研究人员正在使用的方法和分析策略的具体示例，以使他们对精神障碍的社会决定因素有更细微的了解，重点是儿童的心理健康。为了实现这一目标，我们首先描述多层理论，定义其核心要素，然后讨论这些理论建议在实证研究中所需要的内容。在第二部分中，我们概述了研究人员在将多层次理论转化为研究过程中面临的主要挑战。在研究过程的每个阶段都提出了这些挑战。在第三部分中，我们描述了两种方法来替代传统的多级建模技术，以更好地桥接多级理论和多级研究。它们是：（1）多级因子分析和多级结构方程建模； （2）动态系统方法。通过对多层次理论的回顾，对现有策略的评估以及对新兴方法的检验，本文提供了一个框架，以评估和指导关于儿童精神障碍以及整个生命过程中健康状况的社会决定因素的实证研究。

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