Continuity and discontinuity of depressed mood from late adolescence to young adulthood: the mediating and stabilizing roles of young adults' socioeconomic attainment

Tracking of depressed mood from adolescence into adulthood and the role of peer and parental support: A partial test of the Adolescent Pathway Model

•Adolescent depressed mood predicts adult depressed mood.•Peer acceptance during adolescence is not associated with adult depressed mood.•Household income moderates the effect of parental closeness on adult depressed mood.

Heterotypic and homotypic continuity in psychopathology: a narrative review

Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as "continuity," "psychopathology," "infancy," "childhood," "adolescence," "adulthood," "homotypic," and "heterotypic" were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.

Pathways from peers to mental health: Adolescent networks, role attainment, and adult depressive symptoms

Both adolescent peer networks and adult role attainment affect mental health in adulthood. However, whether adult roles mediate associations between adolescent networks and adult mental health is unclear. Using path analysis with survey data from the National Longitudinal Study of Adolescent to Adult Health (N = 8543) in the United States, we examine the direct impact of adolescent (grades 7-12) popularity (received ties) and sociality (sent ties) among school peers on adult (ages 33-43) depressive symptoms, and we assess mediation pathways through four key adult roles: marriage, employment, education, and residential independence. We then examine whether pathways differ across men and women. Results indicate that adolescent popularity, or how others view an adolescent's position in the peer network, benefits adult mental health through the attainment of marriage, employment, and education. Residential independence is a significant mediator for popularity in models for men. Sociality, or how an adolescent views their own position in the peer network, relates to adult depressive symptoms through the attainment of a college degree for women and marriage for men. Sociality also directly predicts lower depressive levels, independent of adult role attainment, in models for women. Overall, results indicate gendered pathways for how adolescent networks relate to mental health decades later through adult roles.

Impact of early intervention on the population prevalence of common mental disorders: 20-year prospective study

BACKGROUND

The potential for early interventions to reduce the later prevalence of common mental disorders (CMD) first experienced in adolescence is unclear.

AIMS

To examine the course of CMD and evaluate the extent to which the prevalence of CMD could be reduced by preventing adolescent CMD, or by intervening to change four young adult processes, between the ages of 20 and 29 years, that could be mediating the link between adolescent and adult disorder.

METHOD

This was a prospective cohort study of 1923 Australian participants assessed repeatedly from adolescence (wave 1, mean age 14 years) to adulthood (wave 10, mean age 35 years). Causal mediation analysis was undertaken to evaluate the extent to which the prevalence of CMD at age 35 years in those with adolescent CMD could be reduced by either preventing adolescent CMD, or by intervening on four young adult mediating processes: the occurrence of young adult CMD, frequent cannabis use, parenting a child by age 24 years, and engagement in higher education and employment.

RESULTS

At age 35, 19.2% of participants reported CMD; a quarter of these participants experienced CMD during both adolescence and young adulthood. In total, 49% of those with CMD during both adolescence and young adulthood went on to report CMD at age 35 years. Preventing adolescent CMD reduced the population prevalence at age 35 years by 3.9%. Intervening on all four young adult processes among those with adolescent CMD, reduced this prevalence by 1.6%.

CONCLUSIONS

In this Australian cohort, a large proportion of adolescent CMD resolved by adulthood, and by age 35 years, the largest proportion of CMD emerged among individuals without prior CMD. Time-limited, early intervention in those with earlier adolescent disorder is unlikely to substantially reduce the prevalence of CMD in midlife.

Does the timing and duration of mental health problems during childhood and adolescence matter for labour market participation of young adults?

Background

Little is known about the timing and duration of mental health problems (MHPs) on young adults’ labour market participation (LMP). This life-course study aims to examine whether and how the timing and duration of MHPs between childhood and young adulthood are associated with LMP in young adulthood.

Methods

Logistic regression analyses were performed with data from the Tracking Adolescents’ Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up (N=874). Internalising and externalising problems were measured by the Youth/Adult Self-Report at ages 11, 13, 16, 19 and 22. Labour market participation (having a paid job yes/no) was assessed at age 26.

Results

Internalising problems at all ages and externalising problems at age 13, 19 and 22 were associated with an increased risk of not having a paid job (internalising problems ORs ranging from 2.24, 95% CI 1.02 to 4.90 at age 11 to OR 6.58, CI 3.14 to 13.80 at age 22; externalising problems ORs from 2.84, CI 1.11 to 7.27 at age 13 to OR 6.36, CI 2.30 to 17.56 at age 22). Especially a long duration of internalising problems increased the risk of not having a paid job in young adulthood.

Conclusion

The duration of MHPs during childhood and adolescence is strongly associated with not having paid work in young adulthood. This emphasises the necessity of applying a life-course perspective when investigating the effect of MHPs on LMP. Early monitoring, mental healthcare and the (early) provision of employment support may improve young adult’s participation in the labour market.

Wellbeing, Developmental Crisis and Residential Status in the Year After Graduating from Higher Education: A 12-Month Longitudinal Study

Graduating from higher education is characterized by a complex set of changes, including the transition into employment as well as residential changes and identity shifts. We explored how wellbeing and depressive symptoms are associated with retrospective appraisals of developmental crisis in the year after leaving university, and the impact of living with parents following graduation. Data were collected from graduates based in the UK over the course of the 12 months following completing an undergraduate degree, via a 3-phase longitudinal design. One-third of the sample reported experiencing a developmental crisis within the year following university. Those who reported a crisis scored significantly lower on measures of environmental mastery across all time points and higher on measures of depression. Those living with parents scored significantly lower on measures of self-acceptance and autonomy and higher on measures of depression. In light of these findings, we conclude that interventions and targeted support to help students manage the psychological challenges of life after university should be developed and implemented.

Adult mental health outcomes of adolescent depression: A systematic review

BACKGROUND

Adolescent depression may increase risk for poor mental health outcomes in adulthood. The objective of this study was to systematically review the literature on the association between adolescent depression and adult anxiety and depressive disorders as well as suicidality.

METHODS

EMBASE, MEDLINE, and PSYCinfo databases were searched and longitudinal cohort studies in which depression was measured in adolescence (age 10-19) and outcomes of depressive disorders, anxiety disorders, or suicidality were measured in adulthood (age 21+), were selected. Meta-analysis using inverse variance and random effects modeling, along with sensitivity analyses, were used to synthesize article estimates.

RESULTS

Twenty articles were identified, representing 15 unique cohorts. Seventeen of 18 articles showed adolescent depression increased risk for adult depression; eleven pooled cohorts estimated that adolescents with depression had 2.78 (1.97, 3.93) times increased odds of depression in adulthood. Seven of eight articles that investigated the association between adolescent depression and any adult anxiety found a significant association. Three of five articles showed a significant association between adolescent depression and adult suicidality.

CONCLUSION

This review shows that adolescent depression increases the risk for subsequent depression later in life. Articles consistently found that adolescent depression increases the risk for anxiety disorders in adulthood, but evidence was mixed on whether or not a significant association existed between adolescent depression and suicidality in adulthood. Early intervention in adolescent depression may reduce long-term burden of disease.

Antecedents of transition patterns of depressive symptom trajectories from adolescence to young adulthood

This study examined (a) transition patterns from adolescent-specific depressive symptom trajectory classes to young adult-specific trajectory classes (N = 537; 15-26 years) and (b) identified risk factors associated with these transition patterns. The latent classes and transition analyses identified three transitional patterns of depressive symptom trajectories, including a deteriorating pattern (8.2%), a recovering pattern (22.5%), and a consistently low pattern (69.3%). Additionally, the results showed that contextual risk factors (i.e., negative economic events, negative romantic relationships, and low college enrolment rates) in the transition period to young adulthood were more positively associated with deteriorated or recovered transition patterns of depressive symptom trajectories than with the consistently low transition patterns even after taking into account the effects of adolescent risk factors. The identification of dynamic transition patterns in depressive symptom trajectories from adolescence to young adulthood and risk factors provide useful tools for preventive and intervention efforts. Statement of contribution What is already known on this subject? Heterogeneous trajectories of depressive symptoms across adolescence and young adulthood have been reported. Psychosocial characteristics differentiate trajectories of depressive symptoms from adolescence to young adulthood. What does this study add? Dynamic transition patterns of depressive symptom trajectories are found between adolescence and young adulthood. Life experiences in the transition period are uniquely associated with the transition patterns of depressive symptom trajectories even after adjusting the effects of adolescent characteristics.

A hierarchical causal taxonomy of psychopathology across the life span

We propose a taxonomy of psychopathology based on patterns of shared causal influences identified in a review of multivariate behavior genetic studies that distinguish genetic and environmental influences that are either common to multiple dimensions of psychopathology or unique to each dimension. At the phenotypic level, first-order dimensions are defined by correlations among symptoms; correlations among first-order dimensions similarly define higher-order domains (e.g., internalizing or externalizing psychopathology). We hypothesize that the robust phenotypic correlations among first-order dimensions reflect a hierarchy of increasingly specific etiologic influences. Some nonspecific etiologic factors increase risk for all first-order dimensions of psychopathology to varying degrees through a general factor of psychopathology. Other nonspecific etiologic factors increase risk only for all first-order dimensions within a more specific higher-order domain. Furthermore, each first-order dimension has its own unique causal influences. Genetic and environmental influences common to family members tend to be nonspecific, whereas environmental influences unique to each individual are more dimension-specific. We posit that these causal influences on psychopathology are moderated by sex and developmental processes. This causal taxonomy also provides a novel framework for understanding the heterogeneity of each first-order dimension: Different persons exhibiting similar symptoms may be influenced by different combinations of etiologic influences from each of the 3 levels of the etiologic hierarchy. Furthermore, we relate the proposed causal taxonomy to transdimensional psychobiological processes, which also impact the heterogeneity of each psychopathology dimension. This causal taxonomy implies the need for changes in strategies for studying the etiology, psychobiology, prevention, and treatment of psychopathology. (PsycINFO Database Record

The natural history of internalizing behaviours from adolescence to emerging adulthood: findings from the Australian Temperament Project

BACKGROUND

The aims of the study were to describe the patterning and persistence of anxiety and depressive symptoms from adolescence to young adulthood and to examine long-term developmental relationships with earlier patterns of internalizing behaviours in childhood.

METHOD

We used parallel processes latent growth curve modelling to build trajectories of internalizing from adolescence to adulthood, using seven waves of follow-ups (ages 11-27 years) from 1406 participants of the Australian Temperament Project. We then used latent factors to capture the stability of maternal reported child internalizing symptoms across three waves of early childhood follow-ups (ages 5, 7 and 9 years), and examined relationships among these patterns of symptoms across the three developmental periods, adjusting for gender and socio-economic status.

RESULTS

We observed strong continuity in depressive symptoms from adolescence to young adulthood. In contrast, adolescent anxiety was not persistent across the same period, nor was it related to later depressive symptoms. Anxiety was, however, related to non-specific stress in young adulthood, but only moderately so. Although childhood internalizing was related to adolescent and adult profiles, the associations were weak and indirect by adulthood, suggesting that other factors are important in the development of internalizing symptoms.

CONCLUSIONS

Once established, adolescent depressive symptoms are not only strongly persistent, but also have the potential to differentiate into anxiety in young adulthood. Relationships with childhood internalizing symptoms are weak, suggesting that early adolescence may be an important period for targeted intervention, but also that further research into the childhood origins of internalizing behaviours is needed.

The rearing environment and risk for drug abuse: a Swedish national high-risk adopted and not adopted co-sibling control study

BACKGROUND

Although drug abuse (DA) is strongly familial, with important genetic influences, we need to know more about the role of rearing environment in the risk for DA. To address this question, we utilized a high-risk adopted and non-adopted co-sibling control design.

METHOD

High-risk offspring had one or more biological parents registered for DA, alcohol use disorders or criminal behavior. Using Swedish registries, we identified 1161 high-risk full-sibships and 3085 high-risk half-sibships containing at least one member who was adopted-away and one member who was not. Registration for DA was via national criminal, medical and pharmacy registers. In Sweden, adoptive families are screened to provide high-quality rearing environment for adoptees.

RESULTS

Controlling for parental age at birth and gender (and, in half-siblings, high-risk status of the other parent), risk for DA was substantially lower in the full- and half-siblings who were adopted v. not adopted [hazard ratios and 95% confidence intervals: 0.55 (0.45-0·69) and 0.55 (95% CI 0.48-0.63), respectively]. The protective effect of adoption on risk for DA was significantly stronger in the full- and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce, or contained a high-risk parent.

CONCLUSIONS

In both full- and half-sibling pairs, we found replicated evidence that rearing environment strongly impacts on risk for DA. High-quality rearing environments can substantively reduce risk for DA in those at high genetic risk.

Gender Moderation of the Intergenerational Transmission and Stability of Depressive Symptoms from Early Adolescence to Early Adulthood

Factors that might exacerbate or mitigate the transmission of depressive symptoms from parents to adolescents and the continuity of depressive symptoms into early adulthood are poorly understood. This study tested the hypothesis that the intergenerational transmission and stability of depressive symptoms would be stronger for girls than boys over adolescence and into early adulthood, while considering the possibility that the pattern of gender moderation might vary depending on parent gender and developmental timing. The participants were 667 rural Midwestern adolescents (52 % female) and their parents. Survey data on maternal and paternal depressive symptoms (at youth age 11) and on adolescent and young adult depressive symptoms (at youth ages 11, 18, and 21) were analyzed via multiple group structural equation modeling. Maternal depressive symptoms predicted increased late adolescent depressive symptoms for girls but not boys, and adolescent depressive symptoms were more stable in girls. Paternal depressive symptoms predicted increased late adolescent depressive symptoms for all youth. The findings suggest the need for early, tailored interventions.

EPA guidance on mental health and economic crises in Europe

This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

Negative events in childhood predict trajectories of internalizing symptoms up to young adulthood: an 18-year longitudinal study

BACKGROUND

Common negative events can precipitate the onset of internalizing symptoms. We studied whether their occurrence in childhood is associated with mental health trajectories over the course of development.

METHODS

Using data from the TEMPO study, a French community-based cohort study of youths, we studied the association between negative events in 1991 (when participants were aged 4-16 years) and internalizing symptoms, assessed by the ASEBA family of instruments in 1991, 1999, and 2009 (n = 1503). Participants' trajectories of internalizing symptoms were estimated with semi-parametric regression methods (PROC TRAJ). Data were analyzed using multinomial regression models controlled for participants' sex, age, parental family status, socio-economic position, and parental history of depression.

RESULTS

Negative childhood events were associated with an increased likelihood of concurrent internalizing symptoms which sometimes persisted into adulthood (multivariate ORs associated with > = 3 negative events respectively: high and decreasing internalizing symptoms: 5.54, 95% CI: 3.20-9.58; persistently high internalizing symptoms: 8.94, 95% CI: 2.82-28.31). Specific negative events most strongly associated with youths' persistent internalizing symptoms included: school difficulties (multivariate OR: 5.31, 95% CI: 2.24-12.59), parental stress (multivariate OR: 4.69, 95% CI: 2.02-10.87), serious illness/health problems (multivariate OR: 4.13, 95% CI: 1.76-9.70), and social isolation (multivariate OR: 2.24, 95% CI: 1.00-5.08).

CONCLUSIONS

Common negative events can contribute to the onset of children's lasting psychological difficulties.

Social factors in childhood and risk of depressive symptoms among adolescents--a longitudinal study in Stockholm, Sweden

Background

In Sweden, self-reported depressive symptoms have increased among young people of both genders, but little is known about social differences in the risk of depressive symptoms among adolescents in welfare states, where such differences can be less pronounced. Therefore, the aim was to investigate whether multiple measures of low social status in childhood affect depressive symptoms in adolescence. A secondary aim was to explore potential gender effect modification.

Methods

Participants were recruited in 1998 for a longitudinal study named BROMS. The study population at baseline consisted of 3020 children, 11–12 years-old, from 118 schools in Stockholm County, followed up through adolescence. This study is based on 1880 adolescents answering the follow-up survey in 2004, at age 17–18 (62% of the initial cohort). Parental education, occupation, country of birth, employment status and living arrangements were reported at baseline, by parents and adolescents. Depressive symptoms were self-reported by the adolescents in 2004, using a 12-item inventory. The associations between childhood social status and depressive symptoms in adolescence are presented as Odds Ratios (OR), estimated through logistic regression. Gender interaction with social factors was estimated through Synergy Index (SI).

Results

Increased risk of depressive symptoms was found among adolescents whose parents had low education (OR 1.8, CI = 1.1-3.1), were unskilled workers (OR 2.1, CI = 1.2-3.7), intermediate non-manual workers (OR 1.8, CI = 1.0-3.0), or self-employed (OR 2.2, CI = 1.2-3.7), compared to parents with high education and high non-manual work. In addition, adolescents living exclusively with one adult had an increased risk compared to those living with two (OR 2.8, CI = 1.1-7.5), while having foreign-born parents was not associated with depressive symptoms. An interaction effect was seen between gender and social factors, with an increased risk for girls of low-educated parents (SI = 3.4, CI = 1.3-8.9) or living exclusively with one adult (SI = 4.9, CI = 1.4-6.8).

Conclusions

The low social position in childhood may increase the risk of depressive symptoms among adolescents even in countries with small social differences and a highly developed welfare system, such as Sweden. Girls with low educated parents or living exclusively with one adult may be particularly vulnerable. This knowledge is of importance when planning preventive interventions or treatment.

Electronic supplementary material

The online version of this article (doi:10.1186/s12939-014-0096-0) contains supplementary material, which is available to authorized users.

Patterns of heterotypic continuity associated with the cross-sectional correlational structure of prevalent mental disorders in adults

IMPORTANCE

Mental disorders predict future occurrences of both the same disorder (homotypic continuity) and other disorders (heterotypic continuity). Heterotypic continuity is inconsistent with a view of mental disorders as fixed entities. In contrast, hierarchical-dimensional conceptualizations of psychopathology, in which each form of psychopathology is hypothesized to have both unique and broadly shared etiologies and mechanisms, predict both homotypic and heterotypic continuity.

OBJECTIVE

To test predictions derived from a hierarchical-dimensional model of psychopathology that (1) heterotypic continuity is widespread, even controlling for homotypic continuity, and that (2) the relative magnitudes of heterotypic continuities recapitulate the relative magnitudes of cross-sectional correlations among diagnoses at baseline.

DESIGN, SETTING, AND PARTICIPANTS

Ten prevalent diagnoses were assessed in the same person twice (ie, in 2 waves separated by 3 years). We used a representative sample of adults in the United States (i.e., 28,958 participants 18-64 years of age in the National Epidemiologic Study of Alcohol and Related Conditions who were assessed in both waves).

MAIN OUTCOMES AND MEASURES

Diagnoses from reliable and valid structured interviews.

RESULTS

Adjusting for sex and age, we found that bivariate associations of all pairs of diagnoses from wave 1 to wave 2 exceeded chance levels (P < .05) for all homotypic (median tetrachoric correlation of ρ = 0.54 [range, 0.41-0.79]) and for nearly all heterotypic continuities (median tetrachoric correlation of ρ = 0.28 [range, 0.07-0.50]). Significant heterotypic continuity was widespread even when all wave 1 diagnoses (including the same diagnosis) were simultaneous predictors of each wave 2 diagnosis. The rank correlation between age- and sex-adjusted tetrachoric correlation for cross-sectional associations among wave 1 diagnoses and for heterotypic associations from wave 1 to wave 2 diagnoses was ρ = 0.86 (P < .001).

CONCLUSIONS AND RELEVANCE

For these prevalent mental disorders, heterotypic continuity was nearly universal and not an artifact of failure to control for homotypic continuity. Furthermore, the relative magnitudes of heterotypic continuity closely mirrored the relative magnitudes of cross-sectional associations among these disorders, consistent with the hypothesis that both sets of associations reflect the same factors. Mental disorders are not fixed and independent entities. Rather, each diagnosis is robustly related to other diagnoses in a correlational structure that is manifested both concurrently and in patterns of heterotypic continuity across time.

Chronic family economic hardship, family processes and progression of mental and physical health symptoms in adolescence

Research has documented the relationship between family stressors such as family economic hardship and marital conflict and adolescents' mental health symptoms, especially depressive symptoms. Few studies, however, have examined the processes whereby supportive parenting lessens this effect and the progression of mental health and physical health symptoms in adolescence. The present study investigates the influences of chronic family economic hardship on adolescents' multiple health problem symptoms (i.e., symptoms of anxiety, and depression and physical complaints) through parents' marital conflict, and supportive parenting; it also examines how there adolescents' health problems mutually influence one another throughout adolescence. We used Structural Equation Modeling to analyze data from a longitudinal sample of European American mothers, fathers, and target adolescents (N = 451, 53% female) to examine direct and indirect effects. Findings generally supported the hypothesized model. Chronic family economic hardship contributed to mental and physical health problems of adolescents. This influence largely was mediated through supportive parenting. Moreover, supportive parenting buffered marital conflict on depressive symptoms of adolescents. Also, there was a tendency for females to show more stable depressive symptoms than males. The study demonstrates key mediating pathways and additional moderating influences based on the family stress model and also highlights the importance of improving health resources for adolescents.