Pathways of self-reported problem behaviors from adolescence into adulthood

Effects of parental mental health and family environment on impulsivity in preadolescents: a longitudinal ABCD study®

Introduction

Impulsivity is a known risk factor for the development of substance use disorders and other psychiatric conditions that is influenced by both genetics and environment. Although research has linked parental mental health to children's impulsivity, potential mediators of this relationship remain understudied. The current investigation leverages the large national Adolescent Brain Cognitive Development (ABCD) Study to assess the mediating role of family conflict - an important social context for youth development - in the relationship between parental mental health and youth impulsivity.

Methods

Data were from the first three annual waves of the ABCD study (Baseline N = 11,876 children, Mage = 9.9 years; 48% female; 52% White). Parental mental health conditions were self-reported internalizing, externalizing, and total problems. Youth completed the family conflict scale, and Urgency, Planning (lack of), Perseverance (lack of), Sensation Seeking, and Positive Urgency (UPPS-P) scale to measure impulsivity. To determine if within-family change in conflict from baseline to year 1 explained changes in the strength of relations between baseline parental mental health and year 2 youth impulsivity, longitudinal causal mediation analyses were conducted, controlling for demographic factors (i.e., age, sex, race, household income, parental education, marital status), as well as baseline levels of family conflict and outcomes. Separate mediation models were run for each mental health condition and each UPPS-P subscale.

Results

Above and beyond bivariate relations, longitudinal mediation models, which included covariates, showed family conflict significantly (ps < 0.001) mediated relations between all three parental mental health conditions and all but one (i.e., sensation seeking) UPPS-P subscales. The proportion mediated through family conflict for internalizing problems and total problems on facets of impulsivity (except sensation seeking) ranged from 9% (for lack of perseverance) to 17% (for lack of planning). Proportion mediated via family conflict for externalizing problems on youth's impulsivity (except sensation seeking) was slightly higher, ranging between 13% (lack of perseverance) to 21% (lack of planning).

Discussion

Family conflict may be an important intergenerational factor linking parental mental health and youth's impulsivity. Addressing parental mental health and family conflict may help curb increased impulsivity in youth, and in turn reduce adolescent substance use disorders.

The body keeps the score: The neurobiological profile of traumatized adolescents

Trauma-related disorders are debilitating psychiatric conditions that affect people who have directly or indirectly witnessed adversities. Experiencing multiple types of traumas appears to be common during childhood, and even more so during adolescence. Dramatic brain/body transformations occurring during adolescence may provide a highly responsive substrate to external stimuli and lead to trauma-related vulnerability conditions, such as internalizing (anxiety, depression, anhedonia, withdrawal) and externalizing (aggression, delinquency, conduct disorders) problems. Analyzing relations among neuronal, endocrine, immune, and biochemical signatures of trauma and internalizing and externalizing behaviors, including the role of personality traits in shaping these conducts, this review highlights that the marked effects of traumatic experience on the brain/body involve changes at nearly every level of analysis, from brain structure, function and connectivity to endocrine and immune systems, from gene expression (including in the gut) to the development of personality.

Prevalence of Exposure to Complex Trauma and Community Violence and Their Associations With Internalizing and Externalizing Symptoms

Studies about trauma often tend to focus on abuse and neglect. However important, these studies may neglect the importance of the broader community context that is often associated with trauma, and complex trauma (CT) in particular. This study aimed to investigate the effects of CT (defined in terms of experiencing abuse and/or neglect occurring in the context of relationships with caregivers), and of broader environmental adversity (i.e., exposure to community violence), in a sample of adolescents (N = 218) from a severely disadvantaged district of Lima, Peru. The study had two aims: (a) to assess the prevalence of CT and its associations with internalizing and externalizing symptoms in these adolescents and (b) to investigate the associations between community violence and both internalizing and externalizing symptoms over and above the effects of CT. In total, 39.4% of the adolescents reported at least one type of moderate to severe trauma. There was a clear association between CT and both internalizing and externalizing symptoms. Ordinal logistic regressions showed that children who were exposed to one or more traumatic experiences were more likely to score within a higher range of internalizing and externalizing symptoms than children with no history of trauma. Finally, exposure to community violence was an important predictor of symptomatology beyond the effects of CT.

Self-Regulation Mitigates the Association between Household Chaos and Children's Behavior Problems

Given the potential negative effects that early childhood behavioral problems have on later development, it is important to elucidate risk and protective factors. This study examined household chaos as a predictor of externalizing and internalizing problems among young children from low-income families. Additionally, self-regulation was examined as a moderator of the association between chaos and behavior problems. One hundred young adult mother-toddler dyads participated. Moderation analyses indicated that self-regulation buffered the association between household chaos and child behavior problems. Specifically, greater household chaos was associated with more behavior problems, but only among children with poorer self-regulation. Notably, this pattern was observed for both externalizing and internalizing problems. These findings suggest that early interventions targeting young children's self-regulation skills could help prevent behavior problems among children living in chaotic home environments.

Ethnic Differences in Health Literacy Among Young Adults in Amsterdam

Background:

Ethnic differences in health commence early in life. Ethnic minority young adults have a greater prevalence of unhealthier lifestyles and poorer health outcomes than their peers. Variations in health literacy could contribute to these ethnic inequalities in health but have not yet been investigated in this group.

Objective:

This study investigated ethnic differences in performance-based and self-reported health literacy in young adults and examined whether these differences are explained by educational level, language difficulties, or cultural distance.

Methods:

Young adults (age 18–25 years) from Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Turkish, and Moroccan ethnic backgrounds (N = 2,215) participated in the HELIUS (HEalthy Life in an Urban Setting) study, a cohort study in Amsterdam, the Netherlands. Performance-based health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine in Dutch (REALM-D). Self-reported health literacy was measured by the Chew's Set of Brief Screening Questions (SBSQ). The association between ethnicity and health literacy, and the role of background characteristics was assessed by linear regression analyses.

Key Results:

Performance-based health literacy was low (REALM-D <60; range, 0–66) among 17% of the participants. After adjustment for educational level, average levels of REALM-D were lower among participants from a Ghanaian, Turkish, and Moroccan background than those from a Dutch background, whereas the two Surinamese groups did not differ from the Dutch group. Additional adjustment for language difficulties and cultural distance did not explain the differences between the five ethnic minority groups. Self-reported health literacy was low (SBSQ <3; range, 0–4) among 3% of the participants. There were no differences in levels of SBSQ between the ethnic minority groups and the Dutch group.

Conclusions:

We found ethnic differences in performance-based health literacy, which largely remained after adjustment for educational level. Further research is needed to gain insight into how young adults from different ethnic groups appraise and apply health information in various contexts. [HLRP: Health Literacy Research and Practice. 2018;2(4):e192–e204.]

Plain Language Summary:

We investigated ethnic differences in health literacy among young adults (age 18–25 years) living in the Netherlands. Compared to the Dutch group, some ethnic minority groups scored lower on performance-based health literacy, independent of educational level. Self-reported health literacy did not differ between Dutch and ethnic minority groups.

Attempted Suicide Among Students and Young Adults in Montreal, Quebec, Canada: A Retrospective Cross-Sectional Study of Hospitalized and Nonhospitalized Suicide Attempts Based on Chart Review

OBJECTIVE

We conducted a chart review to identify postsecondary students and nonstudents in the same age range who presented to the emergency department following a suicide attempt to (1) compare demographic characteristics and suicide risk factors and (2) determine factors associated with more serious attempts requiring hospitalizations.

METHOD

The study was conducted in 1 tertiary trauma hospital and 1 community hospital affiliated with McGill University, Montreal, Quebec, Canada, between January 1, 2009, and March 31, 2010. Charts of patients with potential suicide attempts were identified from medical records using ICD-10 codes that indicated traumatic injury, intentional self-harm, poisoning, and psychiatric or perception/cognition disorders and from the emergency department triage file using keywords that indicated suicidality or self-harm at presentation.

RESULTS

In multivariable logistic regression models (odds ratio, 95% CI), students were younger (per 5-year increase: 0.22, 0.12-0.41), less likely to be born in Canada (0.17, 0.06-0.44), and more likely to use less violent methods (laceration, poisoning, other, multiple methods) versus more violent methods (collision, jump, fire burns, firearm, hanging) in their attempt. Fewer students had a history of substance abuse (0.12, 0.02-0.94) but were not different from nonstudents on history of other mental disorders. Less students attempted suicide in the winter/spring (January-April) versus fall (September-December) semester (0.32, 0.11-0.91). Students who attempted suicide were more likely to have family/social support. Those who attempted suicide in the previous year were more likely to require hospitalization for their current suicide attempt.

CONCLUSIONS

Knowledge of specific factors associated with suicide attempts in young people can help inform and guide suicide prevention efforts in both academic and community settings. Specific to the findings of this study regarding the method of suicide attempt used, for example, limiting access to dangerous substances or large quantities of medications may help prevent or reduce suicide attempts in this population.

Mental disorders diagnosed in childhood and at-risk mental state in a help-seeking population

AIM

Disorders usually first diagnosed in infancy, childhood or adolescence (DUFD-ICA) may have preceded the onset of psychosis by several years and share some co-morbidity with psychotic disorders, but only a few studies have investigated this aspect. We looked for past or current DUFD-ICA in a sample of first adult psychiatric service users assessed for the presence of an at-risk mental state with the Structured Interview for Psychosis-risk Syndromes (SIPS).

METHODS

We interviewed with the SIPS 159 first-time help seekers (age range 13-30 years) at adult psychiatric services who volunteered to participate in the study. For psychiatric diagnoses, we used the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition-Text Revision. We also assessed retrospectively the presence of DUFD-ICA and administered the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning. The sample has been subdivided diagnostically into first-episode psychosis, multiple episode psychosis, ultra-high risk (UHR) and other diagnoses.

RESULTS

The risk for having one of first-episode psychosis, multiple episode psychosis or UHR was over 3.45 higher in the DUFD-ICA-positive history group than in the non-DUFD-ICA. Grouping the UHR with the not full-blown psychosis cases resulted in a further increase of the risk to 4.71. DUFD-ICA-positive participants scored higher than non-DUFD-ICA on the Positive, Negative and Disorganization scales of the SIPS and on several core-psychotic BPRS items.

CONCLUSIONS

A positive history of DUFD-ICA increases the risk of a diagnosis of prodromal or current psychosis at help seeking. Impaired neurodevelopment may be shared among the psychoses and DUFD-ICA.

Neighborhood perceptions and emotional well-being in young adulthood

PROBLEM

While mounting research suggests that neighborhood environment impacts mental health outcomes, for adolescents and adults, there is scant research on how perceived neighborhood context affects young adults. In this article, we explore the role of perceived neighborhood characteristics, specifically indicators of perceived neighborhood stressors, on emotional well-being among young adults.

METHOD

Using a regional sample of young adults, we estimate regression models to examine the relationship of perceived neighborhood stressors on three mental health outcomes (depressed affect, hopelessness, and anger), reflective of a general emotional well-being, while controlling for key individual characteristics related to mental health outcomes.

FINDINGS

Results show perceived neighborhood effects for emotional well-being consistent with a stress process model where the scale of perceived neighborhood stressors is associated with poor emotional well-being for depressed affect and hopelessness. Specific perceived neighborhood measures were significant for each of the mental health outcomes whereby greater perceptions of unsafe conditions and economic hardship are positively associated with poor emotional well-being and greater social intervention and more social attachments are associated with better emotional well-being.

CONCLUSION

For young adults, perceptions of neighborhood stressors are related to indicators of mental health. We discuss the implications of our findings for ongoing research on neighborhood contextual effects and mental health during the transition to adulthood.

Suicide Risk at Young Adulthood: Continuities and Discontinuities From Adolescence

Young adult suicide is an important social problem, yet little is known about how risk for young adult suicide develops from earlier life stages. In this study the authors report on 759 young adults who were potential high school dropouts as youth. At both adolescence and young adulthood, measures of suicide risk status and related suicide risk factors are collected. With a two-by-two classification on the basis of suicide risk status at both adolescence and young adulthood, the authors distinguish four mutually exclusive groups reflecting suicide risk at two life stages. Using ANOVA and logistic regression, both adolescent and young adult suicide risk factors are identified, with evidence of similarity between risk factors at adolescence and at young adulthood, for both individual-level and social-context factors. There is also support for both continuity and discontinuity of adolescent suicide risk. Implications for social policy are discussed.

Low birth weight and psychiatric morbidity; stability and change between adolescence and young adulthood

BACKGROUND

Being born with low birth weight is a risk factor for psychiatric morbidity. Few longitudinal studies have included diagnostic assessment and followed subjects into adulthood.

AIM

To assess stability and change in psychiatric morbidity between adolescence and young adulthood in low birth weight subjects, and explore whether screening in adolescence can predict subsequent psychopathology in these groups.

STUDY DESIGN

Prospective geographically based follow-up study of two low birth weight groups and a control group born between 1986 and 1988, assessed at 14 (T1) and 20 (T2) years of age.

SUBJECTS

Thirty eight subjects born preterm with very low birth weight (VLBW: ≤1500g), 43 born at term but small for gestational age (SGA: <10th percentile) and 64 controls with normal birth weight participated.

OUTCOME MEASURES

Mental health was assessed using diagnostic psychiatric interview at both study points supplemented with the Achenbach System of Empirically Based Assessment and Children's Global Assessment Scale at T1.

RESULTS

There was a trend towards increasing morbidity from T1 among VLBW (p=0.086) and a significant increase among SGA (p=0.003) participants. Supplementary assessment at T1 discriminated satisfactory between persons with and without psychiatric disorders at T2 (area under ROC curve: 0.66 to 0.89), but was most effective in the VLBW group.

CONCLUSION

High psychiatric morbidity continued into young adulthood in the VLBW group and increased significantly in the SGA group. Screening in adolescence can be used to detect individuals at risk especially among those born at very low birth weight.

Dimensional structure and measurement invariance of the youth self-report across gender and age

PURPOSE

The aim of the present work was to examine the correlated eight-syndrome model of the Youth Self-Report (YSR) proposed by Ivanova et al [1], using a confirmatory factor analysis for ordinal data. Likewise, we explored the measurement invariance of the YSR across gender and age using multigroup comparisons, and checked whether there were differences in the latent means.

METHODS

The sample was made up of 4,868 nonclinical adolescents (47.6% males), with a mean age of 14.6 years (SD = 1.6).

RESULTS

The correlated eight-syndrome model proposed by Ivanova et al [1] showed a reasonable fit to the data, both for the total sample and by participants' gender and age. Moreover, the factor-equivalence analysis showed that the hypothesized dimensional model was invariant across gender and age. Statistically significant differences were found when comparing latent means between the groups.

CONCLUSIONS

These results coincide with those found in the literature and are in support of the replicability, generalizability, and consistency of the eight-syndrome model of the YSR, as well as its measurement invariance across gender and age. Future studies should explore the measurement invariance of this model through multigroup comparisons across cultures.

Adolescent health care in India: progressive, regressive or at the cross-roads?

India has a sizeable adolescent population. Adolescents constitute a vulnerable population for both mental and physical illnesses, and yet their health-care needs and delivery systems are neither well defined nor developed. Many of the mental, reproductive and nutritional health needs of this population are required to be addressed and can be addressed in the primary-care pediatric setting itself if the current system of health-care can be re-organized. This restructuring will be more effective for this population if adolescent friendly approaches, public-private partnership and policy as well as sectoral linkage between the NRHM and other national programs are achieved. The health program for this age group should have promotive and preventive as well as remedial and curative components. Also, improving the availability of trained personnel in these areas of health, culturally sensitive evidence based approaches and capacity building in the primary-care approach is essential to ensure the viability of adolescent health-care in this country.

New frontiers in animal research of psychiatric illness

Alterations in neurodevelopment are thought to modify risk of numerous psychiatric disorders, including schizophrenia, autism, ADHD, mood and anxiety disorders, and substance abuse. However, little is known about the cellular and molecular changes that guide these neurodevelopmental changes and how they contribute to mental illness. In this review, we suggest that elucidating this process in humans requires the use of model organisms. Furthermore, we advocate that such translational work should focus on the role that genes and/or environmental factors play in the development of circuits that regulate specific physiological and behavioral outcomes in adulthood. This emphasis on circuit development, as a fundamental unit for understanding behavior, is distinct from current approaches of modeling psychiatric illnesses in animals in two important ways. First, it proposes to replace the diagnostic and statistical manual of mental disorders (DSM) diagnostic system with measurable endophenotypes as the basis for modeling human psychopathology in animals. We argue that a major difficulty in establishing valid animal models lies in their reliance on the DSM/International Classification of Diseases conceptual framework, and suggest that the Research Domain Criteria project, recently proposed by the NIMH, provides a more suitable system to model human psychopathology in animals. Second, this proposal emphasizes the developmental origin of many (though clearly not all) psychiatric illnesses, an issue that is often glossed over in current animal models of mental illness. We suggest that animal models are essential to elucidate the mechanisms by which neurodevelopmental changes program complex behavior in adulthood. A better understanding of this issue, in animals, is the key for defining human psychopathology, and the development of earlier and more effective interventions for mental illness.

Perceived discrimination and antisocial behaviors in Puerto Rican children

This study examined whether perceived discrimination was related to antisocial behaviors (ASB) in a probability sample of Puerto Rican children living in the South Bronx, New York and the San Juan Metropolitan area of Puerto Rico (N = 1,271). After adjusting for a host of well-known factors associated with ASB, such as sociodemographic variables (i.e., age, gender, household composition), psychosocial stressors (i.e., stressful life events, exposure to violence), and various forms of violence and abuse (i.e., coercive parental discipline, verbal, psychological, physical and sexual abuse), perceived discrimination remained a robust correlate of ASB among both samples. Findings are discussed with reference to the detrimental associations of perceived discrimination.

Does adolescent risk taking imply weak executive function? A prospective study of relations between working memory performance, impulsivity, and risk taking in early adolescence

Studies of brain development suggest that the increase in risk taking observed during adolescence may be due to insufficient prefrontal executive function compared to a more rapidly developing subcortical motivation system. We examined executive function as assessed by working memory ability in a community sample of youth (n = 387, ages 10 to 12 at baseline) in three annual assessments to determine its relation to two forms of impulsivity (sensation seeking and acting without thinking) and a wide range of risk and externalizing behavior. Using structural equation modeling, we tested a model in which differential activation of the dorsal and ventral striatum produces imbalance in the function of these brain regions. For youth high in sensation seeking, both regions were predicted to develop with age. However, for youth high in the tendency to act without thinking, the ventral striatum was expected to dominate. The model predicted that working memory ability would exhibit (1) early weakness in youth high in acting without thinking but (2) growing strength in those high in sensation seeking. In addition, it predicted that (3) acting without thinking would be more strongly related to risk and externalizing behavior than sensation seeking. Finally, it predicted that (4) controlling for acting without thinking, sensation seeking would predict later increases in risky and externalizing behavior. All four of these predictions were confirmed. The results indicate that the rise in sensation seeking that occurs during adolescence is not accompanied by a deficit in executive function and therefore requires different intervention strategies from those for youth whose impulsivity is characterized by early signs of acting without thinking.

Adolescent depressive symptomatology and young adult educational attainment: an examination of gender differences

PURPOSE

To examine the association between depressive symptomatology during adolescence and educational attainment in young adulthood and to determine whether this association varies by gender.

METHODS

This study uses data from the first and third waves of the National Longitudinal Study of Adolescent Health (Add Health). Symptoms associated with depression are assessed at Wave 1 with the Center for Epidemiologic Studies Depression Scale (CES-D). Educational attainment is assessed at Wave 3. Measures include failure to complete high school and failure to enter college (among high school graduates). The analytic sample contains 14,232 respondents aged 11-21 years at Wave 1 and aged 18-28 years at Wave 3. Approximately half the sample is female.

RESULTS

Adjusting for individual and family-level characteristics, depressive symptomatology during adolescence is associated with increased odds of failure to complete high school, but only for girls. Among high school graduates of both genders, depressive symptomatology is associated with failure to enter college.

CONCLUSIONS

This study offers support for the hypothesis that mental health problems experienced early in the life course impair status attainment.

Personality and psychopathology in Flemish referred children: five perspectives of continuity

The present study investigates five types of continuity of personality and internalizing and externalizing problems (i.e., structural, differential, mean-level, individual-level and ipsative continuity) in a sample of referred children and adolescents (N = 114) with a broad variety of psychological problems. Mothers were administered a child personality and psychopathology measure, i.e., the Hierarchical Personality Inventory for Children [Handleiding hiërarchische persoonlijkheidsvragenlijst voor kinderen (manual hierarchical personality inventory for children). Ghent University, Department of Developmental, Personality, and Social Psychology, Ghent, 2005] and the Child Behavior Checklist [Handleiding voor de cbcl/4-18: (Manual of the CBCL/4-18), Afdeling Kinder- en Jeugdpsychiatrie. Erasmus Universiteit Rotterdam, The Netherlands, 1996] at two measurement occasions, with a 26-months interval. Personality was substantially stable, paralleling findings for non-referred peers. Internalizing and Externalizing Problem Behavior were almost as stable as personality traits, suggesting that childhood psychopathology is more persistent than generally assumed. Strengths and limitations of the present study and implications for further research are discussed.

Parenting Latino Toddlers and Preschoolers

Parenting practices contribute significantly to the social-emotional development of young children. There is limited literature that addresses the role of culture in parenting, particularly among Latino families who have very young children with significant behavior problems. The current study compared the parenting practices of 30 low-income Latino mothers whose young children had been referred for mental health services for their behavior problems with a similar group of 30 mothers of children without behavior problems. Results showed that mothers in the clinical sample nurtured their children less often and used more frequent verbal and corporal punishment as discipline than the nonclinical sample. The clinical sample also had a significantly higher incidence of mental health problems in their families. Results also showed the significant toll that raising young children with challenging behaviors takes on their mothers. The implications of these findings for the early identification of these children are discussed.

Dysthymia in male adolescents is associated with increased risk of later hospitalization for psychotic disorders: a historical-prospective cohort study

AIM

Retrospective studies indicate that patients with psychotic disorders and schizophrenia often suffer from depressive symptoms before the onset of psychosis. In a historical-prospective design, we studied the association between dysthymia in adolescence and later hospitalization for psychotic disorders and schizophrenia.

METHODS

The Israeli Draft Board screens the entire, unselected population of 16-17 years old male adolescents for psychiatric disorders. These adolescents were followed for hospitalization for psychotic disorders and schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry. Of 275,705 male adolescents screened, 1267 (0.5%) were hospitalized for psychotic disorders (International Classification of Diseases [ICD]-10 20.0-29.9), and 757 (0.3%) were hospitalized for schizophrenia (ICD-10 20.0-20.9) over the next 1-10 years.

RESULTS

Of 275,705 male adolescents screened, 513 (0.2%) were diagnosed as suffering from dysthymia by the Draft Board. Of these adolescents, 10/513 (2.0%) were later hospitalized for psychotic disorders (including schizophrenia, HR=3.967, 95%CI (confidence intervals): 2.129-7.390), and 4/513 (0.8%) were later hospitalized for schizophrenia (HR=2.664, 95%CI: 0.997-7.116).

CONCLUSIONS

In this population-based cohort of male adolescents, dysthymia was associated with increased risk for future psychotic disorders. Dysthymia in some adolescents might be a prodromal symptom, while in others it might be a risk factor for later psychosis. Clinicians assessing dysthymic adolescents should be aware that these symptoms might be part of the prodrome.

Genetically informative designs in the study of resilience in developmental psychopathology

The study of resilience, defined here as the ability to recover from a prior illness or the capacity to remain well in the face of extraordinary genetic or environmental risk factors, is the focus of this article. We believe that to study resilience in the domain of developmental psychopathology it is necessary to use genetically informative strategies. Extending this argument to the study of resilience (eg, why some kids recover) is the focus of last part this article and our research strategies in the next decade.

Childhood predictors of drunkenness in late adolescence among males: a 10-year population-based follow-up study

AIMS

To study childhood precursors of drunkenness frequency among 18-year-old boys in a representative, nation-wide 10-year follow-up study.

DESIGN

In 1989, a general population sample of 2,946 8-year-old boys was collected. Three different informant sources were used: parents, teachers and the boys themselves. The follow-up was 10 years later in 1999, when the boys were called up for their obligatory military service at age 18. Information about drunkenness frequency was obtained from 78.3% (n=2306) of the original sample.

SETTING

Finland, nation-wide; in 1989 at schools, in 1999 at the obligatory military call-up.

PARTICIPANTS

General population sample of Finnish boys born in 1981.

MEASUREMENTS

At age 8, the Rutter A2 scale, Rutter B2 scale and Child Depression Inventory (CDI) were used. At age 18, self-reported drunkenness frequency during the previous 6 months was determined.

FINDINGS

Of the subjects, 15.0% reported never being drunk from alcohol, 74.6% reported being occasionally drunk and 10.4% reported being drunk at least once a week during the previous 6 months. After adjusting for other variables, teacher's estimate of the child's problem behaviour at age 8 predicted frequent drunkenness in late adolescence. Hyperactive problems predicted both occasional and frequent drunkenness. Conduct problems at age 8 predicted only frequent drunkenness. High teacher-reported scores of emotional problems predicted lower occurrence of drunkenness-orientated alcohol use.

CONCLUSIONS

The educational system has a potential role in detecting boys at risk of later risk-taking behaviours, such as frequent drunkenness. Early interventions in children with conduct problems and hyperactivity are called for.

DSM-oriented scales and statistically based syndromes for ages 18 to 59: linking taxonomic paradigms to facilitate multitaxonomic approaches

We used behavioral and emotional problem items to construct (a) nosologically based Diagnostic and Statistical Manual of Mental Disorders (DSM) oriented scales from experts' ratings of the items' consistency with DSM-IV (4th ed.; American Psychiatric Association, 1994) diagnostic categories, and (b) statistically based syndromes from factor analyses of adults' self-ratings and ratings of adults by people who knew them (N = 4,628). Quantified, operationally defined, and normed DSM-oriented scales and statistically based syndromes facilitate multitaxonomic approaches to the assessment of adult psychopathology. Psychometric properties and cross-informant correlations were similar for DSM-oriented scales and statistically derived syndromes. Statistical associations between phenotypically similar DSM-oriented scales and statistically based syndromes were moderate to strong. Multitaxonomic approaches can avoid reification of provisional taxa that may result from excessive reliance on a single taxonomic paradigm.

Evaluation of non-response bias in mental health determinants and outcomes in a large sample of pre-adolescents

Since non-response may jeopardize the validity of studies, comprehensive assessment of non-response is a prerequisite for proper interpretation of study findings. Recently, the baseline assessment of the TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study among Dutch pre-adolescents, was completed. The aim of this report is to examine non-response bias by comparing responders and non-responders regarding mental health determinants (e.g., demographics and cognitive performance) and outcomes, as well as associations between the two. Furthermore, we examine whether extended efforts to recruit participants contribute to the prevention or reduction of non-response bias. Thanks to various recruitment procedures, the initial response rate of 66% increased to a final rate of 76%. The extended efforts to recruit participants prevented non-response bias in the prevalence rates of psychopathology. Although non-responders differed from responders with respect to several individual characteristics, no significant differences were found regarding associations between these characteristics and psychopathology. We conclude that TRAILS provides a solid basis to improve our understanding of the development of mental health during adolescence.

Early anxious/withdrawn behaviours predict later internalising disorders

BACKGROUND

The aim of the study was to examine the association between anxious/withdrawn behaviours at age 8 and the development of internalising disorders in adolescence and young adulthood (ages 16-21).

METHODS

Data were gathered over the course of a 21-year longitudinal study of a birth cohort of over 1,000 New-Zealand-born young people. Over the course of the study, data were gathered on: (a) anxious/withdrawn behaviour at age 8; (b) anxiety disorders and major depression at ages 16-18 and 18-21; (c) a range of potential confounding factors, including measures of adversity and family factors during childhood.

RESULTS

Increasing anxious/withdrawn behaviour at age 8 was associated with increasing risks of social phobia; specific phobia; panic/agoraphobia; and major depression during adolescence and young adulthood. These associations persisted after adjustment for a series of confounding social, childhood, and family factors.

CONCLUSIONS

Anxious/withdrawn behaviour in childhood is associated with elevated rates of anxiety disorders and major depression during adolescence and young adulthood. These data are consistent with, and extend, previous clinical and epidemiologic findings, by showing consistent linkages between childhood anxious/withdrawn behaviours at age 8 and increased risk for anxiety disorders and depression at ages 16-18 and 18-21 among young persons in the community. These results may point to the need to provide support and possibly intervention to children showing early anxious or withdrawn behaviours.