This article reports a comparison on outcomes of 26-year-old males who were defined several
years ago in the Dunedin longitudinal study as exhibiting childhood-onset versus adolescent-onset
antisocial behavior and who were indistinguishable on delinquent offending in adolescence.
Previous studies of these groups in childhood and adolescence showed that childhood-onset
delinquents had inadequate parenting, neurocognitive problems, undercontrolled temperament,
severe hyperactivity, psychopathic personality traits, and violent behavior. Adolescent-onset
delinquents were not distinguished by these features. Here followed to age 26 years, the
childhood-onset delinquents were the most elevated on psychopathic personality traits,
mental-health problems, substance dependence, numbers of children, financial problems, work
problems, and drug-related and violent crime, including violence against women and children. The
adolescent-onset delinquents at 26 years were less extreme but elevated on impulsive personality
traits, mental-health problems, substance dependence, financial problems, and property offenses.
A third group of men who had been aggressive as children but not very delinquent as adolescents
emerged as low-level chronic offenders who were anxious, depressed, socially isolated, and had
financial and work problems. These findings support the theory of life-course-persistent and
adolescence-limited antisocial behavior but also extend it. Findings recommend intervention with
all aggressive children and with all delinquent adolescents, to prevent a variety of maladjustments
in adult life.
SummaryBackground-Research into social inequalities in health has tended to focus on low socioeconomic status in adulthood. We aimed to test the hypothesis that children's experience of socioeconomic disadvantage is associated with a wide range of health risk factors and outcomes in adult life.
Background
Most information about the lifetime prevalence of mental disorders comes from retrospective surveys, but how much these surveys have undercounted due to recall failure is unknown. We compared results from a prospective study with those from retrospective studies.
Method
The representative 1972–1973 Dunedin New Zealand birth cohort (n=1037) was followed to age 32 years with 96% retention, and compared to the national New Zealand Mental Health Survey (NZMHS) and two US National Comorbidity Surveys (NCS and NCS-R). Measures were research diagnoses of anxiety, depression, alcohol dependence and cannabis dependence from ages 18 to 32 years.
Results
The prevalence of lifetime disorder to age 32 was approximately doubled in prospective as compared to retrospective data for all four disorder types. Moreover, across disorders, prospective measurement yielded a mean past-year-to-lifetime ratio of 38% whereas retrospective measurement yielded higher mean past-year-to-lifetime ratios of 57% (NZMHS, NCS-R) and 65% (NCS).
Conclusions
Prospective longitudinal studies complement retrospective surveys by providing unique information about lifetime prevalence. The experience of at least one episode of DSM-defined disorder during a lifetime may be far more common in the population than previously thought. Research should ask what this means for etiological theory, construct validity of the DSM approach, public perception of stigma, estimates of the burden of disease and public health policy.
Most adult disorders should be reframed as extensions of juvenile disorders. In particular, juvenile conduct disorder is a priority prevention target for reducing psychiatric disorder in the adult population.
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