Objective-Cognitive reserve has been proposed as important in the etiology of neuropsychiatric disorders. However, tests of the association between premorbid IQ and adult mental disorders other than schizophrenia have been limited and inconclusive. The authors tested the hypothesis that low childhood IQ is associated with increased risk and severity of adult mental disorders.Method-Participants were members of a representative 1972-1973 birth cohort of 1,037 males and females in Dunedin, New Zealand, who were followed up to age 32 with 96% retention. WISC-R IQ was assessed at ages 7, 9, and 11. Research diagnoses of DSM mental disorders were made at ages 18, 21, 26, and 32.Results-Lower childhood IQ was associated with increased risk of developing schizophrenia spectrum disorder, adult depression, and adult anxiety. Lower childhood IQ was also associated with greater comorbidity and with persistence of depression; the association with persistence of generalized anxiety disorder was nearly significant. Higher childhood IQ predicted increased risk of adult mania.Conclusions-Lower cognitive reserve, as reflected by childhood IQ, is an antecedent of several common psychiatric disorders and also predicts persistence and comorbidity. Thus, many patients who seek mental health treatment may have lower cognitive ability; this should be considered in prevention and treatment planning.Cognitive reserve has been proposed as an important etiologic factor in the development and severity of neuropsychiatric disorders (1). The construct of cognitive reserve refers to individual differences in brain structure (e.g., density of neuronal synapses) and function (e.g., processing efficiency) thought to buffer the effects of neuropathology. Evidence has emerged from the rapidly evolving field of cognitive epidemiology (2) showing that IQ, a marker of cognitive reserve, is inversely related to risk of total psychiatric illness (3). However, with the exception of research on schizophrenia (4), surprisingly few studies have examined the relation Correspondence to: Karestan C. Koenen.Address correspondence and reprint requests to Dr. Koenen, Department of Society, Human Development, and Health, Harvard School of Public Health, Kresge 613, 677 Huntington Ave., Boston, MA 02115; E-mail: kkoenen@hsph.harvard.edu (e-mail). The authors report no competing interests. NIH Public Access Author ManuscriptAm J Psychiatry. Author manuscript; available in PMC 2010 January 1. between IQ early in life and the risk of other specific adult psychiatric disorders. Among those studies that have examined other disorders, the results have been inconclusive. We report a longitudinal study of the 20-year predictive association between childhood IQ and adult mental disorders among members of the Dunedin, New Zealand, birth cohort.In the earlier studies, low IQ at military entry increased the risk of hospitalization for depression in male Swedish conscripts (5) but not male Danish conscripts (6). Studies of bipolar disorder have largely shown no associa...

INTRODUCTION Low health literacy (LHL) remains a formidable barrier to improving health care quality and outcomes. Given the lack of precision of single demographic characteristics to predict health literacy, and the administrative burden and inability of existing health literacy measures to estimate health literacy at a population level, LHL is largely unaddressed in public health and clinical practice. To help overcome these limitations, we developed two models to estimate health literacy. METHODS We analyzed data from the 2003 National Assessment of Adult Literacy (NAAL), using linear regression to predict mean health literacy scores and probit regression to predict the probability of an individual having ‘above basic’ proficiency. Predictors included gender, age, race/ethnicity, educational attainment, poverty status, marital status, language spoken in the home, metropolitan statistical area (MSA) and length of time in U.S. RESULTS All variables except MSA were statistically significant, with lower educational attainment being the strongest predictor. Our linear regression model and the probit model accounted for about 30% and 21% of the variance in health literacy scores, respectively, nearly twice as much as the variance accounted for by either education or poverty alone. CONCLUSIONS Multivariable models permit a more accurate estimation of health literacy than single predictors. Further, such models can be applied to readily available administrative or census data to produce estimates of average health literacy and identify communities that would benefit most from appropriate, targeted interventions in the clinical setting to address poor quality care and outcomes related to LHL.

Background Despite abundant evidence that lower education is associated with a higher risk of smoking, whether the association is causal has not been convincingly established. MethodsWe investigated the association between education and lifetime smoking patterns in a birth cohort established in 1959 and followed through adulthood (n ¼ 1311). We controlled for a wide range of potential confounders that were measured prior to school entry, and also estimated sibling fixed effects models to control for unmeasured familial vulnerability to smoking. Results In

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The positive benefits of father involvement often reported in the literature on child health and development can be extended into the prenatal period. Father involvement is an important, but understudied, predictor of maternal behaviors during the prenatal period, and improving father involvement may have important consequences for the health of his partner, her pregnancy, and their child.

Given the ongoing debate over whether giftedness is associated with mental health disorders, there is a great need to highlight and compare results from the most methodologically rigorous studies. Surprisingly, the vast majority of literature reviews and background sections of research articles include studies that do not directly compare gifted and nongifted youth. Furthermore, almost no attention has been paid to how differences in the definitions of giftedness or mental health outcomes of interest affect the interpretation and comparison of studies. The authors apply an epidemiologic perspective for thinking about these issues, highlight many of the challenges of studying this population, and present results from metaanalyses that include the most methodologically rigorous studies comparing rates of depression, bipolar disorder, anxiety, suicide ideation, and attention deficit hyperactivity disorder (ADHD) between gifted and nongifted youth. They conclude with recommendations to strengthen research in this area. Putting the research to useThrough this review we sought to provide concrete recommendations to strengthen future research on the mental health of gifted children. Most notably, future studies should assess large, population-based cohorts that include both gifted and nongifted individuals. Researchers should also move toward describing their study population according to their specific aptitudes, talents, skills or abilities, rather than using the general term 'gifted'. Thinking more specifically about these relationships will not only help us to understand the association between giftedness and mental health, but will also increase the potential to effectively shape programs and policies for gifted youth, focusing resources on the most vulnerable.

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Background The American Heart Association’s national goals for cardiovascular health promotion emphasize that cardiovascular risk originates early in life, but little is known about child factors that may increase the likelihood of having favorable cardiovascular risk (FCR) in adulthood. We examined the prospective association between positive child factors and likelihood of midlife FCR. We also considered pathways through which child factors may influence FCR. Methods and Results We studied 415 adults (mean age=42.2 years) of the Collaborative Perinatal Project, a national cohort initiated in 1959–1966. We examined three positive child factors assessed at age 7 years: attention regulation (ability to stay focused), cognitive ability and positive home environment. 10.6% had FCR in midlife. Adjusting for demographics and child cardiovascular health, a one unit increase in child attention regulation, cognitive ability and positive home environment was associated with 2.4 (95%CI: 1.1 to 4.7), 1.8 (95%CI: 1.1 to 2.9), and 1.3 (95%CI: 1.1 to 1.6) higher respective odds of having midlife FCR. The association with child attention regulation was maintained when accounting for adult factors; education and diet partly explained the associations with child cognitive ability and home environment. The effect of each attribute was additive as those with high levels of each child factor had 4.3 higher odds (95%CI: 1.01 to 18.2) of midlife FCR compared to those low in all factors. Conclusions Positive child psychosocial factors may promote healthy adult cardiovascular functioning. Primordial prevention efforts aimed at preventing the development of cardiovascular risk should consider building on child psychosocial resources.