Context Most adults with a psychiatric disorder first met diagnostic criteria during childhood and/or adolescence, yet specific homotypic and heterotypic patterns of prediction have not been firmly established. Objective To establish which childhood and adolescent psychiatric disorders predict particular young adult disorders when accounting for comorbidities, disaggregating similar disorders, and examining childhood and adolescent predictors separately. Design/Setting/Patients Eleven waves of data from the prospective population-based Great Smoky Mountains Study (N = 1,420) were used, covering children in the community ages 9−16, 19, and 21 years old. Outcome Common psychiatric disorders were assessed in childhood (ages 9 to 12) and adolescence (ages 13 to 16) with the Child and Adolescent Psychiatric Assessment, and in young adulthood (ages 19 and 21) with the Young Adult Psychiatric Assessment. Results Adolescent depression significantly predicted young adult depression in the bivariate analysis, but this effect was entirely accounted for by comorbidity of adolescent depression with adolescent oppositional defiant disorder, anxiety and substance disorders in adjusted analyses. Generalized anxiety and depression cross-predicted each other, and oppositional defiant disorder (but not conduct disorder) predicted later anxiety disorders and depression. Evidence of homotypic prediction was supported for substance use disorders, antisocial personality disorder (from conduct disorder) and anxiety disorders, although this effect was primary accounted for by DSM-III-R overanxious disorder. Conclusions Stringent tests of homotypic and heterotypic prediction patterns suggest a more developmentally and diagnostically nuanced picture in comparison with the previous literature. The putative link between adolescent and young adult depression was not supported. Oppositional defiant disorder was singular in being part of the developmental history of a wide range of young adult disorders.
Rationale Adolescents and young adults were identified internationally as a group with potentially low compliance rates with public health measures aimed at curbing the spread of coronavirus disease 2019 (COVID-19). Although non-compliance research during pandemics has typically focused on concurrent correlates, less is known about how prior social and psychological risk factors are associated with non-compliance during pandemics. Objective This paper leverages a prospective-longitudinal cohort study with data before and during the pandemic to describe patterns of non-compliance with COVID- 19 related public health measures in young adults and to identify which characteristics increase the risk of non-compliance. Methods Data came from an ongoing cohort study in Zurich, Switzerland (n=737). Non-compliance with public health measures and concurrent correlates were measured at age 22. Antecedent sociodemographic, social, and psychological factors were measured at ages 15-20. Young adults generally complied with COVID-19 public health measures, although non-compliance with some measures (e.g., cleaning/disinfecting mobile phones, standing 1.5-2 meters apart) was relatively higher. Results Non-compliance, especially with hygiene-related measures, was more prevalent in males, and in individuals with higher education, higher SES, and a nonmigrant background. Non-compliance was higher in young adults who had previously scored high on indicators of “antisocial potential,” including low acceptance of moral rules, pre-pandemic legal cynicism, low shame/guilt, low self-control, engagement in delinquent behaviors, and association with delinquent peers. Young adults with low trust, including in the government’s measures for fighting the virus, also complied less. Conclusions In order to increase voluntary compliance with COVID-19 measures, public health campaigns should implement strategies that foster moral obligation and trust in authorities, or leverage trustworthy individuals in the community to disseminate information. For young adults with low self-control, self-monitoring, environmental restructuring, or nudging may increase compliance. Long-term investments into integrating youth with antisocial potential into society may decrease rule-breaking behaviors, including during pandemics when compliance saves lives.
Objective-The aims of this study were twofold: 1) to provide a brief introduction to the prospective, longitudinal Great Smoky Mountains Study and review recent findings; and 2) to use this sample to conduct an epidemiologic analysis of common childhood anxiety disorders.
IMPORTANCE Psychiatric problems are among the most common health problems of childhood.OBJECTIVE To test whether these health problems adversely affect adult functioning even if the problems themselves do not persist. DESIGN, SETTING, AND PARTICIPANTSProspective, population-based study of 1420 participants from 11 predominantly rural counties of North Carolina who were assessed with structured interviews up to 6 times during childhood (9-16 years of age, for a total 6674 observations) for common psychiatric diagnoses and subthreshold psychiatric problems. The period for this study was from 1993 to 2010. MAIN OUTCOMES AND MEASURESA total of 1273 participants were assessed 3 times during young adulthood (19, 21, and 24-26 years of age, for a total of 3215 observations) for adverse outcomes related to health, the legal system, personal finances, and social functioning.RESULTS Participants with a childhood disorder had 6 times higher odds (odds ratio [OR], 5.9 [95% CI, 3.6-9.7]) of at least 1 adverse adult outcome (ie, indicator) compared with those with no history of psychiatric problems and 9 times higher odds (OR, 8.7 [95% CI, 4.3-17.8]) of 2 or more such indicators (1 indicator: 59.5% vs 19.9% [P < .001]; Ն2 indicators: 34.2% vs 5.6% [P < .001]). These associations persisted after statistically controlling for childhood psychosocial hardships and adult psychiatric problems. Risk was not limited to those who received a diagnosis; participants with subthreshold psychiatric problems had 3 times higher odds (OR, 2.9 [95% CI, 1.8-4.8]) of adult adverse outcomes and 5 times higher odds (OR, 5.1 [95% CI, 2.4-10.7]) of 2 or more outcomes (1 indicator: 41.9% vs 19.9% [P < .001]; Ն2 indicators: 23.2% vs 5.6% [P < .001]). The best diagnostic predictor of adverse outcomes was cumulative childhood exposure to psychiatric disorders.CONCLUSIONS AND RELEVANCE Common, typically moderately impairing, childhood psychiatric problems are associated with a disrupted transition to adulthood even if the problems do not persist into adulthood and even if the problems are subthreshold. Such problems provide a potential target for public health efforts to ameliorate adult suffering and morbidity.
Objective-No longitudinal studies beginning in childhood have estimated the cumulative prevalence of psychiatric illness from childhood into young adulthood. The objective of this study was to estimate the cumulative prevalence of psychiatric disorders by young adulthood and to assess how inclusion of not otherwise specified (NOS) diagnoses affects cumulative prevalence estimates. Method-The prospective, population-based Great Smoky MountainsStudy assessed 1420 participants up to 9 times between ages 9 and 21 from 11 counties in southeastern US. Common psychiatric disorders were assessed in childhood and adolescence (ages 9 to 16) with the Child and Adolescent Psychiatric Assessment, and in young adulthood (ages 19 and 21) with the Young Adult Psychiatric Assessment. Cumulative prevalence estimates were derived from multiple imputed datasets.Results-By age 21, 61.1% of participants had met criteria for a well-specified psychiatric disorder. An additional 21.4% had met criteria for an NOS disorder only, increasing the total cumulative prevalence for any disorder to 82.5%. Males had higher rates of both substance and disruptive behavior disorders compared to females; therefore they were more likely to meet criteria for either a well-specified disorder (67.8 vs. 56.7%) or any disorder (89.1 vs. 77.8%). Children with an NOS disorder only were at increased risk for a well-specified young adult disorder compared to children with no disorder in childhood.Conclusions-Only a small percentage of young people meet criteria for a DSM disorder at any given time, but most do by young adulthood. As with other medical illness, psychiatric illness is a nearly universal experience.
Background/Objective-Early pubertal timing in females is associated with psychosocial problems throughout adolescence, but it is unclear whether these problems persist into young adulthood.
Significance Bullying is a common childhood experience that affects children at all income levels and racial/ethnic groups. Being a bully victim has long-term adverse consequences on physical and mental health and financial functioning, but bullies themselves display few ill effects. Here, we show that victims suffer from greater increases in low-grade systemic inflammation from childhood to young adulthood than are seen in others. In contrast, bullies showed lower increases in inflammation into adulthood compared with those uninvolved in bullying. Elevated systemic low-grade inflammation is a mechanism by which this common childhood social adversity may get under the skin to affect adult health functioning, even many years later.
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