Evalill Karevold

Attrition and generalizability in longitudinal studies: findings from a 15-year population-based study and a Monte Carlo simulation study

BackgroundAttrition is one of the major methodological problems in longitudinal studies. It can deteriorate generalizability of findings if participants who stay in a study differ from those who drop out. The aim of this study was to examine the degree to which attrition leads to biased estimates of means of variables and associations between them.MethodsMothers of 18-month-old children were enrolled in a population-based study in 1993 (N=913) that aimed to examine development in children and their families in the general population. Fifteen years later, 56% of the sample had dropped out. The present study examined predictors of attrition as well as baseline associations between variables among those who stayed and those who dropped out of that study. A Monte Carlo simulation study was also performed.ResultsThose who had dropped out of the study over 15 years had lower educational level at baseline than those who stayed, but they did not differ regarding baseline psychological and relationship variables. Baseline correlations were the same among those who stayed and those who later dropped out. The simulation study showed that estimates of means became biased even at low attrition rates and only weak dependency between attrition and follow-up variables. Estimates of associations between variables became biased only when attrition was dependent on both baseline and follow-up variables. Attrition rate did not affect estimates of associations between variables.ConclusionsLong-term longitudinal studies are valuable for studying associations between risk/protective factors and health outcomes even considering substantial attrition rates.

The Impact of Smoking in Adolescence on Early Adult Anxiety Symptoms and the Relationship between Infant Vulnerability Factors for Anxiety and Early Adult Anxiety Symptoms: The TOPP Study

Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18months to age 18–19years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety. Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (β = 0.17, p<0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: β = 0.85,p<0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: β = 0.55,p<0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.

Pathways from maternal distress and child problem behavior to adolescent depressive symptoms: a prospective examination from early childhood to adolescence.

Objective: The main aim of this study was to identify the pathways from maternal distress and child problem behaviors (i.e., internalizing and externalizing problems) across childhood and their impact on depressive symptoms during adolescence among girls and boys. Method: Data from families of 921 Norwegian children in a 15-year longitudinal community sample were used. Using structural equation modeling, the authors explored the interplay between maternal-reported distress and child problem behaviors measured at 5 time points from early (ages 1.5, 2.5, and 4.5 years) and middle (age 8.5 years) childhood to early adolescence (age 12.5 years), and their prediction of self-reported depressive symptoms during adolescence (ages 14.5 and 16.5 years). Results: The findings revealed paths from internalizing and externalizing problems throughout the development for corresponding problems (homotypic paths) and paths from early externalizing to subsequent internalizing problems (heterotypic paths). The findings suggest 2 pathways linking maternal-rated risk factors to self-reported adolescent depressive symptoms. There was a direct path from early externalizing problems to depressive symptoms. There was an indirect path from early maternal distress going through child problem behavior to depressive symptoms. In general, girls and boys were similar, but some gender-specific effects appeared. Problem behaviors in middle childhood had heterotypic paths to subsequent problems only for girls. Conclusion: The findings highlight the developmental importance of child externalizing problems, as well as the impact of maternal distress as early as age 1.5 years for the development of adolescent depressive symptoms. Findings also indicate a certain vulnerable period in middle childhood for girls. Note: See Supplemental Digital Content 1, at http://links.lww.com/JDBP/A45, for a video introduction to this article.

Reciprocal longitudinal associations between depressive symptoms and romantic partners’ synchronized view of relationship quality

Depressive symptoms are negatively associated with relationship satisfaction. The degree to which depression is associated longitudinally with relationship quality as assessed by both partners, versus with the depressed person’s unique view of the relationship, may have implications for interventions. Longitudinal associations between depressive symptoms and relationship satisfaction were examined among 260 couples. Individual measures of relationship satisfaction were decomposed into dyadic relationship quality and each partner’s additional unique view of the relationship. Depressive symptoms and dyadic relationship quality predicted changes in each other, which suggested that the longitudinal associations between depressive symptoms and relationship quality are not due to reporter biases or confounded by other individual factors, but rather that relationship quality and depressive symptoms affect each other over time.

Predicting Well‐Being and Internalizing Symptoms in Late Adolescence From Trajectories of Externalizing Behavior Starting in Infancy

This study aimed to examine the long-term prediction of well-being and internalizing symptoms from trajectories of externalizing behavior problems in 921 children from a population-based sample. We found that a high stable trajectory of externalizing behavior from infancy (age 1.5) to mid-adolescence (age 14.5) predicted lower scores on life satisfaction and flourishing for both girls and boys (age 18.5). The high stable trajectory also predicted higher levels of depressive symptoms in boys and anxiety symptoms in girls (age 18.5). The findings are noteworthy as they document how a person-oriented study of externalizing behavior problems starting in infancy can predict well-being and internalizing in late adolescence. The findings underline the importance of early health promotion and problem intervention efforts.

Cohort Profile: The Tracking Opportunities and Problems Study (TOPP)–study of Norwegian children and their parents followed from infancy to early adulthood

Cohort Profile: The Tracking Opportunities and Problems Study (TOPP)–study of Norwegian children and their parents followed from infancy to early adulthood Wendy Nilsen,* Anne Kjeldsen, Evalill Bølstad Karevold, Anni Skipstein, Maren Sand Helland, Kristin Gustavson, Frøydis Enstad, Silje Baardstu, Espen Røysamb, Tilmann von Soest and Kristin S. Mathiesen Department of Mental Disorders, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway, Work Research Institute, Oslo and Akershus University College of Applied Sciences, Oslo, Norway, Department of Child Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway and Department of Psychology, University of Oslo, Norway

Adolescent Depressive Symptoms and Subsequent Pregnancy, Pregnancy Completion and Pregnancy Termination in Young Adulthood: Findings from the Victorian Adolescent Health Cohort Study

STUDY OBJECTIVE To examine relationships between depressive symptoms in adolescence (14-18 years of age) and becoming pregnant, completing a pregnancy (live birth) and terminating a pregnancy in young adulthood (21-24 years of age). PARTICIPANTS AND DESIGN Data from 1000 females were drawn from a larger sample of 1943 young Australians participating in a longitudinal study of adolescent health and development, followed across 8 waves from adolescence (waves 1-6) to young adulthood (waves 7 and 8). SETTING Victoria, Australia. MAIN OUTCOME MEASURES Pregnancy, pregnancy completion and pregnancy termination between 21-24 years of age. RESULTS We observed a twofold increase in the odds of becoming pregnant in those reporting persisting patterns of depressive symptoms during adolescence (2+ waves); however, after staged adjustment for adolescent antisocial behaviour, drug use and socioeconomic disadvantage, there was no evidence of association. Of particular note, and consistent with previous research, adolescent antisocial and drug use behavior were strongly associated with becoming pregnant and pregnancy termination in young adulthood. CONCLUSIONS Adolescent antisocial and drug use behavior, not depressive symptoms, independently predict pregnancy outcomes in young adulthood.

Maternal Psychological Distress and Offspring Psychological Adjustment in Emerging Adulthood: Findings from Over 18 Years

Objective: To examine the long-term prediction of psychological maladaptive (i.e., symptoms of anxiety and depression) and adaptive adjustment (i.e., self-efficacy) in emerging adult offspring from trajectories of maternal psychological distress from toddlerhood to adolescence. Method: Trajectories of maternal psychological distress (low, moderate, high, and low-rising patterns) from toddlerhood (age 1.5 years) to adolescence (age 14.5 years) were used to predict psychological adjustment in emerging adult offspring (age 18–20 years) (n = 400). Results: Adverse maternal distress trajectories during childhood were linked to maladaptive and adaptive adjustment in adult offspring. Consistently high maternal distress levels experienced across childhood predicted higher symptoms of anxiety and depression and lower self-efficacy than low maternal distress trajectories. Two other adverse maternal distress trajectories (consistently moderate and low-rising patterns) compared with the low trajectory predicted higher offspring depressive symptoms. The findings persisted when adjusting for potential confounders: offspring gender and maternal education, relationship status, language, and economy. Conclusion: The current study showed longitudinal multi-informant impact from adverse maternal distress trajectories to adult offspring maladjustment over 18 years, emphasizing the importance of early identification and prevention.

Mothers’ and fathers’ internalizing symptoms influence parental ratings of adolescent anxiety symptoms.

Clinical assessment of anxiety in adolescents often involves multiple informants, and parental internalizing symptoms have been found to influence parent ratings of adolescents’ anxiety symptoms. We investigated how parental internalizing symptoms (anxiety and depression) were related to adolescent and parent reports of adolescents’ anxiety symptoms in a population-based cross-sectional survey. The sample comprised 337 adolescent–mother–father triads (N = 1,011) drawn from the Tracking Opportunities and Problems in Childhood and Adolescence (TOPP) study. Adolescents (43.9% boys) were 14- and 15-years old. Adolescent and parent ratings of adolescent anxiety symptoms (The Coolidge Personality and Neuropsychological Inventory for Children) were moderately and significantly correlated (mother–adolescent r = .30; father–adolescent r = .25). Parents also self-rated internalizing symptoms (Hopkins Symptom Checklist-25). Regression models showed higher maternal and paternal depression symptoms, but not anxiety symptoms, were associated with higher parent-rated adolescent anxiety symptoms. Higher maternal anxiety and depression symptoms, as well as paternal depression symptoms, but not paternal anxiety symptoms, were associated with lower parent-adolescent agreement on adolescent anxiety symptoms (i.e., parent-rating higher relative to adolescent-rating). When adolescents rate considerably lower anxiety compared with how their parents rate them, considering parental depression as a possible reason may be key to understanding adolescents’ treatment needs.

Body Dissatisfaction and Depressive Symptoms on the Threshold to Adolescence: Examining Gender Differences in Depressive Symptoms and the Impact of Social Support:

The current study focused on the relationship between body dissatisfaction and depressive symptoms on the threshold of adolescence. We aimed to investigate the role of body dissatisfaction in gender differences in depressive symptoms, as well as the impact of social support from peers and parents. Mediation and moderation analyses were based on self-reports from a Norwegian population-based sample (the Tracking Opportunities and Problems Study) of 12- to 13-year-olds (N = 547). Body dissatisfaction explained over 20% of the variance in depressive symptoms. The findings indicate that body dissatisfaction mediates gender differences in depressive symptoms, and that peer support moderates the positive association between body dissatisfaction and depressive symptoms. This is in line with Stress Exposure and Stress-Buffering models. The findings indicate that to prevent depressive symptoms in the transition into adolescence, focus should be on promoting body satisfaction, especially in girls, as well as promoting peer support for adolescents already struggling with body dissatisfaction.