Stephanie Kasen

Variations in Patterns of Developmental Transitions in the Emerging Adulthood Period.

The assumption of adult roles has largely been examined as status changes in school attendance, leaving the parental home, and marriage. Nevertheless, levels of autonomy and individuation vary considerably within these states. This study obtained such information through narrative behavioral descriptions within financial, residential, romantic, and family formation domains covering ages 17 to 27 years. Analyses of data from 240 members of a community-based longitudinal study investigated the association of trajectories in these domains with family socioeconomic status, parental divorce, gender, and race. Findings indicated that subgroup differences were not generally attributable to educational enrollment. Both within and between domains, many individuals showed dramatic changes in the assumption of adult roles, returning to more dependent, other-determined roles for short or even extended periods.

Age-related change in personality disorder trait levels between early adolescence and adulthood: a community-based longitudinal investigation.

Objective: To investigate change in personality disorder (PD) traits between early adolescence and early adulthood among individuals in the community.

The impact of school emotional climate on student psychopathology

Reports of differences among schools in emotional and social climate were related to changes in behavioral and emotional problems and alcohol use in students who remained in these schools over a 2-year interval. Four dimensions of school climate were examined. School conflict and social facilitation were shown to be related to increases in childhood psychopathology, whereas student autonomy was not. Effects of academic focus were even stronger than those of conflict, in the sense of being independently related to more syndromes. School climate effects were examinedfor conditionality on student characteristics and for synergism, It was concluded that intervention to alter the school climate may promote the emotional and behavioral well-being of children and adolescents.

Adolescent school experiences and dropout, adolescent pregnancy, and young adult deviant behavior

Predictive effects of school experiences were studied over a 7-year interval in a random community sample of 452 adolescents, 12 through 18 years of age. Outcomes examined included dropping out of school, adolescent pregnancy, engaging in criminal activities, criminal conviction, antisocial personality disorder, and alcohol abuse. Logistic regression showed academic achievement, academic aspirations, and leaming-focused school settings to be related to a decline in deviant outcomes independent of the effects of disadvantaged socioeconomic background, low intelligence, childhood conduct problems, and having deviant friends during adolescence. Associations between school conflict and later deviancy were mediated by deviant peer relationships in adolescence and other school characteristics. Prior research reporting continuity of childhood conduct problems and the influence of adolescent affiliations with deviant peers on negative outcomes was supported. Implicationsfor using the school context in riskfactor research and the practical applications of such research for intervention are discussed.

Comorbid Axis I and Axis II Disorders in Early Adolescence: Outcomes 20 Years Later

CONTEXT Although Axis II personality disorders in adolescence have been linked to psychopathology and psychosocial impairment in early adulthood, little is known about their effects over longer periods. OBJECTIVES To evaluate and compare long-term prognoses of adolescent personality disorders and co-occurring Axis I disorders. DESIGN Population-based longitudinal study. SETTING Upstate New York. PARTICIPANTS A community sample of 629 adolescents interviewed at a mean age of 13.8 years and again at a mean age of 33.2 years. MAIN OUTCOME MEASURES Clinically assessed psychiatric disorders and self-reported attainment and function. RESULTS Axis I (mood, anxiety, disruptive behavior, and substance use disorders) and Axis II disorders in adolescence showed risks for negative prognoses lasting 20 years. Co-occurring Axis I and Axis II disorders consistently presented the highest risk, often approximating the sum of the axis-associated risk or even several times the risk of disorders in either axis alone. CONCLUSIONS Long-term prognoses of Axis I and Axis II disorders are of comparable magnitude and often additive when comorbid. These findings are highly relevant to the current debate over how personality disorders should be handled in DSM-V.

Diagnostic predictors of treatment patterns in a cohort of adolescents

Data on 776 American adolescents studied longitudinally were used to show treatment patterns related to psychiatric disorders. When DSM-III-R diagnoses based on mother and youth Diagnostic Interview Schedule for Children interviews were used prospectively to determine subsequent treatment seeking, it was found that consultation with mental health specialists, but not with pediatricians or general practitioners, was elevated in those with disorders. The specific diagnoses most associated with treatment seeking were conduct disorder and oppositional/defiant disorder. No compensation for differences in mental health service usage between children with internalizing disorders and those with externalizing disorders in the form of help from informal or other professional sources was present.

Obesity and psychopathology in women : a three decade prospective study

Objective:To evaluate prospective associations between elevations in body mass index (BMI) at average age 27 and generalized anxiety disorder (GAD) and major depressive disorder (MDD) at average age 59 in a community sample of women.Design:Three waves of data collected over three decades were drawn from mothers in the Children in the Community (CIC) Study. Binary logistic regression was used to estimate predictive effects of two BMI cutpoints (⩾30 and ⩾25) on GAD and MDD independent of other risks for psychopathology.Subjects:The 544 mothers who were interviewed in the original wave of the CIC Study in 1975 and in the first and most recent follow-up waves in 1983 and 2002–2005.Measurements:Information about height and weight was obtained by self-report in face-to-face interviews. GAD and MDD were assessed by structured interview covering DSM-IV diagnostic criteria. Other potential risk factors examined included age, race, education, prior depressive symptoms and marital status, chronic disease, social support and financial strain concurrent with GAD and MDD.Results:A baseline BMI ⩾30 significantly increased the odds for subsequent GAD and MDD by 6.27 and 5.25 times, respectively, after adjusting for other significant risk factors. Odds of GAD also increased significantly given a baseline BMI ⩾25 (by 2.44 times); however this association was not independent of other significant risk factors. Predictive associations between a baseline BMI ⩾30 and MDD were not attenuated by attained BMI assessed at outcome.Conclusion:Findings extend existing evidence of the mental health consequences of obesity in a representative sample of mothers, and suggest that obesity may have long-term implications for mental distress in women at a clinical level over the adult years.

Depression in Adult Women: Age Changes and Cohort Effects

OBJECTIVES We sought to separate age and cohort associations with depression, assessed 3 times within a 10-year period in 701 women born between 1928 and 1958. METHODS We used regression analysis to examine age differences in women with depression in 2 birth cohorts, pre-1945 and post-1944, who were assessed at comparable ages. Multilevel modeling was used to estimate changes with age in successive birth year cohorts. RESULTS An age by cohort interaction indicated more depression among younger than older women in the post-1944 cohort but a flat age profile in the pre-1945 cohort. Longitudinal analyses indicated declines in depression with age in more recent cohorts but increases in earlier ones. CONCLUSIONS Increases in depression in younger women in successive cohorts may be offset by decreases in middle age.

Personality disorder traits associated with risk for unipolar depression during middle adulthood

Data from the Children in the Community Study, a prospective longitudinal investigation, were used to investigate the association of personality disorder (PD) traits, evident by early adulthood, with risk for the development of unipolar depressive disorders by middle adulthood. Antisocial, borderline, dependent, depressive, histrionic, and schizotypal PD traits, identified between ages 14 and 22, were significantly associated with risk for dysthymic disorder (DD) or major depressive disorder (MDD) by a mean age of 33 after a history of unipolar depression and other psychiatric disorder was controlled statistically. Individuals without a history of unipolar depression who met diagnostic criteria for > or =1 PD by a mean age of 22 were at elevated risk for DD or MDD by a mean age of 33 years. Individuals identified as having a DSM-IV Cluster A (paranoid, schizoid, or schizotypal) or Cluster C (avoidant, dependent, obsessive-compulsive) PD by a mean age of 22 years were at elevated risk for recurrent or chronic unipolar depression. The findings of this study suggest that some types of PD traits that become evident by early adulthood may contribute to an increased risk for the development or recurrence of unipolar depressive disorders by middle adulthood.

Religiosity and resilience in persons at high risk for major depression

BACKGROUND Few studies have examined religiosity as a protective factor using a longitudinal design to predict resilience in persons at high risk for major depressive disorder (MDD). METHOD High-risk offspring selected for having a depressed parent and control offspring of non-depressed parents were evaluated for psychiatric disorders in childhood/adolescence and at 10-year and 20-year follow-ups. Religious/spiritual importance, services attendance and negative life events (NLEs) were assessed at the 10-year follow-up. Models tested differences in relationships between religiosity/spirituality and subsequent disorders among offspring based on parent depression status, history of prior MDD and level of NLE exposure. Resilience was defined as lower odds for disorders with greater religiosity/spirituality in higher-risk versus lower-risk offspring. RESULTS Increased attendance was associated with significantly reduced odds for mood disorder (by 43%) and any psychiatric disorder (by 53%) in all offspring; however, odds were significantly lower in offspring of non-depressed parents than in offspring of depressed parents. In analyses confined to offspring of depressed parents, those with high and those with average/low NLE exposure were compared: increased attendance was associated with significantly reduced odds for MDD, mood disorder and any psychiatric disorder (by 76, 69 and 64% respectively) and increased importance was associated with significantly reduced odds for mood disorder (by 74%) only in offspring of depressed parents with high NLE exposure. Moreover, those associations differed significantly between offspring of depressed parents with high NLE exposure and offspring of depressed parents with average/low NLE exposure. CONCLUSIONS Greater religiosity may contribute to development of resilience in certain high-risk individuals.