Models of adolescent psychopathology: childhood risk and the transition to adulthood.

OBJECTIVE

To examine the relationship between DSM-III disorder in adolescence (age 15 years) and DSM-III-R disorder in early adulthood (age 18 years), in relation to a history of behavior problems or disorder, other family and individual characteristics, and events commonly associated with the transition to adulthood.

METHOD

The sample came from a New Zealand birth cohort selected from the general population. Data were obtained from ages 3 to 18 years for 890 of those enrolled.

RESULTS

For both males and females, disorder at age 15 was strongly predicted by histories of early mental health problems. However, neither those histories, background characteristics, nor the experience of adolescent transition events modified the strength of association between disorder at ages 15 and 18 years. In childhood, after adjusting for histories of behavior problems, parental separations and (for boys) poor social competence remained independent predictors of disorder at age 15. Overall, boys appeared more vulnerable and those from socially disadvantaged backgrounds in early childhood had an elevated risk of disorder at age 18. After adjusting for disorder at age 15, adolescent unemployment remained an independent predictor of disorder at age 18 for both males and females.

CONCLUSIONS

This study modeled the continuity of disorder across the adolescent transition period and, after taking earlier disorder into account, identified clear predictors of later disorder. This is the first step in the process of developing more effective interventions to reduce the risk of mental health disorders.