Disorders In Young Adults Research Articles

Mental disorders in young adulthood

The effect of mental disorders may be particularly detrimental in early adulthood, and information on mental disorders and their correlates in this age group is important. A questionnaire focusing on mental health was sent to a nationally representative two-stage cluster sample of 1863 Finns aged 19 to 34 years. Based on a mental health screen, all screen-positives and a random sample of screen-negatives were asked to participate in a mental health assessment, consisting of the Structured Clinical Interview for DSM-IV (SCID-I) interview and neuropsychological assessment. We also obtained case-notes from all lifetime mental health treatments. This paper presents prevalences, sociodemographic associations and treatment contacts for current and lifetime mental disorders. Forty percent of these young Finnish adults had at least one lifetime DSM-IV Axis I disorder, and 15% had a current disorder. The most common lifetime disorders were depressive disorders (17.7%) followed by substance abuse or dependence (14.2%) and anxiety disorders (12.6%). Of persons with any lifetime Axis I disorder, 59.2% had more than one disorder. Lower education and unemployment were strongly associated with current and lifetime disorders, particularly involving substance use. Although 58.3% of persons with a current Axis I disorder had received treatment at some point, only 24.2% had current treatment contact. However, 77.1% of persons with a current Axis I disorder who felt in need of treatment for mental health problems had current treatment contact. Mental disorders in young adulthood are common and often co-morbid, and they may be particularly harmful for education and employment in this age group.

Positive Functioning and Alcohol-Use Disorders From Adolescence to Young Adulthood

This research examined the longitudinal relationship between positive functioning and alcohol-use disorders from late adolescence into young adulthood. This study used prospective, longitudinal data from the Seattle Social Development Project on a contemporary sample of 808 young adult men and women interviewed multiple times since childhood. The analysis employed a longitudinal path analysis to examine the relationship between positive functioning and alcohol-use disorders across four time points between ages 15-18 and age 27. Positive functioning and alcohol-use disorders showed moderately strong continuity from adolescence through young adulthood. Positive functioning in adolescence predicts reduced likelihood of a diagnosis of alcohol abuse and dependence (as defined in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) at age 21, and positive functioning at age 21 predicts reduced likelihood of alcohol abuse and dependence at age 24 in this sample. These findings remain even after controlling for continuity in positive functioning and alcohol-use disorders, associations between positive functioning and alcohol use in adolescence, and sociodemographic differences attributable to gender, race/ethnicity, and poverty. Positive functioning in adolescence and early adulthood can decrease the probability of developing alcohol-use disorders in young adulthood. The data from this study suggest that promoting positive development in childhood, adolescence, and early adulthood should be a focus of programs seeking to prevent alcohol abuse and dependence. Providing continued support for the development of positive functioning through the transition from adolescence to adulthood could decrease the chance of the development of alcohol-use disorders in adulthood.

Modeling the pathways linking childhood hyperactivity and substance use disorder in young adulthood.

This study modeled direct and mediated pathways linking childhood hyperactivity and substance use disorder (SUD). Boys (n = 112) were administered the revised Drug Use Screening Inventory at age 12-14 years and the Structured Clinical Interview for DSM-IV at age 22 years. Six newly derived scales having established heritability were conceptually organized into internalizing and externalizing pathways to SUD emanating from childhood hyperactivity. Hyperactivity directly predicts SUD. Neuroticism, conduct problems, and their respective manifestations of social withdrawal and school problems mediated the association between hyperactivity and SUD. Hyperactivity also predicted neuroticism that, in turn, predicted low self-esteem leading to social withdrawal and SUD. These results indicate that hyperactivity is a diathesis for both internalizing and externalizing disturbances that, in turn, portend differential expression of psychosocial maladjustment presaging SUD.

Fetal Alcohol Spectrum Disorders in Young Adulthood

To test the hypothesis that fetal alcohol syndrome (FAS), with the full phenotype, and fetal alcohol effect (FAE), with some but not all of the features, can be combined under the umbrella term fetal alcohol spectrum disorders (FASD). We investigated the long-term sequelae of intrauterine alcohol exposure using physical examination, psychosocial interviews, and a behavioral checklist in a 20-year follow-up study of 37 patients with FASD originally diagnosed as having FAS or FAE in infancy and childhood. Although the characteristic craniofacial malformations of FAS/FAE diminish over time, microcephaly, a poorly developed philtrum and a thin upper lip, and, to a lesser degree, short stature and underweight (in boys) persist. In females, adult body weight increases. Persistent mental handicaps, including intellectual disability, limited occupational options, and dependent living, are the major sequelae, and the scores for various behavioral problems are significantly increased. The devastating effects of intrauterine exposure to alcohol persist into early adulthood and severely limit careers and independent living.

A prospective high-risk study of the association among maternal negativity, apparent frontal lobe dysfunction, and the development of bipolar disorder

In a previous paper, the authors found that impairment on the Wisconsin Card Sorting Test (WCST) in adolescence was predictive of bipolar disorder in young adulthood among offspring of mothers with bipolar illness. In the present study, the authors explore the contribution of maternal characteristics, beyond maternal mood disorder, to the prediction of offspring dysfunction on the WCST. Results showed that maternal bipolar disorder and maternal negativity were both predictive of impaired performance on the WCST during adolescence. The contribution of maternal negativity to offspring WCST impairment was not better explained by maternal personality disorder, mother's functional impairment, family loading for bipolar disorder, or offspring disruptive behavioral disturbance. Findings did not support a moderator model. However, support was found for a mediation model in which maternal negativity contributed to risk for offspring bipolar disorder through its negative association with apparent frontal lobe functioning, as measured by the WCST. Findings are discussed from the perspective of a vulnerability-stress model. In addition, the authors consider the possibility that maternal negativity and offspring impairment on the WCST may be reflective of a common heritable trait.

Adolescent temperament and lifetime psychiatric and substance abuse disorders assessed in young adulthood

This study focused on three research questions related to temperament for the transitional period from adolescence to young adulthood: (1) the rank-order stability of temperament dimensions across six years; (2) continuity of mean levels of temperament; and (3) relationships between adolescent temperament dimensions and lifetime psychiatric and substance abuse disorders in young adulthood. The participants ( N = 760) were selected from a longitudinal community cohort study of the adolescent to young adulthood transition. Moderate stability was indicated for temperament dimensions from adolescence to young adulthood. Continuity of temperament from adolescence to young adulthood was also supported for some dimensions, though change was indicated for others toward lower activity levels and higher task orientation. Findings supported significant associations between temperament dimensions and lifetime psychiatric and substance abuse disorders.

Stability, correlates, and outcome of adolescent suicidal risk

The goal of this study was to investigate the stability and correlates of adolescent suicidal risk across adolescence. Suicidal risk was studied longitudinally in N = 593 subjects in 1994, 1997, and 2001 at mean ages of 13, 16, and 20 years. Three partly overlapping suicidal risk groups were compared to three control groups matched by age and gender regarding behavioural and emotional problems, number and impact of life events, coping capacities, self-related cognitions, and the size and efficiency of the social network. Psychiatric diagnoses were obtained in young adulthood. The group stability of suicidal risk was 43% from time 1 to time 2 and 18% from time 1 to time 3. Intra-individual stability of suicidal risks across adolescence was significantly higher than expected. At all three times of assessment, there was a clear excess of abnormal psychosocial findings in the suicidal risk groups as compared to the matched controls. Substance abuse disorders, depressive disorders, phobias and any psychiatric disorders in young adulthood were predicted by suicidal risk in preadolescence irrespective of behavioural and emotional disorders. Suicidal risk individuals are remarkably stable across adolescence and show a very consistent pattern of associated behavioural and emotional problems and psychosocial variables across time from preadolescence to young adulthood. They also display an increased risk for some mental disorders in young adulthood.

A long‐term outcome study of selective mutism in childhood

Controlled study of the long-term outcome of selective mutism (SM) in childhood. A sample of 33 young adults with SM in childhood and two age- and gender-matched comparison groups were studied. The latter comprised 26 young adults with anxiety disorders in childhood (ANX) and 30 young adults with no psychiatric disorders during childhood. The three groups were compared with regard to psychiatric disorder in young adulthood by use of the Composite International Diagnostic Interview (CIDI). In addition, the effect of various predictors on outcome of SM was studied. The symptoms of SM improved considerably in the entire SM sample. However, both SM and ANX had significantly higher rates for phobic disorder and any psychiatric disorder than controls at outcome. Taciturnity in the family and, by trend, immigrant status and a severity indicator of SM had an impact on psychopathology and symptomatic outcome in young adulthood. This first controlled long-term outcome study of SM provides evidence of symptomatic improvement of SM in young adulthood. However, a high rate of phobic disorder at outcome points to the fact that SM may be regarded as an anxiety disorder variant.

Individual differences in childhood neurobehavior disinhibition predict decision to desist substance use during adolescence and substance use disorder in young adulthood: A prospective study

Genetic, physiological and psychological investigations have demonstrated that deficient inhibitory regulation amplifies the risk for substance use disorder (SUD). This study extends this line of research by determining the association between childhood neurobehavior disinhibition and decision to desist substance use following prevention intervention during adolescence. The sample consisted of 302 boys who were evaluated at ages 10–12, 12–14, 16, and 19. Results indicated that childhood neurobehavior disinhibition negatively covaried with decision to desist substance use during adolescence. These two variables predicted acceleration of drug consumption frequency during adolescence and DSM-IV diagnosis of SUD by age 19. Decision to desist drug use did not mediate the association between neurobehavior disinhibition and substance use/SUD. The findings indicate that substance abuse prevention would be potentiated by ameliorating childhood neurobehavior disinhibition.

Utility of Childhood BMI in the Prediction of Adulthood Disease: Comparison of National and International References

To determine whether the U.S. Centers for Disease Control and Prevention (CDC; CDC Reference) or International Obesity Task Force (IOTF; IOTF Reference) BMI cut-off points for classifying adiposity status in children are more effective at predicting future health risk. The sample (N=1709) included 4- to 15-year-old (at baseline) boys and girls from the Bogalusa Heart Study. Overweight and obesity status were determined using both the CDC Reference and IOTF Reference BMI cut-off points at baseline. The ability of childhood overweight and obesity, determined from the two BMI classification systems, to predict obesity and metabolic disorders in young adulthood (after a 13- to 24-year follow-up) was then compared. Independently of the classification system employed to determine adiposity based on childhood BMI, the odds of being obese and having all of the metabolic disorders in young adulthood were significantly (p<0.05) higher in the overweight and obese groups by comparison with the nonoverweight groups. Childhood overweight and obesity, determined by both the CDC Reference and IOTF Reference, had a low sensitivity and a high specificity for predicting obesity and metabolic disorders in young adulthood. Overweight and obesity as determined by the CDC Reference were slightly more sensitive and slightly less specific than the corresponding values based on the IOTF Reference. Overweight and obesity during childhood, as determined by both the CDC and IOTF BMI cut-off points, are strong predictors of obesity and coronary heart disease risk factors in young adulthood. The differences in the predictive capacity of the CDC Reference and IOTF Reference are, however, minimal.

Youth Transitioning to Adulthood: Effects of Different Population Policies in Child and Adult Mental Health Service Systems

The transition from adolescence into adulthood is a period of rapid psychosocial development that underlies the acquisition of the skills and capacities to function as adults. For young people with serious mental health (MH) conditions, the movement into adulthood is precarious. Most adolescents with psychiatric disorders continue to have those disorders in young adulthood. Psychiatric disorders during the transition to adulthood, roughly ages 16-30, seriously impede the development of adult role functioning. These ages span those served by state child and adult MH systems. For adolescents in child MH and young adults in adult MH systems, continuity of care and the provision of age-appropriate supports are needed to assist them in their quest for adult functioning. One challenge to the continuity of care across child and adult MH systems may stem from differing population policies. Population policies are those that define a system's eligible or target population. The important questions for transition-aged youth include: Do population policies used in the adult MH system differ from those used in the child MH system? If so, does this restrict access to services for adolescents aging out of the child MH system? This brief describes a study which examined these questions by comparing the population policies of child and adult state MH systems.

Panic attacks and the risk of personality disorder

The goal of this study is to determine the association between panic attacks in adolescence and the risk of personality disorders during young adulthood. Data were drawn from the Children in the Community Study, a longitudinal epidemiological study of psychopathology across the life-course in 717 individuals in the community. Multiple logistic regression analyses were used to determine the association between panic attacks during adolescence in 1983 and the risk of personality disorders during young adulthood in 1993, adjusting for differences in sociodemographic characteristics, adolescent personality disorders, and co-morbid depressive and substance use disorders. Panic attacks during adolescence (in 1983) were associated with an increased risk of any DSM-IV personality disorder (in 1993) during young adulthood, which persisted after adjusting for differences in sociodemographic characteristics, adolescent personality disorders, and co-morbid depressive and substance use disorders. Panic attacks were associated with a statistically significantly increased risk of Cluster A, B, and C personality disorders. These data provide initial evidence that panic attacks early in life are a marker or risk factor for the development of personality disorders in young adulthood. Replication of these findings is needed, as is more in-depth investigation into the mechanism of this link. If replicated in future research, these results may reveal a novel potential pathway for identifying youth at high risk for personality disorders.

Suicidal behaviour in adolescence and subsequent mental health outcomes in young adulthood

The aim of this study was to examine the linkages between suicidal ideation and attempt in adolescence and subsequent suicidal behaviours and mental health in young adulthood. Data were gathered during the course of a 25-year longitudinal study of a birth cohort of 1265 New Zealand children. The information collected included: (a) measures of suicidal thoughts and attempts in adolescence (< 18 years); (b) measures of suicidal ideation, suicide attempt, major depression, anxiety disorders, and substance use disorders in young adulthood (18-25 years); and (c) measures of childhood and family background, individual characteristics, and mental disorders in adolescence. After statistical adjustment for confounding factors, suicide attempt in adolescence was associated with increased risks of subsequent suicidal ideation (OR 5.7) suicide attempt (OR 17.8) and major depression (OR 1.5). Those reporting suicidal ideation without suicide attempt showed moderate increases in risks of later suicidal ideation (OR 2.5), suicide attempt (OR 2.0) and major depression (OR 1.6). In addition, there was evidence of an interactive relationship in which suicidal behaviour in adolescence was associated with increased risks of later substance use disorders in females but not males. Young people reporting suicidal ideation or making a suicide attempt are an at-risk population for subsequent suicidal behaviour and depression. Further research is needed into the reasons for suicidal adolescent females being at greater risk of later substance use disorder.

Psychosocial correlates, outcome, and stability of abnormal adolescent eating behavior in community samples of young people

The current study investigated psychosocial correlates of abnormal adolescent eating behavior at three times during adolescence and young adulthood and its association with psychiatric diagnosis in young adulthood in a community sample. Sixty-four (10.5%) high-risk subjects (mean age 15 years) with abnormal eating behavior were identified at Time 1, another 252 (16.9%) were identified at Time 2 (mean age 16.2 years), and 164 (16.9%) were identified at Time 3 (mean age 19.7 years) and compared with three control groups matched for age and gender. Dependent measures included emotional and behavioral problems, life events, coping capacities, self-related cognition, social network, and family functions. Outcome was measured additionally by structured psychiatric interviews, and stability of abnormal eating behavior was studied in a longitudinal sample of 330 subjects. Few subjects showed more than one of five criteria of abnormal eating behavior. High-risk subjects shared a very similar pattern at all three times. They were characterized by higher scores for emotional and behavioral problems, more life events including more negative impact, less active coping, lower self-esteem, and less family cohesion. Among 10 major psychiatric disorders, only clinical eating disorders at Time 3 shared a significant association with abnormal eating disorder at the same time whereas high-risk status at Times 1 and 2 did not predict any psychiatric disorder at Time 3. Stability of abnormal eating behavior across time was very low. Stability of abnormal eating behavior across time was very low. Abnormal eating behavior in adolescence and young adulthood is clearly associated with various indicators of psychosocial maladaption. In adolescence, it does not significantly predict any psychiatric disorder including eating disorder in young adulthood and it is predominantly a transient feature.

Katamnese zur psychosozialen Entwicklung von erstmals im jungen Erwachsenenalter an neurotischen Störungen manifest erkrankten, stationär behandlungsbedürftigen psychiatrischen Patienten

It is often assumed that there is a predictive relationship between the onset of psychiatric disorder in young adulthood and the severity of their course. Because the significance is rather contradictive and poorly backed by empirical data, we have investigated this issue by a catamnestic approach. From 96 inpatients aged between 18 to 25 years with a first manifestation of a "psychogenetic" disorder 54 % were studied 8.6 +/- 1.5 year later. In general there was a positive development as well psychopathological as social, although complete normalisation was not reached. This result is almost identical with catamnestic findings with comparative studies on older patients . Our findings do not support the concept of negative predictive value of first manifestation of psychogenetic disorder in early adulthood.

Young adults’ recollections of parental bonds

Recollections of cold and overprotective behaviors from parents have been hypothesized to lead to the presence of mental disorders in young adulthood through their detrimental effects on individuals' satisfaction in later partner relationships. Previous studies have not explicitly tested, however, whether partner relationship satisfaction mediates the longitudinal relationship from parental bonds to DSM-III-R disorders in young adults. We examined: (1) whether recollections of parental bonds in the first 16 years of life were related to the prevalence of DSM-III-R mental disorders in young adulthood, and (2) whether young adults' satisfaction with current partner relationships mediated these links. Data were used from 1,581 Dutch young adults aged 18-34 years, who were interviewed in three waves (1996, 1997, and 1999) of a nationwide epidemiological study. Structural Equation Models demonstrated that recollections of caring, non-intrusive parenting behaviors were significantly, negatively associated with the prevalence of mood and anxiety disorders (but not substance disorders) in young adulthood. The satisfaction with current partner relationships did not mediate these negative associations. Results replicate and extend earlier findings from the National Comorbidity Survey (Enns et al. 2002), demonstrating that mental disorders are directly related to people's recollections of parental care and overprotection. Low-quality parental bonds were only related to internalizing types of psychopathology, however, and were of a modest strength. Results may indicate that there is relatively little cross-relationship continuity in the experience of intimacy between relationships with parents and with partners.

Childhood abuse and familial violence and the risk of panic attacks and panic disorder in young adulthood

The objectives of the study were to examine linkages between exposure to childhood abuse and interparental violence and the subsequent development of panic attacks and panic disorder using data gathered on a birth cohort of 1265 New Zealand young people studied to the age of 21 years. Data on: (a) exposure to child abuse and interparental violence; (b) the development of panic attacks and panic disorder; and (c) other childhood and related factors were gathered over the course of a 21-year longitudinal study. After adjustment for childhood and related factors, exposure to childhood physical abuse was associated with a significantly increased risk of later panic attack (OR 2.3, 95% CI 1.1-4.9) and panic disorder (OR 3.0, 95% CI 1.1-7.9); childhood sexual abuse was associated with a significantly increased risk of panic attack (OR 4.1, 95% CI 2.3-7.2) and a marginally significant increase risk of panic disorder (OR 2.2; 95% CI 0.98-5.0). Exposure to interparental violence was unrelated to later panic attack or disorder after adjustment. Exposure to childhood sexual and physical abuse was associated with increased risks of later panic attack/disorder even after adjustment for prospectively assessed confounding factors. However, exposure to interparental violence during childhood was not related to increased risk of later panic attack/disorder after adjustment. These data suggest the need for clinicians to be aware that patients with histories of childhood physical and sexual abuse may be at increased risk for panic during young adulthood.

Obstetric optimality and emotional problems and substance use in young adulthood

Background Pregnancy and delivery are complex processes, and isolated obstetric complications rare and often accompanied or followed by a number of others. Aims To study the relationship between the overall obstetric situation (as opposed to single obstetric risk factors) and emotional and substance use disorders in young adulthood, and to analyse whether these links are mediated by temperaments in childhood. Study design In a prospective birth cohort ( n=3162), questionnaires were sent to mothers and teachers when the child was 7–10 years old, and to the children when they were 20–25 years old. Subjects Six hundred and eighty-two cohort members with complete data sets at three ages (perinatal, childhood, and young adulthood). Outcome measures Emotional problems and substance use in young adulthood. Main results Substance use in young adulthood was predicted better by the overall obstetrical optimality score than emotional problems were. Links studied were stronger for men than for women. Conclusions This study demonstrated the use of an aggregated obstetrical optimality score in analysing the associations between early risk factors and emotional problems and substance use in young adulthood.

A prospective study of the association among impaired executive functioning, childhood attentional problems, and the development of bipolar disorder.

Studies of adults who have been diagnosed with, and treated for, bipolar disorder have shown that these patients exhibit impairment on measures of executive functioning. However, it is unclear whether executive dysfunction precedes the diagnosis of bipolar illness, or develops subsequent to its onset. Moreover, investigators have failed to control for the effects of premorbid attentional problems on cognitive performance in these patients. The present authors explored these questions using data from a longitudinal prospective study of individuals at risk for major mood disorder. Results revealed that 67% of participants who met criteria for bipolar disorder in young adulthood showed impairment on the Wisconsin Card Sorting Test (WCST) when they were assessed during adolescence, as compared with 17% of individuals with no major mood diagnosis, and 19% with unipolar depression. This association between performance on the WCST and bipolar illness was not accounted for by high rates of premorbid attentional disturbance. In fact, among participants with early attentional problems, only those who ultimately developed bipolar disorder exhibited impairment on the WCST. Early attentional problems that preceded unipolar depression or no mood disorder were not associated with executive dysfunction.

Stress burden and the lifetime incidence of psychiatric disorder in young adults: racial and ethnic contrasts.

With the exception of studies of individual traumatic events, the significance of stress exposure in psychiatric disorder previously has not been effectively examined. To address the hypothesis that accumulated adversity represents an important risk factor for the subsequent onset of depressive and anxiety disorders. A community-based study of psychiatric and substance use disorders among a large, ethnically diverse cohort representative of young adults in South Florida. Adversity was estimated with a count of major and potentially traumatic events experienced during one's lifetime and prior to the onset of disorder. Most interviews took place in the homes of participants, with 30% conducted by telephone. We obtained a random sample of individuals aged 18 to 23 years from a previously studied representative sample of young adolescents. Because participants in the prior study were predominantly boys, a supplementary sample of girls was randomly obtained from the early-adolescence school class rosters. A total of 1803 interviews were completed, representing a success rate of 70.1%. Depressive and anxiety disorders were assessed through computer-assisted personal interviews using the DSM-IV version of the Michigan Composite International Diagnostic Interview. Level of lifetime exposure to adversity was found to be associated with an increased risk of subsequent onset of depressive and/or anxiety disorder. This association remained clearly observable when childhood conduct disorder, attention-deficit/hyperactivity disorder, prior substance dependence, and posttraumatic stress disorder were held constant and when the possibility of state dependence effects was considered. Evidence suggests that high levels of lifetime exposure to adversity are causally implicated in the onset of depressive and anxiety disorders.