Symptoms In Early Adulthood Research Articles

Associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood

This longitudinal study explored associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood. The baseline data were collected in 1996 from 14-year-old pupils (n = 235; 116 girls, 119 boys) at schools using a structured questionnaire that included a 14-item scale of psychosomatic symptoms. The follow-up data were collected in 2006 from the same persons at the age of 24 using the Symptom Checklist-90. Follow-up questionnaires were returned by 149 (63.4%) young adults (88 women and 61 men). Young adults who had many psychosomatic symptoms in adolescence suffered more often than the others from somatization and anxiety symptoms in early adulthood. In addition, women had more symptoms of depression and paranoid ideation, and men had more interpersonal sensitivity and psychotic symptoms. Psychosomatic symptoms in adolescence might be important signals of mental health and this should be taken seriously in school health and in general primary care.

Effects of Growth in Family Conflict in Adolescence on Adult Depressive Symptoms: Mediating and Moderating Effects of Stress and School Bonding

PurposeTo (1) examine growth in family conflict during adolescence as a predictor of depressive symptoms in early adulthood, (2) examine adult stressful life events as a possible mechanism linking prior family conflict with depressive symptoms, and (3) examine adolescent school bonding as a possible moderator of family conflict and stressful life events in relation to later depression. MethodsAnalyses used a latent variable growth curve modeling approach to examine longitudinal patterns in data from the Seattle Social Development Project. Assessments of a gender-balanced and ethnically diverse sample of 754 participants were conducted from age 10 to age 27. ResultsResults show an increase in conflict each year between ages 14 and 18 for participating youth. High initial levels and growth in family conflict predicted adult stressful life events, which, in turn, predicted adult depressive symptoms, controlling for earlier risks of poverty and internalizing problems. Bonding to school in mid-adolescence did not significantly change the associations among the variables in the model. ConclusionsInhibiting the growth in family conflict over the course of adolescence may reduce the risk for some life stresses linked to depression in early adulthood. Although a test of the protective influence of school bonding during mid-adolescence was not significant, the study offers an example of how longitudinal patterns and protective factors can be analyzed.

The transition to young adulthood in youth with type 1 diabetes on intensive treatment

We sought to examine prospectively patterns of clinical and psychosocial outcomes during the transition from adolescence to young adulthood in a cohort initiating intensive therapy after the Diabetes Control and Complications Trial. We conducted a prospective, descriptive analysis of data from a randomized intervention study with 117 adolescents (45 males and 72 females, mean age at entry = 14.4 +/- 2.0 yr, mean diabetes duration at entry = 5.7 +/- 3.7 yr) recruited from a large pediatric diabetes clinic. Data were collected for each subject over periods of up to 5 yr at 6-month intervals using measures of depressive symptoms, quality of life, and metabolic control, with chart review for prevalence of diabetes complications. Metabolic control worsens during adolescence but returns to early adolescent levels in young adulthood. The negative impact of diabetes on quality of life, disease-related worries, and life satisfaction did not change significantly with age. These results did not vary with treatment group or gender. Participants who showed high levels of depressive symptoms as adolescents were somewhat more likely to be depressed when older. Despite relatively long duration of diabetes, relatively few complications were observed in young adulthood. These data suggest that youth who begin intensive treatment as adolescents generally have good metabolic and psychosocial outcomes as young adults. However, those who have high levels of depressive symptoms in adolescence tend to continue to have such symptoms in early adulthood.

Sensory gating deficits, pattern completion, and disturbed fronto-limbic balance, a model for description of hallucinations and delusions in schizophrenia

Schizophrenia, if not the most difficult, is one of the most difficult mysterious puzzles for psychiatrists, psychologists, and neuroscientists to solve. In this paper, based on the previously known pathologies of schizophrenia, a new model is proposed for explanation of the formation of positive psychotic symptoms of hallucinations and delusions. This model can be used for understanding psychotic or psychotic-like positive symptoms of bipolar mood disorder, posttraumatic stress disorder, obsessive compulsive, and amphetamine and drug-induced psychotic disorders. Based on the postulated model, a spectral view on these disorders with psychotic features is also proposed. These pathologies include auditory sensory gating deficits in hippocampus, abnormal emotional coding in amygdala, pattern completion in thalamic and cortical areas, and disturbed fronto-limbic balance. This model includes anatomical and neurotransmitter defects of hippocampus, amygdala, thalamus, cingula, and prefrontal cortex and their interconnections. A role for hippocampal sensory gating deficits in the pathogenesis of positive psychotic symptoms and interrelation between amygdala and its dopamine level with hippocampus is speculated. This model also hires the interesting function of pattern completion in thalamus and cortical areas for a better explanation of the pathogenesis of hallucinations and delusional psychotic symptoms. Furthermore, there is also explanation for the polygenic etiology of the schizophrenic and psychotic disorders and relation between schizophrenia and bipolar mood disorder in anatomy and neural systems involved. A spectral view is proposed that explains the absence of clear cut border between different psychotic or psychotic-like disorders in their form and severity based on the involved genes and brain functional systems. Including excessive prefrontal pruning, there is also explanation for the appearance of positive psychotic symptoms in early adulthood. An explanation for the high dopamine level of amygdala despite its decreased size and abnormal anatomy is also suggested as a compensatory function which might explain the decline in positive psychotic symptoms when schizophrenics age according to amygdala burn out. Based on this model, speculations are provided for: late onset of the effects of antipsychotics on positive psychotic symptoms, mechanism for the therapeutic effect of serotonin type 2A receptor blockers and GABAergic medications in psychosis, role of smoking in diminution of psychotic symptoms, and relationship between biological and psychological issues in the formation of psychotic symptoms. Finally, based on this model, a new role for nicotinic cholinergic drugs (such as galantamine) for treatment of schizophrenia and other psychotic or psychotic-like disorders is proposed.

Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome.

Most children with Tourette syndrome (TS) experience a marked decline in the severity of tic symptoms during adolescence. Currently no clinical measures can predict whose tic symptoms will persist into adulthood. Previous cross-sectional imaging studies have identified reduced caudate nucleus volumes in subjects with TS. To evaluate whether caudate nucleus volumes in childhood can predict the severity of tic or obsessive-compulsive symptoms at follow-up in early adulthood. In a prospective longitudinal study, clinical status and basal ganglia volumes of 43 children with TS were measured on high-resolution magnetic resonance images before age 14 years. Follow-up clinical assessments were conducted after age 16 years, an average of 7.5 years later. Linear regression and Tobit regression analyses were used to assess the association of basal ganglia volumes measured in childhood with the severity of tic and obsessive-compulsive disorder (OCD) symptoms at the time of childhood MRI and at follow-up in early adulthood. Volumes of the caudate nucleus correlated significantly and inversely with the severity of tic and OCD symptoms in early adulthood. Caudate volumes did not correlate with the severity of symptoms at the time of the MRI scan. Caudate volumes in children with Tourette syndrome predict the severity of tic and obsessive-compulsive symptoms in early adulthood. This study provides compelling evidence that morphologic disturbances of the caudate nucleus within cortico-striatal-thalamo-cortical circuits are central to the persistence of both tics and obsessive-compulsive symptoms into adulthood.

Trajectories of Gender Role Orientations in Adolescence and Early Adulthood: A Prospective Study of the Mental Health Effects of Masculinity and Femininity

Adolescence is the segment of the life course when gender differences in mental health emerge and gender becomes a more salient factor shaping orientations toward oneself and views of one's place in the social world. This study uses mixture modeling, to identify trajectories of masculinity and femininity between ages 12 and 25, and OLS regression, to examine the effects of those trajectories on mental health in young adulthood (measured as depressive symptoms and alcohol problems at age 25). Four waves of prospective data from the Rutgers Health and Human Development Project are used; respondents (n = 447) are age 12 at Wave 1 (1979-81), 15 at Wave 2 (1982-84), 18 at Wave 3 (1985-87), and 25 at Wave 4 (1992-94). Results indicate that having relatively high and increasing levels of masculinity over adolescence decreases depressive symptoms in early adulthood for both males and females. Reflecting the privileging of males over females, the findings suggest that masculinity, but not femininity, is a central axis on which advantages and disadvantages across some dimensions of mental health accumulate over adolescence.

Developmental changes in cortisol secretion in normal and at-risk youth.

Adolescence is associated with an increase in the rate of certain psychiatric symptoms, and it is typically the developmental period when prodromal features of the major psychiatric disorders emerge. This is especially true of schizophrenia, with the majority of patients showing a marked postpubertal rise in schizotypal signs that predates the onset of clinical symptoms in early adulthood. Cross-sectional studies of youth have revealed a positive correlation between age and saliva cortisol level, suggesting a normative maturational increase in activity of the hypothalamic-pituitary-adrenal (HPA) axis. It has been hypothesized that this increase may trigger the expression of symptoms in vulnerable individuals. The present longitudinal study measured cortisol secretion and its relation with symptom development in samples of youth with schizotypal personality disorder (SPD), other personality disorders, or no Axis II disorder. The findings indicate moderate stability in cortisol levels across a 2-year period, with a longitudinal increase in cortisol levels over time. Cortisol levels at the first and second assessments were correlated with the severity of SPD symptoms at follow-up. The results are consistent with the notion that the HPA axis undergoes a postpubertal maturational process that moderates the expression of psychiatric symptoms.

Prospective, Longitudinal Study of Tic, Obsessive-Compulsive, and Attention-Deficit/Hyperactivity Disorders in an Epidemiological Sample

Understanding the interrelatedness of tics, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD) has been complicated by studying only cross-sectional samples of clinically referred subjects. The authors report the cross-sectional and longitudinal associations of these disorders in an epidemiological sample of children followed prospectively into early adulthood. Structured diagnostic interview information was acquired on 976 children, aged 1 to 10 years, who were randomly selected from families living in upstate New York in 1975. Reassessments were acquired in 776 of these subjects 8, 10, and 15 years later. Diagnostic prevalences were estimated at each time point. The associations among tics, OCD, and ADHD were assessed within and across time points, as were their associations with comorbid illnesses and demographic risk factors. In temporal cross-section, tics and ADHD symptoms were associated with OCD symptoms in late adolescence and early adulthood after demographic features and comorbid psychiatric symptoms were controlled. In prospective analyses, tics in childhood and early adolescence predicted an increase in OCD symptoms in late adolescence and early adulthood. ADHD symptoms in adolescence predicted more OCD symptoms in early adulthood, and OCD in adolescence predicted more ADHD symptoms in adulthood. The associations of tics with ADHD were unimpressive in temporal cross-section and were not significant in prospective analyses. Tics, OCD, and ADHD shared numerous complex associations with demographic and psychopathological risk factors. ADHD was associated with lower IQ and lower social status, whereas OCD was associated with higher IQ. Tics and OCD were significantly associated in this sample, as were OCD and ADHD. These findings are in general consistent with those from family studies, and they help to define the natural history, comorbid illnesses, and interrelatedness of these conditions.

Physiological alcohol dependence symptoms in early adulthood: A longitudinal perspective.

The developmental course of physiological dependence on alcohol was investigated by estimating the prevalance, stability, and prognostic significance of individual tolerance and withdrawal symptoms, prospectively over 7 years, in 450 young adults. Different prevalence rates and patterns of stability were observed with alternate tolerance items. Consistently low base rates were observed for all withdrawal items. Person-level stability of tolerance and withdrawal indicators was moderate at test-retest intervals of 1 year and increasingly modest at longer intervals. Reporting tolerance and withdrawal in early adulthood was associated with a substantial risk for later alcohol use disorder. Results suggest that the likelihood of experiencing tolerance or withdrawal symptoms may vary as a function of an individual's stage of development and drinking history. Implications for future assessment and classification of alcohol dependence are discussed. Historically, models of have conceptualized the syndrome as progressive and persistent, characterized by signs of physiological dependence such as tolerance and withdrawal. Such models typically have equated the disease of alcoholism with alcohol dependence and alcohol dependence with physiological dependence. Indeed, the presence of tolerance or withdrawal became necessary for an alcohol dependence diagnosis in the nosologies of the National Council on Alcoholism (1972) and the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association [APA], 1980). An alternative construct, the alcohol dependence syndrome (ADS), placed tolerance and withdrawal on a dimension with other putative markers of dependence, such as impaired control over drinking and preoccupation with drinking. The ADS concept, first proposed by Edwards and Gross (1976), challenged the distinction between psychological and physiological dependence by placing equal emphasis on biological, psychosocial, and behavioral factors. This construct influenced the broadened definition of depen

Long-term Outcome

There are no studies that relate early childhood wheezing to school-age asthma, and relatively few cohort studies have examined the natural history of school-age asthma. Most studies have been conducted on hospitalized or hospital clinic patients, thus leading to possible bias in selection of more severely ill patients. Many were also retrospective in design, thus raising important questions about loss to follow-up. Almost no studies have incorporated a physiologic test of airway reactivity, although several have examined skin-test reactivity. No universally accepted definition of asthma was used in most of the investigations. Finally, no studies have concurrently examined all known main pediatric risk factors such as respiratory infection, active and passive cigarette smoking, and allergen sensitization and exposure and their relationship to the natural history of disease. Twoparticular areas in the natural history of early childhood asthma are poorly understood. First, the fate of wheezy infants and the factors predicting which of these children go on to develop school-age asthma is unclear. Second, we do not know whether early childhood factors such as symptoms, lung function, and airway responsiveness influence the natural history of school-age asthma, specifically maximal-attained FE~, and the presence of chronic symptoms in early adulthood (15-20 yr of age). Almost 40% of children wheeze in the first 3 yr of life, yet the predictors of who will continue to wheeze in later Childhood are unclear. Early childhood lower respiratory illness is a risk factor for later childhood asthma and lower levelsof FE~ (71). Early childhood lower respiratory illness may be a risk factor for adult chronic obstructive pulmonary disease (COPD) (4, 72, 73). Between 30 and 70% of school-age children with doctordiagnosed asthma can expect a marked improvement in their condition or to become symptom-free by early adulthood (72, 74-76). Significant disease will persist in approximately 30% of patients (77). School-age boys with asthma appear to have a better longterm (adult) prognosis than school-age girls (74-76, 78, 79). The incidence of school-age asthma is greater in males until puberty and increases in females after puberty (80, 81).Over 80% of school-age asthmatics have positive skin test reactivity (14, 74-79,82). Children of school age who have continuous respiratory symptoms will have lower levels of lung function and a worse prognosis, as measured by lower levels of pulmonary function (83-85). Airway reactivity in the absence of asthma is associated with differences in lung function growth in school-age children, specifically reductions in FEV2575 in both males and females, larger vital capacities in males, and reduced FE~ in females. Pulmonary function in school-age children with mild asthma has a high tracking correlation and is reasonably predictable. Tracking of lung function also occurs in early childhood (86-89). Available data suggest that adult doctor-diagnosed asthma is associated with an accelerated decline in lung function and, hence, the development of COPD (90-93). The presence of atopic dermatitis in school-age children is associated with more persistent symptoms of wheeze (74-76, 78, 79, 94-97). Wheezing only with respiratory illness is associated with improved lung function and reduced symptoms in early adulthood (71, 72, 98), though one risk factor for wheezing lower respiratory illnesses is low lung function soon after birth (12, 13, 52).