Background. Hypothalamic-pituitary-adrenal axis functioning, with cortisol as its major output hormone, has been presumed to play a key role in the development of psychopathology. Predicting affective disorders from diurnal cortisol levels has been inconclusive, whereas the predictive value of stress-induced cortisol concentrations has not been studied before. The aim of this study was to predict mental disorders over a 3-year follow-up from awakening and stress-induced cortisol concentrations. Method. Data were used from 561 TRAILS (TRacking Adolescents' Individual Lives Survey) participants, a prospective cohort study of Dutch adolescents. Saliva samples were collected at awakening and half an hour later and during a social stress test at age 16. Mental disorders were assessed 3 years later with the Composite International Diagnostic Interview (CIDI). Results. A lower cortisol awakening response (CAR) marginally significantly predicted new disorders [odds ratio (OR) 0.77, p = 0.06]. A flat recovery slope predicted disorders with a first onset after the experimental session (OR 1.27, p = 0.04). Recovery revealed smaller, non-significant ORs when predicting new onset affective or anxiety disorders, major depressive disorder, or dependence disorders in three separate models, corrected for all other new onsets. Conclusions. Our results suggest that delayed recovery and possibly reduced CAR are indicators of a more general risk status and may be part of a common pathway to psychopathology. Delayed recovery suggests that individuals at risk for mental disorders perceived the social stress test as less controllable and less predictable.
Peer cliques form an important context for the social development of adolescents. Although clique members are often similar in social status, also within cliques, status differences exist. How differences in social status between clique members are related to behaviors of its individual members is rather unknown. This study examined to what extent the relationship of individual social status (i.e., perceived popularity) with aggression and prosocial behavior depends on the level of internal clique hierarchy. The sample consists of 2674 adolescents (49.8% boys), with a mean age of 14.02. We focused specifically on physical and relational aggression, and practical and emotional support, because these behaviors have shown to be of great importance for social relationships and social standing among adolescents. The internal status hierarchy of cliques was based on the variation in individual social status between clique members (i.e., clique hierarchization) and the structure of status scores within a clique (pyramid shape, inverted pyramid, or equal distribution of social status scores) (i.e., clique status structure). The results showed that differences in aggressive and prosocial behaviors were particularly moderated by clique status structure: aggression was stronger related to individual social status in (girls') cliques where the clique status structure reflected an inverted pyramid with relatively more high status adolescents within the clique than low status peers, and prosocial behavior showed a significant relationship with individual social status, again predominantly in inverted pyramid structured (boys' and girls') cliques. Furthermore, these effects differed by types of gender cliques: the associations were found in same gender but not mixed-gender cliques. The findings stress the importance of taking into account internal clique characteristics when studying adolescent social status in relationship to aggression and prosociality.
It is well-known that childhood adversities can have long-term effects on mental health, but a lot remains to be learned about the risk they bring about for a first onset of various psychiatric disorders, and how this risk develops over time. In the present study, which was based on a Dutch longitudinal population survey of adolescents TRAILS (N = 1,584), we investigated whether and how childhood adversities, as assessed with three different measures, affected the risk of developing an incident depressive, anxiety, or disruptive behavior in childhood and adolescence. In addition, we tested gender differences in any of the effects under study. The results indicated that depressive, anxiety and disruptive behavior disorders each had their own, characteristic, pattern of associations with childhood adversities across childhood and adolescence, which was maintained after adjustment for comorbid disorders. For depressive disorders, the overall pattern suggested a high excess risk of incidence during childhood, which decreased during adolescence. Anxiety disorders were characterized by a moderately increased incident risk during childhood, which remained approximately stable over time. Disruptive behavior disorders took an intermediate position. Of the three childhood adversities tested, an overall rating of the stressfulness of the childhood appeared to predict onset of psychiatric disorders best. To conclude, the risk of developing a psychiatric disorder after exposure to adversities early in life depends on the nature of the adversities, the nature of the outcome, and the time that has passed since the adversities without disorder onset.
Background. With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders. Method. We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths. Results. Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5-10% of the sample, experiencing 34-55% of all severe lifetime disorders. Conclusions. At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5-10% of the adolescent population.
In the current study, the role of pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) was studied in the association between prior adversities and antisocial behavior in adolescence. PEP and RSA task reactivity and recovery to a public speaking task were assessed in adolescents from a longitudinal population-based study (N=624, Mage=16.14 years, 49.2% boys). Perinatal adversities were unrelated to antisocial behavior, but experiencing more stressful adversities between age 0 and 15 was associated with antisocial behavior at age 16 in boys with blunted PEP reactivity and smaller PEP differences from rest to recovery. Number of adversities between age 0 and 15 was associated with antisocial behavior in boys with blunted and girls with heightened RSA reactivity and larger PEP differences from rest to recovery. The association between prior adversities and antisocial behavior were small in effect size and depended upon sex and PEP and RSA reactivity and recovery.
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This study examined associations between the Structured Assessment of Violence Risk in Youth (SAVRY; Borum, Bartel, & Forth, 2002) risk and protective items, identified clusters of SAVRY items, and used these clusters to predict police contact and violence. SAVRY items were assessed in a community sample of adolescent boys and girls (N = 963, 46.5% boys) via self-, parent, and teacher reports at ages 11 and 13.5 as part of a longitudinal cohort study. Police contact and violence were assessed at age 19. Correlations between risk and protective items and police contact and violence were largely similar in boys and girls, though there were some differences with regard to outcome measure. Principal factor analysis on the SAVRY items yielded a 2-factor model, distinguishing between History of Violence/Dysregulation and Social Support factors. Follow-up analyses showed incremental validity of the Social Support factor over and beyond the History of Violence/Dysregulation factor and sex in the prediction of violence. The findings provide new insights into the SAVRY factor structure and show that the SAVRY was able to predict violence in a community sample of adolescents over a period of 4 to 7 years.
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