All peer reviewed publications are listed below. Other publications will be uploaded shortly.

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Robertson, L.A., Iosua, E., McGee, R., Hancox, R. J. | 2015

Non-daily, low-rate daily and high-rate daily smoking in young adults: A 17 year follow-up

Nicotine & Tobacco Research, 2015, Advance access online August 17, 2015, doi: 10.1093/ntr/ntv167.

Our ref: RO674

Show abstract » Introduction: While overall tobacco consumption is declining in many countries, patterns of low-frequency smoking"such as nondaily and low-rate daily smoking"appear to be increasing. We aimed firstly to describe differences in demographic, smoking- and quitting-related characteristics between nondaily and daily smokers in young adults; secondly, to determine the proportion of low-frequency smokers who transition to a higher rate of smoking by age 38 and factors associated with this. Methods: We assessed a cohort of individuals born in Dunedin, New Zealand, in 1972"1973, at regular intervals from age 21 to age 38 years. Smokers were categorized as either nondaily, low-rate daily (ie, defined as five or less cigarettes per day) or high-rate daily smokers (six or more cigarettes per day). Descriptive statistics, linear and logistic regression were used. Results: Nondaily smokers at age 21 tended to self-identify as nonsmokers. Both nondaily smokers and low-rate daily smokers reported higher readiness and confidence in quitting compared to high-rate daily smokers. Around 40% of the age 21 low-rate daily smokers reported smoking daily at age 38, compared to 13% of the nondaily smokers and 4% of the nonsmokers. Nondaily smoking at age 21 was associated with increased odds of being a daily smoker by age 38 (OR: 3.6; 95% CI = 1.7% to 7.8%) compared to nonsmokers. Conclusions: Different patterns of smoking are associated with differences in readiness to quit and confidence in quitting ability. For a considerable proportion of smokers, low-frequency smoking in young adulthood develops into daily smoking by adulthood. Implications: Low-frequency smoking, including nondaily smoking, in early adulthood is a significant risk factor for being a daily smoker in the long-term. Cessation interventions should be tailored to low-frequency smokers, taking into account differences between them and heavier smokers in terms of smoking motivation and quitting-related cognitions.
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Connor, J., Kydd, R.M., Dickson, N. | 2015

Alcohol involvement in sexual behaviour and adverse sexual health outcomes from 26 to 38 years of age

PLOS ONE, 2015, Available online, doi:10.1371/journal.pone.0135660.

Our ref: RO673

Show abstract » Background: Research on alcohol and sexual behaviour has focused on young adults or high-risk groups, showing alcohol use contributing to riskier sexual choices. Adults now in their late thirties have been exposed to heavier drinking norms than previously, raising questions about effects on sexual wellbeing. We examined self-reported use and consequences of alcohol in sexual contexts, and its association with usual drinking pattern at age 38, and also associations of heavy drinking occasion (HDO) frequency with number of sexual partners, sexually transmitted infections (STIs), and terminations of pregnancy (TOPs), from 26"32 and 32"38 years of age.
Methods: Members of the Dunedin Study birth cohort answered computer-presented questions about sexual behaviour and outcomes, and interviewer-administered alcohol consumption questions, at age 26, 32 and 38 years.
Results: Response level was >90% at each assessment. At 38, drinking before or during sex in the previous year was common (8.2% of men; 14.6% of women reported usually/always), and unwanted consequences were reported by 13.5% of men and 11.9% of women, including regretted sex or failure to use contraception or condoms. Frequent heavy drinkers were more likely to use alcohol to make it easier to have sex and regret partner choice, particularly women. Heavy drinking frequency was strongly associated with partner numbers for men and women at 32, but only for women at 38. Significantly higher odds of STIs amongst the heaviest drinking men, and TOPs amongst the heaviest drinking women were seen at 32"38.
Conclusions: Alcohol involvement in sex continues beyond young adulthood where it has been well documented, and is common at 38. Women appear to be more affected than men, and heavy drinking is associated with poorer outcomes for both. Improving sexual health and wellbeing throughout the life course needs to take account of the role of alcohol in sexual behaviour.
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Foster Page, L.A. , Thomson, W. M., Broadbent, J. M. | 2015

Validity of self-reported periodontal questions in a New Zealand cohort

Clinical Oral Investigations, 2015, Published online 24 July 2015, DOI 10.1007/s00784-015-1526-0.

Our ref: RO672

Show abstract » Methods: Full-mouth periodontal examinations (three sites/tooth) were undertaken at age 38 in a complete birth cohort born in 1972/1973 in New Zealand. Four self-reported periodontal screening questions were included (Do you think you have gum disease; Has a dental professional ever told you that you have lost bone around your teeth; Have you ever had scaling, root planing, surgery, or other treatment for gum disease and Have you ever had any teeth that have become loose by themselves without some injury), and the sensitivity and specificity of those self-reported items were calculated for individual questions and using a multivariable binary logistic regression model. Generalised linear models were used to compare relative risks for periodontitis and smoking, using the (a) clinical measures and (b) self-reported questions. Results: Among the 895 who had periodontal examinations, the prevalence of periodontitis was 43.7, 22.8 and 12.0 %, respectively, for one or more sites with =4, =5 and =6 mm clinical attachment loss (AL). The specificity of the four self-reported questions was high (82"94 %), but the sensitivity was low for all, except the question: Do you think you have gum disease. The four questions' highest combined sensitivity?+?specificity value was 1.33 for one or more sites with =4 mm AL, with the area under the receiver operating characteristic (ROC) curve being greatest for one or more sites with =6 mm AL, at 0.84. For the smoking"periodontitis association, the estimates of relative risk for periodontitis among smokers were as follows: (a) 1.81, 2.88 and 5.79, respectively, clinically determined to have one or more sites with =4, =5 and =6 mm AL and (b) 2.19, 2.17, 1.23 and 1.89, respectively, for the four self-reported questions. Conclusion: The four self-reported periodontal screening questions performed adequately in identifying clinically determined periodontal disease, and they showed moderate validity when used together as a set. However, the strength of the association between smoking and periodontitis was underestimated when they were used instead of clinically determined periodontal disease. Clinical relevance: These findings suggest that clinical examinations remain to be the desired approach for periodontal surveys, but where resource constraints preclude those, self-reported methods can provide useful information; after all, some periodontal information is better than none at all.
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Goldman-Mellor, S., Caspi, A., Gregory, A. M., Harrington, H. L., Poulton, R., Moffitt, T.E. | 2015

Is insomnia associated with deficits in neuropsychological functioning? Evidence from a population-based study

Sleep, 2015, 38(4), 623-631.

Our ref: RO671

Show abstract » Study Objectives: People with insomnia complain of cognitive deficits in daily life. Results from empirical studies examining associations between insomnia and cognitive impairment, however, are mixed. Research is needed that compares treatment-seeking and community-based insomnia study samples, measures subjective as well as objective cognitive functioning, and considers participants' pre-insomnia cognitive function. Design and Participants: We used data from the Dunedin Study, a representative birth cohort of 1,037 individuals, to examine whether insomnia in early midlife was associated with subjective and objective cognitive functioning. We also tested whether individuals with insomnia who reported seeking treatment for their sleep problems (treatment-seekers) showed greater impairment than other individuals with insomnia (non-treatment-seekers). The role of key confounders, including childhood cognitive ability and comorbid health conditions, was evaluated. Measurements: Insomnia was diagnosed at age 38 according to DSM-IV criteria. Objective neuropsychological assessments at age 38 included the WAIS-IV IQ test, the Wechsler Memory Scale, and the Trail-Making Test. Childhood cognitive functioning was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R). Results: A total of 949 cohort members were assessed for insomnia symptoms and other study measures at age 38. Although cohort members with insomnia (n = 186, 19.6%) had greater subjective cognitive impairment than their peers at age 38, they did not exhibit greater objective impairment on formal testing. Treatment-seekers, however, exhibited significant objective impairment compared to non-treatment-seekers. Controlling for comorbidity, daytime impairment, and medications slightly decreased this association. Childhood cognitive deficits antedated the adult cognitive deficits of treatment-seekers.
Conclusions: Links between insomnia and cognitive impairment may be strongest among individuals who seek clinical treatment. Clinicians should take into account the presence of complex health problems and lower premorbid cognitive function when planning treatment for insomnia patients.
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Ramrakha, S., Fergusson, D.M., Horwood, L.J., Dalgard, F., Ambler, A., Kokaua, J., Milne, B.J., Poulton, R. | 2015

Cumulative mental health consequences of acne: 23-year follow-up in a general population birth cohort study

British Journal of Dermatology, 2015, Accepted article published online 27 March, doi:10.1111/bjd.13786.

Our ref: RO670

Show abstract » Acne is a highly prevalent condition during adolescence and young adulthood worldwide. School and university samples indicate rates between 12% and 99%, depending on how acne was classified. General population surveys report rates between 14% and 88%.Acne remains a problem in adulthood with rates ranging from 20 to 54%. The effects of acne, regardless of severity, can be debilitating. Studies have shown a range of psychosocial and interpersonal impacts including feelings of shame and loneliness, anger, impaired self-image, attitude and esteem, lack of pride and body satisfaction. It can also affect interpersonal relationships including poor attachment to friends, and not having romantic or sexual relationships. Finally, it has been associated with impaired functioning in other life domains, for example, not thriving at school, decreased participation in sport and exercise and employment problems. Although acne has been associated with negative emotion, impaired ability to function in daily life and a decreased quality of life only a small number of cross-sectional studies have reported an association between acne and specific psychological problems, including symptoms of anxiety and depression and suicide ideation when compared to those with little or no acne. However, no study has examined the relationship of acne and with psychiatric disorder (i.e. psychological distress of greatest severity and clinical interest), nor has research ascertained the cumulative lifecourse effects of acne on psychiatric disorder. In the present study, prospective-longitudinal data from a general population sample was used to determine whether acne preceded poor mental health at the disorder level from adolescence to adulthood. The specific aim of this study was to examine the association between acne and the development of the most common psychiatric disorders of anxiety, depression, alcohol and cannabis dependence.
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Belsky, D.W., Caspi, A., Houts, R., Corcoran, D.L., Danese, A., Harrington, H. L., Israel, S., Levine, M., Schaefer, J., Sugden, K., Williams, B.S., Yashin, A.I., Poulton, R., Moffitt, T.E. | 2015

Quantification of biological aging in young adults

PNAS (Proceedings of the National Academy of Sciences of the USA) , 2015, 112(30), E4104-E4110.

Our ref: RO669

Show abstract » Antiaging therapies show promise in model organism research. Translation to humans is needed to address the challenges of an aging global population. Interventions to slow human aging will need to be applied to still-young individuals. However, most human aging research examines older adults, many with chronic disease. As a result, little is known about aging in young humans. We studied aging in 954 young humans, the Dunedin Study birth cohort, tracking multiple biomarkers across three time points spanning their third and fourth decades of life. We developed and validated two methods by which aging can be measured in young adults, one cross-sectional and one longitudinal. Our longitudinal measure allows quantification of the pace of coordinated physiological deterioration across multiple organ systems (e.g., pulmonary, periodontal, cardiovascular, renal, hepatic, and immune function). We applied these methods to assess biological aging in young humans who had not yet developed age-related diseases. Young individuals of the same chronological age varied in their biological aging (declining integrity of multiple organ systems). Already, before midlife, individuals who were aging more rapidly were less physically able, showed cognitive decline and brain aging, self-reported worse health, and looked older. Measured biological aging in young adults can be used to identify causes of aging and evaluate rejuvenation therapies.
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Schaefer, J., Caspi, A., Belsky, D.W., Harrington, H. L., Houts, R., Israel, S., Levine, M., Sugden, K., Williams, B.S., Poulton, R., Moffitt, T.E. | 2015

Early-life intelligence predicts midlife biological age

Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 2015, First published online May 26, 2015, doi: 10.1093/geronb/gbv035.

Our ref: RO668

Show abstract » Objectives. Early-life intelligence has been shown to predict multiple causes of death in populations around the world. This finding suggests that intelligence might influence mortality through its effects on a general process of physiological deterioration (i.e., individual variation in 'biological age'). We examined whether intelligence could predict measures of aging at midlife before the onset of most age-related disease. Methods. We tested whether intelligence assessed in early childhood, middle childhood, and midlife predicted midlife biological age in members of the Dunedin Study, a population-representative birth cohort. Results. Lower intelligence predicted more advanced biological age at midlife as captured by perceived facial age, a 10-biomarker algorithm based on data from the National Health and Nutrition Examination Survey (NHANES), and Framingham heart age (r = 0.1"0.2). Correlations between intelligence and telomere length were less consistent. The associations between intelligence and biological age were not explained by differences in childhood health or parental socioeconomic status, and intelligence remained a significant predictor of biological age even when intelligence was assessed before Study members began their formal schooling. Discussion. These results suggest that accelerated aging may serve as one of the factors linking low early-life intelligence to increased rates of morbidity and mortality.
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Moffitt, T.E., Houts, R., Asherson, P., Belsky, D.W., Corcoran, D.L., Hammerle, M., Harrington, H. L., Hogan, S., Meier, M.H., Polanczyk, G., Poulton, R., Ramrakha, S., Sugden, K., Williams, B.S., Rohde, L.A., Caspi, A. | 2015

Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study.

American Journal of Psychiatry, 2015, AJP in Advance May 2015 (doi: 10.1176/appi.ajp.2015.14101266).

Our ref: RO667

Show abstract » Objective: Despite a prevailing assumption that adult ADHD is a childhood-onset neurodevelopmental disorder, no prospective longitudinal study has described the childhoods of the adult ADHD population. The authors report follow-back analyses of ADHD cases diagnosed in adulthood, alongside follow-forward analyses of ADHD cases diagnosed in childhood, in one cohort. Method: Participants belonged to a representative birth cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed to age 38, with 95% retention. Symptoms of ADHD, associated clinical features, comorbid disorders, neuropsychological deficits, genome-wide association study-derived polygenic risk, and life impairment indicators were assessed. Data sources were participants, parents, teachers, informants, neuropsychological test results, and administrative records. Adult ADHD diagnoses used DSM-5 criteria, apart from onset age and cross-setting corroboration, which were study outcome measures. Results: As expected, childhood ADHD had a prevalence of 6% (predominantly male) and was associated with childhood comorbid disorders, neurocognitive deficits, polygenic risk, and residual adult life impairment. Also as expected, adult ADHD had a prevalence of 3% (gender balanced) and was associated with adult substance dependence, adult life impairment, and treatment contact. Unexpectedly, the childhood ADHD and adult ADHD groups comprised virtually nonoverlapping sets; 90% of adult ADHD cases lacked a history of childhood ADHD. Also unexpectedly, the adult ADHD group did not show tested neuropsychological deficits in childhood or adulthood, nor did they show polygenic risk for childhood ADHD.
Conclusions: The findings raise the possibility that adults presenting with the ADHD symptom picture may not have a childhood-onset neurodevelopmental disorder. If this finding is replicated, then the disorder's place in the classification system must be reconsidered, and research must investigate the etiology of adult ADHD.
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Belsky, D.W., Caspi, A., Israel, S., Blumenthal, J.A., Poulton, R., Moffitt, T.E. | 2015

Cardiorespiratory fitness and cognitive function at midlife: Neuroprotection or Neuroselection?

Annals of Neurology, 2015, 77(4), 607-617.

Our ref: RO666

Show abstract » Objective: A study was undertaken to determine whether better cognitive functioning at midlife among more physically fit individuals reflects neuroprotection, by which fitness protects against age-related cognitive decline, or neuroselection, by which children with higher cognitive functioning select more active lifestyles. Methods: Children in the Dunedin Longitudinal Study (N?=?1,037) completed the Wechsler Intelligence Scales and the Trail Making, Rey Delayed Recall, and Grooved Pegboard tasks as children and again at midlife (age?=?38 years). Adult cardiorespiratory fitness was assessed using a submaximal exercise test to estimate maximum oxygen consumption adjusted for body weight in milliliters/minute/kilogram. We tested whether more fit individuals had better cognitive functioning than their less fit counterparts (which could be consistent with neuroprotection), and whether better childhood cognitive functioning predisposed to better adult cardiorespiratory fitness (neuroselection). Finally, we examined possible mechanisms of neuroselection. Results: Participants with better cardiorespiratory fitness had higher cognitive test scores at midlife. However, fitness-associated advantages in cognitive functioning were already present in childhood. After accounting for childhood baseline performance on the same cognitive tests, there was no association between cardiorespiratory fitness and midlife cognitive functioning. Socioeconomic and health advantages in childhood and healthier lifestyles during young adulthood explained most of the association between childhood cognitive functioning and adult cardiorespiratory fitness. Interpretation: We found no evidence for a neuroprotective effect of cardiorespiratory fitness as of midlife. Instead, children with better cognitive functioning are selecting healthier lives. Fitness interventions may enhance cognitive functioning. However, observational and experimental studies testing neuroprotective effects of physical fitness should consider confounding by neuroselection.
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Hancox, R. J., Shin, H.H., Gray, A.R., Poulton, R. , Sears, M.R. | 2015

Effects of quitting cannabis on respiratory symptoms

European Respiratory Journal, 2015, Published ahead of print 2 April 2015, doi: 10.1183/09031936.00228914.
doi: 10.1183/09031936.00228914

Our ref: RO665

Show abstract » Smoking cannabis is associated with symptoms of bronchitis. Little is known about the persistence of symptoms after stopping cannabis use. We assessed associations between changes in cannabis use and respiratory symptoms in a population-based cohort of 1037 young adults. Participants were asked about cannabis and tobacco use at ages 18, 21, 26, 32 and 38 years. Symptoms of morning cough, sputum production, wheeze, dyspnoea on exertion and asthma diagnoses were ascertained at the same ages. Frequent cannabis use was defined as .52 occasions over the previous year. Associations between frequent cannabis use and respiratory symptoms were analysed using generalised estimating equations with adjustments for tobacco smoking, asthma, sex and age. Frequent cannabis use was associated with morning cough (OR 1.97, p<0.001), sputum production (OR 2.31, p<0.001) and wheeze (OR 1.55, p<0.001). Reducing or quitting cannabis use was associated with reductions in the prevalence of cough, sputum and wheeze to levels similar to nonusers. Frequent cannabis use is associated with symptoms of bronchitis in young adults. Reducing cannabis use often leads to a resolution of these symptoms.

Media Report:
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Poulton, R. , Moffitt, T.E., Silva, P.A. | 2015

The Dunedin Multidisciplinary Health and Development Study: Overview of the first 40 years, with an eye to the future

Social Psychiatry and Psychiatric Epidemiology , 2015, 50(5), 679-693.
DOI 10.1007/s00127-015-1048-8

Our ref: RO664

Show abstract » The Dunedin Multidisciplinary Health and Development Study began more than four decades ago. Unusual at the time, it was founded as a multidisciplinary research enterprise, and was strongly supported by the Dunedin community, both professional and lay, in its early years. Seven research themes have evolved over the last 40 years focusing on: mental and neuro-cognition, cardiovascular risk, respiratory health, oral health, sexual and reproductive health and psychosocial functioning. A seventh, more applied theme, seeks to maximise the value of the Study findings for New Zealand's indigenous people Mâori (or tangata whenua transl people of the land). The Study has published over 1200 papers and reports to date, with almost 2/3 of these being in peer reviewed journals. Here we provide an overview of the study, its history, leadership structure, scientific approach, operational foci, and some recent examples of work that illustrates: (i) the value of multidisciplinary data; (ii) how the Study is well positioned to addresses contemporary issues; and (iii) how research can simultaneously address multiple audiences - from researchers and theoreticians to policy makers and practitioners. Near future research plans are described, and we end by reflecting upon the core aspects of the Study that portend future useful contributions.
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Kydd, R.M., Connor, J. | 2015

Inconsistency in Reporting Abstention and Heavy Drinking Frequency: Associations with Sex and Socioeconomic Status, and Potential Impacts

Alcohol and Alcoholism, 2015, 50(3), 333-345.
doi: 10.1093/alcalc/agu106

Our ref: RO663

Show abstract » Aims: To describe inconsistencies in reporting past-year drinking status and heavy drinking occasions (HDOs) on single questions from two different instruments, and to identify associated characteristics and impacts. Methods: We compared computer-presented Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) with categorical response options, and mental health interview (MHI) with open-ended consumption questions, completed on the same day. Participants were 464 men and 459 women aged 38 (91.7% of surviving birth cohort members). Differences in dichotomous single-item measures of abstention and HDO frequency, associations of inconsistent reporting with sex, socioeconomic status (SES) and survey order, and impacts of instrument choice on associations of alcohol with sex and SES were examined. Results: The AUDIT-C drinking frequency question estimated higher past-year abstention prevalence (AUDIT = 7.6%, MHI = 5.4%), with one-third of AUDIT-C abstainers being MHI drinkers. Only AUDIT-C produced significant sex differences in abstainer prevalence. Inconsistencies in HDO classifications were bidirectional, but with fewer HDOs reported on the MHI than AUDIT-C question. Lower SES was associated with inconsistency in abstention and weekly+ HDOs. Abstention and higher HDO frequency were associated with lower SES overall, but sex-specific associations differed by instrument. Conclusions: In this context, data collection method affected findings, with inconsistencies in abstention reports having most impact. Future studies should: (a) confirm self-reported abstention; (b) consider piloting data collection methods in target populations; (c) expect impacts of sex and SES on measurements and analyses.
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van Roode, T., Dickson, N., Righarts, A., Gillett, W. | 2015

Cumulative incidence of infertility in a New Zealand birth cohort to age 38 by sex, and the relationship with family formation

Fertility and Sterility, 2015, Available online first 27 January 2015,

Our ref: RO662

Show abstract » Objective: To estimate the cumulative incidence of infertility for men and women in a population-based sample. Design: Longitudinal study of a birth cohort. Setting: Research unit. A population-based birth cohort of 1,037 men and women born in Dunedin, New Zealand, between 1972 and1973. Main Outcome Measure(s): Cumulative incidence of infertility by age 32 and 38, distribution of causes and service use for infertility, live birth subsequent to infertility, and live birth by age38. Result(s): The cumulative incidence of infertility by age 38 ranged from 14.4% to 21.8% for men and from 15.2% to 26.0% for women depending on the infertility definition and data used. Infertility, defined as having tried to conceive for 12months or more or having sought medical help to conceive, was experienced by 21.8% (95% confidence interval [CI], 17.726.2) of men and 26.0% (95% CI, 21.830.6) of women by age 38. For those who experienced infertility, 59.8% (95% CI, 48.370.4) of men and 71.8% (95% CI, 62.180.3) of women eventually had a live birth. Successful resolution of infertility and entry into parenthood by age 38 were much lower for those who first experienced infertility in their mid to late thirties compared with at a younger age. Conclusion(s): Comparison of reports from two assessments in this cohort study suggests infertility estimates from a single cross-sectional study may underestimate lifetime infertility. The lower rate of resolution and entry into parenthood for those first experiencing infertility in their mid to late thirties highlights the consequences of postponing parenthood and could result in involuntary childlessness and fewer children than desired.
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Parsons, M.J., Moffitt, T.E., Gregory, A. M., Goldman-Mellor, S., Nolan, P.M., Poulton, R., Caspi, A. | 2015

Social Jetlag, Obesity and Metabolic Disorder: Investigation in a Cohort Study

International Journal of Obesity, 2015, Advance online publication 20 January 2015; doi: 10.1038/ijo.2014.201.

Our ref: RO661

Show abstract » Background: Obesity is one of the leading causes of preventable death worldwide. Circadian rhythms are known to control both sleep timing and energy homeostasis, and disruptions in circadian rhythms have been linked with metabolic dysfunction and obesity-associated disease. In previous research, social jetlag, a measure of chronic circadian disruption caused by the discrepancy between our internal versus social clocks, was associated with elevated self-reported body mass index, possibly indicative of a more generalized association with obesity and metabolic dysfunction. Methods: We studied participants from the population-representative Dunedin Longitudinal Study (N=1037) to determine whether social jetlag was associated with clinically assessed measurements of metabolic phenotypes and disease indicators for obesity-related disease, specifically, indicators of inflammation and diabetes. Results: Our analysis was restricted to N=815 non-shift workers in our cohort. Among these participants, we found that social jetlag was associated with numerous clinically assessed measures of metabolic dysfunction and obesity. We distinguished between obese individuals who were metabolically healthy versus unhealthy, and found higher social jetlag levels in metabolically unhealthy obese individuals. Among metabolically unhealthy obese individuals, social jetlag was additionally associated with elevated glycated hemoglobin and an indicator of inflammation. Conclusions: The findings are consistent with the possibility that living against our internal clock' may contribute to metabolic dysfunction and its consequences. Further research aimed at understanding that the physiology and social features of social jetlag may inform obesity prevention and have ramifications for policies and practices that contribute to increased social jetlag, such as work schedules and daylight savings time.
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Broadbent, J. M. , Thomson, W. M., Ramrakha, S., Moffitt, T.E., Zeng, J., Foster-Page, L.A. , Poulton, R. | 2015

Community water fluoridation and intelligence: Prospective Study in New Zealand

American Journal of Public Health, 2015, 105(1), 72-76.

Our ref: RO653

Show abstract » Objectives.This study aimed to clarify the relationship between community water fluoridation (CWF) and IQ. Methods. We conducted a prospective study of a general population sample of those born in Dunedin, New Zealand, between April 1, 1972, and March 30, 1973 (95.4% retention of cohort after 38 years of prospective follow-up). Residence in a CWF area, use of fluoride dentifrice and intake of 0.5-milligram fluoride tablets were assessed in early life (prior to age 5 years); we assessed IQ repeatedly between ages 7 to 13 years and at age 38 years. Results. No significant differences in IQ because of fluoride exposure were noted. These findings held after adjusting for potential confounding variables, including sex, socioeconomic status, breastfeeding, and birth weight (as well as educational attainment for adult IQ outcomes). Conclusions. These findings do not support the assertion that fluoride in the context of CWF programs is neurotoxic. Associations between very high fluoride exposure and low IQ reported in previous studies may have been affected by confounding, particularly by urban or rural status.
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Goldman-Mellor, S., Gregory, A. M., Caspi, A., Harrington, H. L., Parsons, M.J., Poulton, R., Moffitt, T.E. | 2014

Mental health antecedents of early midlife insomnia: Evidence from a four-decade longitudinal study

Sleep, 2014, 37(11), 1767-1775.

Our ref: RO660

Show abstract » Study objectives. Insomnia is a highly prevalent condition that constitutes a major public health and economic burden. However, little is known about the developmental etiology of adulthood insomnia. Design. We examined whether indicators of psychological vulnerability across multiple developmental periods (psychiatric diagnoses in young adulthood and adolescence, childhood behavioral problems, and familial psychiatric history) predicted subsequent insomnia in adulthood. Setting and participants. We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1,037 children in New Zealand who were followed prospectively from birth (19721973) through their fourth decade of life with a 95% retention rate. Measurements. Insomnia was diagnosed at age 38 according to DSM-IV criteria. Psychiatric diagnoses, behavioral problems, and family psychiatric histories were assessed between ages 5 and 38. Results. In cross-sectional analyses, insomnia was highly comorbid with multiple psychiatric disorders. After controlling for this concurrent comorbidity, our results showed that individuals who have family histories of depression or anxiety, and who manifest lifelong depression and anxiety beginning in childhood, are at uniquely high risk of age-38 insomnia. Other disorders did not predict adulthood insomnia. Conclusions. The link between lifelong depression and anxiety symptoms and adulthood insomnia calls for further studies to clarify the neurophysiological systems or behavioral conditioning processes that may underlie this association.
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Shalev, I., Caspi, A., Ambler, A., Belsky, D.W., Chapple, S., Cohen, H., Israel, S., Poulton, R. , Ramrakha, S., Rivera, C., Sugden, K., Williams, B.S., Wolke, D., Moffitt, T.E. | 2014

Perinatal Complications and Aging Indicators by Midlife

Pediatrics, 2014, 134 e1315-e1323. Available early view online DOI: 10.1542/peds.2014-1669.

Our ref: RO658

Show abstract » BACKGROUND: Perinatal complications predict increased risk for morbidity and early mortality. Evidence of perinatal programming of adult mortality raises the question of what mechanisms embed this long-term effect. We tested a hypothesis related to the theory of developmental origins of health and disease: that perinatal complications assessed at birth predict indicators of accelerated aging by midlife. METHODS: Perinatal complications, including both maternal and neonatal complications, were assessed in the Dunedin Multidisciplinary Health and Development Study cohort (N = 1037), a 38-year, prospective longitudinal study of a representative birth cohort. Two aging indicators were assessed at age 38 years, objectively by leukocyte telomere length (TL) and subjectively by perceived facial age. RESULTS: Perinatal complications predicted both leukocyte TL (b =20.101; 95% confidence interval, 20.169 to 20.033; P = .004) and perceived age (b = 0.097; 95% confidence interval, 0.029 to 0.165; P = .005) by midlife. We repeated analyses with controls for measures of family history and social risk that could predispose to perinatal complications and accelerated aging, and for measures of poor health taken in between birth and the age-38 follow-up. These covariates attenuated, but did not fully explain the associations observed between perinatal complications and aging indicators. CONCLUSIONS: Our findings provide support for early-life developmental programming by linking newborns' perinatal complications to accelerated aging at midlife. We observed indications of accelerated aging inside, as measured by leukocyte TL, an indicator of cellular aging, and outside, as measured by perceived age, an indicator of declining tissue integrity. A better understanding of mechanisms underlying perinatal programming of adult aging is needed.
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Israel, S., Caspi, A., Belsky, D.W., Harrington, H. L., Hogan, S., Houts, R., Ramrakha, S., Sanders, S., Poulton, R. , Moffitt, T.E. | 2014

Credit Scores, Cardiovascular Disease Risk and Human Capital

PNAS, 2014, Available Early Edition online DOI: 10.1073.

Our ref: RO659

Show abstract » Credit scores are the most widely used instruments to assess whether or not a person is a financial risk. Credit scoring has been so successful that it has expanded beyond lending and into our everyday lives, even to inform how insurers evaluate our health. The pervasive application of credit scoring has outpaced knowledge about why credit scores are such useful indicators of individual behavior. Here we test if the same factors that lead to poor credit scores also lead to poor health. Following the Dunedin (New Zealand) Longitudinal Study cohort of 1,037 study members, we examined the association between credit scores and cardiovascular disease risk and the underlying factors that account for this association. We find that credit scores are negatively correlated with cardiovascular disease risk. Variation in household income was not sufficient to account for this association. Rather, individual differences in human capital factors educational attainment, cognitive ability, and self-control predicted both credit scores and cardiovascular disease risk and accounted for ~45% of the correlation between credit scores and cardiovascular disease risk. Tracing human capital factors back to their childhood antecedents revealed that the characteristic attitudes, behaviors, and competencies children develop in their first decade of life account for a significant portion (~22%) of the link between credit scores and cardiovascular disease risk at midlife. We discuss the implications of these findings for policy debates about data privacy, financial literacy, and early childhood interventions.
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Shin, H.H., Sears, M.R., Hancox, R. J. | 2014

Prevalence and correlates of a 'knee' pattern on the maximal expiratory flow volume loop in young adults

Respirology, 2014, 19(7), 1052-1058.

Our ref: RO657

Show abstract » Background and objective: Visual inspection of the maximal flow-volume curve is an important step in interpreting spirometry. Many young people have a convex inflection or 'knee' on the expiratory part of the loop. This is thought to be a normal variant, but this view is based on theoretical grounds, and the epidemiology of the knee pattern has never been reported. Methods: Flow-volume loops from an unselected birth cohort of 1037 individuals at ages 18, 26, 32 and 38 years were visually inspected for a knee pattern. Associations with asthma diagnoses, smoking history, body mass index (BMI) and spirometry were assessed. Results: The knee pattern was found in approximately two thirds of men and women at age 18. The prevalence decreased with age, but it was more likely to persist in women. The knee was more common after bronchodilator and was associated with higher forced expiratory volume in 1 s/forced vital capacity ratios and mid-expiratory flow rates. There was no association with smoking, except for an inverse correlation in men at age 18. No association was found with BMI. Women with asthma were less likely to have a knee at both ages 18 and 38, whereas men with asthma showed an inverse association at age 18. Conclusions: A knee is a very common pattern on flow-volume loop in young adults. In accordance with theoretical predictions, the prevalence of the knee declines with age, but it is more likely to persist in women. It is associated with less airflow obstruction and is less common in people with asthma.
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Belsky, D.W., Shalev, I., Sears, M.R., Hancox, R. J., Harrington, H. L., Houts, R., Moffitt, T.E., Sugden, K., Williams, B.S., Poulton, R., Caspi, A. | 2014

Is Chronic Asthma Associated with Shorter Leukocyte Telomere Length at Midlife?

American Journal of Respiratory and Critical Care Medicine, 2014, First published online 23 Jun 2014 as DOI: 10.1164/rccm.201402-0370OC.

Our ref: RO656

Show abstract » Background. Asthma is prospectively associated with age-related chronic diseases and mortality, suggesting the hypothesis that asthma may relate to a general, multi-system phenotype of accelerated aging. Objective. To test whether chronic asthma is associated with a proposed biomarker of accelerated aging, leukocyte telomere length. Method. Asthma was ascertained prospectively in the Dunedin Multidisciplinary Health and Development Study cohort (N=1,037) at 9 in-person assessments spanning ages 9 to 38 years. Leukocyte telomere length was measured at ages 26 and 38 years. Asthma was classified as life-course-persistent, childhood-onset not meeting criteria for persistence, and adolescent/adult onset. We tested associations between asthma and leukocyte telomere length using regression models. We tested for confounding of asthma-leukocyte telomere length associations using covariate adjustment. We tested serum C-reactive protein and white blood cell counts as potential mediators of asthma-leukocyte telomere length associations. Results. Study members with life-course-persistent asthma had shorter leukocyte telomere length as compared to sex- and age-matched peers with no reported asthma. In contrast, leukocyte telomere length in study members with childhood-onset and adolescent/adult-onset asthma was not different from leukocyte telomere length in peers with no reported asthma. Adjustment for life histories of obesity and smoking did not change results. Study members with life-course-persistent asthma had elevated blood eosinophil counts. Blood eosinophil count mediated 29% of the life-course-persistent asthma-leukocyte telomere length association. Conclusions. Life-course-persistent asthma is related to a proposed biomarker of accelerated aging, possibly via systemic eosinophilic inflammation. Life histories of asthma can inform studies of aging.
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Iosua, E., Gray, A.R., McGee, R., Landhuis, C.E., Keane, R., Hancox, R. J. | 2014

Employment among schoolchildren and its associations with adult substance use, psychological wellbeing, and academic achievement

Journal of Adolescent Health, 2014, 55(4), 542-548.

Our ref: RO655

Show abstract » Purpose: To examine the association between paid part-time employment among schoolchildren, and adult substance use, psychological wellbeing, and academic achievement. Methods: Longitudinal data from the Dunedin Multidisciplinary Health and Development Study were used to evaluate the association between employment at each of 11, 13, and 15 years, and adult smoking, regular alcohol binge drinking, regular cannabis use, Sense of Coherence, social participation, positive coping style, prosociality, no formal qualifications, and university degree. Associations were initially assessed using unadjusted regression analyses and then adjusted for the potential childhood confounders IQ, reading development, Student's Perception of Ability Scale, socioeconomic disadvantage, family climate, harsh parent-child interaction, parental opinion of their child's attitude to school, and child's personal attitude to school. Results: Employment at 11 years of age was associated with a lower odds of adult smoking; the odds of subsequent regular alcohol binge drinking were greater for those who were employed at age 13; and higher adult rates of social participation and prosociality were identified for adolescents who were employed at 15 years of age. When the potential confounders were con- trolled, employment at age 13 was predictive of both adult smoking and regular binge drinking, and working at 15 years of age was protective against regular cannabis use and associated with greater social participation. Conclusion: There is no consistent evidence that exposing schoolchildren to part-time employment compromised subsequent health, wellbeing, and education in a developed country.
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Breslau, N., Koenen, K., Swanson, S., Agnew-Blais, M.A., Houts, R., Poulton, R., Moffitt, T.E. | 2014

Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: A prospective investigation

Psychological Medicine, 2014, 44(9), 1937–1945.

Our ref: RO654

Show abstract » Background We examine prospectively the influence of two separate but potentially inter-related factors in the etiology of post-traumatic stress disorder (PTSD): childhood maltreatment as conferring a susceptibility to the PTSD response to adult trauma and juvenile disorders as precursors of adult PTSD. Method The Dunedin Multidisciplinary Health and Development Study (DMHDS) is a birth cohort (n = 1037) from the general population of New Zealand's South Island, with multiple assessments up to age 38 years. DSM-IV PTSD was assessed among participants exposed to trauma at ages 26"38. Complete data were available on 928 participants. Results Severe maltreatment in the first decade of life, experienced by 8.5% of the sample, was associated significantly with the risk of PTSD among those exposed to adult trauma [odds ratio (OR) 2.64, 95% confidence interval (CI) 1.16"6.01], compared to no maltreatment. Moderate maltreatment, experienced by 27.2%, was not associated significantly with that risk (OR 1.55, 95% CI 0.85"2.85). However, the two estimates did not differ significantly from one another. Juvenile disorders (ages 11"15), experienced by 35% of the sample, independent of childhood maltreatment, were associated significantly with the risk of PTSD response to adult trauma (OR 2.35, 95% CI 1.32"4.18). Conclusions Severe maltreatment is associated with risk of PTSD response to adult trauma, compared to no maltreatment, and juvenile disorders, independent of earlier maltreatment, are associated with that risk. The role of moderate maltreatment remains unresolved. Larger longitudinal studies are needed to assess the impact of moderate maltreatment, experienced by the majority of adult trauma victims with a history of maltreatment.
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Dickson, N., Righarts, A., van Roode, T., Paul, C., Taylor, J., Cunningham, A.L. | 2014

HSV-2 incidence by sex over four age periods to age 38 in a birth cohort

Sexually Transmitted Infections, 2014, 90(3), 143-145.

Our ref: R0652

Show abstract » Objectives: To examine herpes simplex virus type 2 (HSV-2) incidence over four periods to age 38 in a birth cohort, and to compare risks for men and women, taking into account sexual behaviour. Methods: At ages 21, 26, 32 and 38, participants in the Dunedin Multidisciplinary Health and Development Study were invited to provide serum for HSV-2 serology, and information on sexual behaviour. HSV-2 incidence rates were calculated for four age periods, and comparisons made by sex and period, taking into account number of sexual partners. Results: By age 38, 17.3% of men and 26.8% of women had ever been seropositive for HSV-2. Incidence peaked for women from age 21 to 26 (19.1 per 1000 person-years) and men from age 26 to 32 (14.1 per 1000 person-years); it fell markedly for both from age 32 to 38 (5.1 and 6.8 per 1000 person-years for men and women, respectively). Overall risk was significantly higher for women: adjusted incidence rate ratio 1.9 (95% CI 1.4 to 2.7); the sex difference was most marked from age 21 to 26 (3.4, 95% CI 1.9 to 6.3). Conclusions: Our findings are consistent with a greater biological susceptibility to HSV-2 among women, and with the increasing risk to the early/mid-20s for women and late 20s/early 30s for men, being driven by an increasing pool of prevalent infection. The reduced risk in the mid-30s is consistent with declining infectivity of long-term prevalent infections.
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Zeng, J., Williams, S.M., Fletcher, D., Cameron, C., Broadbent, J. M. , Shearer, D.M., Thomson, W. M. | 2014

Re-examining periodontal effects of smoking in a birth cohort study with an enhanced analytical approach. Part 1: cross-sectional associations at each age

Journal of Periodontology, 2014, Posted online first, 20 February 2014, DOI: 10.1902/jop.2014.130577.

Our ref: RO651

Show abstract » Background: Smoking is a major risk factor for periodontal disease. Conventional oral epidemiology approaches have found strong, consistent associations between chronic smoking and periodontal attachment loss (AL) through ages 26, 32, and 38, but those statistical methods disregarded the data's hierarchical structure. We re-examined the association using hierarchical modelling in order to (1) overcome the limitations of an earlier approach (trajectory analysis) to the data, and (2) determine the robustness of the earlier inferences. Method: Periodontal examinations were conducted at ages 26, 32 and 38 in the Dunedin Multidisciplinary Health and Development Study. The number of participants examined at those three ages were 913, 918 and 913, respectively. Generalized Linear Mixed Modelling with a quasi-binomial approach was used to examine associations between chronic smoking and periodontal attachment loss. Results: At ages 26, 32 and 38, smokers had 3.5%, 12.8% and 23.2% (respectively) greater AL than non-smokers. Regular cannabis use was associated with greater AL after age 32, but not at age 26. Males had more AL than females. Participants with high plaque scores had consistently greater AL; those who were of persistently low SES (socio-economic status) had higher AL at age 32 and 38, but not at age 26. The amount of AL in anteriors was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32 and 38. Conclusions: The smoking-periodontitis association is observable with hierarchical modelling, providing strong evidence that chronic smoking is a risk factor for periodontitis.
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Israel, S., Moffitt, T. E., Belsky, D. W., Hancox, R. J., Poulton, R., Roberts, B. W., Thomson, W. M., & Caspi, A. | 2014

Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients

Journal of Personality and Social Psychology, 2014, 106(3), 484-498.

Our ref: RO650

Show abstract » The rising number of newly insured young adults brought on by health care reform will soon increase demands on primary care physicians. Physicians will face more young adult patients, which presents an opportunity for more prevention-oriented care. In the present study, we evaluated whether brief observer reports of young adults' personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the cohort of 1,000 individuals from the Dunedin Multidisciplinary Health and Development Study (Moffitt, Caspi, Rutter, & Silva, 2001), we show that very brief measures of young adults' personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness to Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for health care professionals to personalize preventive medicine. Adding personality information to existing health care electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor"patient communication, health service use, and patient outcomes.
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Robertson, L.A., McGee, R., Hancox, R. J. | 2014

Smoking Cessation and Subsequent Weight Change

Nicotine & Tobacco Research, 2014, 16(6), 867-871.

Our ref: RO649

Show abstract » Introduction: People who quit smoking tend to gain more weight over time than those who continue to smoke. Previous research using clinical samples of smokers suggests that quitters typically experience a weight gain of approximately 5kg in the year following smoking cessation, but these studies may overestimate the extent of weight gain in the general population. The existing population-based research in this area has some methodological limitations. Methods: We assessed a cohort of individuals born in Dunedin, New Zealand, in 1972"1973, at regular intervals from age 15 to 38. We used multiple linear regression analysis to investigate the association between smoking cessation between 21 and 38 years and subsequent change in body mass index (BMI) and weight, controlling for baseline BMI, socioeconomic status, physical activity, alcohol use, and parity (women). Results: Smoking status and outcome data were available at baseline and follow-up for N = 914 Study members. People who smoked at age 21 and who had quit by age 38 had a BMI on average 1.5kg/m2 greater than those who continued to smoke at age 38. This equated to a weight gain of approximately 5.7kg in men and 5.1kg in women above that of continuing smokers. However, the weight gain between age 21 and 38 among quitters was not significantly different to that of never-smokers. Conclusions: The amount of long-term weight gained after quitting smoking is likely to be lower than previous estimates based on research with clinical samples. On average, quitters do not experience greater weight gain than never-smokers.
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Shalev, I., Moffitt, T.E., Braithwaite, A.W. , Danese, A., Fleming, N.I., Goldman-Mellor, S., Harrington, H. L., Houts, R., Israel, S., Poulton, R., Robertson, S. P. , Sugden, K., Williams, B.S., Caspi, A. | 2014

Internalizing disorders and leukocyte telomere erosion: a prospective study of depression, generalized anxiety disorder and post-traumatic stress disorder

Molecular Psychiatry, 2014, 19(11), 1163-1170.

Our ref: RO648

Show abstract » There is evidence that persistent psychiatric disorders lead to age-related disease and premature mortality. Telomere length has emerged as a promising biomarker in studies that test the hypothesis that internalizing psychiatric disorders are associated with accumulating cellular damage. We tested the association between the persistence of internalizing disorders (depression, generalized anxiety disorder and post-traumatic stress disorder) and leukocyte telomere length (LTL) in the prospective longitudinal Dunedin Study (n = 1037). Analyses showed that the persistence of internalizing disorders across repeated assessments from ages 11 to 38 years predicted shorter LTL at age 38 years in a doseresponse manner, specifically in men (� = - 0.137, 95% confidence interval (CI): -0.232, -0.042, P = 0.005). This association was not accounted for by alternative explanatory factors, including childhood maltreatment, tobacco smoking, substance dependence, psychiatric medication use, poor physical health or low socioeconomic status. Additional analyses using DNA from blood collected at two time points (ages 26 and 38 years) showed that LTL erosion was accelerated among men who were diagnosed with internalizing disorder in the interim (� = - 0.111, 95% CI: -0.184, -0.037, P = 0.003). No significant associations were found among women in any analysis, highlighting potential sex differences in internalizing-related telomere biology. These findings point to a potential mechanism linking internalizing disorders to accelerated biological aging in the first half of the life course, particularly in men. Because internalizing disorders are treatable, the findings suggest the hypothesis that treating psychiatric disorders in the first half of the life course may reduce the population burden of age-related disease and extend health expectancy.
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Goldman-Mellor, S., Caspi, A., Harrington, H. L., Hogan, S., Nada-Raja, S., Poulton, R., Moffitt, T.E. | 2014

Suicide attempt in young people: A signal for long-term healthcare and social needs

JAMA Psychiatry, 2014, 71(2), 119-127.

Our ref: RO647

Show abstract » Importance Suicidal behavior has increased since the onset of the global recession, a trend that may have long-term health and social implications. Objective To test whether suicide attempts among young people signal increased risk for later poor health and social functioning above and beyond a preexisting psychiatric disorder. Design We followed up a cohort of young people and assessed multiple aspects of their health and social functioning as they approached midlife. Outcomes among individuals who had self-reported a suicide attempt up through age 24 years (young suicide attempters) were compared with those who reported no attempt through age 24 years (nonattempters). Psychiatric history and social class were controlled for. Setting and Participants The population-representative Dunedin Multidisciplinary Health and Development Study, which involved 1037 birth cohort members comprising 91 young suicide attempters and 946 nonattempters, 95% of whom were followed up to age 38 years. Main Outcomes and Measures Outcomes were selected to represent significant individual and societal costs: mental health, physical health, harm toward others, and need for support. Results As adults approaching midlife, young suicide attempters were significantly more likely to have persistent mental health problems (eg, depression, substance dependence, and additional suicide attempts) compared with nonattempters. They were also more likely to have physical health problems (eg, metabolic syndrome and elevated inflammation). They engaged in more violence (eg, violent crime and intimate partner abuse) and needed more social support (eg, long-term welfare receipt and unemployment). Furthermore, they reported being lonelier and less satisfied with their lives. These associations remained after adjustment for youth psychiatric diagnoses and social class. Conclusions and Relevance Many young suicide attempters remain vulnerable to costly health and social problems into midlife. As rates of suicidal behavior rise with the continuing global recession, additional suicide prevention efforts and long-term monitoring and after-care services are needed.
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McGee, Rob, Williams, Sheila, Nada-Raja, Shyamala, Olsson, Craig A. | 2013

Tobacco Smoking in Adolescence Predicts Maladaptive Coping Styles in Adulthood

Nicotine & Tobacco Research, 2013, 15(12), 1971-1977.

Our ref: RO649.2

Show abstract » Introduction: To examine the extent to which cigarette smoking in adolescence is associated with maladaptive versus adaptive coping behaviors in adulthood.Method: The data came from a longitudinal study of New Zealand adolescents followed into adulthood at age 32 years. Using structural equation modeling (SEM), we examined the predictive association between daily smoking of cigarettes and symptoms of tobacco dependence from 18 to 26 years of age and later coping at age 32 years. We included pathways from childhood family disadvantage in addition to both adolescent stress-worry and adult coping in the model.Results: SEM revealed that cigarette smoking had a small but direct inverse effect on later adaptive coping (-.14) and a direct effect on maladaptive coping (.23) independent of the relationships between adolescent coping and stress-worry and later adult coping.Conclusions: The findings are consistent with the hypothesis that tobacco smoking may inhibit the development of self-efficacy or one's ability to act with appropriate coping behaviors in any given situation.
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Williams, S.M., Taylor, R.W., Taylor, B.J. | 2013

Secular changes in the associations between risk factors and BMI at ages 3 and 7 in two Dunedin cohorts

Pediatric Obesity, 2013, 8(1), 21-30.

Our ref: RO634.2

Show abstract » Objective: Using two cohorts born 29 years apart in Dunedin, New Zealand we aim to examine changes in risk factors and their associations with body mass index (BMI) at ages 3 and 7 years, and estimate their contribution to the secular changes in BMI at age 7 years. Methods: Birth weight and anthropometric measures at ages 3, 5 and 7 years were obtained for 974 participants in the Dunedin Multidisciplinary Health and Development Study (DMHDS), born in 1972"1973, and 241 in the Family Lifestyle, Activity, Movement and Eating Study (FLAME), born in 2001"2002. Information about maternal age, education and smoking in pregnancy, as well as breastfeeding, children's television time and time in bed, was obtained by questionnaire. Results: The increase in BMI over the 29-year period was 0.84 (95% CI 0.61, 1.06) kg m-2 at age 7. A 1-unit difference in the mother's BMI was associated with a 0.06 (0.03, 0.08) kg m-2 difference in offspring in both studies; the 3.4 (2.8, 4.0) kg m-2 increase in the mothers' BMIs accounts for a change of 0.19 kg m-2 in the children's BMI. The much smaller generational increase in fathers' BMI (0.7 kg m-2) correspondingly had a more limited effect on change in child BMI over time (0.06 kg m-2). Although smoking in pregnancy decreased by 15% (8, 21) its association with BMI increased from 0.20 (-0.01, 0.42) in the DMHDS cohort to 1.24 (0.76, 1.71) kg m-2 in the FLAME cohort, contributing 0.18 kg m-2 to the increase in children's BMI. Conclusions: Societal factors such as higher maternal BMI and smoking in pregnancy contribute most to the secular increase in BMI, with changes in behavioural factors, including sleep and television viewing, having little effect in this setting.
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Broadbent, J. M. , Foster-Page, L.A. , Thomson, W. M., Poulton, R. | 2013

Permanent dentition caries through the first half of life

British Dental Journal, 2013, 215(215), E12, DOI: 10.1038/sj.bdj.2013.991.

Our ref: RO646

Show abstract » Aim: To describe the occurrence of dental caries at the person, tooth and tooth surface level from childhood to early mid-life. Background: No studies have reported on age and caries experience in a population-based sample through the first half of life. Methods: Prospective cohort study of a complete birth cohort (n = 1,037) born in 1972/73 in Dunedin, New Zealand. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38, and participation rates remained high. Surface-level caries data were collected at each age (WHO basic methods). Statistical analyses and graphing of data were undertaken using Intercooled Stata Version 10. Results: Data are presented on dental caries experience in the permanent dentition at ages 9, 15, 18, 26, 32 and 38. Percentile curves are charted and reported for person-level caries experience. Data are also presented on the number of decayed teeth and tooth surfaces, (including root surfaces at age 38), as a function of the number of teeth and surfaces present, respectively. Across the cohort, the number of tooth surfaces affected by dental caries increased by approximately 0.8 surfaces per year (on average), while the percentage of at-risk tooth surfaces affected by caries increased by approximately 0.5% per year, with negligible variation in that rate throughout the observation period. Conclusion: These unique data show clearly that dental caries continues as a disease of adulthood, remaining important beyond childhood and adolescence and that rates of dental caries over time remain relatively constant.
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Belsky, D.W., Caspi, A., Goldman-Mellor, S., Meier, M.H., Ramrakha, S., Poulton, R., Moffitt, T.E. | 2013

Is Obesity Associated With a Decline in Intelligence Quotient During the First Half of the Life Course?

American Journal of Epidemiology, 2013, First published online 12 September 2013, doi: 10.1093/aje/kwt135.

Our ref: RO645

Show abstract » Cross-sectional studies have found that obesity is associated with low intellectual ability and neuroimaging abnormalities in adolescence and adulthood. Some have interpreted these associations to suggest that obesity causes intellectual decline in the first half of the life course. We analyzed data from a prospective longitudinal study to test whether becoming obese was associated with intellectual decline from childhood to midlife. We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1,037 children in New Zealand who were followed prospectively from birth (19721973) through their fourth decade of life with a 95% retention rate. Intelligence quotient (IQ) was measured in childhood and adulthood. Anthropometric measurements were taken at birth and at 12 subsequent in-person assessments. As expected, cohort members who became obese had lower adulthood IQ scores. However, obese cohort members exhibited no excess decline in IQ. Instead, these cohort members had lower IQ scores since childhood. This pattern remained consistent when we accounted for children's birth weights and growth during the first years of life, as well as for childhood-onset obesity. Lower IQ scores among children who later developed obesity were present as early as 3 years of age. We observed no evidence that obesity contributed to a decline in IQ, even among obese individuals who displayed evidence of the metabolic syndrome and/or elevated systemic inflammation.
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Meier, M.H., Shalev, I., Moffitt, T.E., Kapur, S., Keefe, R., Wong, T.Y., Belsky, D.W., Harrington, H. L., Hogan, S., Houts, R., Caspi, A., Poulton, R. | 2013

Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging

American Journal of Psychiatry, 2013, 170(170), 1451-1459.

Our ref: RO644

Show abstract » Objective Retinal and cerebral microvessels are structurally and functionally homologous, but unlike cerebral microvessels, retinal microvessels can be noninvasively measured in vivo by retinal imaging. The authors tested the hypothesis that individuals with schizophrenia exhibit microvascular abnormality and evaluated the utility of retinal imaging as a tool for schizophrenia research. Method Participants were members of the Dunedin Study, a population-representative cohort followed from birth with 95% retention. Study members underwent retinal imaging at age 38. The authors assessed retinal arteriolar and venular caliber for all members of the cohort, including individuals who developed schizophrenia. Results Study members who developed schizophrenia were distinguished by wider retinal venules, suggesting microvascular abnormality reflective of insufficient brain oxygen supply. Analyses that controlled for confounding health conditions suggested that wider retinal venules are not simply an artifact of co-occurring health problems in schizophrenia patients. Wider venules were also associated with a dimensional measure of adult psychosis symptoms and with psychosis symptoms reported in childhood. Conclusions The findings provide initial support for the hypothesis that individuals with schizophrenia show microvascular abnormality. Moreover, the results suggest that the same vascular mechanisms underlie subthreshold symptoms and clinical disorder and that these associations may begin early in life. These findings highlight the promise of retinal imaging as a tool for understanding the pathogenesis of schizophrenia.
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Meier, M.H., Caspi, A., Reichenberg, A., Keefe, R., Fisher, H.L., Harrington, H. L., Houts, R., Poulton, R., Moffitt, T.E. | 2013

Neuropsychological Decline in Schizophrenia from the Premorbid to Post-Onset Period: Evidence from a Population-Representative Longitudinal Study

American Journal of Psychiatry, 2013, AJP in advance September 2013, doi:10.1176/appi.ajp.2013.12111438.

Our ref: RO643

Show abstract » Objective Despite the widespread belief that neuropsychological decline is a cardinal feature of the progression from the premorbid stage to the chronic form of schizophrenia, few longitudinal studies have examined change in neuropsychological functioning from before to after illness onset. The authors examined whether neuropsychological decline is unique to schizophrenia, whether it is generalized or confined to particular mental functions, and whether individuals with schizophrenia also have cognitive problems in everyday life. Method Participants were members of a representative cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed prospectively to age 38, with 95% retention. Assessment of IQ and specific neuropsychological functions was conducted at ages 7, 9, 11, and 13, and again at age 38. Informants also reported on any cognitive problems at age 38. Results Individuals with schizophrenia exhibited declines in IQ and in a range of mental functions, particularly those tapping processing speed, learning, executive function, and motor function. There was little evidence of decline in verbal abilities or delayed memory, however, and the developmental progression of deficits in schizophrenia differed across mental functions. Processing speed deficits increased gradually from childhood to beyond the early teen years, whereas verbal deficits emerged early but remained static thereafter. Neuropsychological decline was specific to schizophrenia, as no evidence of decline was apparent among individuals with persistent depression, children with mild cognitive impairment, individuals matched on childhood risk factors for schizophrenia, and psychiatrically healthy individuals. Informants also noticed more cognitive problems in individuals with schizophrenia. Conclusions There is substantial neuropsychological decline in schizophrenia from the premorbid to the postonset period, but the extent and developmental progression of decline varies across mental functions. Findings suggest that different pathophysiological mechanisms may underlie deficits in different mental functions.
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Copeland, W.E., Adair, C.E., Smetanin, P., Stiff, D., Briante, C., Colman, I., Fergusson, D.M., Horwood, L.J., Poulton, R., Costello, J., Angold, A. | 2013

Diagnostic transitions from childhood to adolescence to early adulthood

Journal of Child Psychology and Psychiatry, 2013, 54(54), 791-799.

Our ref: RO642

Show abstract » Background: Quantifying diagnostic transitions across development is needed to estimate the long-term burden of mental illness. This study estimated patterns of diagnostic transitions from childhood to adolescence and from adolescence to early adulthood. Methods: Patterns of diagnostic transitions were estimated using data from three prospective, longitudinal studies involving close to 20,000 observations of 3,722 participants followed across multiple developmental periods covering ages 930. Common DSM psychiatric disorders were assessed in childhood (ages 912; two samples), adolescence (ages 1318; three samples), and early adulthood (ages 19 to age 32; three samples) with structured psychiatric interviews and questionnaires. Results: Having a disorder at an early period was associated with at least a threefold increase in odds for having a disorder at a later period. Homotypic and heterotypic transitions were observed for every disorder category. The strongest evidence of continuity was seen for behavioral disorders (particularly ADHD) with less evidence for emotional disorders such as depression and anxiety. Limited evidence was found in adjusted models for behavioral disorders predicting later emotional disorders. Adult substance disorders were preceded by behavioral disorders, but not anxiety or depression. Conclusions: Having a disorder in childhood or adolescence is a potent risk factor for a range of psychiatric problems later in development. These findings provide further support for prevention and early life intervention efforts and suggest that treatment at younger ages, while justified in its own right, may also have potential to reduce the risk for disorders later in development.
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Caspi, A., Houts, R., Belsky, D.W., Goldman-Mellor, S., Harrington, H. L., Israel, S., Meier, M.H., Ramrakha, S., Shalev, I., Poulton, R., Moffitt, T.E. | 2013

The p Factor: One general psychopathology factor in the structure of psychiatric disorders?

Clinical Psychological Science, 2013, first published online 14 August 2013, DOI: 10.1177/2167702613497473 .

Our ref: RO641

Show abstract » Mental disorders traditionally have been viewed as distinct, episodic, and categorical conditions. This view has been challenged by evidence that many disorders are sequentially comorbid, recurrent/chronic, and exist on a continuum. Using the Dunedin Multidisciplinary Health and Development Study, we examined the structure of psychopathology, taking into account dimensionality, persistence, co-occurrence, and sequential comorbidity of mental disorders across 20 years, from adolescence to midlife. Psychiatric disorders were initially explained by three higher-order factors (Internalizing, Externalizing, and Thought Disorder) but explained even better with one General Psychopathology dimension. We have called this dimension the p factor because it conceptually parallels a familiar dimension in psychological science: the g factor of general intelligence. Higher p scores are associated with more life impairment, greater familiality, worse developmental histories, and more compromised early-life brain function. The p factor explains why it is challenging to find causes, consequences, biomarkers, and treatments with specificity to individual mental disorders. Transdiagnostic approaches may improve research.
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Thomson, W. M. , Shearer, D.M., Broadbent, J. M. , Foster-Page, L.A. , Poulton, R. | 2013

The natural history of periodontal attachment loss during the third and fourth decades of life: findings from the Dunedin Study

Journal of Clinical Periodontology, 2013, 40(40), 672-680.

Our ref: RO640

Show abstract » Aim: To describe changes in the occurrence of periodontal attachment loss through ages 26, 32 and 38 in a complete birth cohort. Materials and methods: Systematic periodontal examinations conducted at ages 26, 32 and 38 in a longstanding New Zealand cohort study (N = 1037). Periodontitis extent data were used to assign participants to periodontitis trajectories using group-based trajectory analysis. Results: 831 individuals were periodontally examined at all three ages; the prevalence and extent of attachment loss increased as the cohort aged. Between 26 and 32, one in nine participants had 1+ sites showing new or progressing attachment loss); that proportion almost doubled between ages 32 and 38. Four periodontitis trajectory groups were identified, comprising 54.2%, 31.7%, 11.0% and 3.1% of the cohort; these were termed the "no disease", "minor disease", "moderate disease" and "extensive disease" trajectory groups, respectively. Those who had smoked tobacco at all ages from 15 through 38 were at higher risk of being in the "moderate disease" or "extensive disease" trajectory groups. There was a similar risk gradient for those who were in the highest 20% of cannabis usage. Conclusions: Periodontitis commences relatively early in adulthood, and its progression accelerates with age, particularly among smokers.
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Belsky, D.W., Sears, M.R., Hancox, R. J. , Harrington, H. L., Houts, R., Moffitt, T.E., Sugden, K., Williams, B.S., Poulton, R., Caspi, A. | 2013

Polygenic risk and the development and course of asthma: an analysis of data from a four-decade longitudinal study

Lancet Respiratory Medicine, 2013, 1(1), 453-461.

Our ref: RO639

Show abstract » Background Genome-wide association studies (GWAS) have discovered loci that predispose individuals to asthma. To integrate these new discoveries with emerging models of asthma pathobiology, we aimed to test how genetic discoveries relate to developmental and biological characteristics of asthma. Methods In this prospective longitudinal study, we investigated a multilocus profile of genetic risk derived from published GWAS of asthma case status. We then tested associations between this genetic risk score and developmental and biological characteristics of asthma in participants enrolled in a population-based long-running birth cohort, the Dunedin Multidisciplinary Health and Development Study (n=1037). We used data on asthma onset, asthma persistence, atopy, airway hyper-responsiveness, incompletely reversible airflow obstruction, and asthma-related school and work absenteeism and hospital admissions obtained during nine prospective assessments spanning the ages of 9 to 38 years. Analyses included cohort members of European descent from whom genetic data had been obtained. Findings Of the 880 cohort members included in our analysis, those at higher genetic risk developed asthma earlier in life than did those with lower genetic risk (hazard ratio [HR] 1·12, 95% CI 1·011·26). Of cohort members with childhood-onset asthma, those with higher genetic risk were more likely to develop life-course-persistent asthma than were those with a lower genetic risk (relative risk [RR] 1·36, 95% CI 1·141·63). Participants with asthma at higher genetic risk more often had atopy (RR 1·07, 1·011·14), airway hyper-responsiveness (RR 1·16, 1·031·32), and incompletely reversible airflow obstruction (RR 1·28, 1·041·57) than did those with a lower genetic risk. They were also more likely to miss school or work (incident rate ratio 1·38, 1·021·86) and be admitted to hospital (HR 1·38, 1·071·79) because of asthma. Genotypic information about asthma risk was independent of and additive to information derived from cohort members' family histories of asthma. Interpretation Our findings confirm that GWAS discoveries for asthma are associated with a childhood-onset phenotype. Genetic risk assessments might be able to predict which childhood-onset asthma cases remit and which become life-course-persistent, who might develop impaired lung function, and the burden of asthma in terms if missed school and work and hospital admissions, although these predictions are not sufficiently sensitive or specific to support immediate clinical translation.
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Meier, M.H., Caspi, A., Houts, R., Slutske, W., Harrington, H. L., Jackson, K.M., Belsky, D.W., Poulton, R. , Moffitt, T.E. | 2013

Prospective developmental subtypes of alcohol dependence from age 18 to 32 years: Implications for nosology, etiology, and intervention

Development and Psychopathology, 2013, 25(25), 785-800.
Our ref: RO638

Show abstract » The purpose of the present study was to identify child and adult correlates that differentiate (a) individuals with persistent alcohol dependence from individuals with developmentally-limited alcohol dependence and (b) individuals with adult-onset alcohol dependence from individuals who never diagnose. Participants are 1,037 members of the Dunedin longitudinal study, a birth cohort followed prospectively from birth until age 32. Past-year DSM-IV alcohol dependence diagnoses were ascertained with structured diagnostic interviews at ages 18, 21, 26, and 32. Individuals were classified as developmentally-limited, persistent, or adult-onset subtypes based on their time-ordered pattern of diagnoses. The persistent subtype generally exhibited the worst scores on all correlates, including family psychiatric history, adolescent and adult externalizing and internalizing problems, adolescent and adult substance use, adult quality of life, and coping strategies. The prospective predictors that distinguished them from the developmentally-limited subtype involved family liability, adolescent negative affectivity, daily alcohol use, and frequent marijuana use. Furthermore, young people who developed the persistent subtype of alcohol dependence were distinguished from the developmentally-limited subtype by an inability to reduce drinking and by continued use despite problems, already by age 18. The adult-onset group members were virtually indistinguishable from ordinary cohort members as children or adolescents, but, in adulthood, adult-onset cases were distinguished by problems with depression, substance use, stress, and strategies for coping with stress. Information about age-of-onset and developmental course is fundamental for identifying subtypes of alcohol dependence. Subtype-specific etiologies point to targeted prevention and intervention efforts based on characteristics of each subtype.
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Shalev, I., Moffitt, T.E., Wong, T.Y., Meier, M.H., Houts, R., Ding, J., Cheung, C.Y.L., Ikram, M.K., Caspi, A., Poulton, R. | 2013

Retinal vessel caliber and lifelong neuropsychological functioning: Retinal imaging as an investigative tool for cognitive epidemiology

Psychological Science, 2013, 24(24), 1198-1207.

Our ref: RO637

Show abstract » Why do more intelligent people live healthier and longer lives? One possibility is that intelligence tests assess health of the brain, but psychological science has lacked technology to evaluate this hypothesis. Digital retinal imaging, a new, noninvasive method to visualize microcirculation in the eye, may reflect vascular conditions in the brain. We studied the association between retinal vessel caliber and neuropsychological functioning in the representative Dunedin birth cohort. Wider venular caliber was associated with poorer neuropsychological functioning at midlife, independently of potentially confounding factors. This association was not limited to any specific test domain and extended to informants' reports of cohort members' cognitive difficulties in everyday life. Moreover, wider venular caliber was associated with lower childhood IQ tested 25 years earlier. The findings indicate that retinal venular caliber may be an indicator of neuropsychological health years before the onset of dementing diseases and suggest that digital retinal imaging may be a useful investigative tool for psychological science.
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