Publications

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

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Israel, S., Moffitt, T.E. | 2014

Commentary: Assessing Conscientious Personality in Primary Care: An Opportunity for Prevention and Health Promotion

Developmental Psychology, 2014, 50(5), 1475-1477.
DOI: 10.1037/a0036113

Our ref: RO658

Show abstract » The articles in this special section bolster the already strong evidence base that personality differences in the trait of conscientiousness predict health. What is now needed is a research agenda for translating documented risk associations between low conscientiousness and poor health into policies and interventions that improve health outcomes for individuals and populations. In this commentary, we highlight 1 such avenue: introducing brief personality assessment into primary care practice. We provide examples of how conscientiousness assessment may help health care professionals get to know their patients better and potentially serve as a guide for more personalized care. We also raise key considerations for implementation research aimed at examining the feasibility and utility of integrating conscientiousness assessment into primary care settings.
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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, Early view first published online 24 July 2014, doi: 10.1111/resp.12352.
http://onlinelibrary.wiley.com/doi/10.1111/resp.12352/abstract

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.
http://www.atsjournals.org/doi/abs/10.1164/rccm.201402-0370OC#.U7NrU1NsHk8

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, avilable online http://dx.doi.org/10.1016/j.jadohealth.2014.03.018 .
http://dx.doi.org/10.1016/j.jadohealth.2014.03.018

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.
http://dx.doi.org/10.1017/S0033291713002651

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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Broadbent, J. M. , Thomson, W. M., Ramrakha, S., Moffitt, T.E., Zeng, J., Foster-Page, L.A. , Poulton, R. | 2014

Community water fluoridation and intelligence: Prospective Study in New Zealand

American Journal of Public Health, 2014, Published online ahead of print May 15, 2014, http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301857.
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301857

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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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.
http://sti.bmj.com/content/90/3/243.full

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.
http://www.joponline.org/doi/pdf/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.
https:// http://www.apa.org/pubs/journals/releases/psp-a0035687.pdf

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, First published online 24 January 2014, doi:10.1093/ntr/ntt284.
http://ntr.oxfordjournals.org/content/early/2014/01/20/ntr.ntt284.abstract

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, advance online publication, 14 January 2014; doi:10.1038/mp.2013.183.
http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2013183a.html

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.
http://archpsyc.jamanetwork.com/article.aspx?articleid=1784715

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.
http://ntr.oxfordjournals.org/content/15/12/1971.abstract

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.
http://onlinelibrary.wiley.com/doi/10.1111/j.2047-6310.2012.00081.x/pdf

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.
http://www.nature.com/bdj/journal/v215/n7/full/sj.bdj.2013.991.html

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.
http://aje.oxfordjournals.org/content/early/2013/09/09/aje.kwt135.full?sid=c280238f-fbac-452b-a2e7-da90ec0b93e6

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.
http://ajp.psychiatryonline.org/article.aspx?articleid=1738034

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.
http://ajp.psychiatryonline.org/Article.aspx?ArticleID=1738030

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.
http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12062/abstract

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 .
http://cpx.sagepub.com/content/early/2013/08/14/2167702613497473

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.
http://onlinelibrary.wiley.com/doi/10.1111/jcpe.12108/pdf

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.
http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(13)70101-2/abstract

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] 112, 95% CI 101126). 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] 136, 95% CI 114163). Participants with asthma at higher genetic risk more often had atopy (RR 107, 101114), airway hyper-responsiveness (RR 116, 103132), and incompletely reversible airflow obstruction (RR 128, 104157) than did those with a lower genetic risk. They were also more likely to miss school or work (incident rate ratio 138, 102186) and be admitted to hospital (HR 138, 107179) 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.
http://pss.sagepub.com/content/24/7/1198

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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Belsky, D.W., Moffitt, T.E., Poulton, R. , Caspi, A. | 2013

Polygenic risk and the developmental progression to heavy, persistent smoking and nicotine dependence: Evidence from a 4-Decade Longitudinal Study

JAMA Psychiatry, 2013, 70(70), 534-542.
http://archpsyc.jamanetwork.com/article.aspx?articleid=1672838

Our ref: RO636

Show abstract » Importance: Genome-wide hypothesis-free discovery methods have identified loci that are associated with heavy smoking in adulthood. Research is needed to understand developmental processes that link newly discovered genetic risks with adult heavy smoking. Objective: To test how genetic risks discovered in genome-wide association studies of adult smoking influence the developmental progression of smoking behavior from initiation through conversion to daily smoking, progression to heavy smoking, nicotine dependence, and struggles with cessation. Design: A 38-year, prospective, longitudinal study of a representative birth cohort. Setting: The Dunedin Multidisciplinary Health and Development Study of New Zealand. Participants: The study included 1037 male and female participants. Exposure: We assessed genetic risk with a multilocus genetic risk score. The genetic risk score was composed of single-nucleotide polymorphisms identified in 3 meta-analyses of genome-wide association studies of smoking quantity phenotypes. Main Outcomes and Measures: Smoking initiation, conversion to daily smoking, progression to heavy smoking, nicotine dependence (Fagerstrm Test of Nicotine Dependence), and cessation difficulties were evaluated at 8 assessments spanning the ages of 11 to 38 years. Results: Genetic risk score was unrelated to smoking initiation. However, individuals at higher genetic risk were more likely to convert to daily smoking as teenagers, progressed more rapidly from smoking initiation to heavy smoking, persisted longer in smoking heavily, developed nicotine dependence more frequently, were more reliant on smoking to cope with stress, and were more likely to fail in their cessation attempts. Further analysis revealed that 2 adolescent developmental phenotypes-early conversion to daily smoking and rapid progression to heavy smoking-mediated associations between the genetic risk score and mature phenotypes of persistent heavy smoking, nicotine dependence, and cessation failure. The genetic risk score predicted smoking risk over and above family history. Conclusions and Relevance: Initiatives that disrupt the developmental progression of smoking behavior among adolescents may mitigate genetic risks for developing adult smoking problems. Future genetic research may maximize discovery potential by focusing on smoking behavior soon after smoking initiation and by studying young smokers.
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Dickson, N., van Roode, T., Cameron, C., Paul, C. | 2013

Stability and change in same-sex attraction, experience, and identity by sex and age in a New Zealand Birth Cohort

Archives of Sexual Behaviour, 2013, 42(42), 753-763.
http://link.springer.com/article/10.1007/s10508-012-0063-z

Our ref: RO635

Show abstract » Gaps remain in knowledge of changes in sexual orientation past adolescence and early adulthood. A longitudinal study of a New Zealand birth cohort was used to examine differences by age and sex in change in sexual attraction between 21 (1993/1994) and 38 years (2010/2011), sexual experiences between 26 and 38 years, and sexual identity between 32 and 38 years. Any same-sex attraction was significantly more common among women than men at all ages. Among women, any same-sex attraction increased up to age 26 (from 8.8 to 16.6 %), then decreased slightly by age 38 (12.0 %); among men, prevalence was significantly higher at age 38 (6.5 %) than 21 (4.2 %), but not in the intermediate assessments. It is likely that the social environment becoming more tolerant was responsible for some of the changes. Same-sex attraction was much more common than same-sex experiences or a same-sex identity, especially among women, with no major sex differences in these latter dimensions. Women exhibited much greater change in sexual attraction between assessments than men; for change in experiences and identity, sex differences were less marked and not statistically confirmed. Changes in the respective dimensions appeared more likely among those initially with mixed attraction and experiences, and among those initially identifying as bisexual, but this did not account for the sex difference in likelihood of change. These results provide contemporary information about the extent and variation of reported sexual attraction, experiences, and identity that we show continues across early and mid-adulthood.
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Hancox, R. J. , Landhuis, C.E., Sears, M.R. | 2013

Forceps birth delivery, allergic sensitisation and asthma: a population-based cohort study

Clinical and Experimental Allergy, 2013, 43(43), 332-336.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2012.04058.x/full

Our ref: RO634

Show abstract » Background: Studies indicate an increased risk of allergies among children born by caesarean section, possibly because immune development is altered by avoiding exposure to maternal vaginal flora. It is unknown if other obstetric interventions are associated with allergies. Objective: To assess associations between delivery with forceps assistance and development of atopy and asthma. Methods: In a population-based cohort of 1037 individuals born in 1972/73, atopy was assessed by skin-prick tests for common allergens at ages 13 and 32 years. A history of asthma was obtained at the same ages. Associations between birth with forceps assistance, atopy, and asthma were assessed with adjustments for sex, head circumference at birth, parental atopy disease, birth order, and socioeconomic status. Results: Children born using forceps were more likely to have atopy at ages 13 (53% vs. 44%) and 32 (68% vs 59%). They were also more likely to have asthma (21% vs. 11% and 23% vs. 16% at ages 13 and 32 respectively). Except for asthma at age 13, these associations were not statistically significant after adjustment for multiple confounding factors. Conclusions & Clinical Relevance: Delivery with forceps assistance is associated with an increased risk of atopy and asthma, but the associations were weaker after adjustment for confounding factors. The previously reported association between caesarean birth and atopic disease may be due to confounding rather than altered exposure to maternal flora, although other factors associated with a difficult labour cannot be ruled out.
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Robertson, L.A., McAnally, H.M., Hancox, R. J. | 2013

Childhood and adolescent television viewing and antisocial behavior in early adulthood

Pediatrics, 2013, 131(131), 439-446.
http://pediatrics.aappublications.org/content/early/2013/02/13/peds.2012-1582

Our ref: RO633

Show abstract » OBJECTIVE: To investigate whether excessive television viewing throughout childhood and adolescence is associated with increased antisocial behavior in early adulthood. METHODS: We assessed a birth cohort of 1037 individuals born in Dunedin, New Zealand, in 19721773, at regular intervals from birth to age 26 years. We used regression analysis to investigate the associations between television viewing hours from ages 5 to 15 years and criminal convictions, violent convictions, diagnosis of antisocial personality disorder, and aggressive personality traits in early adulthood. RESULTS: Young adults who had spent more time watching television during childhood and adolescence were significantly more likely to have a criminal conviction, a diagnosis of antisocial personality disorder, and more aggressive personality traits compared with those who viewed less television. The associations were statistically significant after controlling for sex IQ, socioeconomic status, previous antisocial behavior, and parental control. The associations were similar for both sexes, indicating that the relationship between television viewing and antisocial behavior is similar for male and female viewers. CONCLUSIONS: Excessive television viewing in childhood and adolescence is associated with increased antisocial behavior in early adulthood. The findings are consistent with a causal association and support the American Academy of Pediatrics recommendation that children should watch no more than 1 to 2 hours of television each day.
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Ramrakha, S., Paul, C. , Bell, M.L., Dickson, N. , Moffitt, T.E., Caspi, A. | 2013

The relationship between multiple sex partners and anxiety, depression, and substance dependence disorders: a cohort study

Archives of Sexual Behaviour, 2013, 42(42), 863-872.
DOI: 10.1007/s10508-012-0053-1

Our ref: RO632

Show abstract » Changes in sexual behavior have resulted in longer periods of multiple serial or concurrent relationships. This study investigated the effects of multiple heterosexual partners on mental health, specifically, whether higher numbers of partners were linked to later anxiety, depression, and substance dependency. Data from the Dunedin Multidisciplinary Health and Development Study, a prospective, longitudinal study of a birth cohort born in 19721973 in Dunedin, New Zealand were used. The relationship between numbers of sex partners over three age periods (1820, 2125, and 2632 years) and diagnoses of anxiety, depression, and substance dependence disorder at 21, 26, and 32 years were examined, using logistic regression. Interaction by gender was examined. Adjustment was made for prior mental health status. There was no significant association between number of sex partners and later anxiety and depression. Increasing numbers of sex partners were associated with increasing risk of substance dependence disorder at all three ages. The association was stronger for women and remained after adjusting for prior disorder. For women reporting 2.5 or more partners per year, compared to 01 partners, the adjusted odd ratios (and 95 % CIs) were 9.6 (4.420.9), 7.3 (2.521.3), and 17.5 (3.588.1) at 21, 26, and 32 years, respectively. Analyses using new cases of these disorders showed similar patterns. This study established a strong association between number of sex partners and later substance disorder, especially for women, which persisted beyond prior substance use and mental health problems more generally. The reasons for this association deserve investigation.
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Fisher, H.L., Caspi, A., Poulton, R. , Meier, M.H., Houts, R., Harrington, H. L., Arseneault, L. , Moffitt, T.E. | 2013

Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study

Psychological Medicine, 2013, 43(43), 2077-2086.
doi:10.1017/S0033291712003091

Our ref: RO631

Show abstract » Background. Childhood psychotic symptoms have been used as a subclinical phenotype of schizophrenia in etiological research and as a target for preventative interventions. However, recent studies have cast doubt on the specificity of these symptoms for schizophrenia, suggesting alternative outcomes such as anxiety and depression. Using a prospective longitudinal birth cohort we investigated whether childhood psychotic symptoms predicted a diagnosis of schizophrenia or other psychiatric disorders by 38 years of age. Method. Participants were drawn from a birth cohort of 1037 children from Dunedin, New Zealand, who were followed prospectively to 38 years of age (96% retention rate). Structured clinical interviews were administered at age 11 to assess psychotic symptoms and study members underwent psychiatric assessments at ages 18, 21, 26, 32 and 38 to obtain past-year DSM-III-R/IV diagnoses and self-reports of attempted suicides since adolescence. Results. Psychotic symptoms at age 11 predicted elevated rates of research diagnoses of schizophrenia and post- traumatic stress disorder (PTSD) and also suicide attempts by age 38, even when controlling for gender, social class and childhood psychopathology. No significant associations were found for persistent anxiety, persistent depression, mania or persistent substance dependence. Very few of the children presenting with age-11 psychotic symptoms were free from disorder by age 38. Conclusions. Childhood psychotic symptoms were not specific to a diagnosis of schizophrenia in adulthood and thus future studies of early symptoms should be cautious in extrapolating findings only to this clinical disorder. However, these symptoms may be useful as a marker of adult mental health problems more broadly.
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Thomson, W. M. , Broadbent, J. M. , Foster-Page, L.A. , Poulton, R. | 2013

Antecedents and associations of root surface caries experience among 38-year-olds

Caries Research, 2013, 47(47), 128-134.
DOI: 10.1159/000345078

Our ref: RO630

Show abstract » Objective: Determine whether coronal caries experience to the 30s predicts root surface caries experience by age 38. Method: Prospective study of a complete birth cohort (N = 1037) born in 1972/73 in Dunedin, NZ. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38. Root surface caries data were first collected at age 38. Data from ages 5 through 32 were used previously to identify low, medium and high life-course trajectories of caries experience and plaque accumulation. Results: Of the 916 dentate individuals examined at age 38, 23.0% had 1+ root DFS, 17.2% had 1+ root DS and 11.4% had 1+ root FS. The mean root DS, FS and DFS were 0.6 (sd, 3.5), 0.3 (1.1) and 0.9 (3.8), respectively. The mean Root Caries Index score was 7.2% (sd, 18.0). Age-38 coronal DMFS and root surface caries DFS were only weakly correlated (r = 0.32), but root surface caries experience was strongly associated with coronal caries trajectory, with the mean RCI in the low, medium and high caries trajectory groups being (respectively) 4.4%, 8.0% and 13.5% (P <0.0001); their prevalence of 1+ root DFS was 14.5%, 25.9% and 42.2% (P<0.0001). Those in the high coronal caries trajectory were more likely to have 1+ root surface DFS (Odds Ratio = 3.83; 95% CI 2.33, 6.30); for the medium trajectory, the OR was 1.86 (1.25, 2.75). Conclusion: Lifelong coronal caries experience (represented by discrete longitudintal trajectories of caries experience) is indeed a risk factor for root surface caries experience by age 38.
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Gunduz-Cinar, O., MacPherson, K.P., Cinar, R., Camble-George, J., Sugden, K., Williams, B.S., Godlewski, G., Ramikie, T.S., Gorka, A.X., Alapafuja, S.O., Nikas, S.P., Makriyannis, A., Poulton, R., Patel, S., Hariri, A.R., Caspi, A., Moffitt, T.E., Kunos, G & Holmes, A. | 2013

Convergent translational evidence of a role for anandamide in amygdala-mediated fear extinction, threat processing and stress-reactivity

Molecular Psychiatry, 2013, 18(18), 813-823.
http://www.nature.com/mp/journal/v18/n7/full/mp201272a.html

Our ref: RO625

Show abstract » Endocannabinoids are released �on-demand� on the basis of physiological need, and can be pharmacologically augmented by inhibiting their catabolic degradation. The endocannabinoid anandamide is degraded by the catabolic enzyme fatty acid amide hydrolase (FAAH). Anandamide is implicated in the mediation of fear behaviors, including fear extinction, suggesting that selectively elevating brain anandamide could modulate plastic changes in fear. Here we first tested this hypothesis with preclinical experiments employing a novel, potent and selective FAAH inhibitor, AM3506 (5-(4-hydroxyphenyl)pentanesulfonyl fluoride). Systemic AM3506 administration before extinction decreased fear during a retrieval test in a mouse model of impaired extinction. AM3506 had no effects on fear in the absence of extinction training, or on various non-fear-related measures. Anandamide levels in the basolateral amygdala were increased by extinction training and augmented by systemic AM3506, whereas application of AM3506 to amygdala slices promoted long-term depression of inhibitory transmission, a form of synaptic plasticity linked to extinction. Further supporting the amygdala as effect-locus, the fear-reducing effects of systemic AM3506 were blocked by intra-amygdala infusion of a CB1 receptor antagonist and were fully recapitulated by intra-amygdala infusion of AM3506. On the basis of these preclinical findings, we hypothesized that variation in the human FAAH gene would predict individual differences in amygdala threat-processing and stress-coping traits. Consistent with this, carriers of a low-expressing FAAH variant (385A allele; rs324420) exhibited quicker habituation of amygdala reactivity to threat, and had lower scores on the personality trait of stress-reactivity. Our findings show that augmenting amygdala anandamide enables extinction-driven reductions in fear in mouse and may promote stress-coping in humans.
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Olsson, C.A., McGee, R., Nada-Raja, S. , Williams, S.M. | 2012

A 32-Year Longitudinal Study of Child and Adolescent Pathways to Well-Being in Adulthood

Journal of Happiness Studies, 2012, 14(14), 1069-1083.
DOI 10.1007/s10902-012-9369-8

Our ref: RO629

Show abstract » The purpose of the study was to investigate the relative importance of child and adolescent social and academic pathways to well-being in adulthood (32-years) indicated by a sense of meaning, social engagement, positive coping and prosocial values. Data were drawn from a 15 wave (32-year) longitudinal study of the health and development of around 1000 New Zealanders (Dunedin Multidisciplinary Health and Development Study, New Zealand). Moderate continuity in social connectedness (0.38) and high continuity in academic ability (0.90) was observed across childhood and adolescence. Adolescent social connectedness was a better predictor of adult well-being than academic achievement (0.62 vs. 0.12). There was evidence of an indirect pathway from adolescent academic achievement to adult well-being through social connectedness (0.29). Indicators of well-being in adulthood appear to be better explained by social connection rather than academic competencies pathways. Implications for promoting longer term well-being during the school years are discussed.
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Thomson, W. M. , Mejia, G.C., Broadbent, J. M. , Poulton, R. | 2012

Construct validity of Locker's global oral health item

Journal of Dental Research, 2012, 91(91), 1038-1042.
http://jdr.sagepub.com/content/91/11/1038

Our ref: RO628

Show abstract » With clinical oral examinations not always possible in health surveys, researchers may instead be invited to add questions to a wider health survey. In such situations, an item is needed which adequately represents both clinical and self-reported oral health. This study investigated the clinical validity of Locker's global self-reported oral health item among young middle-aged adults in populations in New Zealand and Australia. Clinical examination and self-report data (including the OHIP-14) were obtained from recent national dental surveys in NZ and Australia, and from age-38 assessments in the Dunedin Multidisciplinary Health and Development Study. National dataset analyses involved 35- to 44-year-olds. Caries and tooth-loss experience showed mostly consistent, statistically significant gradients across the Locker item responses; those responding 'Excellent' had the lowest scores, and those responding 'Poor' the highest. Periodontitis experience gradients in the NZ national sample were mainly as hypothesized; those rating their oral health as 'Poor' had the highest disease experience. OHIP-14 gradients across the Locker item responses were consistent and as hypothesized. The proportion of disease in the population borne by those 'Fair' or 'Poor' ranged from 26% to 72%. These findings provide preliminary support for the measure's validity as a global self-reported oral health measure in young middle-aged adults.
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Thomson, W. M. | 2012

Social inequality in oral health

Community Dentistry and Oral Epidemiology , 2012, 40(40), 28-32.
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0528.2012.00716.x/pdf

Our ref: RO627

Show abstract » Social inequalities in oral health are observable regardless of the population, the culture, the method of social classification or the measure of oral health or disease. They exist because of socially determined differences in opportunity, behaviours, beliefs and exposure to the myriad factors which determine our oral health. Behaviours and practices which affect oral health are embedded in the normal patterns of everyday life; those (in turn) are socially determined and differ across the continuum of social status. This presentation focuses primarily on social inequalities in incremental tooth loss because (i) it is a condition which has been shown to have the greatest effect on people's oral-health-related quality of life, and (ii) it is cumulative and irreversible. Most of the knowledge base on social inequalities in tooth loss comes from cross-sectional studies; investigating the phenomenon in a birth cohort can be more informative because it allows us to determine what happens to those inequalities through the life course. Data on incremental tooth loss from a longstanding cohort study (the Dunedin Multidisciplinary Health and Development Study) are presented to illustrate the cumulative and pervasive effect of social inequalities and changes in social status between childhood and adulthood.
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Wilson, G.A., Welch, D. | 2012

Does amblyopia have a functional impact? Findings from the Dunedin Multidisciplinary Health and Development Study

Clinical and Experimental Ophthalmology, 2012, 41(41), 127-134.
http://onlinelibrary.wiley.com/doi/10.1111/j.1442-9071.2012.02842.x/pdf

Our ref: RO626

Show abstract » Background: Existing data on the functional impact of amblyopia are conflicting. The functional impact of amblyopia is a critical component of the viability and effectiveness of childhood vision screening programmes and treatment regimes. Design: Prospective longitudinal birth cohort (the Dunedin Multidisciplinary Health and Development Study). Participants: 1037 children born in Dunedin, New Zealand, between April 1972 and March 1973, assessed from ages 3 to 32 years. Methods: Comparison of study members with No Amblyopia, Recovered Amblyopia, Possible Amblyopia, or Amblyopia according to both Classic (6/12 visual acuity or worse in at least one eye or a two-line or greater differential between the visual acuity in both eyes) and Modern (6/9 visual acuity or worse in at least one eye) definitions of amblyopia. Main outcome measures: Childhood motor development, teenage self-esteem and adult socioeconomic status (assessed by occupation, education, reading ability and income). Results: There was no evidence of poorer motor development, lower self-esteem, or reduced adult socioeconomic status in study members with Amblyopia or Recovered Amblyopia when compared to those with No Amblyopia. Conclusions: Amblyopia or having Recovered Amblyopia does not functionally impact on childhood motor development, teenage self-esteem or adult socio-economic status within this cohort. The wide range of visual deficits and adaptations that are known to occur in amblyopic vision do not translate into important "real life" outcomes for the study members with Amblyopia or Recovered Amblyopia. The age-related cumulative lifetime risk of bilateral visual impairment in amblyopia will be assessed in future studies.
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Meier, M.H., Caspi, A., Ambler, A., Harrington, H. L., Houts, R., Keefe, R., McDonald, K., Ward, A., Poulton, R. , Moffitt, T.E. | 2012

Persistent Cannabis Users Show Neuropsychological Decline from Childhood to Midlife

PNAS (Proceedings of the National Academy of Sciences of the USA) , 2012, 109(109), E2657-64.
doi:10.1073/pnas.1206820109

Our ref: RO624

Show abstract » Recent reports show that fewer adolescents believe that regular cannabis use is harmful to health. Concomitantly, adolescents are initiating cannabis use at younger ages, and more adolescents are using cannabis on a daily basis. The purpose of the present study was to test the association between persistent cannabis use and neuropsychological decline and determine whether decline is concentrated among adolescent-onset cannabis users. Participants were members of the Dunedin Study, a prospective study of a birth cohort of 1,037 individuals followed from birth (1972/1973) to age 38 y. Cannabis use was ascertained in interviews at ages 18, 21, 26, 32, and 38 y. Neuropsychological testing was conducted at age 13 y, before initiation of cannabis use, and again at age 38 y, after a pattern of persistent cannabis use had developed. Persistent cannabis use was associated with neuropsychological decline broadly across domains of functioning, even after controlling for years of education. Informants also reported noticing more cognitive problems for persistent cannabis users. Impairment was concentrated among adolescent-onset cannabis users, with more persistent use associated with greater decline. Further, cessation of cannabis use did not fully restore neuropsychological functioning among adolescent-onset cannabis users. Findings are suggestive of a neurotoxic effect of cannabis on the adolescent brain and highlight the importance of prevention and policy efforts targeting adolescents.
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Belsky, J., Hancox, R. J. , Sligo, J., Poulton, R. | 2012

Does Being an Older Parent Attenuate the Intergenerational Transmission of Parenting?

Developmental Psychology, 2012, 48(48), 1570-1574.
Our ref: RO623

Show abstract » Evidence that the transition to parenthood is occurring at older ages in the Western world, that older parents provide more growth-facilitating care than do younger ones, and that most prospective studies of the intergenerational transmission of parenting have focused on relatively young parents led us to evaluate whether parental age might moderate-and attenuate-the intergenerational transmission of parenting. On the basis of the seemingly commonsensical assumption that as individuals age they often become more psychologically mature and have more opportunity to reflect upon and free themselves from the legacy of childhood experiences, we hypothesized that deferring parenting would weaken links between rearing experiences in the family of origin and parenting in the family of procreation. To test this proposition we repeated analyses reported by Belsky, Jaffee, Sligo, Woodward, and Silva (2005) on 227 parents averaging 23 years of age linking rearing experiences repeatedly measured from 3 to 15 years of age with observed parenting in adulthood; we added 273 participants who became parents at older ages than did those in the original sample. Although previously reported findings showing that rearing history predicted mothering but not fathering reemerged, parental age generally failed to moderate the intergenerational transmission of parenting. Other investigators prospectively following children and adults into adulthood and studying the intergenerational transmission process should determine whether these null results vis-á-vis the attenuation of transmission with age obtain when parents with older children are studied or when other methods are used.
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Hancox, R. J. , Subbarao, P.J., Sears, M.R. | 2012

Relevance of birth cohorts to assessment of asthma persistence

Current Allergy and Asthma Reports , 2012, 12(12), 175-184.
http://www.ncbi.nlm.nih.gov/pubmed/22415313

Our ref: RO622

Show abstract » The definition of persistent asthma in longitudinal studies reflects symptoms reported at every assessment with no substantive asymptomatic periods. Early-childhood wheezing may be transient, especially if it is of viral etiology. Longitudinal studies provide greater opportunity to confirm the diagnosis by variability of symptoms, objective measurements, and therapeutic responses. Several clinical phenotypes of childhood asthma have been identified, with general consistency between cohorts. Persistent wheezing is often associated with loss of lung function, which is evident from early-childhood and related to persistent inflammation and airway hyperresponsiveness. Female sex, atopy, airway responsiveness, and personal smoking, but not exposure to environmental tobacco smoke, are risk factors for persistence of childhood asthma into adulthood. The effect of breastfeeding remains controversial, but gene-environment interactions may partly explain outcomes. Understanding the natural history and underlying causes of asthma may lead to development of strategies for primary prevention.
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Belsky, D.W., Moffitt, T.E., Houts, R., Bennett, G.G., Biddle, A.K., Blumenthal, J.A., Evans, J.P., Harrington, H. L., Sugden, K., Williams, B.S., Poulton, R. , Caspi, A. | 2012

Polygenic Risk for Adult Obesity is Mediated by Rapid Childhood Growth: Evidence from a 4-Decade Longitudinal Study

Archives of Pediatrics & Adolescent Medicine, 2012, 166(166), 515-521.
Our ref: RO621

Show abstract » Objective To test how genomic loci identified in genome-wide association studies influence the development of obesity. Design A 38-year prospective longitudinal study of a representative birth cohort. Setting The Dunedin Multidisciplinary Health and Development Study, Dunedin, New Zealand. Participants One thousand thirty-seven male and female study members. Main Exposures We assessed genetic risk with a multilocus genetic risk score. The genetic risk score was composed of single-nucleotide polymorphisms identified in genome-wide association studies of obesity-related phenotypes. We assessed family history from parent body mass index data collected when study members were 11 years of age. Main Outcome Measures Body mass index growth curves, developmental phenotypes of obesity, and adult obesity outcomes were defined from anthropometric assessments at birth and at 12 subsequent in-person interviews through 38 years of age. Results Individuals with higher genetic risk scores were more likely to be chronically obese in adulthood. Genetic risk first manifested as rapid growth during early childhood. Genetic risk was unrelated to birth weight. After birth, children at higher genetic risk gained weight more rapidly and reached adiposity rebound earlier and at a higher body mass index. In turn, these developmental phenotypes predicted adult obesity, mediating about half the genetic effect on adult obesity risk. Genetic associations with growth and obesity risk were independent of family history, indicating that the genetic risk score could provide novel information to clinicians. Conclusions Genetic variation linked with obesity risk operates, in part, through accelerating growth in the early childhood years after birth. Etiological research and prevention strategies should target early childhood to address the obesity epidemic.
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