Publications
Mental Health
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Social isolation, loneliness, and inflammation: A multi-cohort investigation in early and mid-adulthood | 2024
Matthews, T.; Rasmussen, L. J. H.; Ambler, A.; Danese, A.; Eugen-Olsen,
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Brain, Behaviour, and Immunity, 2024, 115 727-736.
10.1016/j.bbi.2023.11.022
Our ref: RO815
Social isolation and loneliness have been associated with poor health and increased risk for mortality, and inflammation might explain this link. We used data from the Danish TRIAGE Study of acutely admitted medical patients (N = 6,144, mean age 60 years), and from two population-representative birth cohorts: the New Zealand Dunedin Longitudinal Study (N = 881, age 45) and the UK Environmental Risk (E-Risk) Longitudinal Twin Study (N = 1448, age 18), to investigate associations of social isolation with three markers of systemic inflammation: C-reactive protein (CRP), interleukin-6 (IL-6), and a newer inflammation marker, soluble urokinase plasminogen activator receptor (suPAR), which is thought to index systemic chronic inflammation. In the TRIAGE Study, socially isolated patients (those living alone) had significantly higher median levels of suPAR (but not CRP or IL-6) compared with patients not living by themselves. Social isolation prospectively measured in childhood was longitudinally associated with higher CRP, IL-6, and suPAR levels in adulthood (at age 45 in the Dunedin Study and age 18 in the E-Risk Study), but only suPAR remained associated after controlling for covariates. Dunedin Study participants who reported loneliness at age 38 or age 45 had elevated suPAR at age 45. In contrast, E-Risk Study participants reporting loneliness at age 18 did not show any elevated markers of inflammation. In conclusion, social isolation was robustly associated with increased inflammation in adulthood, both in medical patients and in the general population. It was associated in particular with systemic chronic inflammation, evident from the consistently stronger associations with suPAR than other inflammation biomarkers.
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Tracing the origins of midlife despair: association of psychopathology during adolescence with a syndrome of despair-related maladies at midlife | 2023
Brennan, Grace M.; Moffitt, Terrie E.; Ambler, Antony; Harrington, HonaLee; Hogan,
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Psychological Medicine, 2023, 53(16), 7569-7580.
10.1017/S0033291723001320
Link to full publication »
Our ref: RO813
BackgroundMidlife adults are experiencing a crisis of deaths of despair (i.e. deaths from suicide, drug overdose, and alcohol-related liver disease). We tested the hypothesis that a syndrome of despair-related maladies at midlife is preceded by psychopathology during adolescence.MethodsParticipants are members of a representative cohort of 1037 individuals born in Dunedin, New Zealand in 1972–73 and followed to age 45 years, with 94% retention. Adolescent mental disorders were assessed in three diagnostic assessments at ages 11, 13, and 15 years. Indicators of despair-related maladies across four domains – suicidality, substance misuse, sleep problems, and pain – were assessed at age 45 using multi-modal measures including self-report, informant-report, and national register data.ResultsWe identified and validated a syndrome of despair-related maladies at midlife involving suicidality, substance misuse, sleep problems, and pain. Adults who exhibited a more severe syndrome of despair-related maladies at midlife tended to have had early-onset emotional and behavioral disorders [β = 0.23, 95% CI (0.16–0.30), p < 0.001], even after adjusting for sex, childhood SES, and childhood IQ. A more pronounced midlife despair syndrome was observed among adults who, as adolescents, were diagnosed with a greater number of mental disorders [β = 0.26, 95% CI (0.19–0.33), p < 0.001]. Tests of diagnostic specificity revealed that associations generalized across different adolescent mental disorders.ConclusionsMidlife adults who exhibited a more severe syndrome of despair-related maladies tended to have had psychopathology as adolescents. Prevention and treatment of adolescent psychopathology may mitigate despair-related maladies at midlife and ultimately reduce deaths of despair.
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Construct Validity of Triarchic Model Traits in the Dunedin Multidisciplinary Health and Development Study Using the Multidimensional Personality Questionnaire | 2023
Emma Veltman, Richie Poulton, Christopher J. Patrick and Martin Sellbom
Journal of Personality Disorders, 2023, 37(1), 71-94.
https://doi.org/10.1521/pedi.2023.37.1.71
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Our ref: RO783
The triarchic model of psychopathy emphasizes the role of three phenotypic personality domains (boldness, meanness, and disinhibition) that have been operationalized using the well-established Multidimensional Personality Questionnaire. The present study sought to further validate the MPQ-Tri scales and examine their temporal stability and predictive validity across two time points (ages 18 and 26) from the Dunedin Multidisciplinary Health and Development Study, a population-representative and longitudinal sample (N = 1,037). This investigation necessitated modification of the MPQ-Tri scales to enable their use in a broader range of samples, including the Dunedin Study. The revised MPQ-Tri scales demonstrated good temporal stability, and correlation and multiple linear regression analyses predominantly revealed associations consistent with theoretical expectations. Overall, the findings provide support for the MPQ-Tri scales as reliable, stable, and valid measures of the triarchic constructs, which provide a unique opportunity to examine highly novel research questions concerning psychopathy in a wide variety of samples.
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The Longitudinal Association of Childhood and Adolescent Television Viewing with Substance Use Disorders and Disordered Gambling in Adulthood up to Age 45 | 2022
McAnally, H. M. Wiki Te Oi, A. Nada-Raja, S. Hancox, R. J.
International Journal of Mental Health and Addiction, 2022, .
https://doi.org/10.1007/s11469-022-00918-7
Our ref: RO788
Excessive leisure-time television viewing in childhood has been associated with a range of poorer outcomes in adulthood and may represent an early form of addictive disorder. As addictive disorders are often correlated, we tested the hypothesis that television viewing in childhood and adolescence would be longitudinally associated with adulthood substance-related and behavioural addictive disorders in a population-based cohort born in 1972/1973. Weekday television viewing time was reported at multiple ages from 5 to 15 years, and criteria for alcohol, cannabis, and tobacco use disorders and disordered gambling were assessed at multiple adult ages up to 45 years. Higher television viewing times were associated with a greater likelihood of meeting diagnostic criteria for all substance-related disorders and disordered gambling in models that were adjusted for sex (p values < 0.05). After adjustment for childhood socioeconomic status and childhood selfcontrol, mean television viewing time (hours/day) remained associated with tobacco use disorder (OR = 1.22, 95% CI = 1.04–1.42, p = 0.017) and disordered gambling (OR = 1.33, 95% CI = 1.07–1.66, p = 0.010). Excessive, leisure-time television viewing in childhood and adolescence may be a modifiable risk factor for tobacco use disorder and/or disordered gambling in later life.
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Using a loneliness measure to screen for risk of mental health problems: A replication in two nationally-representative cohorts | 2022
Matthews, T., Bryan, B. T., Danese,
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International Journal of Environmental Research and Public Health, 2022, .
https://doi.org/10.3390/ijerph19031641
Our ref: RO779
Background: Loneliness co-occurs alongside many mental health problems and is associated with poorer treatment outcomes. It could therefore be a phenomenon of interest to clinicians, as an indicator of generalised risk for psychopathology. The present study tested whether a short measure of loneliness can accurately classify individuals who are at increased risk of common mental health problems. Methods: Data were drawn from two nationally-representative cohorts: the age-18 wave of the UK-based Environmental Risk (E-Risk) Longitudinal Twin Study, and the age-38 wave of the New Zealand-based Dunedin Multidisciplinary Health and Development Study. In both cohorts, loneliness was assessed using the 3-item UCLA Loneliness Scale, plus two stand-alone items about feeling alone and feeling lonely. Outcome measures consisted of diag-noses of depression and anxiety, and self-reports of self-harm/suicide attempts, assessed via structured interview. Results: ROC curve analysis showed that the loneliness scale had fair accu-racy in classifying individuals meeting criteria for all three outcomes, with a cut-off score of 5 (on a scale from 3 to 9) having the strongest empirical support. Both of the stand-alone items showed modest sensitivity and specificity, but were more limited in their flexibility. The find-ings replicated across the two cohorts, indicating that they are applicable both to younger and older adults. In addition, the accuracy of the loneliness scale in detecting mental health problems was comparable to a measure of poor sleep quality, a phenomena which is often included in screening tools for depression and anxiety. Conclusions: These findings indicate that a loneliness measure could have utility in mental health screening contexts, as well as in research.
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Do socially isolated children become socially isolated adults? | 2021
Lay-Yee, Roy; Matthews, Timothy; Moffitt, Terrie; Poulton, Richie; Caspi,
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Advances in Life Course Research, 2021, .
10.1016/j.alcr.2021.100419
Link to full publication »
Our ref: RO763
Social isolation - the lack of social contacts in number and frequency – has been shown to have a negative impact on health and well-being. Using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort, we created a typology of social isolation based on onset during the life course and persistence into adulthood. We then characterized each type according to risk factors related to family environment and child behavior that have been shown previously to be associated with social isolation. Based on fit statistics and distinctness of trajectories we considered the four-class model to be the most appropriate: (1) ‘never isolated’ (71.6 % of the cohort), (2) ‘adult only’ (10.1 %), (3) ‘child only’ (14.3 %), and (4) ‘persistent isolation’ (4.0 %). Family-environmental factors – i.e. having a teen-aged mother, having a single parent, frequent changes in residence, or maltreatment – tended to be associated with both child and adult onset and persistence of social isolation, whereas child-behavioral factors – i.e. self-control or internalizing symptoms – applied more to the child onset of social isolation. Sensitivity analyses using empirically defined groups – based on 15 % ‘cut-offs’ for isolation in childhood and adulthood - produced similar life-course groupings and similar associations. Our findings provide insights into the development of social isolation and demonstrate the changeability of social isolation across almost four decades of the life span. They also suggest family-based and child-based interventions could address child onset and the persistence of social isolation into adulthood.
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Association of History of Psychopathology With Accelerated Aging at Midlife | 2021
Wertz, Jasmin, Avshalom Caspi, Antony Ambler, Jonathan Broadbent,
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JAMA Psychiatry, 2021, .
10.1001/jamapsychiatry.2020.4626
Link to full publication »
Our ref: RO757
Importance Individuals with mental disorders are at an elevated risk of developing chronic age-related physical diseases. However, it is not clear whether psychopathology is also associated with processes of accelerated aging that precede the onset of age-related disease.
Objective To test the hypothesis that a history of psychopathology is associated with indicators of accelerated aging at midlife.
Design, Setting, and Participants This prospective cohort study was based on the Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort of 1037 individuals born between April 1, 1972, and March 31, 1973, in Dunedin, New Zealand. Members were followed up to age 45 years (until April 2019). Data were analyzed from January 6 to December 7, 2020.
Exposures Mental disorders were assessed in 6 diagnostic assessments from ages 18 to 45 years and transformed through confirmatory factor analysis into continuous measures of general psychopathology (p-factor) and dimensions of internalizing, externalizing, and thought disorders (all standardized to a mean [SD] of 100 [15]).
Main Outcomes and Measures Signs of aging (biological pace of aging; declines in sensory, motor, and cognitive functioning; and facial age) were assessed up to age 45 years using previously validated measures including biomarkers, clinical tests, and self-reports.
Results Of the original 1037 cohort participants, 997 were still alive at age 45 years, of whom 938 (94%) were assessed (474 men [50.5%]). Participants who had experienced more psychopathology exhibited a faster pace of biological aging (β, 0.27; 95% CI, 0.21-0.33; P < .01); experienced more difficulties with hearing (β, 0.18; 95% CI, 0.12-0.24; P < .01), vision (β, 0.08; 95% CI, 0.01-0.14; P < .05), balance (β, 0.20; 95% CI, 0.14-0.26; P < .01), and motor functioning (β, 0.19; 95% CI, 0.12-0.25; P < .01); experienced more cognitive difficulties (β, 0.24; 95% CI, 0.18-0.31; P < .01); and were rated as looking older (β, 0.20; 95% CI, 0.14-0.26; P < .01). Associations persisted after controlling for sex, childhood health indicators, maltreatment, and socioeconomic status and after taking into account being overweight, smoking, use of antipsychotic medication, and the presence of physical disease. Tests of diagnostic specificity revealed that associations were generalizable across externalizing, internalizing, and thought disorders.
Conclusions and Relevance In this cohort study, a history of psychopathology was associated with accelerated aging at midlife, years before the typical onset of age-related diseases. This link is not specific to any particular disorder family but generalizes across disorders. Prevention of psychopathology and monitoring of individuals with mental disorders for signs of accelerated aging may have the potential to reduce health inequalities and extend healthy lives.
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Early-onset and recurrent depression in parents increases risk of intergenerational transmission to adolescent offspring | 2021
Jaffee, S. R. Sligo, J. L. McAnally, H. M. Bolton, A. E. Baxter,
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Journal of Child Psychology and Psychiatry, 2021, .
10.1111/jcpp.13356
Link to full publication »
Our ref: RO746
BACKGROUND: To assess whether the age-of-onset or the recurrence of parents' major depressive disorder (MDD), measured prospectively in a longitudinal birth cohort study, predicted offspring depression at age 15. METHODS: A two-generation study of New Zealanders, with prospective, longitudinal data in the parents' generation (n = 375) and cross-sectional data from their adolescent offspring (n = 612). Parent and offspring depression was measured with structured clinical interviews. Parent depression was measured at six time points from age 11 to 38 years. Adolescent offspring depression was measured at age 15. RESULTS: Compared to adolescents whose parents were never depressed, those whose parents met criteria for MDD more than once and those whose parents first met criteria before adulthood had more symptoms of depression. The combination of early-onset and recurrent depression in parents made adolescents particularly vulnerable; their odds of meeting criteria for MDD were 4.21 times greater (95% CI = 1.57-11.26) than adolescents whose parents were never depressed. The strength of the intergenerational effect did not vary as a function of parent or offspring sex. The prevalence of adolescent depression was 2.5 times higher in the offspring than at age 15 in the parents' generation. CONCLUSIONS: Recurrent depression in both fathers and mothers increases offspring risk for depression, particularly when it starts in childhood or adolescence, but a single lifetime episode does not. Health practitioners should be aware of age-of-onset and course of depression in both parents when assessing their children's risk for depression.
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Psychotic experiences and schizotypy in early adolescence predict subsequent suicidal ideation trajectories and suicide attempt outcomes from 18- to 38-years | 2020
Kirstie J. M. O’Hare, Richie Poulton, Richard J. Linscott
Schizophrenia Bulletin, 2020, .
https://doi.org/10.1093/schbul/sbaa151
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Our ref: RO741
Subclinical risk markers for schizophrenia predict suicidality, but little is known about the nature of the relationship. Suicidal ideation is often considered homogenous, but distinguishing passive from active ideation (i.e. thoughts of death vs thoughts of killing oneself) and different temporal patterns may further understanding of risk factors. We tested whether schizotypy and psychotic experiences (PE) in early adolescence predict subsequent growth trajectories of suicidal ideation and suicide attempt outcomes. Participants were 1037 members of the population-representative Dunedin Study cohort. PE was measured at 11 years; schizotypy at 13 and 15 years. Outcomes were passive and active suicidal ideation, and suicide attempt, measured at 18, 21, 26, 32, and 38 years. Passive ideation was best represented by two trajectories, including persistent and transient ideation classes. Schizotypy predicted membership in the smaller persistent class (OR = 1.21, p = .041), whereas PE was not associated with class membership. Probability of suicide attempt was 13.8% in the persistent ideation class, compared to 1.8% in the transient class. Active ideation was best represented by a one-class model, the intercept of which was predicted by schizotypy (OR = 1.23, p = .015). Suicide attempts were predicted by schizotypy (OR = 1.53, p = .040) and PE (OR = 3.42, p = .046), and this was partially mediated by indirect effects via the active ideation trajectory. Findings indicate adolescent schizotypy and PE are related to subsequent suicidal ideation and attempts. Suicidal ideation is heterogenous, and schizotypy is specifically related to a persistent passive ideation subgroup.
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Childhood disadvantage and adolescent socioemotional wellbeing as predictors of future parenting behaviour | 2020
McAnally, H. M. Iosua, E. Sligo, J. L. Belsky, J. Spry,
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Journal of Adolescence, 2020, 86 90-100.
https://doi.org/10.1016/j.adolescence.2020.12.005
Link to full publication »
Our ref: RO749
INTRODUCTION: In extending work on early life antecedents of parenting, we investigate associations between childhood family history of disadvantage, adolescent socioemotional wellbeing, and age at first parenthood and subsequent parenting behaviour. METHODS: Parent-child interactions were recorded when participants in the longitudinal Dunedin Multidisciplinary Health and Development Study (New Zealand) had a three-year-old child. Data were available for 358 mothers and 321 fathers, aged between 17.7 and 41.5 at the time of their child's birth. Associations between parenting and antecedent data on socioeconomic disadvantage, adolescent wellbeing and mental health, as well as current adult mental health and age at parenting, were tested for using structural equation modelling. RESULTS: Family disadvantage in childhood and lower adolescent wellbeing was associated with less positive future parenting, but only adult (not adolescent) anxiety/depression symptoms were directly associated with parenting behaviour. Childhood family disadvantage was associated with further disadvantage across the life course that included less positive parenting of the next generation. In contrast, socioemotional wellbeing during adolescence and later age of onset of parenting were associated with more positive parenting. CONCLUSIONS: Reducing childhood disadvantage and improving socioemotional wellbeing during childhood and adolescence is likely to have intergenerational benefits through better parenting of the next generation.
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Pervasively Thinner Neocortex as a Transdiagnostic Feature of General Psychopathology | 2020
Adrienne L. Romer, Maxwell L. Elliott, Annchen R. Knodt, Maria L. Sison, David Ireland,
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Am J Psychiatry, 2020, .
https://doi.org/10.1176/appi.ajp.2020.19090934
Link to full publication »
Our ref: RO737
Objective:
Neuroimaging research has revealed that structural brain alterations are common across broad diagnostic families of disorders rather than specific to a single psychiatric disorder. Such overlap in the structural brain correlates of mental disorders mirrors already well-documented phenotypic comorbidity of psychiatric symptoms and diagnoses, which can be indexed by a general psychopathology or p factor. The authors hypothesized that if general psychopathology drives the convergence of structural alterations common across disorders, then 1) there should be few associations unique to any one diagnostic family of disorders, and 2) associations with the p factor should overlap with those for the broader diagnostic families.
Methods:
Analyses were conducted on structural MRI and psychopathology data collected from 861 members of the population-representative Dunedin Multidisciplinary Health and Development Study at age 45.
Results:
Study members with high scores across three broad diagnostic families of disorders (externalizing, internalizing, thought disorder) exhibited highly overlapping patterns of reduced global and widely distributed parcel-wise neocortical thickness. Study members with high p factor scores exhibited patterns of reduced global and parcel-wise neocortical thickness nearly identical to those associated with the three broad diagnostic families.
Conclusions:
A pattern of pervasively reduced neocortical thickness appears to be common across all forms of mental disorders and may represent a transdiagnostic feature of general psychopathology. As has been documented with regard to symptoms and diagnoses, the underlying brain structural correlates of mental disorders may not exhibit specificity, and the continued pursuit of such specific correlates may limit progress toward more effective strategies for etiological understanding, prevention, and intervention.
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Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study | 2020
Caspi, Avshalom, Houts, Renate M., Ambler,
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JAMA Network Open, 2020, 3(4), e203221-e203221.
Link to full publication »
Our ref: RO735
Mental health professionals typically encounter patients at 1 point in patients’ lives. This cross-sectional window understandably fosters focus on the current presenting diagnosis. Research programs, treatment protocols, specialist clinics, and specialist journals are oriented to presenting diagnoses, on the assumption that diagnosis informs about causes and prognosis. This study tests an alternative hypothesis: people with mental disorders experience many different kinds of disorders across diagnostic families, when followed for 4 decades.To describe mental disorder life histories across the first half of the life course.This cohort study involved participants born in New Zealand from 1972 to 1973 who were enrolled in the population-representative Dunedin Study. Participants were observed from birth to age 45 years (until April 2019). Data were analyzed from May 2019 to January 2020.Diagnosed impairing disorders were assessed 9 times from ages 11 to 45 years. Brain function was assessed through neurocognitive examinations conducted at age 3 years, neuropsychological testing during childhood and adulthood, and midlife neuroimaging-based brain age.Of 1037 original participants (535 male [51.6%]), 1013 had mental health data available. The proportions of participants meeting the criteria for a mental disorder were as follows: 35% (346 of 975) at ages 11 to 15 years, 50% (473 of 941) at age 18 years, 51% (489 of 961) at age 21 years, 48% (472 of 977) at age 26 years, 46% (444 of 969) at age 32 years, 45% (429 of 955) at age 38 years, and 44% (407 of 927) at age 45 years. The onset of the disorder occurred by adolescence for 59% of participants (600 of 1013), eventually affecting 86% of the cohort (869 of 1013) by midlife. By age 45 years, 85% of participants (737 of 869) with a disorder had accumulated comorbid diagnoses. Participants with adolescent-onset disorders subsequently presented with disorders at more past-year assessments (r = 0.71; 95% CI, 0.68 to 0.74; P < .001) and met the criteria for more diverse disorders (r = 0.64; 95% CI, 0.60 to 0.67; P < .001). Confirmatory factor analysis summarizing mental disorder life histories across 4 decades identified a general factor of psychopathology, the p-factor. Longitudinal analyses showed that high p-factor scores (indicating extensive mental disorder life histories) were antedated by poor neurocognitive functioning at age 3 years (r = −0.18; 95% CI, −0.24 to −0.12; P < .001), were accompanied by childhood-to-adulthood cognitive decline (r = −0.11; 95% CI, −0.17 to −0.04; P < .001), and were associated with older brain age at midlife (r = 0.14; 95% CI, 0.07 to 0.20; P < .001).These findings suggest that mental disorder life histories shift among different successive disorders. Data from the present study, alongside nationwide data from Danish health registers, inform a life-course perspective on mental disorders. This perspective cautions against overreliance on diagnosis-specific research and clinical protocols.
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A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample | 2019
Caye, Arthur; Jessica Agnew-Blais; Louise Arseneault; Ives Cavalcante-Passos; Helen Gonçalves; Christian Kieling; Kate Langley; Ana M. B. Menezes; Terrie E Moffitt; Anita Thapar; Thiago Botter-Maio Rocha; Margaret Sibley; James M. Swanson; Fernando Wehrmeister; Luis Augusto Rohde.
Epidemiology and Psychiatric Sciences, 2019, 29(37), .
https://doi.org/10.1017/s2045796019000283
Link to full publication »
Our ref: RO756
Aim: Few personalised medicine investigations have been conducted for mental health. We aimed to generate and validate a risk tool that predicts adult attention-deficit/hyperactivity disorder (ADHD).
Methods: Using logistic regression models, we generated a risk tool in a representative population cohort (ALSPAC - UK, 5113 participants, followed from birth to age 17) using childhood clinical and sociodemographic data with internal validation. Predictors included sex, socioeconomic status, single-parent family, ADHD symptoms, comorbid disruptive disorders, childhood maltreatment, ADHD symptoms, depressive symptoms, mother's depression and intelligence quotient. The outcome was defined as a categorical diagnosis of ADHD in young adulthood without requiring age at onset criteria. We also tested Machine Learning approaches for developing the risk models: Random Forest, Stochastic Gradient Boosting and Artificial Neural Network. The risk tool was externally validated in the E-Risk cohort (UK, 2040 participants, birth to age 18), the 1993 Pelotas Birth Cohort (Brazil, 3911 participants, birth to age 18) and the MTA clinical sample (USA, 476 children with ADHD and 241 controls followed for 16 years from a minimum of 8 and a maximum of 26 years old).
Results: The overall prevalence of adult ADHD ranged from 8.1 to 12% in the population-based samples, and was 28.6% in the clinical sample. The internal performance of the model in the generating sample was good, with an area under the curve (AUC) for predicting adult ADHD of 0.82 (95% confidence interval (CI) 0.79-0.83). Calibration plots showed good agreement between predicted and observed event frequencies from 0 to 60% probability. In the UK birth cohort test sample, the AUC was 0.75 (95% CI 0.71-0.78). In the Brazilian birth cohort test sample, the AUC was significantly lower -0.57 (95% CI 0.54-0.60). In the clinical trial test sample, the AUC was 0.76 (95% CI 0.73-0.80). The risk model did not predict adult anxiety or major depressive disorder. Machine Learning approaches did not outperform logistic regression models. An open-source and free risk calculator was generated for clinical use and is available online at https://ufrgs.br/prodah/adhd-calculator/.
Conclusions: The risk tool based on childhood characteristics specifically predicts adult ADHD in European and North-American population-based and clinical samples with comparable discrimination to commonly used clinical tools in internal medicine and higher than most previous attempts for mental and neurological disorders. However, its use in middle-income settings requires caution.
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Psychiatry’s Opportunity to Prevent the Rising Burden of Age-Related Disease | 2019
Terrie E. Moffitt, Avshalom Caspi
JAMA Psychiatry, 2019, 76(5), 461–462.
https://doi.org/10.1001/jamapsychiatry.2019.0037
Link to full publication »
Our ref: RO755
Three demographic trends are colliding to form a perfect storm: the postretirement portion of the population is swelling, the human life span is lengthening, and the birth rate is dropping. The result is that the balance of young to old in the population is shifting, leaving fewer young workers to drive the economy and pay taxes to support aging citizens. These 3 trends mean more stress for the young and less support for the old, bringing 2 opportunities for the mental health field. First, an opportunity to prevent disability among young people, which would enhance their well-being and capacity to shoulder the burden of the dependent older population. Young people tend to be physically healthy but can experience behavioral problems, emotional problems, substance abuse, and cognitive impairments. These conditions respond to mental health treatments. Second, an opportunity to prevent ill health among older people, which would reduce the burden of age-related disability. Here, we argue that psychiatry is well situated to prevent disability among older people by doing something it does well: treat young people. Risk-prediction research shows that the same people who have poor mental and cognitive health while young tend to have age-related diseases years later.1,2 Moreover, the timing is right. Mental disorders peak in adolescence and young adulthood, whereas noninfectious diseases peak in midlife and neurodegenerative conditions peak in late life.
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Replicability of structural brain alterations associated with general psychopathology: evidence from a population-representative birth cohort | 2019
Romer, A. L., Knodt, A. R., Sison,
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Molecular Psychiatry, 2019, .
https://doi.org/10.1038/s41380-019-0621-z
Our ref: RO726
Transdiagnostic research has identified a general psychopathology factor – often called the ‘p’
factor – that accounts for shared liability to internalizing, externalizing, and thought disorders in
diverse samples. It has been argued that the p factor may reflect dysfunctional thinking present
in serious mental illness. In support of this, we previously used a theory-free, data-driven
multimodal neuroimaging approach to find that higher p factor scores are associated with
structural deficits within a cerebello-thalamo-cortical circuit (CTCC) and visual association
cortex, both of which are important for monitoring and coordinating information processing in
the service of executive control. Here we attempt to replicate these associations by conducting
region-of-interest analyses of the CTCC and visual association cortex using data from 831
members of the Dunedin Multidisciplinary Health and Development Study, a five-decade
longitudinal study of a population-representative birth cohort now 45 years old. We further
sought to replicate a more recent report that p factor scores can be predicted by patterns of
distributed cerebellar morphology as estimated through independent component analysis. We
successfully replicated associations between higher p factor scores and both reduced grey
matter volume of the visual association cortex and fractional anisotropy of pontine white
matter pathways within the CTCC. In contrast, we failed to replicate prior associations between
cerebellar structure and p factor scores. Collectively, our findings encourage further focus on
the CTCC and visual association cortex as core neural substrates and potential biomarkers of
transdiagnostic risk for mental illness.
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Association of Childhood Lead Exposure With Adult Personality Traits and Lifelong Mental Health | 2019
Reuben, Aaron Schaefer, Jonathan Moffitt, Terrie Broadbent, Jonathan Harrington,
... Show all »
JAMA Psychiatry, 2019, 76(4), 418-425.
10.1001/jamapsychiatry.2018.4192
Our ref: RO714
Importance: Millions of adults now entering middle age were exposed to high levels of lead, a developmental neurotoxin, as children. Although childhood lead exposure has been linked to disrupted behavioral development, the long-term consequences for adult mental and behavioral health have not been fully characterized. Objective: To examine whether childhood lead exposure is associated with greater psychopathology across the life course and difficult adult personality traits. Design, setting, and participants: This prospective cohort study was based on a population-representative birth cohort of individuals born between April 1, 1972, and March 31, 1973, in Dunedin, New Zealand, the Dunedin Multidisciplinary Health and Development Study. Members were followed up in December 2012 when they were 38 years of age. Data analysis was performed from March 14, 2018, to October 24, 2018. Exposures: Childhood lead exposure ascertained as blood lead levels measured at 11 years of age. Blood lead levels were unrelated to family socioeconomic status. Main outcomes and measures: Primary outcomes were adult mental health disorder symptoms assessed through clinical interview at 18, 21, 26, 32, and 38 years of age and transformed through confirmatory factor analysis into continuous measures of general psychopathology and internalizing, externalizing, and thought disorder symptoms (all standardized to a mean [SD] of 100 [15]) and adult personality assessed through informant report using the Big Five Personality Inventory (assessing neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) at 26, 32, and 38 years of age (all scores standardized to a mean [SD] of 0 [1]). Hypotheses were formulated after data collection; an analysis plan was posted in advance. Results: Of 1037 original study members, 579 (55.8%) were tested for lead exposure at 11 years of age (311 [53.7%] male). The mean (SD) blood lead level was 11.08 (4.96) μg/dL. After adjusting for study covariates, each 5-μg/dL increase in childhood blood lead level was associated with a 1.34-point increase (95% CI, 0.11-2.57; P = .03) in general psychopathology, driven by internalizing (b = 1.41; 95% CI, 0.19-2.62; P = .02) and thought disorder (b = 1.30; 95% CI, 0.06-2.54; P = .04) symptoms. Each 5-μg/dL increase in childhood blood lead level was also associated with a 0.10-SD increase in neuroticism (95% CI, 0.02-0.08; P = .02), a 0.09-SD decrease in agreeableness (95% CI, -0.18 to -0.01; P = .03), and a 0.14-SD decrease in conscientiousness (95% CI, -0.25 to -0.03; P = .01). There were no statistically significant associations with informant-rated extraversion (b = -0.09; 95% CI, -0.17 to 0.004; P = .06) and openness to experience (b = -0.07; 95% CI, -0.17 to 0.03; P = .15). Conclusions and relevance: In this multidecade, longitudinal study of lead-exposed children, higher childhood blood lead level was associated with greater psychopathology across the life course and difficult adult personality traits. Childhood lead exposure may have long-term consequences for adult mental health and personality
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Genetics and Crime: Integrating New Genomic Discoveries Into Psychological Research About Antisocial Behavior | 2018
Wertz, J. Caspi, A. Belsky, D. W. Beckley, A. L. Arseneault,
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Psychological Science, 2018, 29(5), 791-803.
Link to full publication »
Our ref: RO703
Drawing on psychological and sociological theories of crime causation, we tested the hypothesis that genetic risk for low educational attainment (assessed via a genome-wide polygenic score) is associated with criminal offending. We further tested hypotheses of how polygenic risk relates to the development of antisocial behavior from childhood through adulthood. Across the Dunedin and Environmental Risk (E-Risk) birth cohorts of individuals growing up 20 years and 20,000 kilometers apart, education polygenic scores predicted risk of a criminal record with modest effects. Polygenic risk manifested during primary schooling in lower cognitive abilities, lower self-control, academic difficulties, and truancy, and it was associated with a life-course-persistent pattern of antisocial behavior that onsets in childhood and persists into adulthood. Crime is central in the nature-nurture debate, and findings reported here demonstrate how molecular-genetic discoveries can be incorporated into established theories of antisocial behavior. They also suggest that improving school experiences might prevent genetic influences on crime from unfolding.
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Is low cognitive functioning a predictor or consequence of major depressive disorder? A test in two longitudinal birth cohorts | 2017
Schaefer, J. D. Scult, M. A. Caspi, A. Arseneault, L. Belsky,
... Show all »
Development and Psychopathology, 2017, 16 1-15.
https://doi.org/10.1017/S095457941700164X
Our ref: RO710
Cognitive impairment has been identified as an important aspect of major depressive disorder (MDD). We tested two theories regarding the association between MDD and cognitive functioning using data from longitudinal cohort studies. One theory, the cognitive reserve hypothesis, suggests that higher cognitive ability in childhood decreases risk of later MDD. The second, the scarring hypothesis, instead suggests that MDD leads to persistent cognitive deficits following disorder onset. We tested both theories in the Dunedin Study, a population-representative cohort followed from birth to midlife and assessed repeatedly for both cognitive functioning and psychopathology. We also used data from the Environmental Risk Longitudinal Twin Study to test whether childhood cognitive functioning predicts future MDD risk independent of family-wide and genetic risk using a discordant twin design. Contrary to both hypotheses, we found that childhood cognitive functioning did not predict future risk of MDD, nor did study members with a past history of MDD show evidence of greater cognitive decline unless MDD was accompanied by other comorbid psychiatric conditions. Our results thus suggest that low cognitive functioning is related to comorbidity, but is neither an antecedent nor an enduring consequence of MDD. Future research may benefit from considering cognitive deficits that occur during depressive episodes from a transdiagnostic perspective.
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Enduring mental health: Prevalence and prediction | 2017
Schaefer, J. D., Caspi, A., Belsky,
... Show all »
J Abnorm Psychol, 2017, 126(2), 212-224.
DOI: 10.1037/abn0000232
Our ref: RO694
We review epidemiological evidence indicating that most people will develop a diagnosable mental disorder, suggesting that only a minority experience enduring mental health. This minority has received little empirical study, leaving the prevalence and predictors of enduring mental health unknown. We turn to the population-representative Dunedin cohort, followed from birth to midlife, to compare people never-diagnosed with mental disorder (N = 171; 17% prevalence) to those diagnosed at 1-2 study waves, the cohort mode (N = 409). Surprisingly, compared to this modal group, never-diagnosed Study members were not born into unusually well-to-do families, nor did their enduring mental health follow markedly sound physical health, or unusually high intelligence. Instead, they tended to have an advantageous temperament/personality style, and negligible family history of mental disorder. As adults, they report superior educational and occupational attainment, greater life satisfaction, and higher-quality relationships. Our findings draw attention to "enduring mental health" as a revealing psychological phenotype and suggest it deserves further study. (PsycINFO Database Record
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Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health | 2016
Reuben, A., Moffitt, T. E., Caspi,
... Show all »
Journal of Child Psychology and Psychiatry, 2016, 57(10), 1103-1112.
DOI: 10.1111/jcpp.12621
Our ref: RO692
Background: Adverse childhood experiences (ACEs; e.g. abuse, neglect, and parental loss) have been associated with increased risk for later-life disease and dysfunction using adults’ retrospective self-reports of ACEs. Research should test whether associations between ACEs and health outcomes are the same for prospective and retrospective ACE measures. Methods: We estimated agreement between ACEs prospectively recorded throughout childhood (by Study staff at Study member ages 3, 5, 7, 9, 11, 13, and 15) and retrospectively recalled in adulthood (by Study members when they reached age 38), in the population-representative Dunedin cohort (N = 1,037). We related both retrospective and prospective ACE measures to physical, mental, cognitive, and social health at midlife measured through both objective (e.g. biomarkers and neuropsychological tests) and subjective (e.g. self-reported) means. Results: Dunedin and U.S. Centers for Disease Control ACE distributions were similar. Retrospective and prospective measures of adversity showed moderate agreement (r = .47, p < .001; weighted Kappa = .31, 95% CI: .27–.35). Both associated with all midlife outcomes. As compared to prospective ACEs, retrospective ACEs showed stronger associations with life outcomes that were subjectively assessed, and weaker associations with life outcomes that were objectively assessed. Recalled ACEs and poor subjective outcomes were correlated regardless of whether prospectively recorded ACEs were evident. Individuals who recalled more ACEs than had been prospectively recorded were more neurotic than average, and individuals who recalled fewer ACEs than recorded were more agreeable. Conclusions: Prospective ACE records confirm associations between childhood adversity and negative life outcomes found previously using retrospective ACE reports. However, more agreeable and neurotic dispositions may, respectively, bias retrospective ACE measures toward underestimating the impact of adversity on objectively measured life outcomes and overestimating the impact of adversity on self-reported outcomes. Associations between personality factors and the propensity to recall adversity were extremely modest and warrant further investigation. Risk predictions based on retrospective ACE reports should utilize objective outcome measures. Where objective outcome measurements are difficult to obtain, correction factors may be warranted.
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Persistent cannabis dependence and alcohol dependence represent risks for midlife economic and social problems: A longitudinal cohort study | 2016
Cerda, M., Moffitt, T.E., Meier,
... Show all »
Clinical Psychological Science, 2016, Published online before print 22 March 2016, DOI: 10.1177/2167702616630958.
DOI: 10.1177/2167702616630958
Link to full publication »
Our ref: RO685
With the increasing legalization of cannabis, understanding the consequences of cannabis use is particularly timely. We examined the association between cannabis use and dependence, prospectively assessed between ages 18 and 38, and economic and social problems at age 38. We studied participants in the Dunedin Longitudinal Study, a cohort (N = 1,037) followed from birth to age 38. Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility, more financial difficulties, workplace problems, and relationship conflict in early midlife. Cannabis dependence was not linked to traffic-related convictions. Associations were not explained by socioeconomic adversity, childhood psychopathology, achievement orientation, or family structure; cannabis-related criminal convictions; early onset of cannabis dependence; or comorbid substance dependence. Cannabis dependence was associated with more financial difficulties than was alcohol dependence; no difference was found in risks for other economic or social problems. Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence.
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Adult-onset offenders: Is a tailored theory warranted? | 2016
Beckley, A.L., Caspi, A., Harrington,
... Show all »
Journal of Criminal Justice, 2016, 46 64-81.
doi:10.1016/j.jcrimjus.2016.03.001
Link to full publication »
Our ref: RO681
Purpose: To describe official adult-onset offenders, investigate their antisocial histories and test hypotheses about their origins. Methods: We defined adult-onset offenders among 931 Dunedin Study members followed to age 38, using criminal-court conviction records. Results: Official adult-onset offenders were 14% of men, and 32% of convicted men, but accounted for only 15% of convictions. As anticipated by developmental theories emphasizing early-life influences on crime, adult-onset offenders' histories of antisocial behavior spanned back to childhood. Relative to juvenile-offenders, during adolescence they had fewer delinquent peers and were more socially inhibited, which may have protected them from conviction. As anticipated by theories emphasizing the importance of situational influences on offending, adult-onset offenders, relative to non-offenders, during adulthood more often had schizophrenia, bipolar disorder, and alcohol-dependence, had weaker social bonds, anticipated fewer informal sanctions, and self-reported more offenses. Contrary to some expectations, adult-onset offenders did not have high IQ or high socioeconomic-status families protecting them from juvenile conviction. Conclusions: A tailored theory for adult-onset offenders is unwarranted because few people begin crime de novo as adults. Official adult-onset offenders fall on a continuum of crime and its correlates, between official non-offenders and official juvenile-onset offenders. Existing theories can accommodate adult-onset offenders.
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Is insomnia associated with deficits in neuropsychological functioning? Evidence from a population-based study | 2015
Goldman-Mellor, S., Caspi, A., Gregory,
... Show all »
Sleep, 2015, 38(4), 623-631.
Link to full publication »
Our ref: RO671
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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Cumulative mental health consequences of acne: 23-year follow-up in a general population birth cohort study | 2015
Ramrakha, S., Fergusson, D.M., Horwood,
... Show all »
British Journal of Dermatology, 2015, doi:10.1111/bjd.13786.
Link to full publication »
Our ref: RO670
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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Early-life intelligence predicts midlife biological age | 2015
Schaefer, J., Caspi, A., Belsky,
... Show all »
Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 2015, First published online May 26, 2015, doi: 10.1093/geronb/gbv035.
doi:10.1093/geronb/gbv035
Link to full publication »
Our ref: RO668
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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Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. | 2015
Moffitt, T.E., Houts, R., Asherson,
... Show all »
American Journal of Psychiatry, 2015, .
Link to full publication »
Our ref: RO667
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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Cardiorespiratory fitness and cognitive function at midlife: Neuroprotection or Neuroselection? | 2015
Belsky, D.W., Caspi, A., Israel,
... Show all »
Annals of Neurology, 2015, 77(4), 607-617.
Link to full publication »
Our ref: RO666
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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The Dunedin Multidisciplinary Health and Development Study: Overview of the first 40 years, with an eye to the future | 2015
Poulton, R. , Moffitt, T.E., Silva,
... Show all »
Social Psychiatry and Psychiatric Epidemiology , 2015, 50(5), 679-693.
DOI 10.1007/s00127-015-1048-8
Our ref: RO664
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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Inconsistency in Reporting Abstention and Heavy Drinking Frequency: Associations with Sex and Socioeconomic Status, and Potential Impacts | 2015
Kydd, R.M., Connor, J.
Alcohol and Alcoholism, 2015, 50(3), 333-345.
doi: 10.1093/alcalc/agu106
Link to full publication »
Our ref: RO663
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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Mental health antecedents of early midlife insomnia: Evidence from a four-decade longitudinal study | 2014
Goldman-Mellor, S., Gregory, A. M., Caspi,
... Show all »
Sleep, 2014, 37(11), 1767-1775.
https://doi.org/10.1038/mp.2012.72
Link to full publication »
Our ref: RO660
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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Credit Scores, Cardiovascular Disease Risk and Human Capital | 2014
Israel, S., Caspi, A., Belsky,
... Show all »
PNAS, 2014, Available Early Edition online DOI: 10.1073.
doi/10.1073/pnas.1409794111
Link to full publication »
Our ref: RO659
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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Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: A prospective investigation | 2014
Breslau, N., Koenen, K., Swanson,
... Show all »
Psychological Medicine, 2014, 44(9), 1937–1945.
Link to full publication »
Our ref: RO654
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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Internalizing disorders and leukocyte telomere erosion: a prospective study of depression, generalized anxiety disorder and post-traumatic stress disorder | 2014
Shalev, I., Moffitt, T.E., Braithwaite,
... Show all »
Molecular Psychiatry, 2014, 19(11), 1163-1170.
10.1038/mp.2013.183
Link to full publication »
Our ref: RO648
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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Suicide attempt in young people: A signal for long-term healthcare and social needs | 2014
Goldman-Mellor, S., Caspi, A., Harrington,
... Show all »
JAMA Psychiatry, 2014, 71(2), 119-127.
10.1001/jamapsychiatry.2013.2803
Link to full publication »
Our ref: RO647
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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Lifelong Impact of Early Self-Control | 2013
Terrie E. Moffitt, Richie Poulton, and Avshalom Caspi
American Scientist, 2013, 101 352-359.
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Our ref: PJ39
The Dunedin Study is a longitudinal research effort that has followed more than 1,000 people from birth over four decades, collecting information on their physical health and social wellbeing. Over the past 38 years, the participants have been physically and psychologically examined 12 times, at birth and then at ages 3, 5, 7,9,11,13,15,18,21,26,32, and 38.
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Tobacco Smoking in Adolescence Predicts Maladaptive Coping Styles in Adulthood | 2013
McGee, Rob, Williams, Sheila, Nada-Raja,
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Nicotine & Tobacco Research, 2013, 15(12), 1971-1977.
10.1093/ntr/ntt081
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Our ref: RO649.2
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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Is Obesity Associated With a Decline in Intelligence Quotient During the First Half of the Life Course? | 2013
Belsky, D.W., Caspi, A., Goldman-Mellor,
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American Journal of Epidemiology, 2013, First published online 12 September 2013, doi: 10.1093/aje/kwt135.
10.1093/aje/kwt135
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Our ref: RO645
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 (1972'1973) 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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Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging | 2013
Meier, M.H., Shalev, I., Moffitt,
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American Journal of Psychiatry, 2013, 170(170), 1451-1459.
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Our ref: RO644
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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Diagnostic transitions from childhood to adolescence to early adulthood | 2013
Copeland, W.E., Adair, C.E., Smetanin,
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Journal of Child Psychology and Psychiatry, 2013, 54(54), 791-799.
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Our ref: RO642
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 9'30. Common DSM psychiatric disorders were assessed in childhood (ages 9'12; two samples), adolescence (ages 13'18; 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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The p Factor: One general psychopathology factor in the structure of psychiatric disorders? | 2013
Caspi, A., Houts, R., Belsky,
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Clinical Psychological Science, 2013, DOI: 10.1177/2167702613497473 .
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Our ref: RO641
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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