The Dunedin Study - DMHDRU


All peer reviewed publications are listed below.

Displaying page 4 of 23.

Systemic inflammation and lung function: A longitudinal analysis | 2016
Hancox, R. J., Gray, A.R., Sears, ... Show all » M.R., Poulton, R. « Hide
Respiratory Medicine, 2016, 111 54-59.
Our ref: RO684
Show abstract » Abstract: Background. Systemic inflammation is associated with impaired lung function in healthy adults as well as in patients with lung disease. The mechanism for this association is unknown and it is unclear if systemic inflammation leads to impaired lung function or if poor lung function leads to inflammation. We explored the temporal associations between blood C-reactive protein (CRP), fibrinogen, and white blood cells, and lung function in young adults. Methods. Spirometry, plethysmography, and diffusion capacity were measured in a population-based cohort at ages 32 and 38 years. Highsensitivity CRP, fibrinogen, and white blood cells were measured at the same ages. Results. Higher levels of CRP and, to a lesser extent, fibrinogen were associated with lower lung volumes in cross-sectional analyses at both ages 32 and 38 years. Higher CRP and fibrinogen at age 32 were associated with higher FEV1 and FEV1/FVC at age 38, but not other measures of lung function. Lower lung volumes (total lung capacity, functional residual capacity, and residual volume) but not airflow obstruction (FEV1/FVC) at age 32 were associated with higher CRP at age 38. Associations between age 32 lung function and fibrinogen at follow-up were weaker, but consistent. There were no longitudinal associations between white blood cells and lung function. Conclusions. We found no evidence that systemic inflammation causes a decline in lung function. However, lower lung volumes were associated with higher CRP and fibrinogen at follow-up indicating that pulmonary restriction may be a risk factor for systemic inflammation. The mechanism for this association remains unclear.
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Associations between cannabis use and physical health problems in early midlife: a longitudinal comparison of persistent cannabis versus tobacco users | 2016
Meier, M.H., Caspi, A., Cerda, ... Show all » M., Hancox, R. J., Harrington, H. L., Houts, R., Poulton, R., Ramrakha, S., Thomson, W. M., Moffitt, T.E. « Hide
JAMA Psychiatry, 2016, .
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Our ref: RO683
Show abstract » Importance: After major policy changes in the United States, policymakers, health care professionals, and the general public seek information about whether recreational cannabis use is associated with physical health problems later in life. Objective: To test associations between cannabis use over 20 years and a variety of physical health indexes at early midlife.
Design, Setting, and Participants: Participants belonged to a representative birth cohort of 1037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed to age 38 years, with 95% retention (the Dunedin Multidisciplinary Health and Development Study). We tested whether cannabis use from ages 18 to 38 years was associated with physical health at age 38, even after controlling for tobacco use, childhood health, and childhood socioeconomic status. We also tested whether cannabis use from ages 26 to 38 years was associated with within-individual health decline using the same measures of health at both ages. Exposures: We assessed frequency of cannabis use and cannabis dependence at ages 18, 21, 26, 32, and 38 years. Main Outcomes and Measures: We obtained laboratory measures of physical health (periodontal health, lung function, systemic inflammation, and metabolic health), as well as self-reported physical health, at ages 26 and 38 years. Results: The 1037 study participants were 51.6% male (n = 535). Of these, 484 had ever used tobacco daily and 675 had ever used cannabis. Cannabis use was associated with poorer periodontal health at age 38 years and within-individual decline in periodontal health from ages 26 to 38 years. For example, cannabis joint-years from ages 18 to 38 years was associated with poorer periodontal health at age 38 years, even after controlling for tobacco pack-years (ß = 0.12; 95% CI, 0.05-0.18; P <.001). Additionally, cannabis joint-years from ages 26 to 38 years was associated with poorer periodontal health at age 38 years, even after accounting for periodontal health at age 26 years and tobacco pack-years (ß = 0.10; 95% CI, 0.05-0.16; P <.001) However, cannabis use was unrelated to other physical health problems. Unlike cannabis use, tobacco use was associated with worse lung function, systemic inflammation, and metabolic health at age 38 years, as well as within-individual decline in health from ages 26 to 38 years. Conclusions and Relevance: Cannabis use for up to 20 years is associated with periodontal disease but is not associated with other physical health problems in early midlife.

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The Genetics of Success: How single nucleotide polymorphisms associated with educational attainment relate to life-course development | 2016
Belsky, D.W., Moffitt, T.E., Corcoran, ... Show all » D.L., Domingue, B., Harrington, H. L., Houts, R., Ramrakha, S., Sugden, K., Williams, B.S., Poulton, R., Caspi, A. « Hide
Psychological Science, 2016, .
download pdf Our ref: RO682
Show abstract » A previous genome-wide association study (GWAS) of more than 100,000 individuals identified molecular-genetic predictors of educational attainment. We undertook in-depth life-course investigation of the polygenic score derived from this GWAS using the four-decade Dunedin Study (N = 918). There were five main findings. First, polygenic scores predicted adult economic outcomes even after accounting for educational attainments. Second, genes and environments were correlated: Children with higher polygenic scores were born into better-off homes. Third, children’s polygenic scores predicted their adult outcomes even when analyses accounted for their social-class origins; social-mobility analysis showed that children with higher polygenic scores were more upwardly mobile than children with lower scores. Fourth, polygenic scores predicted behavior across the life course, from early acquisition of speech and reading skills through geographic mobility and mate choice and on to financial planning for retirement. Fifth, polygenic-score associations were mediated by psychological characteristics, including intelligence, self-control, and interpersonal skill. Effect sizes were small. Factors connecting DNA sequence with life outcomes may provide targets for interventions to promote population-wide positive development.
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Telomere length and periodontal attachment loss: a prospective cohort study | 2016
Thomson, W. M., Zeng, J., Broadbent, ... Show all » J. M. , Foster-Page, L.A. , Shalev, I., Moffitt, T.E., Caspi, A., Williams, S.M., Braithwaite, A., Robertson, S. P. , Poulton, R. « Hide
Journal of Clinical Periodontology, 2016, 43(2), 121-127.
Our ref: RO680
Show abstract » Aim: To examine the association between telomere erosion and periodontitis in a longstanding prospective cohort study of New Zealand adults. Specific hypotheses tested were: (1) that exposure to periodontitis at ages 26 and 38 was associated with accelerated leucocyte telomere erosion; and (2) that accelerated leucocyte telomere erosion was associated with higher rates of periodontitis by ages 26 and 38. Materials and Methods: Periodontal attachment loss data were collected at ages 26 and 38. Blood samples taken at the same ages were analysed to obtain estimates of leucocyte telomere length and erosion over a 12-year period. Results: Overall, mean telomere length reduced by 0.15 TS ratio (adjusted) from age 26 to 38 among the 661 participants reported on here. During the same period, the mean attachment loss increased by 10%, after adjusting for sex, socio-economic status and smoking. Regression models showed that attachment loss did not predict telomere length, and that telomere erosion did not predict attachment loss. Conclusions: Although both periodontitis and telomere length are age-dependent, they do not appear to be linked, suggesting that determination of leucocyte telomere length may not be a promising clinical approach for identifying people who are at risk for periodontitis.
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Adult-onset offenders: Is a tailored theory warranted? | 2016
Beckley, A.L., Caspi, A., Harrington, ... Show all » H. L., Houts, R., McGee, T.R., Morgan, N., Schroeder, F., Ramrakha, S., Poulton, R. , Moffitt, T. E. « Hide
Journal of Criminal Justice, 2016, 46 64-81.
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Our ref: RO681
Show abstract » 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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Oral-health-related beliefs, behaviours, and outcomes through the life course | 2016
Broadbent, J. M. , Zeng, J., Foster Page, ... Show all » L.A. , Baker, S.R., Thomson, W. M. « Hide
Journal of Dental Research, 2016, First published online 2 March 2016 , doi: 10.1177/0022034516634663.
Our ref: RO679
Show abstract » Complex associations exist among socioeconomic status (SES) in early life, beliefs about oral health care (held by individuals and their parents), and oral health–related behaviors. The pathways to poor adult oral health are difficult to model and describe, especially due to a lack of longitudinal data. The study aim was to explore possible pathways of oral health from birth to adulthood (age 38 y). We hypothesized that higher socioeconomic position in childhood would predict favorable oral health beliefs in adolescence and early adulthood, which in turn would predict favorable self-care and dental attendance behaviors; those would lead to lower dental caries experience and better self-reported oral health by age 38 y. A generalized structural equation modeling approach was used to investigate the relationship among oral health–related beliefs, behaviors in early adulthood, and dental health outcomes and quality of life in adulthood (age, 38 y), based on longitudinal data from a population-based birth cohort. The current investigation utilized prospectively collected data on early (up to 15 y) and adult (26 and 32 y) SES, oral health–related beliefs (15, 26, and 32 y), self-care behaviors (15, 28, and 32 y), oral health outcomes (e.g., number of carious and missing tooth surfaces), and oral health–related quality of life (38 y). Early SES and parental oral health–related beliefs were associated with the study members’ oral health–related beliefs, which in turn predicted toothbrushing and dental service use. Toothbrushing and dental service use were associated with the number of untreated carious and missing tooth surfaces in adulthood. The number of untreated carious and missing tooth surfaces were associated with oral health–related quality of life. Oral health toward the end of the fourth decade of life is associated with intergenerational factors and various aspects of people’s beliefs, SES, dental attendance, and self-care operating since the childhood years.
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Is Toxoplasma Gondii Infection Related to Brain and Behavior Impairments in Humans? Evidence from a Population-Representative Birth Cohort | 2016
Sugden, K., Moffitt, T.E., Pinto, ... Show all » L., Poulton, R., Williams, B.S., Caspi, A. « Hide
PlosOne, 2016, 11(2), e0148435.
download pdf Our ref: RO678
Show abstract » Toxoplasma gondii (T. gondii) is a protozoan parasite present in around a third of the human population. Infected individuals are commonly asymptomatic, though recent reports have suggested that infection might influence aspects of the host’s behavior. In particular, Toxoplasma infection has been linked to schizophrenia, suicide attempt, differences in aspects of personality and poorer neurocognitive performance. However, these studies are often conducted in clinical samples or convenience samples. In a population-representative birth-cohort of individuals tested for presence of antibodies to T. gondii (N=837) we investigated the association between infection and four facets of human behavior: neuropsychiatric disorder (schizophrenia and major depression), poor impulse control (suicidal behavior and criminality), personality, and neurocognitive performance. Suicide attempt was marginally more frequent among individuals with T. gondii seropositivity (p = .06). Seropositive individuals also performed worse on one out of 14 measures of neuropsychological function. On the whole, there was little evidence that T. gondii was related to increased risk of psychiatric disorder, poor impulse control, personality aberrations or neurocognitive impairment.
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The effect of cigarette smoking on lung function in young adults with asthma | 2016
Hancox, R. J., Poulton, R., Caspi, ... Show all » A., Sears, M.R. « Hide
American Journal of Respiratory and Critical Care Medicine, 2016, First published online 11 Feb 2016 as DOI: 10.1164/rccm.201512-2492OC.
Our ref: RO677
Show abstract » Rationale. Life-course persistent asthma and tobacco smoking are risk factors for irreversible airflow obstruction. It is often assumed that smoking and asthma have additive or multiplicative effects on the risk for airflow obstruction, but this has not been demonstrated in prospective studies of children with persistent asthma. Objective. To investigate the effects of smoking and asthma on the development of airflow obstruction in a population-based birth-cohort followed to age 38 years. Measurements and Main Results. Reports of childhood asthma from ages 9, 11, and 13 and self-reports of adult asthma at ages 32 and 38 years were used to define childhood-onset persistent (n=91), late-onset (n=93), asthma in remission (n=85), and non-asthmatic (n=572) phenotypes. Cumulative tobacco smoking histories and spirometry were obtained at ages 18, 21, 26, 32, and 38 years. Analyses were by generalised estimating equations (GEEs) adjusting for childhood spirometry, body mass index, age, and sex. Smoking history and childhood-onset persistent asthma were both associated with lower FEV1/FVC ratios. Associations between smoking and FEV1/FVC ratios were different between asthma phenotypes (interaction p<0.001). Smoking was associated with lower pre- and post-bronchodilator FEV1/FVC ratios among non-asthmatics and those with late-onset or remittent asthma, but smoking was not associated with lower FEV1/FVC ratios among those with childhood-onset persistent asthma. Conclusions. Childhood-onset persistent asthma is associated with airflow obstruction by mid adult life, but this does not appear to be made worse by tobacco smoking. We found no evidence that smoking and childhood-persistent asthma have additive or multiplicative effects on airflow obstruction.
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Systolic blood pressure trajectories from childhood to early mid-life: early life predictors, effect modifiers, and adult cardiovascular outcomes | 2015
Theodore, R., Broadbent, J. M. , Nagin, ... Show all » D.S., Ambler, A., Hogan, S., Ramrakha, S., Cutfield, W., Williams, M. J. A., Harrington, H. L., Moffitt, T.E., Caspi, A., Poulton, R. « Hide
Hypertension, 2015, 66 1108-1115.
Our ref: RO675
Show abstract » Previous studies examining blood pressure change over time have modelled an 'average' population trajectory. Recent research among older adults suggests there may be subgroups with different blood pressure trajectories. Identifying subgroups at risk of developing adult hypertension early in life can inform effective risk reduction efforts. We sought to identify different systolic blood pressure trajectories from childhood, their correlated risk factors and early midlife cardiovascular outcomes. Blood pressure data at ages 7, 11, 18, 26, 32 and 38 years from a longitudinal, representative birth cohort study (n=975) were used to identify four distinct trajectory groups via group-based trajectory modeling: 'normal' (21.8%), 'high-normal' (43.3%), 'prehypertensive' (31.6%), and 'hypertensive' (4.2%). The categories refer to blood pressure beginning at age 7 and most recently measured at age 38. Family history of high blood pressure (OR=43.23, 95% CI 5.27, 354.65), male gender (OR=109.48, 95% CI=26.82, 446.96), being first born (OR=2.5 95% CI=1.00, 8.69) and low birthweight (OR=2.79, 95% CI 2.49, 3.09) were associated with hypertensive group membership (compared to the normal group). Higher body mass index and cigarette smoking resulted in increasing blood pressure across trajectories, particularly for the higher blood pressure groups. Prehypertensive and hypertensive trajectory groups had worse cardiovascular outcomes by early midlife. Harmful blood pressure trajectories are identifiable in childhood, associated with both antecedent and modifiable risk factors over time, and predict adult cardiovascular disease risk. Early detection, subsequent targeted prevention and/or intervention may reduce the lifecourse burden associated with higher blood pressure.
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Do reports of age and circumstances of first intercourse differ in a birth cohort when asked seventeen years apart? | 2015
Dickson, N., Righarts, A., van Roode, ... Show all » T., Cameron, C., Connor, J. « Hide
Journal of Sex Research, 2015, 53(3), .
download pdf Our ref: RO676
Show abstract » Conclusions about temporal changes in age and circumstances of first intercourse are generally derived from retrospective reports by people of various ages in cross-sectional studies, with an inherent assumption of no bias stemming from time since the event. We examined this assumption through repeated questions on age and circumstances of first heterosexual intercourse (FHI) at ages 21 and 38 in a birth cohort. Despite considerable movement in individual reports, there was no bias in reported age of FHI. However, a greater proportion of both men and women stated at the later assessment both partners had been equally willing (versus persuading or persuaded). The distribution of current views of the appropriateness of the timing did not differ markedly between assessments, although there were many individual changes. Reports of contraceptive usage were similar at the two assessments for men but differed among women, mainly through more reporting that they could not remember. These findings imply that among cohorts born in the 1970s, there is no bias in reports of age of FHI many years after the event, and views on the appropriateness of timing persist. However, time biases reports in favor of a more mutual willingness.
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Non-daily, low-rate daily and high-rate daily smoking in young adults: A 17 year follow-up | 2015
Robertson, L.A., Iosua, E., McGee, ... Show all » R., Hancox, R. J. « Hide
Nicotine & Tobacco Research, 2015, Advance access online August 17, 2015, doi: 10.1093/ntr/ntv167.
Our ref: RO674
Show abstract » Introduction: While overall tobacco consumption is declining in many countries, patterns of low-frequency smoking—such as nondaily and low-rate daily smoking—appear to be increasing. We aimed firstly to describe differences in demographic, smoking- and quitting-related characteristics between nondaily and daily smokers in young adults; secondly, to determine the proportion of low-frequency smokers who transition to a higher rate of smoking by age 38 and factors associated with this. Methods: We assessed a cohort of individuals born in Dunedin, New Zealand, in 1972–1973, at regular intervals from age 21 to age 38 years. Smokers were categorized as either nondaily, low-rate daily (ie, defined as five or less cigarettes per day) or high-rate daily smokers (six or more cigarettes per day). Descriptive statistics, linear and logistic regression were used. Results: Nondaily smokers at age 21 tended to self-identify as nonsmokers. Both nondaily smokers and low-rate daily smokers reported higher readiness and confidence in quitting compared to high-rate daily smokers. Around 40% of the age 21 low-rate daily smokers reported smoking daily at age 38, compared to 13% of the nondaily smokers and 4% of the nonsmokers. Nondaily smoking at age 21 was associated with increased odds of being a daily smoker by age 38 (OR: 3.6; 95% CI = 1.7% to 7.8%) compared to nonsmokers. Conclusions: Different patterns of smoking are associated with differences in readiness to quit and confidence in quitting ability. For a considerable proportion of smokers, low-frequency smoking in young adulthood develops into daily smoking by adulthood. Implications: Low-frequency smoking, including nondaily smoking, in early adulthood is a significant risk factor for being a daily smoker in the long-term. Cessation interventions should be tailored to low-frequency smokers, taking into account differences between them and heavier smokers in terms of smoking motivation and quitting-related cognitions.
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Alcohol involvement in sexual behaviour and adverse sexual health outcomes from 26 to 38 years of age | 2015
Connor, J., Kydd, R.M., Dickson, ... Show all » N. « Hide
PLOS ONE, 2015, Available online, doi:10.1371/journal.pone.0135660.
Our ref: RO673
Show abstract » Background: Research on alcohol and sexual behaviour has focused on young adults or high-risk groups, showing alcohol use contributing to riskier sexual choices. Adults now in their late thirties have been exposed to heavier drinking norms than previously, raising questions about effects on sexual wellbeing. We examined self-reported use and consequences of alcohol in sexual contexts, and its association with usual drinking pattern at age 38, and also associations of heavy drinking occasion (HDO) frequency with number of sexual partners, sexually transmitted infections (STIs), and terminations of pregnancy (TOPs), from 26–32 and 32–38 years of age.
Methods: Members of the Dunedin Study birth cohort answered computer-presented questions about sexual behaviour and outcomes, and interviewer-administered alcohol consumption questions, at age 26, 32 and 38 years.
Results: Response level was >90% at each assessment. At 38, drinking before or during sex in the previous year was common (8.2% of men; 14.6% of women reported “usually/always”), and unwanted consequences were reported by 13.5% of men and 11.9% of women, including regretted sex or failure to use contraception or condoms. Frequent heavy drinkers were more likely to “use alcohol to make it easier to have sex” and regret partner choice, particularly women. Heavy drinking frequency was strongly associated with partner numbers for men and women at 32, but only for women at 38. Significantly higher odds of STIs amongst the heaviest drinking men, and TOPs amongst the heaviest drinking women were seen at 32–38.
Conclusions: Alcohol involvement in sex continues beyond young adulthood where it has been well documented, and is common at 38. Women appear to be more affected than men, and heavy drinking is associated with poorer outcomes for both. Improving sexual health and wellbeing throughout the life course needs to take account of the role of alcohol in sexual behaviour.

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Validity of self-reported periodontal questions in a New Zealand cohort | 2015
Foster Page, L.A. , Thomson, W. M., Broadbent, ... Show all » J. M. « Hide
Clinical Oral Investigations, 2015, Published online 24 July 2015, DOI 10.1007/s00784-015-1526-0.
Our ref: RO672
Show abstract » Methods: Full-mouth periodontal examinations (three sites/tooth) were undertaken at age 38 in a complete birth cohort born in 1972/1973 in New Zealand. Four self-reported periodontal screening questions were included (“Do you think you have gum disease”; “Has a dental professional ever told you that you have lost bone around your teeth”; “Have you ever had scaling, root planing, surgery, or other treatment for gum disease” and “Have you ever had any teeth that have become loose by themselves without some injury”), and the sensitivity and specificity of those self-reported items were calculated for individual questions and using a multivariable binary logistic regression model. Generalised linear models were used to compare relative risks for periodontitis and smoking, using the (a) clinical measures and (b) self-reported questions. Results: Among the 895 who had periodontal examinations, the prevalence of periodontitis was 43.7, 22.8 and 12.0 %, respectively, for one or more sites with =4, =5 and =6 mm clinical attachment loss (AL). The specificity of the four self-reported questions was high (82–94 %), but the sensitivity was low for all, except the question: “Do you think you have gum disease”. The four questions’ highest combined sensitivity?+?specificity value was 1.33 for one or more sites with =4 mm AL, with the area under the receiver operating characteristic (ROC) curve being greatest for one or more sites with =6 mm AL, at 0.84. For the smoking–periodontitis association, the estimates of relative risk for periodontitis among smokers were as follows: (a) 1.81, 2.88 and 5.79, respectively, clinically determined to have one or more sites with =4, =5 and =6 mm AL and (b) 2.19, 2.17, 1.23 and 1.89, respectively, for the four self-reported questions. Conclusion: The four self-reported periodontal screening questions performed adequately in identifying clinically determined periodontal disease, and they showed moderate validity when used together as a set. However, the strength of the association between smoking and periodontitis was underestimated when they were used instead of clinically determined periodontal disease. Clinical relevance: These findings suggest that clinical examinations remain to be the desired approach for periodontal surveys, but where resource constraints preclude those, self-reported methods can provide useful information; after all, some periodontal information is better than none at all.
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Is insomnia associated with deficits in neuropsychological functioning? Evidence from a population-based study | 2015
Goldman-Mellor, S., Caspi, A., Gregory, ... Show all » A. M., Harrington, H. L., Poulton, R., Moffitt, T.E. « Hide
Sleep, 2015, 38(4), 623-631.
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Our ref: RO671
Show abstract » Study Objectives: People with insomnia complain of cognitive deficits in daily life. Results from empirical studies examining associations between insomnia and cognitive impairment, however, are mixed. Research is needed that compares treatment-seeking and community-based insomnia study samples, measures subjective as well as objective cognitive functioning, and considers participants' pre-insomnia cognitive function. Design and Participants: We used data from the Dunedin Study, a representative birth cohort of 1,037 individuals, to examine whether insomnia in early midlife was associated with subjective and objective cognitive functioning. We also tested whether individuals with insomnia who reported seeking treatment for their sleep problems (treatment-seekers) showed greater impairment than other individuals with insomnia (non-treatment-seekers). The role of key confounders, including childhood cognitive ability and comorbid health conditions, was evaluated. Measurements: Insomnia was diagnosed at age 38 according to DSM-IV criteria. Objective neuropsychological assessments at age 38 included the WAIS-IV IQ test, the Wechsler Memory Scale, and the Trail-Making Test. Childhood cognitive functioning was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R). Results: A total of 949 cohort members were assessed for insomnia symptoms and other study measures at age 38. Although cohort members with insomnia (n = 186, 19.6%) had greater subjective cognitive impairment than their peers at age 38, they did not exhibit greater objective impairment on formal testing. Treatment-seekers, however, exhibited significant objective impairment compared to non-treatment-seekers. Controlling for comorbidity, daytime impairment, and medications slightly decreased this association. Childhood cognitive deficits antedated the adult cognitive deficits of treatment-seekers.
Conclusions: Links between insomnia and cognitive impairment may be strongest among individuals who seek clinical treatment. Clinicians should take into account the presence of complex health problems and lower premorbid cognitive function when planning treatment for insomnia patients.

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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 » L.J., Dalgard, F., Ambler, A., Kokaua, J., Milne, B.J., Poulton, R. « Hide
British Journal of Dermatology, 2015, doi:10.1111/bjd.13786.
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Our ref: RO670
Show abstract » Acne is a highly prevalent condition during adolescence and young adulthood worldwide. School and university samples indicate rates between 12% and 99%, depending on how acne was classified. General population surveys report rates between 14% and 88%.Acne remains a problem in adulthood with rates ranging from 20 to 54%. The effects of acne, regardless of severity, can be debilitating. Studies have shown a range of psychosocial and interpersonal impacts including feelings of shame and loneliness, anger, impaired self-image, attitude and esteem, lack of pride and body satisfaction. It can also affect interpersonal relationships including poor attachment to friends, and not having romantic or sexual relationships. Finally, it has been associated with impaired functioning in other life domains, for example, not thriving at school, decreased participation in sport and exercise and employment problems. Although acne has been associated with negative emotion, impaired ability to function in daily life and a decreased quality of life only a small number of cross-sectional studies have reported an association between acne and specific psychological problems, including symptoms of anxiety and depression and suicide ideation when compared to those with little or no acne. However, no study has examined the relationship of acne and with psychiatric disorder (i.e. psychological distress of greatest severity and clinical interest), nor has research ascertained the cumulative lifecourse effects of acne on psychiatric disorder. In the present study, prospective-longitudinal data from a general population sample was used to determine whether acne preceded poor mental health at the disorder level from adolescence to adulthood. The specific aim of this study was to examine the association between acne and the development of the most common psychiatric disorders of anxiety, depression, alcohol and cannabis dependence.
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Quantification of biological aging in young adults | 2015
Belsky, D.W., Caspi, A., Houts, ... Show all » R., Corcoran, D.L., Danese, A., Harrington, H. L., Israel, S., Levine, M., Schaefer, J., Sugden, K., Williams, B.S., Yashin, A.I., Poulton, R., Moffitt, T.E. « Hide
PNAS (Proceedings of the National Academy of Sciences of the USA) , 2015, 112(30), E4104-E4110.
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Our ref: RO669
Show abstract » Antiaging therapies show promise in model organism research. Translation to humans is needed to address the challenges of an aging global population. Interventions to slow human aging will need to be applied to still-young individuals. However, most human aging research examines older adults, many with chronic disease. As a result, little is known about aging in young humans. We studied aging in 954 young humans, the Dunedin Study birth cohort, tracking multiple biomarkers across three time points spanning their third and fourth decades of life. We developed and validated two methods by which aging can be measured in young adults, one cross-sectional and one longitudinal. Our longitudinal measure allows quantification of the pace of coordinated physiological deterioration across multiple organ systems (e.g., pulmonary, periodontal, cardiovascular, renal, hepatic, and immune function). We applied these methods to assess biological aging in young humans who had not yet developed age-related diseases. Young individuals of the same chronological age varied in their “biological aging” (declining integrity of multiple organ systems). Already, before midlife, individuals who were aging more rapidly were less physically able, showed cognitive decline and brain aging, self-reported worse health, and looked older. Measured biological aging in young adults can be used to identify causes of aging and evaluate rejuvenation therapies.
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Early-life intelligence predicts midlife biological age | 2015
Schaefer, J., Caspi, A., Belsky, ... Show all » D.W., Harrington, H. L., Houts, R., Israel, S., Levine, M., Sugden, K., Williams, B.S., Poulton, R., Moffitt, T.E. « Hide
Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 2015, First published online May 26, 2015, doi: 10.1093/geronb/gbv035.
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Our ref: RO668
Show abstract » Objectives. Early-life intelligence has been shown to predict multiple causes of death in populations around the world. This finding suggests that intelligence might influence mortality through its effects on a general process of physiological deterioration (i.e., individual variation in 'biological age'). We examined whether intelligence could predict measures of aging at midlife before the onset of most age-related disease. Methods. We tested whether intelligence assessed in early childhood, middle childhood, and midlife predicted midlife biological age in members of the Dunedin Study, a population-representative birth cohort. Results. Lower intelligence predicted more advanced biological age at midlife as captured by perceived facial age, a 10-biomarker algorithm based on data from the National Health and Nutrition Examination Survey (NHANES), and Framingham heart age (r = 0.1–0.2). Correlations between intelligence and telomere length were less consistent. The associations between intelligence and biological age were not explained by differences in childhood health or parental socioeconomic status, and intelligence remained a significant predictor of biological age even when intelligence was assessed before Study members began their formal schooling. Discussion. These results suggest that accelerated aging may serve as one of the factors linking low early-life intelligence to increased rates of morbidity and mortality.
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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 » P., Belsky, D.W., Corcoran, D.L., Hammerle, M., Harrington, H. L., Hogan, S., Meier, M.H., Polanczyk, G., Poulton, R., Ramrakha, S., Sugden, K., Williams, B.S., Rohde, L.A., Caspi, A. « Hide
American Journal of Psychiatry, 2015, .
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Our ref: RO667
Show abstract » Objective: Despite a prevailing assumption that adult ADHD is a childhood-onset neurodevelopmental disorder, no prospective longitudinal study has described the childhoods of the adult ADHD population. The authors report follow-back analyses of ADHD cases diagnosed in adulthood, alongside follow-forward analyses of ADHD cases diagnosed in childhood, in one cohort. Method: Participants belonged to a representative birth cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed to age 38, with 95% retention. Symptoms of ADHD, associated clinical features, comorbid disorders, neuropsychological deficits, genome-wide association study-derived polygenic risk, and life impairment indicators were assessed. Data sources were participants, parents, teachers, informants, neuropsychological test results, and administrative records. Adult ADHD diagnoses used DSM-5 criteria, apart from onset age and cross-setting corroboration, which were study outcome measures. Results: As expected, childhood ADHD had a prevalence of 6% (predominantly male) and was associated with childhood comorbid disorders, neurocognitive deficits, polygenic risk, and residual adult life impairment. Also as expected, adult ADHD had a prevalence of 3% (gender balanced) and was associated with adult substance dependence, adult life impairment, and treatment contact. Unexpectedly, the childhood ADHD and adult ADHD groups comprised virtually nonoverlapping sets; 90% of adult ADHD cases lacked a history of childhood ADHD. Also unexpectedly, the adult ADHD group did not show tested neuropsychological deficits in childhood or adulthood, nor did they show polygenic risk for childhood ADHD.
Conclusions: The findings raise the possibility that adults presenting with the ADHD symptom picture may not have a childhood-onset neurodevelopmental disorder. If this finding is replicated, then the disorder’s place in the classification system must be reconsidered, and research must investigate the etiology of adult ADHD.

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Cardiorespiratory fitness and cognitive function at midlife: Neuroprotection or Neuroselection? | 2015
Belsky, D.W., Caspi, A., Israel, ... Show all » S., Blumenthal, J.A., Poulton, R., Moffitt, T.E. « Hide
Annals of Neurology, 2015, 77(4), 607-617.
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Our ref: RO666
Show abstract » Objective: A study was undertaken to determine whether better cognitive functioning at midlife among more physically fit individuals reflects neuroprotection, by which fitness protects against age-related cognitive decline, or neuroselection, by which children with higher cognitive functioning select more active lifestyles. Methods: Children in the Dunedin Longitudinal Study (N?=?1,037) completed the Wechsler Intelligence Scales and the Trail Making, Rey Delayed Recall, and Grooved Pegboard tasks as children and again at midlife (age?=?38 years). Adult cardiorespiratory fitness was assessed using a submaximal exercise test to estimate maximum oxygen consumption adjusted for body weight in milliliters/minute/kilogram. We tested whether more fit individuals had better cognitive functioning than their less fit counterparts (which could be consistent with neuroprotection), and whether better childhood cognitive functioning predisposed to better adult cardiorespiratory fitness (neuroselection). Finally, we examined possible mechanisms of neuroselection. Results: Participants with better cardiorespiratory fitness had higher cognitive test scores at midlife. However, fitness-associated advantages in cognitive functioning were already present in childhood. After accounting for childhood baseline performance on the same cognitive tests, there was no association between cardiorespiratory fitness and midlife cognitive functioning. Socioeconomic and health advantages in childhood and healthier lifestyles during young adulthood explained most of the association between childhood cognitive functioning and adult cardiorespiratory fitness. Interpretation: We found no evidence for a neuroprotective effect of cardiorespiratory fitness as of midlife. Instead, children with better cognitive functioning are selecting healthier lives. Fitness interventions may enhance cognitive functioning. However, observational and experimental studies testing neuroprotective effects of physical fitness should consider confounding by neuroselection.
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Effects of quitting cannabis on respiratory symptoms | 2015
Hancox, R. J., Shin, H.H., Gray, ... Show all » A.R., Poulton, R. , Sears, M.R. « Hide
European Respiratory Journal, 2015, .
doi: 10.1183/09031936.00228914
download pdf Our ref: RO665
Show abstract » Smoking cannabis is associated with symptoms of bronchitis. Little is known about the persistence of symptoms after stopping cannabis use. We assessed associations between changes in cannabis use and respiratory symptoms in a population-based cohort of 1037 young adults. Participants were asked about cannabis and tobacco use at ages 18, 21, 26, 32 and 38 years. Symptoms of morning cough, sputum production, wheeze, dyspnoea on exertion and asthma diagnoses were ascertained at the same ages. Frequent cannabis use was defined as .52 occasions over the previous year. Associations between frequent cannabis use and respiratory symptoms were analysed using generalised estimating equations with adjustments for tobacco smoking, asthma, sex and age. Frequent cannabis use was associated with morning cough (OR 1.97, p<0.001), sputum production (OR 2.31, p<0.001) and wheeze (OR 1.55, p<0.001). Reducing or quitting cannabis use was associated with reductions in the prevalence of cough, sputum and wheeze to levels similar to nonusers. Frequent cannabis use is associated with symptoms of bronchitis in young adults. Reducing cannabis use often leads to a resolution of these symptoms.

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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 » P.A. « Hide
Social Psychiatry and Psychiatric Epidemiology , 2015, 50(5), 679-693.
DOI 10.1007/s00127-015-1048-8
download pdf Our ref: RO664
Show abstract » The Dunedin Multidisciplinary Health and Development Study began more than four decades ago. Unusual at the time, it was founded as a multidisciplinary research enterprise, and was strongly supported by the Dunedin community, both professional and lay, in its early years. Seven research themes have evolved over the last 40 years focusing on: mental and neuro-cognition, cardiovascular risk, respiratory health, oral health, sexual and reproductive health and psychosocial functioning. A seventh, more applied theme, seeks to maximise the value of the Study findings for New Zealand’s indigenous people Mâori (or tangata whenua transl people of the land). The Study has published over 1200 papers and reports to date, with almost 2/3 of these being in peer reviewed journals. Here we provide an overview of the study, its history, leadership structure, scientific approach, operational foci, and some recent examples of work that illustrates: (i) the value of multidisciplinary data; (ii) how the Study is well positioned to addresses contemporary issues; and (iii) how research can simultaneously address multiple audiences - from researchers and theoreticians to policy makers and practitioners. Near future research plans are described, and we end by reflecting upon the core aspects of the Study that portend future useful contributions.
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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
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Our ref: RO663
Show abstract » Aims: To describe inconsistencies in reporting past-year drinking status and heavy drinking occasions (HDOs) on single questions from two different instruments, and to identify associated characteristics and impacts. Methods: We compared computer-presented Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) with categorical response options, and mental health interview (MHI) with open-ended consumption questions, completed on the same day. Participants were 464 men and 459 women aged 38 (91.7% of surviving birth cohort members). Differences in dichotomous single-item measures of abstention and HDO frequency, associations of inconsistent reporting with sex, socioeconomic status (SES) and survey order, and impacts of instrument choice on associations of alcohol with sex and SES were examined. Results: The AUDIT-C drinking frequency question estimated higher past-year abstention prevalence (AUDIT = 7.6%, MHI = 5.4%), with one-third of AUDIT-C abstainers being MHI drinkers. Only AUDIT-C produced significant sex differences in abstainer prevalence. Inconsistencies in HDO classifications were bidirectional, but with fewer HDOs reported on the MHI than AUDIT-C question. Lower SES was associated with inconsistency in abstention and weekly+ HDOs. Abstention and higher HDO frequency were associated with lower SES overall, but sex-specific associations differed by instrument. Conclusions: In this context, data collection method affected findings, with inconsistencies in abstention reports having most impact. Future studies should: (a) confirm self-reported abstention; (b) consider piloting data collection methods in target populations; (c) expect impacts of sex and SES on measurements and analyses.
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Cumulative incidence of infertility in a New Zealand birth cohort to age 38 by sex, and the relationship with family formation | 2015
van Roode, T., Dickson, N., Righarts, ... Show all » A., Gillett, W. « Hide
Fertility and Sterility, 2015, Available online first 27 January 2015,
Our ref: RO662
Show abstract » Objective: To estimate the cumulative incidence of infertility for men and women in a population-based sample. Design: Longitudinal study of a birth cohort. Setting: Research unit. A population-based birth cohort of 1,037 men and women born in Dunedin, New Zealand, between 1972 and1973. Main Outcome Measure(s): Cumulative incidence of infertility by age 32 and 38, distribution of causes and service use for infertility, live birth subsequent to infertility, and live birth by age38. Result(s): The cumulative incidence of infertility by age 38 ranged from 14.4% to 21.8% for men and from 15.2% to 26.0% for women depending on the infertility definition and data used. Infertility, defined as having tried to conceive for 12months or more or having sought medical help to conceive, was experienced by 21.8% (95% confidence interval [CI], 17.726.2) of men and 26.0% (95% CI, 21.830.6) of women by age 38. For those who experienced infertility, 59.8% (95% CI, 48.370.4) of men and 71.8% (95% CI, 62.180.3) of women eventually had a live birth. Successful resolution of infertility and entry into parenthood by age 38 were much lower for those who first experienced infertility in their mid to late thirties compared with at a younger age. Conclusion(s): Comparison of reports from two assessments in this cohort study suggests infertility estimates from a single cross-sectional study may underestimate lifetime infertility. The lower rate of resolution and entry into parenthood for those first experiencing infertility in their mid to late thirties highlights the consequences of postponing parenthood and could result in involuntary childlessness and fewer children than desired.
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Social Jetlag, Obesity and Metabolic Disorder: Investigation in a Cohort Study | 2015
Parsons, M.J., Moffitt, T.E., Gregory, ... Show all » A. M., Goldman-Mellor, S., Nolan, P.M., Poulton, R., Caspi, A. « Hide
International Journal of Obesity, 2015, Advance online publication 20 January 2015; doi: 10.1038/ijo.2014.201.
Our ref: RO661
Show abstract » Background: Obesity is one of the leading causes of preventable death worldwide. Circadian rhythms are known to control both sleep timing and energy homeostasis, and disruptions in circadian rhythms have been linked with metabolic dysfunction and obesity-associated disease. In previous research, social jetlag, a measure of chronic circadian disruption caused by the discrepancy between our internal versus social clocks, was associated with elevated self-reported body mass index, possibly indicative of a more generalized association with obesity and metabolic dysfunction. Methods: We studied participants from the population-representative Dunedin Longitudinal Study (N=1037) to determine whether social jetlag was associated with clinically assessed measurements of metabolic phenotypes and disease indicators for obesity-related disease, specifically, indicators of inflammation and diabetes. Results: Our analysis was restricted to N=815 non-shift workers in our cohort. Among these participants, we found that social jetlag was associated with numerous clinically assessed measures of metabolic dysfunction and obesity. We distinguished between obese individuals who were metabolically healthy versus unhealthy, and found higher social jetlag levels in metabolically unhealthy obese individuals. Among metabolically unhealthy obese individuals, social jetlag was additionally associated with elevated glycated hemoglobin and an indicator of inflammation. Conclusions: The findings are consistent with the possibility that ‘living against our internal clock’ may contribute to metabolic dysfunction and its consequences. Further research aimed at understanding that the physiology and social features of social jetlag may inform obesity prevention and have ramifications for policies and practices that contribute to increased social jetlag, such as work schedules and daylight savings time.
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Community water fluoridation and intelligence: Prospective Study in New Zealand | 2015
Broadbent, J. M. , Thomson, W. M., Ramrakha, ... Show all » S., Moffitt, T.E., Zeng, J., Foster-Page, L.A. , Poulton, R. « Hide
American Journal of Public Health, 2015, 105(1), 72-76.
Our ref: RO653
Show abstract » Objectives.This study aimed to clarify the relationship between community water fluoridation (CWF) and IQ. Methods. We conducted a prospective study of a general population sample of those born in Dunedin, New Zealand, between April 1, 1972, and March 30, 1973 (95.4% retention of cohort after 38 years of prospective follow-up). Residence in a CWF area, use of fluoride dentifrice and intake of 0.5-milligram fluoride tablets were assessed in early life (prior to age 5 years); we assessed IQ repeatedly between ages 7 to 13 years and at age 38 years. Results. No significant differences in IQ because of fluoride exposure were noted. These findings held after adjusting for potential confounding variables, including sex, socioeconomic status, breastfeeding, and birth weight (as well as educational attainment for adult IQ outcomes). Conclusions. These findings do not support the assertion that fluoride in the context of CWF programs is neurotoxic. Associations between very high fluoride exposure and low IQ reported in previous studies may have been affected by confounding, particularly by urban or rural status.
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Mental health antecedents of early midlife insomnia: Evidence from a four-decade longitudinal study | 2014
Goldman-Mellor, S., Gregory, A. M., Caspi, ... Show all » A., Harrington, H. L., Parsons, M.J., Poulton, R., Moffitt, T.E. « Hide
Sleep, 2014, 37(11), 1767-1775.
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Our ref: RO660
Show abstract » Study objectives. Insomnia is a highly prevalent condition that constitutes a major public health and economic burden. However, little is known about the developmental etiology of adulthood insomnia. Design. We examined whether indicators of psychological vulnerability across multiple developmental periods (psychiatric diagnoses in young adulthood and adolescence, childhood behavioral problems, and familial psychiatric history) predicted subsequent insomnia in adulthood. Setting and participants. We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1,037 children in New Zealand who were followed prospectively from birth (19721973) through their fourth decade of life with a 95% retention rate. Measurements. Insomnia was diagnosed at age 38 according to DSM-IV criteria. Psychiatric diagnoses, behavioral problems, and family psychiatric histories were assessed between ages 5 and 38. Results. In cross-sectional analyses, insomnia was highly comorbid with multiple psychiatric disorders. After controlling for this concurrent comorbidity, our results showed that individuals who have family histories of depression or anxiety, and who manifest lifelong depression and anxiety beginning in childhood, are at uniquely high risk of age-38 insomnia. Other disorders did not predict adulthood insomnia. Conclusions. The link between lifelong depression and anxiety symptoms and adulthood insomnia calls for further studies to clarify the neurophysiological systems or behavioral conditioning processes that may underlie this association.
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Perinatal Complications and Aging Indicators by Midlife | 2014
Shalev, I., Caspi, A., Ambler, ... Show all » A., Belsky, D.W., Chapple, S., Cohen, H., Israel, S., Poulton, R. , Ramrakha, S., Rivera, C., Sugden, K., Williams, B.S., Wolke, D., Moffitt, T.E. « Hide
Pediatrics, 2014, 134 e1315-e1323. Available early view online DOI: 10.1542/peds.2014-1669.
download pdf Our ref: RO658
Show abstract » BACKGROUND: Perinatal complications predict increased risk for morbidity and early mortality. Evidence of perinatal programming of adult mortality raises the question of what mechanisms embed this long-term effect. We tested a hypothesis related to the theory of developmental origins of health and disease: that perinatal complications assessed at birth predict indicators of accelerated aging by midlife. METHODS: Perinatal complications, including both maternal and neonatal complications, were assessed in the Dunedin Multidisciplinary Health and Development Study cohort (N = 1037), a 38-year, prospective longitudinal study of a representative birth cohort. Two aging indicators were assessed at age 38 years, objectively by leukocyte telomere length (TL) and subjectively by perceived facial age. RESULTS: Perinatal complications predicted both leukocyte TL (b =20.101; 95% confidence interval, 20.169 to 20.033; P = .004) and perceived age (b = 0.097; 95% confidence interval, 0.029 to 0.165; P = .005) by midlife. We repeated analyses with controls for measures of family history and social risk that could predispose to perinatal complications and accelerated aging, and for measures of poor health taken in between birth and the age-38 follow-up. These covariates attenuated, but did not fully explain the associations observed between perinatal complications and aging indicators. CONCLUSIONS: Our findings provide support for early-life developmental programming by linking newborns’ perinatal complications to accelerated aging at midlife. We observed indications of accelerated aging “inside,” as measured by leukocyte TL, an indicator of cellular aging, and “outside,” as measured by perceived age, an indicator of declining tissue integrity. A better understanding of mechanisms underlying perinatal programming of adult aging is needed.
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Credit Scores, Cardiovascular Disease Risk and Human Capital | 2014
Israel, S., Caspi, A., Belsky, ... Show all » D.W., Harrington, H. L., Hogan, S., Houts, R., Ramrakha, S., Sanders, S., Poulton, R. , Moffitt, T.E. « Hide
PNAS, 2014, Available Early Edition online DOI: 10.1073.
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Our ref: RO659
Show abstract » Credit scores are the most widely used instruments to assess whether or not a person is a financial risk. Credit scoring has been so successful that it has expanded beyond lending and into our everyday lives, even to inform how insurers evaluate our health. The pervasive application of credit scoring has outpaced knowledge about why credit scores are such useful indicators of individual behavior. Here we test if the same factors that lead to poor credit scores also lead to poor health. Following the Dunedin (New Zealand) Longitudinal Study cohort of 1,037 study members, we examined the association between credit scores and cardiovascular disease risk and the underlying factors that account for this association. We find that credit scores are negatively correlated with cardiovascular disease risk. Variation in household income was not sufficient to account for this association. Rather, individual differences in human capital factors educational attainment, cognitive ability, and self-control predicted both credit scores and cardiovascular disease risk and accounted for ~45% of the correlation between credit scores and cardiovascular disease risk. Tracing human capital factors back to their childhood antecedents revealed that the characteristic attitudes, behaviors, and competencies children develop in their first decade of life account for a significant portion (~22%) of the link between credit scores and cardiovascular disease risk at midlife. We discuss the implications of these findings for policy debates about data privacy, financial literacy, and early childhood interventions.
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Prevalence and correlates of a 'knee' pattern on the maximal expiratory flow volume loop in young adults | 2014
Shin, H.H., Sears, M.R., Hancox, ... Show all » R. J. « Hide
Respirology, 2014, 19(7), 1052-1058.
Our ref: RO657
Show abstract » Background and objective: Visual inspection of the maximal flow-volume curve is an important step in interpreting spirometry. Many young people have a convex inflection or 'knee' on the expiratory part of the loop. This is thought to be a normal variant, but this view is based on theoretical grounds, and the epidemiology of the knee pattern has never been reported. Methods: Flow-volume loops from an unselected birth cohort of 1037 individuals at ages 18, 26, 32 and 38 years were visually inspected for a knee pattern. Associations with asthma diagnoses, smoking history, body mass index (BMI) and spirometry were assessed. Results: The knee pattern was found in approximately two thirds of men and women at age 18. The prevalence decreased with age, but it was more likely to persist in women. The knee was more common after bronchodilator and was associated with higher forced expiratory volume in 1 s/forced vital capacity ratios and mid-expiratory flow rates. There was no association with smoking, except for an inverse correlation in men at age 18. No association was found with BMI. Women with asthma were less likely to have a knee at both ages 18 and 38, whereas men with asthma showed an inverse association at age 18. Conclusions: A knee is a very common pattern on flow-volume loop in young adults. In accordance with theoretical predictions, the prevalence of the knee declines with age, but it is more likely to persist in women. It is associated with less airflow obstruction and is less common in people with asthma.
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Is Chronic Asthma Associated with Shorter Leukocyte Telomere Length at Midlife? | 2014
Belsky, D.W., Shalev, I., Sears, ... Show all » M.R., Hancox, R. J., Harrington, H. L., Houts, R., Moffitt, T.E., Sugden, K., Williams, B.S., Poulton, R., Caspi, A. « Hide
American Journal of Respiratory and Critical Care Medicine, 2014, First published online 23 Jun 2014 as DOI: 10.1164/rccm.201402-0370OC.
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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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Employment among schoolchildren and its associations with adult substance use, psychological wellbeing, and academic achievement | 2014
Iosua, E., Gray, A.R., McGee, ... Show all » R., Landhuis, C.E., Keane, R., Hancox, R. J. « Hide
Journal of Adolescent Health, 2014, 55(4), 542-548.
Our ref: RO655
Show abstract » Purpose: To examine the association between paid part-time employment among schoolchildren, and adult substance use, psychological wellbeing, and academic achievement. Methods: Longitudinal data from the Dunedin Multidisciplinary Health and Development Study were used to evaluate the association between employment at each of 11, 13, and 15 years, and adult smoking, regular alcohol binge drinking, regular cannabis use, Sense of Coherence, social participation, positive coping style, prosociality, no formal qualifications, and university degree. Associations were initially assessed using unadjusted regression analyses and then adjusted for the potential childhood confounders IQ, reading development, Student’s Perception of Ability Scale, socioeconomic disadvantage, family climate, harsh parent-child interaction, parental opinion of their child’s attitude to school, and child’s personal attitude to school. Results: Employment at 11 years of age was associated with a lower odds of adult smoking; the odds of subsequent regular alcohol binge drinking were greater for those who were employed at age 13; and higher adult rates of social participation and prosociality were identified for adolescents who were employed at 15 years of age. When the potential confounders were con- trolled, employment at age 13 was predictive of both adult smoking and regular binge drinking, and working at 15 years of age was protective against regular cannabis use and associated with greater social participation. Conclusion: There is no consistent evidence that exposing schoolchildren to part-time employment compromised subsequent health, wellbeing, and education in a developed country.
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Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: A prospective investigation | 2014
Breslau, N., Koenen, K., Swanson, ... Show all » S., Agnew-Blais, M.A., Houts, R., Poulton, R., Moffitt, T.E. « Hide
Psychological Medicine, 2014, 44(9), 1937–1945.
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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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HSV-2 incidence by sex over four age periods to age 38 in a birth cohort | 2014
Dickson, N., Righarts, A., van Roode, ... Show all » T., Paul, C., Taylor, J., Cunningham, A.L. « Hide
Sexually Transmitted Infections, 2014, 90(3), 143-145.
Our ref: R0652
Show abstract » Objectives: To examine herpes simplex virus type 2 (HSV-2) incidence over four periods to age 38 in a birth cohort, and to compare risks for men and women, taking into account sexual behaviour. Methods: At ages 21, 26, 32 and 38, participants in the Dunedin Multidisciplinary Health and Development Study were invited to provide serum for HSV-2 serology, and information on sexual behaviour. HSV-2 incidence rates were calculated for four age periods, and comparisons made by sex and period, taking into account number of sexual partners. Results: By age 38, 17.3% of men and 26.8% of women had ever been seropositive for HSV-2. Incidence peaked for women from age 21 to 26 (19.1 per 1000 person-years) and men from age 26 to 32 (14.1 per 1000 person-years); it fell markedly for both from age 32 to 38 (5.1 and 6.8 per 1000 person-years for men and women, respectively). Overall risk was significantly higher for women: adjusted incidence rate ratio 1.9 (95% CI 1.4 to 2.7); the sex difference was most marked from age 21 to 26 (3.4, 95% CI 1.9 to 6.3). Conclusions: Our findings are consistent with a greater biological susceptibility to HSV-2 among women, and with the increasing risk to the early/mid-20s for women and late 20s/early 30s for men, being driven by an increasing pool of prevalent infection. The reduced risk in the mid-30s is consistent with declining infectivity of long-term prevalent infections.
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Re-examining periodontal effects of smoking in a birth cohort study with an enhanced analytical approach. Part 1: cross-sectional associations at each age | 2014
Zeng, J., Williams, S.M., Fletcher, ... Show all » D., Cameron, C., Broadbent, J. M. , Shearer, D.M., Thomson, W. M. « Hide
Journal of Periodontology, 2014, .
DOI: 10.1902/jop.2014.130577
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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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Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients | 2014
Israel, S., Moffitt, T. E., Belsky, ... Show all » D. W., Hancox, R. J., Poulton, R., Roberts, B. W., Thomson, W. M., & Caspi, A. « Hide
Journal of Personality and Social Psychology, 2014, 106(3), 484-498.
Our ref: RO650
Show abstract » The rising number of newly insured young adults brought on by health care reform will soon increase demands on primary care physicians. Physicians will face more young adult patients, which presents an opportunity for more prevention-oriented care. In the present study, we evaluated whether brief observer reports of young adults’ personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the cohort of 1,000 individuals from the Dunedin Multidisciplinary Health and Development Study (Moffitt, Caspi, Rutter, & Silva, 2001), we show that very brief measures of young adults’ personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness to Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for health care professionals to personalize preventive medicine. Adding personality information to existing health care electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor–patient communication, health service use, and patient outcomes.
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Smoking Cessation and Subsequent Weight Change | 2014
Robertson, L.A., McGee, R., Hancox, ... Show all » R. J. « Hide
Nicotine & Tobacco Research, 2014, 16(6), 867-871.
Our ref: RO649
Show abstract » Introduction: People who quit smoking tend to gain more weight over time than those who continue to smoke. Previous research using clinical samples of smokers suggests that quitters typically experience a weight gain of approximately 5kg in the year following smoking cessation, but these studies may overestimate the extent of weight gain in the general population. The existing population-based research in this area has some methodological limitations. Methods: We assessed a cohort of individuals born in Dunedin, New Zealand, in 1972–1973, at regular intervals from age 15 to 38. We used multiple linear regression analysis to investigate the association between smoking cessation between 21 and 38 years and subsequent change in body mass index (BMI) and weight, controlling for baseline BMI, socioeconomic status, physical activity, alcohol use, and parity (women). Results: Smoking status and outcome data were available at baseline and follow-up for N = 914 Study members. People who smoked at age 21 and who had quit by age 38 had a BMI on average 1.5kg/m2 greater than those who continued to smoke at age 38. This equated to a weight gain of approximately 5.7kg in men and 5.1kg in women above that of continuing smokers. However, the weight gain between age 21 and 38 among quitters was not significantly different to that of never-smokers. Conclusions: The amount of long-term weight gained after quitting smoking is likely to be lower than previous estimates based on research with clinical samples. On average, quitters do not experience greater weight gain than never-smokers.
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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 » 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. « Hide
Molecular Psychiatry, 2014, 19(11), 1163-1170.
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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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Suicide attempt in young people: A signal for long-term healthcare and social needs | 2014
Goldman-Mellor, S., Caspi, A., Harrington, ... Show all » H. L., Hogan, S., Nada-Raja, S., Poulton, R., Moffitt, T.E. « Hide
JAMA Psychiatry, 2014, 71(2), 119-127.
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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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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
Show abstract » 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, ... Show all » Shyamala, Olsson, Craig A. « Hide
Nicotine & Tobacco Research, 2013, 15(12), 1971-1977.
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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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