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Childhood and Adolescent Psychiatric Disorders as Predictors of Young Adult Disorders
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CONTEXT: Most adults with a psychiatric disorder first met diagnostic criteria during childhood and/or adolescence, yet specific homotypic and heterotypic patterns of prediction have not been firmly established. OBJECTIVE: To establish which childhood and adolescent psychiatric disorders predict particular young adult disorders when accounting for comorbidities, disaggregating similar disorders, and examining childhood and adolescent predictors separately. DESIGN: Eleven waves of data from the prospective population-based Great Smoky Mountains Study (N = 1420) were used. SETTING: The Great Smoky Mountains Study is a longitudinal study of the development of psychiatric disorder and need for mental health services in rural and urban youth. A representative sample of children was recruited from 11 counties in western North Carolina. PARTICIPANTS: Children in the community aged 9 to 16, 19, and 21 years. MAIN OUTCOME MEASURES: Common psychiatric disorders were assessed in childhood (ages 9-12 years) and adolescence (ages 13-16 years) with the Child and Adolescent Psychiatric Assessment and in young adulthood (ages 19 and 21 years) with the Young Adult Psychiatric Assessment. RESULTS: Adolescent depression significantly predicted young adult depression in the bivariate analysis, but this effect was entirely accounted for by comorbidity of adolescent depression with adolescent oppositional defiant disorder, anxiety, and substance disorders in adjusted analyses. Generalized anxiety and depression cross-predicted each other, and oppositional defiant disorder (but not conduct disorder) predicted later anxiety disorders and depression. Evidence of homotypic prediction was supported for substance use disorders, antisocial personality disorder (from conduct disorder), and anxiety disorders, although this effect was primarily accounted for by DSM-III-R overanxious disorder. CONCLUSIONS: Stringent tests of homotypic and heterotypic prediction patterns suggest a more developmentally and diagnostically nuanced picture in comparison with the previous literature. The putative link between adolescent and young adult depression was not supported. Oppositional defiant disorder was singular in being part of the developmental history of a wide range of young adult disorders.
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“and another found a relatively equal risk for childhood internalizing and externalizing disorders.10”
From Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis. (2017) · cites this paper as [10]
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“Both these disorders tend to reveal a chronic course that may fluctuate by evolving into other ADs or mood disorders in adulthood [21, 68, 69].”
From Acceptance and commitment therapy as a transdiagnostic approach to adolescents with different anxiety disorders: study protocol. (2025) · cites this paper as [21]
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“Adolescence is a critical phase of human development where mental health problems, particularly ADs, are highly prevalent (e.g., [3, 4]) and often persist and/or develop into other disorders throughout an individual's life (e.g., [14, 21]).”
From Acceptance and commitment therapy as a transdiagnostic approach to adolescents with different anxiety disorders: study protocol. (2025) · cites this paper as [21]
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“The answer was complex, as some behavioral dyscontrol with chronic irritability in fact did predict depression in later life (17,18)”
From Pediatric psychopharmacology: Too much or too little? (2013) · cites this paper as [17]
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“internalizing and externalizing disorders of childhood are associated with an increased likelihood to develop a psychiatric disorder later in adulthood [39]”
From Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? (2020) · cites this paper as [39]
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“Importantly, it is also a time when many psychological disorders are first diagnosed (Copeland et al., 2009).”
From The Effect of Mindfulness Interventions for Parents on Parenting Stress and Youth Psychological Outcomes: A Systematic Review and Meta-Analysis (2019) · cites this paper as Copeland et al., 2009
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Metadata
- Authors
- Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A.
- Affiliations
- Duke University (US)
- University of North Carolina at Greensboro (US)
- Duke Medical Center (US)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2009-07-01
- Volume
- 66
- Issue
- 7
- Pages
- 764
- ISSN
- 0003-990X (ISSN-L)
- PMC
- PMC2891142
- OpenAlex
- W2013747980
- Cited by
- 844
- References
- 65
- Citations by year
- 2026: 24 · 2025: 39 · 2024: 46 · 2023: 43 · 2022: 61 · 2021: 59 · 2020: 61 · 2019: 53 · 2018: 47 · 2017: 66 · 2016: 58 · 2015: 55 · 2014: 59 · 2013: 60 · 2012: 47
- FWCI
- 39.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH-63671, R01MH063970, R01MH048085, MH-63970, K23MH080230, R01MH063671)
- National Institute on Drug Abuse (DA/MH11301, R01DA011301)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD007376)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- child psychopathology, adolescent mental disorders, comorbidities, adolescent depression, young adult depression, oppositional defiant disorder, conduct disorder, antisocial personality disorder, substance use disorders, anxiety disorders, overanxious disorder
- MeSH terms
- Adolescent, Age Factors, Antisocial Personality Disorder, Anxiety Disorders, Mental Disorders, Child, Child Behavior Disorders, Depressive Disorder, Humans, Longitudinal Studies, North Carolina, Personality Assessment, Prognosis, Prospective Studies, Psychometrics, Cohort Studies, Comorbidity, Conduct Disorder, Attention Deficit and Disruptive Behavior Disorders, Substance-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders, Early Diagnosis, Young Adult
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