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Associations between conduct problems in childhood and adverse outcomes in emerging adulthood: a longitudinal Swedish nationwide twin cohort
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden; Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA .
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2020 (English)In: Journal of Child Psychology and Psychiatry, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 61, no 7, p. 798-806Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: We examined whether childhood conduct problems predicted a wide range of adverse outcomes in emerging adulthood and whether the association with internalizing problems remained after adjusting for general comorbidity and externalizing problems.

METHODS: Participants were 18,649 twins from the Child and Adolescent Twin Study in Sweden. At age 9/12, parents rated their children on eight conduct problems. Adverse outcomes were retrieved from national registers in emerging adulthood (median follow-up time = 9.2 years), including diagnoses of six psychiatric disorders, prescriptions of antidepressants, suicide attempts, criminality, high school ineligibility, and social welfare recipiency. We estimated risk for the separate outcomes and examined if conduct problems predicted an internalizing factor above and beyond a general comorbidity and an externalizing factor. We used twin analyses to estimate genetic and environmental contributions to these associations.

RESULTS:  On the average, each additional conduct symptom in childhood was associated with a 32% increased risk of the adverse outcomes in emerging adulthood (mean hazard ratio = 1.32; range = 1.16, 1.56). A latent childhood conduct problems factor predicted the internalizing factor in emerging adulthood (beta(boys) = .24, standard error, SE = 0.03; beta(girls) = .17, SE = 0.03), above and beyond its association with the externalizing (beta(boys) = 0.21, SE = 0.04; beta(girls) = 0.17, SE = 0.05) and general factors (beta(boys) = 0.45, SE = 0.03; beta(girls) = 0.34, SE = 0.04). These associations were differentially influenced by genetic and environmental factors.

CONCLUSIONS: It is important to monitor boys and girls with conduct problems not only for future externalizing problems, but also for future internalizing problems. Prevention of specific outcomes, however, might require interventions at different levels.

Place, publisher, year, edition, pages
Blackwell Publishing, 2020. Vol. 61, no 7, p. 798-806
Keywords [en]
Twins, comorbidity, conduct disorder, externalizing disorder, internalizing disorder
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-78820DOI: 10.1111/jcpp.13169ISI: 000503051200001PubMedID: 31849046Scopus ID: 2-s2.0-85076780103OAI: oai:DiVA.org:oru-78820DiVA, id: diva2:1381134
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-1678Swedish Research Council, 2013-2280 2014-3831 2017-01358Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2023-08-28Bibliographically approved

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Martin, CederlöfLarsson, Henrik

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