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We review epidemiological evidence indicating that most people will develop a diagnosable mental disorder, suggesting that only a minority experience enduring mental health. This minority has received little empirical study, leaving the prevalence and predictors of enduring mental health unknown. We turn to the population-representative Dunedin cohort, followed from birth to midlife, to compare people never-diagnosed with mental disorder (N = 171; 17% prevalence) to those diagnosed at 1-2 study waves, the cohort mode (N = 409). Surprisingly, compared to this modal group, never-diagnosed Study members were not born into unusually well-to-do families, nor did their enduring mental health follow markedly sound physical health, or unusually high intelligence. Instead, they tended to have an advantageous temperament/personality style, and negligible family history of mental disorder. As adults, they report superior educational and occupational attainment, greater life satisfaction, and higher-quality relationships. Our findings draw attention to "enduring mental health" as a revealing psychological phenotype and suggest it deserves further study. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Purpose: To examine the associations between leaving school without qualifications and subsequent mental health to age 30, using data gathered over the course of a 30-year longitudinal study., Methods: Data were gathered over the course of a 30-year study (Christchurch Health and Development Study) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from 18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems., Results: Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR = 1.37 at 95 % CI 1.05-1.78, p = 0.019); anxiety disorder (OR = 1.99 at 95 % CI 1.55-2.57, p < 0.001); suicidal ideation/attempt (OR = 1.60 at 95 % CI 1.15-2.36, p = 0.005); alcohol abuse/dependence (OR = 1.54 at 95 % CI 1.20-1.98, p < 0.001); and illicit substance abuse/dependence (OR = 2.97 at 95 % CI 2.16-4.07, p < 0.001). Adjustment for the covariate factors above (family social background; family violence; child abuse and adolescent mental health problems) reduced these associations substantially and to the point of statistical non-significance., Conclusions: The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving.

Importance: There has been growing research into the mental health consequences of major disasters. Few studies have controlled for prospectively assessed mental health. This article describes a natural experiment in which 57% of a well-studied birth cohort was exposed to a major natural disaster (the Canterbury, New Zealand, earthquakes in 2010-2011), with the remainder living outside of the earthquake area., Objective: To examine the relationships between the extent of earthquake exposure and mental health outcomes following the earthquakes-net of adjustment for potentially confounding factors related to personal circumstances, prior mental health, and childhood family background., Design, Setting, and Participants: Data were gathered from the Christchurch Health and Development Study, a 35-year longitudinal study of a birth cohort of New Zealand children (635 males and 630 females). This general community sample included 952 participants with available data on earthquake exposure and mental health outcomes at age 35 years., Exposures: A composite measure of exposure to the events during and subsequent to the 4 major (Richter Scale >6.0) Canterbury earthquakes during the years 2010-2011., Main Outcomes and Measures: DSM-IV symptom criteria for major depression; posttraumatic stress disorder; anxiety disorder; suicidal ideation/attempt; nicotine dependence; alcohol abuse/dependence; and illicit drug abuse/dependence. Outcomes were measured approximately 20 to 24 months after the onset of exposure to the earthquakes and were assessed using DSM-IV diagnostic criteria and measures of subclinical symptoms., Results: After covariate adjustment, cohort members with high levels of exposure to the earthquakes had rates of mental disorder that were 1.4 (95% CI, 1.1-1.7) times higher than those of cohort members not exposed. This increase was due to increases in the rates of major depression; posttraumatic stress disorder; other anxiety disorders; and nicotine dependence. Similar results were found using a measure of subclinical symptoms (incidence rate ratio, 1.4; 95% CI, 1.1-1.6). Estimates of attributable fraction suggested that exposure to the Canterbury earthquakes accounted for 10.8% to 13.3% of the overall rate of mental disorder in the cohort at age 35 years., Conclusions and Relevance: Following extensive control for prospectively measured confounding factors, exposure to the Canterbury earthquakes was associated with a small to moderate increase in the risk for common mental health problems.

Background: This study examined the associations between measures of alcohol abuse/dependence (AAD) and several classifications of offending behaviour to age 30 in a New Zealand birth cohort., Methods: Outcomes included: assault; use of a weapon; theft/burglary/vehicle conversion; property damage/vandalism/arson; and fraud/embezzlement/misappropriation of funds. The study also used measures of AAD symptoms; and time-dynamic covariate factors including life stress, other substance use, mental health status, peer and partner substance use and offending, and unemployment. Data were analysed using conditional fixed effects regression modelling augmented by time-dynamic covariate factors to control for confounding., Results: Those with five or more AAD symptoms had unadjusted odds of offending that ranged from 6.23 to 21.25 times higher than those with no symptoms, with little evidence to suggest these associations varied with age. Adjustment for both unobserved fixed effects and time-dynamic covariate factors reduced the magnitude of the associations between AAD and offending, with those with five or more AAD symptoms having odds of offending that were 0.88-4.10 times higher than those with no symptoms. After adjustment, only the associations between AAD and: a) assault (OR=4.10; 95% CI=1.91-8.62; p<0.0001); and b) property damage/vandalism/arson (OR=3.87; 95% CI=1.30-11.39; p<0.0001); remained statistically significant., Conclusions: The results suggest a causal association between alcohol misuse and "impulsive" crimes such as assault and property damage/vandalism/arson, with estimates suggesting that AAD accounted for approximately 9.6-9.9% of these types of reported offending in the cohort., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

The present study examined errors of reporting, including unreliability and recall bias, in retrospective reports of childhood maltreatment. Data were gathered on retrospective reports of childhood sexual and physical abuse and current mental health in a birth cohort of over 980 participants studied at ages 18 and 21. A structural equation model was developed to estimate the contributions of test unreliability and recall bias to reporting variation. Retrospective abuse reports were of modest test-retest reliability (r(tt)  = 0.50 approximately). Recall bias accounted for <1% of report variance. As a consequence the observed correlations between maltreatment and mental health closely approximated the corresponding estimated true correlations. The results of the study suggested that, for this cohort, errors of measurement in reports of childhood maltreatment did not pose a significant threat to study validity., (Copyright © 2011 John Wiley & Sons, Ltd.)

Objective: This study examined associations between age of menarche and psychosocial outcomes in early adulthood, including sexual behavior, mental health, criminal behavior, and education/employment, to identify the possible causal role of earlier age of menarche in increasing risks of adverse outcomes., Method: Data were gathered from 497 female members of a New Zealand longitudinal birth cohort. Outcome measures (to age 18 years) were as follows: pregnancy; sexually transmitted infection (STI); DSM-IV major depression, anxiety disorder, alcohol dependence and conduct disorder/ASPD; self-reported crime; convictions; leaving school without qualifications; and unemployment. Associations between age of menarche and outcome measures were then adjusted for confounding factors spanning family background, family functioning, and individual factors. Additional analyses examined sexual behavior outcomes to age 21, and all other outcomes to age 30 years., Results: Analyses showed that sexual behavior outcomes (pregnancy, STI) were significantly associated with age of menarche, even after controlling for confounding factors. Anxiety disorder was marginally (p < .10) associated with age of menarche. In addition, pregnancy during ages 18 to 21 years was significantly associated with age of menarche. There were no significant associations between age of menarche and outcomes at any other age (to age 30)., Conclusions: The study showed that females reaching menarche at an earlier age were at increased risk of early pregnancy, and STI by age 18. The present study found little evidence to suggest that age of menarche was related to mental health, criminal behavior, or education/employment outcomes for this cohort., (Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)

Background: This paper sought to examine the relationship between sexual orientation and mental health in a New Zealand birth cohort studied to age 25 years., Method: The analysis is based on a sample of 967 participants (469 males; 498 females) in the Christchurch Health and Development Study. As part of this study information was gathered on: (a) measures of sexual orientation, same-sex behaviour and sexual attraction obtained at ages 21 and 25 years; (b) measures of mental disorders and suicidal behaviours over the interval 21-25 years; (c) measures of childhood and family background., Results: Latent class analysis was used to combine indicators of sexual orientation, same sex behaviour and attraction to form an empirically based classification of sexual orientation. The best-fitting model classified the sample into three groups: exclusively heterosexual orientation (87.6%); predominantly heterosexual but with same-sex inclinations or experience (9.6%); predominantly homosexual (2.8%). Proportionately more women than men were classified as predominantly heterosexual (14.2% v. 4.8% respectively) or predominantly homosexual (3.9% v. 1.5% respectively). Cohort members with a predominantly homosexual orientation had rates of mental disorder and suicidal behaviours that were between 1.5 and 12 times higher than for those with an exclusively heterosexual orientation. These associations persisted after adjustment for confounding. The associations between sexual orientation and mental health were more marked for males than females. CONCLUSIONS. The findings suggest a continuum of sexual preferences amongst young adults. Variations in sexual orientation were clearly associated with mental health. These associations tended to be stronger for males.

Background: The aim of this study was to examine the linkages between suicidal ideation and attempt in adolescence and subsequent suicidal behaviours and mental health in young adulthood., Method: Data were gathered during the course of a 25-year longitudinal study of a birth cohort of 1265 New Zealand children. The information collected included: (a) measures of suicidal thoughts and attempts in adolescence (< 18 years); (b) measures of suicidal ideation, suicide attempt, major depression, anxiety disorders, and substance use disorders in young adulthood (18-25 years); and (c) measures of childhood and family background, individual characteristics, and mental disorders in adolescence., Results: After statistical adjustment for confounding factors, suicide attempt in adolescence was associated with increased risks of subsequent suicidal ideation (OR 5.7) suicide attempt (OR 17.8) and major depression (OR 1.5). Those reporting suicidal ideation without suicide attempt showed moderate increases in risks of later suicidal ideation (OR 2.5), suicide attempt (OR 2.0) and major depression (OR 1.6). In addition, there was evidence of an interactive relationship in which suicidal behaviour in adolescence was associated with increased risks of later substance use disorders in females but not males., Conclusions: Young people reporting suicidal ideation or making a suicide attempt are an at-risk population for subsequent suicidal behaviour and depression. Further research is needed into the reasons for suicidal adolescent females being at greater risk of later substance use disorder.

Objective: This research examined linkages between exposure to childhood sexual abuse (CSA) and childhood physical punishment/abuse (CPA) and mental health issues in early adulthood. Method: The investigation analyzed data from a birth cohort of over 1,000 New Zealand young adults studied to the age of 25. Results: Exposure to CSA and CPA was associated with increased risks of later mental disorders including depression, anxiety disorder, conduct/anti-social personality disorder, substance dependence, suicidal ideation, and suicide attempts at ages 16-25. Control for social, family, and individual factors reduced the associations between CPA and mental health outcomes to the point of statistical non-significance. However, there was a consistent finding for CSA to remain associated with increased risks of later mental health problems. After adjustment, those exposed to CSA including attempted or completed sexual penetration had rates of disorder that were 2.4 times higher than those not exposed to CSA. Those exposed to harsh or abusive physical punishment had rates of disorder that were 1.5 times higher than those exposed to no or occasional physical punishment. It was estimated that exposure to CSA accounted for approximately 13% of the mental health problems experienced by the cohort. Findings showed that exposure to CPA had only weak effects on later mental health. It was estimated that exposure to CPA accounted for approximately 5% of the mental health problems experienced by the cohort. Conclusions: Exposure to CSA was associated with consistent increases in risks of later mental health problems. Exposure to CPA had weaker and less consistent effects on later mental health. These findings suggest that much of the association between CPA and later mental health reflects the general family context in which CPA occurs, whereas this is less the case for CSA. (Contains 4 tables.)

Background: The extent to which abortion has harmful consequences for mental health remains controversial. We aimed to examine the linkages between having an abortion and mental health outcomes over the interval from age 15-25 years. Methods: Data were gathered as part of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of New Zealand children. Information was obtained on: a) the history of pregnancy/abortion for female participants over the interval from 15-25 years; b) measures of DSM-IV mental disorders and suicidal behaviour over the intervals 15-18, 18-21 and 21-25 years; and c) childhood, family and related confounding factors. Results: Forty-one percent of women had become pregnant on at least one occasion prior to age 25, with 14.6% having an abortion. Those having an abortion had elevated rates of subsequent mental health problems including depression, anxiety, suicidal behaviours and substance use disorders. This association persisted after adjustment for confounding factors. Conclusions: The findings suggest that abortion in young women may be associated with increased risks of mental health problems.

This study examines the prevalence and extent of domestic violence and the consequences of domestic violence for mental health outcomes in a birth cohort of New Zealand young adults studied at age 25 years. A total of 828 young people (437 women and 391 men) were interviewed about the domestic violence victimization and violence perpetration in their current or most recent partner relationship. Key findings of the study were (a) domestic conflict was present in 70% of relationships, with this conflict ranging from minor psychological abuse to severe assault; (b) men and women reported similar experiences of victimization and perpetration of domestic violence; and (c) exposure to domestic violence was significantly related to increased risks of major depression (p [is less than] .05) and suicidal ideation (p [is less than] .005) even after extensive control for covariates.

Background: There has been ongoing interest in the role of intelligence in longer-term educational and occupational achievement and social adjustment. The aims of this study were to examine the extent to which IQ in middle childhood (8-9 years) was prognostic of future outcomes when due allowance was made for confounding personal and social factors. Methods: Data were gathered on (WISC-R) IQ at ages 8-9 years and a range of educational and social adjustment measures over the course of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of 1,265 New Zealand children. Results: IQ assessed at ages 8-9 years was related to a range of outcomes: later crime (offending, arrest/conviction); substance use disorders (nicotine dependence, illicit drug dependence); mental health (anxiety, suicidality); sexual adjustment (number of sexual partners, pregnancy); educational achievement (school leaving qualifications, tertiary qualifications); and occupational outcomes (unemployment, income). However, intelligence was largely unrelated to many of these outcomes: crime, mental health, sexual behaviours, and illicit substance dependence after statistical adjustment for early behaviour problems and family background. Strong relationships remained between childhood intelligence and later educational and occupational outcomes. Conclusions: Much of the association between early intelligence and later social adjustment is mediated by childhood conduct problems and family social circumstances. However, strong relationships exist between early intelligence and later academic achievement and income independently of these factors.

Background: This paper seeks to extend research into the adult sequelae of childhood conduct problems by investigating the associations between conduct problems in middle childhood and psychosocial outcomes in adulthood. Method: Data were gathered during the course of a 25-year longitudinal study of a birth cohort of New Zealand young people. Information was collected on: a) parent and teacher reports of child conduct problems at ages 7, 8 and 9 years; b) measures of crime, substance use, mental health, sexual/partner relationships, education/employment; c) confounding factors, including childhood, family and educational characteristics. Results: There were statistically significant associations between childhood conduct problems from 7-9 years and risks of adverse outcomes across all domains of functioning. After control for confounding factors the associations between conduct problems and education/employment outcomes became statistically non-significant. Associations persisted for other outcomes (crime, substance dependence, mental health and sexual/partner relationships). Children in the most disturbed 5% of the cohort had rates of these outcomes that were between 1.5 and 19 times higher than rates for the least disturbed 50% of the cohort. The associations between conduct problems and adult outcomes were similar for males and females. Conclusions: Childhood conduct problems were associated with a wide range of adverse psychosocial outcomes (crime, substance use, mental health, sexual/partner relationships) even after control for confounding factors. The results reinforce the need for greater investment into interventions to address these problems.

Objective: Long-term studies following disasters are rare. It is important to quantify long-term effects of disasters to determine impacts on populations over time. We therefore aim to report the long-term associations between exposure to the Canterbury earthquakes and common mental disorders, taking into account potential confounding factors. Methods: The Christchurch Health and Development Study is a 40-year longitudinal study of a birth cohort of New Zealand children (635 males and 630 females). The Christchurch Health and Development Study includes 884 participants with data on earthquake exposure and mental health outcomes at ages 34 and 40 years. Rates of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) disorders were measured categorically and using an expanded definition that included sub-syndromal symptoms. The current impact of the earthquakes is reported using 12-month prevalence data 7 years after the earthquakes. The cumulative impact of the earthquakes over the 7 years since onset is also reported. Results: There was a linear trend towards increasing rates of disorder with increasing exposure to the earthquakes. After adjusting for covariates, the 12-month prevalence of anxiety disorder symptoms was significantly increased (p = 0.003). The earthquakes were also associated with cumulative increases in symptoms of post-traumatic stress disorder (p < 0.001), anxiety disorder (p = 0.016), nicotine dependence (p = 0.012), and the total number of disorders (p = 0.039). Conclusion: The Canterbury earthquakes were associated with persistent increases in Anxiety Disorder symptoms 7 years after their onset. The earthquakes were also associated with cumulative increases in symptoms of common psychiatric disorders. The magnitude of these effects is small, may no longer be clinically significant and has decreased over time. [ABSTRACT FROM AUTHOR]

Background: Antenatal corticosteroids (ACS) given to mothers with anticipated very preterm delivery are widely used and improve infant outcomes. Follow‐up studies of the first trials of ACS have shown no adverse effects, but recently there have been concerns about possible longer‐term harms. Objectives: We aimed to assess the relationship of ACS therapy to a range of physical health and welfare measures in a cohort of very low birthweight (VLBW; <1500 g) young adults. Methods: Population‐based cohort follow‐up study. All VLBW infants born in New Zealand in 1986 were included in a prospective audit of retinopathy of prematurity. Perinatal data collection included information on ACS. At 26–30 years, 250 of 323 (77%) survivors participated, 58% having received ACS, with 229 assessed in one centre, including cardiovascular, metabolic, respiratory and neurocognitive measures. Differences in outcome between those receiving/not receiving ACS were summarised by the mean difference for continuous outcomes supplemented by Cohen's d as a standardised measure of effect size (ES), and risk ratios (RRI) for dichotomous outcomes, adjusted for relevant covariates using generalised linear regression methods. Results: There were no or minimal adverse effects of receipt of ACS versus no receipt across a range of health and welfare outcomes, both for the full cohort (adjusted ES range d = 0.01–0.23; adjusted RR range 0.78–2.03) and for individuals with gestation <28 weeks (extremely preterm; EP), except for a small increase in rates of major depression. In EP adults, receipt of ACS was associated with a higher incidence of hypertension, but might have a small benefit for IQ. Conclusions: In this population‐based VLBW cohort, we detected minimal adverse outcomes associated with exposure to ACS by the third decade of life, a similar result to the 30‐year follow‐up of participants in the first ACS trial. However, further follow‐up is warranted. [ABSTRACT FROM AUTHOR]

Background and aims: Little is known about how cannabis use over the life‐course relates to harms in adulthood. The present study aimed to identify trajectories of cannabis use from adolescence to adulthood and examine both the predictors of these trajectories and adverse adult outcomes associated with those trajectories. Design A latent trajectory analysis of a longitudinal birth cohort (from birth to age 35 years). Setting and participants: General community sample (n = 1065) from New Zealand. Measurement Annual frequency of cannabis use (ages 15–35 years); childhood family and individual characteristics (birth to age 16 years); measures of adult outcomes (substance use disorders, ages 30–35 years; mental health disorders, ages 30–35 years; socio‐economic outcomes at age 35 years; social/family outcomes at age 35 years). Findings A six‐class solution was the best fit to the data. Individuals assigned to trajectories with higher levels of cannabis use were more likely to have experienced adverse childhood family and individual circumstances. Membership of trajectories with higher levels of use was associated with increased risk of adverse outcomes at ages 30–35 years. Adjustment of these associations for the childhood family and individual predictors largely did not reduce the magnitude of the associations. Conclusions: In New Zealand, long‐term frequent cannabis use, or transition to such use, appears to be robustly associated with diverse harms in adulthood. [ABSTRACT FROM AUTHOR]

Abstract: Background and Aims: Studies have linked adolescent alcohol use with adverse consequences in adulthood, yet it is unclear how strong the associations are and to what extent they may be due to confounding. Our aim was to estimate the strength of association between different patterns of adolescent drinking and longer‐term psychosocial harms taking into account individual, family and peer factors. Design: Participant‐level data were integrated from four long‐running longitudinal studies: Australian Temperament Project, Christchurch Health and Development Study, Mater Hospital and University of Queensland Study of Pregnancy and Victorian Adolescent Health Cohort Study. Setting: Australia and New Zealand. Participants: Participants were assessed on multiple occasions between ages 13 and 30 years (from 1991 to 2012). Number of participants varied (up to n = 9453) by analysis. Measurements: Three patterns of alcohol use (frequent, heavy episodic and problem drinking) were assessed prior to age 17. Thirty outcomes were assessed to age 30 spanning substance use and related problems, antisocial behaviour, sexual risk‐taking, accidents, socio‐economic functioning, mental health and partner relationships. Findings: After covariate adjustment, weekly drinking prior to age 17 was associated with a two‐ to threefold increase in the odds of binge drinking [odds ratio (OR) = 2.14; 95% confidence interval (CI) = 1.57–2.90], drink driving (OR = 2.78; 95% CI = 1.84–4.19), alcohol‐related problems (OR = 3.04; 95% CI = 1.90–4.84) and alcohol dependence (OR = 3.30; 95% CI = 1.69–6.47) in adulthood. Frequency of drinking accounted for a greater proportion of the rate of most adverse outcomes than the other measures of alcohol use. Associations between frequent, heavy episodic and problem drinking in adolescence and most non‐alcohol outcomes were largely explained by shared risk factors for adolescent alcohol use and poor psychosocial functioning. Conclusions: Frequency of adolescent drinking predicts substance use problems in adulthood as much as, and possibly more than, heavy episodic and problem drinking independent of individual, family and peer predictors of those outcomes. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examined whether abortion reduces mental health risks among women having unwanted or unintended pregnancy. A number of outcome domains considered in this study. Results of the study showed that abortion was not associated with reduced rates of mental health problems. However, the study found an association between abortion and small to moderate increases in anxiety risks, alcohol misuse, illicit drug use/misuse and suicidal behavior.

Background: Marriage is known to be associated with improved mental health, but little research has examined whether the duration of a cohabiting relationship is associated with mental health.Aims: To examine the associations between relationship duration and mental health problems in a birth cohort of 30-year-olds.Method: Associations between relationship duration and mental health were examined using a generalised estimating equation approach. Associations were adjusted for covariates, including prior mental health problems.Results: Longer relationship duration was significantly associated with lower rates of depression, suicidal behaviour and substance abuse/dependence, even after adjustment for covariates. In most cases the associations did not vary with gender. Legal relationship status (legally or de facto married) was not significantly related to mental health once due allowance was made for relationship duration.Conclusions: Increasing relationship duration, but not legal relationship status, has a protective effect on mental health for men and women. [ABSTRACT FROM AUTHOR]

Background: There has been continued interest in the extent to which women have positive and negative reactions to abortion.Aims: To document emotional reactions to abortion, and to examine the links between reactions to abortion and subsequent mental health outcomes.Method: Data were gathered on the pregnancy and mental health history of a birth cohort of over 500 women studied to the age of 30.Results: Abortion was associated with high rates of both positive and negative emotional reactions; however, nearly 90% of respondents believed that the abortion was the right decision. Analyses showed that the number of negative responses to the abortion was associated with increased levels of subsequent mental health disorders (P<0.05). Further analyses suggested that, after adjustment for confounding, those having an abortion and reporting negative reactions had rates of mental health disorders that were approximately 1.4-1.8 times higher than those not having an abortion.Conclusions: Abortion was associated with both positive and negative emotional reactions. The extent of negative emotional reactions appeared to modify the links between abortion and subsequent mental health problems. [ABSTRACT FROM AUTHOR]

Background: There is considerable evidence suggesting that many children show conduct problems that are specific to a given context (home; school). What is less well understood is the extent to which children with situation-specific conduct problems show similar outcomes to those with generalised conduct problems. Methods: Data were gathered as part of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of New Zealand children. Information was obtained on: (a) conduct problems during the period 7–9 years; (b) criminal offending during the period 16–25 years; (c) measures of DSM-IV mental disorders and suicidal behaviour over the interval 16–25 years; (d) measures of DSM-IV substance dependence over the interval 16–25 years; and (e) measures of relationship, pregnancy, and parenthood outcomes during the period 16–25 years. Results: Latent-class modelling suggested three distinct groups of children with conduct problems: those with mother reports; those with teacher reports; and those with both mother and teacher reports. Both situation-specific and generalised conduct disorder were associated with increased risk of criminal offending, mental health disorders, substance dependence, and relationship and parenthood issues in late adolescence and early adulthood. Conclusions: There is a need for recognition of the significance of situation-specific conduct problems in both developmental theory and in the treatment of childhood conduct disorders. A focus only on those children with generalised conduct problems is likely to overlook the features and needs of children whose conduct problems are confined to a specific context. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the association between alcohol abuse or dependence (AAD) and major depression (MD) using data from the Christchurch Health and Development Study, a 25-year longitudinal study in Christchurch, New Zealand. The participants aging 18, 21 and 25 years were interviewed on a structural mental health interview intended to evaluate aspects of mental health and psychological adjustments. The results of the study showed a significant (P<.001) shared association between AAD and MD. Additionally, the findings of the study proposed that a causal model in which alcoholism results to increased risk of MD best justifies the link between AAD and MD.

This paper examines the relationship between self-esteem in adolescence and later mental health, substance use, and life and relationship outcomes in adulthood. The investigation analyzed data from a birth cohort of approximately 1,000 New Zealand young adults studied to the age of 25. Lower levels of self-esteem at age 15 were associated with greater risks of mental health problems, substance dependence, and lower levels of life and relationship satisfaction at ages 18, 21, and 25. Adjustment for potentially confounding factors reduced the strength of these associations to either moderate or statistically nonsignificant levels. It was concluded that the effects of self-esteem during adolescence on later developmental outcomes were weak, and largely explained by the psychosocial context within which self-esteem develops. [ABSTRACT FROM PUBLISHER]

This study investigated the relationship between self-esteem in adolescence and later violent offending and hostility via self- and other-report, examining data from a birth cohort of over 1,000 New Zealand young adults studied to age 25. Lower levels of self-esteem at age 15 were related to greater risks of violent offending and higher levels of hostility at ages 18, 21, and 25. Adjustment for potentially confounding factors reduced the strength of the associations between self-esteem at age 15 and both self- and other-reported violent offending and other-reported hostility at ages 18, 21, and 25 to statistically non-significant levels. The association between self-esteem at age 15 and later self-reported hostility remained statistically significant, but was small in magnitude. A similar pattern of results were obtained using self-esteem at age 10 as the predictor variable in place of the age 15 measure. In addition, a persistent association was found between unstable high self-esteem and self-reported violent offending. The results suggest that self-esteem level plays a limited role in the understanding of violent behavior. [ABSTRACT FROM AUTHOR]

Background It is unclear how the recurrence of major depression in adolescence affects later life outcomes. Aims To examine the associations between the frequency of major depression at ages 16-21 and later outcomes, both before and after controlling for potentially confounding factors. Method Data were gathered from a 25-year longitudinal study of a birth cohort of New Zealand children (n=982). Outcome measures included DSM-IV symptom criteria for major depression and anxiety disorders, suicidal ideation and attempted suicide, achieving university degree or other tertiary education qualification, welfare dependence and unemployment, and income at ages 21-25 years. Results There were significant (P < 0.05) associations between the frequency of depression at ages 16-21 years and all outcome measures. After adjustment for confounding factors, the association between frequency of depression and all mental health outcomes, and welfare dependence and unemployment, remained significant (P

The article reports on single parenthood and mental health. It examines the link between the extent of exposure to single parenthood in childhood and later mental health, educational, economic and criminal behavior outcomes. In this research, data were collected during the Christchurch Health and Development Study. Participants of this study were 971 individuals with available data on exposure to single parenthood from birth up to the age of 16. Results show significant associations between the extent of exposure anxiety disorder and single parenthood.

The article presents a response by the authors to comments on their paper "Partner Violence and Mental Health Outcomes in a New Zealand Birth Cohort." It was argued that there is only one kind of violence that people think of when they hear the term domestic violence. This type of violence is described as "intimate terrorism" and this type of violence is primarily male perpetrated. The authors view that these arguments are founded on the reification of what is currently only a speculative hypothesis and that they tend to trivialize the experiences of their cohort. Some critics were concerned to show that male and female domestic violence differs and that male violence is more damaging. Within the authors' sample, however, this was not the case. The rates and types of injury appeared similar for men and women, and both gender groups appeared to experience similar psychological consequences. Given these findings, the weight of the evidence clearly suggests that the consequences of mild to moderate domestic violence in terms of both physical injury and psychological trauma appeared to be similar for men and women.

Background There is increasing interest in the extent to which individuals with subthreshold depression face increased risks of subsequent major depression and other disorders. Objective To examine linkages between the extent of depressive symptoms (asymptomatic, subthreshold, major depression) at ages 17 to 18 years and mental health outcomes up to age 25 years in a New Zealand birth cohort. Design Data were gathered during the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of 1265 New Zealand children (635 males, 630 females). Setting General community sample. Participants The analysis was based on 1006 participants who represented 80% of the original cohort. Main Outcome Measures Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom criteria for major depression and anxiety disorder, treatment-seeking, suicidal ideation, and suicide attempt. Results There were significant associations (P<.01) between the extent of depression at ages 17 to 18 years and rates of subsequent depressive symptoms, major depression, treatment for depression, anxiety disorder, treatment for anxiety disorder, suicidal ideation, and suicide attempts. After adjustment for covariate factors, the extent of depression at ages 17 to 18 years remained associated with later depression and suicidal tendencies. Planned comparisons showed that sample members with subthreshold depression had a similar prognosis to those meeting criteria for major depression. Conclusions Findings suggest that sample members with subthreshold depression are a group with elevated risks of later depression and suicidal behaviors. Current diagnostic procedures, which classify people with subthreshold depression into complex discrete groups, might obscure the fact that depressive symptoms are dimensional and range from none to severe. [ABSTRACT FROM AUTHOR]

To describe the pattern of drinking at age 16 and to relate this to outcomes at 16–21 years and 21–25 years across a number of psychosocial domains.A prospective birth cohort study with annual follow-up until age 16 then at 18, 21 and 25 years.Christchurch, New Zealand.Of 1265 subjects, 953 were interviewed at age 16.Multiple measures of family background were collected from birth to 16 years. Alcohol consumption was measured in terms of frequency, usual or last quantity drunk and most drunk per occasion. Problems were also recorded. Questions about psychiatric symptoms enabledDiagnostic and Statistical Manual(DSM) criteria to be applied. Detailed reports on educational outcomes, employment, sexual behaviours and offending were collected.Four latent classes were required to describe drinking at age 16, but these appeared to lie along a single dimension which strongly predicted outcomes at ages 16–21 and 21–25 across all domains (alcohol-related, substance dependence, mental health, education, sexual relationships and offending). After controlling for background and correlates only a small number of outcomes were still related consistently to drinking at age 16 over both periods: most alcohol-related outcomes, the number of sexual partners and the extent of violent offending.Drinking at age 16 is a clear indicator of future life-course over most domains in late adolescence and early adulthood. Many of these associations are due to other covariates. Outcomes specific to drinking at age 16 are alcohol outcomes, number of sexual partners and violence. [ABSTRACT FROM AUTHOR]

Objective: This paper provides an overview of the Christchurch Health and Development Study (CHDS) and a summary of findings relating to child and adolescent mental health. Method: The CHDS is a longitudinal study of a birth cohort of 1265 children born in the Christchurch (New Zealand) urban region during mid 1977. This cohort has now been studied from birth to age 21. Results: The paper examines the ways in which the study has been able to examine a wide range of issues. Key issues examined include: (i) measurement of disorder (respondent effects; dimensionality; scales vs categories); (ii) prevalence and treatment of disorder; (iii) stability and continuity of disorders; (iv) the contribution of risk and aetiological factors (e.g. lead exposure, parental divorce, child abuse, family adversity, sexual orientation) to psychosocial adjustment; and (v) the psychosocial consequences of mental health problems in adolescence. Conclusions: The study findings illustrate the many advantages of a longitudinal study, such as the CHDS, in providing methodologically sound, theoretically relevant and cost effective research that caters for the interests of multiple end-users including the scientific community, clinicians and applied policy makers. [ABSTRACT FROM AUTHOR]

This paper examines the effects of living in a stepfamily during childhood and adolescence on a range of psychosocial outcomes at age 18 years. Data collected during an 18-year longitudinal study were used to examine a sample of 907 children with respect to: exposure to living in a stepfamily during the period from age 6 to 16 years; measures of psychosocial outcomes including mental health, antisocial behaviour, substance use, restricted life opportunities, and sexual risk-taking at age 18 years; and measures of prospectively collected confounding factors. The analyses revealed that children exposed to living in a stepfamily for the first time between ages 6-16 years had elevated risks of a range of psychosocial outcomes at 18 years. These included elevated risks of: (1) juvenile offending; (2) nicotine dependence; (3) abuse or dependence on illicit substances; (4) leaving school without qualifications; (5) early onset of sexual activity ; and (6) multiple sexual partners. However, these risks were reduced substantially when psychosocial outcomes were adjusted for the confounding effects of antecedent factors such as: family socioeconomic characteristics ; family history of instability, adversity, and conflict; mother's age, religiosity, and smoking; child gender; and preexisting child conduct and attentional problems. After adjustment, the odds ratios between exposure to a stepfamily and adolescent outcomes were nonsignificant. Additional analysis revealed that there were no significant differences in outcomes for boys and girls exposed to stepfamilies. It was concluded that although young people exposed to living in a stepfamily had increased risks of poor psychosocial outcomes, much of this association appeared to be spurious, and arose from confounding social, contextual, and individual factors that were present prior to the formation of the stepfamily. [ABSTRACT FROM AUTHOR]

Background: This study examines the extent to which gay, lesbian, and bisexual young people are at increased risk of psychiatric disorder and suicidal behaviors using data gathered on a New Zealand birth cohort studied to age 21 years. Methods: Data were gathered during the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand. At 21 years of age, 1007 sample members were questioned about their sexual orientation and relationships with same-sex partners since the age of 16 years. Twenty-eight subjects (2.8%) were classified as being of gay, lesbian, or bisexual sexual orientation. Over the period from age 14 to 21 years, data were gathered on a range of psychiatric disorders that included major depression, generalized anxiety disorder, conduct disorder, and substance use disorders. Data were also gathered on suicidal ideation and suicide attempts. Results: Gay, lesbian, and bisexual young people were at increased risks of major depression (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.8-9.3), generalized anxiety disorder (OR, 2.8; 95% CI, 1.2-6.5), conduct disorder (OR, 3.8; 95% CI, 1.7-8.7), nicotine dependence (OR, 5.0; 95% CI, 2.3-10.9), other substance abuse and/or dependence (OR, 1.9; 95% CI, 0.9-4.2), multiple disorders (OR, 5.9; 95% CI, 2.4-14.8), suicidal ideation (OR, 5.4; 95% CI, 2.4-12.2), and suicide attempts (OR, 6.2; 95% CI, 2.7-14.3). Conclusions: Findings support recent evidence suggesting that gay, lesbian, and bisexual young people are at increased risk of mental health problems, with these associations being particularly evident for measures of suicidal behavior and multiple disorder. [ABSTRACT FROM AUTHOR]

Objective: To study the relationships between retrospective reports of exposure to interparental violence in childhood and rates of psychosocial adjustment problems in young adulthood in a birth cohort of New Zealand subjects. Method: Data were gathered during the course of an 18 year longitudinal study of a birth cohort of 1,265 New Zealand children. At age 18 retrospective reports of exposure to interparental violence were obtained. At this time the cohort was also assessed on measures of psychosocial adjustment including mental health problems, substance abuse behaviors, and criminal offending. Results: Young people reporting high levels of exposure to interparental violence had elevated rates of adjustment problems at age 18. These problems included mental health problems, substance abuse behaviors and criminal offending. Analyses using multiple logistic regression showed that much of this elevated risk was explained by social and contextual factors associated with exposure to interparental violence. However, even after adjustment for confounding factors, exposure to father initiated violence was associated with increased risks of anxiety, conduct disorder and property crime, while exposure to mother initiated violence was associated only with increased risks of later alcohol abuse/dependence. Conclusion: Children exposed to high levels of interparental violence are an at risk population for psychosocial adjustment problems in young adulthood. Much of the elevated risk of these children arises from the social context within which interparental violence occurs. Nonetheless, exposure to interparental violence, and particularly father initiated violence, may be associated with later increased risks of anxiety, conduct disorder, problems with alcohol, and criminal offending. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Abortion and mental health disorders: evidence from a 30-year longitudinal study," by D. M. Fergusson in the 2008; 193 issue.

Abstract: Purpose: This study examined the associations between measures of alcohol abuse/dependence symptoms and a range of psychosocial outcomes from ages 21 to 30 in a New Zealand birth cohort. Methods: Outcome measures included measures of: criminal offending, family violence and relationship instability, sexual risk-taking and consequences, mental health, and other adverse health and adjustment outcomes. Bivariate associations between a three-level classification of alcohol misuse (no symptoms, subclinical level of symptoms, met criteria for alcohol dependence) and each outcome during the period 21–30 years were computed using Generalised Estimating Equation models. These associations were then adjusted for non-observed sources of confounding using conditional fixed effects regression modelling, augmented by time-dynamic covariate factors. For both sets of models estimates of the attributable risk (AR) were computed. Results: There were statistically significant (p <.05) bivariate associations between alcohol misuse and each of the fifteen outcome measures, with estimates of the AR ranging from 7.4% to 46.5%. Adjustment for non-observed fixed effects generally reduced the magnitude of these associations; however, after adjustment, 12 of the 15 associations remained statistically significant (p <.05). Estimates of the AR after adjustment for fixed effects ranged from 3.6% to 44.3%. Conclusions: The results suggest that there are pervasive and persistent linkages between alcohol misuse and a range of adverse psychosocial outcomes. A reduction in levels of alcohol misuse amongst individuals of this age group could reduce substantially the overall level of personal and societal cost of hazardous levels of alcohol consumption. [Copyright &y& Elsevier]

Abstract: Background: This study examined the associations between measures of alcohol abuse/dependence (AAD) and relationship dissolution from ages 19 to 30 in a New Zealand birth cohort. Methods: The outcome measure was self-reported breakdown of a marital/cohabiting relationship during each year from age 20–21 to age 29–30. The study also used contemporaneous and one-year lagged measures of AAD symptoms; and time-dynamic covariate factors including life stress, other substance use, mental health status, peer and partner substance use and offending, unemployment, exposure to intimate partner violence, and prior relationship breakdown. Data were analysed using conditional fixed effects regression modelling augmented by time-dynamic covariate factors to control for confounding. Results: Those with three or more AAD symptoms had unadjusted odds of relationship breakdown that were 2.17–2.23 times higher than those with no symptoms, but these associations did not differ by gender. Adjustment of the associations for both unobserved fixed effects and time-dynamic covariate factors reduced the magnitude of the associations, with those with three or more AAD symptoms having rates of relationship breakdown that were 1.57–1.66 times higher than those with no symptoms. Conclusions: The results suggest a causal association between alcohol misuse and relationship breakdown, with estimates suggesting that alcohol use disorder accounted for 4.5–4.6% of marital/cohabiting relationship dissolution in the cohort. [Copyright &y& Elsevier]

Abstract: The aims of this study were to use data gathered over the course of a 30-year longitudinal study to examine the linkages between economic circumstances in childhood and subsequent developmental outcomes spanning educational achievement; economic circumstances; crime; mental health; and teenage pregnancy. All of these outcomes have been linked with childhood economic conditions and it is frequently argued that reducing income inequalities will mitigate psychosocial risks of children reared in families facing economic hardship. Alternatively it may be suggested that the associations between childhood family economic circumstances and later outcomes are mediated by individual, family and social factors that are correlated with low family income and contribute to later outcomes. To examine these issues, data were drawn from a birth cohort of New Zealand children born in 1977 and followed to age 30. Declining childhood family income was associated with a range of negative outcomes in adulthood, including: lower educational achievement; poorer economic circumstances; higher rates of criminal offending; higher rates of mental health problems; and higher rates of teenage pregnancy. After covariate adjustment, childhood family income remained significantly associated with educational achievement and economic circumstances, but was no longer significantly associated with the mental health, offending and teenage pregnancy outcomes. These findings suggest that, after due allowance has been made for social, family and individual contextual factors, low family income during childhood is associated with a range of educational and economic disadvantages in adulthood but is not directly related to increased risks of crime, mental health problems or teen pregnancy. [Copyright &y& Elsevier]

Abstract: Background: This study examined the associations between measures of alcohol abuse/dependence (AAD) and violent offending and intimate partner violence (IPV) to age 30 in a New Zealand birth cohort. Methods: Outcomes included: measures of violent offending, violence victimization, and physical IPV perpetration and victimization. The study also used measures of AAD symptoms; and time-dynamic covariate factors including life stress, other substance use, mental health status, peer and partner substance use and offending, and unemployment. Data were analysed using conditional fixed effects regression modelling augmented by time-dynamic covariate factors to control for confounding. Results: Those with five or more AAD symptoms had unadjusted rates of violence outcomes that ranged from 4.10 to 11.85 times higher than those with no symptoms, but these associations did not differ by gender. Adjustment of the associations for both unobserved fixed effects and time-dynamic covariate factors reduced the magnitude of the associations for violent offending, violence victimization and IPV perpetration, with those with five or more AAD symptoms having rates of violence outcomes that were 1.91–3.58 times higher than those with no symptoms. However, control for both fixed effects and time-dynamic covariate factors reduced the associations between AAD symptoms and physical IPV victimization to statistical non-significance (IRR=0.73, 95% CI: 0.51–1.06). Conclusions: The results suggest a causal association between alcohol misuse and violent offending/victimization and IPV perpetration, with estimates suggesting that alcohol use disorder accounted for approximately 4.6–9.3% of the reported violent offending/victimization and IPV perpetration in the cohort. [Copyright &y& Elsevier]

The present study examined issues relating to the measurement and discriminant validity of Diagnostic and Statistical Manual of Menial Disorders (DSM) diagnostic criteria for behavior disorders in adolescence (conduct disorder [CD], oppositional defiant disorder [ODD], attention-deficit/hyperactivity disorder [ADHD]). Data were obtained from a birth cohort of 995 New Zealand-born individuals studied to the age of 25 years and modeled associations between behavior disorder from ages 14 to 16 years and later outcomes including crime, substance use, mental health, parenthood and partnership outcomes, and education and employment outcomes to age 25 years. The associations between behavior disorders and outcomes were adjusted for both comorbid behavior disorders and a range of confounding factors. The results suggested that (a) dimensional measures of behavior disorder were more strongly correlated with Outcomes than categorical (DSM) measures; (b) CD, ODD, and ADHD each had a distinctive pattern of associations with longer term consequences; and (c) there was no evidence to suggest that the developmental consequences of CD, ODD, and ADHD differed by gender. In general, the results supported the validity of DSM diagnostic domains but also highlighted the importance of including in DSM-V methods for both recognizing the severity of disorder and addressing subclinical symptom levels. [ABSTRACT FROM AUTHOR]

To examine associations between offending trajectory in adolescence/young adulthood and mental health outcomes in adulthood. Data were used from the Christchurch Health and Development Study, a longitudinal birth cohort studied to age 35. Latent trajectory models were fitted to conduct problems and offending data from ages 8 to 21. Outcome measures included measures of DSM-IV major depression and anxiety disorders during the periods 21–25, 25–30, and 30–35 years. Associations between trajectory groups and mental health were adjusted for a series of childhood/adolescent sociodemographic, family functioning, and individual characteristics. In addition, the associations were adjusted for the mediating effects of life circumstances in adulthood, including substance use disorders, life stress, police contacts, and partner deviance. The bivariate associations showed clear linkages between offending and major depression and anxiety disorder in adulthood, which were reduced in magnitude following control for childhood and adolescent covariate factors. Finally, the analyses showed that these residual associations were largely mediated by adult life circumstances. The results suggest that offending in adolescence/early adulthood is a risk marker for later mental health disorders, but that the causal role of offending in later mental health problems is likely to be relatively weak. [ABSTRACT FROM AUTHOR]

Abstract: Globally, suicide has emerged as the second leading cause of death among youth aged 10–24 years old. In order to better understand the causes of this phenomenon, we investigate the relationship between suicidal ideation and cannabis use. Our empirical analysis is based on a 30-year longitudinal study of a birth cohort. We find that intensive cannabis use – at least several times per week – leads to a higher transition rate into suicidal ideation for males. We find no evidence that suicidal ideation leads to cannabis use for either males or females. [Copyright &y& Elsevier]

The purpose of this paper is to provide a descriptive profile of the personal characteristics and socio-economic circumstances of a cohort of young parents (N = 155) who had full-time care of at least one dependent child at 25 years of age. In addition, we investigated the extent to which these families were faced with material hardship and adverse living conditions, and examined the life-course pathways and concurrent risk factors that place young families at elevated risk of material hardship. Employing longitudinal data from the Christchurch Health and Development Study, the results showed that around one in five of these young families were experiencing moderate to severe material hardship. Higher levels of material hardship were predicted by a range of antecedent and concurrent life-course experiences, including family socio-economic status in childhood, mental health problems in adolescence, family structure, and employment- and income-related factors in young adulthood. These findings are discussed in light of current social and economic policy for income maintenance, employment facilitation and welfare reduction. [ABSTRACT FROM AUTHOR]