Associations between conduct problems in childhood and adverse outcomes in emerging adulthood: a longitudinal Swedish nationwide twin cohort
Author(s) -
Lichtenstein Paul,
Cederlöf Martin,
Lundström Sebastian,
D'Onofrio Brian M.,
Anckarsäter Henrik,
Larsson Henrik,
Pettersson Erik
Publication year - 2020
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.13169
Subject(s) - psychology , conduct disorder , comorbidity , twin study , cohort , risk factor , psychiatry , injury prevention , cohort study , poison control , young adult , protective factor , clinical psychology , developmental psychology , medicine , genetics , environmental health , pathology , heritability , biology
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 (β boys = .24, standard error, SE = 0.03; β girls = .17, SE = 0.03), above and beyond its association with the externalizing (β boys = 0.21, SE = 0.04; β girls = 0.17, SE = 0.05) and general factors (β boys = 0.45, SE = 0.03; β 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.