Prevalence, Persistence, and Sociodemographic Correlates of DSM-IV Disorders in the National Comorbidity Survey Replication Adolescent Supplement

Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
Archives of general psychiatry (Impact Factor: 13.75). 12/2011; 69(4):372-80. DOI: 10.1001/archgenpsychiatry.2011.160
Source: PubMed

ABSTRACT Community epidemiological data on the prevalence and correlates of adolescent mental disorders are needed for policy planning purposes. Only limited data of this sort are available.
To present estimates of 12-month and 30-day prevalence, persistence (12-month prevalence among lifetime cases and 30-day prevalence among 12-month cases), and sociodemographic correlates of commonly occurring DSM-IV disorders among adolescents in the National Comorbidity Survey Replication Adolescent Supplement.
The National Comorbidity Survey Replication Adolescent Supplement is a US national survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents based on face-to-face interviews in the homes of respondents with supplemental parent questionnaires.
Dual-frame household and school samples of US adolescents.
A total of 10,148 adolescents aged 13 to 17 years (interviews) and 1 parent of each adolescent (questionnaires).
The DSM-IV disorders assessed with the World Health Organization Composite International Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Good concordance (area under the receiver operating characteristic curve ≥0.80) was found between Composite International Diagnostic Interview and Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses.
The prevalence estimates of any DSM-IV disorder are 40.3% at 12 months (79.5% of lifetime cases) and 23.4% at 30 days (57.9% of 12-month cases). Anxiety disorders are the most common class of disorders, followed by behavior, mood, and substance disorders. Although relative disorder prevalence is quite stable over time, 30-day to 12-month prevalence ratios are higher for anxiety and behavior disorders than mood or substance disorders, suggesting that the former are more chronic than the latter. The 30-day to 12-month prevalence ratios are generally lower than the 12-month to lifetime ratios, suggesting that disorder persistence is due more to episode recurrence than to chronicity. Sociodemographic correlates are largely consistent with previous studies.
Among US adolescents, DSM-IV disorders are highly prevalent and persistent. Persistence is higher for adolescents than among adults and appears to be due more to recurrence than chronicity of child-adolescent onset disorders.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: To examine how early onset anxiety disorders are related to age of first alcohol use in a general population sample. Discrete time survival analysis was used to model the odds of first alcohol use among those with, vs without, early onset anxiety disorders. Data came from the 2007 Australian National Survey of Mental Health and Wellbeing. After adjusting for the effects of family history of alcohol/drug use, sex, age cohort and education, people who experienced an early onset anxiety disorder had a 27% increased odds of first alcohol use in any given year, when compared to those with no anxiety disorder. This effect was particularly strong for transitions to first alcohol use that occurred after the age of 13 years. Early onset anxiety disorders significantly predict first alcohol use in the general population and this relationship appears to be related to change over time. These results point to the need for developmentally appropriate and integrated prevention programs that target anxiety and alcohol use together. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Journal of anxiety disorders 03/2015; 31. DOI:10.1016/j.janxdis.2015.02.008 · 2.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive theories of depression posit that selective attention for negative information contributes to the maintenance of depression. The current study experimentally tested this idea by randomly assigning adults with Major Depressive Disorder (MDD) to 4 weeks of computer-based attention bias modification designed to reduce negative attention bias or 4 weeks of placebo attention training. Findings indicate that compared to placebo training, attention bias modification reduced negative attention bias and increased resting-state connectivity within a neural circuit (i.e., middle frontal gyrus and dorsal anterior cingulate cortex) that supports control over emotional information. Further, pre- to post-training change in negative attention bias was significantly correlated with depression symptom change only in the active training condition. Exploratory analyses indicated that pre- to post-training changes in resting state connectivity within a circuit associated with sustained attention to visual information (i.e., precuenus and middle frontal gyrus) contributed to symptom improvement in the placebo condition. Importantly, depression symptoms did not change differentially between the training groups-overall, a 40% decrease in symptoms was observed across attention training conditions. Findings suggest that negative attention bias is associated with the maintenance of depression; however, deficits in general attentional control may also maintain depression symptoms, as evidenced by resting state connectivity and depression symptom improvement in the placebo training condition. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Journal of Abnormal Psychology 04/2015; DOI:10.1037/abn0000049 · 4.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD) are among the most commonly diagnosed childhood behavioral health disorders. Although there is substantial evidence of heterogeneity of symptom presentations, DSM diagnoses of CD and ODD are formally diagnosed on the basis of symptom counts without regard to individual symptom patterns. We used unidimensional item response theory (IRT) two-parameter logistic (2PL) models to examine item parameters for the individual symptoms of CD and ODD using data on 6,491 adolescents (ages 13-17) from the National Comorbidity Study: Adolescent Supplement (NCS-A). For each disorder, the symptoms differed in terms of severity and discrimination parameters. As a result, some adolescents who were above DSM diagnostic thresholds for disruptive behavior disorders exhibited lower levels of the underlying construct than others below the thresholds, based on their unique symptom profile. In terms of incremental benefit, our results suggested an advantage of latent trait scores for CD but not ODD.
    Journal of Abnormal Child Psychology 03/2015; DOI:10.1007/s10802-015-0007-x · 3.09 Impact Factor