Adrian Angold's research while affiliated with Duke University Medical Center and other places

Publications (209)

Article
Objective: The prevalence of depression increases dramatically during puberty in girls. Earlier work in this sample reported that the sex steroids estradiol and testosterone were associated with increased depression in girls. Using three additional data waves (983 new observations), we retest the relative contributions of pubertal timing, pubertal...
Article
Full-text available
Aims: To describe the Great Smoky Mountains Study (GSMS). Methods: GSMS is a longitudinal study of child psychiatric disorders that began in 1992 to look at need for mental health services in a rural area of the USA. Over 20 years it has expanded its range to include developmental epidemiology more generally, not only the development of psychiat...
Chapter
Introducing epidemiology as the study of health and illness in human populations, we discuss what questions modern epidemiology addresses, the key methods it uses, and how these methods can be applied to developmental psychopathology. A short history of how child psychiatric epidemiology has grown into developmental epidemiology illustrates society...
Article
We examined the clinical significance of moderate and severe selective eating (SE). Two levels of SE were examined in relation to concurrent psychiatric symptoms and as a risk factor for the emergence of later psychiatric symptoms. Findings are intended to guide health care providers to recognize when SE is a problem worthy of intervention. A popul...
Article
Full-text available
The public health burden of alcohol is unevenly distributed across the life course, with levels of use, abuse, and dependence increasing across adolescence and peaking in early adulthood. Here, we leverage this temporal patterning to search for common genetic variants predicting developmental trajectories of alcohol consumption. Comparable psychiat...
Article
Full-text available
In this prospective, longitudinal study of young children, we examined whether a history of preschool generalized anxiety, separation anxiety, and/or social phobia is associated with amygdala-prefrontal dysregulation at school-age. As an exploratory analysis, we investigated whether distinct anxiety disorders differ in the patterns of this amygdala...
Article
Full-text available
Objective: During the transition to adulthood, youths face challenges that may limit their likelihood of obtaining services for psychiatric problems. The goal of this analysis was to estimate changes in rates of service use and untreated psychiatric disorders during the transition from adolescence to adulthood. Methods: In a prospective, populat...
Article
Full-text available
Objective: Living with food allergy is a unique and potentially life-threatening stressor that requires constant vigilance to food-related stimuli, but little is known about whether adolescents with food allergies are at increased risk for psychopathology-concurrently and over time. Methods: Data came from the prospective-longitudinal Great Smok...
Article
We tested whether sleep problems co-occur with, precede, and/or follow common psychiatric disorders during childhood and adolescence. We also clarified the role of comorbidity and tested for specificity of associations among sleep problems and psychiatric disorders. Data came from the Great Smoky Mountains Study, a representative population sample...
Article
Full-text available
Objective: Disruptive mood dysregulation disorder (DMDD) is a new disorder for DSM-5 that is uncommon and frequently co-occurs with other psychiatric disorders. Here, the authors test whether meeting diagnostic criteria for this disorder in childhood predicts adult diagnostic and functional outcomes. Method: In a prospective, population-based st...
Article
Full-text available
We examined the perceived impact of child anxiety disorders on family functioning, because such impact is a key predictor of mental health service receipt. In addition, we examined the relative impact of preschool anxiety compared to that of other early childhood disorders, and whether this impact persisted after accounting for the effects of comor...
Article
Full-text available
The aims of this study were 2-fold: to provide a brief introduction to the prospective longitudinal Great Smoky Mountains Study and review recent findings; and to use this sample to conduct an epidemiologic analysis of common childhood anxiety disorders. The population-based Great Smoky Mountains Study assessed 1,420 participants from 11 counties i...
Article
Full-text available
We sought to establish prevalence rates and detail patterns of comorbidity for generalized anxiety disorder, separation anxiety disorder, and social phobia in preschool-aged children. The Duke Preschool Anxiety Study, a screen-stratified, cross-sectional study, drew from pediatric primary care and oversampled for children at risk for anxiety. A tot...
Article
Full-text available
Objective: Comorbidity between psychiatric disorders is common, but pairwise associations between two disorders may be explained by the presence of other diagnoses that are associated with both disorders or “indirect” comorbidity. Materials and Methods: Comorbidities of common childhood psychiatric disorders were tested in three community samples o...
Article
Full-text available
Dysregulated immune function and elevated inflammation markers are seen in adults with chronic diseases, including some psychiatric disorders, but evidence on inflammation in the case of drug abuse is conflicting. To test the concurrent and predictive relations between C-reactive protein (CRP) and use and abuse of alcohol, nicotine and cannabis in...
Article
Full-text available
Bullying is a serious problem for schools, parents, and public-policymakers alike. Bullying creates risks of health and social problems in childhood, but it is unclear if such risks extend into adulthood. A large cohort of children was assessed for bullying involvement in childhood and then followed up in young adulthood in an assessment of health,...
Article
To test whether children and adolescents with co-occurring asthma and depression are at risk for elevated inflammation-concurrently and at the next assessment. Up to 6 yearly assessments per person from the prospective, population-based Great Smoky Mountains Study (N = 1420) were used, covering children in the community aged 10-16 years old. High-s...
Article
Full-text available
DSM-IV grants episodic irritability an equal status to low mood as a cardinal criterion for the diagnosis of depression in youth, yet not in adults; however, evidence for irritability as a major criterion of depression in youth is lacking. This article examines the prevalence, developmental characteristics, associations with psychopathology, and lo...
Article
Full-text available
Background: Sex differences in levels of C-reactive protein (CRP) are well established in adulthood, but little is known about when and why they emerge. Here, we tested longitudinal models of CRP levels from ages 9 to 21, when marked physical and behavioral changes could contribute to growing sex disparities in CRP. Methods: Data from the commun...
Article
We investigate the effect of household cash transfers during childhood on young adult body mass indexes (BMI). The effects of extra income differ depending on the household's initial socioeconomic status (SES). Children from the initially poorest households have a larger increase in BMI relative to children from initially wealthier households. Seve...
Article
Full-text available
The importance of including developmental and environmental measures in genetic studies of human pathology is widely acknowledged, but few empirical studies have been published. Barriers include the need for longitudinal studies that cover relevant developmental stages and for samples large enough to deal with the challenge of testing gene-environm...
Article
Background Quantifying diagnostic transitions across development is needed to estimate the long-term burden of mental illness. This study estimated patterns of diagnostic transitions from childhood to adolescence and from adolescence to early adulthood.Methods Patterns of diagnostic transitions were estimated using data from three prospective, long...
Article
Full-text available
Importance Both bullies and victims of bullying are at risk for psychiatric problems in childhood, but it is unclear if this elevated risk extends into early adulthood. Objective To test whether bullying and/or being bullied in childhood predicts psychiatric problems and suicidality in young adulthood after accounting for childhood psychiatric prob...
Article
Full-text available
Objective: No empirical studies on the DSM-5 proposed disruptive mood dysregulation disorder have yet been published. This study estimated prevalence, comorbidity, and correlates of this proposed disorder in the community. Method: Prevalence rates were estimated using data from three community studies involving 7,881 observations of 3,258 partic...
Article
To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) ("respondent-based"), the Child and Adolescent Psychiatric Assessment (CAPA) ("interviewer-based"), and the Development and Well-Being Assessment (DAWBA) ("expert judgment"). Roughly equal numbers of males and females of wh...
Article
Full-text available
Background: Generalized anxiety disorder (GAD) is highly co-morbid with depression. Depression is associated with elevated levels of the inflammation marker C-reactive protein (CRP), cross-sectionally and over time. To date, no studies have looked at the association between CRP and GAD. Method: A total of nine waves of data from the prospective...
Article
This chapter has covered a lot of ground; from the first stirrings of understanding about childhood psychiatric disorders to the possibility of using molecular genetics to identify gene–environment interactions that can generate psychiatric disorder. There are fuzzy boundaries between epidemiology and developmental psychopathology, life course epid...
Article
  Many disorders in childhood and adolescence were already present in the preschool years. However, there is little empirical research on the prevalence of psychiatric disorders in young children. A true community study using structured diagnostic tools has yet to be published.   All children born in 2003 or 2004 in the city of Trondheim, Norway, w...
Article
Full-text available
Rates of alcohol disorders peak in late adolescence and decrease substantially into the mid-20s. Our aim was to identify risk factors that predict alcohol problems that persist into the mid-20s. Data are from the prospective, population-based Great Smoky Mountains Study (GSMS; n=1420), which followed children through late adolescence and into young...
Article
Full-text available
Depression is associated with elevated levels of the inflammation marker C-reactive protein (CRP); yet, the direction of this association remains unclear. This study tested bi-directional longitudinal associations between CRP and depression in a sample of adolescents and young adults. The study compared the effect of current depression with the eff...
Article
With the emergence of new technologies, there has been an explosion of basic and clinical research on the affective and cognitive neuroscience of face processing and emotion perception. Adult emotional face stimuli are commonly used in these studies. For developmental research, there is a need for a validated set of child emotional faces. This pape...
Article
Little is known about changes in the prevalence of psychiatric disorders between childhood and adolescence, and adolescence and adulthood. We reviewed papers reporting prevalence rates of psychiatric disorders separately for childhood, adolescence, and early adulthood. Both longitudinal and cross-sectional papers published in the past 15 years were...
Article
Full-text available
Previous research reported that childhood adversity predicts juvenile- onset but not adult-onset depression, but studies confounded potentially genuine differences in adversity with differences in the recency with which adversity was experienced. The current study paper took into account the recency of risk when testing for differences among child-...
Article
No longitudinal studies beginning in childhood have estimated the cumulative prevalence of psychiatric illness from childhood into young adulthood. The objective of this study was to estimate the cumulative prevalence of psychiatric disorders by young adulthood and to assess how inclusion of not otherwise specified diagnoses affects cumulative prev...
Chapter
In this chapter we (1) lay out a definition of development as it relates to psychopathology; (2) make the case that nearly all psychiatric disorders are ‘‘developmental’’; and (3) examine, with some illustrations, methods from developmental research that can help to identify causal mechanisms leading to mental illness. The philosopher Ernst Nagel (...
Article
Full-text available
Most teenage fears subside with age, a change that may reflect brain maturation in the service of refined fear learning. Whereas adults clearly demarcate safe situations from real dangers, attenuating fear to the former but not the latter, adolescents' immaturity in prefrontal cortex function may limit their ability to form clear-cut threat categor...
Article
Full-text available
Variation in the μ-opioid receptor gene has been associated with early social behavior in mice and rhesus macaques. The current study tested whether the functional OPRM1 A118G predicted various indices of social relations in children. The sample included 226 subjects of self-reported European ancestry (44% female; mean age 13.6, SD=2.2) who were pa...
Article
In this chapter we review the prevalence and comorbidity of anxiety disorders in general, and where possible the specifics of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), specific phobias, panic, social phobia, and panic disorder. There were too few reports of agoraphobia to make a reliable estimate. We have not included p...
Article
Full-text available
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) specifies a developmental relationship between oppositional defiant disorder (ODD) and conduct disorder (CD). Evidence for this link is mixed, however, and recent studies suggest that different symptom dimensions in ODD may have d...
Article
To examine potential differences in psychiatric symptoms between parent-bereaved youth (N = 172), youth who experienced the death of another relative (N = 815), and nonbereaved youth (N = 235), aged 11 to 21 years, above and beyond antecedent environmental and individual risk factors. Sociodemographics, family composition, and family functioning we...
Article
Full-text available
Early pubertal timing in girls is associated with psychosocial problems throughout adolescence, but it is unclear whether these problems persist into young adulthood. The authors analyzed outcomes in adolescence and young adulthood in girls in a longitudinal study. The data for this study were from the prospective population-based Great Smoky Mount...
Article
Full-text available
It remains unclear to what degree children show signs of posttraumatic stress disorder (PTSD) after experiencing low-magnitude stressors, or stressors milder than those required for the DSM-IV extreme stressor criterion. A representative community sample of 1,420 children, ages 9, 11, and 13 at intake, was followed annually through age 16. Low-magn...
Article
Full-text available
In a natural experiment in which some families received income supplements, prevalence of adolescent behavioral symptoms decreased significantly. These adolescents are now young adults. To examine the effects of income supplements in adolescence and adulthood on the prevalence of adult psychiatric disorders. Quasi-experimental, longitudinal. A repr...
Article
This article examines family stress dynamics and conduct disorder trajectories prospectively in the lives of adolescents from the Great Smoky Mountains Study of Youth (n = 1,319). Semi-parametric mixture models are used to identify distinct trajectories of conduct disorder, poverty, and family structure. We specify criminogenic features of dynamic...
Article
One of the conceptual difficulties faced by developmental psychopathologists is the plethora of terms for “things that predate the full manifestation of a psychiatric disorder.” We have causes, vulnerabilities, susceptibilities, antecedents, risk factors, exposures, precursors, sub-threshold syndromes, and, of course, prodromes, the subject of this...
Article
The differentiation hypothesis posits that the underlying liability distribution for psychopathology is of low dimensionality in young children, inflating diagnostic comorbidity rates, but increases in dimensionality with age as latent syndromes become less correlated. This hypothesis has not been adequately tested with longitudinal psychiatric sym...
Article
Full-text available
This paper examines how exogenous income transfers during adolescence affect contemporaneous body mass index (BMI) measures and young adult obesity rates using evidence from the Great Smoky Mountains Study of Youth. The effects of extra income differ depending on the households’ initial socio-economic status, tracing out an inverted U-shaped relati...
Article
Full-text available
We examine the role an exogenous increase in household income, due to a government transfer unrelated to household characteristics, plays in children's long-run outcomes. Children in affected households have higher levels of education in their young adulthood and a lower incidence of criminality for minor offenses. Effects differ by initial househo...
Article
Full-text available
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. To establish which childhood and adolescent psychiatric disorders predict particular young adult disorders when accounting for comorbidities, disag...
Article
Full-text available
Adolescents ages 10-15 experience dramatic changes in their biological, cognitive, emotional, and social development as well as in their physical and social environments. These include the physiological and psychological changes associated with puberty; further development of the brain; changes in family, peer, and romantic relationships; and expos...
Article
Full-text available
Anthropologists are beginning to translate insights from ethnography into tools for population studies that assess the role of culture in human behavior, biology, and health. We describe several lessons learned in the creation and administration of an ethnographically-based instrument to assess the life course perspectives of Appalachian youth, the...
Article
Full-text available
Co-occurrence of psychosocial risk factors is commonplace, but little is known about psychiatrically-predictive configurations of psychosocial risk factors. Latent class analysis (LCA) was applied to 17 putative psychosocial risk factors in a representative population sample of 920 children ages 9 to 17. The resultant class structure was retested i...
Article
This chapter reviews methods for studying individual differences across the life course. It starts from the position that even when a life course study is basically observational or descriptive, there is an underlying concern to understand more about causality. There are two aspects of research methods that have to be considered in designing a life...
Article
The last 50 years have witnessed enormous strides in the measurement and classification of child and adolescent psychiatric disorders. Debates about whether we should continue to depend upon a categorical nosology still continue, but we argue that, despite the absence of clear dividing lines between psychiatric disorders and normality and ubiquity...
Article
To examine the association between attention-deficit/hyperactivity disorder symptomatology and parent-reported sleep problems among preschoolers ages 2 to 5 years. A total of 1,073 parents of preschoolers ages 2 to 5 years attending a large pediatric clinic completed the Child Behavior Checklist 1(1/2)-5 years. A stratified probability sample of 19...
Article
. Subjective social status (SSS) is associated with physical and mental health in diverse samples. However, community, cultural, and ethnic influences on SSS are poorly understood, especially among rural and American Indian populations. We aimed to examine similarities and differences in how community poverty, family context, and life course attain...
Article
Full-text available
A vast and often confusing economics literature relates competition to investment in innovation. Following Joseph Schumpeter, one view is that monopoly and large scale promote investment in research and development by allowing a firm to capture a larger fraction of its benefits and by providing a more stable platform for a firm to invest in R&D. Ot...
Article
Full-text available
Numerous developmental changes occur across levels of personal organization (eg, changes related to puberty, brain and cognitive-affective structures and functions, and family and peer relationships) in the age period of 10 to 15 years. Furthermore, the onset and escalation of alcohol use commonly occur during this period. This article uses both an...
Article
Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on risk factor-d...
Article
Identifying the effect of parental incomes on child outcomes is difficult due to the correlation of unobserved ability, education levels and income. Previous research has relied on the use of instrumental variables to identify the effect of a change in household income on the young adult outcomes of the household's children. In this research, we ex...
Article
Few longitudinal studies of child and adolescent psychopathology have examined the links between specific childhood anxiety disorders and adolescent psychiatric disorder. In this paper we test the predictive specificity of separation anxiety disorder (SAD), overanxious disorder (OAD), generalized anxiety disorder (GAD), and social phobia. Data come...