Peter M. Lewinsohn's research while affiliated with Oregon Research Institute and other places

Publications (277)

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Background The long‐term trajectory of depressive symptoms has a heterogeneous pattern. Identifying factors associated with different trajectories and outcomes may have important theoretical and clinical implications. This study explored patterns of depressive symptom trajectory from adolescence to adulthood, and their relationship with subsequent...
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Objective: We investigated associations between the number of parents with histories of alcohol use disorder (AUD) and several offspring (proband) variables through age 30: occurrence of AUD and, separately, alcohol dependence; onset age of the initial AUD episode; time to recovery from the first AUD episode; number of distinct AUD episodes; and c...
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This study evaluated the risk for alcohol use disorders (AUDs) among first-degree relatives depending on whether a specific family member (proband) had an AUD history. For probands with AUD histories, we also evaluated whether certain clinical features were associated with higher rates of AUDs in family members as a means for identifying markers th...
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Background: There is considerable evidence that pre- and post-natal factors are associated with a wide range of psychopathology in offspring during childhood and adolescence. Objective: The main aims of the present study were to examine the associations between pre- and perinatal factors and psychopathology in offspring during adulthood, and to...
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Background: Anxiety disorders are common in childhood, adolescence, and adulthood, and frequently comorbid with other mental disorders. Objective: The main aim of the present study was to examine the incidence, recurrence and comorbidity rates of anxiety disorders across four developmental periods, namely, during childhood (5 - 12.9 years), adol...
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Numerous studies have focused on characterizing personality differences between individuals with and without psychopathology. For drawing valid conclusions for these comparisons, the personality instruments used must demonstrate psychometric equivalence. However, we are unaware of any studies that examine measurement invariance in personality acros...
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Objective: Emotional disorders and alcohol use disorders (AUDs) frequently demonstrate significant 12-month and lifetime comorbid associations. This comorbidity has been incorporated into influential theories of addiction processes that posit direct or indirect causal associations between these disorder categories. There is currently no consensus,...
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Aims: To estimate cannabis use disorder (CUD) trajectory classes from ages 14 to 30 years and compare classes on clinical characteristics, risk factors and psychosocial outcomes. Design: Four waves (T1-T4) of data from an epidemiological study of psychopathology among a regionally representative sample. Trajectory classes described risk for CUD...
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Background: The developmental pathways associated with an enhanced risk for future alcohol use disorders (AUDs) continue to be a topic of both interest and debate. In this research, internalizing and externalizing disorders were evaluated as prospective predictors of the index AUD episode onset, separately within three developmental periods: early...
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Risk factors for the development of cannabis use disorders (CUDs) have been well-researched. Comparatively little is known, however, about factors associated with the persistence of CUDs over time. This research explored whether the temporal sequencing of comorbid psychiatric disorders in relation to the onset of the index CUD episode were associat...
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The kindling hypothesis for depression predicts that with more recurrences, the interval between successive recurrences decreases. Studies with unipolar and bipolar samples generally have been consistent with this premise. However, previous research is subject to a statistical artifact. Slater's fallacy maintains that these intermorbid intervals ap...
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Risk-related liabilities associated with the development of cannabis use disorders (CUDs) during adolescence and early adulthood are thought to be established well before the emergence of the index episode. In this study, internalizing and externalizing psychopathology from earlier developmental periods were evaluated as risk factors for CUDs durin...
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We investigated the risk of cannabis use disorder (CUD) among probands as a function of parental psychopathology and explored parent-offspring gender concordance as a mechanism of parental CUD transmission to offspring. Four waves of data collection from a longitudinal epidemiological study of psychopathology among a regionally representative sampl...
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Background: Despite its importance as a public health concern, relatively little is known about the natural course of cannabis use disorders (CUDs). The primary objective of this research was to provide descriptive data on the onset, recovery and recurrence functions of CUDs during the high-risk periods of adolescence, emerging adulthood and young...
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Background Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were associated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (object...
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Background There have been mixed findings on the temporal relation between anxiety disorders and alcohol use disorders (AUDs), suggesting that the pathway to AUDs may differ among individuals. The aim of the current study was to test whether parental support moderated the association between anxiety disorders and the development of AUDs. We also te...
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Background The presence of subthreshold depressive symptoms (SubD) in adolescence is associated with high prospective risk of developing Major Depressive Disorder (MDD). Little is known about variables that predict escalation from SubD to MDD. This study used a longitudinal prospective design in a community sample of adolescents to identify combina...
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Background: There is a growing awareness that the treatment of patients with substance use disorders (SUDs) should target increasing patients' involvement in alternative pleasant reinforcers that compete with the reinforcing effects of substance use. The present cross-sectional study sought to identify factors that promote or impede engaging in pl...
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Anxiety disorders are associated with adverse psychosocial functioning, and are predictive of a wide range of psychiatric disorders in adulthood. The present study examined the associations between anxiety disorders during childhood and adolescence and psychosocial outcomes at age 30, and sought to address the extent to which psychopathology after...
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This article summarizes characteristics of major depressive disorder (MDD) in the Oregon Adolescent Depression Project, using data from 816 participants (56% female; 89% White). Contrasting four developmental periods (childhood, 5.0–12.9 years of age; adolescence, 13.0–17.9; emerging adulthood, 18.0–23.9; adulthood, 24–30), we examine MDD incidence...
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Postpartum depression (PPD)-the most common complication of childbirth-is a significant and prevalent public health problem that severely disrupts family interactions and can result in serious lasting consequences to the health of women and the healthy development of infants. These consequences increase in severity when left untreated; most women w...
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Limited information exists regarding the long-term development of comorbidity between Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD; abuse/dependence). Using a representative prospective study, we examine multiple aspects pertaining to MDD+AUD comorbidity, with a focus on the relation between disorders across periods (adolescence, e...
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The study of dyadic interaction plays a major role in infancy research. To advance conceptually-informed measurement of dyadic interaction and integration across studies, we examined factor structure of individual parents' and infants' measures and dyadic measures from face-to-face interactions in two samples of 6-mo-old infants and their parents:...
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Background: The aim of this study was to examine the prospective relationship between a history of attention-deficit/hyperactivity disorder (ADHD) assessed in mid-adolescence and the onset of major depressive disorder (MDD) through early adulthood in a large school-based sample. A secondary aim was to examine whether this relationship was robust af...
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Item response theory (IRT) methods allow for comparing the utility of instruments based on the range and precision of severity assessed by each instrument. As adolescents and young adults can display rapid increases in depressive symptoms, there is a crucial need to sensitively assess mild elevations of symptoms (as an index of initial risk) and mo...
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Many individuals who experience a major depressive episode will subsequently develop recurrent episodes. Although numerous studies have investigated predictors of recurrent episodes, methodological limitations have made it difficult to determine the extent to which liability to recurrent major depressive disorder (rMDD) exists prior to first onset...
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Little is known about the psychosocial circumstances under which children develop excessive body mass. A community sample was followed up from age 2-10 years to determine which early problems were predictive of increased body mass index. Hypothesized mediators (i.e. eating habits, physical activity, and "screen time") were also examined. After cont...
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Objective: More than 50% of mothers of children with attention-deficit/hyperactivity disorder (ADHD) have a lifetime history of major depressive disorder (MDD). Maternal depressive symptoms are associated with impaired parenting and predict adverse developmental and treatment outcomes for children with ADHD. For these reasons, we developed and exa...
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Background: The aim of this study was to examine the prospective relationship between a history of attention-deficit/hyperactivity disorder (ADHD) assessed in mid-adolescence and the onset of major depressive disorder (MDD) through early adulthood in a large school-based sample. A secondary aim was to examine whether this relationship was robust a...
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Longitudinal data from representative birth cohorts on the aggregation of psychiatric disorders, or the cumulative number of unique diagnosed disorders experienced by persons within a circumscribed period, are limited. As a consequence, risk factors for and psychosocial implications of lifetime disorder aggregation in the general population remain...
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There is a dearth of prospective information regarding adolescent precursors of borderline personality disorder (BPD). This study aimed to determine the unique associations between early maladaptive family functioning, parental psychiatric diagnoses, proband early onset psychiatric diagnosis, and BPD symptoms in adulthood using an existing longitud...
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The aim of this study was to investigate the potential role of youth smoking, parental cigarette smoking and parental anxiety/depressive disorders in the relationship between respiratory symptoms and mental health problems among youth. Adjusting for both parental smoking and parental anxiety/depressive disorders in the association between respirato...
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Hierarchical models of psychopathology based on substantial numbers of lifetime diagnostic categories have not been sufficiently evaluated, even though such models have relevance for theories of disorder etiology, course, or prognosis. In this research, a hierarchical component model of 16 Axis I disorders is derived, and model elements are evaluat...
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Background Postpartum depression is a significant public health problem affecting approximately 13% of women. There is strong evidence supporting Cognitive Behavioral Therapy (CBT) for successful psychosocial treatment. This treatment model combines cognitive and behavioral strategies to address pessimism, attributions for failure, low self-esteem,...
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Despite the considerable amount of research demonstrating the relationship between parental depressive symptoms and child behavior problems, few studies have examined the direction of the relationship between these variables. Therefore, the purpose of this study was to examine transactional effects between parental depressive symptoms and child beh...
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Background: Depressive symptoms display heterogeneous trajectories across adolescence and early adulthood. Identifying risk and protective factors for distinct trajectory groups, and their respective outcomes, may provide insight into the etiological underpinnings of different symptom courses and inform the targets and timing of intervention. Met...
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Background: Previous research has demonstrated that depression and family history of illicit substance use disorders (ISUDs) are risk factors for the development of ISUDs. However, no study to date has examined whether these risk factors interact to predict onset. In addition, history of parental and sibling ISUDs have been identified as risk fact...
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The first onset of major depressive disorder (MDD) most frequently occurs in young adulthood. However, few studies have examined predictors of first lifetime MDD during this high-risk period. The present study examined a broad range of demographic, clinical, and psychosocial variables as prospective predictors of first onset of MDD in a large commu...
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Lifetime prevalence rates of psychopathology vary a great deal depending on whether they are estimated from cross-sectional or prospective longitudinal studies, with the former yielding significantly lower rates. Such findings, however, come from comparisons of separate studies from different countries and cohorts. Here, we compare lifetime rates o...
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Objective: Develop and pilot an Internet-facilitated cognitive-behavioral treatment intervention for depression, tailored to economically disadvantaged mothers of young children. Method: Mothers (N = 70) of children enrolled in Head Start, who reported elevated levels of depressive symptoms, were randomized to either the 8-session, Internet-faci...
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Individuals with a psychiatric disorder are significantly more likely to have a spouse with a clinical diagnosis--marital concordance. We used a community sample of 304 couples concordant for either major depressive disorder (MDD) or substance use disorders (SUDs) to examine the relationship between marital functioning and gendered patterns of ment...
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Evaluations of assessment instruments using classical test theory typically rely on indices of internal consistency, test-retest reliability, and construct validity. However, the use of models from item response theory (IRT) allows comparison of instruments (and items) in terms of the information they provide and where they provide it along the con...
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Prior studies have demonstrated that events causing displacement from parents--such as parental death, abandonment of the adolescent, or divorce--represent a risk factor for adolescent suicide, but research to date has not established a theoretical model explaining the association between parental displacement and adolescent suicidal behavior. The...
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Several recent studies using factor analytic methods find that the structure of psychopathology reflects broad internalizing and externalizing dimensions, with the internalizing dimension being further divided into fear and distress disorders. Although these variable-centered studies have provided important insights into the structure of psychopath...
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Major depressive disorder (MDD) and anxiety disorders (ANX) are debilitating and prevalent conditions that often co-occur in adolescence and young adulthood. The leading theoretical models of their co-morbidity include the direct causation model and the shared etiology model. The present study compared these etiological models of MDD-ANX co-morbidi...
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Two broadband latent factors--internalizing and externalizing--have frequently been identified in studies of the hierarchical structure of psychopathology. In the present research, 3 competing measurement models of putative internalizing disorders (i.e., a parsimonious single-factor model, a model based on the Diagnostic and Statistical Manual of M...
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The concomitant influence of grandparental (Generation 1; G1) and parental (G2) substance use disorder (SUD) on grandchild (G3) emotional disorder (EmD) across three generations is unclear. The present study addressed this in a sample of 284 families participating in the Oregon Adolescent Depression Project. Structured clinical interviews were used...
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Longitudinal trajectories of depressive symptoms, perceived support from family, and perceived support from friends were examined among 816 emerging adults (480 women; 59%). In the context of a larger longitudinal investigation on the predictors and course of depression, data were drawn from eight self-report questionnaire assessments that roughly...
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There is ample evidence for female preponderance of major depressive disorder (MDD) in adolescence and adulthood. This study examined gender differences in the developmental course (i.e., incidence, duration, number of depressive episodes, and recovery rates) of MDD in non-referred adolescents and young adults. Data from the Oregon Adolescent Depre...
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Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar...
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Stress generation and stress exposure models of the relations among depressive symptoms, minor hassles, and major event stress were investigated among 815 community-dwelling participants. Autoregressive latent trajectory models were constructed to examine latent growth patterns from ages 15 years to 30 years and to test 1-year lagged, reciprocal pa...
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The clinical benefit for depression of an interactive computer-assisted cognitive-behavioral program on CD-ROM, the Wellness Workshop (WW), was evaluated in a randomized controlled trial. A total of 191 individuals referred by primary-care physicians were randomly assigned to a control group, where physician-directed treatment as usual (TAU) was pr...
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The purpose of this study was to examine the effect of maternal depression during the child's first year of life (i.e., sensitive period) on subsequent behavior problems. Participants were 175 mothers participating in the Oregon Adolescent Depression Project (OADP) who met lifetime diagnostic criteria for major depressive disorder (MDD) and complet...
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This study used person-oriented analyses to identify subgroups of individuals who exhibit different patterns of depressive and anxiety disorders over the course of adolescence and young adulthood. Using latent class growth analysis, six trajectory classes were identified. Two classes were mainly characterized by depressive disorders; one class was...
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The past decade has witnessed a resurgence of interest in behavioral interventions for depression. This contemporary work is grounded in the work of Lewinsohn and colleagues, which laid a foundation for future clinical practice and science. This review thus summarizes the origins of a behavioral model of depression and the behavioral activation (BA...
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This paper describes the development of a new 139-item behavioral questionnaire (PAL) assessing the frequency and enjoyability of pleasant activities occurring in the natural environment of patients with substance use disorders. The sample consisted of 265 patients with mainly substance use disorders and 272 healthy controls. Group comparisons indi...
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This study examined the temporal sequencing of eating and anxiety disorders to delineate which anxiety disorders increase eating disorder risk and whether individuals with eating disorders are at greater risk for particular anxiety disorders. The sample was drawn from the Oregon Adolescent Depression Project. Temporal relations between specific eat...
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Research on hierarchical modeling of psychopathology has frequently identified 2 higher order latent factors, internalizing and externalizing. When based on the comorbidity of psychiatric diagnoses, the externalizing domain has usually been modeled as a single latent factor. Multivariate studies of externalizing symptom features, however, suggest m...
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Subthreshold depressive disorder is one of the best established risk factors for the onset of full-syndrome depressive disorders. However, many youths with subthreshold depressive disorder do not develop full-syndrome depression. We examined predictors of escalation to full-syndrome depressive disorders in a community sample of 225 adolescents with...
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There has been increasing interest in the distinction between subthreshold and full syndrome disorders and specifically whether subthreshold conditions escalate or predict the onset of full syndrome disorders over time. Most of these studies, however, examined whether a single subthreshold condition escalates into the full syndrome form of that dis...
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The “Coping with Depression” course (CWD) is by the far the best studied psychoeducational intervention for the treatment and prevention of depression, and is used in routine practice in several countries. The CWD is a highly structured cognitive-behavioral intervention, which has been adapted for several goals, contexts, and target populations. Th...
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The present study prospectively evaluated cannabis use, abuse, and dependence in relation to the development of panic attacks and panic disorder. Participants at the start of the study were adolescents (n=1709) with a mean age of 16.6 years (SD=1.2; time 1) and were re-assessed 1 year later (time 2) and then again as young adults (time 3; mean age=...
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Research on the long-term course of major depressive disorder (MDD) is hindered by the absence of established course criteria and by idiosyncratic definitions of chronicity. The aims of this study were to derive an empirical index of MDD course, to examine its predictive validity, and to identify the adulthood outcomes associated with a chronic cou...
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Major depressive disorder (MDD) is phenomenologically heterogeneous, which has prompted investigation of intermediate MDD phenotypes based on specific key symptoms. Presence and type of psychomotor disturbance may be an important psychopathologic feature that differentiates clinically distinct forms of juvenile MDD. This study examined the phenotyp...
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Effects of lifetime histories of grandparental (G1) and parental (G2) major depressive disorder (MDD) on children's (G3) internalizing problems were investigated among 267 G3 children (ages 2-18 years) who received Child Behavior Checklist (CBCL) ratings and had diagnostic data available on 267 biological G2 parents and 527 biological G1 grandparen...
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At least five symptoms must occur for a DSM diagnosis of major depressive disorder (MDD), one of which must be sadness or anhedonia. The present study is the first known investigation of the implications of the presence or absence of these prioritized symptoms on symptom expression and clinical characteristics among 564 young adults with MDD. Diffe...
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To ascertain the extent to which childhood separation anxiety disorder (SAD) confers risk for the development of psychopathology during young adulthood (ages 19-30). A subset of the participants of the Oregon Adolescent Depression Project (n = 816) was used. Subjects provided retrospective reports of lifetime mental illness (including SAD) and conc...
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Most previous studies of the depression-mortality association have not examined distinct depressive symptom clusters. This ex post facto study examined which aspects of depression may account for its association with mortality. The Center for Epidemiologic Studies Depression Scale (CES-D) was administered to 3,867 community dwelling adults. Cox pro...