Psychopathology and adversities from early- to late-adolescence: a general population follow-up study with the CBCL DSM-Oriented Scales

Abstract

Aims. Adolescence is a critical transition phase between childhood and adulthood, when the burden of mental disorder may still be prevented. The aim of this study was to evaluate the continuity and discontinuity of behavioural problems in adolescence while taking into account the multiple co-variation of psychopathological traits and the complex role of recent stressful life events (SLEs). Methods. This is a 5-year follow-up investigation of emotional and behavioural problems assessed by the newly developed Child Behavior Checklist (CBCL) DSM-Oriented Scales (DOSs) in 420 general population subjects aged 15-19 years. Results. The DOSs showed good stability, even when multiple co-variation was taken into account. Longitudinal data showed that homotypic evolution of psychopathology was to be expected in the first place. Equifinality and multifinality were also found. Oppositional Defiant Problems emerged to be polyvalent predictors of both internalizing and externalizing problems. Furthermore, Oppositional Defiant Problems predicted more SLEs, which in turn predicted more Depression, Anxiety and Oppositional Defiant Problems. Mediational analyses confirmed the role of SLEs in partially accounting for the continuity of Oppositional Defiant Problems and for the heterotypic progression towards Affective Problems. Conclusions. These data underscore early adolescence behavioural problems as an important focus for primary and secondary intervention.

Fig. 1.

Mediational analysis. Step (a) represents the direct effect of CBCL DOS z scores at W1 on CBCL DOS z scores at W2; step (b) represents the direct effect of CBCL DOS scores at W1 on number of recent SLEs; step (c) represents the association of SLEs with DOS at W2. Step (d) and β′ represents the effect of CBCL DOS scores at W1 after recent SLEs were added to the model. All steps were conducted controlling for other psychopathologies at W1 and gender. For all regression analysis β values and significance level (*p < 0.05; **p < 0.01; ***p < 0.001) are reported.