Posted February, 2002

14-Year Prediction of DSM-IV Adult Diagnoses from Childhood CBCL Scores in the Netherlands

Dutch researchers Marijke Hofstra, Jan van der Ende, and Frank Verhulst (2002) tested the ability of CBCL scores obtained on a random sample of 1,578 children to predict diagnoses made from DSM-IV interviews 14 years later, when the participants were 18 to 30 years old. Numerous statistically significant predictive relations were found, many of which differed for men vs. women. For men, significant predictive relations were found between 5 different CBCL syndromes and diagnoses of DSM-IV disruptive disorders (Oppositional Defiant Disorder, Antisocial Personality Disorder, ADHD, and any other disruptive disorder). For females, by contrast, no CBCL syndromes predicted adult disruptive disorders. However, four syndromes predicted women's anxiety disorders (Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, Agoraphobia, Social Phobia, Specific Phobia, and any other anxiety disorder), whereas no syndromes predicted men's anxiety disorders. When the research team controlled for associations among the eight CBCL syndromes, socioeconomic status, and age at initial assessment, the Anxious/Depressed and Delinquent (Rule-Breaking) Behavior syndromes survived as significant predictors of disruptive disorders for men, whereas the Social Problems syndrome survived as a significant predictor of anxiety disorders for women. Even though individual syndromes did not predict disruptive disorders among women, CBCL Externalizing scores strongly predicted women's disruptive disorders (odds ratio = 10.4). This indicated that global Externalizing problem patterns, rather than more specific sets of childhood problems, were forerunners of disruptive disorders among women. Of special interest was the finding that CBCL Internalizing scores and Delinquent Behavior scores were significant predictors of mood disorders (Major Depression, Bipolar Disorder, Dysthymia, any other mood disorder) among men, but that no CBCL scores significantly predicted mood disorders among women. These findings led Hofstra and her colleagues to suggest "that the developmental pathways toward mood disorders in adult males tend to be rooted in earlier problems during childhood, whereas the much more prevalent mood disorders in adult females tend to emerge de novo later in life" (p. 187). Another especially interesting finding was that boys who were deviant on both the Anxious/Depressed and Delinquent Behavior syndromes were at exceptionally high risk for having disruptive disorders in adulthood (odds ratio = 8.0).

Reference: Hofstra, M.B., van der Ende, J., & Verhulst, F.C. (2002). Child and Adolescent Problems Predict DSM-IV Disorders in Adulthood: A 14-year Follow-up of a Dutch Epidemiological Sample. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 182-189.