Articles
Life Course Outcomes of Young People With Anxiety Disorders in Adolescence

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ABSTRACT

Objective

This study examined associations between the extent of anxiety disorder in adolescence (14–16 years) and young people's later risks of a range of mental health, educational, and social role outcomes (16–21 years).

Method

Data were gathered over the course of a 21-year longitudinal study of a birth cohort of 1,265 New Zealand children. Measures collected included (1) an assessment of DSM-III-R anxiety disorders between the ages of 14 and 16 years; (2) assessments of mental health, educational achievement, and social functioning between the ages of 16 and 21 years; and (3) measures of potentially confounding social, family, and individual factors.

Results

Significant linear associations were found between the number of anxiety disorders reported in adolescence and later risks of anxiety disorder; major depression; nicotine, alcohol, and illicit drug dependence; suicidal behavior; educational underachievement; and early parenthood. Associations between the extent of adolescent anxiety disorder and later risks of anxiety disorder, depression, illicit drug dependence, and failure to attend university were shown to persist after statistical control for the confounding effects of sociofamilial and individual factors.

Conclusions

Findings suggest that adolescents with anxiety disorders are at an increased risk of subsequent anxiety, depression, illicit drug dependence, and educational underachievement as young adults. Clinical and research implications are considered.

Section snippets

SUBJECTS

Participants were members of an unselected birth cohort that has been extensively studied as part of the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal study of a birth cohort of 1,265 children (635 males; 630 females) born in the Christchurch, New Zealand urban region during mid-1977. These young people have been studied at birth, 4 months, 1 year, annual intervals to age 16, and again at 18 and 21 years. The analyses reported in this paper were based on a sample

Life Course Outcomes of Anxious Adolescents

Table 1 shows the sample of 964 young people studied to the age of 21 years divided into four groups according to the extent of anxiety disorder in middle adolescence (ages 14–16). These groups included (1) those individuals who did not meet DSM-III-R diagnostic criteria for an anxiety disorder (n = 676), (2) those who met DSM-III-R criteria for one anxiety disorder (n = 201), (3) those who met DSM-III-R criteria for two anxiety disorders (n = 61), and (4) those who met DSM-III-R criteria for

DISCUSSION

In this paper we have used prospective longitudinal data to examine the mental health, educational, and social role outcomes of adolescents with varying severity of anxiety disorders. The results extend our empirical understanding of the longer term effects of adolescent anxiety disorders in several important ways. First, the use of a large, representative sample helped to avoid the difficulties associated with referral bias and poor generalizability. Second, the assessment of a range of

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    This research was funded by grants from the Health Research Council of New Zealand, the National Child Health Research Foundation, the Canterbury Medical Research Foundation, and the New Zealand Lottery Grants Board.

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