Childhood conduct problems may predict depression among young adults

Preadolescents who reported high levels of conduct problems were nearly four times as likely to have experienced an episode of depression in early adulthood than were children who reported low rates of conduct problems, according to a new University of Washington study. The research published in the Journal of the American Academy of Child and Adolescent Psychiatry looked at possible links between early childhood behavior problems and depression, violence and social phobia at age 21.

The study collected data on children when they were 10 or 11 years old and again a decade later. It found that 20 percent of them had suffered from depression in the previous year as young adults and 21 percent had committed two or more violent acts. Seventeen percent experienced social phobia, an anxiety disorder marked by an unreasonable fear of social situations involving strangers, of being judged in such settings and avoiding those kinds of situations. In some cases, the young people in the study met the criteria for two or all three of these disorders.

The study also showed that early conduct problems were a strong predictor of later violence. Children who reported report high levels of such problems at ages 10 or 11 were three and a half times more likely to have engaged in violent behavior at 21 than those who reported low levels of conduct problems. "The finding that children who have conduct problems are more likely to show later violent behavior isn't surprising, but the discovery that they are more likely to experience depression is," said J. David Hawkins, one of the study's authors, director the UW's Social Development Research Group and a professor of social work.

"This is important because we now have a clear behavioral predictor of future depression -- conduct problems in childhood. If we can reduce conduct problems in childhood, and there is clear evidence from research that we can, we should be able to prevent violence and depression in adulthood. By identifying this behavioral marker in young people at risk for these future disorders, we can focus preventive interventions on those at greatest risk by virtue of childhood conduct problem."

The study used data from the on-going Seattle Social Development Project of more than 800 Seattle school children who are now adults. Half the subjects are male and half are female. Forty-seven percent identified themselves as white, 23 percent as black, 21 percent as Asian Americans, 6 percent as American Indian and 3 percent as being from another ethnic or racial group. When the children were in the fifth grade, their emotional and behavioral problems were assessed by their parents and teachers, and the children themselves. Eleven years later, when they averaged slightly more than 21 years of age, they were surveyed about depression, social phobia and violent behavior. Analysis of the data also showed that: 

Women were significantly more likely to report depression, while men reported more violent behavior at age 21.

There was no gender difference in reporting social phobia.

Blacks from low-income backgrounds were more likely than whites to report violent behavior.

Asian Americans from low-income backgrounds were significantly more likely to meet the criteria for social phobia at 21.

Self-reported shyness at 10 or 11 was associated with increased chances of social phobia at 21. It also reduced the odds of engaging in later violence.

While data from parents, teachers and the children about conduct problem forecast later violence, the most consistent predictor of all the age 21 disorders studied was the self-reported data from children on conduct problems at 10. The predictive power of children's own reports about their behavior at age 10 emphasizes the need for adults to listen to children more closely, according to Hawkins. "Children know what's happening to them. When they know their answers are confidential and think you will listen to them, young people are quite candid and honest," he said. "We need to create more openings where kids feel they can be heard."

The research was funded by the National Institute of Mental Health, the National Institute on Drug Abuse and the Robert Wood Johnson Foundation. Co-authors of the paper include the UW's Social Development Research Group members Alex Mason, a research analyst; Richard Kosterman, a research scientist; and Todd Herrenkohl, who is also an assistant professor of social work. Other co-authors are Liliana Lengua, associate psychology professor, and Elizabeth McCauley, associate professor of psychiatry and behavioral sciences.