Publications by authors named "William E Copeland"

76 Publications

Ecological Momentary Assessment of Physical Activity and Wellness Behaviors in College Students Throughout a School Year: Longitudinal Naturalistic Study.

JMIR Public Health Surveill 2022 Jan 4;8(1):e25375. Epub 2022 Jan 4.

Vermont Center for Children, Youth, and Families, Division of Child Psychiatry, University of Vermont, Burlington, VT, United States.

Background: The Wellness Environment app study is a longitudinal study focused on promoting health in college students.

Objective: The two aims of this study were (1) to assess physical activity (PA) variation across the days of the week and throughout the academic year and (2) to explore the correlates that were associated with PA, concurrently and longitudinally.

Methods: The participants were asked to report their wellness and risk behaviors on a 14-item daily survey through a smartphone app. Each student was provided an Apple Watch to track their real time PA. Data were collected from 805 college students from Sept 2017 to early May 2018. PA patterns across the days of the week and throughout the academic year were summarized. Concurrent associations of daily steps with wellness or risk behavior were tested in the general linear mixed-effects model. The longitudinal, reciprocal association between daily steps and health or risk behaviors were tested with cross-lagged analysis.

Results: Female college students were significantly more active than male ones. The students were significantly more active during the weekday than weekend. Temporal patterns also revealed that the students were less active during Thanksgiving, winter, and spring breaks. Strong concurrent positive correlations were found between higher PA and self-reported happy mood, 8+ hours of sleep, ≥1 fruit and vegetable consumption, ≥4 bottles of water intake, and ≤2 hours of screen time (P<.001). Similar longitudinal associations found that the previous day's wellness behaviors independently predicted the following day's higher PA except for mood. Conversely, the higher previous-day PA levels were associated with better mood, more fruit and vegetable consumption, and playing less music, but with higher liquor consumption the next day.

Conclusions: This study provides a comprehensive surveillance of longitudinal PA patterns and their independent association with a variety of wellness and risk behaviors in college students.
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http://dx.doi.org/10.2196/25375DOI Listing
January 2022

Impact of the COVID-19 pandemic on substance use among adults without children, parents, and adolescents.

Addict Behav Rep 2021 Dec 21;14:100388. Epub 2021 Oct 21.

Indiana University, United States.

Impact of the COVID-19 pandemic on alcohol and illicit substance use among adults without children, parents, and adolescents was investigated through two studies with five samples from independent ongoing U.S. longitudinal studies. In Study 1, 931 adults without children, parents, and adolescents were surveyed about the pandemic's impact on personal behavior. 19-25% of adults without children, parents, and adolescents reported an increase in alcohol or illicit substance use. In Study 2, 274 adults without children, parents, and adolescents who had been interviewed prior to the pandemic onset about alcohol and illicit substance use problems were re-interviewed after the pandemic's onset to test within-person change. The rate of alcohol or illicit substance use problems increased from pre-pandemic to post-pandemic onset from 13% to 36% among the three groups. Increase in alcohol and illicit substance use problems was positively correlated with increased depression/anxiety and household disruption, suggesting possible mechanisms for increases in substance problems. Findings in both studies held across low- and middle-income families. Findings suggest the need for communitywide policies to increase resources for alcohol and illicit substance use screening and intervention, especially for adolescents.
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http://dx.doi.org/10.1016/j.abrep.2021.100388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664966PMC
December 2021

Dual methylation and hydroxymethylation study of alcohol use disorder.

Addict Biol 2021 Nov 17:e13114. Epub 2021 Nov 17.

Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.

Using an integrative, multi-tissue design, we sought to characterize methylation and hydroxymethylation changes in blood and brain associated with alcohol use disorder (AUD). First, we used epigenomic deconvolution to perform cell-type-specific methylome-wide association studies within subpopulations of granulocytes/T-cells/B-cells/monocytes in 1132 blood samples. Blood findings were then examined for overlap with AUD-related associations with methylation and hydroxymethylation in 50 human post-mortem brain samples. Follow-up analyses investigated if overlapping findings mediated AUD-associated transcription changes in the same brain samples. Lastly, we replicated our blood findings in an independent sample of 412 individuals and aimed to replicate published alcohol methylation findings using our results. Cell-type-specific analyses in blood identified methylome-wide significant associations in monocytes and T-cells. The monocyte findings were significantly enriched for AUD-related methylation and hydroxymethylation in brain. Hydroxymethylation in specific sites mediated AUD-associated transcription in the same brain samples. As part of the most comprehensive methylation study of AUD to date, this work involved the first cell-type-specific methylation study of AUD conducted in blood, identifying and replicating a finding in DLGAP1 that may be a blood-based biomarker of AUD. In this first study to consider the role of hydroxymethylation in AUD, we found evidence for a novel mechanism for cognitive deficits associated with AUD. Our results suggest promising new avenues for AUD research.
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http://dx.doi.org/10.1111/adb.13114DOI Listing
November 2021

Frequent teenage cannabis use: Prevalence across adolescence and associations with young adult psychopathology and functional well-being in an urban cohort.

Drug Alcohol Depend 2021 11 21;228:109063. Epub 2021 Sep 21.

Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, PO Box 1931, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Winterthurerstr. 190, Y55 J04, 8057 Zurich, Switzerland.

Background: Amidst cannabis legalization efforts and laws, we do not fully understand how the youngest frequent cannabis users fare during young adulthood. This study aims to 1) examine the prevalence of cannabis use during adolescence, and 2) investigate links of frequent (i.e., weekly or daily) teenage cannabis use with psychopathology and functional well-being at age 20-compared to no or occasional use.

Methods: Data came from a prospective-longitudinal cohort study (assessments from 2004 to 2018, from ages 7-20) in an urban setting (N = 1482). Substance use was assessed with self-reports between ages 13 and 20. At age 20, participants reported on psychopathology (psychotic symptoms, problematic substance use, aggression, and internalizing symptoms) and functional well-being (delinquency, financial difficulties, social exclusion, general well-being, and not being in education, employment, or training). Covariates were based on self-, parent-, teacher-, and behavioral measures.

Findings: Almost one in five adolescents had used cannabis frequently between ages 13 and 17 (26.6% of males, 9.8% of females). Adjusting nearly 20 potential confounders, frequent teenage cannabis use was associated with age 20 problematic substance use and poorer functional well-being compared to the no cannabis use and the occasional use groups. Frequent teenage cannabis use was more consistently associated with age 20 functional outcomes compared to frequent teenage nicotine or alcohol use.

Conclusions: Frequent teenage cannabis use was common and associated with problematic substance use, more delinquency, and poorer functional well-being at age 20. Accordingly, frequent teenage cannabis users could experience increased difficulties in mastering the transitions of young adulthood.
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http://dx.doi.org/10.1016/j.drugalcdep.2021.109063DOI Listing
November 2021

A methylation study implicates the rewiring of brain neural circuits during puberty in the emergence of sex differences in depression symptoms.

J Child Psychol Psychiatry 2021 Sep 19. Epub 2021 Sep 19.

Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA, USA.

Background: Women are 1.5-3 times more likely to suffer from depression than men. This sex bias first emerges during puberty and then persists across the reproductive years. As the cause remains largely elusive, we performed a methylation-wide association study (MWAS) to generate novel hypotheses.

Methods: We assayed nearly all 28 million possible methylation sites in blood in 595 blood samples from 487 participants aged 9-17. MWASs were performed to identify methylation sites associated with increasing sex differences in depression symptoms as a function of pubertal stage. Epigenetic deconvolution was applied to perform analyses on a cell-type specific level.

Results: In monocytes, a substantial number of significant associations were detected after controlling the FDR at 0.05. These results could not be explained by plasma testosterone/estradiol or current/lifetime trauma. Our top results in monocytes were significantly enriched (ratio of 2.48) for genes in the top of a large genome-wide association study (GWAS) meta-analysis of depression and neurodevelopment-related Gene Ontology (GO) terms that remained significant after correcting for multiple testing. Focusing on our most robust findings (70 genes overlapping with the GWAS meta-analysis and the significant GO terms), we find genes coding for members of each of the major classes of axon guidance molecules (netrins, slits, semaphorins, ephrins, and cell adhesion molecules). Many of these genes were previously implicated in rodent studies of brain development and depression-like phenotypes, as well as human methylation, gene expression and GWAS studies.

Conclusions: Our study suggests that the emergence of sex differences in depression may be related to the differential rewiring of brain circuits between boys and girls during puberty.
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http://dx.doi.org/10.1111/jcpp.13522DOI Listing
September 2021

Adult Psychiatric, Substance, and Functional Outcomes of Different Definitions of Early Cannabis Use.

J Am Acad Child Adolesc Psychiatry 2021 Aug 17. Epub 2021 Aug 17.

University of Zurich, Switzerland.

Objective: Research on associations of early cannabis use with adult functioning reports mixed findings. This may be due, in part, to wide variations in the definitions of early cannabis use. This study aims to compare associations of 4 commonly used definitions of early cannabis use-related to timing, dose, duration, and associated symptoms-with adult outcomes.

Method: Analyses were based on a 20-year longitudinal, community-representative study of 1,420 participants. Between ages 9 and 21 years (8,806 observations), participants were assessed for cannabis use and DSM-5 Cannabis Use Disorder. In early adulthood (ages 24-26 and 30; 2,424 observations of 1,266 subjects), participants were also assessed for psychiatric, substance use, and functional outcomes.

Results: All definitions of early use were associated with multiple adult outcomes in models that adjusted for sex and race/ethnicity. In models that also adjusted for childhood psychiatric problems and family adversities, only daily use and a persistent developmental subtype (defined as daily/problematic use that began in adolescence and continued into early adulthood) were associated with later substance use/disorders, poorer functional outcomes, and derailments in the transition to adulthood.

Conclusion: Daily, continued-over-time cannabis use beginning on adolescence was most problematic for a range of adult outcomes. Cessation of early use did not fully eliminate later risks; but was associated with fewer negative outcomes, with weaker effect sizes.
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http://dx.doi.org/10.1016/j.jaac.2021.07.824DOI Listing
August 2021

Genetic association study of childhood aggression across raters, instruments, and age.

Transl Psychiatry 2021 07 30;11(1):413. Epub 2021 Jul 30.

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Childhood aggressive behavior (AGG) has a substantial heritability of around 50%. Here we present a genome-wide association meta-analysis (GWAMA) of childhood AGG, in which all phenotype measures across childhood ages from multiple assessors were included. We analyzed phenotype assessments for a total of 328 935 observations from 87 485 children aged between 1.5 and 18 years, while accounting for sample overlap. We also meta-analyzed within subsets of the data, i.e., within rater, instrument and age. SNP-heritability for the overall meta-analysis (AGG) was 3.31% (SE = 0.0038). We found no genome-wide significant SNPs for AGG. The gene-based analysis returned three significant genes: ST3GAL3 (P = 1.6E-06), PCDH7 (P = 2.0E-06), and IPO13 (P = 2.5E-06). All three genes have previously been associated with educational traits. Polygenic scores based on our GWAMA significantly predicted aggression in a holdout sample of children (variance explained = 0.44%) and in retrospectively assessed childhood aggression (variance explained = 0.20%). Genetic correlations (r) among rater-specific assessment of AGG ranged from r = 0.46 between self- and teacher-assessment to r = 0.81 between mother- and teacher-assessment. We obtained moderate-to-strong rs with selected phenotypes from multiple domains, but hardly with any of the classical biomarkers thought to be associated with AGG. Significant genetic correlations were observed with most psychiatric and psychological traits (range [Formula: see text]: 0.19-1.00), except for obsessive-compulsive disorder. Aggression had a negative genetic correlation (r = ~-0.5) with cognitive traits and age at first birth. Aggression was strongly genetically correlated with smoking phenotypes (range [Formula: see text]: 0.46-0.60). The genetic correlations between aggression and psychiatric disorders were weaker for teacher-reported AGG than for mother- and self-reported AGG. The current GWAMA of childhood aggression provides a powerful tool to interrogate the rater-specific genetic etiology of AGG.
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http://dx.doi.org/10.1038/s41398-021-01480-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324785PMC
July 2021

Genetic association study of childhood aggression across raters, instruments, and age.

Transl Psychiatry 2021 07 30;11(1):413. Epub 2021 Jul 30.

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Childhood aggressive behavior (AGG) has a substantial heritability of around 50%. Here we present a genome-wide association meta-analysis (GWAMA) of childhood AGG, in which all phenotype measures across childhood ages from multiple assessors were included. We analyzed phenotype assessments for a total of 328 935 observations from 87 485 children aged between 1.5 and 18 years, while accounting for sample overlap. We also meta-analyzed within subsets of the data, i.e., within rater, instrument and age. SNP-heritability for the overall meta-analysis (AGG) was 3.31% (SE = 0.0038). We found no genome-wide significant SNPs for AGG. The gene-based analysis returned three significant genes: ST3GAL3 (P = 1.6E-06), PCDH7 (P = 2.0E-06), and IPO13 (P = 2.5E-06). All three genes have previously been associated with educational traits. Polygenic scores based on our GWAMA significantly predicted aggression in a holdout sample of children (variance explained = 0.44%) and in retrospectively assessed childhood aggression (variance explained = 0.20%). Genetic correlations (r) among rater-specific assessment of AGG ranged from r = 0.46 between self- and teacher-assessment to r = 0.81 between mother- and teacher-assessment. We obtained moderate-to-strong rs with selected phenotypes from multiple domains, but hardly with any of the classical biomarkers thought to be associated with AGG. Significant genetic correlations were observed with most psychiatric and psychological traits (range [Formula: see text]: 0.19-1.00), except for obsessive-compulsive disorder. Aggression had a negative genetic correlation (r = ~-0.5) with cognitive traits and age at first birth. Aggression was strongly genetically correlated with smoking phenotypes (range [Formula: see text]: 0.46-0.60). The genetic correlations between aggression and psychiatric disorders were weaker for teacher-reported AGG than for mother- and self-reported AGG. The current GWAMA of childhood aggression provides a powerful tool to interrogate the rater-specific genetic etiology of AGG.
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http://dx.doi.org/10.1038/s41398-021-01480-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324785PMC
July 2021

Adolescent depression and adult labor market marginalization: a longitudinal cohort study.

Eur Child Adolesc Psychiatry 2021 Jun 25. Epub 2021 Jun 25.

Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.

Adolescent depression is linked to adult ill-health and functional impairment, but recent research suggests that individual/contextual factors might account for this association. This study aimed to test whether the clinical heterogeneity of adolescent depression is related to marginalization from the labor market across early to middle adulthood. Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort initially assessed with structured clinical interviews at age 16-17. The cohort (n = 321 depressed; n = 218 nondepressed) was followed up after 2+ decades through linkage to nationwide population-based registries. Outcomes included consecutive annual data on unemployment, work disability, social welfare recipiency, and a composite marginalization measure, spanning from age 21 to 40. Longitudinal associations were examined using logistic regression analysis in a generalized estimating equations modeling framework. Subsequent depressive episodes and educational attainment in early adulthood were explored as potential pathways. The results showed that adolescent depression was associated with adult marginalization outcomes, but the strength of association varied across depressed subgroups. Adolescents with persistent depressive disorder had higher odds of all outcomes, including the composite marginalization measure (adjusted OR = 2.0, 95% CI = 1.4-2.7, p < 0.001), and this was partially (31%) mediated by subsequent depressive episodes in early adulthood. Exploratory moderation analysis revealed that entry into tertiary education mitigated the association with later marginalization, but only for adolescents with episodic major depression. In conclusion, the risk for future labor market marginalization is elevated among depressed adolescents, particularly those presenting with persistent depressive disorder. Targeted interventions seem crucial to mitigate the long-lasting impact of early-onset depression.
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http://dx.doi.org/10.1007/s00787-021-01825-3DOI Listing
June 2021

Childhood loneliness as a specific risk factor for adult psychiatric disorders.

Psychol Med 2021 Jun 14:1-9. Epub 2021 Jun 14.

Department of Psychiatry, Vermont Center for Children, Youth and Families, University of Vermont, Burlington, USA.

Background: Loneliness is a major risk factor for both psychological disturbance and poor health outcomes in adults. This study aimed to assess whether childhood loneliness is associated with a long-term disruption in mental health that extends into adulthood.

Methods: This study is based on the longitudinal, community-representative Great Smoky Mountains Study of 1420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to eight times in childhood (ages 9-16; 6674 observations; 1993-2000) for childhood loneliness, associated psychiatric comorbidities and childhood adversities. Participants were followed up four times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1334 participants; 1999-2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric anxiety, depression, and substance use outcomes.

Results: Both self and parent-reported childhood loneliness were associated with adult self-reported anxiety and depressive outcomes. The associations remained significant when childhood adversities and psychiatric comorbidities were accounted for. There was no evidence for an association of childhood loneliness with adult substance use disorders. More associations were found between childhood loneliness and adult psychiatric symptoms than with adult diagnostic status.

Conclusion: Childhood loneliness is associated with anxiety and depressive disorders in young adults, suggesting that loneliness - even in childhood - might have long-term costs in terms of mental health. This study underscores the importance of intervening early to prevent loneliness and its sequelae over time.
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http://dx.doi.org/10.1017/S0033291721001422DOI Listing
June 2021

Longitudinal associations of trauma exposure with disordered eating: Lessons from the Great Smoky Mountains Study.

Eat Disord 2021 May-Jun;29(3):208-225. Epub 2021 May 19.

Department of Psychiatry, University of Vermont, Burlington, Vermont, United States.

Disordered eating is prevalent among trauma survivors, yet little is known about mechanisms underlying this relation. We explored cross-sectional and longitudinal associations of trauma exposure and posttraumatic stress disorder symptoms (PTSD) with disordered eating among 1,420 community-based youth participating in the Great Smoky Mountain Study. Participants were interviewed about trauma exposure, PTSD symptoms, and disordered eating at regular intervals throughout childhood, adolescence, and early adulthood. Our findings confirmed associations of all forms of trauma exposure (violent, sexual, and other) with disordered eating symptoms in childhood and adulthood, although the pattern of results varied by disordered eating symptom and trauma exposure type. Only non-sexual, non-violent trauma exposure in childhood had significant associations with any disordered eating symptoms in adulthood. Within childhood, trauma exposures but not PTSD symptoms showed significant longitudinal associations with bulimia nervosa symptoms and sustained appetite changes and preoccupation with eating. In adulthood, PTSD symptoms but not trauma exposures showed significant longitudinal associations only with bulimia nervosa symptoms. The association of specific PTSD clusters on bulimia nervosa symptoms was significant for reexperiencing, whereas hyperarousal symptoms trended toward significance. The impact of trauma exposures on disordered eating may vary by developmental period.
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http://dx.doi.org/10.1080/10640266.2021.1921326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373713PMC
October 2021

Psychiatry and Deaths of Despair.

JAMA Psychiatry 2021 07;78(7):695-696

The Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington.

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http://dx.doi.org/10.1001/jamapsychiatry.2021.0256DOI Listing
July 2021

Methylomic Investigation of Problematic Adolescent Cannabis Use and Its Negative Mental Health Consequences.

J Am Acad Child Adolesc Psychiatry 2021 12 22;60(12):1524-1532. Epub 2021 Feb 22.

Virginia Commonwealth University, Richmond.

Objective: The impact of adolescent cannabis use is a pressing public health question owing to the high rates of use and links to negative outcomes. This study considered the association between problematic adolescent cannabis use and methylation.

Method: Using an enrichment-based sequencing approach, a methylome-wide association study (MWAS) was performed of problematic adolescent cannabis use in 703 adolescent samples from the Great Smoky Mountain Study. Using epigenomic deconvolution, MWASs were performed for the main cell types in blood: granulocytes, T cells, B cells, and monocytes. Enrichment testing was conducted to establish overlap between cannabis-associated methylation differences and variants associated with negative mental health effects of adolescent cannabis use.

Results: Whole-blood analyses identified 45 significant CpGs, and cell type-specific analyses yielded 32 additional CpGs not identified in the whole-blood MWAS. Significant overlap was observed between the B-cell MWAS and genetic studies of education attainment and intelligence. Furthermore, the results from both T cells and monocytes overlapped with findings from an MWAS of psychosis conducted in brain tissue.

Conclusion: In one of the first methylome-wide association studies of adolescent cannabis use, several methylation sites located in genes of importance for potentially relevant brain functions were identified. These findings resulted in several testable hypotheses by which cannabis-associated methylation can impact neurological development and inflammation response as well as potential mechanisms linking cannabis-associated methylation to potential downstream mental health effects.
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http://dx.doi.org/10.1016/j.jaac.2021.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8380262PMC
December 2021

Prevalence and Childhood Precursors of Opioid Use in the Early Decades of Life.

JAMA Pediatr 2021 03;175(3):276-285

Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington.

Importance: Opioid use disorder and opioid deaths have increased dramatically in young adults in the US, but the age-related course or precursors to opioid use among young people are not fully understood.

Objective: To document age-related changes in opioid use and study the childhood antecedents of opioid use by age 30 years in 6 domains of childhood risk: sociodemographic characteristics; school or peer problems; parental mental illness, drug problems, or legal involvement; substance use; psychiatric illness; and physical health.

Design, Setting, And Participants: This community-representative prospective longitudinal cohort study assessed 1252 non-Hispanic White individuals and American Indian individuals in rural counties in the central Appalachia region of North Carolina from January 1993 to December 2015. Data were analyzed from January 2019 to January 2020.

Exposures: Between ages 9 and 16 years, participants and their parents were interviewed up to 7 times using the Child and Adolescent Psychiatric Assessment and reported risk factors in 6 risk domains.

Main Outcomes And Measures: Participants were assessed again at ages 19, 21, 25, and 30 years for nonheroin opioid use (any and weekly) and heroin use using the structured Young Adult Psychiatric Assessment.

Results: Of 1252 participants, 342 (27%) were American Indian. By age 30 years, 322 participants had used a nonheroin opioid (24.2%; 95% CI, 21.8-26.5), 155 had used a nonheroin opioid weekly (8.8%; 95% CI, 7.2-10.3), and 95 had used heroin (6.6%; 95% CI, 5.2-7.9). Childhood risk markers for later opioid use included male sex, tobacco use, depression, conduct disorder, cannabis use, having peers exhibiting social deviance, parents with legal involvement, and elevated systemic inflammation. In final models, childhood tobacco use, depression, and cannabis use were most robustly associated with opioid use in young adulthood (ages 19 to 30 years). Chronic depression and dysthymia were strongly associated with any nonheroin opioid use (OR. 5.43; 95% CI, 2.35-12.55 and OR, 7.13; 95% CI, 1.99-25.60, respectively) and with weekly nonheroin opioid use (OR, 8.89; 95% CI, 3.61-21.93 and OR, 11.51; 95% CI, 3.05-42.72, respectively). Among young adults with opioid use, those with heroin use had the highest rates of childhood psychiatric disorders and comorbidities.

Conclusions And Relevance: Childhood tobacco use and chronic depression may be associated with impaired reward system functioning, which may increase young adults' vulnerability to opioid-associated euphoria. Preventing and treating early substance use and childhood mental illness may help prevent later opioid use.
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http://dx.doi.org/10.1001/jamapediatrics.2020.5205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7770613PMC
March 2021

Daily wellness behaviors in college students across a school year.

J Am Coll Health 2020 Nov 5:1-7. Epub 2020 Nov 5.

Vermont Center for Children, Youth, and Families, Division of Child Psychiatry Department, University of Vermont, Burlington, Vermont, USA.

Objective: To establish the prevalence of mood and wellness behaviors in college students across a school year. 1,554 college students (69.4% female; average age 18.8 years) were followed with daily surveys on wellness behaviors for the school year. 1,207 participants completed at least 50% of daily surveys on mood, exercise, sleep, nutrition, mindfulness practice and singing/playing musical instrument. Over 88.7% of college students reported at least one wellness behavior each day with 17.7% reporting 4 or more. Each of the wellness behaviors, however, displayed distinct prevalence patterns, varied significantly across the school year, and often across a given school week. Almost every individual wellness behavior was associated with a positive mood, and the cumulative number of daily wellness behaviors was a strongly associated with mood state. Daily wellness behaviors are collectively common, vary significantly within individuals, and are strongly associated with positive mood, both individual and cumulatively.
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http://dx.doi.org/10.1080/07448481.2020.1819291DOI Listing
November 2020

A large-scale genome-wide association study meta-analysis of cannabis use disorder.

Lancet Psychiatry 2020 12 20;7(12):1032-1045. Epub 2020 Oct 20.

Stanford University Graduate School of Education, Stanford University, Stanford, CA, USA.

Background: Variation in liability to cannabis use disorder has a strong genetic component (estimated twin and family heritability about 50-70%) and is associated with negative outcomes, including increased risk of psychopathology. The aim of the study was to conduct a large genome-wide association study (GWAS) to identify novel genetic variants associated with cannabis use disorder.

Methods: To conduct this GWAS meta-analysis of cannabis use disorder and identify associations with genetic loci, we used samples from the Psychiatric Genomics Consortium Substance Use Disorders working group, iPSYCH, and deCODE (20 916 case samples, 363 116 control samples in total), contrasting cannabis use disorder cases with controls. To examine the genetic overlap between cannabis use disorder and 22 traits of interest (chosen because of previously published phenotypic correlations [eg, psychiatric disorders] or hypothesised associations [eg, chronotype] with cannabis use disorder), we used linkage disequilibrium score regression to calculate genetic correlations.

Findings: We identified two genome-wide significant loci: a novel chromosome 7 locus (FOXP2, lead single-nucleotide polymorphism [SNP] rs7783012; odds ratio [OR] 1·11, 95% CI 1·07-1·15, p=1·84 × 10) and the previously identified chromosome 8 locus (near CHRNA2 and EPHX2, lead SNP rs4732724; OR 0·89, 95% CI 0·86-0·93, p=6·46 × 10). Cannabis use disorder and cannabis use were genetically correlated (r 0·50, p=1·50 × 10), but they showed significantly different genetic correlations with 12 of the 22 traits we tested, suggesting at least partially different genetic underpinnings of cannabis use and cannabis use disorder. Cannabis use disorder was positively genetically correlated with other psychopathology, including ADHD, major depression, and schizophrenia.

Interpretation: These findings support the theory that cannabis use disorder has shared genetic liability with other psychopathology, and there is a distinction between genetic liability to cannabis use and cannabis use disorder.

Funding: National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Center for Genomics and Personalized Medicine and the Centre for Integrative Sequencing; The European Commission, Horizon 2020; National Institute of Child Health and Human Development; Health Research Council of New Zealand; National Institute on Aging; Wellcome Trust Case Control Consortium; UK Research and Innovation Medical Research Council (UKRI MRC); The Brain & Behavior Research Foundation; National Institute on Deafness and Other Communication Disorders; Substance Abuse and Mental Health Services Administration (SAMHSA); National Institute of Biomedical Imaging and Bioengineering; National Health and Medical Research Council (NHMRC) Australia; Tobacco-Related Disease Research Program of the University of California; Families for Borderline Personality Disorder Research (Beth and Rob Elliott) 2018 NARSAD Young Investigator Grant; The National Child Health Research Foundation (Cure Kids); The Canterbury Medical Research Foundation; The New Zealand Lottery Grants Board; The University of Otago; The Carney Centre for Pharmacogenomics; The James Hume Bequest Fund; National Institutes of Health: Genes, Environment and Health Initiative; National Institutes of Health; National Cancer Institute; The William T Grant Foundation; Australian Research Council; The Virginia Tobacco Settlement Foundation; The VISN 1 and VISN 4 Mental Illness Research, Education, and Clinical Centers of the US Department of Veterans Affairs; The 5th Framework Programme (FP-5) GenomEUtwin Project; The Lundbeck Foundation; NIH-funded Shared Instrumentation Grant S10RR025141; Clinical Translational Sciences Award grants; National Institute of Neurological Disorders and Stroke; National Heart, Lung, and Blood Institute; National Institute of General Medical Sciences.
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http://dx.doi.org/10.1016/S2215-0366(20)30339-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674631PMC
December 2020

Impact of COVID-19 Pandemic on College Student Mental Health and Wellness.

J Am Acad Child Adolesc Psychiatry 2021 01 19;60(1):134-141.e2. Epub 2020 Oct 19.

University of Vermont, Burlington.

Objective: To test the impact of the coronavirus disease 2019 (COVID) pandemic on the emotions, behavior, and wellness behaviors of first-year college students.

Method: A total of 675 first-year university students completed a full assessment of behavioral and emotional functioning at the beginning of the spring semester 2020. Of these, 576 completed the same assessment at the end of the spring semester, 600 completed at least 1 item from a COVID-related survey after the onset of COVID pandemic, and 485 completed nightly surveys of mood and wellness behaviors on a regular basis before and after the onset of the COVID crisis.

Results: Externalizing problems (mean = -0.19, 95% CI = -0.06 to 0.33, p = .004) and attention problems (mean = -0.60, 95% CI = -0.40 to 0.80, p < .001) increased after the onset of COVID, but not internalizing symptoms (mean = 0.18, 95% CI = -0.1 to 0.38, p = .06). Students who were enrolled in a campus wellness program were less affected by COVID in terms of internalizing symptoms (β = 0.40, SE = 0.21, p = .055) and attention problems (β = 0.59, SE = 0.21, p = .005) than those who were not in the wellness program. Nightly surveys of both mood (β = -0.10, SE = 0.03, p = .003) and daily wellness behaviors (β = -0.06, SE = 0.03, p = .036), but not stress (β = 0.02, SE = 0.03, p = .58), were negatively affected by the COVID crisis. The overall magnitude of these COVID-related changes were modest but persistent across the rest of the semester and different from patterns observed in a prior year.

Conclusion: COVID and associated educational/governmental mitigation strategies had a modest but persistent impact on mood and wellness behaviors of first-year university students. Colleges should prepare to address the continued mental health impacts of the pandemic.
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http://dx.doi.org/10.1016/j.jaac.2020.08.466DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173277PMC
January 2021

Associations of Childhood and Adolescent Depression With Adult Psychiatric and Functional Outcomes.

J Am Acad Child Adolesc Psychiatry 2021 05 3;60(5):604-611. Epub 2020 Aug 3.

University of Zurich, Switzerland.

Objective: Depression is common, impairing, and the leading cause of disease burden in youths. This study aimed to identify the effects of childhood/adolescent depression on a broad range of longer-term outcomes.

Method: The analysis is based on the prospective, representative Great Smoky Mountains Study of 1,420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to 8 times in childhood (age 9-16 years; 6,674 observations; 1993-2000) for DSM-based depressive disorders, associated psychiatric comorbidities, and childhood adversities. Participants were followed up 4 times in adulthood (ages 19, 21, 25, and 30 years; 4,556 observations of 1,336 participants; 1999-2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric outcomes and functional outcomes.

Results: In all, 7.7% of participants met criteria for a depressive disorder in childhood/adolescence. Any childhood/adolescent depression was associated with higher levels of adult anxiety and illicit drug disorders and also with worse health, criminal, and social functioning; these associations persisted when childhood psychiatric comorbidities and adversities were accounted for. No sex-specific patterns were identified. However, timing of depression mattered: individuals with adolescent-onset depression had worse outcomes than those with child-onset. Average depressive symptoms throughout childhood and adolescence were associated with more adverse outcomes. Finally, specialty mental health service use was protective against adult diagnostic outcomes.

Conclusion: Early depression and especially persistent childhood/adolescent depressive symptoms have robust, lasting associations with adult functioning. Some of these effects may be attenuated by service use.
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http://dx.doi.org/10.1016/j.jaac.2020.07.895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051642PMC
May 2021

Associations of Childhood and Adolescent Depression With Adult Psychiatric and Functional Outcomes.

J Am Acad Child Adolesc Psychiatry 2021 05 3;60(5):604-611. Epub 2020 Aug 3.

University of Zurich, Switzerland.

Objective: Depression is common, impairing, and the leading cause of disease burden in youths. This study aimed to identify the effects of childhood/adolescent depression on a broad range of longer-term outcomes.

Method: The analysis is based on the prospective, representative Great Smoky Mountains Study of 1,420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to 8 times in childhood (age 9-16 years; 6,674 observations; 1993-2000) for DSM-based depressive disorders, associated psychiatric comorbidities, and childhood adversities. Participants were followed up 4 times in adulthood (ages 19, 21, 25, and 30 years; 4,556 observations of 1,336 participants; 1999-2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric outcomes and functional outcomes.

Results: In all, 7.7% of participants met criteria for a depressive disorder in childhood/adolescence. Any childhood/adolescent depression was associated with higher levels of adult anxiety and illicit drug disorders and also with worse health, criminal, and social functioning; these associations persisted when childhood psychiatric comorbidities and adversities were accounted for. No sex-specific patterns were identified. However, timing of depression mattered: individuals with adolescent-onset depression had worse outcomes than those with child-onset. Average depressive symptoms throughout childhood and adolescence were associated with more adverse outcomes. Finally, specialty mental health service use was protective against adult diagnostic outcomes.

Conclusion: Early depression and especially persistent childhood/adolescent depressive symptoms have robust, lasting associations with adult functioning. Some of these effects may be attenuated by service use.
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http://dx.doi.org/10.1016/j.jaac.2020.07.895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051642PMC
May 2021

Income dividends and subjective survival in a Cherokee Indian cohort: a quasi-experiment.

Biodemography Soc Biol 2020 Apr-Jun;65(2):172-187

Program in Public Health, Anteater Instruction & Research Offices (AIRB), University of California, Irvine, CA, USA.

Persons with high temporal discounting tend to value immediate gratification over future gains. Low self-reported lifespan (SRL)-an individual's assessment of a relatively short future lifespan-concentrates in low-income populations and may reflect high temporal discounting. We use casino-based cash dividends among the Eastern Band of Cherokee Indians (EBCI) as a quasi-experiment to test whether large income gains among EBCI members translate into increased SRL. We used SRL data for EBCI and White youth, aged 19 to 28, participating in two waves of the Life Time Trajectory of Youth (LTI-Y) survey from 2000 to 2010. We controlled for unobserved confounding across individuals, time, and region through a longitudinal design using a difference-in-difference analytic approach (N = 294). We conducted all analyses separately by gender and by quartile of socioeconomic status. Cash dividends correspond with a 15.23 year increase in SRL among EBCI men below the lowest socio-economic quartile at baseline relative to Whites (standard error = 5.39, < .01). Results using other socio-economic cut-points support improved SRL among EBCI men (but not women). The large magnitude of this result among EBCI men indicates that a non-trivial cash dividend to a low-income population may confer long-term benefits on perceptions of future lifespan and, in turn, reduce temporal discounting. EBCI: Eastern Band of Cherokee Indians; SES: Socioeconomic Status; LTI-Y: Life Trajectory Interview for Youth; GSMS: Great Smoky Mountains Study; SRL: Self-Reported Lifespan; SSS: Subjective Social Status.
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http://dx.doi.org/10.1080/19485565.2020.1730155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250001PMC
October 2020

Leveraging genome-wide data to investigate differences between opioid use vs. opioid dependence in 41,176 individuals from the Psychiatric Genomics Consortium.

Mol Psychiatry 2020 08 26;25(8):1673-1687. Epub 2020 Feb 26.

Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA.

To provide insights into the biology of opioid dependence (OD) and opioid use (i.e., exposure, OE), we completed a genome-wide analysis comparing 4503 OD cases, 4173 opioid-exposed controls, and 32,500 opioid-unexposed controls, including participants of European and African descent (EUR and AFR, respectively). Among the variants identified, rs9291211 was associated with OE (exposed vs. unexposed controls; EUR z = -5.39, p = 7.2 × 10). This variant regulates the transcriptomic profiles of SLC30A9 and BEND4 in multiple brain tissues and was previously associated with depression, alcohol consumption, and neuroticism. A phenome-wide scan of rs9291211 in the UK Biobank (N > 360,000) found association of this variant with propensity to use dietary supplements (p = 1.68 × 10). With respect to the same OE phenotype in the gene-based analysis, we identified SDCCAG8 (EUR + AFR z = 4.69, p = 10), which was previously associated with educational attainment, risk-taking behaviors, and schizophrenia. In addition, rs201123820 showed a genome-wide significant difference between OD cases and unexposed controls (AFR z = 5.55, p = 2.9 × 10) and a significant association with musculoskeletal disorders in the UK Biobank (p = 4.88 × 10). A polygenic risk score (PRS) based on a GWAS of risk-tolerance (n = 466,571) was positively associated with OD (OD vs. unexposed controls, p = 8.1 × 10; OD cases vs. exposed controls, p = 0.054) and OE (exposed vs. unexposed controls, p = 3.6 × 10). A PRS based on a GWAS of neuroticism (n = 390,278) was positively associated with OD (OD vs. unexposed controls, p = 3.2 × 10; OD vs. exposed controls, p = 0.002) but not with OE (p = 0.67). Our analyses highlight the difference between dependence and exposure and the importance of considering the definition of controls in studies of addiction.
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http://dx.doi.org/10.1038/s41380-020-0677-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392789PMC
August 2020

Shared genetic risk between eating disorder- and substance-use-related phenotypes: Evidence from genome-wide association studies.

Addict Biol 2021 01 16;26(1):e12880. Epub 2020 Feb 16.

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.

Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa and problem alcohol use (genetic correlation [r ], twin-based = 0.23-0.53). We estimated the genetic correlation between eating disorder and substance use and disorder phenotypes using data from genome-wide association studies (GWAS). Four eating disorder phenotypes (anorexia nervosa [AN], AN with binge eating, AN without binge eating, and a bulimia nervosa factor score), and eight substance-use-related phenotypes (drinks per week, alcohol use disorder [AUD], smoking initiation, current smoking, cigarettes per day, nicotine dependence, cannabis initiation, and cannabis use disorder) from eight studies were included. Significant genetic correlations were adjusted for variants associated with major depressive disorder and schizophrenia. Total study sample sizes per phenotype ranged from ~2400 to ~537 000 individuals. We used linkage disequilibrium score regression to calculate single nucleotide polymorphism-based genetic correlations between eating disorder- and substance-use-related phenotypes. Significant positive genetic associations emerged between AUD and AN (r = 0.18; false discovery rate q = 0.0006), cannabis initiation and AN (r = 0.23; q < 0.0001), and cannabis initiation and AN with binge eating (r = 0.27; q = 0.0016). Conversely, significant negative genetic correlations were observed between three nondiagnostic smoking phenotypes (smoking initiation, current smoking, and cigarettes per day) and AN without binge eating (r = -0.19 to -0.23; qs < 0.04). The genetic correlation between AUD and AN was no longer significant after co-varying for major depressive disorder loci. The patterns of association between eating disorder- and substance-use-related phenotypes highlights the potentially complex and substance-specific relationships among these behaviors.
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http://dx.doi.org/10.1111/adb.12880DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429266PMC
January 2021

Young Adolescents' Digital Technology Use, Perceived Impairments, and Well-Being in a Representative Sample.

J Pediatr 2020 04 11;219:180-187. Epub 2020 Feb 11.

Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC; Department of Psychology and Social Behavior, University of California-Irvine, Irvine, CA.

Objective: To examine the cross-sectional associations between young adolescents' access, use, and perceived impairments related to digital technologies and their academic, psychological, and physical well-being.

Study Design: There were 2104 adolescents (ages 10-15 years), representative of the North Carolina Public School population, who completed questionnaires in 2015. Administrative educational records were linked with parental consent.

Results: Nearly all young adolescents (95%) had Internet access, 67% owned a mobile phone, and 68% had a social media account. Mobile phone ownership was not associated with any indicators of well-being (math and reading test scores, school belonging, psychological distress, conduct problems, or physical health) after controlling for demographic factors. Having a social media account and frequency of social media use were only robustly associated with conduct problems (explaining ∼3% of the variation in conduct problems). Despite the lack of strong associations, 91% of adolescents reported at least 1 perceived technology-related impairment and 29% of adolescents reported online-to-offline spillover of negative experiences. Economically disadvantaged adolescents reported similar access, but greater online-to-offline spillover and stronger associations between social media account ownership and poor psychological well-being compared with their more affluent peers.

Conclusions: At the population level, there was little evidence that digital technology access and use is negatively associated with young adolescents' well-being. Youth from economically disadvantaged families were equally likely to have access to digital technologies, but were more likely than their more affluent peers to report negative online experiences. Closing the digital divide requires prioritizing equity in experiences and opportunities, as well as in access.
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http://dx.doi.org/10.1016/j.jpeds.2019.12.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7570431PMC
April 2020

Young Adolescents' Digital Technology Use, Perceived Impairments, and Well-Being in a Representative Sample.

J Pediatr 2020 04 11;219:180-187. Epub 2020 Feb 11.

Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC; Department of Psychology and Social Behavior, University of California-Irvine, Irvine, CA.

Objective: To examine the cross-sectional associations between young adolescents' access, use, and perceived impairments related to digital technologies and their academic, psychological, and physical well-being.

Study Design: There were 2104 adolescents (ages 10-15 years), representative of the North Carolina Public School population, who completed questionnaires in 2015. Administrative educational records were linked with parental consent.

Results: Nearly all young adolescents (95%) had Internet access, 67% owned a mobile phone, and 68% had a social media account. Mobile phone ownership was not associated with any indicators of well-being (math and reading test scores, school belonging, psychological distress, conduct problems, or physical health) after controlling for demographic factors. Having a social media account and frequency of social media use were only robustly associated with conduct problems (explaining ∼3% of the variation in conduct problems). Despite the lack of strong associations, 91% of adolescents reported at least 1 perceived technology-related impairment and 29% of adolescents reported online-to-offline spillover of negative experiences. Economically disadvantaged adolescents reported similar access, but greater online-to-offline spillover and stronger associations between social media account ownership and poor psychological well-being compared with their more affluent peers.

Conclusions: At the population level, there was little evidence that digital technology access and use is negatively associated with young adolescents' well-being. Youth from economically disadvantaged families were equally likely to have access to digital technologies, but were more likely than their more affluent peers to report negative online experiences. Closing the digital divide requires prioritizing equity in experiences and opportunities, as well as in access.
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http://dx.doi.org/10.1016/j.jpeds.2019.12.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7570431PMC
April 2020

Association of Parental Incarceration With Psychiatric and Functional Outcomes of Young Adults.

JAMA Netw Open 2019 08 2;2(8):e1910005. Epub 2019 Aug 2.

Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington.

Importance: In 2016, an estimated 8% of US children younger than 18 years had experienced the incarceration of a parent, and rates were substantially higher among children from racial and ethnic minority backgrounds and disadvantaged groups. Little is known about whether parental incarceration during childhood is associated with adult psychiatric problems and functional outcomes.

Objective: To examine whether parental incarceration is associated with increased levels of psychiatric diagnosis and poor outcomes in health, legal, financial, and social domains in adulthood.

Design, Setting, And Participants: This cohort study used data from the community-representative, prospective, longitudinal Great Smoky Mountains Study. Children and their parents were interviewed up to 8 times from January 1993 to December 2000 (ages 9-16 years; 6674 observations of 1420 participants) using the Child and Adolescent Psychiatric Assessment, which assessed parental incarceration, childhood psychiatric diagnoses, and other adversities. Young adults were followed up at ages 19, 21, 25, and 30 years from January 1999 to December 2015 (4556 observations of 1334 participants) to assess psychiatric diagnoses and functional outcomes indicative of a disrupted transition to adulthood. Data analysis was conducted from June 2018 to June 2019.

Results: By age 16 years, 475 participants (weighted percentage, 23.9%) had a parental figure who had been incarcerated, including 259 young men (22.2%) and 216 young women (25.5%). Parental incarceration was associated with higher prevalence of childhood psychiatric diagnoses (eg, any depressive diagnosis: adjusted odds ratio [aOR], 2.5; 95% CI, 1.3-4.6; P = .006; attention-deficit/hyperactivity disorder: aOR, 2.3; 95% CI, 1.0-5.5; P = .06; and conduct disorder: aOR, 2.5; 95% CI, 1.4-4.3; P = .001). After accounting for childhood psychiatric diagnoses and adversity exposure, parental incarceration remained associated with increased odds of having an adult anxiety disorder (aOR, 1.7; 95% CI, 1.0-3.0; P = .04), having an illicit drug use disorder (aOR, 6.6; 95% CI, 2.6-17.0; P < .001), having a felony charge (aOR, 3.4; 95% CI, 1.8-6.5; P < .001), incarceration (aOR, 2.8; 95% CI, 1.4-5.4; P = .003), not completing high school (aOR, 4.4; 95% CI, 2.2-8.8; P < .001), early parenthood (aOR, 1.7; 95% CI, 1.0-3.0; P = .04), and being socially isolated (aOR, 2.2; 95% CI, 1.2-4.0; P = .009).

Conclusions And Relevance: This study suggests that parental incarceration is associated with a broad range of psychiatric, legal, financial, and social outcomes during young adulthood. Parental incarceration is a common experience that may perpetuate disadvantage from generation to generation.
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http://dx.doi.org/10.1001/jamanetworkopen.2019.10005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714027PMC
August 2019

Conduct disorder.

Nat Rev Dis Primers 2019 06 27;5(1):43. Epub 2019 Jun 27.

School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK.

Conduct disorder (CD) is a common and highly impairing psychiatric disorder that usually emerges in childhood or adolescence and is characterized by severe antisocial and aggressive behaviour. It frequently co-occurs with attention-deficit/hyperactivity disorder (ADHD) and often leads to antisocial personality disorder in adulthood. CD affects ~3% of school-aged children and is twice as prevalent in males than in females. This disorder can be subtyped according to age at onset (childhood-onset versus adolescent-onset) and the presence or absence of callous-unemotional traits (deficits in empathy and guilt). The aetiology of CD is complex, with contributions of both genetic and environmental risk factors and different forms of interplay among the two (gene-environment interaction and correlation). In addition, CD is associated with neurocognitive impairments; smaller grey matter volume in limbic regions such as the amygdala, insula and orbitofrontal cortex, and functional abnormalities in overlapping brain circuits responsible for emotion processing, emotion regulation and reinforcement-based decision-making have been reported. Lower hypothalamic-pituitary-adrenal axis and autonomic reactivity to stress has also been reported. Management of CD primarily involves parent-based or family-based psychosocial interventions, although stimulants and atypical antipsychotics are sometimes used, especially in individuals with comorbid ADHD.
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http://dx.doi.org/10.1038/s41572-019-0095-yDOI Listing
June 2019

Conduct disorder.

Nat Rev Dis Primers 2019 06 27;5(1):43. Epub 2019 Jun 27.

School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK.

Conduct disorder (CD) is a common and highly impairing psychiatric disorder that usually emerges in childhood or adolescence and is characterized by severe antisocial and aggressive behaviour. It frequently co-occurs with attention-deficit/hyperactivity disorder (ADHD) and often leads to antisocial personality disorder in adulthood. CD affects ~3% of school-aged children and is twice as prevalent in males than in females. This disorder can be subtyped according to age at onset (childhood-onset versus adolescent-onset) and the presence or absence of callous-unemotional traits (deficits in empathy and guilt). The aetiology of CD is complex, with contributions of both genetic and environmental risk factors and different forms of interplay among the two (gene-environment interaction and correlation). In addition, CD is associated with neurocognitive impairments; smaller grey matter volume in limbic regions such as the amygdala, insula and orbitofrontal cortex, and functional abnormalities in overlapping brain circuits responsible for emotion processing, emotion regulation and reinforcement-based decision-making have been reported. Lower hypothalamic-pituitary-adrenal axis and autonomic reactivity to stress has also been reported. Management of CD primarily involves parent-based or family-based psychosocial interventions, although stimulants and atypical antipsychotics are sometimes used, especially in individuals with comorbid ADHD.
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http://dx.doi.org/10.1038/s41572-019-0095-yDOI Listing
June 2019

The University of Vermont Wellness Environment: Feasibility and Initial Results of a College Undergraduate Health-Promoting Program.

Child Adolesc Psychiatr Clin N Am 2019 04 3;28(2):247-265. Epub 2019 Jan 3.

Division of Child Psychiatry, Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, USA. Electronic address:

The University of Vermont Wellness Environment program is a neuroscience-inspired, incentive-based behavioral change program designed to improve health and academic outcomes in college-age students. The program uses health promotion and illness prevention delivered in classrooms, residential halls, and via a customized App that incentivizes healthy behaviors and monitors the use of health-promoting activities. This article presents feasibility data on participation of college students in ongoing data collection about key outcomes related to health and well-being. The data collection component were easily implemented in college students and yielded high-quality data.
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http://dx.doi.org/10.1016/j.chc.2018.11.011DOI Listing
April 2019

Perceived social status and mental health among young adolescents: Evidence from census data to cellphones.

Dev Psychol 2019 Mar;55(3):574-585

Department of Psychological Science.

Adolescents in the United States live amid high levels of concentrated poverty and increasing income inequality. Poverty is robustly linked to adolescents' mental health problems; however, less is known about how perceptions of their social status and exposure to local area income inequality relate to mental health. Participants consisted of a population-representative sample of over 2,100 adolescents (ages 10-16), 395 of whom completed a 14-day ecological momentary assessment (EMA) study. Participants' subjective social status (SSS) was assessed at the start of the EMA, and mental health symptoms were measured both at baseline for the entire sample and daily in the EMA sample. Adolescents' SSS tracked family, school, and neighborhood economic indicators (|r| ranging from .12 to .30), and associations did not differ by age, race, or gender. SSS was independently associated with mental health, with stronger associations among older (ages 14-16) versus younger (ages 10-13) adolescents. Adolescents with lower SSS reported higher psychological distress and inattention problems, as well as more conduct problems, in daily life. Those living in areas with higher income inequality reported significantly lower subjective social status, but this association was explained by family and neighborhood income. Findings illustrate that adolescents' SSS is correlated with both internalizing and externalizing mental health problems, and that by age 14 it becomes a unique predictor of mental health problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/dev0000551DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391740PMC
March 2019

Early Pubertal Timing and Testosterone Associated With Higher Levels of Adolescent Depression in Girls.

J Am Acad Child Adolesc Psychiatry 2019 12 14;58(12):1197-1206. Epub 2019 Feb 14.

Duke University Medical Center, Durham, NC.

Objective: The prevalence of depression increases dramatically during puberty in girls. Earlier work in this sample reported that the sex steroids estradiol and testosterone were associated with increased depression in girls. Using three additional data waves (983 new observations), we retest the relative contributions of pubertal timing, pubertal status, and sex hormones on the increases in female depression.

Method: Eight waves of data from the prospective, representative Great Smoky Mountains Study were used covering female participants in the community who were 9 to 16 years of age (3,005 assessments of 630 girls; 1993-2000). Structured interviews assessed depressive disorders. Youth rated their pubertal status using Tanner stage drawings, and sex steroids were assayed from dried blood spots.

Results: Risk for depression during puberty was associated with both age and Tanner stage in univariate models. In adjusted models accounting for pubertal timing and sex steroids, the apparent effects of age and Tanner stage were attenuated both in terms of statistical significance and effect size. The only significant predictors of change in depression status during puberty were early pubertal timing (odds ratio = 5.8, 95% CI = 1.9-17.9, p = .002 after age 12 years) and higher testosterone levels (odds ratio = 2.0, 95% CI = 1.1-3.8, p = .03 for quartile-split variable).

Conclusion: The added observations have modified the original conclusions, implicating the following: testosterone only, but not estradiol; and early pubertal timing, but not age or pubertal status per se. These findings argue for multiple pubertal determinants of depression risk, including factors that are socially and biologically mediated.
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http://dx.doi.org/10.1016/j.jaac.2019.02.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693999PMC
December 2019
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