Joshua G Rivenbark1, Candice L Odgers1,2, Avshalom Caspi3,4,5,6, HonaLee Harrington3, Sean Hogan7, Renate M Houts3, Richie Poulton7, Terrie E Moffitt3,4,5,6. 1. Sanford School of Public Policy, Duke University, Durham, NC, USA. 2. Department of Psychology and Social Behavior, University of California, Irvine, CA, USA. 3. Department of Psychology and Neuroscience, Duke University, Durham, NC, USA. 4. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA. 5. Center for Genomic and Computational Biology, Duke University, Durham, NC, USA. 6. Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 7. Department of Psychology, University of Otago, Dunedin, New Zealand.
Abstract
BACKGROUND: Children with conduct problems that persist into adulthood are at increased risk for future behavioral, health, and social problems. However, the longer term public service usage among these children has not been fully documented. To aid public health and intervention planning, adult service usage across criminal justice, health care, and social welfare domains is compared among all individuals from a representative cohort who followed different conduct problem trajectories from childhood into adulthood. METHODS: Participants are from the Dunedin Multidisciplinary Health and Development Study, a prospective, representative cohort of consecutive births (N = 1,037) from April 1972 to March 1973 in Dunedin, New Zealand. Regression analyses were used to compare levels of public service usage up to age 38, gathered via administrative and electronic medical records, between participants who displayed distinct subtypes of childhood conduct problems (low, childhood-limited, adolescent-onset, and life-course persistent). RESULTS: Children exhibiting life-course persistent conduct problems used significantly more services as adults than those with low levels of childhood conduct problems. Although this group comprised only 9.0% of the population, they accounted for 53.3% of all convictions, 15.7% of emergency department visits, 20.5% of prescription fills, 13.1% of injury claims, and 24.7% of welfare benefit months. Half of this group (50.0%) also accrued high service use across all three domains of criminal justice, health, and social welfare services, as compared to only 11.3% of those with low conduct problems (OR = 7.27, 95% CI = 4.42-12.0). CONCLUSIONS: Conduct problems in childhood signal high future costs in terms of service utilization across multiple sectors. Future evaluations of interventions aimed at conduct problems should also track potential reductions in health burden and service usage that stretch into midlife.
BACKGROUND: Children with conduct problems that persist into adulthood are at increased risk for future behavioral, health, and social problems. However, the longer term public service usage among these children has not been fully documented. To aid public health and intervention planning, adult service usage across criminal justice, health care, and social welfare domains is compared among all individuals from a representative cohort who followed different conduct problem trajectories from childhood into adulthood. METHODS: Participants are from the Dunedin Multidisciplinary Health and Development Study, a prospective, representative cohort of consecutive births (N = 1,037) from April 1972 to March 1973 in Dunedin, New Zealand. Regression analyses were used to compare levels of public service usage up to age 38, gathered via administrative and electronic medical records, between participants who displayed distinct subtypes of childhood conduct problems (low, childhood-limited, adolescent-onset, and life-course persistent). RESULTS: Children exhibiting life-course persistent conduct problems used significantly more services as adults than those with low levels of childhood conduct problems. Although this group comprised only 9.0% of the population, they accounted for 53.3% of all convictions, 15.7% of emergency department visits, 20.5% of prescription fills, 13.1% of injury claims, and 24.7% of welfare benefit months. Half of this group (50.0%) also accrued high service use across all three domains of criminal justice, health, and social welfare services, as compared to only 11.3% of those with low conduct problems (OR = 7.27, 95% CI = 4.42-12.0). CONCLUSIONS: Conduct problems in childhood signal high future costs in terms of service utilization across multiple sectors. Future evaluations of interventions aimed at conduct problems should also track potential reductions in health burden and service usage that stretch into midlife.
Authors: Kenneth A Dodge; Karen L Bierman; John D Coie; Mark T Greenberg; John E Lochman; Robert J McMahon; Ellen E Pinderhughes Journal: Am J Psychiatry Date: 2014-10-31 Impact factor: 18.112
Authors: Candice L Odgers; Avshalom Caspi; Jonathan M Broadbent; Nigel Dickson; Robert J Hancox; Honalee Harrington; Richie Poulton; Malcolm R Sears; W Murray Thomson; Terrie E Moffitt Journal: Arch Gen Psychiatry Date: 2007-04
Authors: Eva-Maria Bonin; Madeleine Stevens; Jennifer Beecham; Sarah Byford; Michael Parsonage Journal: BMC Public Health Date: 2011-10-14 Impact factor: 3.295
Authors: Holly E Erskine; Alize J Ferrari; Guilherme V Polanczyk; Terrie E Moffitt; Christopher J L Murray; Theo Vos; Harvey A Whiteford; James G Scott Journal: J Child Psychol Psychiatry Date: 2014-01-22 Impact factor: 8.982
Authors: Francis Vergunst; Richard E Tremblay; Daniel Nagin; Yann Algan; Elizabeth Beasley; Jungwee Park; Cedric Galera; Frank Vitaro; Sylvana M Côté Journal: JAMA Psychiatry Date: 2019-10-01 Impact factor: 21.596
Authors: Rebecca Waller; Samuel W Hawes; Amy L Byrd; Anthony S Dick; Matthew T Sutherland; Michael C Riedel; Michael J Tobia; Katherine L Bottenhorn; Angela R Laird; Raul Gonzalez Journal: Biol Psychiatry Cogn Neurosci Neuroimaging Date: 2020-01-22
Authors: Samuel W Hawes; Rebecca Waller; Wesley K Thompson; Luke W Hyde; Amy L Byrd; S Alexandra Burt; Kelly L Klump; Raul Gonzalez Journal: Psychol Med Date: 2019-03-08 Impact factor: 7.723