Suchergebnisse

The timing and sequencing of completing education, leaving home, beginning full-time work, forming intimate relationships, and parenting are evolving rapidly worldwide. This study describes patterns of transition in a population-based longitudinal study of Australians at ages 20 and 29 ( N = 1,366). Latent class analysis and latent transition analysis identified four categories of emerging adulthood in both age-groups. At age 20, 41.8% were in the category of students living in their parents' home; at age 29, most were categorized as "established young adults" with (25.7%) or without children (51.1%). A majority of "young independents" at age 20 went on to become "established parents" at 29, and most students living independently at age 20 were "established young adults without children" at 29. Findings suggest that the directions of emerging adulthood are largely set in place by age 20. Programs and policies may be needed to support transitions into stable life partnerships and parenthood.

Background Little is known about the long-term psychosocial outcomes associated with self-harm during adolescence. We aimed to determine whether adolescents who self-harm are at increased risk of adverse psychosocial outcomes in the fourth decade of life, using data from the Victorian Adolescent Health Cohort Study. Methods We recruited a stratified, random sample of 1943 adolescents from 44 schools across the state of Victoria, Australia. The study started on Aug 20, 1992, and finished on March 4, 2014. We obtained data relating to self-harm from questionnaires and telephone interviews at eight waves of follow-up, commencing at mean age 15·9 years (SD 0·5; waves 3–6 during adolescence, 6 months apart) and ending at mean age 35·1 years (SD 0·6; wave 10). The outcome measures at age 35 years were social disadvantage (divorced or separated, not in a relationship, not earning money, receipt of government welfare, and experiencing financial hardship), common mental disorders such as depression and anxiety, and substance use. We assessed the associations between self-harm during adolescence and the outcome measures at 35 years (wave 10) using logistic regression models, with progressive adjustment: (1) adjustment for sex and age; (2) further adjustment for background social factors; (3) additional adjustment for common mental disorder in adolescence; and (4) final additional adjustment for adolescent antisocial behaviour and substance use measures. Findings From the total cohort of 1943 participants, 1802 participants were assessed for self-harm during adolescence (between waves 3 and 6). Of these, 1671 were included in the analysis sample. 135 (8%) reported having self-harmed at least once during adolescence. At 35 years (wave 10), mental health problems, daily tobacco smoking, illicit drug use, and dependence were all more common in participants who had reported self-harm during the adolescent phase of the study (n=135) than in those who had not (n=1536): for social disadvantage odds ratios [ORs] ranged from 1·34 (95% CI 1·25–1·43) for unemployment to 1·88 (1·78–1·98) for financial hardship; for mental health they ranged from 1·61 (1·51–1·72) for depression to 1·92 (1·79–2·04) for anxiety; for illicit drug use they ranged from 1·36 (1·25–1·49) for any amphetamine use to 3·39 (3·12–3·67) for weekly cannabis use; for dependence syndrome they were 1·72 (1·57–1·87) for nicotine dependence, 2·67 (2·38–2·99) for cannabis dependence, and 1·74 (1·62–1·86) for any dependence; and the OR for daily smoking was 2·00 (1·89–2·12). Adjustment for socio-demographic factors made little difference to these associations but a further adjustment for adolescent common mental disorders substantially attenuated most associations, with the exception of daily tobacco smoking (adjusted OR 1·74, 95% CI 1·08–2·81), any illicit drug use (1·72, 1·07–2·79) and weekly cannabis use (3·18, 1·58–6·42). Further adjustment for adolescent risky substance use and antisocial behaviour attenuated the remaining associations, with the exception of weekly cannabis use at age 35 years, which remained independently associated with self-harm during adolescence (2·27, 1·09–4·69). Interpretation Adolescents who self-harm are more likely to experience a wide range of psychosocial problems later in life. With the notable exception of heavy cannabis use, these problems appear to be largely accounted for by concurrent adolescent mental health disorders and substance use. Complex interventions addressing the domains of mental state, behaviour, and substance use are likely to be most successful in helping this susceptible group adjust to adult life.

Background: Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal approach to reporting of young adult sequelae. We aimed to provide a broad picture of the psychosocial sequelae of adolescent cannabis use. Methods: We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765). Findings: We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion (adjusted odds ratio 0·37, 95% CI 0·20-0·66) and degree attainment (0·38, 0·22-0·66), and substantially increased odds of later cannabis dependence (17·95, 9·44-34·12), use of other illicit drugs (7·80, 4·46-13·63), and suicide attempt (6·83, 2·04-22·90). Interpretation: Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects. Funding: Australian Government National Health and Medical Research Council.

Background: Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal approach to reporting of young adult sequelae. We aimed to provide a broad picture of the psychosocial sequelae of adolescent cannabis use. Methods: We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765). Findings: We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion (adjusted odds ratio 0·37, 95% CI 0·20-0·66) and degree attainment (0·38, 0·22-0·66), and substantially increased odds of later cannabis dependence (17·95, 9·44-34·12), use of other illicit drugs (7·80, 4·46-13·63), and suicide attempt (6·83, 2·04-22·90). Interpretation: Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects. Funding: Australian Government National Health and Medical Research Council.

The Australian New Zealand Intergenerational Cohort Consortium (ANZ-ICC) brings together three of the longest running intergenerational cohort studies in Australia and New Zealand to examine the extent to which preconception parental life histories (from infancy to parenthood) predict next generation early health and development. The aims are threefold: (1) to describe pathways of advantage that strengthen emotional health and well-being from one generation to the next, (2) to describe pathways of disadvantage that perpetuate cycles of emotional and behavioural problems across generations, and (3) to identify modifiable factors capable of breaking intergenerational cycles. The Victorian Intergenerational Health Cohort Study has followed 1,943 young Australians from adolescence to adulthood across ten waves since 1992, and 1,030 offspring from pregnancy to early childhood since 2006. The Australian Temperament Project Generation 3 Study has followed 2,443 young Australians from infancy to adulthood across 15 waves since 1983, and 1170 offspring from pregnancy to early childhood since 2012. The Dunedin Multidisciplinary Health and Development Study Parenting Study has followed 1,037 young New Zealanders across 15 waves since 1972, and 730 offspring in early childhood since 1994. Cross-cohort replication analyses will be conducted for common preconception exposures and next generation offspring outcomes, while integrated data analysis of pooled data will be used for rare exposures and outcomes. The ANZ-ICC represents a unique collaboration that bridges the disciplines of lifecourse epidemiology, biostatistics, developmental psychology and psychiatry, to study the role of parental preconception exposures on next generation health and development.

Findings from longitudinal research, globally, repeatedly emphasise the importance of taking an early life course approach to mental health promotion; one that invests in the formative years of development, from early childhood to young adulthood, just prior to the transition to parenthood for most. While population monitoring systems have been developed for this period, they are typically designed for use within discrete stages (i.e., childhood or adolescent or young adulthood). No system has yet captured development across all ages and stages (i.e., from infancy through to young adulthood). Here we describe the development, and pilot implementation, of a new Australian Comprehensive Monitoring System (CMS) designed to address this gap by measuring social and emotional development (strengths and difficulties) across eight census surveys, separated by three yearly intervals (infancy, 3-, 6-, 9- 12-, 15-, 18 and 21 years). The system also measures the family, school, peer, digital and community social climates in which children and young people live and grow. Data collection is community-led and built into existing, government funded, universal services (Maternal Child Health, Schools and Local Learning and Employment Networks) to maximise response rates and ensure sustainability. The first system test will be completed and evaluated in rural Victoria, Australia, in 2022. CMS will then be adapted for larger, more socio-economically diverse regional and metropolitan communities, including Australian First Nations communities. The aim of CMS is to guide community-led investments in mental health promotion from early childhood to young adulthood, setting secure foundations for the next generation.