Abstract:
OBJECTIVE:Exposure to violence and other forms of potentially traumatic events (PTEs) are common among youths with externalizing psychopathology. These associations likely reflect both heightened risk for the onset of externalizing problems in youth exposed to PTEs and elevated risk for experiencing PTEs among youth with externalizing disorders. In this study, we disaggregate the associations between exposure to PTEs and externalizing disorder onset in a population-representative sample of adolescents. METHOD:We analyzed data from 13- to 18-year-old participants in the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) (N = 6,379). Weighted survival models estimated hazard ratios (HRs) for onset of oppositional defiant disorder (ODD), conduct disorder (CD), and substance use disorders (SUDs) associated with PTEs, and for exposure to PTEs associated with prior-onset externalizing disorders. Multiplicative interaction terms tested for effect modification by sex, race/ethnicity, and household income. RESULTS:All types of PTEs were associated with higher risk for SUD (HRs = 1.29-2.21), whereas only interpersonal violence (HR = 2.49) was associated with onset of CD and only among females. No associations were observed for ODD. Conversely, ODD and CD were associated with elevated risk for later exposure to interpersonal violence and other/nondisclosed events (HRs = 1.45-1.75). CONCLUSION:Externalizing disorders that typically begin in adolescence, including SUDs and CD, are more likely to emerge in adolescents with prior trauma. ODD onset, in contrast, is unrelated to trauma exposure but is associated with elevated risk of experiencing trauma later in development. CD and interpersonal violence exposure exhibit reciprocal associations. These findings have implications for interventions targeting externalizing and trauma-related psychopathology.
journal_name
J Am Acad Child Adolesc Psychiatryauthors
Carliner H,Gary D,McLaughlin KA,Keyes KMdoi
10.1016/j.jaac.2017.06.006subject
Has Abstractpub_date
2017-09-01 00:00:00pages
755-764.e3issue
9eissn
0890-8567issn
1527-5418pii
S0890-8567(17)30312-Xjournal_volume
56pub_type
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journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
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journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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更新日期:2010-10-01 00:00:00
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journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章,评审
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journal_title:Journal of the American Academy of Child and Adolescent Psychiatry
pub_type: 杂志文章
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