Developmental trajectories of child to adolescent externalizing behavior and adult DSM-IV disorder: results of a 24-year longitudinal study

Childhood externalizing behavior is found to be relatively persistent. Developmental pathways within types of externalizing behavior have been recognized from childhood to adolescence. We aimed to describe the prediction of adult DSM-IV disorders from developmental trajectories of externalizing behavior over a period of 24 years on a longitudinal multiple birth cohort study of 2,076 children. This has not been examined yet. Trajectories of the four externalizing behavior types aggression, opposition, property violations, and status violations were determined separately through latent class growth analysis (LCGA) using data of five waves, covering ages 4-18 years. Psychiatric disorders of 1,399 adults were assessed with the CIDI. We used regression analyses to determine the associations between children's trajectories and adults' psychiatric disorders. All externalizing behavior types showed significant associations with disruptive disorder in adulthood. In all antisocial behavior types high-level trajectories showed the highest probability for predicting adult disorders. Particularly the status violations cluster predicted many disorders in adulthood. The trajectories most often predicted disruptive disorders in adulthood, but predicted also anxiety, mood, and substance use disorders. We can conclude that an elevated level of externalizing behavior in childhood has impact on the long-term outcome, regardless of the developmental course of externalizing behavior. Furthermore, different types of externalizing behavior (i.e., aggression, opposition, property violations, and status violations) were related to different adult outcomes, and children and adolescents with externalizing behavior of the status violations subtype were most likely to be affected in adulthood.