ABSTRACT
This study investigates the age 25 outcomes of late adolescent mental health and substance use disorders. A hierarchical cluster analysis of age 19 DSM-III-R mental health and substance diagnoses placed participants into one of 9 clusters: Anxious, Depressed, Antisocial, Drug Abuser, Problem Drinker, Anxious Drinker, Depressed Drug Abuser and Antisocial Drinker, and No Diagnosis. Diagnoses were generated from the University of Michigan Composite International Diagnostic Interview. Repeated measures multivariate analyses of variance revealed distinct trajectories of improvement and decline among the 9 clusters. Clusters with co-occurring substance and mental health disorders improved over adolescent levels, but continued to have higher levels of depression symptoms, poorer global functioning, and higher levels of substance use than the No Diagnosis cluster. Members of the The Problem Drinkers cluster, who tended to have alcohol use disorders only at age 19, did not differ from their peers with no diagnoses. Drug use disorders in adolescence, with or without a co-occurring mental health disorders, were associated with a poor prognosis in emerging adulthood. Clinical interventions should distinguish among these diverse clinical presentations.
Subject(s)
Mental Disorders/epidemiology , Substance-Related Disorders/epidemiology , Adolescent , Adult , Canada/epidemiology , Comorbidity , Female , Humans , Longitudinal Studies , Male , Young AdultABSTRACT
BACKGROUND: Increasing evidence suggests that childhood language problems persist into early adulthood. Nevertheless, little is known about how individual and environmental characteristics influence the language growth of individuals identified with speech/language problems. METHOD: Individual growth curve models were utilised to examine how speech/language impairment and environmental variables (socioeconomic status, family separation, and maternal factors) influence vocabulary development from age 5 to 25. Participants were taken from a community sample of children initially diagnosed with speech/language problems at age 5 and their sex- and age-matched controls. RESULTS: The language impaired group had significantly poorer receptive vocabulary than the speech impaired and control groups throughout the 20-year period. Family income was a significant predictor of vocabulary growth when considered separately, but ceased to be a predictor when language impairment status was taken into account. Maternal education and family separation were determinants of vocabulary at age 5, over and above language impairment status. CONCLUSION: Language impairment is a significant risk factor for vocabulary development from childhood to adulthood. Individuals with speech impairment were less impaired on receptive vocabulary than individuals with language impairment. Further investigation into maternal and familial risk factors may provide targets for early intervention with children at risk for language impairment.
Subject(s)
Child Development , Language Development Disorders/diagnosis , Vocabulary , Adolescent , Adult , Child , Child, Preschool , Educational Status , Female , Humans , Language Development Disorders/etiology , Longitudinal Studies , Male , Mothers , Reference Values , Risk Factors , Single Parent , Social Environment , Socioeconomic Factors , Speech Disorders/diagnosis , Speech Disorders/etiologyABSTRACT
Both children and adults with disabilities face increased prevalence of abuse and assault, including sexual assault. Women and girls are disproportionately the victims of sexual assault in both disabled and nondisabled populations. Communication difficulties have been identified as a factor that may increase the vulnerability of individuals with disabilities to sexual assault. However, few studies have examined whether language impairment increases risk for sexual assault. This study reports on a community sample of children with speech or language impairment, followed to age 25. Sexual assault history was assessed based on two questions from the Composite International Diagnostic Interview Posttraumatic Stress Disorder module. Women with language impairment (n = 33) were more likely than women with unimpaired language (n = 59) to report sexual abuse/assault, controlled for socioeconomic status. Sexual assault was associated with higher rates of psychiatric disorders and poorer functioning. Women with neither language impairment nor a history of sexual assault had fewer psychiatric disorders and higher functioning than women with language impairment and/or a history of sexual assault.
