Findings from the Pittsburgh Youth Study: cognitive impulsivity and intelligence as predictors of the age-crime curve.

OBJECTIVE: This article first summarizes key research findings from the Pittsburgh Youth Study from 1987 to the present, and focuses on delinquency in 1,517 young men who have been followed up from late childhood into their 20s. Second, the article addresses how indicators of self-control prospectively predict later offending, and whether the prediction shows individual difference in the age-crime curve, particularly the up-slope, peak, and down-slope of that curve. METHOD: Longitudinal analyses were conducted on a sample of boys in the middle sample of the Pittsburgh Youth Study (n = 422), whose cognitive impulsivity and intelligence were assessed at about age 12 years. Criminal records on the sample were until age 28. RESULTS: The results show that cognitive impulsivity and intelligence, measured between ages 12 and 13 by means of psychometric tests, predicted the age-crime curve. The age-arrest curve was substantially higher in boys with high cognitive impulsivity and in boys with low IQ. However, there was a significant interaction between cognitive impulsivity and intelligence. For boys with high IQ, cognitive impulsivity was associated with a greater escalation in the prevalence of offending during early adolescence, followed by a more rapid decline in offending as boys entered early adulthood with a slight subsequent increase in criminal offending then occurring late 20. In contrast, there was no evidence that cognitive impulsivity independently influenced criminal offending at any developmental period for boys with low IQ. CONCLUSIONS: The results are discussed in terms of interventions to reduce individuals' delinquency from childhood through early adulthood and lower the age-crime curve for populations. However, the association was complex because it was moderated by both age and intelligence.

The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban African-American population.

This study investigated the effectiveness of a community-academic health center partnership, utilizing nurse-supervised indigenous community health workers, in decreasing the blood pressure in an urban African-American population. A four-year randomized clinical trial was conducted in the Sandtown-Winchester community, which has an excess prevalence of high blood pressure, in order to test the effectiveness of 2 different levels of intervention intensity on increasing the control of high blood pressure. Community health workers were trained and certified in blood pressure management, monitoring, education and counseling, social support mobilization, and community outreach and follow up. The primary results were a significant decrease in mean systolic and diastolic pressures after both levels of intervention, and a significant increase in the percentage of individuals with controlled high blood pressure. Surprisingly, no differences in results were observed between the 2 levels of intervention intensity. This study supports the use of community-based partnership efforts, and the utilization of indigenous health workers, to enhance the control of high blood pressure in a high-risk, African-American urban population.

Rapid disease progression in human immunodeficiency virus type 1-infected seroconverters in India.

To determine if the early immunological and virological events of HIV infection are unique in a setting with limited access to health care and HIV-1 subtype C infection, we undertook a prospective cohort study to characterize the early natural history of HIV viral load and CD4(+) T lymphocyte counts in individuals with recent HIV seroconversion in India. CD4(+) T lymphocyte counts were prospectively measured for up to 720 days in 46 antiviral drug-naive persons with very early HIV infection, documented by HIV antibody seroconversion. HIV viral RNA levels were measured subsequently on reposited plasma samples from these same time points. The median viral load "set point" for Indian seroconverters was 28,729 RNA copies/ml. The median CD4(+) cell count following acute primary HIV infection was 644 cells/mm(3). Over the first 2 years since primary infection, the annual rate of increase in HIV viral load was +8274 RNA copies/ml/year and the annual decline in CD4 cell count was -120 cells/year. Although the viral "set point" was similar, the median trajectory of increasing viral load in Indian seroconverters was greater than what has been reported in untreated HIV seroconverters in the United States. These data suggest that the more rapid HIV disease progression described in resource-poor settings may be due to very early virological and host events following primary HIV infection. A rapid increase in viral load within the first 2 years after primary infection may have to be considered when applying treatment guidelines for antiretroviral therapy and opportunistic infection prophylaxis.