Influence of child and adolescent psychiatric disorders on young adult personality disorder

Objective: This study examines associations between childhood psychopatholo gy and young adult personality disorder in a random sample of 551 youths, w ho were 9 to 16 years old at first assessment. Method: Subjects were evalua ted for DSM-III-R psychiatric disorders. Information was obtained prospecti vely from youths and their mothers at three points over 16 years. The predi ctive effects of prior axis I disorders and adolescent axis II personality disorder clusters A, B, and C on young adult personality disorder were exam ined in logistic regression analyses. Results: The odds of young adult pers onality disorder increased given an adolescent personality disorder in the same cluster. Prior disruptive disorders, anxiety disorders, and major depr ession all significantly increased the odds of young adult personality diso rder independent of an adolescent personality disorder. In addition, comorb idity of axis I and axis II disorders heightened the odds of young adult pe rsonality disorder relative to the odds of a disorder on a single axis. Con clusions: Assessment of personality pathology before late adolescence may b e warranted. Childhood or adolescent axis I disorders may set in motion a c hain of maladaptive behaviors and environmental responses that foster more persistent psychopathology over time. Identification and treatment of child hood disorder may help to reduce that risk.