This report describes a longitudinal study of children and their families. The first phase of the study, conducted in 1990 on a sample of 185 children, revealed that a considerable number of children (16%) and approximately a third of mothers showed evidence of clinically significant psychiatric disorder. Disorder in the child was associated with the economic circumstances of the family, and maternal health was linked to disadvantage as well as dissatisfaction with domestic roles and inadequate social support. The second phase of the research, on which this report is based, included 97 young people, successfully contacted and interviewed for the study in 2000. The aim was to examine their subsequent health and social development and to determine whether childhood psychological and behavioural disturbance was associated with long-term outcome.
Social Development and Family Background
- The average age of respondents was twenty-one years. Almost all were raised in the family home by both parents. All were unmarried; approximately a fifth now had children. They came mainly from semi-skilled manual backgrounds and a fifth of the mothers reported severe financial hardship during the participants' childhood.
- There were wide discrepancies in relation to educational attainment. Approximately one-third respondents had not completed second level education yet a high percentage (60%) of those who did finish secondary schooling went on to third level. Almost all were currently employed or engaged in full-time education or training.
- Approximately one-quarter of those interviewed, three-quarters of whom were male, had had some contact with the law but this was generally for minor offences. Health and Well-being
- In general, respondents were well-adjusted and happy. They demonstrated adequate levels of self-esteem and independence and were well integrated socially.
- There was no evidence of serious psychiatric disorder and only a small percentage were receiving treatment for psychological difficulties. However, symptom levels were high amongst those interviewed, albeit below that required to establish a formal psychiatric diagnosis.
- There was little indication of serious drug misuse but a majority (55%) had used non-prescription drugs at some time. Alcohol consumption was high, especially amongst male respondents, and participants tended to underestimate their level of alcohol use.
- Respondents' mothers showed little evidence of formal psychiatric disorder despite the relatively high levels of disorder recorded for them in Phase One.
Childhood Health and Behaviour and Adult Outcome
- An assessment of behavioural deviancy at age eleven was highly predictive of poor educational outcome and this likelihood increased with the accumulation of risk factors.
- Socio-economic disadvantage was a major risk factor for poor educational outcome. Respondents with a diagnosis and/or categorisation of deviancy were generally from economically disadvantaged backgrounds and these circumstances together considerably affected their educational progress.
- IQ was importantly related to educational achievement but economic factors modified its effects. Participants without economic disadvantage were able to reach higher educational levels even when they had equivalent or lower IQ levels.
- The relatively positive adult profile of participants which emerged from the study must be considered in the context of findings relating to untraced individuals. At age eleven this group had a significantly higher level of behaviour disorder than either participants or refusals. They subsequently had considerably higher levels of juvenile offending then other respondents.
The young people studied for this report were, in general, healthy and happy and benefiting from increased educational and employment opportunities available in this country. For the majority of participants in this longitudinal study the high prevalence of psychiatric and conduct disorder, evident ten years previously, when they were aged eleven years, proved to be transitory and without long-term psychological consequences. However, early behavioural and or psychological disorder in the child did impact on educational progress, especially if this was combined with economic disadvantage. Economic resources compensated for IQ deficiencies and children from better-off families, whatever their intellectual capacity, were more likely to access higher educational levels. Early behavioural difficulties are thus signalled here as key to understanding outcome, especially educational attainment. These findings are reinforced by the possibility that had the untraced group been included the impact of behavioural problems would most likely have been greater. Untraced individuals had higher levels of childhood disorder at Phase One, and considerably elevated offending rates, compared to study respondents (and refusals). The fact that the mothers interviewed were now, despite past diagnoses, relatively symptom free raises the possibility that at least some of the disorder seen in the mothers of ten years ago may have resulted from the stress inherent in coping with behavioural disturbance in the child. In the light of these findings it may be opportune to re-examine the association between economic disadvantage, behavioural difficulties and child heath.