Publications by Year: 2004

Background  Adolescents with early psychiatric hospitalization are likely to be at a significant risk for long-term difficulties.

Objective  To examine early adulthood outcomes of psychiatrically hospitalized adolescents.

Design  Inception cohort recruited from 1978 to 1981 and observed until 2002.

Setting  Northeastern United States.

Participants  Adolescents (aged 12-15 years) from 2 matched cohorts were recruited and assessed repeatedly across 20 years: 70 psychiatrically hospitalized youths and 76 public high school students.

Main Outcome Measures  Death, emotional distress, high school completion, and educational attainment.

Results  Psychiatrically hospitalized youths were significantly more likely to die and to report higher levels of emotional distress. Hospitalized youths were significantly less likely to graduate from high school and complete college and graduate school.

Conclusions  The association between psychiatric symptoms sufficient to result in psychiatric hospitalization during adolescence and later mortality, emotional distress, high school completion, and educational attainment is striking. Further study is needed to identify and understand linkages between adolescent psychiatric impairment and decrements in adult functioning, particularly the processes that may underlie these linkages. Increasing school completion and educational attainment among hospitalized youths may minimize decrements in adult adaptation.

This study examined both continuity and familial, intrapsychic, and environmental predictors of change in adolescent attachment security across a two-year period from mid- to late-adolescence. Assessments included the Adult Attachment Interview, observed mother-adolescent interactions, test-based data, and adolescent self-reports obtained from an ethnically and socio-economically diverse sample of moderately at-risk adolescents interviewed at ages 16 and 18. Substantial stability in security was identified. Beyond this stability, however, relative declines in attachment security were predicted by adolescents’ enmeshed, overpersonalizing behavior with their mothers, depressive symptoms, and poverty status. Results suggest that while security may trend upward for non-stressed adolescents, stressors that overwhelm the capacity for affect regulation and that are not easily assuaged by parents predict relative declines in security. over time.

In this report, we drew on data from an ongoing longitudinal study that began in 1978 (Hauser, Powers, Noam, Jacobson, Weiss, & Folansbee, 1984). Focusing on late, young-adult life among individuals who were psychiatrically hospitalized during adolescence, we examined markers of resilience empirically defined in terms of adult success and well-being. The study includes a demographically similar group recruited from a public high school. Major goals were to (a) develop preliminary models of adaptive functioning among adults in their 30s, (b) examine the extent to which adults with histories of serious mental disorders can be characterized by these models, and (c) explore predictors of successful adult lives from indicators of individuals' psychosocial adjustment at age 25. Results showed significant cohort effects on indexes of adaptive functioning, especially for men. Findings suggest that social relations as well as self-views of competence and relatedness play important roles in characterizing adjustment during the adult years. In addition, indexes of psychosocial adjustment as well as symptoms of psychiatric distress and hard drug use at age 25 made a difference in adult social functioning and well-being, providing hints of possible mechanisms likely to facilitate the ability to “bounce back” after a difficult adolescence.

Adolescent ego-development trajectories were related to close-relationship outcomes in young adulthood. An adolescent sample completed annual measures of ego development from ages 14 through 17. The authors theoretically determined and empirically traced five ego-development trajectories reflecting stability or change. At age 25, the sample completed a close-relationship interview and consented for two peers to rate the participants’ego resiliency and hostility. Participants who followed the profound-arrest trajectory in adolescence reported more mundane sharing of experiences, more impulsive or egocentric conflict-resolution tactics, and less mature interpersonal understanding in their young adult relationships, and their young adult peers described these participants as more hostile. Participants who attained or maintained higher levels of ego development in adolescence reported more complex sharing of experiences, more collaborative conflict-resolution strategies, and greater interpersonal understanding, and their young adult peers rated them as less hostile and as more flexible.

This study examined links between emotion expression in couple interactions and marital quality and stability. Core aspects of emotion expression in marital interactions were identified with the use of naïve observational coding by multiple raters. Judges rated 47 marital discussions with 15 emotion descriptors. Coders’ pooled ratings yielded good reliability on 4 types of emotion expression: hostility, distress, empathy, and affection. These 4 types were linked with concurrent marital satisfaction and interviewer ratings of marital adjustment as well as with marital stability at a 5-year follow-up. The study also examined the extent to which naïve judges’ ratings of emotion expression correspond to “expert” ratings using the Specific Affect Coding System (SPAFF). The unique advantages of naïve coding of emotion expression in marital interaction are discussed.