title: Cumulative risk, cumulative outcome: a 20-year longitudinal study.
abstract: Cumulative risk (CR) models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO). We also predicted that early CR (assessed at age 5/6) explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20). The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a "mediated net of adversity" model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.
authors.affiliation: Ryerson University, Toronto, Ontario, Canada.
authors.forename: Leslie
authors.initials: L
authors.lastname: Atkinson
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: Beitchman
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gonzalez
authors.affiliation: University of Guelph, Guelph, Ontario, Canada.
authors.forename: Arlene
authors.initials: A
authors.lastname: Young
authors.affiliation: Social Planning Toronto, Toronto, Ontario, Canada.
authors.forename: Beth
authors.initials: B
authors.lastname: Wilson
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Escobar
authors.affiliation: Queen Margaret University, Edinburgh, United Kingdom.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Chisholm
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brownlie
authors.affiliation: Ryerson University, Toronto, Ontario, Canada.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Khoury
authors.affiliation: Ryerson University, Toronto, Ontario, Canada.
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Ludmer
authors.affiliation: Ryerson University, Toronto, Ontario, Canada.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Villani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D006801:Humans; D008137:Longitudinal Studies; D012044:Regression Analysis; D012307:Risk Factors; D055815:Young Adult