Behavior problems in adolescence and subsequent mental health in early adulthood: Results from the World Trade Center Health Registry Cohort

BACKGROUND: The present study examined the association between 9/11-related adolescent behavioral problems on mental health outcomes in early adulthood. METHODS: Data from enrollees of the World Trade Center Health Registry who completed at least one adolescent (2006-2007 or 2011-2012) and adult survey (2011-2012 or 2015-2016) were analyzed. Adolescent behavioral difficulties were assessed using the adolescent-reported Strengths and Difficulties Questionnaire (SDQ). Adult mental health outcomes included: binge drinking; smoking status history; 9/11-related post-traumatic stress disorder (PTSD); depression; and the self-reported number of physician mental health diagnoses. Multivariable regression was used to estimate associations of SDQ with mental health outcomes. RESULTS: Of the 297 enrollees, 16.8% (n=50) had abnormal/borderline SDQ as an adolescent. Binge drinking was not associated with adolescent SDQ. Enrollees with abnormal/borderline SDQ as an adolescent were more likely to be a consistent smoker (odds ratio (OR): 5.6, 95% confidence interval (CI): 1.2-25.2), have probable PTSD (OR: 3.5, 95% CI: 1.3-9.8); depression (OR: 6.2, 95% CI: 2.7-13.9); and to have 2 or more self-reported physician diagnosed mental health conditions as an adult (OR 5.6, 95% CI: 2.0-12.5). CONCLUSIONS: This study’s findings underscore the need to intervene early with children exposed to traumatic events so as to avert later adolescent and adult problem behaviors.