Purpose: Both aggression toward others and self peak in adolescence and interpersonal violence and suicide are among the leading causes of death in young people worldwide. Individuals who show both aggression toward others and self, i.e. dual-harm, may experience the worst outcomes. The current study investigates clinical and parenting factors associated with dual-harming in adolescence, to provide new insights for prevention and treatment. Methods: In a prospective cohort of adolescents, oversampled on emotional and behavioral problems (n = 1022; aged 12–17 years), we investigated co-occurrence in harm toward others and self and presented findings in an area-proportional Euler diagram. Four harm groups (no harm, other-harm, self-harm, and dual-harm) were compared on intelligence scores, general functioning, emotional and behavioral problems, substance use, parental hostility, and harsh parenting with ANCOVAs and logistic regressions. Results: In adolescents that other-harmed, the risk of self-harm was 1.9 times higher than for those who did not harm others. Dual-harm adolescents reported worse overall functioning, more emotional and behavioral problems, more parental hostility and harshness, and were more likely to use substances than those who did not engage in aggressive behaviors. No evidence of differences in intelligence scores between groups were found. Conclusion: These findings highlight a vulnerable group of adolescents, at risk of future suicide, violent offending, and the development of severe psychopathology. Dual-harm is a promising marker for early intervention and referral to specialized mental health professionals. Further research is needed to examine underlying pathways and risk factors associated with persistent dual-harm trajectories into adulthood.

The present study investigated sex differences in the associations between adolescent psychopathology and delinquent behavior over time. In a Dutch prospective population-based cohort, oversampled on emotional and behavioral problems, we examined the associations between psychopathology, based on multi-informant standardized assessments (mean age, 15 years) and self-reported early delinquency outcomes on average 3 years later in 725 adolescents. Associations between psychopathology (ie, depressive, anxiety, attention-deficit/hyperactivity disorder [ADHD], oppositional defiant and conduct problems, and psychotic experiences) and self-reported early delinquent behavior were tested using logistic regression models. Sex–psychopathology interaction effects were explored. Of the participating adolescents, 21% reported serious delinquent behavior at follow-up. ADHD and conduct problems at age 15 years were associated with higher odds of serious delinquent behavior at age 18 years (OR = 1.96, 95% CI = 1.21-3.18 and OR = 4.75, 95% CI = 2.32-9.76, respectively). ADHD was associated with serious delinquent behavior in boys, but not in girls. In cross-sectional analyses at age 18 years, having anxiety problems was protectively associated with serious delinquent behavior. Psychopathological problems are associated with serious delinquent behavior, with variations in the associations observed between adolescent boys and girls. These findings indicate that the pathways linking psychiatric conditions to delinquent behavior differ across sexes.

Background and Hypothesis: Psychotic symptoms are common in adolescents and predictive of psychiatric disorders. Numerous risk factors have been shown to precede psychiatric disorders. However, investigating individual risk factors does not account for the cumulative effect these risk factors may have. Therefore, we combined well-researched environmental risk factors for psychotic disorder in a composite measure: the poly-environmental risk score (PERS). Study Design: Risk factors were assessed in a cohort of 801 adolescents (aged 15) at risk for psychopathology. Binarized risk factors included winter birth, low gestational age, low birth weight, ethnic minority status, urban living environment, cannabis use, victim of bullying, emotional abuse, physical abuse, sexual abuse, high paternal age, parental severe mental illness, parental divorce, and parental death. The PERS was weighted with the log odds derived from recent meta-analyses. At age 18, self-reported psychotic experiences (PE) and clinician-rated psychotic symptoms (PS) were assessed. This updated PERS was compared to previous PERS models, which included fewer risk factors and different weightings. Study Results: The PERS was associated with PE and PS. Specifically, a PERS between 3 and 4, and PERS > 4 corresponded with a 2.2- and 5.2-fold increase in the odds of psychotic symptoms in late adolescence. The updated 14-item PERS performed better compared to previous compositions of the PERS. Conclusions: A composite score of childhood and adolescent risk factors measured at age 15 was associated with psychotic symptoms at age 18. Future research should consider the cumulative effect of risk factors when examining the determinants of psychopathology.

Background: Patients with psychiatric disorders are more likely to experience financial difficulties. Yet, there is limited knowledge about the longitudinal relationship between psychopathology in adolescence and debts or experienced financial scarcity in emerging adulthood. Aims: We aimed to examine whether distinct types of psychological symptoms in mid-adolescence precede the occurrence of unsecured debts and experienced financial scarcity in emerging adulthood. Method: Data from a Dutch adolescent cohort (N = 659, 53.9% female) oversampled on the risk of psychopathology was used. Psychological symptoms were self-reported at baseline (mean age 14.80 years, s.d. = 0.79), using the Youth Self-Report and the Prodromal Questionnaire-16. At follow-up (mean age 17.95 years, s.d. = 0.80), adolescents reported presence of unsecured debts and completed the Psychological Inventory of Financial Scarcity. Logistic and linear regression analyses were applied, adjusting for the baseline characteristics of sex, age, ethnic background, parental psychopathology and household income as an indicator of family socioeconomic status. Results: More attention-deficit/hyperactivity problems (adjusted odds ratio 1.15, 95 CI% 1.04–1.27), oppositional defiant problems (adjusted odds ratio 1.17, 95 CI% 1.00–1.35) and psychotic experiences (adjusted odds ratio 1.10, 95 CI% 1.01–1.21) at age 15 years were associated with unsecured debts at age 18 years. Depressive, anxiety, somatic and conduct problems were not associated with later unsecured debts. Depressive, anxiety, attention-deficit/hyperactivity, oppositional defiant, conduct problems and psychotic experiences at age 15 years were associated with increased experienced financial scarcity at age 18 years. Conclusions: Psychological symptoms during mid-adolescence precede both objective and subjective financial difficulties when entering adulthood. Integrating financial education into prevention efforts could potentially provide significant long-term benefits, particularly for those with mental health problems.