A Life Course Dynamics Perspective on Comorbidity: Trajectories of Conduct Disorder and Substance Use

Holly Foster, Carnegie Mellon University
Daniel S. Nagin, Carnegie Mellon University
John Hagan, Northwestern University
Jane Costello, Duke University
Adrian Angold, Duke University

This paper uses a dynamic approach to modeling comorbidity using prospectively gathered data from multiple informants on youth conduct disorder and substance use. The resultant patterns of trajectories from these semi-parametric mixture models are described. We extend research specifying the influences of the frequency and quantity of substances used in comorbid relationships by examining how the duration of time spent in the disordered state, as indicated by the types of trajectories, affects subsequent functioning. Selected time varying and invariant risk factors are also examined for amplification effects on the joint trajectories by gender. Three cohorts of adolescents followed over time in the Great Smoky Mountains Study of Youth (GSMSd) data are used to examine these research objectives. This sample includes information on three ethnic groups in rural North Carolina from the baseline ages of nine, eleven, and thirteen through mid to late adolescence. Detailed information on risk trajectories and their amplification may facilitate more developmentally sensitive preventive interventions.

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Updated 05/20/2006