Cumulative risk, cumulative outcome: a 20-year longitudinal study

Area of Science:

• Developmental Psychology
• Public Health
• Longitudinal Studies

Background:

• Cumulative risk (CR) models are robust in developmental research.
• Existing studies often predict outcomes individually or with short-term designs.
• A comprehensive, single-sample approach is needed to predict diverse outcomes prospectively.

Purpose of the Study:

• To test if a single CR index prospectively predicts diverse outcomes (depression, intelligence, school dropout, arrest, smoking, physical disease).
• To examine if the number of risk factors predicts the number of adverse outcomes (cumulative outcome; CO).
• To determine if early CR explains variance in CO beyond subsequent risk exposure.

Main Methods:

• A sample of 284 individuals was assessed for cumulative risk at ages 5/6, 12/13, and 19/20.
• Outcomes were assessed at age 25/26.
• Statistical analyses were used to evaluate the predictive power of CR and the association between risk factors and outcomes.

Main Results:

• Cumulative risk consistently predicted all assessed outcomes at age 25/26.
• A higher number of risk factors was positively associated with a greater number of adverse outcomes.
• Early CR significantly predicted CO, even after accounting for later risk exposure.

Conclusions:

• A single cumulative risk index effectively predicts a wide range of adverse developmental outcomes.
• Early adversity has lasting effects, influencing cumulative outcomes throughout life.
• Findings support a "mediated net of adversity" model, where early risk impacts central factors affecting multiple health domains.