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Trajectories of dynamic predictors of disorder: Their meanings and implications

  • KENNETH J. SHER (a1), HEATHER J. GOTHAM (a1) and AMY L. WATSON (a1)

Abstract

Developmental psychopathologists are increasingly focused on characterizing heterogeneity of trajectories of psychological disorders across the life course (e.g., developmentally limited vs. chronic forms of disorder). Although the developmental significance of trajectories has been highlighted, there has been little attention to relations between trajectories and their etiologically and clinically relevant time-varying covariates (dynamic predictors). Depending upon the functional relation between a disorder and a dynamic predictor, we expect to see different trajectories of dynamic predictors. Thus, we propose a taxonomy of trajectories of dynamic predictors of course of disorder and provide an initial investigation into its validity. Using a mixed-gender, high-risk sample of young adults followed over 7 years, we identified dynamic predictors that covary with the course of alcohol use disorder (AUD). Based on a logically derived classification to facilitate interpretation of findings, three comparison groups were examined: persons whose AUD “remitted” (n = 33), those with a chronic AUD (n = 29), and nondiagnosers (n = 274). We hypothesized seven patterns of dynamic prediction (stable vulnerability indicators, course trackers, deterioration markers, developmentally specific variables, developmental lag markers, course-referenced variables, and recovery behaviors) and found evidence for five of them. The interpretation of markers of risk for development and course of AUDs and their implications for prevention, early intervention and formal/self-change treatments are discussed.Preparation of this article was supported by NIH Grants R37AA07231 and R01AA013987 to Kenneth J. Sher and P50 AA11998 to Andrew Heath from the National Institute on Alcohol Abuse and Alcoholism. Portions of this research were presented at the annual meeting of the Research Society on Alcoholism, Denver, CO, June 2000; the biennial meeting for the Society for Research on Adolescence, April 2000; and the Michigan Symposium on Developmental Discontinuities, June 2002. We gratefully acknowledge Laurie Chassin, Patrick Curran, Andrea Hussong, Kristina M. Jackson, Jenny Larkins, Terrie Moffitt, and Susan O'Neill for providing numerous, helpful comments on an earlier version of this article.

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Corresponding author

Address correspondence and reprint requests to: Kenneth J. Sher, Department of Psychological Sciences, 200 South Seventh Street, University of Missouri–Columbia, Columbia, MO 65211; E-mail: sherk@missouri.edu.

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