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Impulsive Aggression and the Incidence of Early-Onset Depression in Youth

He, Jiayan (2012) Impulsive Aggression and the Incidence of Early-Onset Depression in Youth. Master's Thesis, University of Pittsburgh. (Unpublished)

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Objective: To assess the relationship between impulsive aggression (IA) and the early-onset depression (OD) in youth.
Method: The data consists of records from 348 youth aged 10 to 25 years who had never had a mood disorder by the time of study entry, but had at least one parent with a diagnosed mood disorder. The participants were recruited at two different sites. The primary outcome was OD and the primary measure of interest was IA. The effect of the baseline IA level was evaluated univariately and after adjusting for other risk factors associated with OD. Univariate analyses of the effect of categorical factors were performed using log-rank and Wilcoxon tests, with the corresponding tests for trends being implemented for ordinal variables. Multivariable modeling was done using the discrete-time proportional hazards model. Optimal dichotomization of IA into high and low risk groups was obtained using the outcome-oriented technique by Contal and O’Quigley.
Results: Univariate analyses indicated that participants with a high level of impulsive aggression had an increased risk of OD (hazard ratio (HR) = 2.0, 95% CI: 1.13 to 3.55). Increased risk for youth with high IA was observed after adjusting for site, offspring risk factors of behavior disorder and puberty, proband risk factors of anxiety disorder and alcohol/substance abuse. Among these factors, only one, behavior disorder, alleviated the effect of IA. Behavior disorder was strongly associated with high risk for depression (HR = 2.51, 95% CI: 1.32 to 4.77) and behavior disorder and IA were closely related, with the rate of behavior disorder in the high IA group being significantly greater than in the low IA group (26.5% vs. 9.4%, p < 0.001).
Conclusions: The results suggest that impulsive aggression is a significant prognostic factor for depression onset. Although part of the information carried by the IA measurement is captured by other measurements (e.g., behavior disorder), the level of IA still offers useful information regarding the future depression onset.
Implication for public health: An understanding of the relationship between impulsive aggression and depression onset is important for the treatment and prevention of depression.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
He, Jiayanjih58@pitt.eduJIH58
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBandos, AndriyAnb61@pitt.eduANB61
Committee MemberBrent, DavidBrentDA@upmc.eduBRENT
Committee MemberMazumdar, Satimaz1@pitt.eduMAZ1
Date: 13 August 2012
Date Type: Completion
Defense Date: 29 May 2012
Approval Date: 13 August 2012
Submission Date: 6 June 2012
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 56
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Impulsive Aggression; Depression; behavior disorder; survival analysis
Date Deposited: 13 Aug 2012 16:14
Last Modified: 13 Aug 2017 05:15

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