TRAILS-cc: Mental health from preadolescence into adulthood. Risk Concentration and Dilution, Turning Points and Unmet Need

Rational - Three considerations contribute to our overall aim: (1) Adolescence
is increasingly recognized as a developmental period during which spirals of
risk accumulation and dilution are set in motion or become entrenched, with
probably important implications for understanding chronic/recurrent adult
mental disorder. (2) The incidence of mental disorder in adolescence is high,
and these disorders frequently extend into adulthood. (3) Adolescence is a
period of gender-related shifts in the distribution of psychopathology, the
prepubescent preponderance of male over female levels of psychopathology giving
way to a reverse pattern in post-puberty.

Overall Aim - The TRAILS study group*s overall aim is to chart and explain the
development of mental health from preadolescence into adulthood, both at the
level of psychopathology and the levels of underlying vulnerability (and
resilience) and environmental risk. TRAILS seeks to identify early determinants
of chronic/recurrent mental illness and to elucidate the mechanisms that carry
forward their risks. In addition, junctures will be identified at which
environment and individual vulnerability interact to modify the direction of
developmental trajectories, set by past (preadolescent) vulnerability, from
problem resolution to problem accumulation, or vice versa.

Method - TRAILS is a multi-disciplinary, prospective cohort study of all
10-year-olds in approximately five cities, who will be assessed biannually
tracked with bi-annual assessments until their 24th birthday. Information will
be collected from multiple sources: subjects themselves, their teachers and
their parents. Although the need for this type of prospective, longitudinal
research has long been recognized in the Netherlands, it has not materialized
to date.

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