Skip to main content
Article thumbnail
Location of Repository

Economic outcomes in adulthood and their associations with antisocial conduct, attention deficit and anxiety problems in childhood

By Martin Knapp, Derek King, Andrew Healey and Cicely Thomas


Mental health problems in childhood have negative effects on individuals and families for potentially many years. Using data from a British birth cohort study, we tested for links between behavioural and emotional problems in childhood, and occupational status and earnings in adulthood, adjusting for individual and family covariates. Among males, antisocial conduct at age 10 was associated with a higher probability unemployment at age 30, but higher earnings if employed, and higher expected earnings. Childhood attention deficit problems were associated with lower employment rates, worse jobs, lower earnings if employed, and lower expected earnings overall for both males and females. Childhood anxiety problems were associated with lower earnings in adulthood. Prevention, early detection and treatment of these mental health problems might head off many of these long-term negative consequences for children, their families and wider society. Background: Conduct disorder (antisocial conduct), attention deficit problems and anxiety in childhood have negative effects on individuals during their childhood, on their families, and often into adulthood. Aims of the Study: To quantify the connections between childhood antisocial conduct, attention deficit and anxiety, and some adulthood economic consequences. Methods: Data from a British birth cohort study were examined for links between behavioural and emotional problems in childhood, and occupational status and earnings in adulthood, after adjusting for individual and family covariates. Results: The effects of antisocial conduct on adult labour market outcomes were complex. Results for males with antisocial conduct at age 10 showed a higher probability of being unemployed at age 30 (after adjustment for other factors). However, males with antisocial conduct at age 10 had higher earnings than those without such behaviour, again after adjusting for other factors. There were no such differences for females with antisocial conduct. Attention deficit problems at age 10 were associated with lower employment rates, worse jobs, lower earnings if employed, and lower expected earnings overall - for both males and females. Anxiety problems were associated with lower earnings. Other childhood factors associated with worse adulthood economic outcomes included cognitive attainment, living in a disadvantaged neighbourhood, mother's educational qualifications, family income and being looked after by a local authority. Discussion: Links between antisocial conduct and attention deficit in childhood and high adulthood personal and societal costs support arguments for effective interventions to prevent and treat behavioural problems in childhood. However, the cost-effectiveness of such interventions still needs to be considered carefully. Implications for Policy: Childhood mental health problems are strongly linked to adverse adulthood experiences across a number of domains. Early detection and intervention might head off many of these negative outcomes for children, their families and wider society. The positive impact of antisocial conduct on earnings needs further examination: it is not necessarily counter-intuitive, but it raises interesting policy questions. Implications for Further Research: The long-term outcomes of childhood problems and interventions need further study, as do the pathways connecting childhood morbidity, adulthood outcomes and other potential intervening factors

Topics: BF Psychology, H Social Sciences (General), HC Economic History and Conditions, RJ101 Child Health. Child health services
Publisher: International Center of Mental Health Policy and Economics
Year: 2011
OAI identifier:
Provided by: LSE Research Online

Suggested articles


  1. (1967). A children's behaviour questionnaire for completion by teachers: Preliminary findings. doi
  2. (1969). A teacher rating scale for use in drug studies with children. doi
  3. (1991). Adult disorders predicted by childhood conduct problems: Results from the NIMH Epidemiologic Catchment Area project. Psychiatry
  4. (2004). Adult labour market implications of antisocial behaviour in childhood and adolescence: findings from a UK longitudinal study, Appl Econ doi
  5. (2000). Aggression in childhood and long-term unemployment in adulthood: a cycle of maladaptation and some protective factors. Dev Psychol doi
  6. (2001). Antisocial children grown up. doi
  7. (2001). Assessing Costs and Benefits of Early Childhood Intervention Programs.
  8. (2001). Association between behaviour at age 3 years and adult criminality. doi
  9. (2004). Benefits and Costs of Prevention and Early Intervention Programs for Youth.
  10. (1978). British Ability Scales Windsor: National Foundation for Educational Research,
  11. (2006). Child mental health and human capital accumulation: the case of ADHD. doi
  12. (2009). Childhood mental health and life chances in post-war Britain – Insights from three national birth cohort studies. A report for the Sainsbury Centre for Mental Health
  13. (2006). Childhood predictors of male criminality: a prospective population-based follow-up study from age 8 to late adolescence. doi
  14. (2007). Conduct disorders in children: parent programmes are effective but training and provision are inadequate (editorial),
  15. (2008). Conduct disorders of childhood and adolescence, doi
  16. (1998). Continuities and discontinuities in antisocial behaviour from childhood to adult life. doi
  17. (2005). Continuities between childhood and adult life. doi
  18. (2010). Cost-effectiveness analysis and child and adolescent mental health problems, doi
  19. (1997). Costs and Benefits of Primary Prevention: A review of the literature. Paper presented at Primary Prevention of Adult Antisocial Behaviour Meeting,
  20. (1998). Early failure in the labour market: Childhood and adolescent predictors of unemployment in the transition to adulthood. Am Socio Rev doi
  21. (2006). Economic cost of severe antisocial behaviour in children – and who pays it. doi
  22. (2005). Economic evaluations of child and adolescent mental health interventions: a systematic review, doi
  23. (2005). Economic implications of psychosocial development in childhood: longterm outcomes and the costs of interventions,
  24. (1999). Effectiveness of early interventions for preventing mental illness in young people: a critical appraisal of the literature.
  25. (2001). Estimating log models; to transform or not to transform? doi
  26. (1966). Estimation with heteroskedastic error terms. Econometrica doi
  27. (2001). Financial cost of social exclusion: follow-up study of antisocial children into adulthood, doi
  28. (2007). Interventions for children at risk of developing antisocial personality disorder: Report to the Department of Health and Prime Minister’s Strategy Unit. London: Policy Research Bureau,
  29. (2007). Is stacking intervention components cost-effective? An analysis of the Incredible Years Program. doi
  30. (2009). Long-term consequences of childhood ADHD on criminal activities. doi
  31. (1995). Long-Term Effects of Early Childhood Programs on Cognitive and School Outcomes. Future Child doi
  32. (1995). Long-term effects of early childhood programs on social outcomes and delinquency. doi
  33. (2000). Mental Health of Children and Adolescents in Great Britain. London; The Stationery Office, doi
  34. (1998). Much ado about two: reconsidering retransformation and the twopart model in health econometrics. doi
  35. Multiple Imputation for Non-Response in Surveys. doi
  36. (1999). NORM: Multiple Imputation of Incomplete Multivariate Data under a Normal Model, version 2. Retrieved 3/2004 from
  37. (1999). On the performance of multiple imputation for multivariate data with small sample size. In
  38. (2007). Oppositional defiant and conduct disorders. doi
  39. (2006). Predicting adult life outcomes from earlier signals: identifying those at risk.
  40. (2006). Predictors of antisocial behaviour in children with attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry doi
  41. (2003). Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry doi
  42. (1979). Sample selection bias as a specification error. Econometrica doi
  43. (2005). Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood. doi
  44. (1954). Social learning and clinical psychology. doi
  45. (2004). Support from the start: working with young children and their families to reduce the risks of crime and anti-social behaviour. DfES Brief No: RB524, doi
  46. (2009). The clinical effectiveness of different parenting programmes for children with conduct problems: a systematic review of randomised controlled trials. Child and Adolescent Psychiatry and Mental Health doi
  47. (1976). The common structure of statistical models of truncation, sample selection and limited dependent variables and a simple estimator for such models.
  48. (1981). The development of a self-esteem questionnaire. doi
  49. (2007). The economic analysis of prevention: an illustration involving children’s behaviour problems.
  50. (2000). The Heckman correction for sample selection and its critique. doi
  51. (2005). The high costs of aggression: public expenditures resulting from conduct disorder. Rev Panam Salud Publica doi
  52. (2002). The Maudsley longterm follow-up study of child and adolescent depression: impact of comorbid conduct disorder on service use and costs in adulthood. doi
  53. (1998). The monetary value of saving a high-risk youth. doi
  54. (1992). The outcome of childhood conduct disorder: implications for defining adult personality disorder and conduct disorder. Psychol Med doi
  55. (2000). The relative economic importance of academic, psychological and behavioural attributes developed in childhood. Centre for Economic Performance (LSE) Discussion Paper,
  56. (2004). Time trends in adolescent mental health. doi
  57. (2001). Using multivariate statistics (4th edition).
  58. (2000). Young children who commit crime: Epidemiology, developmental origins, risk factors, early interventions, and policy implications. Dev Psychopathol doi

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.