Joint modeling of a linear mixed effects model for selfesteem from mean ages 13 to 22 and a generalized linear model for anxiety disorder at mean age 33

Abstract

Recent work has identified the transition from adolescence to young adulthood as a period with distinct characteristics that is important for understanding of human development. Self-esteem plays a critical role in this developmental process. We use self-esteem data measured at mean ages 13, 16 and 22, and anxiety disorder diagnosis at mean age of 33 to examine the impact of development of self-esteem on onset of adult anxiety disorder. To analyze these data, we propose a Bayesian joint model with: (1) a linear mixed effects model for the longitudinal measurements, and (2) a generalized linear model for the binary primary endpoint. Our analysis indicates that the mean level of self-esteem, not the change of self-esteem, significantly predicts the onset of adult anxiety disorder. A comparison shows that the joint model yields better predictive accuracy than a two-step model. The respective area under ROC curve (AUC) is 0.60 and 0.75 for the two-step model and the joint model, respectively. The two-step estimate may be biased because this method ignores variability in the individual random effects. We conclude that joint model is th