Second, early-onset axis I psychopathology is an important risk factor for the development and persistence of axis II psychopathology in adulthood (4–6). Building on earlier results from long-term longitudinal studies from the New York State Psychiatric Institute (4, 5) and the Oregon Research Institute (6), Kasen and colleagues report that a range of early-onset disorders significantly increased the risk of developing personality disorders in adulthood. The increase in risk was nearly monotonic: as the number of axis I diagnoses increased, so did the risk of having a personality disorder. For example, the risk of being diagnosed with a cluster B (antisocial, borderline, histrionic, and narcissistic) DSM-III-R personality disorder increased from 11.6% for subjects with no axis I diagnosis, to 21.9% for one axis I diagnosis, to 33.9% for two or three axis I diagnoses, to 50.0% for four or more axis I diagnoses. Similar increases were observed for both cluster A (paranoid, schizoid, and schizotypal) and cluster C (avoidant, dependent, and passive-aggressive) personality disorders. The range of prior axis I diagnoses that contributed to these findings included ADHD, conduct disorder, oppositional defiant disorder, overanxious disorder, separation anxiety disorder, social phobia, and major depressive disorder.