Finally, there is some direct evidence that personality traits assessed in childhood predict the development of depressive disorders in adults. Caspi et al. (1996) reported that children who were rated as socially reticent, inhibited, and easily upset at age 3 had elevated rates of depressive (but not anxiety or substance use) disorders at age 21. Moreover, van Os et al. (1997) found that physicians’ ratings of behavioral apathy at ages 6, 7, and 11 were predictive of both adolescent mood disorder and chronic depression in middle adulthood. However, BI appears to predict the development of anxiety disorders at least as strongly as depression (Hirshfeld-Becker et al. 2008).