Background
Childhood adversity strongly predicts adolescent multiple health risk behaviours (MRBs)
such as alcohol/tobacco use, self-harm, and physical inactivity, and both adversities and
MRBs are associated with premature mortality as well as several chronic health conditions
that are among the leading causes of death in adults. ...
Background
Childhood adversity strongly predicts adolescent multiple health risk behaviours (MRBs)
such as alcohol/tobacco use, self-harm, and physical inactivity, and both adversities and
MRBs are associated with premature mortality as well as several chronic health conditions
that are among the leading causes of death in adults. It is therefore important to
understand the relationship between adversities and MRBs and what could mediate any
association. The aim of this study was to explore whether childhood psychopathology
mediates associations between adversities and MRBs.
Methods
Participants were young people in the Avon Longitudinal Study of Parents and Children
(ALSPAC) (N=5799). Using structural equation modelling, we explored the associations
between adversities before 9 years and MRBs at age 16 years. We also explored potential
mediating pathways through dimensional psychopathology measured by the Strength and
Difficulties Questionnaire subscales at age 12 years.
Results
There were strong positive associations between adversities and MRBs (β 0.25, 95% CI 0.20,
0.31, p<0.001) suggesting that each additional adversity is associated with a 0.25 increase in
number of MRBs out of 13 total risk behaviours. We found robust evidence of mediating
pathways from adversities through conduct problems (β 0.05, 95% CI 0.03, 0.06, p<0.001), hyperactivity/inattention (β 0.02, 95% CI 0.01, 0.03, p<0.001) and peer relationship
problems (β -0.02, 95% CI -0.03, -0.02, p<0.001) to MRBs.
Conclusions
Increased conduct problems and hyperactivity/inattention appear to partially explain the
relationship between adversities and MRBs. Peer relationship problems also appear to
reduce the association between adversities and MRBs and further research is needed to
understand how to encourage peer connectivity without increasing risk of MRBs. These
results suggest that interventions aimed at reducing MRBs among those exposed to
childhood adversities could focus on prevention of behavioural problems.
