Are psychosocial factors in late childhood and mid-adolescence associated with multiple risk behaviours at age 16 years: Analysis using the ALSPAC birth cohort.

Aims: To explore the potential mediating pathways between psychosocial factors in late childhood and mid-adolescence and multiple risk behaviours (MRB) at age 16 years. Background: Engagement in MRB is associated with adverse health outcomes in later life, including chronic health conditions, morbidity and premature mortality. It is therefore important to understand the antecedents of MRB. Methodology: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort of children born in England between 1991-3 were used to explore pathways from late childhood through to adolescence. Using structural equation models, we explored the associations between depressive symptoms and antisocial behaviour at age 10 and sensation seeking at age 11; and MRB at age 16 years. We also explored potential mediating pathways through: self-image, social relations at school, perception of teachers and perception of school at age 14 years and experimentation with tobacco, alcohol or cannabis, before age 13 years. Results: There are strong associations between depressive symptoms (0.22, 95%CI=[0.12,0.31], p<0.001), antisocial behaviour (0.44, 95%CI=[0.32,0.56], p<0.001) and sensation seeking (0.58, 95%CI=[0.49,0.66] p<0.001) in late childhood and higher MRB at age 16 years. We also found strong evidence of mediating pathways through depressive symptoms and negative perception of school (0.04, 95%CI=[0.02,0.06], p<0.001) and negative perception of teachers (0.06, 95%CI=[0.03,0.08], p<0.001); from sensation seeking through negative perception of teachers (0.05, 95%CI=[0.03,0.08], p<0.001) and early experimentation with tobacco, alcohol or cannabis (0.09, 95%CI=[0.08,0.11], p<0.001); and from antisocial behaviour through negative perception of school (0.04, 95%CI=[0.02,0.07], p=0.001) and higher MRB at age 16 years. Conclusions: There were strong associations between psychosocial factors in late childhood and higher MRB at age 16 years. Whilst these three psychosocial factors were related, there were distinct mediating pathways through factors in mid-adolescence. These results provide evidence of important targets for interventions aimed at reducing adolescent MRB.