Is Mental Health Competence in Childhood Associated With Health Risk Behaviors in Adolescence? Findings From the UK Millennium Cohort Study


 Objective: The objective of this academic work is to demonstrate evidences available in literature about the association among the pubertal maturation and health risk behavior in adolescents.
 Methods: It was used the database from MEDLINE/Pubmed, Scopus, Lilacs and Web of Science. The terms used in the research, with its variations, were “puberty”, “maturation”, “maturity”, “risk behaviors”, “risk factors”, “adolescent” and “student”.
 Results: Out of 838 manuscripts found in the databases, after the sorting and applied the eligibility criteria, remained in this systematic review 13 articles. Early maturation was associated significantly with the use of alcohol, cigarettes and illegal drugs, early sexual initiation, sedentary behaviors and involvement in fights, where girls showed higher prevalence.
 Conclusions: Henceforth, the results from the current study indicates that the early maturation is associated with health risk behaviors in adolescents, especially with the use of alcohol and cigarettes. 

Adolescence is a critical period where major physical and psychologic changes occur. It is also a period where several lifelong health related behaviors are adopted and established. Behaviors such as unhealthy eating, tobacco use, alcohol use, and physical inactivity are related to major causes of morbidity and mortality among young and adults. Physical activity (PA) is an important behavior during adolescence not only because it is associated with general health, but also because it may be associated with other health-related risk behaviors. PURPOSE: To examine the association of physical activity with health risk behaviors in adolescents from Curitiba- Brazil. METHODS: A cross-section study was carried out with a representative sample of 928 (mean age 14.06 ± 1.91 years old, 467 girls) adolescents enrolled in 14 randomly selected public schools from Curitiba, Brazil. The Brazilian version of the Youth Activity Profile survey evaluated PA levels and the YRBS survey evaluated fruit, vegetable, alcohol, and tobacco consumption in the past 30 days. The Adolescent Sedentary Questionnaire evaluated total screen time. Binary Logistic regression measured the association between PA levels and risk behaviors after controlling for gender, age, BMI status, income status, and parent educational level. RESULTS: PA was inversely associated with low fruit consumption (OR = .50, 95% IC = .38 - .66, p <.001), low vegetable consumption (OR =.55, 95% IC = .42 - .73, p < .001), and high screen Time (≥3 hours/day) (OR = .79, 95% IC = .65 - .96, p < .001). Additionally, PA was positively associated with the consumption of at least one dose of alcohol in the past 30 days (OR = 1.47, 95% IC = 1.15 – 1.88, p < .001), and with the excessive consumption of alcohol (OR = 1.73, 95% IC = 1.29 – 2.33, p <.001). PA was not associated with Tobacco consumption (OR = 1.01, 95% IC = .67 – 1.52, p = .96). CONCLUSION: The results indicated that adolescents with higher PA levels consumed more fruits and vegetables and spent less time in front of electronic screens. However, adolescents with higher levels of PA were also more likely to report alcohol consumption in the past 30 days. The social characteristics of alcohol consumption may explain its positive relationship to PA. Supported by CNPq, Brazil.

To conduct a systematic review and meta-analysis to verify the association of aspects of sports practice with health risk behaviors in adolescents. A systematic search was conducted of electronic manuscripts from the United States National Library of Medicine (PubMed)/ Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, Science Direct, and Scientific Electronic Library Online (SciELO) published from January 2015 to December 2022. Studies examining the association between sport and health risk behaviors in adolescents aged 11 to 19 years were included. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42023392053. In total, 22 studies fulfilled the inclusion criteria. The association of sports practice with sedentary behavior showed odds ratio (OR) values ranging from 0,61 to 0,92, tobacco use from 0,35 to 0,73, illicit drugs from 0,40 to 0,91, and reduced inadequate sleep on weekdays of 0.57 (95% confidence interval - 95%CI 0.52-0.63) and weekends 0.79 (95%CI 0.69-0.89). In the meta-analysis, sports practice was significantly associated with alcohol consumption for boys (OR 1,36; CI95% 1,09-1,70), and was inversely associated with tobacco use for boys and girls (OR 0,59; CI95% 0,56-0,61). Adolescents who practice sports tend to have lower occurrences of sedentary behavior, tobacco and illicit drug use, and adequate amounts of sleep; and, in the meta-analysis, boys present higher values for alcohol consumption and boys and girls present lower values for tobacco use.

Recent attachment research suggests that children with avoidant attachment often underreport their psychological distress compared to their physiologic indicators of distress (neuroendocrine reactivity, startle response, event-related potentials). This pattern of behavior (referred to as psychobiological divergence) may confer risk for suboptimal coping behaviors, including substance use, sexual risk-taking, and non-suicidal self-injury (NSSI), because individuals who are not aware of or cannot express their emotional needs may engage in maladaptive strategies to regulate their emotions. In the current pilot study (N = 45 youth), we investigate whether psychobiological divergence of neuroendocrine and self-reported reactivity in middle childhood prospectively predicts health risk behaviors (HRBs) in adolescence. The results revealed that divergence was significantly associated with adolescents’ substance use and non-suicidal self-injury (NSSI), but not with their sexual behavior. Among adolescents currently reporting low levels of attachment security, divergence was associated with greater self-reported NSSI. Our results provide initial evidence that psychobiological divergence confers risk for substance use and NSSI in combination with current relational distress. We discuss the implications of our findings for adolescent development and clinical risk.

Objective: This study used a large U.S. population-based dataset to examine associations between childhood attention problems and adolescent substance use, sexual risk behavior, and delinquency. Methods: This prospective cohort study used data from the Future of Families and Child Wellbeing Study (n = 2,716). Bivariate statistics, multivariable logistic regression, and negative binomial models assessed associations between attention problems at age 9 years and subsequent use of cigarettes, alcohol, and marijuana, engagement in sex without a condom, and delinquency at age 15 years. Results: Nearly one-fifth (18.3%) of adolescents had elevated scores (more than 1 standard deviation above the sample mean) for attention problems at age 9 years. Adolescents with elevated attention problem scores in childhood were more likely than adolescents who did not have elevated scores to have ever smoked an entire cigarette (9% vs. 4%) and ever tried marijuana (24% vs. 20%). Elevated attention problem scores were associated with higher odds of ever having smoked an entire cigarette (adjusted odds ratio [AOR] = 2.06, 95% CI [1.39, 3.05], p < .01) and higher delinquent behavior scores (incidence rate ratio [IRR] = 1.30, 95% CI [1.11, 1.53], p < .01). In adjusted models, there were no significant associations between elevated attention problem scores and ever having tried marijuana, consumed alcohol, or engaged in unprotected sex. Conclusions: This study found that elevated attention problem scores in childhood were associated with higher risk of cigarette smoking and delinquent behaviors in adolescence. Results provide support for screening for attention problems among elementary school-age children and early intervention strategies to prevent health risk behaviors in adolescence.

BackgroundPositive mental health may support healthy development in childhood, although few studies have investigated this at a population level. We aimed to construct a measure of mental health competence (MHC), a skills-based assessment of positive mental health, using existing survey items in a representative sample of UK children, and to investigate its overlap with mental health difficulties (MHD), socio-demographic patterning, and relationships with physical health and cognitive development.MethodsWe analysed the UK Millennium Cohort Study (MCS) when children were aged 11 years. Maternal (n = 12,082) and teacher (n = 6739) reports of prosocial behaviours (PS) and learning skills (LS) were entered into latent class models to create MHC measures. Using descriptive statistics, we examined relationships between MHC and MHD, and the socio-demographic patterning of MHC. Associations between MHC and physical health and cognitive development were examined with relative risk ratios [RRR] (from multinomial models): BMI status (healthy weight, overweight, obesity); unintentional injuries since age 7 (none, 1, 2+); asthma symptoms (none, 1, 2+); and tertiles of test scores for verbal ability, spatial working memory and risk-taking. Models were adjusted for potential confounding.ResultsFour MHC classes were identified [percentages for maternal and teacher reports, respectively]: high MHC (high PS, high LS) [37%; 39%], high-moderate MHC (high PS, moderate LS) [36%; 26%]; moderate MHC (moderate PS, moderate LS) [19%; 19%]; low MHC (moderate PS, low LS) [8%; 16%]. Higher MHC was less common in socially disadvantaged children. While MHC and MHD were associated, there was sufficient separation to indicate that MHC captures more than the absence of MHD. Compared to children with high MHC, those in other MHC classes tended to have poorer physical health and cognitive development, particularly those with low MHC or high-moderate MHC. For example, children with maternal-report Low MHC were more likely to have experienced 2+ unintentional injuries (RRR: 1.5 [1.1–2.1]) and to have lower verbal ability scores (RRR: 2.5 [1.9–3.2]). Patterns of results were similar for maternal- and teacher-report MHC.ConclusionMHC is not simply the inverse of MHD, and high MHC is associated with better physical health and cognitive development. Findings suggest that interventions to improve MHC may support healthy development, although they require replication.

Objective To explore the status of adolescents' health risk behaviors, relationship between cognitive ability and health risk behaviors, and provide an empirical reference for reducing the occurrence and early prevention of health risk behaviors among adolescents. Methods Samples were extracted by hierarchical, multi-stage, probability and scale proportional (PPS) methods. There were 112 schools randomly selected from 28 county-level regions (county, district, city), and 19 487 students were investigated by baseline survey, a follow-up study was conducted among 8 636 students during 2014-2015. Descriptive statistical methods of using 2 test and t test, and logistic multivariate regression analysis were used to analyze the relationship between cognitive abilities and healthy risk behaviors. Results The reported rate of a healthy risk behavior was 20.77%, and the incidence of more than one type of health risk behavior was 16.03%. The student’s cognitive ability standardized score was (0.33±0. 82). The average score of cognitive ability of adolescents with healthy risk behavior was 0.14, which was lower than the average score of cognitive ability of adolescents without healthy risk behaviors (0.43). Boys, having rural household registeration, non-residential schools, and parents with low education levels adolescents were more likely to be involved in health behavior risks. There was a significant correlation between adolescent cognitive ability and healthy risk behavior ( OR = 0.67, P <0.01). Conclusion The current status of adolescent health risk behaviors is worrying. The cognitive ability has a significant impact on health risk behaviors. It is recommended to use the cognitive ability of adolescents as a starting point to prevent and reduce the occurrence of adolescent health risk behaviors. 【摘要】目的 探究青少年健康危险行为现状及其与认知能力的关系，为减少青少年健康危险行为的发生及早期预 防提供实证参考。 方法 采用分层次、多阶段、概率与规模成比例（PPS)的方法，从全国28个县级单位（县、区、市）随机抽 取112所学校，2013—2014学年基线调査19 487名学生，2014—2015学年追踪调査8 636名初中学生。运用妒检验、《检 验的描述性统计方法，以及Logistic多因素回归分析认知能力与健康危险行为的关系。 结果 学生存在1种健康危险行为 的报告率为20.77%，1种以上的健康危险行为报告率为16.03%。学生认知能力标准化得分为（0.33±0.82)分。有健康危 险行为的青少年认知能力标准化得分均分为0.14分，没有健康危险行为青少年的得分为0.43分。男性、农村户口、非住 校、父母受教育程度低的青少年更容易发生健康危险行为。Logistic回归分析显示，青少年认知能力与其健康危险行为的 相关有统计学意义（ OR = 0.67， P <0.01)。 结论 青少年健康危险行为现状堪忧，认知能力对健康危险行为的影响显著。建 议以青少年的认知能力为出发点，预防和减少青少年健康危险行为的发生。

Background Facets of decision‐making and risk‐taking are implicated in adolescent health risk behaviors; however, whether they may lead to adolescent engagement in substance use, gambling, and self‐harm is unknown. Methods We used the Millennium Cohort Study to test whether a task‐based measure of decision‐making and risk‐taking predicts engagement in adolescent health risk behaviors. Participants were born in the United Kingdom (2000–2002) and surveyed in‐home at ages 14 ( n = 10,531) and 17 ( n = 8417). A computerized task‐based measure of decision‐making and risk‐taking for reward (Cambridge Gambling Task) measured impulsivity, quality of decision‐making, risk adjustment, and risk‐taking (exposures) at age 14. Several health risk behaviors (outcomes) were self‐reported at 14/17 years: cigarette use, electronic cigarette/vaping use, drinking, cannabis use, other illegal drug use (e.g., ecstasy), gambling, and self‐harm. We conducted adjusted multinomial and logistic regression models. Results Computerized task‐based measures of greater impulsivity and risk‐taking were most consistently associated with self‐reported health risk behaviors at 14 and 17 years. Better quality of decision‐making and risk adjustment were inconsistently associated with health outcomes at age 14; however, better risk adjustment was related to a reduced likelihood of all levels of cigarette and e‐cigarette/vaping use (e.g., occasionally/regularly) when compared to nonusers. At age 14, risk‐taking was associated with every self‐reported health risk behavior (e.g., substance use, gambling) except for self‐harm. In prospective models, relationships were attenuated, but risk‐taking predicted new onset engagement in all forms of substance use except alcohol consumption and self‐harm. Risk‐taking was most strongly associated with other drug use (age 14: odds ratio (OR) = 11.26, 95% CI: 1.48, 86.01) and predictive of former vaping use (age 17: OR = 4.10, 95% CI: 1.43, 11.76). Conclusion Risky betting on a computerized risk‐taking task appears highly indicative of substance use and recent gambling at age 14 and predictive of new onset substance use and gambling 3 years later (age 17) for both sexes, but not self‐harm.

Background Positive mental health (not simply absence of mental disorder) may hold potential for fostering resilience and reducing risks of poor health and well-being. However, it is challenging to define and measure. One promising conceptualisation is mental health competence (MHC), comprising age-relevant developmental tasks and abilities. To date MHC has not been investigated in UK children. Methods We developed a measure of MHC in the UK Millennium Cohort Study (MCS) (~18 000 children born 2000–2002) using seven items addressing learning skills and prosocial behaviours, reported by mothers at age 11 (n=12082). Latent class analysis (LCA) was used to identify classes of MHC, and children were assigned to the class they had the highest probability of belonging to. We investigated associations between MHC classes and child’s physical health (healthy weight, overweight or obese, based on measured heights and weights, using International Obesity Task Force cut-offs; maternal report of unintentional injuries since age 7 [none, 1, 2+]) and poor mental well-being (low self-esteem [SE] and low life-satisfaction [LS] reported by the child; maternal report of child’s emotional problems [EP], all dichotomised at the bottom decile of scores). Relative risk ratios (aRRR, 95% CI) and odds ratios (aORs, 95% CI) were used to examine three-category and binary outcomes respectively, adjusting for potential confounding. Survey weights accounted for sample design and attrition. Analyses were undertaken in Stata/SE 13.1. Results Four classes were identified (ranging from high to low MHC): “High learning skills and high prosocial behaviour” (37%), “Moderate learning skills and high prosocial behaviour” (36%), “Moderate learning skills and moderate prosocial behaviour” (19%), and “Low learning skills and moderate prosocial behaviour” (8%). Risks of 2+injuries were raised in “Moderate learning and high prosocial behaviour” (aRRR: 1.4 [95%CI:1.2–1.7]) and “Low learning skills and moderate prosocial behaviour” (aRRR: 1.4 [95%CI:1.1–1.9]) as compared to “High learning and high prosocial behaviour”. Associations with MHC were absent or weak for single injury, overweight and obesity. Compared to “High learning skills and high prosocial behaviour”, odds of poor mental well-being were elevated for children from all other classes, with highest odds for “Low learning skills and moderate prosocial behaviour” (SE: aOR: 2.9 [95%CI:2.3–3.6]; EP: aOR: 4.2 [95%CI:3.4–5.1]; LS: aOR: 3.0 [95%CI:2.4–3.7]). Conclusion Lower MHC, using a composite measure developed in a representative sample of UK children, was associated with injuries, low self-esteem and life-satisfaction, and emotional problems, but not overweight and obesity. Identifying and promoting MHC at the population-level may provide an opportunity to improve health in children and young people.

Racial variability in associations of neighborhood socioeconomic disadvantage and neighborhood disorder with adolescent health risk behaviors remains under-researched, which this study examined over 1 year among racially diverse adolescents. High school students (N = 345; 18% Asian, 44% Black, 16% Multiracial, 22% White) completed surveys assessing neighborhood socioeconomic disadvantage and neighborhood disorder, and health risk behaviors (lifetime alcohol, cannabis, and cigarette use, number of sexual partners) at baseline (Year 1) and 1-year follow-up (Year 2). Asian, Black, and Multiracial adolescents were more likely to endorse health risk behaviors in Year 2 compared to White adolescents living in similarly disadvantaged neighborhoods at Year 1. Associations of neighborhood disorder with health risk behavior did not differ by race. Neighborhood socioeconomic disadvantage (but not neighborhood disorder) may predispose Asian, Black, and Multiracial adolescents to health risk behaviors. Findings may inform interventions to address racial disparities in adolescent health risk behaviors.

Body weight dissatisfaction has been described as a marker for various health diseases, given its direct association with social, physical, and emotional suffering. We investigated the association between body weight dissatisfaction and health risk behaviors in adolescents. This was a cross-sectional study conducted with 668 adolescents aged 14-19years in the city of São José, southern Brazil. Body weight satisfaction/dissatisfaction was assessed using a questionnaire validated for the investigated population. Health risk behaviors included smoking, alcohol, illicit drugs, medication, non-prescription anabolic steroids, not using seatbelt, unsafe sexual behavior and not knowing how to deal with day-to-day stress. Among males, 66.1% were dissatisfied with their body weight (32.1% due to thinness and 34.0% due to overweight). Among females, 80.0% were dissatisfied with their body weight (24.5% due to thinness and 55.5% due to overweight). There were no significant differences regarding health risk behaviors according to body weight satisfaction/dissatisfaction and sex. Compared to males who were satisfied with their body weight, those who were dissatisfied due to being overweight were more likely to be using tobacco (OR: 2.9; 95% CI: 2.1-4.2), alcohol (OR: 1.7; 95% CI: 1.5-1.9) and anabolic steroids (OR: 2.7; 95% CI: 1.2-5.7). Compared to females who were satisfied with their body weight, those who were dissatisfied due to thinness were more likely to be consuming alcoholic beverages (OR: 1.6; 95% CI: 1.2-2.0) and less likely to be consuming illicit drugs (OR: 0.5; 95% CI: 0.3-0.8). Interventions aimed at health education regarding the non-adoption of risk behaviors such as alcohol and tobacco use, as well as the non-use of anabolic steroids, and favoring the maintenance of general health, may be important for adolescents with body dissatisfaction. These data suggest that health risk behaviors such as adolescent male use of tobacco, alcohol, and anabolic steroids and the use of alcohol and drugs by female adolescents can be related to body weight dissatisfaction.

IntroductionAdolescent health risk behaviors are linked to poor physical and mental health outcomes. While past research shows that maternal psychological distress predicts those behaviors, we know less about the role of paternal psychological distress and the role of sensitive periods.MethodsUsing 11,128 data from families (50.5% female children) from the UK's Millennium Cohort Study, we examined the role of timing of exposure to paternal and maternal psychological distress in engagement in health risk behaviors (smoking, alcohol use, binge drinking, and sexual activity) at age 14. Paternal and maternal psychological distress, measured with the Kessler‐6 scale, were assessed at child ages 3, 7, and 11. We performed path analysis, adjusting for key covariates, modeling maternal distress parallel to paternal, and allowing for autoregressive paths.ResultsPaternal distress experienced at age 11 predicted a higher likelihood of smoking at age 14. Maternal distress at age 7 also predicted a higher likelihood of smoking, alcohol use, and binge drinking, but only for boys. Moreover, maternal distress at age 3 was associated with a lower risk for alcohol use. Effects were not replicated in the sensitivity analysis we performed, including only families with resident biological fathers across the study period. Instead, maternal and paternal distress at age 11 raised girls' risk for binge drinking and sexual activity, respectively.ConclusionsParental distress in early childhood does not predict adolescent health risk behaviors. In late childhood, however, both paternal and maternal distress seem to influence the likelihood of engagement in such behaviors.

Background: The advances in medical practice have increased the average life expectancy of people living with sickle cell disease (SCD) to 54 years. The high prevalence rates of SCD in Nigeria therefore highlights the need for research that will support overall disease management. Objective: To determine the health risk behavior (HRB) of adolescents with sickle cell disease in Nigeria. Materials and methods: In a cross-sectional descriptive survey using purposive sampling method, 122 adolescents with SCD attending sickle cell clubs in Ogun State, Nigeria were selected for the study. A 58-item questionnaire adapted from the Youth Risk Behavior Survey (YRBS) instrument developed by Centre for Disease Control and Prevention (CDC) was used to collect data from the adolescents. Results: The mean age of the respondents was 15.7 ± 2.3 years, there were more females (58.2%) than males (41.2%). Majority were from a monogamous family setting and average to large family size (≥3siblings) (63% and 76% respectively) and only 6% of the parents had no formal education. The mean ages at first sexual intercourse, cigarette smoking and alcohol use were 16 ± 5.7, 15.7 ± 0.7, and 14.9 ± 1.9 years respectively. One-fifth (21.3%) have had sex and half (50%) of them have had sex by the age of 17. Over one-tenth (13.9%) had smoked cigarette while 14.8% had taken alcohol. Adolescents from monogamous family background were more likely to be involved in substance abuse (χ2: 4.99; P=0.008) and exposed to sexual activities (χ2: 10.9; P=0.004) than those from polygamous or single parent family. Conclusion: It was concluded that adolescents with SCD are involved in HRB and may be dependent on family characteristics. It is recommended that regular health care of chronically ill adolescents should include screening and counselling for HRBs.

The objective of this study was to compare the frequency of risk behaviors and to measure the extent of co-occurrence of these behaviors in chronically ill and healthy adolescents. Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health database, a nationally representative survey of 7548 adolescents in postmandatory school aged 16 to 20 years. There were 760 subjects who reported a chronic illness and/or a disability. The comparison group consisted of 6493 subjects who answered negatively to both questions. We defined 8 risk behaviors: daily smoking, alcohol misuse, current cannabis use, current use of any other illegal drug, early sexual debut, eating disorder, violent acts, and antisocial acts. We analyzed each behavior and the sum of behaviors, controlling for age, gender, academic track, parents' education level, depression, and health status. Results are given as adjusted odds ratios using the comparison group as the reference category. Youth with a chronic condition were more likely to smoke daily, to be current cannabis users, and to have performed violent or antisocial acts. Youth with a chronic condition were also more likely to report 3 or >or=4 risk behaviors. These results indicate that having a chronic condition carries additional risks for engaging in health risk behaviors and emphasize the importance of health risk screening and preventive counseling for young people in general and among those suffering from chronic conditions in particular.

Obesity is a public health issue and childhood is a critical window in which to establish healthy eating patterns and modify risk factors for overweight. This study aims to verify the association of weight perception, body satisfaction, and weight loss intention with patterns of health risk behaviors in adolescents with overweight and obesity. We analyzed health risk behavior from a school-based national survey conducted in 2015 in Brazil (n = 2,703 students with overweight or obesity, aged 13–17 years). We performed latent class analysis of alcohol consumption, tobacco use, physical activity, screen time, and eating habits for adolescents with overweight and identified four distinct health behavior patterns. The association of these patterns with weight perception, body satisfaction, and weight loss intention was analyzed through multinomial logistic regression. Adolescents who perceived themselves as “fat” or “very fat” were more likely to have a sedentary lifestyle and low consumption of fruit and vegetables. Body satisfaction was a protective factor against sedentary lifestyle. Students who reported weight loss intention were less likely to be in high–health-risk behavior groups (low consumption of fruit and vegetables; sedentary lifestyle; tobacco and alcohol use). Self-perception as overweight had detrimental associations, while body satisfaction was a protective factor for a healthy lifestyle. Weight loss intention still requires rigorous analysis due to inconsistencies in the literature. The complexity of the relationship between body image and obesity needs to be highlighted. Multicomponent strategies are required to control the global obesity pandemic.