Abstract
BackgroundIn the UK, around 5% of 11–16-year olds experience conduct problems of clinical importance. However, there are limited data on prevalence of conduct problems by ethnic group, and how putative social risk factors may explain any variations in prevalence. This study has two main aims: (1) to estimate the prevalence and nature of conduct problems overall, and by ethnic group and gender, among adolescents in diverse inner-city London schools; (2) to assess the extent to which putative risk factors - racial discrimination, socioeconomic status, parental control, and troublesome friends - explain any observed differences in prevalence of conduct problems between ethnic groups.MethodsThis study uses baseline data from REACH, an accelerated cohort study of adolescent mental health in inner-city London. Self-report questionnaire data were collected on conduct problems and a range of distinct putative social risk factors (including racial discrimination, free school meals, troublesome friends, and parental care and control). A total of 4353 pupils, 51% girls, aged 11–14 participated. We estimated prevalence of conduct problems and used multilevel logistic regression to examine differences by ethnicity and gender and associations with putative risk factors.ResultsPrevalence of conduct problems in inner-city schools was around three times higher than reported in national studies (i.e., 16% [95%CI: 15·2–17·5] vs. 5% [95%CI 4·6–5·9]). Compared with overall prevalence, conduct problems were lower among Indian/Pakistani/Bangladeshi (RR: 0.53 [95% CI:0.31–0.87]) and white British (RR: 0.65 [0.51–0.82]) groups, and higher among black Caribbean (RR: 1.39 [95%CI:1.19–1.62]) and mixed white and black (RR: 1.29 [95% CI: 1.02–1.60]) groups. Risk of conduct problems was higher among those who were exposed to racial discrimination compared with those who were not (RR: 1.95 [95% CI: 1.59–2.31]).ConclusionsConduct problems are markedly more common in inner-city schools, and variations in the prevalence of conduct problems are, to some extent, rooted in modifiable social contexts and experiences, such as experiences of racial discrimination.
Highlights
In the UK, around 5% of 11–16-year olds experience conduct problems of clinical importance
2) To assess the extent to which putative risk factors racial discrimination, socioeconomic status, parental control, and troublesome friends - explain any observed differences in prevalence of conduct problems between ethnic groups
This is over three times higher than the estimated national prevalence of conduct problems using the same measure in the UK Millennium Cohort (MCS) at age 14 (5·2% [95%Confidence Intervals (CI) 4·6–5·9]), and the MHCYP3 age 11–16 (6.2% [CI’s not available]) (Hypothesis 1a)
Summary
In the UK, around 5% of 11–16-year olds experience conduct problems of clinical importance. Conduct problems - aggressive and rule-breaking behaviours - harm individuals, families, and communities, and are a serious public health concern These behaviours during adolescence are associated with low education attainment and, later, unemployment, criminality, and premature mortality [1, 2]. Existing studies - outdated - suggest mixed and black Caribbean adolescents may report symptoms consistent with conduct problems more frequently than their white British peers [6, 7]. If true, this may contribute to long-term ethnic inequalities in health, wellbeing, and mortality
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