Care Youth Survey Research Articles

The German Communities That Care Youth Survey: dimensionality and validity of risk factors.

Communities That Care (CTC) is an evidence-based community change strategy for supporting healthy youth development. One of its key elements is the development of a community profile to identify and prioritise risk factors for health and behavioural problems in adolescents based on the CTC Youth Survey. The strategy was originally developed and evaluated in the United States. An adapted version of the survey has been used in Germany since its first implementation in 2008. However, the dimensionality and validity of the adapted risk factor scales have not yet been evaluated. Therefore, this study aimed to confirm the assumed unidimensional structure and to establish the concurrent criterion validity of each risk factor. A sample of 1,911 adolescents attending grades six to eleven in Lower-Saxony, Germany, was used to evaluate 23 risk factor scales of the German CTC Youth Survey covering the domains peer/individual, family, school, and community. Confirmatory factor analysis was used to assess the dimensional structure of all risk factors with sufficient item numbers. Goodness of fit was determined using CFI, SRMR, and RMSEA. Latent regression analysis tested the concurrent criterion validity of all unidimensional risk factors. For this, violent and delinquent behaviour, substance use, and depressive symptomatology were regressed on each risk factor. All evaluable risk factors demonstrated acceptable to good model fit regarding unidimensionality and predicted violent and delinquent behaviour, and substance use better than depressive symptomatology. Regarding the peer/individual risk factors, there are particularly high correlations with violent and delinquent behaviour, and substance use. In contrast, two risk factors were not correlated with substance use, whilst two other risk factors were not correlated with depressive symptomatology. Overall, the results indicate that most risk factors demonstrate unidimensionality and are valid in terms of concurrent criterion validity. Although some risk factors were not correlated with every outcome, they still predicted most outcomes, suggesting that the CTC Youth Survey is a viable tool for communities to assess their community risk profile. Risk factors that did not demonstrate unidimensionality or concurrent criterion validity should be monitored in future surveys and interpreted with caution until further evidence is available.

Examining risk and protective factors for mental health among school-going tribal adolescents in Meghalaya, India: Insights from the communities that care youth survey [CTC-YS

Risk and protective factors play crucial roles in shaping problem behavior, substance use, and mental health outcomes among adolescents. The study aims to examine the risk and protective factors and their association with emotional and behavioral problems among school-going tribal adolescents in Meghalaya, India. This study employed a cross-sectional design, utilizing a simple random sampling method to select schools from the Ri-Bhoi district (Nongpoh town) and East Khasi Hills district (Shillong cantonment area) of Meghalaya. A total of 450 students participated in the survey, out of which 300 students belonged to tribal ethnicity. The study focused on school-going adolescents with tribal ethnicity, aged 13-19 years, encompassing both genders (male and female). Participation in the study required both parental consent and the adolescent's assent. The Communities That Care Youth Survey (CTC-YS) and the Strength and Difficulty Questionnaires (SDQ), scale were administered. The findings highlighted significant risk factors including laws and norms favorable to drug use, community disorganization, poor family management, and low school commitment. Protective factors such as opportunities for prosocial involvement were evident across all domains. Family conflict, family history of antisocial behavior, and parental overcontrol were significant contributors (P < 0.05) to total difficulty scores. Among individual risk factors, "Interaction with anti-social peers" (P = 0.009) and "Intentions to use substance" (P = 0.021) had significant associations with higher difficulty scores. The overall prevalence of mental health problems, as indicated by the total difficulty score, was 31.3% among school-going tribal adolescents. The high prevalence of mental health problems, especially among tribal adolescents, underscores the urgent need for targeted interventions. By addressing these factors, policymakers and stakeholders can work toward fostering healthier outcomes for tribal adolescents in Meghalaya and similar communities.

Adaptation of the Communities That Care Youth Survey for Use in Estonia: A Pilot Study.

The Communities That Care Youth Survey (CTCYS) assesses risk and protective factors, predicting a range of behavioural health problems, including substance use, violence, and delinquency. Although the survey has been adapted to other contexts and languages, further studies on cross-cultural adaptations, particularly in non-English speaking countries, are needed. In 2022, CTCYS was adapted for Estonia, incorporating 38 risk and protective factors, along with measures of substance use, antisocial behaviour, mental health problems, and self-harm. This study investigated the psychometric properties and applicability of the CTCYS in Estonia. The adaptation process involved translating and refining the US CTCYS, followed by focus group discussions with students and specialists and a pilot study in two municipalities, with data obtained from 265 students. A focus group with municipality members explored the measure's feasibility. Results indicate that the original CTC framework largely captures key issues within the Estonian context. Overall, the survey showed good validity, as evidenced by its ability to predict problem outcomes through both risk and protective factors. Regarding reliability, with the removal of one item, internal consistency reached acceptable levels for all but eight risk and protective factor subscales. The most problematic scales in the Estonian context were Prosocial Involvement, Social Skills, and Belief in the Moral Order. Municipality members perceived the measure as useful but highlighted some challenges regarding its practicality and comprehensibility. It became clear that other elements are needed to effectively support communities in using the CTCYS results for preventive efforts.

Reincidencia delictiva en adolescentes colombianos: factores de riesgo y protectores relacionados

Research with adolescent offenders is concerned with identifying risk and protective factors that influence recidivism and desistance from crime. A quantitative and cross-sectional investigation designed to examine the influence of risk and protective factors on recidivism in Colombian adolescents is presented. In seven regions of Colombia, a convenience sample was obtained, and 646 adolescents aged 14 to 19 years (M = 17.08; SD: 1.23; 15 % girls) belonging to the Sistema de Responsabilidad Penal para Adolescentes (SRPA) participated. The Communities That Care Youth Survey (CTC-YS) was used for the evaluation. It evaluated a broad set of risk and protective factors identified through the community, school, family, peer group, individual conditions, and behavioral outcomes, including drug use, antisocial behavior, and delinquency. Descriptive analyses were conducted, and all CTC-YS factors were correlated with antisocial behavior. The results show varying degrees of relationship between the factors assessed and antisocial behavior. Binary logistic regression was used to determine which risk and protective factors influence recidivism. It was noted that favorable parental attitudes towards drug use and antisocial behavior, early onset of drug use, low school engagement, and interaction with antisocial peers increases the probability of recidivism. Recidivism was identified as being affected by, among other factors, favorable parental attitudes toward drug use and antisocial behavior, early onset of drug use, and low school engagement. It was also observed that beliefs in a moral order, opportunities for prosocial school participation and lower drug use frequency reduce the probability of recidivism. According to the results, the factors that influence criminal recidivism are multiple, and social, family, school, and individual factors need to be addressed. The need to intervene in attitudes favorable to antisocial behavior on the part of parents, strengthen school services, and carry out treatment for drug use to favor the reduction of recidivism in Colombian adolescents is discussed. https://doi.org/10.16888/interd.2023.40.1.25

A COMPARISON OF THE DRUG USE AND PROTECTIVE FACTORS OF RURAL AND URBAN STUDENTS

Based on data from the Communities that Care Youth Survey (CCYS), the authors compare the relationships between the drug use and protective factors of rural and urban students in grades 6, 8, 10, and 12. The authors used a rural/urban index that classifies zip codes into ten categories with percentage urban/rural. Only the 2 extreme categories (those zip codes that are 90% or more rural versus 90% or more urban) were used. Findings indicated urban and rural students are similar in terms of drug use. Rural students had higher rates of alcohol use in all grades. Rural youth had higher protective factor scores.

Predicting suicidal thoughts and behavior among adolescents using the risk and protective factor framework: A large-scale machine learning approach.

IntroductionAddressing the problem of suicidal thoughts and behavior (STB) in adolescents requires understanding the associated risk factors. While previous research has identified individual risk and protective factors associated with many adolescent social morbidities, modern machine learning approaches can help identify risk and protective factors that interact (group) to provide predictive power for STB. This study aims to develop a prediction algorithm for STB among adolescents using the risk and protective factor framework and social determinants of health.MethodsThe sample population consisted of more than 179,000 high school students living in Utah and participating in the Communities That Care (CTC) Youth Survey from 2011-2017. The dataset includes responses to 300+ questions from the CTC and 8000+ demographic factors from the American Census Survey for a total of 1.2 billion values. Machine learning techniques were employed to extract the survey questions that were best able to predict answers indicative of STB, using recent work in interpretable machine learning.ResultsAnalysis showed strong predictive power, with the ability to predict individuals with STB with 91% accuracy. After extracting the top ten questions that most affected model predictions, questions fell into four main categories: familial life, drug consumption, demographics, and peer acceptance at school.ConclusionsModern machine learning approaches provide new methods for understanding the interaction between root causes and outcomes, such as STB. The model developed in this study showed significant improvement in predictive accuracy compared to previous research. Results indicate that certain risk and protective factors, such as adolescents being threatened or harassed through digital media or bullied at school, and exposure or involvement in serious arguments and yelling at home are the leading predictors of STB and can help narrow and reaffirm priority prevention programming and areas of focused policymaking.

Adaptation of the Communities That Care Youth Survey for use in Brazil: A pilot study.

Substance use and violence are serious problems affecting Brazilian youth, prompting local authorities to invest in adapting and implementing evidence-based prevention programs developed abroad. To ensure that interventions are effective, valid and reliable measures of risk factors for substance use and violence are needed. We conducted a pilot examination of the measurement properties of risk factors in the Communities That Care Youth Survey (CTCYS), a school-based survey developed in the United States. The Brazilian-adapted CTCYS included 25 risk factors as well as measures of substance use and antisocial behaviors. The survey was translated into Brazilian Portuguese and adapted for use in Brazil, incorporating suggestions from local experts. The survey was administered to 926 students in one Brazilian community. Results indicate that scale internal consistency was acceptable for all but two scales: (i) Academic Failure and (ii) Rebelliousness. Confirmatory factor analyses suggested good model fit for most measurement models albeit with minor modifications for most scales. Findings from this pilot study provide a foundation for the use of the CTCYS in Brazil to assess community levels of adolescent risk and evaluate prevention programs.

Adolescent Antecedents of Young Adult Homelessness: a Cross-national Path Analysis.

Adolescent and young adult health, development, and behavior lay a foundation for future population health. Increasing rates of young adult homelessness mean there is a need for research which generates evidence to support a stronger focus on population-level prevention. Using longitudinal data from a population-based sample of young adults participating in the cross-nationally matched International Youth Development Study, we examined adolescent antecedents of young adult homelessness in Washington State in the USA and in Victoria, Australia. Participants were surveyed using a modified version of the Communities That Care youth survey. Analyses of prospective, longitudinal data from 1945 participants, recruited as state-representative secondary school samples at grade 7 (average age 13, 2002) and longitudinally compared at young adulthood (average age 25, 2014), showed that young adults in Washington State reported higher rates of past year homelessness (5.24%) compared to those in Victoria (3.25%). Path modeling showed less positive family management strategies at age 13 uniquely increased risk for age 25 homelessness. This effect remained after accounting for age 15 antecedents in peer-group, school, and community environments. Friends' drug use, school suspension, academic failure, and low neighborhood attachment at age 15 mediated the association between less positive family management strategies at age 13 and age 25 homelessness. Despite observing some cross-national differences in levels of family, peer-group, school, and community antecedents, we found that these factors equally increased risk for age 25 homelessness in both states, suggesting similar cross-national influences for young adult homelessness. The findings indicate cross-nationally common adolescent antecedents for young adult homelessness that could be targeted by prevention strategies across international settings.

Psychometrics and cultural adaptations of the Communities That Care Youth Survey: A systematic review.

The Communities That Care Youth Survey (CTCYS) is an assessment for youth risk and protective factors focused on antisocial behaviors, drug abuse, violence, and delinquency. The systematic review aimed to analyze psychometric validations and cross-cultural adaptation processes of CTCYS to prepare its Brazilian validation. PubMed, SpringerLink, Scopus, and Web of Science were the databases included. The study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol. Twenty articles were selected based on the inclusion/exclusion criteria. In general, the construct validity indexes were considered adequate, and the measures of risk and protective factors were equivalent between ethnic groups, gender, and populations at risk. Reliability values for most scales are good, averaging about 0.78. We found cultural adaptations from six different countries with some satisfactory results, but not so good as the original properties of CTCYS and the adjustments to other ethnic groups or subpopulations in the United States. This survey may be a potentially reliable and valid instrument to assess risk and protection in different cultures and populations. However, there is still a gap in the instrument's cross-cultural adaptation processes.

La Percepción de Apego con la Escuela Como un Factor Protector Para Conductas Antisociales en Escolares Chilenos

La escuela puede ser considerada un espacio vital de desarrollo humano e incluso un factor protector para el desarrollo de conductas de riesgo en adolescentes. El presente estudio buscó examinar la percepción de un mayor apego escolar como un factor protector de la influencia de pares en conductas antisociales en el contexto chileno. Se usó una muestra estratificada con afijación igual de 815 escolares de 7° año básico a IV año medio provenientes de 15 establecimientos escolares seleccionados aleatoriamente de 5 diferentes NSE de la Región Metropolitana, 46,6% mujeres, con una edad promedio de 15,11 años DE = 1,78). Se utilizó una adaptación del instrumento Communities That Care Youth Survey, analizando el reporte de conductas antisociales en la escuela, relación con pares antisociales, consumo de drogas por parte de pares y apego con la escuela. Por medio de un análisis de regresión múltiple, se evidenció un efecto de interacción, en donde para aquellos estudiantes que perciben un mayor apego con la escuela, la influencia de los pares con conductas antisociales se ve moderada, en comparación con los estudiantes que tienen una percepción de bajo apego con la escuela. Este resultado provee evidencia sobre la importancia del apego con la escuela para prevenir conductas antisociales en adolescentes y para informar programas de prevención en contextos escolares.

Assessment of Exposure to Sexually Explicit Materials and Substance Abuse among High-School Adolescents in North Shewa Zone: Application of Logistic Regression Analysis.

Background The use of substances such as cigarettes, khat, alcohol, and other illicit drugs like hashish, heroine, cannabis, and cocaine is a global major public threat, which affects young adult people particularly in developing countries. This study aims to assess the risk factors associated with substance use and exposure to sexually explicit materials among high-school adolescents in north Shewa zone, Oromia region. Method A cross-sectional study was conducted to assess substance use and exposure to sexually explicit materials among high-school adolescents in North Shewa zone, Oromiya, Ethiopia, using a structured self-administered questionnaire adapted from the 2008 “Community That Care Youth Survey” for adolescent substance use and problem behaviors. The study used descriptive statistics and logistic regression analysis to identify the significant factors associated with substance use and exposure to sexually explicit materials among high school adolescents in the study area. Result The prevalence of lifetime and current substance use was 47.7% (95% CI: 0.427, 0.527) and 30.4% (95% CI: 0.258, 0.350), respectively. 17.8% use khat in their life and 16.6% used khat in the past 30 days; 42.2% ever used alcohol and 26.1% currently uses alcohol; 4.8% and 4.5% used cigarette in lifetime and in the past 30 days, while 16.4% use other illicit drugs in lifetime and 8.4% use illicit drugs in the past 30 days, respectively. Distributions of substance use by sex indicate that male adolescents are more like likely 61.1% use substances than females. While, the prevalence of exposure to sexually explicit materials among high school adolescents was 35.8% (95% CI: 0.310, 0.406). Factors positively associated with increased substance use were being male (OR = 2.334, 95% CI: 1.549, 9.926), living through high level of family conflict (OR = 6.25, 95% CI: 1.745, 10.00), poor family management OR = 27.084, 95% CI: 1.624, 45.56), peer pressure (OR = 12.882, 95% CI: 1.882, 88.153), poor academic performance (OR = 14.48, 95% CI: 1.290, 162.58), and low school commitment (OR = 11.951, 95% CI: 1.418, 100.73). While, being male (OR = 7.52, 95% CI: 2.611, 21.739), age 14–16 (OR = 0.201, 95% CI: 0.071, 0.565), friends watch/read sexually explicit materials (OR = 5.376, 95% CI: 1.010, 28.571), and khat chewing (OR = 12.5, 95% CI: 2.924, 25.632) were factors significantly associated with high-school adolescents exposure to sexually explicit materials. Conclusion The magnitude of prevalence for substance uses and exposure to sexually explicit materials in the study area was still higher. Therefore, interventions that focus on family management, peer pressure, and school commitment are required to decrease the prevalence of substance uses and exposure to sexually explicit materials among high-school adolescents.

Childhood social environmental and behavioural predictors of early adolescent onset cannabis use

This study prospectively investigates behavioural and social antecedents of different patterns of adolescent cannabis use, specifically, early adolescent onset cannabis use and late onset occasional use. The sample comprised 852 adolescents (53% female) drawn from the Australian arm of the International Youth Development Study. Data were collected via self-report surveys. Risk and protective factors from a modified version of the Communities That Care youth survey were measured in fifth grade (mean [M] = 10.9 years, SD = 0.4). Frequency of cannabis use was measured at six time-points throughout adolescence (ages 12-19 years). Early adolescent onset cannabis use (10.7% of the sample [n = 91]) was predicted by childhood family-related factors including poor family management, family history of antisocial behaviour and attachment to parents. Cigarette use and drinking until drunk were the strongest predictors of early adolescent onset cannabis use. Cumulative risks associated with community, family, peer/individual environments and early substance use (cigarettes, alcohol) in childhood were predictive of early adolescent onset cannabis use (e.g. relative risk ratio = 2.64; 95% confidence interval 1.40-4.97 for early substance use). Family and early substance use-related cumulative risks were predictive of late adolescent onset occasional cannabis use (n = 231; 27%). Cumulative early substance use risk was the strongest independent predictor of both early adolescent onset and late adolescent onset occasional cannabis use. Primary prevention efforts should focus on reducing exposure and access to licit substances during late childhood and delaying the onset of use. Prevention and intervention targeted toward the family environment also appears likely to be important in the prevention of early adolescent onset cannabis use.

Prevalence of homelessness and co-occurring problems: A comparison of young adults in Victoria, Australia and Washington State, United States

Homelessness is associated with various co-occurring health and social problems yet; few contemporary international studies have examined these problems in young adulthood. This descriptive study presents cross-state comparison of the prevalence of young adult homelessness in Washington State, USA and Victoria, Australia using state representative samples from the International Youth Development Study (IYDS; n = 1945, 53% female). Associations between young adult homelessness and a range of co-occurring problems were examined using a modified version of the Communities That Care youth survey. Results showed significantly higher rates of past year homelessness were reported by young adults in Washington State (5.24% vs. 3.25% in Victoria). Cross-state differences were evident in levels of friends’ drug use, antisocial behavior, weekly income and support from peers. Unemployment (Adjusted Odds Ratio [AOR] = 2.67), antisocial behavior (AOR = 3.54) and victimization (AOR = 3.37) were more likely among young adults reporting homelessness in both states. Young adults with higher weekly income were less likely to report homelessness (AOR = 0.69) in both states. No significant association between mental health problem symptoms, substance use, family conflict or interaction with antisocial peers and homelessness were found in either state. Rates of violent behavior were more strongly related to young adult homelessness in Washington State than Victoria. The current findings suggest that programs that enable young adults to pursue income and employment, reduce antisocial behavior and include services for those who have been victimized, may help to mitigate harm among young adults experiencing homelessness.

Social psychological risk factors, delinquency and age of onset

Based on data from the 2014 Communities that Care Youth Survey (CCYS), the authors examine the association between risk factors of tenth graders and age of onset (never, 14 or older, 13 or younger) of three antisocial behaviors/delinquency (got arrested; carried a handgun to school; and attacked someone with the intent of seriously hurting them). Risk factors are under four domains: family, community, school, and peer. The age of onset and risk literature are discussed. The purpose of this research is to examine what risk factors are associated with age of onset. Individual risk factors under the peer domain had the strongest association with all three antisocial behaviors.

Cross-sectional relationship of perceived familial protective factors with depressive symptoms in vulnerable youth

BackgroundThere are multiple negative consequences associated with heavy episodic drinking and close associations between substance abuse and depression, alcohol-intoxicated adolescents (AIA) represent a vulnerable group. We aim to add to the current literature by investigating the cross-sectional relationship of perceived familial protective factors with depressive symptoms in AIA in hospitals, with respect to sex. Depression is among the 10 leading causes of disabilities during childhood and adolescence, with girls being more vulnerable than boys. Considerable evidence reveals a strong association between depression and alcohol abuse. The family provides the possibility to positively influence depressive symptoms.MethodsWe present cross-sectional data of a German multisite, epidemiological cohort study on AIA. By using youth’s self-reports, we assessed sociodemographic data, as well as data on perceived familial protective factors and depressive symptoms using items of the Communities that Care Youth Survey instrument. We performed descriptive and multigroup analyses to evaluate the measurement invariance of the used instruments. Moreover, to investigate the relationships between the constructs, we used structural equation modelling.ResultsThe study sample comprised 342 AIA, with a mean age of 15.5 years (SD = 1.2; 48.1% girls). The final structural equation model achieved an acceptable model fit of χ2 (69, 342) = 110.056; p = .001; TLI = 0.97; CFI = 0.98; RMSEA = 0.046; SRMR = 0.042, and the rewards for prosocial involvement in the family context correlated significantly negatively with present depressive symptoms, (ß = − 0.540, p < 0.001). The effects were stronger in boys (ß = − 0.576, p < 0.001) than in girls (ß = − 0.519, p < 0.001).ConclusionIn vulnerable youth in Germany, depressive symptoms are correlated to good experiences within the family. Future research should assess whether interventions that enhance parental support reduce the risk of depressive symptoms in AIA. Our findings highlight the need for family-based prevention programmes, particularly for AIA with an increased risk of depression.

Examining heroin use and prescription opioid misuse among adolescents

Based on data from 2008 thru the 2014 Communities that Care Youth Survey (CCYS), the authors examine change in lifetime use frequencyof heroin and misuse of prescription opiates using a cohort longitudinal model. The cohort were 6th graders in 2008; 8th graders in 2010; 10th graders in 2012 and 12th graders in 2014. Findings indicate a declining numbers of abstainers for both drugs and moderate associations between using both drugs in all 4 grades. Implications for delinquency models are discussed.

The Poly-Drug User: Examining Associations between Drugs Used by Adolescents

ABSTRACTBased on data from the 2014 Communities that Care Youth Survey, the authors examine the associations between drug use frequencies among 11 drugs. This research represents a step in determining what leads to the use of dangerous drugs like heroin, other opioids, and other not so dangerous substances. Findings indicate the highest association is between marijuana and alcohol use. Most drugs show at least a low to medium association with all other drugs. Findings indicate the difficulty in making gateway assumptions and that poly-drug use determined by peer associations is a better explanation.

Family dynamics and alcohol and marijuana use among adolescents: The mediating role of negative emotional symptoms and sensation seeking

The literature indicates a close relationship between family dynamics and psychoactive substance use among adolescents, and multi-causality among substance use-related problems, including personal adolescent characteristics as potential influential aspects in this relationship. The purpose of this study is to investigate the role of emotional symptoms and sensation seeking as mediators in the relationship between family dynamics and alcohol and marijuana use among adolescents. The sample consisted of 571 high school students with a mean age of 14.63, who completed the Communities That Care Youth Survey in its Spanish version. We propose and test a mediation-in-serial model to identify the relationships between the study variables. The results of the mediation models indicate that, in most cases, the relationship between family dynamics and the substance use variables is meaningfully carried through the proposed mediators, first through negative emotional symptoms, and then through sensation seeking. The meaning of the mediation varies as a function of the facet of family dynamics (conflict or attachment) and the use aspect (age of onset, frequency of use, and use intention). We discuss the implications of these findings for intervention and prevention strategies.

Protective Factors for Deviance: A Comparison of Rural and Urban Youth

ABSTRACTBased on data from the 2010, 2012, and 2014 Communities that Care Youth Survey, the authors examine the protective factors associated with rural and urban students in grades 6 through 12 across several domains. This research is based on the literature that associates rural areas with a more protective environment and resulting lower rates of deviance. Findings were mixed, but overall rural youth had higher protective factor scores. A summary of all 84 protective factor scores follows: 26 factors shown no significant different between rural and urban students; on 42 protective factors rural youth had higher scores, as opposed to urban youth with higher protective scores on only 16 factors. Implications of findings for crime and delinquency are discussed.

Developmental Hazards Among Young Alcohol Intoxicated Patients

PurposeThe rising numbers of alcohol intoxicated adolescents (AIA) treated in emergency care units in several European countries have drawn attention to this target group for prevention. To our knowledge, this is the first study to assess a broad array of developmental hazards and their stability in AIA and to compare their distribution with representative samples (RS). MethodsA multisite cohort study of AIA aged 13–17 years assessed, in the hospital (t0) and 6 months later (t1), (family) violence, cannabis and alcohol use, school problems, delinquency, homelessness, depression, and suicidality, using items from representative German surveys: Children and Adolescent Health Survey (KiGGS), Childhood Trauma Questionnaire and Communities That Care Youth Survey. We calculated the differences between AIA and RS and corresponding 95% confidence intervals. For AIA respondents who completed t0 and t1 information, we calculated prevalence/persistence/incidence of developmental hazards and corresponding 95% confidence interval. ResultsA total of 342 AIA participated at t0, 228 at t1 (67%). AIA had a significantly higher burden of concomitant risks regarding physical and emotional family abuse, (sexual) victimization, cannabis use, binge drinking, school expulsion, police arrest, gang membership, and being violent. Six months after hospitalization, emotional family abuse (34.1%), cannabis use (23.5%), depression (14.8%), and being violent (13.2%) were especially prevalent. ConclusionsDevelopmental hazards are up to six times more prevalent in AIA than in RS. Therefore, when assessing the risk profile of AIA, it is important to consider developmental hazards as well as detrimental alcohol use.