1. Externalizing Behaviors in Adolescence as a Stepping Stone on the Trajectory to Young Adult Poor Physical Health . Elenda T. Hessel, Joseph S. Tan, Emily L. Loeb, Leah Grande, & Joseph P. Allen University of Virginia. , We would like to thank the National Institute of Child Health & Human Development for funding awarded to Joseph P. Allen, Principal Investigator, (R01 HD & R01-MH58066) for funding to conduct this study as well as for the write-up of this study.
Introduction
Measures .
Externalizing Behaviors
(Close Peer and Mother reports – Target Teen age 13)
Close peer and mother reported adolescent externalizing behaviors were measured using the Friend and Parent versions of the Child Behavior Checklist, (Achenbach, 1991). Subscales investigated include aggression, hostility, delinquency, hyperactivity, and immaturity. Overall externalizing behaviors were also considered. Sample items include, “S/he destroys things belonging to her/his family or others” or “S/he acts too young for her/his age” . This questionnaire has been well validated and it showed good internal consistency in this sample.
Self-Reported Health
(Target Teen age 25)
Target teens self-reported health was assessed the RAND-36 (Ware, & Sherbourne, 1992). The items assessed individuals perceptions of their overall health, general health difficulties, and their expectations about their future health. Examples include items such as “In general, would you say your health is: (Poor, Fair, Good, Very Good, or Excellent)”, and ratings of how true statements such as “I am as healthy as anybody I know” or “I seem to get sick a little easier than other people” are for them. This questionnaire is widely used, has been well validated and showed good internal consistency in this sample.
Premises
Adolescents who engage heavily in externalizing behaviors are at increased risk for many maladaptive outcomes, both concurrently and into adulthood.
These behaviors have been linked with subsequent “unhealthy” outcomes, such as STI’s, problem drinking, and others, but little research has investigated any associations with general physical health in early adulthood.
Adult psychosocial functioning has been linked with current physical health, including sleep quality, cardiovascular reactivity to stress, and body mass index, and increasingly it is thought that adolescent psychosocial functioning may also foretell adult physical functioning.
As such, it is important to identify early psychosocial markers— such as externalizing behaviors—that may help to identify who is at greater risk for adverse physical health outcomes.
This study seeks to investigate whether early adolescent externalizing behaviors predict early adult self-rated global health.
Hypotheses .
Engagement in high levels of externalizing behaviors at age 13, including aggression, hostility, delinquency, hyperactivity, and immaturity as reported by parents and peers at that time, will predict general physical health outcomes in early adulthood at age 25.
Results
All analyses controlled for adolescent gender and family of origin income.
Self-reported general health at age 25 was predicted by a variety of best friend’s, but not mother’s, ratings of age 13 adolescent externalizing behaviors.
Specifically, poorer emerging adult general health was significantly predicted by close-friend rated adolescent aggression (β=-.16, p≤ .05, see table 1), hostility, (β=-.17, p<.05, see table 2), and hyperactivity (β=-.20, p<.05, see table 3).
Additionally, poorer emerging adult general health was significantly predicted by close friend overall externalizing behaviors at age 13 (β=-.16, p≤.05).
No results were found predicting adult general health from delinquency or immaturity, nor were any predictions from the mother’s rating of the adolescent significant.
Method
Participants
Multi-method longitudinal data were obtained from 184 teenagers along with their closest peer and their parents at age 13, and again from the target teens at age 25.
58% Caucasian, 29% African American, and 13% Mixed or Other ethnicity.
Median household income was within the $40,000 to $59,000 range.
Target teen mean age was years at Time 1 and at Time 2.
Procedures .
Time 1 (Age 13) – Closest peer of target teen as well as target teen’s mother filled out a questionnaire about their perception of target teen’s engagement in externalizing behaviors, including aggression, hostility, delinquency, hyperactivity, and immaturity.
Time 2 (Age 25) - Target teen filled out a questionnaire reporting on their own physical health and functioning.
Conclusions
These results indicate that adolescents who are engaging in more externalizing behaviors—particularly more aggressive, hostile, and hyperactive behaviors—at age 13 may be at a heighted risk for diminished physical health in early adulthood (age 25). Moreover, this research suggests those adolescents’ peers, more so than their mothers, may be uniquely positioned to help identify those at risk of these adverse outcomes. Given the known associations between poor self-rated general health and mortality, the implications of this association between adolescent externalizing behaviors and poor health in early adulthood could be far reaching.
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Thoughts? Questions? Ideas?
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