... Results: The scale was developed and assessed using Rasch, 2-and 3-parameter item response th... more ... Results: The scale was developed and assessed using Rasch, 2-and 3-parameter item response theory (IRT) models. ... Full Text PDF (273kb). To cite this article: Horsburgh-McLeod,Geraldine F; Gray, Andrew R; Reeder, Anthony I and McGee, Rob. ...
Background. Sun-tanning perceptions are monitored to identify changes and help refine targeting o... more Background. Sun-tanning perceptions are monitored to identify changes and help refine targeting of skin cancer prevention messages. Aim. To investigate associations between perceptions of sun-tanning and demographic factors among a New Zealand urban population, 1994–2006. Methods. A telephone survey series was conducted during summer in 1994, 1997, 1999/2000, 2002/2003, and 2005/2006. Demographic and personal information (sex, age group, skin sun-sensitivity, and self-defined ethnicity) obtained from 6,195 respondents, 50.2% female, 15–69 years, was investigated in relation to six sun-tanning related statements. A total “positive perceptions of tanning” (ProTan) score was also calculated. Regression analyses modelled each component and the ProTan score against survey year and respondent characteristics. Results. Statistically significantly higher ProTan scores were found for age group (strong reverse dose-response effect), male sex, residence (highest in Auckland), ethnicity (highest among Europeans), and sun sensitivity (an -shaped association). There was no statistically significant change in total ProTan scores from baseline. Conclusions. The development, pretesting, and evaluation of messages for those groups most likely to endorse ProTan statements should be considered for the New Zealand skin cancer prevention program. To achieve and embed significant change, mass media campaigns may require greater intensity and reinforcement with sustained contextual support for settings-based behavioural change.
In this article we describe summer weekend sun exposure and sunburn experience, 1994–2006, among ... more In this article we describe summer weekend sun exposure and sunburn experience, 1994–2006, among urban New Zealand adults (15–69 years) by sex, age group, skin type and outdoor activity type. A series of five telephone surveys undertaken in the summers of 1994, 1997, 1999–2000, 2002–3 and 2005–6 provided a sample of 6,195 adult respondents with usable data from five major cities (Auckland, Hamilton, Wellington, Christchurch and Dunedin). Overall, 69% of the sample had spent at least 15 minutes outdoors between 11am and 4pm. Weekend sunburn was reported by 21%, and was more common among males, young adults and those with highly sunsensitive skin than females, older adults and those with less sensitive skin. The head/face/neck was the body area most frequently and severely sunburned. Sunburn was associated with greater time spent outdoors and occurred most frequently during water-based (29%) and passive recreational activities (25%) and paid work (23%). Sun protection messages could usefully be targeted not only towards at-risk population groups, but also towards those activities and contexts most strongly associated with potentially harmful sun exposure.
Reducing high rates of sunburn occurrence, linked to the development of skin cancers, has been th... more Reducing high rates of sunburn occurrence, linked to the development of skin cancers, has been the focus of sustained social marketing campaigns in Australasia. Despite substantial investment in public health warnings, barriers to preventing sunburn and associated skin cancers remain. The purpose of this article is to illustrate through a holistic model of sunburn how social marketing interventions can be made at both the macro- and micro-environmental levels to minimise the remaining barriers to sun protection. This is achieved though a review of population studies that identify the barriers to preventable sunburn. Integration of the barriers suggests that a holistic approach is needed to understand sun protection behaviour among the general population. This approach supplements existing public health promotion approaches which tend to target an individual’s knowledge and attitude toward sun protection and tanning. From this holistic model of sunburn, the implications for social marketers and directions for future research are presented.
Childhood physical abuse is known to be associated with impaired outcomes in adulthood (e.g., par... more Childhood physical abuse is known to be associated with impaired outcomes in adulthood (e.g., particularly for mental and physical health). However, relatively little is known about adult partnership outcomes for those exposed to childhood physical punishment or maltreatment. This study aims to examine the associations between childhood physical punishment or maltreatment and partnership outcomes at age 30. This investigation analyzed data from a birth cohort of more than 900 New Zealand adults studied to age 30. At ages 18 and 21, cohort members reported on the extent of exposure to childhood physical punishment or maltreatment prior to age 16. Measures of partner relations were collected up to age 30. After adjustment for childhood social, family, and related factors, increasing exposure to childhood physical punishment or maltreatment was associated with greater negative partner relationships (p =.002), partner social adjustment problems (p= .006), interpartner violence victimization (p =.010), and interpartner violence perpetration (p = .019). However, after adjustment, the association between childhood physical punishment or maltreatment and the number of cohabiting relationships was no longer statistically significant (p =.151). Interactions between childhood physical punishment or maltreatment and gender were tested for each of the outcomes. This analysis showed an interactive relationship between childhood physical punishment or maltreatment and partner social adjustment problems in which childhood physical punishment or maltreatment for females, but not males, was associated with partner social adjustment problems. These findings suggest that increasing exposure to childhood physical punishment or maltreatment is associated with impaired partnership outcomes: more negative partner relations, increased reports of a partner with social adjustment problems, and higher levels of interpartner violence.
Purpose To examine the associations between leaving school without qualifications and subsequent ... more Purpose To examine the associations between leaving school without qualifications and subsequent mental health to age 30, using data gathered over the course of a 30 year longitudinal study. Methods Data were gathered over the course of a 30 year study (Christchurch Health and Development Study (CHDS)) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems. Results Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR=1.37 at 95% CI:1.05-1.78, p = 0.019); anxiety disorder (OR=1.99 at 95% CI:1.55-2.57, p < 0.001); suicidal ideation/attempt (OR=1.60 at 95% CI:1.15-2.36, p = 0.005); alcohol abuse/dependence (OR=1.54 at 95% CI:1.20-1.98, p < 0.001); and illicit substance abuse/dependence (OR=2.97 at 95% CI:2.16-4.07, p < 0.001). Adjustment for the covariate factors above (family social background; family violence; child abuse and adolescent mental health problems) reduced these associations substantially and to the point of statistical non-significance. Conclusions The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving. Key words: Longitudinal; Mental health; High school dropout; Educational qualifications
Objective: To examine the associations between exposure to unemployment and psychosocial outcomes... more Objective: To examine the associations between exposure to unemployment and psychosocial outcomes over the period from 16-30 years, using data from a well-studied birth cohort. Method: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal study of a birth cohort of 1265 children, born in Christchurch in 1977, who have been studied to age 30. Assessments of unemployment and psychosocial outcomes (mental health, substance abuse/dependence, criminal offending, adverse life events and life satisfaction) were obtained at ages 18, 21, 25 and 30 years. Results: Prior to adjustment, increasing duration of unemployment was associated with significant increases in the risk of all psychosocial outcomes. These associations were adjusted for confounding using conditional fixed-effects regression techniques. The analyses showed significant (p<0.05), or marginally significant (p<0.10), associations between duration of unemployment and: major depression (p=0.050), alcohol abuse/dependence (p=0.043), illicit substance abuse/dependence (p=0.012), property/violent crime (p<0.001), arrests/convictions (p=0.052), financial problems (p=0.007) and life satisfaction (p=0.092). To test for reverse causality, the fixed-effects regression models were extended to include lagged time-dynamic variables representing the respondent’s psychosocial burden prior to the experience of unemployment. The findings suggested that the association between unemployment and psychosocial outcomes was likely to involve a causal process in which unemployment led to increased risks of adverse psychosocial outcomes. Effect sizes were estimated using attributable risk; exposure to unemployment accounted for between 4.2% and 14.0% (median 10.8%) of the risk of experiencing the significant psychosocial outcomes. Conclusions: The findings of this study suggest that exposure to unemployment had small but pervasive effects on psychosocial adjustment in adolescence and young adulthood. Keywords Unemployment, longitudinal study, fixed-effects regression, psychosocial outcomes
Background: Previous research has found that children exposed to separation/divorce may also expe... more Background: Previous research has found that children exposed to separation/divorce may also experience relationship problems in adulthood. The aim of this investigation was to examine this issue in a birth cohort of over 900 New Zealand children studied to age 30. Methods: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a 30 year longitudinal study of a birth cohort of 1265 children born in Christchurch (NZ) in 1977. The data collected included: a) timing and number of parental separations and divorces from birth to 15 years; b) partnership outcomes (16-30 years) of the number of cohabiting/marriage partnerships; positive partner relations; negative partner relations; partner adjustment/conduct problems; and interpartner violence victimization and perpetration; and c) potential covariate factors. Results: Study findings showed the presence of significant associations between childhood parental separations/divorces and: number of cohabiting/marriage partnerships (16-30 years) (p<.001), negative partner relations (p=.021), extent of partner adjustment/conduct problems (p<.001), and perpetration of interpartner violence (p=.018). Childhood parental separation/divorce explained less than 2.5% of the variance in partnership outcomes. These associations were explained statistically by a series of covariate factors associated with childhood parental separation/divorce including: parental history of illicit drug use, childhood sexual abuse, childhood conduct problems (7-9 years), interparental conflict and violence, childhood physical punishment/maltreatment, family socio-economic status at the child’s birth, and parental history of criminality. Tests of gender interaction showed that the effect of childhood parental separations/divorces may be the same for males and females. Analysis of the number of childhood parental separations/divorces experienced into three age groups (birth to 5, 5 to 10 years and 10 to 15 years) yielded similar results. Conclusions: These findings suggest that the general associations between childhood parental separation/divorce and partner relationships in adulthood reflect the consequences of various contextual factors that are associated with childhood parental separation. Keywords: Adulthood; Child development; Family factors; Marital relationships; Longitudinal studies
Background: This study examined the associations between duration of breast feeding, early infant... more Background: This study examined the associations between duration of breast feeding, early infant growth and body mass index (BMI) at 30 and 35 years, in a birth cohort studied to age 35. Methods: Data were gathered on duration of exclusive and non-exclusive breast feeding (months), early growth (kg; 0-9 months) and BMI at ages 30 and 35 from the Christchurch Health and Development Study. The Christchurch Health and Development Study is a study of a birth cohort of 1265 children, born in Christchurch in 1977. Results: Population-averaged generalised estimating regression models showed statistically significant associations between: duration of breast feeding and mean BMI; and early growth and mean BMI. After adjustment for perinatal, family and social background factors, statistically significant associations were found between: longer duration of breast feeding and lower adult BMI (B=-0.424 [95% CI -0.708, -0.140]); and increasing early growth and higher adult BMI (B=0.393 [95% CI 0.080, 0.707]). When breast feeding and infant growth were entered into the regression model and adjusted for covariates, breast feeding was no longer statistically significantly associated with BMI (B=-0.250 [95% CI -0.553, 0.054]); while early growth remained statistically significantly associated with BMI (B=0.355 [95% CI 0.039, 0.671]). A test for mediation showed that the association between breast feeding and BMI was mediated by early growth (P=0.01). Conclusions: The association between longer duration of breast feeding and later lower BMI scores in adulthood was mediated by lower early growth. Breast feeding may be included as one component of multi-compartment programs targeted at early growth and later obesity.
Objectives: Childhood sexual abuse (CSA) has been associated with many adverse medical, psycholog... more Objectives: Childhood sexual abuse (CSA) has been associated with many adverse medical, psychological, behavioral and socioeconomic outcomes in adulthood. This study aims to examine the linkages between CSA and a wide range of developmental outcomes over a protracted time period to age 30. Methods: Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30. Results: After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <0.001); anxiety disorder (0.364, 0.089, <0.001); suicidal ideation (0.395, 0.089, <0.001); suicide attempt (1.863, 0.403, <0.001); alcohol dependence (0.374, 0.118, <0.002); and illicit drug dependence (0.425, 0.113, <0.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, 0.017); decreased self-esteem (-0.371, 0.181, 0.041); and decreased life satisfaction (-0.510, 0.189, 0.007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <0.001), increased number of sexual partners (0.175, 0.035, <0.001); increased medical contacts for physical health problems (0.105, 0.023, <0.001); and welfare dependence (0.310, 0.099, 0.002). Effect sizes (Cohen’s d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%. Conclusions: CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial. Keywords: Child sexual abuse; Longitudinal; Psychological problems; Sexual risk-taking, Physical health; Socioeconomic
... Results: The scale was developed and assessed using Rasch, 2-and 3-parameter item response th... more ... Results: The scale was developed and assessed using Rasch, 2-and 3-parameter item response theory (IRT) models. ... Full Text PDF (273kb). To cite this article: Horsburgh-McLeod,Geraldine F; Gray, Andrew R; Reeder, Anthony I and McGee, Rob. ...
Background. Sun-tanning perceptions are monitored to identify changes and help refine targeting o... more Background. Sun-tanning perceptions are monitored to identify changes and help refine targeting of skin cancer prevention messages. Aim. To investigate associations between perceptions of sun-tanning and demographic factors among a New Zealand urban population, 1994–2006. Methods. A telephone survey series was conducted during summer in 1994, 1997, 1999/2000, 2002/2003, and 2005/2006. Demographic and personal information (sex, age group, skin sun-sensitivity, and self-defined ethnicity) obtained from 6,195 respondents, 50.2% female, 15–69 years, was investigated in relation to six sun-tanning related statements. A total “positive perceptions of tanning” (ProTan) score was also calculated. Regression analyses modelled each component and the ProTan score against survey year and respondent characteristics. Results. Statistically significantly higher ProTan scores were found for age group (strong reverse dose-response effect), male sex, residence (highest in Auckland), ethnicity (highest among Europeans), and sun sensitivity (an -shaped association). There was no statistically significant change in total ProTan scores from baseline. Conclusions. The development, pretesting, and evaluation of messages for those groups most likely to endorse ProTan statements should be considered for the New Zealand skin cancer prevention program. To achieve and embed significant change, mass media campaigns may require greater intensity and reinforcement with sustained contextual support for settings-based behavioural change.
In this article we describe summer weekend sun exposure and sunburn experience, 1994–2006, among ... more In this article we describe summer weekend sun exposure and sunburn experience, 1994–2006, among urban New Zealand adults (15–69 years) by sex, age group, skin type and outdoor activity type. A series of five telephone surveys undertaken in the summers of 1994, 1997, 1999–2000, 2002–3 and 2005–6 provided a sample of 6,195 adult respondents with usable data from five major cities (Auckland, Hamilton, Wellington, Christchurch and Dunedin). Overall, 69% of the sample had spent at least 15 minutes outdoors between 11am and 4pm. Weekend sunburn was reported by 21%, and was more common among males, young adults and those with highly sunsensitive skin than females, older adults and those with less sensitive skin. The head/face/neck was the body area most frequently and severely sunburned. Sunburn was associated with greater time spent outdoors and occurred most frequently during water-based (29%) and passive recreational activities (25%) and paid work (23%). Sun protection messages could usefully be targeted not only towards at-risk population groups, but also towards those activities and contexts most strongly associated with potentially harmful sun exposure.
Reducing high rates of sunburn occurrence, linked to the development of skin cancers, has been th... more Reducing high rates of sunburn occurrence, linked to the development of skin cancers, has been the focus of sustained social marketing campaigns in Australasia. Despite substantial investment in public health warnings, barriers to preventing sunburn and associated skin cancers remain. The purpose of this article is to illustrate through a holistic model of sunburn how social marketing interventions can be made at both the macro- and micro-environmental levels to minimise the remaining barriers to sun protection. This is achieved though a review of population studies that identify the barriers to preventable sunburn. Integration of the barriers suggests that a holistic approach is needed to understand sun protection behaviour among the general population. This approach supplements existing public health promotion approaches which tend to target an individual’s knowledge and attitude toward sun protection and tanning. From this holistic model of sunburn, the implications for social marketers and directions for future research are presented.
Childhood physical abuse is known to be associated with impaired outcomes in adulthood (e.g., par... more Childhood physical abuse is known to be associated with impaired outcomes in adulthood (e.g., particularly for mental and physical health). However, relatively little is known about adult partnership outcomes for those exposed to childhood physical punishment or maltreatment. This study aims to examine the associations between childhood physical punishment or maltreatment and partnership outcomes at age 30. This investigation analyzed data from a birth cohort of more than 900 New Zealand adults studied to age 30. At ages 18 and 21, cohort members reported on the extent of exposure to childhood physical punishment or maltreatment prior to age 16. Measures of partner relations were collected up to age 30. After adjustment for childhood social, family, and related factors, increasing exposure to childhood physical punishment or maltreatment was associated with greater negative partner relationships (p =.002), partner social adjustment problems (p= .006), interpartner violence victimization (p =.010), and interpartner violence perpetration (p = .019). However, after adjustment, the association between childhood physical punishment or maltreatment and the number of cohabiting relationships was no longer statistically significant (p =.151). Interactions between childhood physical punishment or maltreatment and gender were tested for each of the outcomes. This analysis showed an interactive relationship between childhood physical punishment or maltreatment and partner social adjustment problems in which childhood physical punishment or maltreatment for females, but not males, was associated with partner social adjustment problems. These findings suggest that increasing exposure to childhood physical punishment or maltreatment is associated with impaired partnership outcomes: more negative partner relations, increased reports of a partner with social adjustment problems, and higher levels of interpartner violence.
Purpose To examine the associations between leaving school without qualifications and subsequent ... more Purpose To examine the associations between leaving school without qualifications and subsequent mental health to age 30, using data gathered over the course of a 30 year longitudinal study. Methods Data were gathered over the course of a 30 year study (Christchurch Health and Development Study (CHDS)) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems. Results Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR=1.37 at 95% CI:1.05-1.78, p = 0.019); anxiety disorder (OR=1.99 at 95% CI:1.55-2.57, p < 0.001); suicidal ideation/attempt (OR=1.60 at 95% CI:1.15-2.36, p = 0.005); alcohol abuse/dependence (OR=1.54 at 95% CI:1.20-1.98, p < 0.001); and illicit substance abuse/dependence (OR=2.97 at 95% CI:2.16-4.07, p < 0.001). Adjustment for the covariate factors above (family social background; family violence; child abuse and adolescent mental health problems) reduced these associations substantially and to the point of statistical non-significance. Conclusions The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving. Key words: Longitudinal; Mental health; High school dropout; Educational qualifications
Objective: To examine the associations between exposure to unemployment and psychosocial outcomes... more Objective: To examine the associations between exposure to unemployment and psychosocial outcomes over the period from 16-30 years, using data from a well-studied birth cohort. Method: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal study of a birth cohort of 1265 children, born in Christchurch in 1977, who have been studied to age 30. Assessments of unemployment and psychosocial outcomes (mental health, substance abuse/dependence, criminal offending, adverse life events and life satisfaction) were obtained at ages 18, 21, 25 and 30 years. Results: Prior to adjustment, increasing duration of unemployment was associated with significant increases in the risk of all psychosocial outcomes. These associations were adjusted for confounding using conditional fixed-effects regression techniques. The analyses showed significant (p<0.05), or marginally significant (p<0.10), associations between duration of unemployment and: major depression (p=0.050), alcohol abuse/dependence (p=0.043), illicit substance abuse/dependence (p=0.012), property/violent crime (p<0.001), arrests/convictions (p=0.052), financial problems (p=0.007) and life satisfaction (p=0.092). To test for reverse causality, the fixed-effects regression models were extended to include lagged time-dynamic variables representing the respondent’s psychosocial burden prior to the experience of unemployment. The findings suggested that the association between unemployment and psychosocial outcomes was likely to involve a causal process in which unemployment led to increased risks of adverse psychosocial outcomes. Effect sizes were estimated using attributable risk; exposure to unemployment accounted for between 4.2% and 14.0% (median 10.8%) of the risk of experiencing the significant psychosocial outcomes. Conclusions: The findings of this study suggest that exposure to unemployment had small but pervasive effects on psychosocial adjustment in adolescence and young adulthood. Keywords Unemployment, longitudinal study, fixed-effects regression, psychosocial outcomes
Background: Previous research has found that children exposed to separation/divorce may also expe... more Background: Previous research has found that children exposed to separation/divorce may also experience relationship problems in adulthood. The aim of this investigation was to examine this issue in a birth cohort of over 900 New Zealand children studied to age 30. Methods: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a 30 year longitudinal study of a birth cohort of 1265 children born in Christchurch (NZ) in 1977. The data collected included: a) timing and number of parental separations and divorces from birth to 15 years; b) partnership outcomes (16-30 years) of the number of cohabiting/marriage partnerships; positive partner relations; negative partner relations; partner adjustment/conduct problems; and interpartner violence victimization and perpetration; and c) potential covariate factors. Results: Study findings showed the presence of significant associations between childhood parental separations/divorces and: number of cohabiting/marriage partnerships (16-30 years) (p<.001), negative partner relations (p=.021), extent of partner adjustment/conduct problems (p<.001), and perpetration of interpartner violence (p=.018). Childhood parental separation/divorce explained less than 2.5% of the variance in partnership outcomes. These associations were explained statistically by a series of covariate factors associated with childhood parental separation/divorce including: parental history of illicit drug use, childhood sexual abuse, childhood conduct problems (7-9 years), interparental conflict and violence, childhood physical punishment/maltreatment, family socio-economic status at the child’s birth, and parental history of criminality. Tests of gender interaction showed that the effect of childhood parental separations/divorces may be the same for males and females. Analysis of the number of childhood parental separations/divorces experienced into three age groups (birth to 5, 5 to 10 years and 10 to 15 years) yielded similar results. Conclusions: These findings suggest that the general associations between childhood parental separation/divorce and partner relationships in adulthood reflect the consequences of various contextual factors that are associated with childhood parental separation. Keywords: Adulthood; Child development; Family factors; Marital relationships; Longitudinal studies
Background: This study examined the associations between duration of breast feeding, early infant... more Background: This study examined the associations between duration of breast feeding, early infant growth and body mass index (BMI) at 30 and 35 years, in a birth cohort studied to age 35. Methods: Data were gathered on duration of exclusive and non-exclusive breast feeding (months), early growth (kg; 0-9 months) and BMI at ages 30 and 35 from the Christchurch Health and Development Study. The Christchurch Health and Development Study is a study of a birth cohort of 1265 children, born in Christchurch in 1977. Results: Population-averaged generalised estimating regression models showed statistically significant associations between: duration of breast feeding and mean BMI; and early growth and mean BMI. After adjustment for perinatal, family and social background factors, statistically significant associations were found between: longer duration of breast feeding and lower adult BMI (B=-0.424 [95% CI -0.708, -0.140]); and increasing early growth and higher adult BMI (B=0.393 [95% CI 0.080, 0.707]). When breast feeding and infant growth were entered into the regression model and adjusted for covariates, breast feeding was no longer statistically significantly associated with BMI (B=-0.250 [95% CI -0.553, 0.054]); while early growth remained statistically significantly associated with BMI (B=0.355 [95% CI 0.039, 0.671]). A test for mediation showed that the association between breast feeding and BMI was mediated by early growth (P=0.01). Conclusions: The association between longer duration of breast feeding and later lower BMI scores in adulthood was mediated by lower early growth. Breast feeding may be included as one component of multi-compartment programs targeted at early growth and later obesity.
Objectives: Childhood sexual abuse (CSA) has been associated with many adverse medical, psycholog... more Objectives: Childhood sexual abuse (CSA) has been associated with many adverse medical, psychological, behavioral and socioeconomic outcomes in adulthood. This study aims to examine the linkages between CSA and a wide range of developmental outcomes over a protracted time period to age 30. Methods: Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30. Results: After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <0.001); anxiety disorder (0.364, 0.089, <0.001); suicidal ideation (0.395, 0.089, <0.001); suicide attempt (1.863, 0.403, <0.001); alcohol dependence (0.374, 0.118, <0.002); and illicit drug dependence (0.425, 0.113, <0.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, 0.017); decreased self-esteem (-0.371, 0.181, 0.041); and decreased life satisfaction (-0.510, 0.189, 0.007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <0.001), increased number of sexual partners (0.175, 0.035, <0.001); increased medical contacts for physical health problems (0.105, 0.023, <0.001); and welfare dependence (0.310, 0.099, 0.002). Effect sizes (Cohen’s d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%. Conclusions: CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial. Keywords: Child sexual abuse; Longitudinal; Psychological problems; Sexual risk-taking, Physical health; Socioeconomic
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than 900 New Zealand adults studied to age 30. At ages 18 and 21, cohort members reported on the extent of exposure to childhood physical punishment or maltreatment prior to age 16.
Measures of partner relations were collected up to age 30. After adjustment for childhood social, family, and related factors, increasing exposure to childhood physical punishment or maltreatment was associated with greater negative partner relationships (p =.002), partner social adjustment problems (p= .006), interpartner violence victimization (p =.010), and interpartner violence perpetration (p = .019). However, after adjustment, the association between childhood physical punishment or maltreatment and the number of cohabiting relationships was no longer statistically significant (p =.151). Interactions between childhood physical punishment or
maltreatment and gender were tested for each of the outcomes. This analysis showed an interactive relationship between childhood physical punishment or maltreatment and partner social adjustment problems in which childhood physical punishment or maltreatment for females, but not males, was associated with partner social adjustment problems. These findings suggest that increasing exposure to childhood physical punishment or maltreatment is associated with impaired partnership outcomes: more negative partner relations, increased reports of a partner with social adjustment problems, and higher levels of interpartner violence.
Methods Data were gathered over the course of a 30 year study (Christchurch Health and Development Study (CHDS)) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems.
Results Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR=1.37 at 95% CI:1.05-1.78, p = 0.019); anxiety disorder (OR=1.99 at 95% CI:1.55-2.57, p < 0.001); suicidal ideation/attempt (OR=1.60 at 95% CI:1.15-2.36, p = 0.005); alcohol abuse/dependence (OR=1.54 at 95% CI:1.20-1.98, p < 0.001); and illicit substance abuse/dependence (OR=2.97 at 95% CI:2.16-4.07, p < 0.001). Adjustment for the covariate factors above (family social background; family violence; child abuse and adolescent mental health problems) reduced these associations substantially and to the point of statistical non-significance.
Conclusions The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving.
Key words: Longitudinal; Mental health; High school dropout; Educational qualifications
Method: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal study of a birth cohort of 1265 children, born in Christchurch in 1977, who have been studied to age 30. Assessments of unemployment and psychosocial outcomes (mental health, substance abuse/dependence, criminal offending, adverse life events and life satisfaction) were obtained at ages 18, 21, 25 and 30 years.
Results: Prior to adjustment, increasing duration of unemployment was associated with significant increases in the risk of all psychosocial outcomes. These associations were adjusted for confounding using conditional fixed-effects regression techniques. The analyses showed significant (p<0.05), or marginally significant (p<0.10), associations between duration of unemployment and: major depression (p=0.050), alcohol abuse/dependence (p=0.043), illicit substance abuse/dependence (p=0.012), property/violent crime (p<0.001), arrests/convictions (p=0.052), financial problems (p=0.007) and life satisfaction (p=0.092). To test for reverse causality, the fixed-effects regression models were extended to include lagged time-dynamic variables representing the respondent’s psychosocial burden prior to the experience of unemployment. The findings suggested that the association between unemployment and psychosocial outcomes was likely to involve a causal process in which unemployment led to increased risks of adverse psychosocial outcomes. Effect sizes were estimated using attributable risk; exposure to unemployment accounted for between 4.2% and 14.0% (median 10.8%) of the risk of experiencing the significant psychosocial outcomes.
Conclusions: The findings of this study suggest that exposure to unemployment had small but pervasive effects on psychosocial adjustment in adolescence and young adulthood.
Keywords
Unemployment, longitudinal study, fixed-effects regression, psychosocial outcomes
Methods: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a 30 year longitudinal study of a birth cohort of 1265 children born in Christchurch (NZ) in 1977. The data collected included: a) timing and number of parental separations and divorces from birth to 15 years; b) partnership outcomes (16-30 years) of the number of cohabiting/marriage partnerships; positive partner relations; negative partner relations; partner adjustment/conduct problems; and interpartner violence victimization and perpetration; and c) potential covariate factors.
Results: Study findings showed the presence of significant associations between childhood parental separations/divorces and: number of cohabiting/marriage partnerships (16-30 years) (p<.001), negative partner relations (p=.021), extent of partner adjustment/conduct problems (p<.001), and perpetration of interpartner violence (p=.018). Childhood parental separation/divorce explained less than 2.5% of the variance in partnership outcomes. These associations were explained statistically by a series of covariate factors associated with childhood parental separation/divorce including: parental history of illicit drug use, childhood sexual abuse, childhood conduct problems (7-9 years), interparental conflict and violence, childhood physical punishment/maltreatment, family socio-economic status at the child’s birth, and parental history of criminality. Tests of gender interaction showed that the effect of childhood parental separations/divorces may be the same for males and females. Analysis of the number of childhood parental separations/divorces experienced into three age groups (birth to 5, 5 to 10 years and 10 to 15 years) yielded similar results.
Conclusions: These findings suggest that the general associations between childhood parental separation/divorce and partner relationships in adulthood reflect the consequences of various contextual factors that are associated with childhood parental separation.
Keywords: Adulthood; Child development; Family factors; Marital relationships; Longitudinal studies
Methods: Data were gathered on duration of exclusive and non-exclusive breast feeding (months), early growth (kg; 0-9 months) and BMI at ages 30 and 35 from the Christchurch Health and Development Study. The Christchurch Health and Development Study is a study of a birth cohort of 1265 children, born in Christchurch in 1977.
Results: Population-averaged generalised estimating regression models showed statistically significant associations between: duration of breast feeding and mean BMI; and early growth and mean BMI. After adjustment for perinatal, family and social background factors, statistically significant associations were found between: longer duration of breast feeding and lower adult BMI (B=-0.424 [95% CI -0.708, -0.140]); and increasing early growth and higher adult BMI (B=0.393 [95% CI 0.080, 0.707]). When breast feeding and infant growth were entered into the regression model and adjusted for covariates, breast feeding was no longer statistically significantly associated with BMI (B=-0.250 [95% CI -0.553, 0.054]); while early growth remained statistically significantly associated with BMI (B=0.355 [95% CI 0.039, 0.671]). A test for mediation showed that the association between breast feeding and BMI was mediated by early growth (P=0.01).
Conclusions: The association between longer duration of breast feeding and later lower BMI scores in adulthood was mediated by lower early growth. Breast feeding may be included as one component of multi-compartment programs targeted at early growth and later obesity.
Methods: Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30.
Results: After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <0.001); anxiety disorder (0.364, 0.089, <0.001); suicidal ideation (0.395, 0.089, <0.001); suicide attempt (1.863, 0.403, <0.001); alcohol dependence (0.374, 0.118, <0.002); and illicit drug dependence (0.425, 0.113, <0.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, 0.017); decreased self-esteem (-0.371, 0.181, 0.041); and decreased life satisfaction (-0.510, 0.189, 0.007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <0.001), increased number of sexual partners (0.175, 0.035, <0.001); increased medical contacts for physical health problems (0.105, 0.023, <0.001); and welfare dependence (0.310, 0.099, 0.002). Effect sizes (Cohen’s d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%.
Conclusions: CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial.
Keywords: Child sexual abuse; Longitudinal; Psychological problems; Sexual risk-taking, Physical health; Socioeconomic
than 900 New Zealand adults studied to age 30. At ages 18 and 21, cohort members reported on the extent of exposure to childhood physical punishment or maltreatment prior to age 16.
Measures of partner relations were collected up to age 30. After adjustment for childhood social, family, and related factors, increasing exposure to childhood physical punishment or maltreatment was associated with greater negative partner relationships (p =.002), partner social adjustment problems (p= .006), interpartner violence victimization (p =.010), and interpartner violence perpetration (p = .019). However, after adjustment, the association between childhood physical punishment or maltreatment and the number of cohabiting relationships was no longer statistically significant (p =.151). Interactions between childhood physical punishment or
maltreatment and gender were tested for each of the outcomes. This analysis showed an interactive relationship between childhood physical punishment or maltreatment and partner social adjustment problems in which childhood physical punishment or maltreatment for females, but not males, was associated with partner social adjustment problems. These findings suggest that increasing exposure to childhood physical punishment or maltreatment is associated with impaired partnership outcomes: more negative partner relations, increased reports of a partner with social adjustment problems, and higher levels of interpartner violence.
Methods Data were gathered over the course of a 30 year study (Christchurch Health and Development Study (CHDS)) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems.
Results Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR=1.37 at 95% CI:1.05-1.78, p = 0.019); anxiety disorder (OR=1.99 at 95% CI:1.55-2.57, p < 0.001); suicidal ideation/attempt (OR=1.60 at 95% CI:1.15-2.36, p = 0.005); alcohol abuse/dependence (OR=1.54 at 95% CI:1.20-1.98, p < 0.001); and illicit substance abuse/dependence (OR=2.97 at 95% CI:2.16-4.07, p < 0.001). Adjustment for the covariate factors above (family social background; family violence; child abuse and adolescent mental health problems) reduced these associations substantially and to the point of statistical non-significance.
Conclusions The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving.
Key words: Longitudinal; Mental health; High school dropout; Educational qualifications
Method: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal study of a birth cohort of 1265 children, born in Christchurch in 1977, who have been studied to age 30. Assessments of unemployment and psychosocial outcomes (mental health, substance abuse/dependence, criminal offending, adverse life events and life satisfaction) were obtained at ages 18, 21, 25 and 30 years.
Results: Prior to adjustment, increasing duration of unemployment was associated with significant increases in the risk of all psychosocial outcomes. These associations were adjusted for confounding using conditional fixed-effects regression techniques. The analyses showed significant (p<0.05), or marginally significant (p<0.10), associations between duration of unemployment and: major depression (p=0.050), alcohol abuse/dependence (p=0.043), illicit substance abuse/dependence (p=0.012), property/violent crime (p<0.001), arrests/convictions (p=0.052), financial problems (p=0.007) and life satisfaction (p=0.092). To test for reverse causality, the fixed-effects regression models were extended to include lagged time-dynamic variables representing the respondent’s psychosocial burden prior to the experience of unemployment. The findings suggested that the association between unemployment and psychosocial outcomes was likely to involve a causal process in which unemployment led to increased risks of adverse psychosocial outcomes. Effect sizes were estimated using attributable risk; exposure to unemployment accounted for between 4.2% and 14.0% (median 10.8%) of the risk of experiencing the significant psychosocial outcomes.
Conclusions: The findings of this study suggest that exposure to unemployment had small but pervasive effects on psychosocial adjustment in adolescence and young adulthood.
Keywords
Unemployment, longitudinal study, fixed-effects regression, psychosocial outcomes
Methods: Data were gathered over the course of the Christchurch Health and Development Study (CHDS). The CHDS is a 30 year longitudinal study of a birth cohort of 1265 children born in Christchurch (NZ) in 1977. The data collected included: a) timing and number of parental separations and divorces from birth to 15 years; b) partnership outcomes (16-30 years) of the number of cohabiting/marriage partnerships; positive partner relations; negative partner relations; partner adjustment/conduct problems; and interpartner violence victimization and perpetration; and c) potential covariate factors.
Results: Study findings showed the presence of significant associations between childhood parental separations/divorces and: number of cohabiting/marriage partnerships (16-30 years) (p<.001), negative partner relations (p=.021), extent of partner adjustment/conduct problems (p<.001), and perpetration of interpartner violence (p=.018). Childhood parental separation/divorce explained less than 2.5% of the variance in partnership outcomes. These associations were explained statistically by a series of covariate factors associated with childhood parental separation/divorce including: parental history of illicit drug use, childhood sexual abuse, childhood conduct problems (7-9 years), interparental conflict and violence, childhood physical punishment/maltreatment, family socio-economic status at the child’s birth, and parental history of criminality. Tests of gender interaction showed that the effect of childhood parental separations/divorces may be the same for males and females. Analysis of the number of childhood parental separations/divorces experienced into three age groups (birth to 5, 5 to 10 years and 10 to 15 years) yielded similar results.
Conclusions: These findings suggest that the general associations between childhood parental separation/divorce and partner relationships in adulthood reflect the consequences of various contextual factors that are associated with childhood parental separation.
Keywords: Adulthood; Child development; Family factors; Marital relationships; Longitudinal studies
Methods: Data were gathered on duration of exclusive and non-exclusive breast feeding (months), early growth (kg; 0-9 months) and BMI at ages 30 and 35 from the Christchurch Health and Development Study. The Christchurch Health and Development Study is a study of a birth cohort of 1265 children, born in Christchurch in 1977.
Results: Population-averaged generalised estimating regression models showed statistically significant associations between: duration of breast feeding and mean BMI; and early growth and mean BMI. After adjustment for perinatal, family and social background factors, statistically significant associations were found between: longer duration of breast feeding and lower adult BMI (B=-0.424 [95% CI -0.708, -0.140]); and increasing early growth and higher adult BMI (B=0.393 [95% CI 0.080, 0.707]). When breast feeding and infant growth were entered into the regression model and adjusted for covariates, breast feeding was no longer statistically significantly associated with BMI (B=-0.250 [95% CI -0.553, 0.054]); while early growth remained statistically significantly associated with BMI (B=0.355 [95% CI 0.039, 0.671]). A test for mediation showed that the association between breast feeding and BMI was mediated by early growth (P=0.01).
Conclusions: The association between longer duration of breast feeding and later lower BMI scores in adulthood was mediated by lower early growth. Breast feeding may be included as one component of multi-compartment programs targeted at early growth and later obesity.
Methods: Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30.
Results: After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <0.001); anxiety disorder (0.364, 0.089, <0.001); suicidal ideation (0.395, 0.089, <0.001); suicide attempt (1.863, 0.403, <0.001); alcohol dependence (0.374, 0.118, <0.002); and illicit drug dependence (0.425, 0.113, <0.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, 0.017); decreased self-esteem (-0.371, 0.181, 0.041); and decreased life satisfaction (-0.510, 0.189, 0.007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <0.001), increased number of sexual partners (0.175, 0.035, <0.001); increased medical contacts for physical health problems (0.105, 0.023, <0.001); and welfare dependence (0.310, 0.099, 0.002). Effect sizes (Cohen’s d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%.
Conclusions: CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial.
Keywords: Child sexual abuse; Longitudinal; Psychological problems; Sexual risk-taking, Physical health; Socioeconomic