Skinner S Rachel, Marino Jennifer, Rosenthal Susan L, Cannon Jeffrey, Doherty Dorota A, Hickey Martha
Discipline of Child and Adolescent Health, University of Sydney, the Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.
Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Vic. 3010, Australia.
Sex Health. 2017 Nov;14(6):492-501. doi: 10.1071/SH16240.
Background Externalising (delinquent, aggressive) and internalising (anxious/depressed, withdrawn) behaviour problems are prevalent in childhood. Few studies have prospectively measured relationships between childhood behaviour problems and adolescent health risk behaviour, a major predictor of morbidity and mortality. This study sought to determine relationships, by gender, between childhood behaviour problems and adolescent risky sexual behaviours and substance use.
In a population-based birth cohort [The Western Australian Pregnancy Cohort (Raine) Study], total, externalising and internalising behaviour problems (domain-specific T≥60) were calculated from parent-reported Child Behavior Checklist at ages 2, 5, 8, 10 and 14 years. At age 17 years, 1200 (49% male) participants reported sexual and substance use activity Results: For both genders, those with earlier externalising behaviour problems were more likely to be sexually active (oral sex or sexual intercourse) by age 17 years. Males with childhood externalising behaviour problems were more likely to have multiple sexual partners by age 17 years than those without such problems [adjusted odds ratio (aOR) 2.96, 95% confidence interval (CI) 1.49-5.86]. Females with childhood externalising behaviour problems were more likely to have had unwanted sex (aOR 1.91, 95% CI 1.04-3.53). Externalising behaviour problems were associated with substance use for both genders. No association was found between internalising behaviour problems and risky behaviour.
Externalising behaviour problems from as early as 5 years old in boys and 8 years old in girls predict a range of risky sexual behaviour in adolescence, which has important implications for targeting interventions in adolescence.
背景 外化（违纪、攻击）和内化（焦虑/抑郁、孤僻）行为问题在儿童期很常见。很少有研究前瞻性地测量儿童行为问题与青少年健康风险行为之间的关系，而青少年健康风险行为是发病率和死亡率的主要预测因素。本研究旨在确定儿童行为问题与青少年危险性性行为和物质使用之间按性别划分的关系。
在一个基于人群的出生队列[西澳大利亚妊娠队列（Raine）研究]中，根据家长报告的2岁、5岁、8岁、10岁和14岁儿童行为清单计算总的、外化和内化行为问题（特定领域T≥60）。在17岁时，1200名（49%为男性）参与者报告了性活动和物质使用情况。结果：对于两性而言，较早出现外化行为问题的人在17岁时更有可能有性活动（口交或性交）。有儿童期外化行为问题的男性在17岁时比没有此类问题的男性更有可能有多个性伴侣[调整后的优势比（aOR）2.96，95%置信区间（CI）1.49 - 5.86]。有儿童期外化行为问题的女性更有可能有过非自愿性行为（aOR 1.91，95% CI 1.04 - 3.53）。外化行为问题与两性的物质使用都有关联。未发现内化行为问题与风险行为之间存在关联。
男孩早在5岁、女孩早在8岁出现的外化行为问题预示着青少年期一系列危险性性行为，这对于确定青少年期的干预目标具有重要意义。
