Department of Social and Behavioral Sciences, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
Department of Social and Behavioral Sciences, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
J Epidemiol Community Health. 2023 Apr;77(4):216-223. doi: 10.1136/jech-2022-219930. Epub 2023 Feb 3.
Child homelessness has been associated with elevated mental health problems during early adolescence, a period of onset for psychiatric problems. Prior literature has relied on cross-sectional studies, limiting the understanding of temporality and trajectories of psychopathology. We extend prior literature by examining associations between child homelessness and internalising and externalising symptom trajectories in early adolescence, with consideration of timing and persistence of homelessness.
Using population-based longitudinal data from the Avon Longitudinal Study of Parents and Children, we used multilevel models to examine the effects of homelessness prior to age 9, the timing of homelessness (eg, early vs middle childhood) and cumulative exposure to homelessness on internalising and externalising trajectories across ages <0-9 years. We also tested for sex differences in these associations.
Of the 8391 participants, 5.5% reported exposure to homelessness at least once before age 9. Children who experienced homelessness had elevated internalising and externalising symptoms compared with their consistently housed peers, with excess risk evident among children who first experienced homelessness in middle childhood (relative to early childhood) and children who experienced recurrent homelessness. We did not observe changes in symptom trajectories over the course of 4 years. Men who experienced homelessness displayed a more pronounced risk of internalising symptoms relative to women and men who did not experience homelessness.
Childhood homelessness is associated with persistently elevated internalising and externalising symptoms across early adolescence compared with their consistently housed peers. Interventions and policies to address family homelessness may lead to better mental health among adolescents.
儿童无家可归与青少年早期心理健康问题的增加有关，而青少年早期是精神病发病的时期。先前的文献依赖于横断面研究，限制了对精神病理学的时间性和轨迹的理解。我们通过检查儿童无家可归与青少年早期的内化和外化症状轨迹之间的关联，以及对无家可归的时间和持续时间的考虑，扩展了先前的文献。
使用来自阿冯纵向研究父母和儿童的基于人群的纵向数据，我们使用多层次模型来研究 9 岁之前的无家可归、无家可归的时间（例如，早期或中期儿童）以及无家可归的累积暴露对<0-9 岁年龄段内化和外化轨迹的影响。我们还测试了这些关联中的性别差异。
在 8391 名参与者中，有 5.5%的人报告至少在 9 岁之前经历过无家可归。与一直有房的同龄人相比，经历过无家可归的儿童表现出更高的内化和外化症状，与早期儿童相比，在儿童中期首次经历无家可归的儿童和经历反复无家可归的儿童存在更高的风险。我们没有观察到 4 年内症状轨迹的变化。与没有经历过无家可归的男性和女性相比，经历过无家可归的男性表现出更明显的内化症状风险。
与一直有房的同龄人相比，儿童无家可归与青少年早期持续存在的内化和外化症状增加有关。解决家庭无家可归问题的干预措施和政策可能会改善青少年的心理健康。
