Halvorson Max A, Caouette Justin D, Briney John S, Kuklinski Margaret R, Oesterle Sabrina, Hawkins J David
Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington, USA.
Southwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service & Community Solutions, Arizona State University, Tempe, Arizona, USA.
Crim Behav Ment Health. 2025 Feb;35(1):22-30. doi: 10.1002/cbm.2365. Epub 2025 Jan 7.
Cumulative risk scores predict negative outcomes including antisocial behaviour and mental health. Less work has examined the role of cumulative protection, despite the availability of preventive interventions focused on bolstering protection across domains. Understanding links between cumulative risk and protection measured in childhood and later outcomes can help to guide the timing of prevention programmes.
The study aimed to understand the relative contributions of early adolescent cumulative risk and cumulative protection in Grade 6 on distal outcomes six to seven years later, at ages 18-19.
Data are from the Community Youth Development Study, a community-randomised trial of the Communities That Care prevention system. The analysis sample consisted of 2002 participants from 12 control communities. Logistic regression models were estimated to quantify the main and interactive effects of Grade 6 cumulative risk and protection on alcohol, tobacco and cannabis use; antisocial behaviour, and depression at ages 18-19.
When considered in separate models, cumulative risk and protection were each associated with later alcohol, tobacco and cannabis misuse; antisocial behaviour and depression. When considered together, coefficients for cumulative protection were attenuated, whereas coefficients for cumulative risk remained similar in magnitude. Cumulative risk was associated with larger outcome prevalence differences (average of 9%) than cumulative protection (average of 2%). Evidence for risk-protection interactions was not observed.
Although early adolescent cumulative protection was associated with later outcomes, these associations were largely reduced when considering cumulative risk. Findings emphasise the importance of addressing cumulative risk when designing preventive interventions.
累积风险评分可预测包括反社会行为和心理健康在内的负面结果。尽管有针对加强各领域保护的预防性干预措施，但对累积保护作用的研究较少。了解儿童期测量的累积风险与保护之间的联系以及后期结果，有助于指导预防方案的时机。
本研究旨在了解青少年早期累积风险和六年级时的累积保护对六至七年后18 - 19岁时的远期结果的相对贡献。
数据来自社区青年发展研究，这是一项针对“关心社区”预防系统的社区随机试验。分析样本包括来自12个对照社区的2002名参与者。采用逻辑回归模型来量化六年级累积风险和保护对18 - 19岁时酒精、烟草和大麻使用、反社会行为及抑郁的主要和交互作用。
在单独模型中考虑时，累积风险和保护均与后期酒精、烟草和大麻滥用、反社会行为及抑郁相关。综合考虑时，累积保护的系数减弱，而累积风险的系数大小保持相似。累积风险导致的结果患病率差异（平均9%）比累积保护（平均2%）更大。未观察到风险 - 保护交互作用的证据。
尽管青少年早期累积保护与后期结果相关，但在考虑累积风险时，这些关联大多减弱。研究结果强调在设计预防性干预措施时应对累积风险的重要性。
