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Childhood Behavior Problems and Adolescent Sexual Risk Behavior: Familial Confounding in the Child and Adolescent Twin Study in Sweden (CATSS).

Journal article
Authors Kelly L Donahue
Paul Lichtenstein
Sebastian Lundström
Henrik Anckarsäter
Clara Hellner Gumpert
Niklas Långström
Brian M D'Onofrio
Published in The Journal of adolescent health : official publication of the Society for Adolescent Medicine
Volume 52
Issue 5
Pages 606–612
ISSN 1879-1972
Publication year 2013
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Gillberg Neuropsychiatry Centre
Pages 606–612
Language en
Links dx.doi.org/10.1016/j.jadohealth.201...
Keywords Conduct disorder, Opposition defiant disorder, Adolescence, Clustered data analysis, Confounding factors, Mental health, Sex education programs, Sexual behavior
Subject categories Psychiatry, Child and adolescent psychiatry

Abstract

OBJECTIVE: Previous studies have found associations between childhood behavior problems and adolescent sexual risk behavior. Using a quasi-experimental approach, we examined the extent to which this association may be due to between-family differences (i.e., unmeasured familial confounds) not adequately explored in prior research. METHODS: We used data from a longitudinal, population-based cohort of young twins in Sweden (first assessment: age 9 or 12 years; second assessment: age 15; n = 2,388). We explored the nature of the association between symptom scores for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) at age 9 or 12 and the likelihood of having had sexual intercourse and number of sexual partners by age 15. Two-level mixed-effects models were used to estimate the effect of symptom score on each outcome after controlling for potential unmeasured familial confounds. RESULTS: Higher ADHD, ODD, and CD scores were associated with significantly increased likelihood of sexual intercourse by age 15. Higher ADHD and ODD scores were also associated with increased number of sexual partners. After controlling for unmeasured familial confounds, however, behavior problems were no longer significantly associated with either outcome. CONCLUSION: The association between childhood behavior problems and sexual risk behaviors may be due to characteristics shared within families. Hence, prevention strategies aimed at reducing these behaviors might need to address broader risk factors that contribute to both behavior problems and a greater likelihood of sexual risk behavior.

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