Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium.

BACKGROUND: This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum. METHODS: Data were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13-18 years), young adulthood (19-29 years) and at ages 29-35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum. RESULTS: Frequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception. CONCLUSIONS: Persistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.

Impact of New Zealand teenagers' fertility intentions on childbearing.

Objective: To assess the impact of age 15 fertility intentions on childbearing outcomes three decades later. Background: Evidence is mixed about the implications of teenage fertility intentions on later childbearing. Taking a prospective life course approach to assessing intentions and outcomes may help clarify these mixed findings. Method: A general population birth cohort (born 1972/73) was asked about their fertility intentions at age 15 and 775 of this sample (384 women, 391 men) provided data on their childbearing between ages 15 and 45. Results: At age 15, almost all of the sample indicated they would like to have children in the future (93%). Most (79%) reported having had a biological child by they time they were 45; but those who professed to not wanting children as teenagers were significantly less likely to have had a child three decades later. Conclusion: Fertility intentions during adolescence are probably influenced by social, political and economic norms and may influence later childbearing decisions. This may be particularly true for those whose intentions counter established norms around childbearing. Implications: A life course framework is useful for examining the relationship between hypothetical fertility intentions and outcomes.

Lifetime cannabis exposure and small airway function in a population-based cohort study.

Background and objective: The long-term effects of cannabis on small airway function remain unclear. We investigated associations between cannabis use and small airway function in a general population sample. Methods: Cannabis use was ascertained at multiple ages from age 18 to 45 years and quantified as joint-years among 895 participants in the Dunedin Multidisciplinary Health and Development Study. Small airway function at ages 38 and 45 years was measured using impulse oscillometry (IOS) before and after inhalation of salbutamol. Analyses used multiple linear regression adjusting for tobacco use, body mass index and height. Longitudinal analyses of cannabis use between 38 and 45 years also adjusted for IOS at age 38 years. Results: Associations between lifetime cannabis joint-years and IOS differed between men and women: in women, cannabis use was associated with pre-bronchodilator resistance at 5 Hz (R 5) and 20 Hz (R 20), reactance at 5 Hz, area of reactance and resonant frequency, and marginally associated with the difference between R 5 and R 20. Cannabis use was only statistically significantly associated with pre-bronchodilator resonant frequency in men. Cannabis use between the ages of 38 and 45 years was associated with a similar pattern of changes in IOS measures. After salbutamol, cannabis use was only statistically significantly associated with R 5 and R 20 among women and none of the IOS measures among men. Conclusions: Cannabis use is associated with small airway dysfunction at age 45 years, indicating an increase in peripheral airway resistance and reactance. These associations were greater and mostly only statistically significant among women. Associations were weaker and mostly nonsignificant after bronchodilator use, suggesting that cannabis-induced changes in small airways may be at least partially reversible.

Adolescent antecedents of maternal and paternal perinatal depression: a 36-year prospective cohort.

BACKGROUND: Rates of common mental health problems (depression/anxiety) rise sharply in adolescence and peak in young adulthood, often coinciding with the transition to parenthood. Little is known regarding the persistence of common mental health problems from adolescence to the perinatal period in both mothers and fathers. METHODS: A total of 393 mothers (686 pregnancies) and 257 fathers (357 pregnancies) from the intergenerational Australian Temperament Project Generation 3 Study completed self-report assessments of depression and anxiety in adolescence (ages 13-14, 15-16, 17-18 years) and young adulthood (ages 19-20, 23-24, 27-28 years). The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms at 32 weeks pregnancy and 12 months postpartum in mothers, and at 12 months postpartum in fathers. RESULTS: Most pregnancies (81%) in which mothers reported perinatal depression were preceded by a history of mental health problems in adolescence or young adulthood. Similarly, most pregnancies (83%) in which fathers reported postnatal depression were preceded by a preconception history of mental health problems. After adjustment for potential confounders, the odds of self-reporting perinatal depression in both women and men were consistently higher in those with a history of persistent mental health problems across adolescence and young adulthood than those without (ORwomen 5.7, 95% CI 2.9-10.9; ORmen 5.5, 95% CI 1.03-29.70). CONCLUSIONS: Perinatal depression, for the majority of parents, is a continuation of mental health problems with onsets well before pregnancy. Strategies to promote good perinatal mental health should start before parenthood and include both men and women.

Early-onset and recurrent depression in parents increases risk of intergenerational transmission to adolescent offspring.

BACKGROUND: To assess whether the age-of-onset or the recurrence of parents' major depressive disorder (MDD), measured prospectively in a longitudinal birth cohort study, predicted offspring depression at age 15. METHODS: A two-generation study of New Zealanders, with prospective, longitudinal data in the parents' generation (n = 375) and cross-sectional data from their adolescent offspring (n = 612). Parent and offspring depression was measured with structured clinical interviews. Parent depression was measured at six time points from age 11 to 38 years. Adolescent offspring depression was measured at age 15. RESULTS: Compared to adolescents whose parents were never depressed, those whose parents met criteria for MDD more than once and those whose parents first met criteria before adulthood had more symptoms of depression. The combination of early-onset and recurrent depression in parents made adolescents particularly vulnerable; their odds of meeting criteria for MDD were 4.21 times greater (95% CI = 1.57-11.26) than adolescents whose parents were never depressed. The strength of the intergenerational effect did not vary as a function of parent or offspring sex. The prevalence of adolescent depression was 2.5 times higher in the offspring than at age 15 in the parents' generation. CONCLUSIONS: Recurrent depression in both fathers and mothers increases offspring risk for depression, particularly when it starts in childhood or adolescence, but a single lifetime episode does not. Health practitioners should be aware of age-of-onset and course of depression in both parents when assessing their children's risk for depression.

Childhood and adolescent television viewing and internalising disorders in adulthood.

Time spent watching television during childhood and adolescence has been linked to socio-emotional and physical health problems in adulthood. It is unclear whether excessive television viewing is a risk factor for internalising mental health disorders such as anxiety and depression. Longitudinal associations between television viewing in childhood and adult diagnoses of anxiety and depression were investigated in a population-based birth cohort from Dunedin, New Zealand. Mean weekday television viewing time was reported by parents and adolescents between ages 5 and 15 years (1977-1987). Diagnoses of any anxiety disorder and major depression were made using standard criteria from symptoms reported for the previous year at ages 18, 21, 26, 32, and 38 years (between 1990 and 2012). Analyses adjusted for sex, parent and teacher reports of worry/fearfulness at age 5, and socioeconomic status during childhood. Diagnoses were counted if present at any of these assessments. Approximately half of all participants met criteria for anxiety disorder or depression during at least one adult assessment. Participants who had watched more television during childhood and adolescence were more likely to have a diagnosis of anxiety in sex-adjusted analyses (OR [95% CI] 1.22 [1.05, 1.41], p = 0.01), although this association weakened after adjustment for early childhood worry/fearfulness and socioeconomic status. There was no association between television viewing and depression in sex- or fully-adjusted analyses. Excessive television viewing during childhood and adolescence may be a risk factor for developing an anxiety disorder in adulthood, but does not appear to influence the long-term risk for major depression.

Intergenerational changes in adolescents' physical fitness and weight in New Zealand.

AIMS: This research examines fitness and body weight in two cohorts of adolescents, to determine continuity and changes in these measures across two generations. METHODS: Height, weight and fitness were measured in a population-based cohort of 15 year-olds in 1986/7 (Dunedin Study, n=968). The same measures were obtained for their 15-16 year-old children between 2007 and 2015 (Next Generation Study, n=343). Fitness was defined as maximal aerobic capacity (V'O2max). Height and weight were measured in all participants and fitness was adjusted for weight (V'O2max/kg). RESULTS: The Next Generation participants were, on average, heavier than the Dunedin Study participants had been, and had higher body mass index values (kg/m2). Unadjusted V'O2max values for boys did not differ between generations, but were lower in Next Generation girls compared to Dunedin Study girls. For both sexes, the Next Generation participants had lower weight-adjusted V'O2max values than the Dunedin Study participants. Compared to their parents, weight-adjusted V'O2max values were approximately 25% lower in girls and 15% lower in boys. CONCLUSIONS: Overall adolescents today appear to be less fit and heavier than their parents were at the same age. The decline in fitness over a generation is particularly evident in adolescent girls, although boys also have lower levels of fitness once body weight has been taken into account.

Telling the Tale and Living Well: Adolescent Narrative Identity, Personality Traits, and Well-Being Across Cultures.

This study explored links between narrative identity, personality traits, and well-being for 263 adolescents (age 12-21) from three New Zealand cultures: Maori, Chinese, and European. Turning-point narratives were assessed for autobiographical reasoning (causal coherence), local thematic coherence, emotional expressivity, and topic. Across cultures, older adolescents with higher causal coherence reported better well-being. Younger adolescents with higher causal coherence instead reported poorer well-being. Personal development topics were positively linked to well-being for New Zealand European adolescents only, and thematic coherence was positively linked to well-being for Maori adolescents only. Negative expressivity, neuroticism, conscientiousness, and openness were also linked to well-being. Implications of these cultural similarities and differences are considered for theories of narrative identity, personality, and adolescent well-being.

Narratives and traits in personality development among New Zealand Maori, Chinese, and European adolescents.

Narrative and trait levels of personality were assessed in a sample of 268 adolescents from age 12 to 21 from New Zealand Maori, Chinese, and European cultures. Adolescents narrated three critical events and completed a Big Five personality inventory. Each narrative was coded for causal and thematic coherence. NZ Chinese adolescents reported lower levels of extraversion, agreeableness, conscientiousness, and openness, and higher levels of neuroticism, than NZ Maori or European adolescents. Cultural differences were also evident in narrative coherence. Adolescents in all three groups demonstrated age-related increases in thematic coherence, but only NZ European adolescents demonstrated the expected age-related increases in causal coherence. Narrative identity and traits were distinct aspects of personality for younger adolescents, but were linked for middle and older adolescents. These findings support the importance of both narrative identity and traits in understanding personality development in adolescents across cultures.

Childhood and adolescent television viewing and antisocial behavior in early adulthood.

OBJECTIVE: To investigate whether excessive television viewing throughout childhood and adolescence is associated with increased antisocial behavior in early adulthood. METHODS: We assessed a birth cohort of 1037 individuals born in Dunedin, New Zealand, in 1972-1973, at regular intervals from birth to age 26 years. We used regression analysis to investigate the associations between television viewing hours from ages 5 to 15 years and criminal convictions, violent convictions, diagnosis of antisocial personality disorder, and aggressive personality traits in early adulthood. RESULTS: Young adults who had spent more time watching television during childhood and adolescence were significantly more likely to have a criminal conviction, a diagnosis of antisocial personality disorder, and more aggressive personality traits compared with those who viewed less television. The associations were statistically significant after controlling for sex IQ, socioeconomic status, previous antisocial behavior, and parental control. The associations were similar for both sexes, indicating that the relationship between television viewing and antisocial behavior is similar for male and female viewers. CONCLUSIONS: Excessive television viewing in childhood and adolescence is associated with increased antisocial behavior in early adulthood. The findings are consistent with a causal association and support the American Academy of Pediatrics recommendation that children should watch no more than 1 to 2 hours of television each day.

The coherence of critical event narratives and adolescents' psychological functioning.

The present study examined the coherence of low- and high-point life-event narratives among adolescents (aged between 12 and 21 years) and their psychological functioning in terms of well-being and prosocial behaviour. The results showed robust age-related increases in narrative coherence. Age and gender significantly moderated the associations between narrative coherence and psychological functioning. Specifically, higher levels of coherence were significantly associated with prosocial behaviour only for older adolescents. Higher levels of narrative coherence were also associated with lower levels of well-being among adolescent boys, but not among adolescent girls. Results are discussed in terms of why coherent life-event narratives may not be linked to benefits for younger adolescents and for boys, and how low- and high-point life events both contribute to identity construction.

Randomized controlled trial of a web-based primary care intervention for multiple health risk behaviors.

BACKGROUND: Physical inactivity, low fruit and vegetable intake, hazardous drinking, and smoking are leading risk factors for disease and injury. The aim of this study was to obtain estimates of efficacy in reducing the first three of these behaviors. METHOD: The design was a randomized controlled trial: 218 patients (17-24 years) attending a student health service at a New Zealand university in 2003 were assigned to: (A) web-based assessment and personalized feedback (n = 72); or (B) assessment only (n = 74); or (C) minimal contact (n = 72). Outcome measures were the proportion meeting recommendations for fruit and vegetable consumption, physical activity, and alcohol consumption 6 weeks later. RESULTS: Follow-up assessments were attained for 86% of participants, with no evidence of differential attrition. There were significant differences in the proportion meeting recommendations for fruit and vegetable consumption and physical activity in group A relative to C. Hazardous drinking prevalence did not vary significantly by group. CONCLUSIONS: Differences appear attributable to the intervention. The intervention could be routinely provided in primary care, and its efficacy could be assessed in a large randomized controlled trial.

Alcohol and road safety behaviour among New Zealand tertiary students.

In New Zealand, as in most developed countries, rates of injury mortality and morbidity peak in late adolescence (15-19 years), when they account for around three quarters of fatalities and a third of hospitalisations. Road traffic crashes account for over half of fatal injuries in New Zealand as in most developed countries. Individuals engaged in post-secondary education, i.e., tertiary students, are a large and important subgroup of young people exposed to the risk of road traffic injury. The aims of this study were to estimate the prevalence of unsafe road behaviours and to examine the role of demographic variables, alcohol use, driver licence status, and transport needs. Participants were 1,480 students (899 women) from 12 residential halls in Dunedin, New Zealand. They anonymously completed a questionnaire on alcohol use and road safety at the start of the 2000 academic year. A sub-sample of 967 students completed a follow-up survey six months later. The mean age of the sample was 18.3 years (SD=1.6), and 88% had a driver licence. Male gender and drinking status were independently associated with speeding, drink-driving and drink-riding, but not seatbelt use. Drinking levels showed a strong dose-response relationship with the prevalence of unsafe behaviours with the exception of seatbelt use. In marked contrast to drinking levels, which increased from baseline to follow-up, drink-driving and drink-riding levels decreased, probably reflecting the reduced motor vehicle transport needs of students in residential halls, relative to their out-of-term living environments. In addition to various existing, evidence-based countermeasures, application of interventions for reducing hazardous drinking may be required to help reduce road traffic injury rates in this population.