Abstract

There is evidence from longitudinal studies of individuals with childhood problem behaviours that this behavioural risk may translate into health-risk and health problems in adulthood, with implications for health-risk in the next generation. The purpose of this dissertation was to examine the long-term sequelae of childhood aggression and withdrawal on health-risk, health problems, and health-promoting behaviours such as preventative care and use of services. The Concordia Longitudinal Risk Project is a prospective, inter-generational study of individuals from disadvantaged neighborhoods in Montreal, including girls and boys who were selected for extreme levels of aggression and social withdrawal. These individuals were followed across childhood and into adulthood, allowing us to examine processes of continuity and change, primarily experiential factors that precede and support cessation of unhealthy behaviour. In the inter-generational phase of the project, mothers were visited at home at two time points: when offspring were 1-6 years old, and again at 9-12 years old. At both waves of testing, mothers were interviewed about their health-risk, and medical histories were taken for mothers and their target child. In addition, during Study 1 mothers were asked about their adolescent health-risk behaviours and provided obstetric histories, and were asked in Study 2 about preventative health behaviours and use of developmental and medical services. Results indicated that girls who were both highly aggressive and socially withdrawn showed the earliest signs of health-risk behaviour, and that adolescent health risk behaviour was a marker for poor health management in adulthood. Girlhood aggression was a risk factor for health-risk behaviour in both studies, and maternal health-risk behaviours were shown to have a direct impact on health outcomes in offspring. Although the pattern was not as clear for childhood withdrawal, this characteristic appeared to be linked more closely to psychosocial risk than medical risk. Offspring of withdrawn parents were more likely to be prescribed medication during the second wave of testing. Taken together, there was evidence that early problem behaviour was linked to health-risk in adulthood and for young offspring. The results of these two studies have important implications for the long-term sequelae of childhood aggression and withdrawal, and the inter-generational transfer of health-risk.