Accumulation of lifestyle and psychosocial problems and persistence of adverse lifestyle over two-year follow-up among Finnish adolescents

Abstract

BackgroundAdolescent’psychosocial problems associate with unhealthy behaviors, but data on co-occurring patterns is sparse. We investigated 1) whether adolescents could be categorized into meaningful subgroups with respect to psychosocial and lifestyle factors, 2) whether the prevalence of physical inactivity, overweight and smoking vary within the subgroups and 3) whether these unhealthy behaviors persist in a two-year follow-up.MethodsThe study was based on a subgroup of the 1986 Northern Finland Birth Cohort, which consisted of adolescents who replied to a postal questionnaire at 16 years (n = 6792) and a subgroup of this sample at 18 years (n = 1552). Latent class analysis (LCA) was performed to establish clusters at 16 years.ResultsSmoking co-existed with emotional and behavioral problems in both genders. Boys with the most inactive lifestyle slept poorly, whereas multiple problems co-occurred among girls. Those with a high body mass index (BMI) separated as groups of their own. Different combinations of adverse lifestyle and emotional and behavioral problems were relatively common in both sexes as only 51% of boys and 67% of girls belonged to the reference cluster with low probability for these findings. Physical inactivity, high BMI and smoking tended to persist over the two-year follow-up.ConclusionsIt seems that lifestyle and psychosocial factors divide adolescents into distinct subgroups in which unhealthy lifestyle patterns remain between the ages of 16 and 18. This may indicate problems in other life areas and expose them to an increased risk of future health problems.

Accumulation of psychosocial and lifestyle factors and risk of low back pain in adolescence: a cohort study

“…We assessed models with cluster numbers of one to seven and determined the best-fitting cluster solution of these candidates by calculating the Akaike information criterion (AIC), the Bayesian information criterion (BIC), the sample-size adjusted BIC (SSABIC), the Lo-Mendell-Rubin's adjusted likelihood ratio test (LRT), average latent class classification accuracy, and entropy measures [13]. The estimation procedure of the number of the latent clusters for both genders has been presented in detail previously [13]. The statistical program M-Plus Version 6.11 was used for the LCA.…”

“…We first attempted to consider all variables as continuous in the LCA model, but because of too small group sizes we found that it is necessary to use alternative methods to minimise information loss while best representing the data. The procedure behind the selection of using categorical and continuous variables is explained elsewhere in detail [13].…”

“…The classification of weight, which is described elsewhere in detail [13], was carried out using The International Obesity Task Force age-specific cut-off points defining obesity in this population as body mass index (BMI) [28.88 kg/m 2 for boys and [29.43 kg/m 2 for girls. Level of physical activity, sleeping time, and smoking were divided into three categories [12,13,16,24,25]. The reported sedentary hours per day were summed up and categorized as three for boys [16], and for girls, sedentary activity was used as a continuous variable.…”

“…The Finnish version of the Youth Self-Report (YSR) questionnaire was used at 16 years to measure the emotional and behavioural problems of adolescents during the preceding 6 months [13,23]. In the questionnaire, the Eur Spine J items were rated on a three-point scale and then summed and scored on eight syndrome subscales (Table 1).…”

“…However, most of the surveys conducted have examined lifestyle factors, particularly unhealthy behaviours [10][11][12] and psychosocial symptoms [1,3] as separate predictors. Yet these problems tend to occur together [13] and may have parallel and amplifying influences on the development of LBP.…”