Profiles of contextual risk during the prenatal period and adolescent substance misuse in a Finnish birth cohort study

W. Alex Mason, Ph.D.
Boys Town

Gilbert Parra, Ph.D.
University of Nebraska (formerly of Boys Town)

ABSTRACT:
Vulnerability for substance misuse is highest among youth who experience multiple contextual risks, such as birth complications and socioeconomic disadvantage, during early development. Although notable progress has been made in research that derives from the cumulative risk and adverse childhood events traditions, there continues to be a need to better understand how to conceptualize children’s exposure to multiple contextual risk factors. This study examined whether subgroups of youth with unique profiles of multiple contextual risk factors during the prenatal period could be identified. The relation between subgroup membership and adolescent substance misuse during adolescence also was investigated. Data from the 1986 Northern Finland Birth Cohort Study (NFBCS) were used. The NFBCS is a large-scale birth cohort study that includes 9,432 youth who were followed from the prenatal period into emerging adulthood. Eleven measures of contextual risk during the prenatal period were examined. Measures of alcohol, cigarette, and illegal drug misuse were assessed when participants were 16 years old. A latent class analysis (LCA) was conducted using Mplus Version 7.3 to identify subgroups of adolescents with unique profiles of contextual risk. Findings indicated that a five class solution provided the best fit to the data. We described the subgroups as Parent Substance Misuse (n = 385; 6%), Mom High-Risk (n = 167; 2%), Large Family Size (n = 521; 8%), Socioeconomic Disadvantage (n = 352; 5%), and Low Risk (n = 5466; 79%). The Large Family Size and Low Risk groups had the lowest levels of substance-related problems. The Mom High-Risk group, characterized by high probabilities of smoking while pregnant, school dropout, and multiple romantic partners had the highest levels of cigarette use. Implications of the findings for prevention science will be discussed including the importance of cultural considerations.