Longitudinal Associations Between Early Childhood Aggression and Impulsivity, Adolescent Alcohol Use and Negative Sexual Health Outcomes in Emerging Adulthood

Adolescents and young adults are at high risk of experiencing negative health outcomes from risky sexual behavior, including sexually transmitted infections (STI) and unintended pregnancy. In fact, nearly half of all new STIs occur among people ages 15-24  (Weinstock, Berman, & Cates, 2004).  Two factors that are related to negative sexual health outcomes in adolescents are alcohol use (e.g. Schmiege ,Levin, & Bryan, 2009), and early childhood impulsivity/aggression (Kellam et al., 2012), though the mechanisms underlying these relationships are unclear. The current study extends previous research by examining longitudinal relationships between early childhood aggression and impulsivity trajectories, adolescent alcohol use trajectories, and negative sexual health outcomes in emerging adulthood.  Using data from a longitudinal preventive intervention study (N=678), we examined the relationships between trajectories of teacher-rated impulsivity and aggression from first through third grades, adolescent trajectories of alcohol use from eighth grade to age twenty-three, and negative sexual health outcomes in emerging adulthood in a parallel latent class growth analysis.  Two classes of teacher-rated impulsive and aggressive behaviors were found, with a majority of individuals classified in the low impulsivity/aggression class.  Longitudinal latent class analysis was performed on the participants’ past year self report frequency of alcohol use.  Three classes were found, with a majority of individuals being in the little to no use class.  The next most populous class was a normative trajectory, with use peaking at age twenty one.  Impulsive/aggressive class membership was significantly related to alcohol use class (est. = .944, S.E.=.358, p=.008), with individuals in the high impulsivity/aggression class being more likely to be in the moderate to high alcohol use trajectory.  Additionally, alcohol use trajectories were significantly associated with negative sexual health outcomes, including STIs (χ²=8.259, p=.016) and unintended pregnancy (χ²=17.498, p<.001).  Understanding the association between early behavior difficulties and negative outcomes across development is essential to developing effective prevention programming. The results of this study establish a clear link between aggression/impulsivity in early childhood, increased alcohol use in adolescence, and poor sexual health outcomes in young adulthood, underscoring the importance of early interventions targeting self-regulation difficulties in mitigating or preventing an escalating pattern of risky behavior.