Alcohol misuse: tackling the UK epidemic - London

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Risk factors for conduct, depressive and anxiety disorders include:
• adverse temperamental characteristics in the child
• parental mental illness, substance misuse, marital disharmony or personality disorder
• chronic or acute stress at school, at home or in the neighbourhood
• use of tobacco, alcohol and illicit drugs.
Specific risk factors for conduct disorder include:
• inadequate parental supervision
• use of physical methods of punishment
• violence in the home
• a family history of criminal behaviour
• a history of attention-deficit/hyperactivity disorder (ADHD) in the child
• a delinquent peer group
• academic underachievement
• attendance at a ‘failing’ school.
Specific risk factors for anxiety and depressive disorders include a family history of these conditions, and
earlier experience of child abuse. 127
A longitudinal study of over 4,000 families found that maternal anxiety and depression, poverty, parent
relationship conflict and marital break-up during early childhood are associated with a small, but
significantly increased risk, of anxiety-depression symptoms in adolescence. 136
Childhood and adolescent abuse can have a significant impact on mental health. Adolescents who
experienced physical and sexual abuse as children are significantly more likely to experience moderate to
severe depressive symptoms and moderate to high levels of life stress as well as regular smoking, alcohol
consumption and illicit drug use. 137
Evidence suggests that adolescent and persistent maltreatment have
stronger and more consistent negative consequences during adolescence than does maltreatment
experienced only in childhood. 138
A recent study of the psychological effects of stress in childhood and adolescence found a significant
association between stress and psychological symptoms. In adolescence high levels of stress, whether
assessed in terms of negative life events or negative circumstances, were found to be associated with
emotional disorders like depression and anxiety. The study suggested that, since there is an association
between the total number of stressors and the probability of having mental health problems, societal-level
factors place certain populations of children at risk. 139
Some groups of adolescents are known to be at high risk of mental disorders. These include
adolescents who:
• have physical or learning disabilities
• are in care or are care leavers
• are excluded from school
• are in the criminal justice system
• are homeless
• are young carers, especially of a parent with mental illness. 94
British Medical Association Adolescent health