Youths with chronic conditions and risky behaviors: an indirect path

Résumé 0

Objective. To compare risk behaviors between youths living with a chronic condition (CC) and their healthy peers, controlling for condition severity. Methods. Data were drawn from the baseline wave of the GenerationFRee study (students aged 15 to 24 years in post-mandatory education) during the 2014-2015 school year. The sample (N=5179) was divided into youths with CC without limitations (N=536; 10.4%), youths with limitations (N=114; 2.2%), and a control group (CG; N= 4’529; 87.4 %). Groups were compared on internalizing factors (perceived health status, vision of their future, emotional wellbeing) and externalizing behaviors (substance use, gambling, excessive internet use, disordered eating, violent and antisocial acts) controlling for potential confounders. Statistical analyses were carried out through a structural equational modeling (SEM). Results are given as unstandardized coefficients. Results. Overall, CC youths showed an association with internalizing factors (coefficient: 0.78) but not with externalizing behaviors. In fact, the connection with externalizing behaviors was indirect via the internalizing factors (0.32). CC Youths reporting psychological issues were more likely to adopt every externalizing behavior. Analyzing separately youths with CC limiting daily life activities and those without limitations, the results did not change substantially. However, the association with internalizing factors was much higher for those reporting limitations (2.18 vs. 0.42). Conclusions. Our results show that the link between suffering from a CC and adopting risk behaviors is indirect through internalizing factors. Health professionals should address emotional wellbeing and perception of the future rather than focus exclusively on the effects of risk behaviors on specific diseases.