Network analysis of dimensions of childhood adversity and adolescent health risk behaviors

Childhood adversity is associated with increased engagement in health risk behaviors (HRBs), such as substance use, violence, and risky sexual behaviors during adolescence, which contribute to leading causes of death and disability throughout the lifespan. Threat and deprivation are two dimensions of adversity that impact health and wellbeing through partially distinct developmental pathways, but no studies have examined if and how HRBs differ by adversity dimension. This pre-registered network analysis examined the independent associations between threat, deprivation, and adolescent HRBs using data from the 2023 Youth Risk Behavior Survey. We hypothesized that both adversity dimensions would be associated with HRBs, with stronger associations for threat compared to deprivation. Participants were U.S. high school students (<i>N</i> = 7,691; 52% male, 48% female). Forty-six percent were white, 26% multiple races, 12% Black, 7% American Indian/Alaska Native, 4% Asian, < 1% Native Hawaiian/Other Pacific Islander, and 20% Hispanic. Consistent with our hypotheses, network structures revealed that both threat and deprivation were associated with HRBs, the patterns of such associations varied by dimension, and the overall strength and number of HRB associations was greater for threat. Findings support the utility of dimensional models in linking childhood adversity to adolescent HRBs, with implications for research and clinical practice.