title: Childhood aggression, withdrawal and likeability, and the use of health care later: a longitudinal study.
abstract: BACKGROUND
  Literature suggests that early patterns of aggressive behaviour in both girls and boys are predictive of a variety of health risks in adulthood. However, longitudinal examination of the predictive links between childhood aggression, negative physical health outcomes in adulthood and overall use of health care has not been done. We looked at use of health care and a variety of physical health outcomes in adulthood to extend the current body of knowledge regarding the long-term negative sequelae of childhood aggression.
  
  
  METHODS
  Participants of the Concordia Longitudinal Risk Project were eligible for the current study if they had received medical care in the province of Quebec between 1992 and 2006, and if we were able to retrieve their medical and education records. Our primary outcome was use of the health care system, as determined using records from the Régie de l'assurance maladie du Québec and the Ministère de la santé et des services sociaux. Our controlled variables were socioeconomic status of the neighbourhood in which participants lived in 1986 and level of education. We used hierarchical multiple regression to explore the association between childhood behaviour and physical health in adulthood.
  
  
  RESULTS
  During the 15-year period studied, childhood agression corresponded to an increase in medical visits (8.1% per 1 standard deviation increase in agression), and injuries (10.7%) or lifestyle-related illnesses (44.2%), visits to specialists (6.2%) and visits to emergency departments (12.4%). We saw a positive relation between social withdrawal during childhood and government-funded visits to dentists. Peer-rated likeability during childhood showed negative relations with use of health care (overall), medical visits due to injuries and government-funded visits to dentists.
  
  
  CONCLUSIONS
  Childhood aggression is a health risk that should be considered when designing interventions to improve public health and diminish the costs of medical services, particularly when considering interventions targeting children and families.
authors.affiliation: Département de psychoéducation, Université de Sherbrooke, Sherbrooke, Que. caroline.temcheff@usherbrooke.ca
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Temcheff
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Serbin
authors.forename: Alexa
authors.initials: A
authors.lastname: Martin-Storey
authors.forename: Dale M
authors.initials: DM
authors.lastname: Stack
authors.forename: Paul
authors.initials: P
authors.lastname: Hastings
authors.forename: Jane
authors.initials: J
authors.lastname: Ledingham
authors.forename: Alex E
authors.initials: AE
authors.lastname: Schwartzman
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008960:Models, Psychological; D010551:Personality; D011320:Primary Health Care / Q000379:methods*; D011792:Quebec; D012189:Retrospective Studies; D012307:Risk Factors; D012919:Social Behavior; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult
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