The Association between Childhood Relocations & Subsequent Risk of Suicide Attempt, Psychiatric Problems & Low Academic Achievement
BACKGROUND:
Given
the frequency with which families change residences, the effects of childhood
relocations have gained increasing research attention. Many researchers have
demonstrated that childhood relocations are associated with a variety of
adverse outcomes. However, drawing strong causal claims remains problematic due
to uncontrolled confounding factors.
METHOD:
We
utilized longitudinal, population-based Swedish registers to generate a
nationally representative sample of offspring born 1983-1997 (n = 1 510 463). Using
Cox regression and logistic regression, we examined the risk for numerous
adverse outcomes after childhood relocation while controlling for measured
covariates. To account for unmeasured genetic and environmental confounds, we
also compared differentially exposed cousins and siblings.
RESULTS:
In the
cohort baseline model, each annual relocation was associated with risk for the
adverse outcomes, including suicide attempt [hazard ratio (HR) 1.19, 95%
confidence interval (CI) 1.19-1.20]. However, when accounting for offspring and
parental covariates (HR 1.08, 95% CI 1.07-1.09), as well as genetic and
environmental confounds shared by cousins (HR 1.07, 95% CI 1.05-1.09) and
siblings (HR 1.00, 95% CI 0.97-1.04), the risk for suicide attempt attenuated.
We found a commensurate pattern of results for severe mental illness, substance
abuse, criminal convictions, and low academic achievement.
CONCLUSIONS:
Previous
research may have overemphasized the independent association between
relocations and later adverse outcomes. The results suggest that the
association between childhood relocations and suicide attempt, psychiatric
problems, and low academic achievement is partially explained by genetic and
environmental confounds correlated with relocations. This study demonstrates
the importance of using family-based, quasi-experimental designs to test
plausible alternate hypotheses when examining causality.
- 1Indiana University,Bloomington,IN,USA.
- 2University of Chicago,Chicago,IL,USA.
- 3University of Oxford,Oxford,UK.
- 4Karolinska Institutet,Stockholm,Sweden.
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