Evidence map›Paper›PMID 39775882›Full record

Trial reportCriminal behaviour and mental health : CBMH2025

Cumulative Risk and Cumulative Protection: Relative Contributions to Predicting Substance Use, Antisocial Behaviour and Mental Health Across Development.

Max A Halvorson, Justin D Caouette, John S Briney, Margaret R Kuklinski, Sabrina Oesterle, J David Hawkins

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Criminal behaviour and mental health : CBMH, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Max A HalvorsonSocial Development Research Group, School of Social Work, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-3113-2458
Justin D CaouetteSocial Development Research Group, School of Social Work, University of Washington, Seattle, Washington, USA.
John S BrineySocial Development Research Group, School of Social Work, University of Washington, Seattle, Washington, USA.
Margaret R KuklinskiSocial Development Research Group, School of Social Work, University of Washington, Seattle, Washington, USA.
Sabrina OesterleSouthwest Interdisciplinary Research Center, School of Social Work, Watts College of Public Service & Community Solutions, Arizona State University, Tempe, Arizona, USA.
J David HawkinsSocial Development Research Group, School of Social Work, University of Washington, Seattle, Washington, USA.

Funding

The Community Youth Development Study: A Test of Communities That CareR01DA015183 · NIDA · UNIVERSITY OF WASHINGTON · PI HAWKINS, J DAVID, OESTERLE, SABRINA · 2003 to 2016
$34.0M
The interplay of social, normative, and legal marijuana environments and marijuana and ATOD use from late childhood to young adulthoodR01DA044522 · NIDA · UNIVERSITY OF WASHINGTON · PI KUKLINSKI, MARGARET, OESTERLE, SABRINA · 2018 to 2022
$4.3M
NIDA NIH HHS R01 DA015183NIDA NIH HHS R01DA015183NIDA NIH HHS R01 DA044522
6 · The paper itself

Abstract

backgroundCumulative risk scores predict negative outcomes including antisocial behaviour and mental health. Less work has examined the role of cumulative protection, despite the availability of preventive interventions focused on bolstering protection across domains. Understanding links between cumulative risk and protection measured in childhood and later outcomes can help to guide the timing of prevention programmes.

aimsThe study aimed to understand the relative contributions of early adolescent cumulative risk and cumulative protection in Grade 6 on distal outcomes six to seven years later, at ages 18-19.

methodsData are from the Community Youth Development Study, a community-randomised trial of the Communities That Care prevention system. The analysis sample consisted of 2002 participants from 12 control communities. Logistic regression models were estimated to quantify the main and interactive effects of Grade 6 cumulative risk and protection on alcohol, tobacco and cannabis use; antisocial behaviour, and depression at ages 18-19.

resultsWhen considered in separate models, cumulative risk and protection were each associated with later alcohol, tobacco and cannabis misuse; antisocial behaviour and depression. When considered together, coefficients for cumulative protection were attenuated, whereas coefficients for cumulative risk remained similar in magnitude. Cumulative risk was associated with larger outcome prevalence differences (average of 9%) than cumulative protection (average of 2%). Evidence for risk-protection interactions was not observed.

conclusionsAlthough early adolescent cumulative protection was associated with later outcomes, these associations were largely reduced when considering cumulative risk. Findings emphasise the importance of addressing cumulative risk when designing preventive interventions.

Indexed as

Adolescent BehaviorAntisocial Personality DisorderMental HealthSubstance-Related DisordersAdolescentDepressionFemaleHumansMaleRisk FactorsYoung Adult

Identifiers

PMID39775882
PMCPMC12060742

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.