Adolescent perception of premature risk for death: contributions from individual and environmental contextual factors.

Objective: Adolescent perception of premature risk for death is a cause of great concern. This study identified individual and environmental characteristics of youth expressing perception of premature risk for death.

Methods: Data are from Waves 1 (1995) and 3 (2001-2002) of the in-home interviews from the National Longitudinal Study of Adolescent Health. The study sample included 12,103 adolescents and 10,519 parents (Wave 1) and 9130 young adults (Wave 3). Logistic regression models were used to determine contexts for health risk, connection, safety and monitoring, individual/developmental, and caregiver/family characteristics associated with adolescent early death perception.

Results: One in 7 youth endorsed perceived risk for early demise. After controlling for demographic factors, adolescent early death perception is a powerful marker for high-risk status, including involvement in self-destructive behaviors (odds ratio [OR] 1.32-13.97, P = .01-P <.001) and physical and psychological distress (OR 8.33-39.37, P < .001). Alternately, models for stronger connection in the primary socializing domains, perceptions of safety, academic achievement, outlets for participation, and better caregiver capacity offered significant protective effect (OR 0.10-0.91, P < .001). In a final multivariate model, unique relationships between adolescent early death perception and health risk behavior and exposure, adult and peer connection, mental health, and parent/family economic security emerged.

Conclusions: Study findings support further research into constructs for premature death perception as a potential mechanism to facilitate intervention with youth who may be at risk for further negative life trajectories, including depressive reactions and extreme reactions to future adverse life events.