Journal of Adolescent Health - Articles in Press

The Role of Social Networks in Influenza Vaccine Attitudes and Intentions Among College Students in the Southeastern United States - Corrected Proof

Brendan Nyhan, Jason Reifler, Sean Richey — 2012-05-15

Abstract: Purpose: To investigate whether support for vaccines among one's health discussants is associated with beliefs in vaccine safety and intention to vaccinate among college students. Methods: Ordered logistic regression analysis was conducted of data collected from 1,019 undergraduates at a large public university in 2009 and 2010. Results: Having health discussion networks that support vaccination is a significant predictor of beliefs of H1N1 vaccine safety (adjusted odds ratio [aOR] = 2.31) and intention (aOR = 1.86) in 2009 and of influenza vaccine safety (aOR = 1.86) and intention (aOR = 1.80) in 2010. These relationships are strongest among parents, friends, and spouses. Conclusions: Perceptions of flu vaccine attitudes among health discussants were strongly related to vaccination intent and beliefs about flu vaccine safety among survey respondents.

Effects of a Natural Community Intervention Intensifying Alcohol Law Enforcement Combined With a Restrictive Alcohol Policy on Adolescent Alcohol Use - Corrected Proof

Karen Schelleman-Offermans, Ronald A. Knibbe, Emmanuel Kuntsche, Sally Casswell — 2012-05-09

Abstract: Purpose: Determining whether intensified inspections on alcohol retailers, combined with a policy withdrawing liquor licenses if retailers are fined twice per annum, is effective in reducing adolescents' odds to initiate weekly drinking and drunkenness. Causal pathways by which the intervention was assumed to work were tested. Methods: A longitudinal (2008, 2009, and 2010) quasi-experimental comparison group design including two Dutch communities, one intervention and one comparison, was used. Outcomes were assessed by following a cohort of 1,327 adolescents (aged 13–15 years at baseline). Results: The intervention resulted in increased retail inspections but only seven sanctions and no repeated sanctions in 1 year. The intervention did not reduce adolescents' odds to initiate weekly drinking. Weekly drinking adolescents in the intervention community were at reduced risk to initiate drunkenness. This effect was not mediated by smaller increases in the frequency of adolescents' alcohol purchases or their perceived ease of purchasing alcohol. Conclusions: Intensified enforcement was effective in preventing adolescent drunkenness. No mediating causal pathways were detected. Effectiveness of enforcement could be increased by adopting enforcement methods with a high likelihood of apprehension, increasing social support for restrictive measures, and mobilizing the community to be more outspoken against adolescent (heavy) drinking.

Interventions Using New Digital Media to Improve Adolescent Sexual Health: A Systematic Review - Corrected Proof

2012-05-07

Abstract: New digital media (e.g., the Internet, text messaging, and social networking sites [SNS]) have dramatically altered the communication landscape, especially for youth. These communication platforms present new tools for engaging youth in sexual health promotion and risk reduction. We searched eight public databases across multiple disciplines for all peer-reviewed studies published between January 2000 and May 2011 that empirically evaluated the impact of digital media-based interventions on the sexual health knowledge, attitudes, and/or behaviors of adolescents aged 13–24 years. Of 942 abstracts, 10 met inclusion criteria. Seven studies were conducted in the United States. Eight described Web-based interventions, one used mobile phones, and one was conducted on an SNS. Two studies significantly delayed initiation of sex, and one was successful in encouraging users of an SNS to remove sex references from their public profile. Seven interventions significantly influenced psychosocial outcomes such as condom self-efficacy and abstinence attitudes, but at times the results were in directions unexpected by the study authors. Six studies increased knowledge of HIV, sexually transmitted infections, or pregnancy. This area of research is emerging and rapidly changing. More data from controlled studies with longer (>1 year) follow-up and measurement of behavioral outcomes will provide a more robust evidence base from which to judge the effectiveness of new digital media in changing adolescent sexual behavior.

Examining the Effect of Maternal Sexual Communication and Adolescents' Perceptions of Maternal Disapproval on Adolescent Risky Sexual Involvement - Corrected Proof

Atika Khurana, Elizabeth C. Cooksey — 2012-05-04

Abstract: Purpose: To examine the influence of maternal sexual communication during early adolescence on three adolescent sexual risk behaviors (assessed 5–6 years later) in relation to adolescents' perceptions of maternal disapproval of [their] sexual involvement and contraceptive use. Methods: Using data from waves 1 and 3 of the National Longitudinal Study of Adolescent Health (Add Health), we distinguish between youth who reported being virgins from those who reported having had sex by the time maternal sexual communication was assessed. Results: Frequency of maternal sexual communication has a significant influence on adolescents' lifetime number of sexual partners, but its effect is moderated by adolescents' perceptions of maternal disapproval of contraceptive use. This relationship holds regardless of whether the adolescent was a virgin or not at the time of the communication. When occurring in the context of adolescent-perceived maternal nondisapproval, greater frequency of maternal sexual communication is associated with a higher likelihood of having multiple sexual partners. Greater frequency of maternal sexual communication was also associated with inconsistent condom use and positive sexually transmitted infection diagnosis among adolescents who were sexually experienced at baseline and who perceived maternal disapproval of contraceptive use. Conclusions: These findings emphasize the need to evaluate the effect of maternal sexual communication on adolescent risky sexual behaviors in relation to the value context of these discussions as well as the sexual status of the adolescent.

Trait Mindfulness Helps Shield Decision-making From Translating Into Health-risk Behavior - Corrected Proof

David S. Black, Steve Sussman, C. Anderson Johnson, Joel Milam — 2012-05-04

Abstract: Purpose: The cognitive tendency toward mindfulness may influence the enactment of health and risk behaviors by its bringing increased attention to and awareness of decision-making processes underlying behavior. The present study examined the moderating effect of trait mindfulness on associations between intentions to smoke (ITS)/smoking refusal self-efficacy (SRSE) and smoking frequency. Methods: Self-reports from Chinese adolescents (N = 5,287; mean age = 16.2 years, standard deviation = .7; 48.8% female) were collected in 24 schools. Smoking frequency was regressed on latent factor interactions Mindful Attention Awareness Scale*ITS and Mindful Attention Awareness Scale*SRSE, adjusting for school clustering effects and covariates. Results: Both interaction terms were significant in cross-sectional analyses and showed that high ITS predicted higher smoking frequency among those low, relative to high, in trait mindfulness, whereas low SRSE predicted higher smoking frequency among those low, relative to high, in trait mindfulness. Conclusions: Findings suggest trait mindfulness possibly shields against decision-making processes that place adolescents at risk for smoking.

Daily Morning Running for 3 Weeks Improved Sleep and Psychological Functioning in Healthy Adolescents Compared With Controls - Corrected Proof

2012-05-02

Abstract: Purpose: To compare sleep electroencephalographic patterns and psychological functioning of healthy adolescents running regularly in the mornings with those of control subjects. Although several studies have shown that regular moderate-to-vigorous exercise is related to favorable sleep and psychological functioning in adolescents, research on the effectiveness of short interventions is more limited. Methods: Fifty-one adolescents (mean age = 18.30 years; 27 female [53%]) took part in the study; they were randomly assigned either to a running or to a control group. The running group went running every morning for 30 minutes at moderate intensity during weekdays for 3 consecutive weeks. Sleep electroencephalographic patterns and psychological functioning were assessed in both groups before and after the 3-week period. All participants also kept a sleep log for 3 weeks. Results: Objective sleep improved (slow-wave sleep increased; sleep onset latency decreased) in the running group compared with the control group. Subjective sleep quality, mood, and concentration during the day improved, whereas sleepiness during the day decreased. Conclusions: Thirty minutes of running in the morning during weekdays for 3 consecutive weeks impacted positively on sleep and psychological functioning in healthy adolescents compared with control subjects. Running is inexpensive and easy to implement during school schedules, and as both objective and subjective improvements were observed within 3 weeks, regular physical exercise should be promoted.

Trends of Sexual and Violent Content by Gender in Top-Grossing U.S. Films, 1950–2006 - Corrected Proof

Amy Bleakley, Patrick E. Jamieson, Daniel Romer — 2012-04-25

Abstract: Purpose: Because popular media such as movies can both reflect and contribute to changes in cultural norms and values, we examined gender differences and trends in the portrayal of sexual and violent content in top-grossing films from 1950 to 2006. Methods: The sample included 855 of the top-grossing films released over 57 years, from 1950 to 2006. The number of female and male main characters and their involvement in sexual and violent behavior were coded and analyzed over time. The relationships between sexual and violent behavior within films were also assessed. Results: The average number of male and female main characters in films has remained stable over time, with male characters outnumbering female characters by more than two to one. Female characters were twice as likely as male characters to be involved in sex, with differences in more explicit sex growing over time. Violence has steadily increased for both male and female characters. Conclusions: Although women continue to be underrepresented in films, their disproportionate portrayal in more explicit sexual content has grown over time. Their portrayal in violent roles has also grown, but at the same rate as men. Implications of exposure to these trends among young movie-going men and women are discussed.

The Effects of Lisdexamfetamine Dimesylate on Driving Behaviors in Young Adults With ADHD Assessed With the Manchester Driving Behavior Questionnaire - Corrected Proof

2012-04-20

Abstract: Purpose: Young adults with ADHD have been shown to be at increased risk for impairment in driving behaviors. Although stimulant medications have proven efficacy in reducing ADHD symptomatology, there is limited knowledge as to their effects on driving behavior. The focus of this report is on assessing the impact of lisdexamfetamine dimesylate (LDX) on driving behaviors in young adults with ADHD using a validated driving behavior questionnaire. Methods: This assessment was carried out in the context of a randomized, double-blind, 6-week, placebo-controlled, parallel-design study of LDX versus placebo. Subjects were 61 outpatients of both sexes, 18–26 years of age, who met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for ADHD. Subjects were randomized to receive LDX or placebo for 6 weeks. Driving behavior was assessed at baseline and at the end of treatment using a U.S. version of the Manchester Driving Behavior Questionnaire (DBQ). Results: Highly significant improvements were documented on LDX, over placebo, in driving behaviors assessed through the DBQ in measures of driving errors, driving lapses, and a trend toward fewer driving violations. There were no meaningful associations between these DBQ results and previously documented changes in a laboratory driving simulation paradigm or with improvement in symptoms of ADHD assessed through the ADHD rating scale. Conclusions: LDX treatment was associated with significant improvements in self-reported driving behaviors that were independent of improvement in symptoms of ADHD. These results suggest that LDX may reduce behaviors associated with driving risks in young adults with ADHD.

The Development of Associations Among Body Mass Index, Body Dissatisfaction, and Weight and Shape Concern in Adolescent Boys and Girls - Corrected Proof

2012-04-20

Abstract: Purpose: To examine how the associations among body mass index (BMI) and body dissatisfaction and weight and shape concern evolve from late childhood through late adolescence in boys and girls. Methods: We analyze data from subjects aged 9–18 years from the Growing Up Today Study, a national prospective cohort of U.S. youth (n = 16,882, yielding 59,750 repeated-measures observations during five waves of data collection). Generalized additive models produced curves of association for body dissatisfaction and weight concern across BMI percentiles. Generalized estimating equations (adjusting for correlated within-subject repeated measures, sibling clusters, pubertal maturation, and region of residence) tested main and interactive effects of BMI, age, and gender. Results: Girls above the 50th BMI percentile reported greater body dissatisfaction than girls below the 50th percentile. By contrast, boys who reported the most body dissatisfaction were either above the 75th BMI percentile (approaching overweight) or below the 10th percentile (approaching underweight). Body dissatisfaction increased with age for both girls and boys, but the gender-specific patterns of BMI effects remained constant. Male and female participants in the overweight/obese BMI range reported the greatest weight concern, but among older adolescents (particularly girls), healthy weight became increasingly associated with greater weight and shape concern. Conclusions: Body dissatisfaction and weight and shape concern intensify across adolescence, but associations between the constructs and BMI remain gender specific. Findings have important implications for eating disorder risk assessment and prevention.

Reply to “Substance Use, Sexual Intercourse, and Condom Nonuse Among Depressed Adolescents and Young Adults: Scientific Views” - Corrected Proof

2012-04-20

In their letter, Drs. Sulaiman, Said, and Das raise two important points salient to the discussion of substance use and sexual behavior in depressed youth. First, adolescents with substance use disorders are at higher risk of condom nonuse and other sexual risk behaviors than those without substance abuse or dependence . However, only two participants in our sample (5%) had a diagnosis of a substance use disorder according to their referring provider . Second, individuals with both bipolar disorder and borderline personality disorder have increased rates of engaging in impulsive sexual behavior. In our sample, only one participant was diagnosed with bipolar disorder and one with borderline personality disorder. These low prevalence rates may reflect the presence of subthreshold psychiatric symptomatology in a sample recruited largely from primary care clinics. The low rates of these disorders may also reflect sampling bias for participation in the intensive data collection required in this study.

Still Not on the Radar: Adolescent Risk and Gambling, Revisited - Corrected Proof

Rachel A. Volberg — 2012-04-19

Ten years ago, I wrote a chapter for the proceedings of a conference on adolescent risk that asked “why is it that gambling is not even on the radar when we consider the array of risks that adolescents must confront as they move towards adulthood?” . I noted some of the reasons to attend to the gambling done by adolescents, including indications that adults who learn to gamble early in life are more likely to develop gambling-related problems; evidence that adolescents often begin gambling before they begin experimenting with tobacco, alcohol, drugs, and sexual behavior; and the co-occurrence of problem gambling with other mental health problems that, if left unaddressed, could affect adolescents' success in overcoming other difficulties in their lives.

Assessment of Nutritional Status and Eating Disorders in Female Adolescents With Fibromyalgia - Corrected Proof

2012-04-18

Abstract: Purpose: To assess eating disorders, nutritional status, body composition, and food intake in adolescents presenting with fibromyalgia. Methods: In a cross-sectional study, we evaluated the nutritional status (z score of body mass index [ZBMI]), waist circumference, body fat percentage by bioelectrical impedance analysis, symptoms of disordered eating, and possible eating disorders (Kids' Eating Disorders Survey [KEDS]) of 23 female adolescents with fibromyalgia and 23 matched healthy control subjects. Results: Median age for both groups was 15 years. In the fibromyalgia group, the median time for diagnosis was 13.5 months. We did not observe a statistically significant difference between the control and fibromyalgia groups in relation to ZBMI, fat mass percentage, food intake, and symptoms of disordered eating (KEDS). In the fibromyalgia group, there was a significant correlation between fat mass percentage and the total KEDS score (r = .587, p = .003); the same correlation was observed for ZBMI (r = .0778, p < .001). Conclusions: This study verified an absence of nutritional and eating disorders in adolescents recently diagnosed with fibromyalgia that, in addition to the correlation between adiposity indexes and KEDS total score, emphasizes the importance of nutritional and body composition assessment, allowing an early and adequate nutritional intervention.

Substance Use, Sexual Intercourse, and Condom Nonuse Among Depressed Adolescents and Young Adults: Scientific Views - Corrected Proof

Ahmad Hatim Sulaiman, Mas Ayu Said, Srijit Das — 2012-04-18

We read with much interest the article by Shrier et al. . In the study, it was observed that substance use was associated with increased odds of sex on the same day, but not after adjusting for weekend. There was no main effect of substance use on condom nonuse. The authors concluded that contextual factors, not intoxication, influence associations of substance use with sexual behavior in depressed youth.

ADHD Knowledge, Perceptions, and Information Sources: Perspectives From a Community Sample of Adolescents and Their Parents - Corrected Proof

2012-04-18

Abstract: Purpose: The chronic illness model advocates for psychoeducation within a collaborative care model to enhance outcomes. To inform psychoeducational approaches for ADHD, this study describes parent and adolescent knowledge, perceptions, and information sources and explores how these vary by sociodemographic characteristics, ADHD risk, and past child mental health service use. Methods: Parents and adolescents were assessed 7.7 years after initial school district screening for ADHD risk. The study sample included 374 adolescents (56% high and 44% low ADHD risk) aged, on average, 15.4 (standard deviation = 1.8) years, and 36% were African American. Survey questions assessed ADHD knowledge, perceptions, and cues to action and elicited used and preferred information sources. Multiple logistic regression was used to determine potential independent predictors of ADHD knowledge. McNemar tests compared information source utilization against preference. Results: Despite relatively high self-rated ADHD familiarity, misperceptions among parents and adolescents were common, including a sugar etiology (25% and 27%, respectively) and medication overuse (85% and 67%, respectively). African American respondents expressed less ADHD awareness and greater belief in sugar etiology than Caucasians. Parents used a wide range of ADHD information sources, whereas adolescents relied on social network members and teachers/school. However, parents and adolescents expressed similar strong preferences for the Internet (49% and 51%, respectively) and doctor (40% and 27%, respectively) as ADHD information sources. Conclusions: Culturally appropriate psychoeducational strategies are needed that combine doctor-provided ADHD information with reputable Internet sources. Despite time limitations during patient visits, both parents and teens place high priority on receiving information from their doctor.

A Teacher-Delivered Intervention for Adolescents Exposed to Ongoing and Intense Traumatic War-Related Stress: A Quasi-Randomized Controlled Study - Corrected Proof

Rony Berger, Marc Gelkopf, Yotam Heineberg — 2012-04-16

Abstract: Purpose: For the past 8 years, the residents of Sderot—a town in southern Israel—have been exposed to ongoing and intense war-related threat due to daily rocket attacks and mortar shelling from the adjacent Gaza region. This study first evaluates the prevalence of posttraumatic symptomatology in a sample of seventh- and eighth-grade students, and then assesses the efficacy of a universal teacher-delivered skill-oriented and present-focused intervention in preventing and reducing adolescents' posttraumatic stress-related symptoms. Method: In a quasi-randomized controlled trial, 154 seventh- and eighth-grade students with significant levels of war-related exposure were assigned to participate in either a manualized active 16-session intervention (Extended Enhancing Resiliency Amongst Students Experiencing Stress, ERASE-Stress) or a waiting-list control group. They were assessed using self-report measures before and after the intervention on posttraumatic stress-related symptoms, somatic complaints, functional impairment, and anxiety. Results: At baseline, 43.5% were found to have a likely diagnosis of posttraumatic stress disorder. A month after the intervention ended, students in the active intervention showed statistically significant reduction on all outcome measures compared with those in the waiting-list control group. Conclusions: Extended ERASE-Stress—a universal teacher-delivered skill-oriented program not targeting traumatic memories and involving trained and supervised homeroom teachers—may help students suffering from significant war-related posttraumatic symptoms reduce their level of symptomatology and can serve as an important and effective component of a community mental health policy for communities affected by chronic trauma, such as war and terrorism.

Violent Peers, Network Centrality, and Intimate Partner Violence Perpetration by Young Men - Corrected Proof

Marizen Ramirez, Anthony Paik, Kenneth Sanchagrin, Karen Heimer — 2012-04-16

Abstract: Purpose: To measure the association between affiliation with violent peers in adolescence and intimate partner violence (IPV) perpetration by men in early adulthood, and how peer network structure influences the strength of this association. Methods: Using the National Longitudinal Study of Adolescent Health, we analyzed a cohort of male subjects, originally in grades 7–12, reporting on sexual relationships 7 years later. At baseline, peer network violence was estimated as the average of network members' reports of their frequency of fighting during the past year, and centrality (number of friendships) was measured. Logistic regression was used to estimate associations between peer network violence, network centrality, and perpetration of IPV in recent intimate relationships. Results: The probability of IPV perpetration was 37% for young men with a large number of friends (>13) engaging in an average of six to seven fights in the past year. However, young men in small- (<6 friends) or medium-sized peer networks (6–13 friends) with these same levels of violence had probabilities of IPV perpetration between 5% and 7%. Conclusions: School-based interventions that target fighting by male subjects can reduce risk of IPV perpetration later in life.

Smoking Initiation During Young Adulthood: A Longitudinal Study of a Population-Based Cohort - Corrected Proof

Debra H. Bernat, Elizabeth G. Klein, Jean L. Forster — 2012-04-13

Abstract: Purpose: To examine the extent to which young adults initiate smoking between the ages of 18 and 21 years; to characterize the frequency and quantity of use among initiators; and to examine predictors of initiation. Methods: Participants included youth who were part of the Minnesota Adolescent Community Cohort Study and had not smoked a whole cigarette before age of 18 (n = 2,034). Initiation in the present study was defined as having smoked a whole cigarette or more between the ages of 18 and 21. Predictors of initiation were measured at age 18 and included sociodemographic characteristics, social influences, and attitudes and beliefs about smoking. Results: Twenty-five percent (n = 510) of participants initiated smoking between the ages of 18 and 21 years. Among those who initiated, the majority (64%) reported smoking during the past 30 days, and approximately one-quarter (24%) reported smoking 100 cigarettes or more. Predictors of young adult initiation included being male, living in a metropolitan area, having friends who smoke, and the belief that smoking can calm someone down when they are angry or nervous. Conclusions: This study indicates that smoking initiation during young adulthood is not uncommon. These results highlight the need for tobacco prevention programs that target young adults.

A Cross-Sectional and Longitudinal Study of Travel by Walking Before and After School Among Eighth-Grade Girls - Corrected Proof

2012-04-13

Abstract: Purpose: To examine “travel by walking” (TBW) before and after school among eighth-grade girls. Methods: Participants attended 36 middle schools from Arizona, Maryland, Minnesota, Louisiana, California, and South Carolina participating in the Trial of Activity for Adolescent Girls. The cross-sectional sample consisted of 3,076 eighth-grade girls, and the longitudinal sample included 1,017 girls who participated in both sixth and eighth grades. Before- or after-school TBW status was determined from the 3-Day Physical Activity Recall. The main outcomes were body mass index and physical activity, which was measured by accelerometry, estimated for total physical activity (light, moderate, vigorous) and moderate-to-vigorous physical activity (MVPA). Results: Eighth-grade girls who reported TBW had 4 more minutes (95% confidence interval = 2.1–6.1) of MVPA before and after school than nonwalkers, and 2 more minutes of MVPA (95% confidence interval = 1.1–3.1) on an average weekday. In the longitudinal sample, girls who reported TBW before and after school in both sixth and eighth grades (consistent walkers) accumulated more minutes of MVPA for an average weekday than inconsistent walkers in both sixth (27 ± 2.2 vs. 25 ± 1.9 minutes; p = .03) and eighth (28 ± 2.6 vs. 25 ± 2.3 minutes; p = .003) grades. There were no differences in body mass index by walking status. Conclusions: Adolescent girls who reported TBW before and after school accumulated more minutes of MVPA than nonwalkers. Efforts to prevent the decline in walking to school in middle school girls could contribute to their overall physical activity.

Medical Student Performance on an Adolescent Medicine Examination - Corrected Proof

Paritosh Kaul, Gwyn Barley, Gretchen Guiton — 2012-04-11

Abstract: Purpose: To examine the performance of third-year medical students on an adolescent medicine clinical practice examination. Methods: The participants were third-year medical students (2010 [n = 145] and 2011 [n = 134]) at the University of Colorado School of Medicine. Student performance on adolescent contraceptive management was measured in three domains following Accreditation Council for Graduate Medical Education (ACGME) competencies in professionalism, communication, and history-taking skills. Results: With regard to professionalism and communication skills, students performed very well, scoring >95% correct in both years. Students demonstrated relatively poorer performance in history-taking competency in 2010 and 2011 (66% and 67% correct, respectively). Conclusion: In the adolescent Objective Structured Clinical Examination case, third-year medical students demonstrated extremely high performance in communication and professionalism skills. However, performance was lower for history-taking skill in contraceptive management.

Trajectories of Psychosocial Problems in Adolescents Predicted by Findings From Early Well-Child Assessments - Corrected Proof

2012-04-11

Abstract: Purpose: To describe trajectories of emotional and behavioral problems in adolescents and to identify early indicators of these trajectories using data from routine well-child assessments at ages 0–4 years. Methods: Data from three assessment waves of adolescents (n = 1,816) of the TRAILS were used (ages: 11–17 years). Information on early indicators (at ages 0–4 years) came from the records of the well-child services. Trajectories of emotional and behavioral problems were based on the parent-reported Child Behavior Checklist and the adolescent-reported Youth Self-Report, filled out at ages 11, 14, and 17 years. Multinomial logistic regression analysis was used to examine the predictive value of these early indicators on trajectories. Results: For boys and girls, we found four trajectories for each outcome: one with high problem levels, and three with middle-high, middle-low, and low levels. For emotional problems, the type of trajectory was predicted by parental educational level and parental divorce or single parents, for both genders. Moreover, sleep problems were predictive in boys and language problems in girls (odds ratios between 1.53 and 7.42). For behavioral problems, the type of trajectory was predicted by maternal smoking during pregnancy, parental educational level, and parental divorce or single parents, for both genders. Moreover, for boys, early behavioral problems and attention hyperactivity problems were predictive (odds ratios between 1.64 and 5.43). Conclusions: Trajectories of emotional and behavioral problems during adolescence are rather stable and can be predicted by a parsimonious set of data from early well-child assessments.

The Relative Odds of Involvement in Seven Crash Configurations by Driver Age and Sex - Corrected Proof

C.R. Bingham, J.P. Ehsani — 2012-04-11

Abstract: Introduction: Much is known about sex and age differences in collision types, but most studies have examined the effect of declining physical and mental capabilities on older drivers' performance. Fewer studies have focused on the relationship between younger driver's sex and crash type, and these studies have largely ignored the multidimensionality of crashes, have not consistently examined sex differences, and are based on outdated data. This study addressed these issues by examining differences in the likelihood of involvement in seven crash configurations between adolescent and adult male and female drivers. Method: Fatal crash data from the Fatality Analysis Reporting System and nonfatal crash data from the General Estimation System for years 2005–2009 were used. Crash configurations were identified using point of initial impact, manner of collision, and vehicle action (i.e., striking or struck). Logistic regression estimated relative odds ratios among four driver groups: male and female drivers aged 15–19 years, and male and female drivers aged 45–64 years. Results: Crash likelihood varied dramatically by driver age and sex across crash configuration. Adolescent male drivers were most likely to be in single-vehicle and fatal head-on crashes; adolescent drivers had a higher likelihood of front-to-rear crashes; adults had the highest likelihood of rear-end crashes; and female drivers had higher likelihoods of left- and right-side crashes. Conclusions: These findings may result from differences in driving experience, driving styles, or cognitive spatial abilities. Future research is needed to identify contributors to different crash configurations so that they can be directly addressed through tailored interventions and programs.

Shared Genetic Effects Between Age at Menarche and Disordered Eating - Corrected Proof

2012-04-11

Abstract: Purpose: An early age at menarche is associated with disordered eating in women. However, it is unclear whether they share genetic factors. The goal of the current study was to delineate the genetic correlation between age at menarche and disordered eating. Methods: Participants included 427 monozygotic and 329 dizygotic 16–17-year-old female twins from the Swedish Twin Study of Child and Adolescent Development. Disordered eating was assessed with the Eating Disorder Inventory-2. Age at menarche was assessed through self-report. A bivariate correlated factors model was used to delineate the genetic correlation between age at menarche and disordered eating. Results: The analysis revealed a negative genetic correlation of −.18 in the best-fit model, indicating that the genetic factors that influence younger age at menarche are associated with increased liability for disordered eating. Conclusions: Future research should examine possible causes for this correlation, such as the estrogen system and gene–environment interactions.

Cross-Lagged Effects Between Intimate Partner Violence Victimization and Suicidality From Adolescence Into Adulthood - Corrected Proof

2012-04-11

Abstract: Purpose: The current article extended previous research on the association between intimate partner violence (IPV) victimization and suicidality by longitudinally investigating their mutual impact from adolescence into early adulthood. Methods: We analyzed data from a subsample (N= 4,675) of individuals with complete data on IPV victimization from Waves II (mean age = 16.41 years), III (mean age = 22.36 years), and IV (mean age = 28.85 years) of the National Longitudinal Study of Adolescent Health. Suicidality was measured through questions assessing suicidal thoughts and suicidal attempts during the past 12 months. IPV victimization was measured through a construct assessing whether individuals had experienced threat of violence, being pushed/shoved, or had something thrown at them during the past 12 (Waves III and IV) or 18 (Wave II) months. Results: Using a path analysis framework, we found that IPV victimization and suicidality were highly stable across time. Suicidality was associated with IPV victimization prospectively, but IPV victimization did not predict suicidality prospectively. This longitudinal effect was limited to adolescent suicidality predicting IPV in early adulthood, and this effect was not qualified by gender. Conclusions: Although the findings from this study confirm the importance of considering concurrent IPV victimization in evaluating risk for suicidality, they also highlight the importance of considering a history of adolescent suicidality as an important risk marker for IPV victimization.

Motivational Subtypes of Nonmedical Use of Prescription Medications: Results From a National Study - Corrected Proof

Sean Esteban McCabe, James A. Cranford — 2012-04-06

Abstract: Purpose: Very little research has examined the heterogeneity associated with the nonmedical use of prescription medications (NUPM) in nationally representative samples of adolescents. The main objectives of this study were to (1) identify motivational subtypes of past-year NUPM among high school seniors in the United States using a person-centered approach, and (2) examine the associations among motivational subtypes and characteristics of substance abuse (i.e., route of administration, co-ingestion, and subjective high). Methods: Self-administered questionnaires as part of the Monitoring the Future study were completed by nationally representative samples of high school seniors (modal age, 18 years). The sample consisted of five cohorts (senior years of 2002–2006) made up of 12,431 high school seniors in total, of which 53% were women. Results: Approximately 75% of past-year nonmedical users of prescription opioids, stimulants, and tranquilizers endorsed more than one motive. Latent class analysis indicated five motivational subtypes associated with nonmedical use of prescription opioids (experiment, relax, get high, pain relief, and affect regulation), four subtypes of prescription stimulants (weight loss/enhance energy, enhance energy/awake/high, experiment, and affect regulation), and five subtypes of prescription tranquilizers (experiment, get high, relax/sleep, relax, affect regulation). Recreational subtypes were positively associated with characteristics of substance abuse, whereas self-treatment subtypes were associated with medical use before nonmedical use. Conclusions: Because multiple motives underlie NUPM, identifying subgroups of individuals who endorse combinations of motives, versus a single motive, will better inform intervention efforts to reduce nonmedical prescription medication use.

Moderators of Treatment Effectiveness for War-Affected Youth with Depression in Northern Uganda - Corrected Proof

2012-04-06

Abstract: Purpose: As we build the evidence base of interventions for depression among war-affected youth, it is critical to understand factors moderating treatment outcomes. The current study investigated how gender and history of abduction by Lord's Resistance Army rebels moderated treatment outcomes for war-affected youth. Methods: The study—a three-armed, randomized, controlled trial—was conducted with internally displaced war-affected adolescents in northern Uganda. Participants with significant depression symptoms (N = 304; 57% female; 14–17 years of age) were randomly assigned to an interpersonal psychotherapy group (IPT-G), a creative play/recreation group, or a wait-list control condition. Secondary analyses were conducted on data from this randomized controlled trial. Results: A history of abduction by Lord's Resistance Army rebels was reported by 42% of the sample. Gender and abduction history interacted to moderate the effectiveness of IPT-G for the treatment of depression. In the IPT-G intervention arm, treatment effectiveness was greatest among female subjects without an abduction history, with effect size = 1.06. IPT-G was effective for the treatment of depression for both male and female subjects with a history of abduction (effect size = .92 and .50, respectively). Male subjects with no abduction history in IPT-G showed no significant improvement compared with those in the control conditions. Conclusions: Abduction history and gender are potentially important moderators of treatment effects, suggesting that these factors need to be considered when providing interventions for war-affected youth. IPT-G may be an effective intervention for female subjects without an abduction history, as well as for both male and female former child soldiers, but less so for male subjects without an abduction history.

Nonmedical Use of Prescription Medications Among Adolescents in the United States: A Systematic Review - Corrected Proof

April M. Young, Natalie Glover, Jennifer R. Havens — 2012-04-05

Abstract: Purpose: The purpose of this review was to systematically summarize research on nonmedical use of prescription medications (NMUPM) among U.S. adolescents, with specific focus on scheduled medications falling into one of the following drug classes: pain relievers, stimulants, sedatives, or tranquilizers. Methods: Databases were searched for peer-reviewed primary quantitative research published between January 2000 and June 2011 on NMUPM among out-of-treatment U.S. adolescents aged 12–17 years (or age 18 if enrolled in high school). Results: Thirty publications met inclusion criteria. A total of 25 studies were represented; 15 involved nationally representative samples. The prevalence and correlates of NMUPM varied across studies and by drug class. Nonmedical use of pain relievers was more prevalent than for stimulants, sedatives, and tranquilizers. Female gender was generally associated with pain reliever use and, to a lesser degree, with tranquilizer use. White adolescents also appeared to have a higher prevalence of NMUPM, although there was some evidence to the contrary. Older age, illicit drug use, and delinquency were consistently associated with NMUPM across studies. Conclusions: This review identified several areas for further research, including that of racially/ethnically diverse samples of adolescents, more focus on sedative and tranquilizer use, and longitudinal research to examine temporal patterns in NMUPM and other illicit drug use, delinquency, and substance abuse and dependence.

Helpful or Harmful? An Examination of Viewers' Responses to Nonsuicidal Self-Injury Videos on YouTube - Corrected Proof

Stephen P. Lewis, Nancy L. Heath, Michael J. Sornberger, Alexis E. Arbuthnott — 2012-04-05

Abstract: Purpose: To examine viewers' comment responses to nonsuicidal self-injury (NSSI) YouTube videos to determine the potential risks (e.g., NSSI continuation) and benefits (e.g., recovery-oriented social support) of the videos. Methods: Viewers' comments from the 100 most-viewed NSSI videos on YouTube were examined using two coding rubrics, one for the global nature of comments and one for recovery-oriented themes. Both rubrics were developed using an inductive (bottom-up) approach and had high coding inter-rater reliability (exceeding .80 in all cases). For the global nature of comments, 869 randomly selected comments were evaluated using the rubric, which included 8 coding categories and 22 subcategories. For the examination of recovery-oriented themes, self-disclosure comments (n = 377) were evaluated for nature of recovery statements. Results: Results revealed that the most frequent comments were self-disclosure comments in which individuals shared their own NSSI experiences (38.39%), followed by feedback for the video uploader, including admiration of the video quality (21.95%) or message (17.01%), and admiration for the uploader (15.40%) or encouragement to the video uploader (11.15%). Evaluation of the common self-disclosure comments for recovery-oriented content revealed that the majority did not mention recovery at all (42.89%) and indicated that they were still self-injuring (34.00%). Positive recovery statements were uncommon. Conclusions: Results suggest that viewers' responses to videos may maintain the behavior (by sharing their own self-injury experiences) and rarely encourage or mention recovery. It is evident that sharing their own experience online is a strong motivator for viewers of NSSI YouTube videos.

YFHS-WHO+ Questionnaire: Validation of a Measure of Youth-Friendly Primary Care Services - Corrected Proof

2012-04-05

Abstract: Purpose: To develop and validate a research tool to measure the youth friendliness of primary care services from a client's perspective. Methods: The questionnaire was initially developed in English, but as it was to be used in Bosnia and Herzegovina (BiH), it was validated in the language of this country. Items were adapted from two sources: a reproductive health services quality improvement questionnaire from the World Health Organization, and an Australian survey used to assess youth-friendly primary care services. An English-speaking international panel reviewed the list of items for face validity. After translation–back translation, the questionnaire was pretested with adolescent patients from a family practice in BiH. The stability and construct validation were then conducted with 60 young people from six different health services in BiH. Items for the final questionnaire were selected using item response theory. Results: The validation and item response analysis led to a 49-item tool. Test–retest stability at 1 week was excellent (mean κ: .93). Construct validation was supported by the fact that services with the highest and the lowest scores on the questionnaire were also those that had many and few, respectively, youth-friendly characteristics, as assessed by experts, on a predefined evaluation grid. Services seeing a higher proportion of adolescents also had higher scores on the questionnaire. Conclusions: This study supports the validity of the YFHS-WHO+ questionnaire for assessing the level of youth friendliness of family medicine services for research purposes. Further validations in English and French will allow wider use of this tool in the future.

Self-Weighing Behaviors in Young Adults: Tipping the Scale Toward Unhealthy Eating Behaviors? - Corrected Proof

2012-04-05

Abstract: Purpose: This study examined associations between frequency of self-weighing and healthy weight-control behaviors (WCBs), unhealthy WCBs, muscle-enhancing behaviors (e.g., steroid use, protein powders), and psychological well-being (i.e., self-esteem, depression, body satisfaction) in a community sample of young adults. Methods: Data were drawn from Project EAT-III (Eating and Activity in Teens and Young Adults), the third wave of a population-based study. Participants included young adults (n = 2,287, mean age = 25.3 years) from the Minneapolis/St. Paul metropolitan area. Results: Self-weighing a few times per week or more frequently was reported by 18% of young adult women and 12% of young adult men. Linear regression models, adjusted for body mass index and demographic characteristics, indicated that in both women and men, more frequent self-weighing was associated with a higher prevalence of dieting, both healthy and unhealthy WCBs, and muscle-enhancing behaviors. Additionally, young women who reported more frequent self-weighing were more likely to report binge eating. More frequent self-weighing was also associated with more depressive symptoms and lower self-esteem in women and lower body satisfaction in young men. Conclusions: More frequent self-weighing is associated with healthy and unhealthy weight-control practices, muscle-enhancing behaviors, and poorer psychological well-being in young adults. Young adults engaging in self-weighing behaviors should be screened for these health indicators and counseled as appropriate. Before recommending self-weighing as a weight-monitoring tool, health care providers should ensure that young adults are not at risk for an unhealthy preoccupation with body weight or shape.

Identifying Adolescent Females at High Risk of Pregnancy in a Pediatric Emergency Department - Corrected Proof

Lauren Chernick, Elyse Olshen Kharbanda, John Santelli, Peter Dayan — 2012-04-04

Abstract: Purpose: Emergency departments (EDs) care for adolescent females with unmet reproductive health care needs. Our objective was, among adolescents presenting to a pediatric ED, to estimate pregnancy risk, describe pregnancy intentions, and identify potentially modifiable factors associated with pregnancy risk. Methods: Using a paper-based questionnaire, we surveyed females aged 15–19 years presenting to our ED, assessing health care access, sexual behaviors, pregnancy intentions, and receptivity to interventions. We calculated the pregnancy risk index (PRI), which estimates pregnancy risk in the subsequent 12 months, by assessing recent sexual activity, contraception at last intercourse, and known contraceptive failure rates. Independent sample t tests and analysis of variance were used to identify risk factors associated with increased PRI. Results: Of 459 females enrolled, 13% were pregnant and 20% reported prior pregnancy. Among 399 nonpregnant females, 238 (60%) had intercourse in the prior 3 months and 73 (31%) used no contraception at last intercourse. Among nonpregnant adolescents, the PRI was 19.5, which equates to 19.5 expected pregnancies per 100 females per year. Factors associated with higher PRI included lacking a primary provider, prior ED visits, wanting a baby now, and reported partner wantedness of pregnancy. Half believed ED doctors should discuss pregnancy prevention, and one-quarter were interested in starting contraception in the ED. Conclusions: Nearly one-third of adolescent females in a pediatric ED were either pregnant or could be expected to become pregnant within a year. Screening questions can identify adolescents at high risk of pregnancy in the ED setting. These females should be the target for future pregnancy prevention interventions.

Short- and Midterm Effects of Emotional Intelligence Training on Adolescent Mental Health - Corrected Proof

2012-04-04

Abstract: Purpose: To analyze the effects that an emotional intelligence (EI) educational program based on the EI ability model had on adolescent mental health immediately and 6 months after completion of the training. Methods: A pretest–posttest quasi-experimental design with a treatment and a control group was used; 479 Spanish adolescents (47.4% male, mean age of 13 years) were involved in the study. Adolescents were recruited through several schools in three Spanish cities. The 2-year training program involved 24 sessions lasting 1 hour each, conducted weekly during 6 months of 2009 and 2010. Data on psychological adjustment, mental health, and negative affect were collected at baseline, at the end of the training program, and 6 months later. Data were analyzed by multivariate analysis of covariance. Results: Students who participated in the EI educational program reported fewer clinical symptoms compared with students in the control group, and these differences persisted 6 months after the conclusion of the program. Conclusions: These results suggest that EI programs created to develop skills in perceiving, facilitating, understanding, and managing emotions can be effective at promoting mental health in adolescents.

Experience of Low Mood and Suicidal Behaviors Among Adolescents in Vietnam: Findings from Two National Population-Based Surveys - Corrected Proof

Minh Thi Hong Le, Huong Thanh Nguyen, Thach Duc Tran, Jane R.W. Fisher — 2012-04-01

Abstract: Purpose: To date, no population-based data about experiences of low mood and suicidal behaviors among adolescents in Vietnam have been published in the English peer-reviewed literature. The aim was to establish the prevalence of self-reported symptoms of low mood, acts of self-harm, and suicidal thoughts and their correlates among adolescents from two national population-based surveys, Survey Assessment of Vietnamese Youth (SAVY) I (2003–2004) and II (2009–2010). Methods: Data from the subset of participants aged 14–19 years from the two structured SAVYs were analyzed. Descriptive and bivariate statistics were used to test for between-group comparisons. Multiple logistic regressions were performed to determine factors associated with low mood and suicidal ideation. A weighting factor was used in all analyses. Results: Prevalence of experiences of low mood was 34.06% in SAVY I and 37.34% in SAVY II; prevalence of suicidal behaviors was 5.28% (SAVY I) and 12.21% (SAVY II). Significant risk factors were being female, an ethnic minority, illiterate, or exposed to violence; perceiving study load as too heavy; following a religion other than Buddhism; or living in wealthier families. Better family cohesion protected adolescents from these unfavorable outcomes. Alcohol use co-occurred significantly with experiences of low mood and suicidal behaviors. Conclusions: Self-reported lifetime experiences of low mood are common among Vietnamese adolescents, with signs of an increasing trend. Suicidal behaviors are less prevalent than in other settings but are also increasing. Further research is warranted to elucidate these findings and to inform interventions to optimize the mental health of adolescents in Vietnam.

Youth Employment, Income, and Smoking Initiation: Results From Korean Panel Data - Corrected Proof

Young Kyung Do, Eric Andrew Finkelstein — 2012-03-28

Abstract: Purpose: To estimate the effect of youth employment and income on smoking initiation, this study tests whether youth with higher incomes from either employment or allowance are more likely to smoke, and, if so, whether it is the employment effect or the income effect that affects youth smoking initiation. Methods: Data from the 2003–2007 Korea Youth Panel Study were used to estimate the effect of youth employment and income on smoking initiation. A fixed-effects linear probability model was estimated to control for unobserved individual heterogeneity, which may affect both youth employment/income and smoking initiation. Results: Even after controlling for unobserved individual heterogeneity, youth employment raised the probability of smoking initiation by 4.4% points, but neither employment income nor allowance was significantly associated with youth smoking initiation. Conclusions: Youth employment is an important risk factor for smoking initiation in South Korea, suggesting that workplaces that hire youth may be an appropriate target for antismoking interventions.

Older Adolescents' Views Regarding Participation in Facebook Research - Corrected Proof

Megan A. Moreno, Alison Grant, Lauren Kacvinsky, Peter Moreno, Michael Fleming — 2012-03-28

Abstract: Purpose: Facebook continues to grow in popularity among adolescents as well as adolescent researchers. Guidance on conducting research using Facebook with appropriate attention to privacy and ethics is scarce. To inform such research efforts, the purpose of this study was to determine older adolescents' responses after learning that they were participants in a research study that involved identification of participants using Facebook. Methods: Public Facebook profiles of older adolescents aged 18–19 years from a large state university were examined. Profile owners were then interviewed. During the interview, participants were informed that they were identified by examining publicly available Facebook profiles. Participants were asked to discuss their views on this research method. Results: A total of 132 participants completed the interview (70% response rate); the average age was 18.4 years (SD = .5); and our sample included 64 male participants (48.5%). Participant responses included endorsement (19.7%), fine (36.4%), neutral (28.8%), uneasy (9.1%), and concerned (6.1%). Among participants who were uneasy or concerned, the majority voiced confusion regarding their current profile security settings (p = .00). Conclusions: The majority of adolescent participants viewed the use of Facebook for research positively. These findings are consistent with the approach taken by many U.S. courts. Researchers may consider these findings when developing research protocols involving Facebook.

“Coaching Boys into Men”: A Cluster-Randomized Controlled Trial of a Dating Violence Prevention Program - Corrected Proof

2012-03-26

Abstract: Purpose: Dating violence (DV)—physical, sexual, and psychological aggression in adolescent romantic relationships—is prevalent among youth. Despite broad calls for primary prevention, few programs with demonstrated effectiveness exist. This cluster-randomized trial examined the effectiveness of a DV perpetration prevention program targeting coaches and high school male athletes. Methods: The unit of randomization was the high school (16 schools), and the unit of analysis was the athlete (N = 2,006 students). Primary outcomes were intentions to intervene, recognition of abusive behaviors, and gender-equitable attitudes. Secondary outcomes explored bystander behaviors and abuse perpetration. Regression models for clustered, longitudinal data assessed between-arm differences in over-time changes in mean levels of continuous outcomes in 1,798 athletes followed up at 3 months. Results: Intervention athletes' changes in intentions to intervene were positive compared with control subjects, resulting in an estimated intervention effect of .12 (95% CI: .003, .24). Intervention athletes also reported higher levels of positive bystander intervention behavior than control subjects (.25, 95% CI: .13, .38). Changes in gender-equitable attitudes, recognition of abusive behaviors, and DV perpetration were not significant. Secondary analyses estimated intervention impacts according to intensity of program implementation. Compared with control subjects, athletes exposed to full-intensity implementation of the intervention demonstrated improvements in intentions to intervene (.16, 95% CI: .04, .27), recognition of abusive behaviors (.13, 95% CI: .003, .25), and positive bystander intervention (.28, 95% CI: .14, .41). Conclusion: This cluster-randomized controlled trial supports the effectiveness of a school athletics-based prevention program as one promising strategy to reduce DV perpetration.

Caregiver and Adolescent Mental Health in Ethiopian Kunama Refugees Participating in an Emergency Education Program - Corrected Proof

Theresa S. Betancourt, Monica Yudron, Wendy Wheaton, Mary C. Smith-Fawzi — 2012-03-23

Abstract: Purpose: To examine the role of caregiver mental health and risk and protective factors in influencing levels of internalizing and externalizing emotional and behavioral symptoms over time among a sample of refugee adolescents. Methods: Prospective study of 153 Kunama refugee adolescents receiving an emergency education intervention while living in a camp in Ethiopia. Surveys were collected in 2001 (T1) and 2002 (T2). Adolescent and caregiver mental health were assessed using a Kunamenga adaptation of the Youth Self Report; caregiver mental health was assessed using the Hopkins Symptom Checklist-25. Attitudes toward education, satisfaction with education programming, socioeconomic status, and perceptions of access to services were also explored as variables potentially influencing adolescent mental health at follow-up. Results: Caregiver distress was significantly associated with youth externalizing behavior symptoms (β = 8.34, p < .001) and internalizing symptoms (β = 4.02, p < .05). Caregiver perceived access to services had a protective effect on externalizing behaviors (β = −7.54, p < .05) and internalizing behaviors (β = −13.67, p < .001). Higher socioeconomic status (β = −1.47, p < .05) had a protective effect on internalizing symptoms. In terms of modifying effects, among youth with distressed caregivers, those who were satisfied with the International Rescue Committee education intervention had a lower internalizing score (β = −6.34, p < .001) compared with those who were not satisfied with the program. Conclusions: This study presents a rare prospective investigation of caregiver–adolescent mental health during an active refugee displacement. Results suggest that programs targeting mental health in refugee children should consider children within the larger family system, including caregiver influence on child and adolescent mental health adjustment over time.

The Longitudinal Impact of Exposure to Violence on Cortisol Reactivity in Adolescents - Corrected Proof

2012-03-23

Abstract: Purpose: The purpose of this report is to examine the effect of exposure to violence (ETV) on cortisol reactivity (CR) in children with no identified serious mental health problems or reports of maltreatment. ETV was hypothesized to influence development of the stress system in this sample of youth as has been demonstrated in maltreated youth. Methods: The sample consisted of 124 adolescents aged 8–13 years. Data were collected at two waves of measurement 12 months apart. ETV was operationalized as the number of different violent events each child was exposed to as a witness or victim. CR was evaluated in relation to the Trier Social Stress Test for Children. Results: ETV occurring during the 12 months before the first assessment was predictive of CR 12 months later in boys, even after controlling for age and Time 1 symptoms of psychopathology, CR, and lifetime ETV. Lifetime ETV at Time 1 was positively correlated with symptoms of major depressive disorder and generalized anxiety disorder in both sexes. Conclusions: The unique aspect of the current findings is that typically research studying the effects of ETV is conducted with a clinical or maltreated sample. The findings show that recent ETV has an effect on reactions to a laboratory stressor and has longer-term negative mental health consequences. Further study is needed to determine whether these effects are enduring or a shorter-term adaptive response to ETV.

Health Care Transition for Youth With Special Health Care Needs - Corrected Proof

2012-03-23

Abstract: Purpose: Youth with special health care needs (YSHCN) increasingly live into adulthood, and approximately 500,000 U.S. youth transition from pediatric to adult health care systems annually. Through a systematic literature review, we sought to (1) determine adult outcomes for YSHCN who have no special transition interventions and (2) identify evidence for strategies that lead to better outcomes, in particular, access to adult health care. Methods: We searched the medical, nursing, psychology, and social science literature and reviewed selected articles' reference lists. Transition experts also recommended relevant articles. Search criteria included health conditions, transition-related activities, and health care and related outcomes. We selected English-language articles published from 1986 to 2010, with an abstract, description of transition-related interventions (objective 2), and posttransition outcomes. Investigators abstracted study design, population, sample size, description of intervention, data collection methods, and findings. Results: The search yielded 3,370 articles, of which 15 met study criteria. Although many YSHCN appear to make the transition to adult health providers successfully, some experience serious gaps in outcomes; those with more complex conditions or with conditions affecting the nervous system appear to have less good transitions. Some evidence supports introducing YSHCN to adult providers before leaving the pediatric system; one study supports using care coordinators to improve outcomes. Conclusions: Evidence regarding programs to facilitate transition for YSHCN is inconclusive. Weak evidence suggests that meeting adult providers before transfer may facilitate posttransition access to care. We recommend additional studies with strong research designs to guide best practice in preparing YSHCN for adulthood.

Attention-Deficit/Hyperactivity Disorder Subtype Differentially Predicts Smoking Expectancies in Adolescents - Corrected Proof

Ida Foster, Simon Racicot, Jennifer J. McGrath — 2012-03-23

Abstract: Purpose: Attention deficit hyperactivity disorder (ADHD) is an established risk factor for smoking; however, no studies have considered whether precursors to smoking behavior differ among adolescents with ADHD. Smoking expectancies are beliefs about the potential consequences of smoking, and they develop before smoking initiation. ADHD characteristics may contribute to the formation of expectancies and eventual smoking behavior. We evaluated whether clinical levels of ADHD subtypes differentially predicted smoking expectancies. Methods: Adolescents (n = 221; age mean = 12.67 years) completed the Smoking Expectancy Scale for Adolescents, answered standardized questions about their smoking behavior, and provided expired breath samples to verify never-smoking status. Parents completed the Conners' Parent Rating Scale for ADHD symptoms of inattention and hyperactivity/impulsivity. Results: Adolescents with clinical levels of inattention were significantly less likely to endorse negative consequences, including Expected Costs (odds ratio [OR] = .16), Appearance–Presentation Costs (OR = .29), Social Costs (OR = .19), Health Costs (OR = .21), and Addiction Costs (OR = .39). Inattentive female adolescents were significantly more likely to endorse Weight Control as a consequence. Adolescents with clinical levels of hyperactivity/impulsivity were more likely to endorse positive consequences, including Expected Benefits (OR = 5.31), Affect Control (OR = 2.60), and Boredom Reduction (OR = 3.14); they were less likely to endorse Social Costs (OR = .27). Conclusions: ADHD subtype differentially predicted smoking expectancies. Adolescents with ADHD may be more vulnerable to developing pro-smoking expectancies due to subtype-related deficits in neurocognitive processing. These findings have potential implications for developing targeted smoking prevention programs.

Defining and Measuring Cyberbullying Within the Larger Context of Bullying Victimization - Corrected Proof

Michele L. Ybarra, danah boyd, Josephine D. Korchmaros, Jay (Koby) Oppenheim — 2012-03-22

Abstract: Purpose: To inform the scientific debate about bullying, including cyberbullying, measurement. Methods: Two split-form surveys were conducted online among 6–17-year-olds (n = 1,200 each) to inform recommendations for cyberbullying measurement. Results: Measures that use the word “bully” result in prevalence rates similar to each other, irrespective of whether a definition is included, whereas measures not using the word “bully” are similar to each other, irrespective of whether a definition is included. A behavioral list of bullying experiences without either a definition or the word “bully” results in higher prevalence rates and likely measures experiences that are beyond the definition of “bullying.” Follow-up questions querying differential power, repetition, and bullying over time were used to examine misclassification. The measure using a definition but not the word “bully” appeared to have the highest rate of false positives and, therefore, the highest rate of misclassification. Across two studies, an average of 25% reported being bullied at least monthly in person compared with an average of 10% bullied online, 7% via telephone (cell or landline), and 8% via text messaging. Conclusions: Measures of bullying among English-speaking individuals in the United States should include the word “bully” when possible. The definition may be a useful tool for researchers, but results suggest that it does not necessarily yield a more rigorous measure of bullying victimization. Directly measuring aspects of bullying (i.e., differential power, repetition, over time) reduces misclassification. To prevent double counting across domains, we suggest the following distinctions: mode (e.g., online, in-person), type (e.g., verbal, relational), and environment (e.g., school, home). We conceptualize cyberbullying as bullying communicated through the online mode.

Accuracy and Trust of Self-Testing for Bacterial Vaginosis - Corrected Proof

2012-03-22

Abstract: Purpose: Two point-of-care tests are available to detect bacterial vaginosis (BV), a common vaginal condition. This study aimed to (1) compare the accuracy of two self-performed BV tests with clinician-performed BV tests and with clinical diagnosis of BV; and (2) compare trust of results for self-performed BV testing with clinician-performed BV testing. Methods: Participants (14–22 years old) in a study assessing self-testing for Trichomonas vaginalis were also asked to perform a self-test for BV (using a pH or sialidase test). Results were compared with clinician-performed tests and with clinical diagnosis of BV (defined by modified Amsel criteria). A two-item subscale from a larger acceptability scale was used to assess trust at baseline, after testing, and after discussion of results. Results: All 131 women performed self-BV testing correctly. Agreement between self- and clinician-performed tests was good (κ: .5–.7) Compared with clinical diagnosis of BV, self-pH was 73% sensitive and 67% specific, and self-sialidase was 40% sensitive and 90% specific. Trust in self-performed BV testing was lower than trust in clinician-performed BV testing at baseline, but increased after testing and discussion of results. Conclusions: Young women can perform self-tests for BV with reasonable accuracy, which could increase testing when pelvic examinations are not feasible. Trust in self-testing increased after experience and after discussion of test results. Although the pH test is available over the counter, young women may continue to rely on clinicians for testing.

Reaching Youth With Out-of-Facility HIV and Reproductive Health Services: A Systematic Review - Corrected Proof

Donna M. Denno, V. Chandra-Mouli, Majdi Osman — 2012-03-20

Abstract: Purpose: Many young people, particularly those who are marginalized and most at risk for HIV and reproductive health-related problems, cannot or will not seek traditional facility-based health services. Policies and programs are being implemented to provide them with these health services in the community. We sought to review the effectiveness of such approaches in increasing HIV and reproductive health service use. Methods: A systematic literature review was undertaken to identify policies promoting or programs delivering HIV or reproductive health services in the community. We reviewed studies that evaluated uptake of services or commodities. Data from studies meeting inclusion criteria were qualitatively analyzed. Results: Twenty studies met inclusion criteria, including 10 containing comparative data (e.g., before and after study or control study design). The studies generally demonstrated positive impact, although results varied across settings and approaches. The most successful approaches included mail-based chlamydia screening in the Netherlands, condom distribution via street outreach in Louisiana, home-based HIV counseling and testing in Malawi, and promotion of over-the-counter access to emergency contraception in various countries. Conclusion: Overall, this review suggests that out-of-facility approaches can be important avenues to reach youth. Continued evaluation is necessary to better understand specific approaches that can successfully deliver health services.

National Estimates of the Pubertal Milestones Among Urban and Rural Chinese Girls - Corrected Proof

2012-03-16

Abstract: Purpose: To provide clinically meaningful, normative reference data that describe pubertal timing indicators among urban and rural Chinese girls. Methods: Girls of Chinese Han ethnicity from grade 1 in elementary schools through grade 12 in junior high schools in eight regions participated in China Puberty Research Collaboration from October 2010 to May 2011. At examination, stages of breast and pubic hair development were assessed by trained physicians. Data on menses were collected through questionnaire survey. Results: A total of 15,388 girls aged 6.0–18.9 years participated in this collaboration study. Among them, approximately 53.5% (8,238) came from rural areas. The median ages at stage 2 of breast development of Chinese girls were 9.18 (95% confidence interval: 8.91–9.44) years and at stage 2 for pubic hair growth were 11.65 (95% confidence interval: 11.41–11.90) years. Girls with body mass index ≥85th percentile had earlier age for B2 (Tanner stage 2 for breast development), B3 (Tanner stage 3 for breast development), PH2 (Tanner stage 2 for pubic hair development), PH3 (Tanner stage 3 for pubic hair development), and menarche compared with girls with body mass index < 85th percentile. Urban girls achieved PH2, PH3, and menarche at a much earlier age than rural girls, except for B2 and B3 attainment. Mean menarcheal age is 12.43 years. Conclusions: This study presented up-to-date data on female pubertal timing in a national sample of Chinese Han ethnicity girls and separately for urban and rural areas.

Improving Human Papillomavirus Vaccine Delivery: A National Study of Parents and Their Adolescent Sons - Corrected Proof

2012-03-16

Abstract: Purpose: We examined parents' and adolescents' preferences regarding potential strategies to increase human papillomavirus (HPV) vaccination rates, including offering the vaccine in alternative settings, concomitant administration of vaccines, and optimizing the structure of vaccination medical visits. Methods: A national sample of U.S. parents of adolescent boys aged 11–17 years (n = 506) and their sons (n = 391) completed online surveys in August and September 2010. We used analysis of variance for mixed designs to examine preferences for vaccination settings. Results: Parents and sons were most comfortable with sons receiving HPV vaccine in a doctor's office. Parents of sons who had not visited their regular health care providers in the past year were more comfortable with sons receiving HPV vaccine at a public clinic (p < .001) or school (p < .05) compared with parents whose sons had recent visits. Results from the son survey showed a similar pattern. Parents and sons reported moderate levels of acceptability of concomitant administration. They most preferred to have the three HPV vaccine shots administered during brief nurse visits. Conclusions: Offering HPV vaccine in alternative settings and administering it with other recommended adolescent vaccines may increase uptake among adolescent boys. Parents and sons may prefer HPV vaccines be administered during brief nurse visits.

Sexual Dysfunctions Among Young Men: Prevalence and Associated Factors - Corrected Proof

2012-03-16

Abstract: Purpose: The purposes of this study are to measure the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) among a population of Swiss young men and to assess which factors are associated with these sexual dysfunctions in this age-group. Methods: For each condition (PE and ED), we performed separate analyses comparing young men suffering from the condition with those who were not. Groups were compared for substance use (tobacco, alcohol, cannabis, other illegal drugs, and medication without a prescription), self-reported body mass index, sexual orientation, physical activity, professional activity, sexual experience (sexual life length and age at first intercourse), depression status, mental health, and physical health in a bivariate analysis. We then used a log-linear analysis to consider all significant variables simultaneously. Results: Prevalence rates for PE and ED were 11% and 30%, respectively. Poor mental health was the only variable to have a direct association with both conditions after controlling for potential confounders. In addition, PE was directly associated with tobacco, illegal drugs, professional activity, and physical activity, whereas ED was directly linked with medication without a prescription, length of sexual life, and physical health. Conclusions: In Switzerland, one-third of young men suffer from at least one sexual dysfunction. Multiple health-compromising factors are associated with these dysfunctions. These should act as red flags for health professionals to encourage them to take any opportunity to talk about sexuality with their young male patients.

Knowledge and Likelihood to Recommend Intrauterine Devices for Adolescents Among School-based Health Center Providers - Corrected Proof

Julia E. Kohn, Jordan G. Hacker, Marissa A. Rousselle, Marji Gold — 2012-03-14

Abstract: Purpose: The American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention recommend intrauterine devices (IUDs) as safe and highly effective contraceptives for adolescents. Nevertheless, many U.S. providers do not recommend or provide IUDs to adolescents—a population at high risk for unintended pregnancy. The purpose of this study was to identify barriers to IUD provision for adolescents. Methods: A 36-item self-administered survey of knowledge and attitudes regarding IUDs was completed by 162 staff of New York City school-based health centers, including 69 clinicians (e.g., pediatricians and nurse practitioners) and 93 nonclinicians (e.g., social workers and health educators). Results: Half (55%) of all respondents would be likely to recommend an IUD to a patient under age 20 years. Respondents were less likely to recommend an IUD for patients with history of recent STD (31%), remote pelvic inflammatory disease (37%), and patients not in a monogamous relationship (38%). Whereas 77% of respondents indicated that IUDs are safe for adolescents, 18% of those respondents would be unlikely to recommend an IUD to a patient under age 20 years. While 86% of respondents knew that IUDs can be used in nulliparous women, 25% of those respondents would be unlikely to recommend an IUD to a patient who has never been pregnant. Additionally, 61% believed that counseling patients about IUDs would take more time than other methods. Conclusions: Misinformation about risks associated with IUDs and beliefs about patient eligibility may present barriers to provision. Apparent contradictions between knowledge and likelihood to recommend IUDs warrant further study.

Role of Birth Weight and Postnatal Growth on Pulse Wave Velocity in Teenagers - Corrected Proof

2012-03-14

Abstract: Purpose: Low birth weight and accelerated postnatal growth appear to play a significant role in the pathogenesis of hypertension and cardiovascular disease in adulthood. The aim of the present study was to characterize the factors determining pulse wave velocity (PWV) in teenagers and, in particular, to verify the relationship with birth weight, postnatal growth, timing of adiposity rebound, lifestyle, and hemodynamic parameters. Methods: Carotid-femoral and carotid-radial pulse wave velocities of 558 healthy teenagers (age range: 16.2–19.9 years) were determined by means of a PulsePen tonometer. Birth weight and gestational age were obtained from obstetrical records, and data regarding postnatal growth were obtained from pediatric clinical records. Results: No change in aortic PWV was found in association with birth weight, postnatal growth, and timing of adiposity rebound. However, the study showed a strong association between accelerated growth from 0 to 12 months and carotid-radial PWV (trend: p = .02). Subjects with birth weight values <2,500 g showed higher values of upper limb PWV (p < .05) and higher values of diastolic and mean arterial pressure (p < .05). Stepwise regression analysis revealed that mean arterial pressure, age, and height were the main independent factors determining aortic PWV in this young population. Conclusions: These results suggest that there is no linear correlation between birth weight and hemodynamic parameters in teenagers; however, subjects characterized by very low birth weight and accelerated postnatal weight gain appear to demonstrate increased upper limb PWV and diastolic and mean arterial pressure values.

Nonalcoholic Fatty Liver in Children and Adolescents: An Overview - Corrected Proof

2012-03-14

Abstract: Nonalcoholic fatty liver disease is rapidly becoming one of the most common liver diseases in the pediatric population in industrialized countries because of the growing prevalence of obesity and overweight. For this reason, there is a keen and broad interest among researchers to identify new diagnostic noninvasive tools and novel treatment modalities for this condition. Unfortunately, to date, liver biopsy remains the imperfect gold standard for diagnosis. In addition, available noninvasive markers are not fully satisfactory for the diagnosis of fatty liver. Although in recent years many pharmacological agents, on the basis of pathogenetic mechanism of the disease, have been attempted, to date, the guidelines for the management of fatty liver are still lacking. Establishing effective therapeutic strategies to treat the disease represents the challenge for pediatric hepatologists in the near future. In this article, we briefly review the current knowledge and ideas concerning pediatric nonalcoholic fatty liver disease, and discuss the new perspective therapies.

Social Network and Individual Correlates of Sexual Risk Behavior Among Homeless Young Men Who Have Sex With Men - Corrected Proof

2012-03-14

Abstract: Purpose: There is growing interest in network-based interventions to reduce HIV sexual risk behavior among both homeless youth and men who have sex with men. The goal of this study was to better understand the social network and individual correlates of sexual risk behavior among homeless young men who have sex with men (YMSM) to inform these HIV prevention efforts. Methods: A multistage sampling design was used to recruit a probability sample of 121 homeless YMSM (ages: 16–24 years) from shelters, drop-in centers, and street venues in Los Angeles County. Face-to-face interviews were conducted. Because of the different distributions of the three outcome variables, three distinct regression models were needed: ordinal logistic regression for unprotected sex, zero-truncated Poisson regression for number of sex partners, and logistic regression for any sex trade. Results: Homeless YMSM were less likely to engage in unprotected sex and had fewer sex partners if their networks included platonic ties to peers who regularly attended school, and had fewer sex partners if most of their network members were not heavy drinkers. Most other aspects of network composition were unrelated to sexual risk behavior. Individual predictors of sexual risk behavior included older age, Hispanic ethnicity, lower education, depressive symptoms, less positive condom attitudes, and sleeping outdoors because of nowhere else to stay. Conclusions: HIV prevention programs for homeless YMSM may warrant a multipronged approach that helps these youth strengthen their ties to prosocial peers, develop more positive condom attitudes, and access needed mental health and housing services.

Complementary and Alternative Medicine Use Among Youth With Juvenile Arthritis: Are Youth Using CAM, but Not Talking About It? - Corrected Proof

2012-03-13

Abstract: Purpose: To examine self-reported use and correlates of complementary and alternative medicine (CAM) in adolescents with juvenile arthritis (JA). Methods: One hundred thirty-four adolescents with JA completed an online survey of their use of, interest in, and discussions about CAM. The PedsQL 4.0 SF15 assessed quality of life. Results: The majority (72%) of youth reported using ≥1 CAM modality. Use did not differ by sex, age, race, or geographic location. The most commonly used CAM modalities were yoga (45%) and meditation, relaxation, or guided imagery (40%). Low psychosocial quality of life was associated with massage and meditation, relaxation, or guided imagery use (p < .05). Only 46% of youth reported discussing CAM with a health care provider. Nonusers were most interested in learning more about massage (79%) and yoga (57%). Conclusions: Youth with JA reported high use of CAM, but few discussed CAM with health care providers. Findings suggest practitioners should engage adolescents in discussions about CAM.