|
|
|
|
...on Adolescents
|
|
www.ProjectCork.org
|
Winter 2008
|
Physical activity might not be the protective factor for health risk behaviours and psychopathological symptoms in adolescents.
Tao FB; Xu ML; Kim SD; Sun Y; Su PY; Huang K. Journal of Paediatrics and Child Health 43(11): 762-767, 2007. (24 refs.)
Aim: This study aims to examine the effect of physical activity (PA) intensity on tobacco or alcohol abuse, suicide behaviours and psychopathological symptoms in junior and senior high school students in China. Methods: A total of 5453 students from nine middle schools participated in a self-administered anonymous survey to report their frequency of moderate and vigorous physical activity at a normal learning week. Tobacco or alcohol use in the past 30 days, suicide behaviours during the past 12 months were asked. The Symptoms Checklist 90 was used to assess general mental problem and nine special psychopathological symptoms. The Rosenberg's Self-esteem Scale and School Life Satisfaction Rating Questionnaire for Adolescent were selected to rate the respondents' self-esteem and school life satisfaction. Results: Percentage of high-, low-moderate- and very-low-intensity physical activity was 22.0%, 37.0% and 41.0%, respectively. By using multivariable multinomial logistic regression, it was indicated that low-moderate-intensity physical activity was a protective factor of depression (odds ratio (OR) was 0.61, 95% confidence interval (CI) was 0.40-0.91) and psychotic symptoms (OR 0.54, 95% CI 0.31-0.93), while high-intensity physical activity was a risk factor of binge drinking (OR: 1.81, 95% CI: 1.29-2.54), suicide ideation (OR: 1.26, 95% CI: 1.04-1.54), general psychological disorders (OR: 1.43, 95% CI: 1.11-1.84), and hostile symptoms (OR: 1.46, 95% CI: 1.03-2.07). Conclusion: Different intensity physical activity in adolescents had different association with risk health behaviours and psychopathological symptoms. The reasons are worth further researching. Copyright 2007, Blackwell Publishing.
Really underage drinkers: The epidemiology of children's alcohol use in the United States.
Donovan JE. Prevention Science 8(3): 192-205, 2007. (58 refs.)
Little attention has been paid to alcohol use by children aged 12 and younger. The present article summarizes findings on the prevalence of alcohol use from US national and statewide surveys of children in grades 6 and younger based on reports located in searches of the literature and the Internet. Four national surveys and seven statewide surveys of children's alcohol and drug use were located that present rates of lifetime sipping and tasting, lifetime experience of more than a sip, alcohol use in the past year, use in the past month, and use in the past week. Prevalence rates decrease with the level of involvement assessed. Alcohol use increases with age, doubling between grades four and six, with the largest jump in prevalence between grades five and six. At each grade level, boys are more likely to have used alcohol than girls. African-American children are nearly as likely as white and Hispanic children to have used alcohol. Over the past decade or so, the prevalence of both lifetime and current alcohol use has been declining in children. The failure to assess intensity of children's use hampers evaluation of the level of risk experienced by children. There is a need for ongoing nationwide surveillance of alcohol use in this population and for greater education of parents regarding the dangers of introducing children to alcohol use. Copyright 2007, Springer Publishers.
Substance use risk behaviors and decision-making skills among cancer-surviving adolescents.
Hollen PJ; Hobbie WL; Donnangelo SF; Shannon S; Erickson J. Journal of Pediatric Oncology Nursing 24(5): 264-273, 2007. (50 refs.)
The aims of this study were to compare decision making and substance use risk behaviors of a cohort of cancer-surviving adolescents to those of 2 earlier cohorts as well as adolescents in the US general population and to determine the relationship of decision making to substance use risk behaviors. This correlational study used a semistructured interview at the time of the annual clinic visit to obtain data. Teen cancer survivors (N = 76), ages 14-19 years, were recruited from 5 clinics within the United States. Adherence to quality decision-making skills reported by different cancer-surviving adolescent cohorts appears to remain the same over time. However, reported substance use risk behaviors by these teen survivor cohorts have decreased over time. The prevalence rates for lifetime use for the 2004 cohort of teen cancer survivors were 25%, 49%, and 16%, for cigarettes, alcohol, and marijuana use, respectively. These rates are somewhat lower than those in the US general population; yet, they are high given the health vulnerability of cancer-surviving adolescents. Poor-quality decision making was significantly associated with higher levels of substance use risk behaviors for these teen cancer survivors. In conjunction with the statistics related to higher health risks in this vulnerable group of teens, these findings support continued efforts in developing interventions for risk behavior counseling. Copyright 2007, Sage Publications Inc.
Exposure to smoking depictions in movies - Its association with established adolescent smoking.
Sargent JD; Stoolmiller M; Worth KA; Dal Cin S; Wills TA; Gibbons FX et al. Archives of Pediatrics & Adolescent Medicine 161(9): 849-856, 2007. (52 refs.)
Objective: To assess the association between exposure to movie smoking and established adolescent smoking. Design: Longitudinal survey of a representative US adolescent sample. Setting: Adolescents were surveyed by telephone in their homes. Participants: Sixty-five hundred twenty-two US adolescents aged 10 to 14 years at baseline, resurveyed at 8 months (8M) (n= 5503), 16 months (16M) (n= 5019), and 24 months (24M) (n= 4575). Main Exposure: Exposure to smoking in 532 box-office hits released in the 5 years prior to the baseline survey. Outcome Measure: Established smoking (having smoked more than 100 cigarettes during lifetime). Results: Of 108 incident established smokers with data at the 24M survey, 85% were current (30-day smokers) and 83% endorsed at least 1 addiction symptom. Established smoking incidence was 7.4, 15.8, and 19.7 per 1000 person-years of observation for the baseline-to-8M, 8Mto16M, and 16M-to-24M observation periods, respectively. In a multivariate survival model, risk of established smoking was predicted by baseline exposure to smoking in movies with an adjusted overall hazard ratio of 2.04 (95% confidence interval, 1.01-4.12) for teens in the 95th percentile of movie-smoking exposure compared with the 5th percentile. This effect was independent of age; parent, sibling, or friend smoking; and sensation seeking. Teens low on sensation seeking were more responsive to the movie-smoking effect (hazard ratio, 12.7; 95% confidence interval, 2.0-80.6) compared with teens who were high on sensation seeking (hazard ratio, 1.01; 95% confidence interval, 0.4-2.6). Conclusion: In this national US adolescent sample, exposure to smoking in movies predicted risk of becoming an established smoker, an outcome linked with adult dependent smoking and its associated morbidity and mortality. Copyright 2007, American Medical Association.
Agreement between parent and adolescent reports of adolescent substance use.
McGillicuddy NB; Rychtarik RG; Morsheimer ET; Burke-Storer MR. Journal of Child & Adolescent Substance Abuse 16(4): 59-78, 2007. (47 refs.)
This study examined the correspondence between parent and adolescent reports of the adolescent's substance use in a population of parents concerned about, and experiencing problems resulting from, their teen's substance use. Seventy-five parents and their adolescents (76% not in treatment; 24% in treatment) were interviewed separately regarding the teen's recent use of cigarettes, alcohol, marijuana, and other illicit drugs. Irrespective of adolescent treatment status, fair-to-good congruence was found on cigarette and marijuana use, alcohol use frequency, and overall substance use frequency. Poor congruence was found on the incidence of alcohol and other illicit drug use, and the quantity of alcohol consumed per drinking day. Multiple regression analysis revealed that poorer congruence on substance use frequency occurred when the teen was younger, when the parent scored low on monitoring and high on psychological distress, and when the parent used alcohol more frequently. Results indicate that parental awareness of teen substance use varies with the substance used and its measurement. In the absence of a cooperative teen, however, parental report of the frequency of adolescent substance use appears to serve as a fair-to-good proxy. Copyright 2007, Haworth Press.
Alcohol use and tobacco abstinence among adolescents in cessation treatment: Preliminary findings.
Jaszyna-Gasior M; Schroeder JR; Moolchan ET. Addictive Behaviors 32(3): 617-621, 2007. (11 refs.)
Although adult alcohol use is negatively associated with tobacco cessation, this relationship has not been reported for adolescents. We assessed the relationship between alcohol use and point prevalence abstinence from smoking in a sample of tobacco-dependent adolescents undergoing cessation treatment. Alcohol use both at baseline and) during tobacco cessation treatment was examined as predicting smoking abstinence in 101 adolescents (age = 15.1 years, S. D. = 1.31 years; age at first cigarette = 11.3 years, S.D. = 1.93 years; age at first drink = 12.01 years, S.D. = 2.87 years) attending a total of 642 treatment visits. Mixed regression analysis showed that participants who reported alcohol use during tobacco cessation treatment were significantly less likely to abstain from tobacco smoking (OR = 0.42, 95% CI=0.23-0.78, t=-2.78, df=540, p=0.0057). However, pre-enrollment alcohol use was not significantly associated with either short- or long-term tobacco abstinence. If confirmed in a larger group of adolescents, our findings suggest that youths attempting to quit smoking should abstain from alcohol. Copyright 2007, Elsevier Science.
Depression symptoms and substance abuse in adolescents with asthma.
Bender BG. Annals of Allergy, Asthma, & Immunology 99(4): 319-324, 2007. (47 refs.)
Background: Depression and risk behaviors occur often in adolescents in the United States, but their frequency in youth with asthma is not well documented. Objective: To establish rates of and associations between depression and substance use in youth with asthma. Methods: The Centers for Disease Control and Prevention conducted the 2005 Youth Risk Behavior Survey with 13,917 students in grades 9 to 12 from 159 high schools in 40 states, producing a nationally representative distribution of students by grade, sex, and race/ethnicity. The Youth Risk Behavior Survey documents self-reported suicide intent and health risk behaviors, including use of tobacco, marijuana, alcohol, and cocaine. Results: In 720 adolescents reporting current asthma (5.2% of the total sample), depression symptoms, cigarette smoking, and cocaine use occurred more frequently than in youth without asthma. Substance use increased with depression; of youth with asthma reporting suicidal ideation, 40% had smoked cigarettes, 67% had smoked marijuana, 37% had engaged in binge drinking, and 12% had used cocaine in the past 30 days. Overall odds ratios for substance abuse in the group with asthma were not altered when controlling for age, sex, and race, although odds ratios for specific risk behaviors in those with asthma varied slightly within age, sex, and race groups. Conclusions: National rates of depression and associated risk behaviors in youth with asthma have not been previously reported, indicate a need to screen adolescents with asthma for depression, and suggest that risk behaviors in this population may signal heightened need for intervention. Copyright 2007, American College of Allergy, Asthma & Immunology.
Does smoking in adolescence affect body mass index, waist or height? Findings from a longitudinal study.
Fidler JA; West R; Van Jaarsveld CHM; Jarvis MJ; Wardle J. Addiction102(9): 1493-1501, 2007. (30 refs.)
Aim: To assess the effect of smoking uptake on body mass index (BMI), waist circumference and height during adolescence. Design:a Five-year longitudinal study. Setting Thirty-six schools in South London, England, selected by a stratified random sampling procedure designed to ensure ethnic and socio-economic diversity. Participants A total of 5863 students took part in the HABITS (Health and Behaviour in Teenagers) Study between 1999 and 2003. Measurements Self-reported smoking behaviour, saliva cotinine concentrations and measured weight, waist circumference and height were obtained, along with information on gender, ethnicity, socio-economic deprivation, pubertal status, self-reported exercise and dieting. Students were examined annually from school year 7 (ages 11-12) to year 11 (ages 15-16), with response rates ranging from 74 to 84%. A total of 2665 never smokers at year 7 with complete data for years 7 and 11 were included in the analyses. Findings: Adjusting for year 7 BMI and other potential confounders, regular smokers (more than six cigarettes a week) at year 11 had significantly lower BMI (P = 0.002) than other students. Smokers defined by a cotinine above 15 ng/ml also had lower BMI (P < 0.0001). Waist circumferences were lower in regular smokers (P = 0.014) and cotinine-defined smokers (P < 0.011). No consistent association was found between smoking and height. The adjusted difference in weight between regular smokers and other students amounted to 1.8 kg (95% CI, 0.52-3.17) for an average-height student. Conclusion: Taking up regular smoking during adolescence may result in a lower BMI, but the effect is small and of uncertain significance. Copyright 2007, Society for the Study of Addiction to Alcohol and Other Drugs.
Doping prevalence among preadolescent athletes: A 4-year follow-up.
Laure P; Binsinger C. British Journal of Sports Medicine 41(10): 660-663, 2007. (21 refs.)
Objective: To describe the prevalence of doping and its progression in a cohort of preadolescent athletes during a 4-year follow-up. Design and settings: Prospective cohort study. Self-questionnaire survey. Participants: All of the pupils entering the first year of secondary school (sixth grade) in the Vosges Department (east France) and followed for 4 years. Main outcome measurements: Drug use (prohibited substances, tobacco, alcohol, cannabis), intention to use, reported health hazards, perceived drug effectiveness, self-esteem, trait anxiety. Results: At the beginning of the study, 1.2% (95% CI 0.8 to 1.6) stated that they had taken doping agents at least once in the preceding 6 months, and this had risen to 3.0% (95% CI 2.3-3.7) 4 years later (p < 0.001). Of those who had used doping agents, 4% reported that they had experienced a health problem related to doping, and 44% reported that they had won at least one sports event as a result of using the drug. Use of doping agents is linked to the number of hours of practice per week, intention to use, use of other drugs, self-esteem and trait anxiety. Conclusions: The results show that doping does exist in preadolescent athletes who train every day. This fact should to be taken into account in preventive actions. Copyright 2007, BMJ Publishing Group.
Factors associated with the initiation of cocaine and heroin among problem drug users: Reflections on interventions.
Witteveen E; Van Ameijden EJC; Prins M; Schippers GM. Substance Use & Misuse42(6): 933-947, 2007. (42 refs.)
Objective: This study identifies self-reported factors facilitating initiation of cocaine and heroin among young problem users in Amsterdam to enable interventions to be targeted at issues personally relevant for this population. Method: A qualitative study using in-depth interviews to obtain retrospective drug use histories. Recruitment took place both directly (by street outreach, outreach at methadone outposts) and indirectly (by respondent-driven sampling). The study started in the year 2001 and included 50 problem drug users, aged 18-30, of whom 72% were male, 64% were polydrug users, and 36% were homeless. Results: The seven most common self-reported factors facilitating initiation of cocaine and heroin are desire for affect regulation, drug availability, curiosity, desire to be part of a group, misinformation, desire for energy, and starting because it has a depressant effect. Conclusion: Some factors perceived to facilitate initiation of cocaine and/or heroin revealed in this study are hardly addressed by current prevention programs and could inform future initiatives. Programs can be targeted at young people who we identified to be at high risk. Research using quantitative methods is likely to be valuable in determining the relative importance of mentioned factors for different groups of young people. Copyright 2007, Marcel Dekker, Inc.
Family breakup and adolescents' psychosocial maladjustment: Public health implications of family disruptions.
Roustit C; Chaix B; Chauvin P. Pediatrics 120(4): E984-e991, 2007. (51 refs.)
OBJECTIVES. Recent changes in family structure are associated with an increase in psychosocial maladjustment in adolescents. We examined, from a public health intervention perspective, the association between family breakup and psychosocial maladjustment in adolescents and assessed the mediating role of family-functioning variables. METHODS. We analyzed data from the Social and Health Survey of Children and Adolescents in Quebec, Montreal, Canada, which was conducted in 1999. Sample-weighted logistic regression analyses were performed to determine the risk of internalizing disorders, externalizing disorders, substance abuse, and alcohol consumption in relation to family breakups and family-functioning variables, after adjusting for socioeconomic factors. RESULTS. All 4 of the indicators of psychosocial maladjustment were significantly associated with family breakup. The association between family breakups and internalizing disorders was mediated by parental psychological distress and low paternal emotional support. Independently, the witnessing of interparental violence was also strongly associated with internalizing disorders. For the other 3 outcomes, that is, externalizing disorders, substance abuse, and alcohol consumption, family breakup and family-functioning variables had independent effects. CONCLUSIONS. Family-based interventions and social approaches are complementary support modalities for adolescents experiencing family disruptions. Copyright 2007, American Academy of Pediatrics.
Inhalant use and suicidality among incarcerated youth.
Freedenthal S; Vaughn MG; Jenson JM; Howard MO. Drug and Alcohol Dependence 90(1): 81-88, 2007. (43 refs.)
Studies consistently indicate that inhalant use is associated with increased mental health problems in adolescents, but few investigations have focused on the potential relationship of inhalant use to suicidality (ideation or attempt). This study examined how different levels of volatile solvent use relate to suicidal ideation and attempted suicide among 723 incarcerated youth (mean age = 15.5, S.D. = 1.2; 87% male) in Missouri, and whether any associations between solvent use and suicidality differ by gender. In bivariate analyses, severity of inhalant use was positively associated with histories of suicidal ideation and suicide attempt for both boys and girls. In multivariate analyses, inhalant use disorders remained significantly associated with suicidal ideation and suicide attempt histories even after adjusting for general level of psychiatric symptoms, prior trauma, other substance use, gender, and additional potential confounders. Inhalant use without abuse or dependence also significantly related to suicidal ideation in multivariate analyses, but an interaction between gender and inhalant use signified this relationship was stronger for girls. Inhalant use disorders in incarcerated youth, as well as inhalant use without abuse or dependence (particularly in girls), may signal elevated suicide risk. Suicide risk assessments should, therefore, include questions about inhalation of volatile solvents such as paint, gasoline, and household cleaners. Copyright 2007, Elsevier Science.
Changing incidence of psychotic disorders among the young in Zurich.
Ajdacic-Gross V; Lauber C; Warnke I; Haker H; Murray RM; Rossler W. Schizophrenia Research 95(1-3): 9-18, 2007. (55 refs.)
There is controversy over whether the incidence rates of schizophrenia and psychotic disorders have changed in recent decades. To detect deviations from trends in incidence, we analysed admission data of patients with an ICD-8/9/10 diagnosis of psychotic disorders in the Canton Zurich / Switzerland, for the period 1977-2005. The data was derived from the central psychiatric register of the Canton Zurich. Ex-post forecasting with ARIMA (Autoregressive Integrated Moving Average) models was used to assess departures from existing trends. In addition, age-period-cohort analysis was applied to determine hidden birth cohort effects. First admission rates of patients with psychotic disorders were constant in men and showed a downward trend in women. However, the rates in the youngest age groups showed a strong increase in the second half of the 1990's. The trend reversal among the youngest age groups coincides with the increased use of cannabis among young Swiss in the 1990's. Copyright 2007, Elsevier Science.
Effects of home access and availability of alcohol on young adolescents' alcohol use.
Komro KA; Maldonado-Molina MM; Tobler AL; Bonds JR; Muller KE. Addiction102(10): 1597-1608, 2007. (52 refs.)
Aims: The purpose of the present study was to examine the effects of parental provision of alcohol and home alcohol accessibility on the trajectories of young adolescent alcohol use and intentions. Design Data were part of a longitudinal study of alcohol use among multi-ethnic urban young adolescents who were assigned randomly to the control group of a prevention trial. Setting Data were collected from a cohort of youth, and their parents, who attended public schools in Chicago, Illinois (2002-2005). Participants: The sample comprised the 1388 students, and their parents, who had been assigned randomly to the control group and were present and completed surveys at baseline, in the beginning of 6th grade (age 12). The sample was primarily low-income, and African American and Hispanic. Measurements: Students completed self-report questionnaires when in the 6th, 7th and 8th grades (age 12-14 years; response rates 91-96%). Parents of the 6th grade students also completed questionnaires (70% response rate). Findings: Student report, at age 12, of parental provision of alcohol and home alcohol availability, and parental report of providing alcohol to their child and the accessibility of alcohol in the home, were associated with significant increases in the trajectories of young adolescent alcohol use and intentions from ages 12-14 years. Student report of receiving alcohol from their parent or taking it from home during their last drinking occasion were the most robust predictors of increases in alcohol use and intentions over time. Conclusion: Results indicate that it is risky for parents to allow children to drink during early adolescence. When these findings are considered together with the risks associated with early onset of alcohol use, it is clear that parents can play an important role in prevention. Copyright 2007, Society for the Study of Addiction to Alcohol and Other Drugs.
Interest in genetic counseling and testing for adolescent nicotine addiction susceptibility among a sample of adolescent medicine providers attending a scientific conference on adolescent health.
Tercyak KP; Peshkin BN; Abraham A; Wine L; Walker LR. Journal of Adolescent Health 41(1): 42-50, 2007. (42 refs.)
Purpose: Preventing adolescents from smoking and becoming addicted to nicotine is an important public health issue. New research on the genetics of susceptibility to nicotine addition is emerging and may eventually help to identify adolescents at high risk. Over time, genetic counseling and testing for nicotine addiction susceptibility may become incorporated into tobacco control practice, and providers in primary care settings are likely to be at the forefront of these services. As such, it is important to understand the attitudes and practices of adolescent medicine providers toward tobacco control and genetic testing to anticipate better the needs and interests of these individuals and prepare for the future. This study describes adolescent medicine providers' interest, and correlates of their interest, in genetic counseling and testing for nicotine addiction susceptibility among their adolescent patients-a test that is not yet clinically available. Methods: Adolescent medicine providers attending a national scientific conference (N = 232) completed a survey about their patient tobacco control and other screening behaviors, perceptions of their patients' attitudes and beliefs toward tobacco control, and their own attitudes and beliefs about smoking and genetics. Results: Providers who engaged in more regular tobacco screening behaviors with their adolescent patients (odds ratio [OR] = 4.07, 95% confidence interval [CI] = 2.20, 7.751, p = .00) and those who were more optimistic that biobehavioral research would lead to significant improvements in adolescent smoking prevention and treatment (OR = 2.47, 95% CI = 1.40, 4.37, p = .00), were more interested in counseling and testing. Conclusions: In the future, adolescent wellness visits may present an opportunity to offer genetic counseling and testing for nicotine addiction susceptibility. Implementation at the provider level may depend on tobacco screening behavior and research optimism. Educating providers about safe and effective adolescent tobacco control strategies incorporating genetics will be essential. Copyright 2007, Society for Adolescent Medicine.
Neuropsychological functioning in adolescent marijuana users: Subtle deficits detectable after a month of abstinence.
Medina KL; Hanson KL; Schweinsburg AD; Cohen-Zion M; Nagel BJ; Tapert SF. Journal of the International Neuropsychological Society 13(5): 807-820, 2007. (103 refs.)
In adults, studies examining the long-lasting cognitive effects of marijuana use demonstrate subtle deficits in attention, executive function and memory. Because neuromaturation continues through adolescence, these results cannot necessarily generalize to adolescent marijuana users. The goal of this study was to examine neuropsychological functioning in abstinent marijuana using and demographically similar control adolescents. Data were collected from 65 adolescent marijuana users (n = 31, 26% females) and controls (n 34, 26% females) 16-18 years of age. Extensive exclusionary criteria included independent psychiatric, medical, and neurologic disorders. Neuropsychological assessments were conducted after > 23 days of monitored abstinence. After controlling for lifetime alcohol use and depressive symptoms, adolescent marijuana users demonstrated slower psychomotor speed (p < .05), and poorer complex attention (p < .04), story memory (p < .04), and planning and sequencing ability (p < .001) compared with controls. Post hoc analysis revealed that the number of lifetime marijuana use episodes was associated with poorer cognitive function, even after controlling for lifetime alcohol use. The general pattern of results suggested that, even after a month of monitored abstinence, adolescent marijuana users demonstrate subtle neuropsychological deficits compared with nonusers. It is possible that frequent marijuana use during adolescence may negatively influence neuromaturation and cognitive development. Copyright 2007, Cambridge University Press.
High school drug use predicts job-related outcomes at age 29.
Ringel JS; Ellickson PL; Collins RL. Addictive Behaviors 32(3): 576-589, 2007. (26 refs.)
The present study examines the relationship between hard drug use in high school and occupational and job quality outcomes measured at approximately age 29. We use two different methods aimed at ruling out the possibility of spurious correlations between high school drug use and occupational outcomes: (1) directly controlling for pre-high school characteristics that may affect both high school drug use and later occupational characteristics (e.g., educational orientation, early drug use and deviant behavior); and (2) matching high school users with a subset of nonusers that have very similar characteristics and then estimating the difference in labor market outcomes for these two groups (i.e., propensity score matching). Overall, the results suggest that adolescent drug use is linked with poorer occupational and job quality outcomes as much as 10 years after high school. Interestingly, which job-related outcomes are affected by early hard drug use varies by gender. Females who use hard drugs as adolescents end up in lower skill, lower status jobs while males who use hard drugs as adolescents are more likely to end up in jobs with fewer benefits (e.g., health, retirement). Copyright 2007, Elsevier Science
|
