A network analysis of childhood trauma, perceived social support and alexithymia in Chinese adolescents.

Breast flattening, or breast ironing, is a damaging cultural practice popular in regions of West and Central Africa, especially Nigeria, where it is often conducted secretly. This study evaluated the prevalence and psychological effects of breast flattening on adolescent females in some communities in Calabar South LGA, Cross River State, Nigeria, and its influence on their educational participation. The study was guided by five research questions. The Breast Flattering Practice questionnaire was designed by researchers and validated by experts. The data demonstrated that breast flattening is a frequent practice in the study communities (mean = 3.18 on a 4-point scale; p < .001), with 57.1% of respondents reporting awareness of it. It is largely practiced without official medical supervision (mean = 3.07, p < .001) and is recognised as a cultural norm (mean = 2.84, p = .003). The practice substantially corresponds with lower academic performance (r = .572, p < .001), and victims encounter severe psychosocial hurdles, including self-consciousness (mean = 3.24, p < .001), avoidance of school activities (mean = 2.62, p = .004), and anxiety (mean = 2.98, p = .001). However, the study demonstrates the effectiveness of counselling interventions, including individual and group therapy and peer support, all of which were perceived as beneficial (weighted mean = 2.90, p = .002). Recommendations stress improving legal enforcement, conducting awareness programs (mean = 3.10, p < .001), establishing school support policies, and involving community and religious leaders to defend girls' rights and futures.

Our previous research indicated that patients with self-reported onset of eating disorders (EDs) during Japan's first state of emergency (declared April 7, 2020) for COVID-19 were significantly Eyounger at presentation and had a shorter illness duration, which potentially facilitated earlier clinical intervention. Since early consultation is often associated with better prognosis in anorexia nervosa (AN), we hypothesized that patients with AN development during the first state of emergency would exhibit more favorable outcomes. This age-adjusted comparative study included 36 female adolescent and young adult patients (aged 12-24 years) with restricting-type AN (AN-R) diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria. Both inpatients and outpatients were included and categorized into three groups: those who visited the hospital before (Before group, n = 12) and after (After group, n = 12) the emergency declaration and those with self-reported symptom onset during the first state of emergency (During group, n = 12). Patients were evaluated at their initial visit (T0) and 3 (T1), 6 (T2), and 12 months (T3) thereafter using the Global Clinical Score (GCS) and percent standard weight as outcome measures. Psychological characteristics at T0 were assessed using the Parental Bonding Instrument (PBI) and Eating Disorder Inventory (EDI). The During group demonstrated significantly earlier improvement compared to the other two groups. Specifically, GCS scores at T1 were significantly lower in the During group (Before vs. During: 11 vs. 9, p = 0.006; After vs. During: 11 vs. 9, p = 0.0030), indicating a large effect. Percent standard body weight at T2 was significantly higher in the During group than in the After group (After vs. During: 73 vs. 83.5, p = 0.01), exhibiting a large effect. EDI and PBI scores were comparable among groups. Patients whose patient-reported AN-R symptom onset occurred during the first state of emergency showed a faster recovery trajectory than did those who presented before or after the emergency, consistent with our hypothesis. Increased time spent at home with family during the "stay-at-home" period may have contributed to earlier medical consultation and subsequent recovery, although this interpretation remains speculative. These findings highlight the importance of early intervention in AN treatment.

Black adolescent females are disproportionately affected by obesity and its associated adverse health outcomes. Though racial disparities in obesity and related health outcomes are often attributed to differences in socioeconomic status, growing evidence suggests that structural racism is a contributing factor. To prevent the numerous comorbidities associated with obesity in black females, interventionists must confront the tripartite impact of structural racism, racial discrimination, and intersectionality on physical activity and dietary behaviors. The purpose of this paper was to describe Public Health Critical Race Praxis (PHCRP) as a race-conscious approach to intervention development, refinement, and evaluation. PHCRP can be applied to behavioral intervention research to provide a lens to develop, refine, deliver, and/or evaluate culturally tailored interventions. We present a description of the 4 PHCRP foci for interventionists with examples of the 10 affiliated principles.PHCRP Application:The intervention team led with the overarching principle, race consciousness, to guide their refinement efforts, including acknowledgment of personal biases, identification of the mechanisms in which bias perpetuates racism, and development of counteractivities to combat these biases. The intervention team operationalized PHCRP by critically evaluating decisions through a race-conscious lens, ensuring that the 4 foci remained foundational throughout the refinement process. Interventionists have unintentionally reinforced racism with complicit silence by not directly addressing the profound influence of racism on health behaviors. We urge interventionists to regard the inclusion of a race-conscious framework, such as PHCRP, as a necessary requirement for designing interventions with marginalized populations.

ABSTRACT Despite the widespread use of social media among adolescents, there has been limited research on its impact on risky sexual behaviors, which can have long-lasting consequences, especially for young girls. This study investigated the link between social media use and risky sexual behaviors among female adolescents. Participants (n = 5,468) were high school girls who reported their social media use and risky sexual behaviors in the 2023 Youth Behavior Risk Survey. Chi-squared tests and log-binomial regression models were used for analysis, with a sensitivity analysis performed using the same approach in SAS 9.4 (p < .05). Frequent social media users were more likely to engage in risky sexual behaviors and reported a higher number of such behaviors compared to non-frequent users. This association between social media use and risky sexual behaviors reinforces the need for systemic interventions within schools, like school-based media literacy programs and comprehensive sex education, and intervention from school counselors. This study provides valuable insights for school counselors and shares CBT, ACT, and mindfulness skills to help adolescents challenge distorted beliefs and build resilience.

Introduction: Cardiorespiratory fitness and body composition are central components of physical health in adolescents, and those with higher cardiorespiratory fitness tend to have better body composition, suggesting a relationship between these variables. Objective: To analyze the magnitude of the correlation between cardiorespiratory fitness and body composition in adolescents in northern Mozambique. Methodology: This is an observational, cross-sectional, and correlational study, whose sample consisted of 919 adolescents aged 13 to 17 years. Cardiorespiratory fitness was estimated by maximum oxygen consumption using the 20-meter shuttle run test; body composition was assessed using the body mass index, and the magnitude of correlation was calculated using Pearson's correlation test. Results: A statistically significant negative correlation (P &lt; 0.05) was found in female adolescents, varying with age (r = -0.189 to -0.355) and with body mass index classification (r = -0.230 to -0.544). Discussion: Similar results have been found in other studies, but in both sexes, although with a smaller sample size in this age group. In a study conducted on overweight and obese adolescents, the magnitude of the correlation was greater than that of the present study. Conclusion: Cardiorespiratory fitness shows a significant, moderately weak negative correlation with body composition in female adolescents in northern Mozambique. The strength of this relationship tends to form an inverted U-shaped pattern with advancing age, being more pronounced in underweight adolescents.

Lower-limb strength is a health and performance indicator in adolescents, although its assessment often fails to account for the influence of sex and biological development. This study aimed to analyze the associations between anthropometric parameters, maturational status, and physical activity levels with jumping performance in adolescents. A cross-sectional study was conducted with male and female adolescents (mean age: 13.60 ± 1.50 years). Anthropometric variables, maturational status, and physical activity levels were assessed. Performance was measured using the Countermovement Jump (CMJ) and Standing Broad Jump (SBJ). In males, jumping performance was significantly associated with height (p = 0.002), lower-limb length (p &lt; 0.001), and muscle mass (p &lt; 0.001). However, fat mass emerged as a substantial factor, exhibiting a large effect size on performance (p &lt; 0.001). Maturational status in males showed significant differences, with late maturers performing lower than on-time and early maturers (p &lt; 0.023). In females, structural anthropometry and maturation showed limited-to-no significant associations with performance, except for a negative association with fat mass (p &lt; 0.035) and a positive association between muscle mass and CMJ (p &lt; 0.020). Active adolescents of both sexes performed significantly better than inactive ones in both CMJ and SBJ (p &lt; 0.011). In conclusion, jumping performance in adolescents is characterized by marked sexual dimorphism. In males, greater height, lower-limb length, lower fat mass, and early maturation are positively associated with superior performance. Conversely, in females, these factors exhibit limited influence on jump outcomes.

This study examined the associations between sedentary behavior (SB) at age 11 and mathematics ability at age 17, and assessed the mediating effect of internalizing and externalizing problems at age 14, using UK Millennium Cohort Study data (N = 3622; 53% male). Self-reported frequency of SB (listening to music, Internet use, reading, and playing games) and parental-reported SB duration (time spent on TV viewing and doing homework) were collected at age 11. Behavioral issues were assessed at age 14 via the Strengths and Difficulties Questionnaire. Mathematics ability was examined at age 17 using the Number Analogies Activity Task. Negative binomial regression and mediation analysis (med4way in Stata) were applied. Among female adolescents, reading, doing homework, and using the Internet were positively associated with mathematics ability. For males, TV viewing was negatively associated with mathematics ability, mediated by internalizing problems. Findings suggest that in children sex-dependent association between SB characteristics and mathematical abilities exists, implying that future initiatives targeting SB may consider leveraging sex-specific interventions.

The burden of poor mental health among young people in the United States was rising before the onset of COVID-19. Prior research documents short-term increases in anxiety and depression in the wake of the pandemic, especially among older females. We study how the pandemic altered pre-existing trends in adolescent mental health and examine differential effects across demographic groups and time. We used electronic health record data from a national primary care practice registry to identify primary care visits with diagnoses for anxiety, affective mood disorders, attention-deficit hyperactivity disorder (ADHD), trauma and stressor-related disorders, behavior and conduct problems, and eating disorders. Using an interrupted time-series design, we compared changes in the level and slope of monthly visit rates before (January 2017-February 2020), during (March 2020-February 2021), and after (March 2021-December 2023) the first year of the pandemic. Average monthly visit rates with anxiety diagnoses increased significantly between the pre- and postpandemic periods, especially among 12 to 17-year-old females (71% increase) and males (62% increase). Rates of mood disorder and ADHD diagnoses also increased among older females and remained significantly higher (35% and 8.5%) one year after the pandemic. Despite short-term increases, monthly rates began decreasing significantly in the postpandemic period. The impact of the pandemic on pediatric mental health was heterogeneous across demographic groups and mental health conditions. Older adolescent females experienced persistently high levels of diagnosed ADHD, anxiety, and mood disorders, although there are signs of reversion to prepandemic levels.

Sports-related ankle injuries are often reported to occur more frequently in female adolescents than males, but it remains unclear whether this reflects higher per-participant risk or differences in injury distribution within injured populations. Using 2024 National Electronic Injury Surveillance System data, we analyzed 33,977 sports-related injuries among individuals aged 10–24 years to examine sex differences across developmental stages and to distinguish within-sample injury distribution from participation-adjusted risk. Among adolescents (10–17 years), females had higher adjusted odds that an injury involved the ankle/foot rather than another body region (OR 1.70, 95% CI: 1.58–1.83), whereas this difference was attenuated and non-significant among young adults (18–24 years; OR 1.08, 95% CI: 0.92–1.27). Ankle/foot injuries accounted for a greater proportion of injuries among females in early adolescence (16.4% vs. 8.0%), with convergence by ages 22–24 (12.9% vs. 13.0%). However, participation-normalized analyses indicated comparable ankle injury risk between sexes in early adolescence and lower per-participant risk among females from mid-adolescence onward. These findings demonstrate that widely reported sex differences in ankle injury patterns during adolescence primarily reflect differences in injury distribution within injured samples rather than elevated absolute risk among female athletes. The observed convergence across developmental stages further suggests that these disparities are transient rather than persistent. Distinguishing injury distribution from denominator-based risk is essential for accurate interpretation of sex differences and for designing appropriately targeted prevention strategies.

Adolescent females in Canada begin menstruation around age 12, and the onset of menstruation is associated with decreased participation in sport and physical activity. Coaches play an important role in supporting athletes’ participation in sport, and adolescent athletes who report greater coach support also report greater intention to stay in sport. While previous research on menstruation in sport has focused on older female athletes and athletes in aesthetic sports (e.g., dance), few studies have examined coaches’ perspectives of coaching adolescent female athletes who are navigating menstruation. A qualitative approach was taken; thirteen coaches (female n = 7; male n = 6) participated in semi-structured qualitative interviews, and data were analyzed using reflexive thematic analysis. Key themes included the ways coaches discussed menstruation (medicalising, optimising, and avoiding altogether); coaches’ beliefs about girls in sport (periods hindering performance, and concerns over sexualizing adolescent athletes); and positioning female coaches as the experts when discussing menstruation with athletes. Male coaches demonstrated discomfort in discussing menstruation by using euphemisms and drew on stereotypes of menstruation. For coaches, medicalizing menstruation was a useful entry point into discussions with athletes, although this reflected a pathologizing of menstruation. The overall results reflect the concerns of coaches regarding the topic of menstruation, and the results shed light on broader narratives regarding women in sport that influence the ways in which coaches navigate these issues.

Introduction: This study aimed to examine COVID-19 pandemicrelated differences in the prevalence of anxiety and depression among adolescents aged 12–17 years in the United States. Methods: A cross-sectional study was conducted using NSCH data from the United States between 2016 and 2022, including adolescents aged 12–17 years. The pre-pandemic period was defined as 2016–2019, and the pandemic period as 2020–2022. Weighted prevalence and prevalence ratios (PR) were calculated. Results: The prevalence of anxiety was 13.14% (12.6, 13.7) during the prepandemic period and 17.59% (16.95, 18.26) during the pandemic. The PR of anxiety during the pandemic versus the pre-pandemic period was 1.339 (1.266, 1.416), p &lt; 0.001. The prevalence of depression was 8.45% (7.95, 8.97) during the pre-pandemic period and 10.68% (10.16, 11.22) during the pandemic. The PR of depression during the pandemic versus the pre-pandemic period was 1.264 (1.17, 1.367), p &lt; 0.001. Anxiety trends consistently increased across all subgroup analyses, whereas the increase in depression was more pronounced in specific subgroups, including White, female, and Hispanic adolescents. Discussion: Our study identified an increase in the prevalence of anxiety and depression among adolescents aged 12–17 years during the COVID-19 pandemic compared to the pre-pandemic period. The rise in anxiety prevalence was observed consistently across all subgroups analyzed, including both males and females, as well as across diverse racial and socioeconomic groups. Conclusion: The prevalence of anxiety and depression among US adolescents was higher during the COVID-19 pandemic. These findings underscore the need for targeted mental health screening, school-based prevention programs, and expanded access to telehealth.

Admission Delays in Receiving Treatment for Cannabis Use Disorder among US Adolescents.

Multisite pain is common during adolescence and is influenced by sex-related neurobiological and developmental factors, but its developmental neural mechanisms are unclear. Utilizing data from the Adolescent Brain and Cognitive Development Study, we investigated the relation between cortical brain structure and multisite pain (assessed by youth self-reports of painful regions on a body map) in male (N = 3,299) and female (N = 2,844) adolescents aged 11-12 years. We focused on brain regions functionally linked to multisite pain (i.e., bilateral sensorimotor, cingulate, fronto-insular and inferior parietal cortex). We also explored the moderating role of pubertal status (assessed by the Pubertal Development Scale). Findings revealed distinct brain structure-pain associations in male and female youth. Male youth exhibited an inverse linear relation between cortical thickness of the left pre- and postcentral gyri and number of pain sites. Female youth exhibited a non-linear relation between surface area of the right supramarginal gyrus and number of pain sites. Pubertal status moderated the cingulate cortical thickness-pain association in males; those in early puberty had an inverse relation between anterior and mid cingulate cortex thickness and pain sites, whereas this relation was positive in those beyond mid-puberty. This study provides valuable insights into the sex-dependent neural organization linked to adolescent pain.

Trends and determinants of modern contraceptive use among sexually active adolescent females in Bangladesh: Evidence of four national surveys (2011-2022).

Breast Masses in Adolescent Females: A Scoping Review.

In this paper we use a constructivist grounded theory approach to conduct individual, qualitative interviews with a racially and ethnically diverse group of adolescent and young adult cisgender females (AYACF) (18–24 years of age) to generate theoretical knowledge of the relationship between Social Determinants of Health (SDOH), STI and HIV risk perception, and dual-method contraceptive decision-making (the use of, both, a prescribed contraceptive [commonly referred to as “birth control”] and a condom during vaginal intercourse). Twenty-five AYACF were selected through theoretical sampling. Data were collected using semi-structured interviews and analyzed using constant comparison. AYACF expressed having a greater fear of pregnancy than sexually transmitted infections (STIs). They described deferring to their partners and making assumptions about their partner’s STI status based on partner and relationship factors, therefore not needing to engage in condom negotiation. Mother-daughter sexual health conversations and state school-based sex education and abortion policies influenced participants’ STI risk perception and dual-method contraceptive decision-making. Participants who were diagnosed with an STI reported experiencing a shift in perception about their likelihood of acquiring an STI, often resulting in behavior change. These findings are important as they provide insight into the complex decision-making processes, influenced by SDOH, that a racially and ethnically diverse group of AYACF associate with STI risk perception and dual-method contraceptive use.

Earlier age at menarche may influence mental health but less is known of other measures of pubertal development. We aimed to investigate general mental health consequences of altered timing and tempo of several pubertal milestones in adolescents from the population-based Danish National Birth Cohort (DNBC). Information on pubertal development (Tanner stages, age at menarche, age at first ejaculation, and voice break), was provided half-yearly throughout puberty in 6941 adolescent females and 6267 adolescent males. Timing (earlier, average, later) and tempo (faster, average, slower) of puberty were derived using non-linear mixed effect growth models and analysed as categorical and continuous variables. Outcomes included self-rated health obtained from the DNBC 18-year follow-up, and redemption of any prescribed psychotropic medication or any psychiatric diagnosis obtained from the Danish registers up to age 19years. Adjusted odds ratios were estimated using logistic regression. Earlier pubertal timing and faster pubertal tempo were associated with higher odds, whereas later pubertal timing and slower pubertal tempo were associated with lower odds of the mental health outcomes, ranging from poor self-rated health to redeeming any psychotropic medication and receiving a psychiatric diagnosis. Associations were strongest in female adolescents. Altered pubertal development was associated with all unfavorable mental health outcomes. Vulnerable adolescents at increased risk of poor mental health due to earlier pubertal timing or faster pubertal tempo should be identified with the potential to introduce earlier interventions and support preventive actions for these adolescents.

Childhood Maltreatment Profiles and Premenstrual Dysphoric Disorder (PMDD) among Female Adolescents in Nigeria: A Latent Class Analysis

95. Diagnostic Guidelines Derived from Emergency Gynecologic Presentations in Female Adolescents Under 19 Years: A Retrospective Analysis from a Tertiary Center