Adolescent Health Risk Behaviors Research Articles

A factor analytic approach to understanding health risk behaviors and resilience among multi-racial/ethnic adolescents in New Mexico

ABSTRACT Objective This study examined the factor validity of health risk behaviors and resilience indicators and their covariation across a large racially/ethnically diverse adolescent population. Design The study subsample (47% Hispanic, 31% White Non-Hispanic, 17% American Indian) was derived from the 2013 New Mexico Youth Risk Resilience Survey (YRRS; N-19,033). We conducted a confirmatory factor analysis on the 6 health risk domains identified by the CDC as contributing most to adolescent morbidity/mortality: (1) cigarette use, (2) alcohol and other illicit drug use, (3) marijuana use, (4) sexual activity, (5) nutrition habits, and (6) physical activity. Results A 4-factor CFA model of adolescent health risk behaviors was replicated, and a hypothesized 6-factor structure based on behaviors that contribute most to adolescent morbidity/mortality was confirmed. The pattern of covarying risk behaviors differed by Hispanic, Native American, and Non-Hispanic White groups. We also confirmed a single external resilience-interference factor (decreased parental support, low school/community engagement, negative peer associations) that positively correlated with all six risk behaviors. Conclusion This study described the structure of adolescent health risk behaviors within a context of psychosocial resilience for American Indian and Hispanic adolescents in contrast to Non-Hispanic White adolescents. Our findings provided evidence for the construct validity of six health-risk behavior dimensions within a large racially/ethnically diverse adolescent sample, which reveal different patterns of loadings, degrees of model fit, and factor inter-correlations across the three racial/ethnic groups. Patterns of covarying risk behaviors differed in strength and direction by racial/ethnic group. Results suggest that interventions should target multiple behaviors and be tailored for different racial/ethnic groups. Targeting health risk and resilience indicators supports the use of multi-level health interventions at the individual, school, family, and community level by identifying individuals based on external resilience scores.

Self‐Perceptions, Normative Beliefs, and Substance Use Associated With High School Girls Comparing Themselves to Peers

We assessed whether self-descriptions, self-perceptions, perceived substance use of friends, and actual substance use were associated with high school girls' frequency of making social comparisons to peers. We analyzed data from the Adolescent Health Risk Behavior Survey data for 357 high school girls using multinomial logistic regression. Compared to those who "never/rarely" made social comparisons, participants who self-described as fearing something constantly (p=.014) and forced to imitate the people they like (p=.009) were more likely to "usually" compare themselves to peers. Participants who described themselves as feeling forced to imitate the people they like (p=.022), were not the person they would like to be (p=.005), and did not remain calm under pressure (p=.010), were more likely to "often/always" make social comparisons. Participants who perceived themselves as unattractive (p=.034) and self-centered (p=.016) were more likely to "often/always" make social comparisons. Participants who perceived a larger proportion of friends use illicit drugs were less likely to "usually" make social comparisons (p=.027). Participants who perceived a larger proportion of friends drink alcohol were more likely to "often/always" make social comparisons (p=.018). Girls who perceive and describe themselves more negatively are at increased odds of making social comparisons to peers.

Parental School‐Involvement and Substance Use? A Novel Family‐Based Prevention Strategy for Latino Youth

ObjectiveTo examine the association of parental school involvement with reductions in adolescent substance initiation among Latino immigrant youth.BackgroundParental school involvement is an important determinant of children's academic achievement. Likewise, academic achievement is associated with multiple adolescent health risk behaviors. Little research has examined whether parental school involvement is associated with adolescent drug use, and no research has examined this link among Latino immigrant youth.MethodUsing a census of Latino students (N = 661; mean age = 13.1 years) in 12 urban middle schools, we used a multilevel model with zero‐inflated outcomes to test whether (a) parental school involvement is inversely associated with alcohol, tobacco, and other drug use; (b) school‐level parental involvement affects individual‐level drug use; and (c) child gender moderates these associations.ResultsParental school involvement was negatively associated with lifetime prevalence of all substances and with increases in the age of first alcohol use. School‐level parental involvement was negatively associated with lifetime prevalence of substance use and age of first use for girls and marginally significant with boys.ConclusionParental school involvement is a promising target for prevention efforts to reduce early‐onset substance use.ImplicationsParental school involvement may address multiple negative outcomes in youth even for youth whose parents are relatively uninvolved, and may increase program dosage.

Childhood psychopathology mediates associations between childhood adversities and multiple health risk behaviours in adolescence: analysis using the ALSPAC birth cohort.

BackgroundChildhood adversity strongly predicts adolescent multiple health risk behaviours (MRBs) such as alcohol/tobacco use, self‐harm and physical inactivity, and both adversities and MRBs are associated with premature mortality and several chronic health conditions that are among the leading causes of death in adults. It is therefore important to understand the relationship between adversities and MRBs and what could mediate any association. The aim of this study was to explore whether childhood psychopathology mediates associations between adversities and MRBs.MethodsParticipants were young people in the Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 5,799). Using structural equation modelling, we explored the associations between adversities before 9 years and MRBs at age 16 years. We also explored potential mediating pathways through dimensional psychopathology measured by the Strength and Difficulties Questionnaire subscales at age 12 years.ResultsThere were strong positive associations between adversities and MRBs (β .25, 95% CI 0.20, 0.31, p < .001) suggesting that each additional adversity is associated with a 0.25 increase in number of MRBs out of 13 total risk behaviours. We found robust evidence of mediating pathways from adversities through conduct problems (β .05, 95% CI 0.03, 0.06, p < .001), hyperactivity/inattention (β .02, 95% CI 0.01, 0.03, p < .001) and peer relationship problems (β −.02, 95% CI −0.03, −0.02, p < .001) to MRBs.ConclusionsIncreased conduct problems and hyperactivity/inattention appear to partially explain the relationship between adversities and MRBs. Peer relationship problems also appear to reduce the association between adversities and MRBs, and further research is needed to understand how to encourage peer connectivity without increasing risk of MRBs. These results suggest that interventions aimed at reducing MRBs among those exposed to childhood adversities could focus on prevention of behavioural problems.

Understanding adolescent health risk behaviour and socioeconomic position: A grounded theory study of UK young adults.

Health risk behaviours such as tobacco smoking, excessive alcohol consumption, drug use, unhealthy diet and unprotected sexual intercourse contribute to the global burden of non‐communicable diseases and are often initiated in adolescence. An individualistic focus on ‘health risk behaviours’ has resulted in behaviour change strategies that are potentially ineffective and increase inequalities. We conducted a grounded theory study of 25 young adults to increase the limited qualitative evidence base surrounding young people, health risk behaviours and socioeconomic inequalities. We found that health risk behaviours were perceived as class markers, manifesting as class stigma, leading some participants from lower socioeconomic backgrounds to employ strategies to avoid such behaviours. Peers and family were core constructs for understanding the relationship between health risk behaviours and socioeconomic life trajectories. However, individualism and choice were consistently expressed as the overriding narrative for understanding health risk behaviour and socioeconomic position during the transition to adulthood. The use of ‘personal responsibility’ discourse by young adults, we argue, highlights the need for a public health focus on achieving structural changes as opposed to individualised approaches to avoid reinforcing neoliberal ideologies that serve to marginalise and maintain social inequalities.

Initial engagement and persistence of health risk behaviors through adolescence: longitudinal findings from urban South Africa

BackgroundLittle is known about longitudinal patterns of adolescent health risk behavior initial engagement and persistence in low- and middle-income countries.MethodsBirth to Twenty Plus is a longitudinal birth cohort in Soweto-Johannesburg, South Africa. We used reports from Black African participants on cigarette smoking, alcohol, cannabis, illicit drug, and sexual activity initial engagement and adolescent pregnancy collected over 7 study visits between ages 11 and 18 y. We fit Kaplan-Meier curves to estimate behavior engagement or adolescent pregnancy, examined current behavior at age 18 y by age of first engagement, and performed a clustering analysis to identify patterns of initial engagement and their sociodemographic predictors.ResultsBy age 13 y, cumulative incidence of smoking and alcohol engagement were each > 21%, while the cumulative incidence of other behaviors and adolescent pregnancy were < 5%. By age 18 y (15 y for cannabis), smoking, alcohol, and sexual activity engagement estimates were each > 65%, cannabis and illicit drug engagement were each > 16%; adolescent pregnancy was 31%. Rates of engagement were higher among males. Current risk behavior activity at age 18 y was generally unrelated to age of initial engagement. We identified three clusters reflecting low, moderate, and high-risk patterns of initial risk behavior engagement. One-third of males and 17% of females were assigned to the high-risk cluster. Sociodemographic factors were not associated with cluster membership.ConclusionsAmong urban dwelling Black South Africans, risk behavior engagement across adolescence was common and clustered into distinct patterns of initial engagement which were unrelated to the sociodemographic factors assessed. Patterns of initial risk behavior engagement may inform the timing of primary and secondary public health interventions and support integrated prevention efforts that consider multiple behaviors simultaneously.

Self-concept, interpersonal processes, exploratory and health risk behaviors in adolescents – a study regarding student engagement with school

Self-concept, interpersonal processes, exploratory and health risk behaviors in adolescents – a study regarding student engagement with school

Religious Attendance in a Secular Country Protects Adolescents from Health-Risk Behavior Only in Combination with Participation in Church Activities.

Religiosity and spirituality have been considered to be protective factors of adolescent health-risk behavior (HRB). The aim of this study was to assess the relationship between adolescents’ HRB and their religiosity, taking into account their parents’ faith and their own participation in church activities. A nationally representative sample (n = 13377, 13.5 ± 1.7 years, 49.1% boys) of Czech adolescents participated in the 2018 Health Behavior in School-aged Children cross-sectional study. We measured religious attendance (RA), faith importance (FI) (both of respondents and their parents), participation in church activities and adolescent HRB (tobacco, alcohol, and cannabis use and early sexual intercourse). We found that neither RA nor FI of participants or their parents had a significant effect on adolescents’ HRB. Compared to attending respondents who participate in church activities (AP), non-attending respondents who participate in church activities were more likely to report smoking and early sexual intercourse, with odds ratios (ORs) ranging from 3.14 (1.54–6.39) to 3.82 (1.99–7.35). Compared to AP, non-attending respondents who did not participate in church activities were more likely to report early sexual intercourse, with OR = 1.90 (1.14–3.17). Thus, our findings show that RA does not protect adolescents from HRB; they suggest that RA protects adolescents from HRB only in combination with participation in church activities.

Emotional and behavioural pathways to adolescent substance use and antisocial behaviour: results from the UK Millennium Cohort Study.

This study examines the emotional and behavioural pathways to adolescent substance use and antisocial behaviour. Using a sample of 17,223 participants from the UK Millennium Cohort Study, we applied parallel-process growth mixture modelling on emotional and behavioural symptoms in those aged 3-14 and employed latent class analysis to identify patterns of substance use and antisocial behaviours at age 14. We then performed a multinomial regression analysis to explore the association between emotional and behavioural trajectories and patterns of adolescent substance use and antisocial behaviours, including sociodemographic, family, and maternal factors. We found five trajectories of emotional and behavioural symptoms and four classes of adolescence substance use and antisocial behaviour. Children and adolescents in the 'high externalising and internalising' and 'moderate externalising' trajectories were more likely to belong to any problematic behaviour class, especially the 'poly-substance use and antisocial behaviours' class. Inclusion in the 'moderate externalising and internalising (childhood limited)' class was associated with higher odds of belonging to the 'alcohol and tobacco' class. These associations remained significant after adjusting for important sociodemographic and contextual factors, such as maternal substance use, poverty, and parental status. Interventions on adolescent health promotion and risk behaviour prevention need to address the clustering of substance use and antisocial behaviour as well as the significant influence of early and chronic internalising and externalising symptoms on the aetiology of these behaviours.

VIOLENCE-RELATED BEHAVIORS AMONG SCHOOL GOING ADOLESCENTS IN PENINSULAR MALAYSIA

Violence among adolescents is a significant public health issue. The focus was on school-going adolescents because of the life-long negative impact at an individual level both for the perpetrator and victim. Besides, it increases the costs to provide health, welfare, and criminal justice as well as decreases general productivity at the community level. The study aims to determine the prevalence of violence-related behavior, characteristics of both victims and perpetrators, in addition to inter and intrapersonal factors associated with violence-related behaviors. A study was carried out in 2013, which involved all upper secondary school students (aged 16 to 17 years). It was a part of the Malaysian Adolescent Health Risk Behavior (MyAHRB) study, which was conducted in 11 states in Peninsular Malaysia. Standardized, validated questionnaires were used for data collection. The prevalence of violence-related behaviors was 22.4%, and this was higher among male students as compared to females (29.1% vs. 16.3%). Multivariable analysis revealed that the odds of violence-related behaviour increased among males, Malay race, drug use, smoking, had exposure to sex, which sometimes and always felt lonely and had attempted suicide. Agreeable to ensure that their lifestyles do not transgress religious limit and belief was significantly protective. This study provides evidence for a targeted approach to combat violence-related behaviors among adolescents.

Comportamentos de Risco à Saúde em adolescentes: uma associação entre o Tempo de Televisão e uso de álcool

The objective of this study was to describe health risk behaviors in adolescents and to verify the possible associations between them. It was a cross-sectional study conducted in Teresina / PI, with 540 adolescents aged 14 to 19 years. The instrument used for data collection was an adaptation of the COMPAC project questionnaire. About 35% of teens reported watching television for four hours, only 22% reported using their computer for one to two hours, while 60% reported using their cell phone for more than four hours during the week. The percentage of adolescents considered physically inactive was greater than 35%. More than 15% of adolescents consumed alcoholic beverages one to two times, and 11% consumed up to two doses per week. The amount of daily doses of alcoholic beverages was significantly associated with TV watching time per week (OR = 2.45, p = 0.040) and at the weekend (OR = 2.05, p = 0.032). It was found a high prevalence of physically inactive adolescents and time spent in sedentary behaviors. In addition, sedentary behavior was associated with alcohol consumption. Thus, it is important to rethink television and alcohol use in adolescents' daily lives.

Studies on Male Adolescent Health-Risk Behaviors in East Kassala Locality - Kassala State, Sudan

Adolescent health risk behaviors are becoming a serious health care as adolescents engage in health-compromising behaviors at a high frequency in several crucial domains. One domain involves tobacco, alcohol, and illicit drug use. This is a cross section study covered 405 adolescents recruited randomly from Kassala locality, Kassala state, Sudan 2016, data was collected via closed ended standardized questionnaires. Pre testing was done to ensure quality survey instruments and fieldwork procedures were conducted. The fieldwork was coordinated by the Research Team Members, who will also provide the overall supervision during fieldwork to ensure quality and consistency among the teams. Ten data collectors was carrying out the fieldwork. Adolescent participating in the study showed variations in information about behavioral and psychological changes associated with adolescence, concerning the knowledge of the male adolescences regarding the associated with health changes with adolescences, about 89.5% knew those change and effects in general and 44% of them thought that the changes are physical while 25.2% thought that these changes are Psychological &amp; emotional.

Is Mental Health Competence in Childhood Associated With Health Risk Behaviors in Adolescence? Findings From the UK Millennium Cohort Study

PurposePromoting positive mental health, particularly through enhancing competencies (such as prosocial behaviors and learning skills), may help prevent the development of health risk behaviors in adolescence and thus support future well-being. Few studies have examined how mental health competencies in childhood are associated with adolescent health risk behaviors, which could inform preventative approaches. MethodsUsing UK Millennium Cohort Study data (n = 10,142), we examined how mental health competence (MHC) measured at the end of elementary school (11 years) is associated with self-reported use of cigarettes, e-cigarettes, alcohol, illegal drugs, antisocial behavior, and sexual contact with another young person at age 14 years. A latent measure of MHC was used, capturing aspects of prosocial behavior and learning skills, categorized as high MHC, high–moderate MHC, moderate MHC, and low MHC. Logistic and multinomial regression estimated odds ratios and relative risk ratios for binary and categorical outcomes, respectively, before and after adjusting for confounders. Weights accounted for sample design and attrition and multiple imputation for item missingness. ResultsThose with low, moderate, or high-moderate MHC at age 11 years were more likely to have taken part in health risk behaviors at age 14 years compared with those with high MHC. The largest associations were seen for low MHC with binge drinking (relative risk ratio: 1.6 [95% confidence interval: 1.1–2.4]), having tried cigarettes (odds ratio: 2.2 [95% confidence interval: 1.6-3.1]) and tried illegal drugs (odds ratio: 2.0 [95% confidence interval: 1.3-3.1) after adjusting for confounders (which attenuated results but largely maintained significant findings). ConclusionsMHC in late childhood is associated with health risk behaviors in midadolescence. Interventions that increase children's MHC may support healthy development during adolescence, with the potential to improve health and well-being through to adulthood.

Doing Nothing is Sometimes Worse: Comparing Avoidant versus Approach Coping Strategies with Peer Victimization and Their Association to Depression and Suicide Ideation

ABSTRACT Peer victimization is a major stressor adolescents often face in the school environment, and has been linked to depression and suicidal risk. This study analyzed the associations between three behavioral coping strategies (avoidance, seeking social support from adults/peers, and retaliation) and depression and suicidal ideation. Participants included 4,254 victimized students who were part of the Saving and Empowering Young Lives in Europe (SEYLE) study that compared three school-based prevention interventions and collected information on health risk behaviors in adolescents from 11 European countries. Results showed behavioral avoidance to be associated with an increase in levels of depression, as compared to the other coping strategies (adult social support, peer social support, retaliation). Seeking social support from adults was associated with lower depression and suicidal ideation rates. A more than 25% increase in suicidal ideation was associated with behavioral avoidance, compared to seeking social support from adults. By contrast, retaliation to peer victimization was not found to be associated with increased depression or suicidal ideation. The findings support the Coping Deficit model and may suggest that abstaining by doing nothing when victimized can be associated with certain adverse emotional outcomes.

Correlation analysis between adolescent cognitive ability and health risk behaviors

Objective To explore the status of adolescents' health risk behaviors, relationship between cognitive ability and health risk behaviors, and provide an empirical reference for reducing the occurrence and early prevention of health risk behaviors among adolescents. Methods Samples were extracted by hierarchical, multi-stage, probability and scale proportional (PPS) methods. There were 112 schools randomly selected from 28 county-level regions (county, district, city), and 19 487 students were investigated by baseline survey, a follow-up study was conducted among 8 636 students during 2014-2015. Descriptive statistical methods of using 2 test and t test, and logistic multivariate regression analysis were used to analyze the relationship between cognitive abilities and healthy risk behaviors. Results The reported rate of a healthy risk behavior was 20.77%, and the incidence of more than one type of health risk behavior was 16.03%. The student’s cognitive ability standardized score was (0.33±0. 82). The average score of cognitive ability of adolescents with healthy risk behavior was 0.14, which was lower than the average score of cognitive ability of adolescents without healthy risk behaviors (0.43). Boys, having rural household registeration, non-residential schools, and parents with low education levels adolescents were more likely to be involved in health behavior risks. There was a significant correlation between adolescent cognitive ability and healthy risk behavior ( OR = 0.67, P <0.01). Conclusion The current status of adolescent health risk behaviors is worrying. The cognitive ability has a significant impact on health risk behaviors. It is recommended to use the cognitive ability of adolescents as a starting point to prevent and reduce the occurrence of adolescent health risk behaviors. 【摘要】目的 探究青少年健康危险行为现状及其与认知能力的关系，为减少青少年健康危险行为的发生及早期预 防提供实证参考。 方法 采用分层次、多阶段、概率与规模成比例（PPS)的方法，从全国28个县级单位（县、区、市）随机抽 取112所学校，2013—2014学年基线调査19 487名学生，2014—2015学年追踪调査8 636名初中学生。运用妒检验、《检 验的描述性统计方法，以及Logistic多因素回归分析认知能力与健康危险行为的关系。 结果 学生存在1种健康危险行为 的报告率为20.77%，1种以上的健康危险行为报告率为16.03%。学生认知能力标准化得分为（0.33±0.82)分。有健康危 险行为的青少年认知能力标准化得分均分为0.14分，没有健康危险行为青少年的得分为0.43分。男性、农村户口、非住 校、父母受教育程度低的青少年更容易发生健康危险行为。Logistic回归分析显示，青少年认知能力与其健康危险行为的 相关有统计学意义（ OR = 0.67， P <0.01)。 结论 青少年健康危险行为现状堪忧，认知能力对健康危险行为的影响显著。建 议以青少年的认知能力为出发点，预防和减少青少年健康危险行为的发生。

Physical Disorders are Associated with Health Risk Behaviors in Chinese Adolescents: A Latent Class Analysis.

It is known that health risk behaviors (HRBs) can lead to a variety of physical and mental health problems among adolescents, but few studies have paid attention to the relationship between latent classes of HRBs and adolescent diseases. The purpose of this study was to use latent class analysis (LCA) to clarify the potential subgroups of HRBs (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries) and examine the association between the subgroups of HRBs and physical disorders (diarrhea, fever, cough, and vomiting) with multiple logistic regression analysis, in Chinese adolescents. Self-reported HRBs and physical disorders were used to evaluate 22,628 middle school students in six cities of China, from November 2015 to January 2016, based on a multistage stratified cluster sampling approach. The prevalence of diarrhea, fever, cough, and vomiting was 23.5%, 15.9%, 50.6%, and 10.7%, respectively. We identified four latent classes of HRBs by LCA, including low-risk class, moderate-risk class 1 (smoking, drinking, and screen time), moderate-risk class 2 (non-suicidal self-injuries and suicidal behaviors, unintentional injuries), and high-risk class (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries), which were 64.0%, 4.5%, 28.8% and 2.7% of participants, respectively. Compared to the low-risk class, all other classes showed higher risk for these physical disorders (P < 0.01 for each). In particular, the high-risk class had the highest risk (diarrhea (odds ratio (OR) = 2.628, 95% confidence interval (CI) 2.219 to 3.113), fever (OR = 3.103, 95% CI 2.591 to 3.717), cough (OR = 2.142, 95% CI 1.805 to 2.541), and vomiting (OR = 3.738, 95% CI 3.081 to 4.536). In conclusion, these results indicated that heterogeneity exists in HRBs, and subgroups of HRBs were correlated to the occurrence of common physical disorders in Chinese adolescents. Therefore, multiple HRBs rather than single factors should be considered for the prevention of common physical disorders in schools.

Role of Sleep Duration in the Association Between Socioecological Protective Factors and Health Risk Behaviors in Adolescents.

The purpose of this study was to examine the associations of sleep duration and socioecological protective factors with patterns of adolescent risk behaviors in Fairfax County, VA-one of the largest public school districts in the United States. A total of 21,360 and 20,330 students in 10th and 12th grades who completed the Youth Risk Behavior Survey were included in this cross-sectional analysis. Sleep duration was measured by self-report of the average number of hours of sleep on a school night. Ten socioecological protective factors included peer-individual, family, school, and community domains. Latent class analysis was used to classify 7 risk behaviors (alcohol use, cigarette use, illicit drug use, inappropriate prescription drug use, risky sexual behavior, deviant behavior, and academic failure) into 4 class memberships (low, some, moderate, and high). Multinomial regression models were adjusted for age, sex, and race. Adolescents who reported sleeping the recommended 8 to 9 hours were significantly less likely to belong to the class memberships of greater risk behaviors compared with those who reported short and long sleep duration after controlling for age, sex, race, and survey year. There was a significant inverse relationship between the number of socioecological protective factors and risk behaviors for both 10th and 12th graders. Potential risks of age, sex, and race on risk behaviors were observed. No significant interaction between sleep duration and protective factors was found in either grade. This study highlights the significant associations between sleep duration and risk behaviors in adolescents with diverse socioecological protective factors. Prioritization of prevention-focused resources should consider sleep duration in addition to the socioecological protective factors commonly cited in the literature when addressing adolescent risk behaviors.

Underweight, body image, and weight loss measures among adolescents in Saudi Arabia: is it a fad or is there more going on?

Background and ObjectiveAdolescence is considered to be a pivotal point in which optimum nutrition and eating habits are developed. Although tackling the obesity epidemic has been much discussed, addressing the issue of underweight and body image is often neglected. This study was carried out to get a better understanding of underweight status among adolescents in Saudi Arabia, and exploring self-perceptions of body image and weight loss measures among underweight adolescents.MethodsData from Jeeluna®, a national cross-sectional school-based survey were utilized. Jeeluna® assessed the health status and health-risk behaviors of adolescents in school through data obtained by a self-administered questionnaire, anthropologic measurements, and laboratory investigations.ResultsA total of 12,463 adolescents participated. Eighteen percent of adolescent males and 12.4% of females were found to be underweight, representing 14.9% of adolescents collectively. Forty-five percent of underweight participants were happy with their weight. Underweight females between the age group of 10 and 14 years were the most likely to believe that they still need to lose weight (16.0%) followed by females aged 15–19 years (9.7%). Underweight females aged 10–14 years were also the group most likely to engage in purging (1.6%). Stepwise logistic regression found that the strongest association with being underweight was with having a lower household income (OR 2.0, CI 1.5–2.7) and having more than 5 siblings (OR 1.8, CI 1.5–2.3).ConclusionUnderweight status is prevalent among adolescents in Saudi Arabia and deserves more attention as a public health issue. Distorted body image and disordered eating behaviors exist, necessitating further investigation of underlying causes.

ASSOCIATION BETWEEN PHYSICAL ACTIVITY PRACTICE AND CLUSTERING OF HEALTH RISK BEHAVIORS IN ADOLESCENTS.

ABSTRACTObjective: To verify the association between participation in physical activity (PA) and the clustering of health risk behaviors (HRB) in adolescents of both genders.Methods: A cross-sectional study involving 862 adolescents (11 to 17 years old) enrolled in 14 randomly selected public schools from Curitiba, Paraná, Brazil. Participation in PA, screen time, consumption of fruit, vegetables, cigarettes and alcoholic beverages were the criteria evaluated. Multinomial logistic regression tested the association between participation in PA and clustering of HRB, and results are expressed Odds Ratio (OR) with 95% confidence intervals (95%CI).Results: Adolescents with high participation in PA had lower odds of clustering 2-3 HRB (OR 0.38, 95%CI 0.21-0.68; p<0.01) and 4-5 HRB (OR 0.29; 95%IC 0.16-0.53; p<0.01). Boys with high participation in PA had lower chances of clustering 2-3 HRB (OR 0.31, 95%CI 0.13-0.75; p=0.01), and girls had lower odds of clustering 2-3 HRB (OR 0.41; 95%CI 0.17-0.99; p=0.04) and 4-5 HRB (OR 0.25; 95%CI 0.10-0.61; p<0.01).Conclusions: High participation in PA was inversely associated with the clustering of HRB in adolescents.

Insular Risk Processing Predicts Alcohol Use Via Externalizing Pathway in Male Adolescents

Male adolescents exhibit greater impulsivity and externalizing symptomatology relative to female adolescents. Furthermore, externalizing symptomatology has been associated with greater alcohol use and differential anterior insula functioning. The current longitudinal study on adolescents examined whether activity in the anterior insula, when processing uncertain outcomes and representing risk, is directly associated with gender differences in later adolescent alcohol use frequency, as well as indirectly through externalizing symptomatology. Using functional magnetic resonance imaging, we examined whether gender moderated these associations in a sample of 161 adolescents (53% male) with repeated annual measurements over 3 years. We monitored responding of a region implicated in risk processing during an economic lottery choice task involving uncertain outcomes. Self-reported externalizing symptomatology and alcohol use frequency were collected at all time points. Results indicated that there was a significant indirect effect of anterior insula processing during the task at Time 1 on alcohol use at Time 3 through externalizing symptomatology at Time 2 for male, but not female, adolescents. Externalizing symptomatology predicted alcohol use for both male and female adolescents. The findings suggest gender differences in vulnerability to later alcohol use, specifically in terms of how a neurobiological susceptibility to risk insensitivity may disproportionately influence male adolescents' externalizing symptomatology. Male adolescents who do not effectively integrate risk-related signals are likely to engage in externalizing behaviors, which in turn are related to later alcohol use. Findings also suggest differential roles of risk-related brain function that contribute to gendered pathways to adolescent health-risk behaviors.