Population-based Sample Of Adolescents Research Articles

Overeating with and without loss of control: Associations with weight status, weight-related characteristics, and psychosocial health.

The relative importance of loss of control and overeating in the relationship between binge eating and eating-related and general psychopathology has been debated in the literature. This study assessed the prevalence and correlates of overeating with and without loss of control within a diverse, population-based sample of adolescents. A highly diverse (81.1% non-White) sample of adolescents (n = 2,793) from EAT-2010 (Eating and Activity in Teens) completed self-report questionnaires assessing eating-related psychopathology, substance use, nonsuicidal self-injury, depressive symptoms, and self-esteem. Overeating without loss of control was reported by 6.9% of girls and 5.0% of boys, while 9.6% of girls and 6.3% of boys reported overeating with loss of control (binge eating). Overall, overeating (with or without loss of control) was positively associated with unhealthy or extreme weight control behaviors, dieting, nonsuicidal self-injury, lower body satisfaction, and self-esteem, and higher depressive symptoms relative to no overeating. Among girls, binge eating was associated with unhealthy or extreme weight control behaviors, lower self-esteem, and higher depressive symptoms relative to overeating without loss of control, while in boys, binge eating was associated with greater cigarette usage, lower body satisfaction, and greater depressive symptoms than overeating without loss of control (although cigarette usage was comparable in boys reporting binge eating and no overeating). Any overeating, with or without loss of control, was associated with multiple adverse correlates among adolescents. Loss of control was uniquely associated with multiple health indicators, further highlighting its importance as a marker of severity of overeating.

Abstract P075: Stroke Volume and Visceral Fat Drive Differences in Blood Pressure Between Two Generations: A Population-Based Study of Adolescents and Their Parents

Excess total body fat (TBF) and visceral fat (VF) are major risk factors of hypertension. Blood pressure (BP) increases with age, as do TBF and VF. Here we investigated whether TBF and VF contribute to BP differences between adolescents and adults. A population-based sample of adolescents (n=933, 12-18 years) and their parents (n=429, 38-65 years) was studied as part of the Saguenay Youth Study. In all participants, beat-by-beat values of SBP, DBP and underlying hemodynamic parameters (heart rate, stroke volume [SV] and total peripheral resistance) were obtained with a Finometer during a 52-minute protocol mimicking daily life activities and including posture and math-stress tests. TBF was assessed by bioelectrical impedance and VF was examined by magnetic resonance imaging. SBP was higher in parents than adolescents by an average of 10.2±0.3 mmHg in males and 9.1±0.3 mmHg in females (p<0.0001 for both sexes). DBP differed minimally throughout the protocol (p=0.3 and 0.1, respectively). In males and females, respectively, the ‘generation’ differences in SBP were reduced to 6.0±0.1 and 4.3±0.1 mmHg when adjusted for height and TBF (p<0.0001 for both), and were further reduced to 1.9±0.1 and 2.5±0.2 mmHg when additionally adjusted for VF (p=0.1 and 0.02). Of the underlying hemodynamic parameters, only SV was higher in parents than adolescents (by 46±2 ml in males and 39±2 ml in females, p<0.0001 for both). Again, the ‘generation’ differences in SV were reduced to 23±1 (males) and 20±1 ml (females) when adjusted for height and TBF (p<0.0001 for both sexes), and were further reduced to 11.8±0.6 and 15.7±0.8 ml when additionally adjusted for VF (p<0.0001 for both sexes). These results suggest that the transition from adolescence to middle-aged adulthood is associated with an increase in SBP (but not DBP), which is driven mainly by SV augmentation. They also suggest that VF contributes to the generational differences in both SBP and SV above and beyond the contribution of TBF, despite VF being a relatively small fraction of TBF. The co-occurrence of these differences in VF, SV and SBP may be related to sympathoactivation and renal handling of sodium and water reabsorption; further research is required to confirm this possibility.

Abstract P181: Circulating Second-messenger Glycerophosphocholines and Cardiovascular Risk Factors in a Population-based Sample of Adolescents

Circulating second-messenger glycerophosphocholines (smGPCs), including lysophosphatidylcholines and platelet-activating factors, are low-abundance plasma phospholipids that modulate atherosclerosis and inflammation and, in turn, the risk for cardiovascular disease (CVD). Although CVD is a slow-progressing disease culminating in middle-to-late adulthood, its initial stages may be seen already in adolescence. Here, we investigated whether circulating smGPCs are associated with classical CVD risk factors - excess body fat, elevated BP, insulin resistance and low-grade inflammation - during adolescence. We studied a population-based sample of 1029 adolescents (52% females, 12-18 years), as part of the Saguenay Youth Study. We used targeted serum lipidomics (LC-ESI-MS) to identify and quantify circulating smGPCs within the 440-640 Da range. In all participants, we also measured: (i) visceral fat with MRI and total body fat with bioimpedance; (ii) blood pressure (BP) beat-by-beat for five minutes under standard clinical conditions; and (iii and iv) fasting serum insulin (as an index of insulin resistance) and CRP (as an index of low-grade inflammation). We identified a total of 81 smGPCs that varied by the length and saturation of their fatty acyl residues and the type of linkage these residues are attached to the glycerol backbone. Over 30 of them were associated with multiple CVD risk factors (p<6x10 -4 ). Most of these associations were inverse and involved ‘medium’ mass smGPCs. Positive associations were also seen and these involved ‘low’ or ‘high’ mass smGPCs. Most strongly inversely associated smGPCs were: (i) PC(20:6/0:0) and PC(O-18:6/2:0), which were associated with total body fat (p<3x10 -14 ) and CRP (p<8x10 -36 ); and (ii) PC(16:0/2:0), which was associated with visceral fat (p=2x10 -18 ) and BP (p<1x10 -5 ). The most strongly positively associated smGPC was PC(14:1/0:0), which was associated with visceral fat (p=8x10 -8 ) and fasting insulin (p=2x10 -24 ). Thus, specific circulating smGPCs are strongly associated with multiple CVD risk factors in adolescence; some of these associations may be ‘protective’ whereas others ‘adverse’. Circulating smGPCs may serve as novel biomarkers of early risk for CVD.

Let's Get Physical: Sexual Orientation Disparities in Physical Activity, Sports Involvement, and Obesity Among a Population-Based Sample of Adolescents.

We examined sexual orientation disparities in physical activity, sports involvement, and obesity among a population-based adolescent sample. We analyzed data from the 2012 Dane County Youth Assessment for 13,933 students in grades 9 through 12 in 22 Wisconsin high schools. We conducted logistic regressions to examine sexual orientation disparities in physical activity, sports involvement, and body mass index among male and female adolescents. When we accounted for several covariates, compared with heterosexual females, sexual minority females were less likely to participate in team sports (adjusted odds ratio [AOR] = 0.44; 95% confidence interval [CI] = 0.37, 0.53) and more likely to be overweight (AOR = 1.28; 95% CI = 1.02, 1.62) or obese (AOR = 1.88; 95% CI = 1.43, 2.48). Sexual minority males were less likely than heterosexual males to be physically active (AOR = 0.62; 95% CI = 0.46, 0.83) or to participate in team sports (AOR = 0.26; 95% CI = 0.20, 0.32), but the 2 groups did not differ in their risk of obesity. Sexual orientation health disparities in physical activity and obesity are evident during adolescence. Culturally affirming research, interventions, and policies are needed for sexual minority youths.

Association between levels of serum bisphenol A, a potentially harmful chemical in plastic containers, and carotid artery intima-media thickness in adolescents and young adults.

Bisphenol A (BPA) is a chemical produced at high volumes and used widely in food and drink packaging. In adults, elevated BPA concentrations are associated with cardiovascular disease. BPA exposure is plausibly linked to atherosclerosis in adolescents and young adults, but evidence is lacking to date. We recruited 886 subjects (12-30 years of age) from a population-based sample of adolescents and young adults based on a mass urine screening to determine the relationship between serum levels of BPA and carotid intima-media thickness (CIMT). The geometric mean (standard deviation) of concentrations of BPA were 1.72 (5.5) ng/mL After controlling for confounding factors, linear regression analyzes showed a 1-unit increase in natural log BPA was significantly associated with an increase in mean CIMT (mm) (β=0.005, 95% C.I.=0.003-0.007, p<0.001) and other measurement of CIMT (including right and left side of common carotid artery, carotid bulb and internal carotid artery). Higher serum concentrations of BPA were associated with increased CIMT in this cross-sectional study of adolescents and young adults. Studies to clarify the mechanisms of these associations are needed.

Antisocial behavior reduces the association between subdimensions of ADHD symptoms and alcohol use in a large population-based sample of adolescents.

The aim of this study was to investigate possible effects of antisocial behavior on reducing the association between subdimensions of ADHD symptoms (inattention, hyperactivity and impulsivity) and alcohol use. Boys and girls were analyzed separately using a population-based Swedish adolescent sample. A randomly selected cross-sectional survey was performed in secondary and upper secondary schools in Västmanland County during 2010. Participants were a population of 2,439 15-16 year-olds and 1,425 17-18 year-olds (1,947 girls and 1,917 boys). Psychosocial adversity, antisocial behaviors, symptoms of ADHD and alcohol use were assessed by questionnaires. Except for girls' inattention, subdimensions of ADHD symptoms were not associated with alcohol use when variance due to antisocial behavior was accounted for. Among boys, instead of an indirect effect of antisocial behavior on the association between impulsivity and alcohol use, a moderating effect was found. Among girls, the inattention component of ADHD was independently associated with alcohol use even when adjusted for antisocial behavior. The reduced associations between symptoms of hyperactivity, impulsivity, and alcohol use for boys and girls after adjusting for antisocial behavior suggest a considerable overlap between hyperactivity, impulsivity, and antisocial behavior. The direct pathway between inattention and alcohol use among girls suggests that girls with inattention symptoms are at risk of alcohol use regardless of antisocial behavior. Special attention should be given to these girls. Accounting for antisocial behavior reduced the relation between subdimensions of ADHD symptoms and alcohol use, and antisocial behaviors should therefore be screened for when symptoms of ADHD are present.

Sleep variability and cardiac autonomic modulation in adolescents – Penn State Child Cohort (PSCC) study

ObjectiveTo investigate the effects of objectively measured habitual sleep patterns on cardiac autonomic modulation (CAM) in a population-based sample of adolescents. MethodsWe used data from 421 adolescents who completed the follow-up examination in the Penn State Children Cohort study. CAM was assessed by heart rate (HR) variability (HRV) analysis of beat-to-beat normal R-R intervals from a 39-h electrocardiogram, on a 30-min basis. The HRV indices included frequency domain (HF, LF, and LF/HF ratio), and time domain (SDNN, RMSSD, and heart rate or HR) variables. Actigraphy was used for seven consecutive nights to estimate nightly sleep duration and time in bed. The seven-night mean (SD) of sleep duration and sleep efficiency were used to represent sleep duration, duration variability, sleep efficiency, and efficiency variability, respectively. HF and LF were log-transformed for statistical analysis. Linear mixed-effect models were used to analyze the association between sleep patterns and CAM. ResultsAfter adjusting for major confounders, increased sleep duration variability and efficiency variability were significantly associated with lower HRV and higher HR during the 39-h, as well as separated by daytime and nighttime. For instance, a 1-h increase in sleep duration variability is associated with −0.14(0.04), −0.12(0.06), and −0.16(0.05) ms2 decrease in total, daytime, and nighttime HF, respectively. No associations were found between sleep duration, or sleep efficiency and HRV. ConclusionHigher habitual sleep duration variability and efficiency variability are associated with lower HRV and higher HR, suggesting that an irregular sleep pattern has an adverse impact on CAM, even in healthy adolescents.

The circadian pattern of cardiac autonomic modulation and obesity in adolescents.

To assess the impact of obesity and population attributes on the circadian pattern of cardiac autonomic modulation (CAM) in a population-based sample of adolescents. We used data from 421 adolescents who completed the follow-up exam in the Penn State Children Cohort study. CAM was assessed by heart rate variability (HRV) analysis of beat-to-beat, normal R-R intervals from a 24-hour ECG, on a 30-minute basis. The HRV indices included frequency-domain (HF, LF, and LF/HF ratio) and time-domain (SDNN, RMSSD, and HR) variables. Nonlinear mixed-effect models were used to calculate a cosine periodic curve, each having three parameters quantifying its circadian period: M (mean levels of the HRV variables), Â (amplitude of the oscillation), and θ (the time of the highest oscillation). The mean (SD) age was 16.9 (2.2)years, with 54% male and 77% white. The mean BMI percentile was 66, with 16% obese (BMI percentile≥95). Overall, HF (a marker of parasympathetic modulation) gradually increased from the late afternoon, reached peak amplitude around 3a.m., and then decreased throughout the daytime until late afternoon. In contrast, obesity had adverse effects on all circadian parameters. The age, sex and race showed varying differences on the CAM circadian parameters. The adjusted means (95%Cls) of M, Â, and θ for HF were 5.99 (5.79-6.19), 0.77 (0.66-0.89), 3:15 (2:15-4:15) a.m., and 6.21 (6.13-6.29), 0.66 (0.61-0.70), 2:45 (2:30-3:15) a.m. for obese and non-obese subjects, respectively. The circadian pattern of CAM can be quantified by the three cosine parameters. Obesity is associated with lower HRV even in young individuals like children/adolescents.

Abdominal Obesity and Metabolic Syndrome Burden in Adolescents—Penn State Children Cohort Study

To investigate the association between abdominal obesity and metabolic syndrome (MetS) burden in a population-based sample of adolescents, we used data from 421 adolescents who completed the follow-up examination in the Penn State Children Cohort study. Dual-energy x-ray absorptiometry (DXA) was used to assess abdominal obesity, as measured by android/gynoid fat ratio (A/G ratio), android/whole body fat proportion (A/W proportion), visceral (VAT) and subcutaneous fat (SAT) areas. Continuous metabolic syndrome score (cMetS), calculated as the sum of the age and sex-adjusted standardized residual (Z-score) of five established MetS components, was used to assess the MetS burden. Linear regression models were used to analyze the impact of DXA measures on cMetS components. All models were adjusted for age, race, sex, and general obesity. We found abdominal obesity is significantly associated with increased cMetS. With 1 standard deviation (SD) increase in A/G ratio, A/W proportion, VAT area, and SAT area, cMetS increased by 1.34 (SE=0.17), 1.25 (SE=0.19), 1.67 (SE=0.17), and 1.84 (SE=0.20) units, respectively. At individual component level, strongest association was observed between abdominal obesity and insulin resistance (IR) than lipid-based or blood pressure-based components. VAT and SAT had a stronger impact on IR than android ratio-based DXA measurements. In conclusion, abdominal obesity is associated with higher MetS burden in adolescent population. The association between abdominal obesity and IR measure is the strongest, suggesting the key impact of abdominal obesity on IR in adolescents MetS burden.

Maternal psychological distress mediates the relationship between asthma and physician visits in a population-based sample of adolescents

Objective: This study examined whether maternal psychological distress mediates the relationship between presence of adolescent asthma and number of physician visits and whether the association between maternal psychological distress and physician visits is moderated by adolescent general health. Methods: Data were obtained from the Mater University Study of Pregnancy and included 4025 adolescents. Path analysis was used to examine mediating and moderating effects. Results: Maternal psychological distress was found to partially mediate the relationship between adolescent asthma and number of physician visits, accounting for 25% of the effect of adolescent asthma on physician visits (p = 0.046). There was no evidence to suggest that adolescent general health moderated the association between maternal psychological distress and physician visits (p = 0.093). Conclusions: These findings suggest that maternal psychological distress is associated with increased physician visits, regardless of adolescents’ general health. Lowering maternal psychological distress may serve to reduce health care utilization and costs among adolescents with asthma.

Nonsuicidal self-injury in adolescence: longitudinal course, trajectories, and intrapersonal predictors.

Although prevalence rates of nonsuicidal self-injury (NSSI) has been established throughout adolescence, little is known about the progression of NSSI, and consequently, about the risk factors for youth NSSI engagement. This study aimed to describe the overall longitudinal course of NSSI and the latent trajectory classes of NSSI in a population-based sample of adolescents using multi-wave data. Moreover, this study examined whether sex, lifetime history of depression, rumination, and negative attributional style predicted the longitudinal course of NSSI and trajectory group membership. Participants were 617 Chinese adolescents in Grades 10 through 12 (51.4 % girls). NSSI was assessed across eight waves of data. History of depression, rumination, and negative attributional style were assessed at baseline. Latent growth curve modeling revealed that only lifetime depression predicted the longitudinal course of NSSI from Grades 10 to 12, with depressed adolescents showing greater and more stable NSSI engagement over time than non-depressed adolescents. Group-based trajectory modeling yielded three distinct trajectory classes of NSSI engagement: low (69.2 %), moderate (26.1 %), and chronic (4.7 %). Negative attributional style distinguished adolescents in the chronic vs. low and moderate NSSI trajectory classes. Sex, rumination, and lifetime depression predicted membership in the chronic and/or moderate vs. low NSSI trajectory class. NSSI trajectory classes, based on frequency of NSSI, exist and are differentiated by sex, depression history, rumination, and negative attributional style. This study suggests that during this period of adolescence NSSI may be a relatively stable behavior, especially for some adolescents. Negative attributional style may be a salient risk factor for chronic NSSI engagement.

Association between malocclusion and headache among 12- to 15-year-old adolescents: a population-based study.

Headaches are a common problem among adolescents, and malocclusion is a possible risk factor. The purpose of this study was to investigate the association between malocclusion and headache among Japanese adolescents aged 12-15 years using a population-based sample. A total of 938 adolescents (94.7% of the target population in Koshu City) participated. A modified version of the Index of Orthodontic Treatment Need (IOTN) was used by orthodontists to evaluate occlusal characteristics, and the frequency of headaches (none, rarely, sometimes) was assessed via questionnaire (N = 938). Ordered logistic regression analyses were used to analyze the association between malocclusion and headache. The prevalence of malocclusion diagnosed using the modified version of the IOTN was 44.9%. Multiple ordered logistic regression analyses showed that the odds ratio (OR) of having malocclusion for headache was 1.38 (95% confidence interval [CI]: 1.06-1.80), after adjustment for demographics, lifestyle, and dental status including orthodontic treatment history and tooth size. Moreover, among occlusal traits, lower crowding was independently associated with headache (OR: 1.64, 95% CI: 1.07-2.51). We found that malocclusion, especially lower crowding, was associated with headache in a population-based sample of adolescents aged 12-15 years in Japan. Further study is needed to elucidate the mechanisms by which malocclusion affects headache.

Abstract P200: The Circadian Pattern of Cardiac Autonomic Modulation and its Correlates in Adolescents- Penn State Child Cohort (PSCC) Study

Objective: To examine the circadian pattern of cardiac autonomic modulation (CAM) and its correlates in a population-based sample of adolescents. Methods: We used the data from 400 adolescents who completed the follow up exam in the PSCC study. CAM was assessed by heart rate variability (HRV) analysis of beat-to-beat normal R-R intervals from a 24-hour (7:00 PM to 7:00 PM) ECG, on a 30-minute basis (48 segments/person). The HRV indices included frequency domain: [high and low frequency powers (HF, LF), and LF/HF ratio] and time domain: [standard deviation of normal RRs (SDNN), and the square root of the mean squared difference of successive normal RRs (RMSSD), and heart rate (HR)]. We used a cosine periodic model to estimate each participant’s circadian parameters: mean (M), amplitude (Â), and crescent time (θ). We then used mixed-effects models to calculate group level circadian pattern as the overall M, Â of the oscillation, and θ of the highest oscillation. Results: The mean age was 16.9 yrs (SD=2.2), with 54% male and 77% white. The mean BMI percentile is 61, with 16% were obese (BMI percentile ≥ 95). Overall, the parasympathetic modulation gradually increases from late afternoon throughout the evening, and reaches the peak amplitude around 3:00 AM, at which it gradually decrease throughout most of the daytime until late afternoon. The age, sex and race showed varying differences on the CAM circadian parameters. In contrast, obesity in adolescents had adverse effects on all three circadian parameters. Using HF (a reliable index of parasympathetic modulation) as an example, the circadian pattern of the entire sample, and stratified by obesity are shown in Figure 1. Conclusion: Circadian pattern of CAM can be quantified by three cosine parameters (M, Â, and θ). Obesity in adolescents is already associated with a CAM profile indicative of sympathetic overflow and reduced parasympathetic modulation, at all levels of the CAM circadian rhythm.

Abstract P242: Abdominal Adipose Tissue Distribution and Metabolic Syndrome Burden in Adolescents - Penn State Child Cohort (PSCC) Study

Objectives: To investigate the association between abdominal adipose tissue distribution and metabolic syndrome burden in a population-based sample of adolescents. Methods: We used available data from 400 adolescents who completed the follow up examinations in the PSCC study. We used whole body low-dose dual energy absorptiometry (DXA) to assess and calculate the following abdominal and body fat distribution measures: Android/Gynoid Fat ratio, Android/whole body fat ratio, Gynoid/whole body fat ratio, visceral fat area, and subcutaneous fat area in the abdominal region. . Metabolic syndrome burden was assessed by using continuous metabolic syndrome score (cMetS) - the sum of the age and sex adjusted standardized residual (Z-score) of five established metabolic syndrome components: waist circumference, mean arterial pressure, homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides, and HDL cholesterol. Linear regression models were used to data analysis. Results: The mean age was 16.9 yrs (SD=2.19), with 54% male and 77% white. The average cMets score was 0.04 SD (3.01). The regression coefficients on cMets score per one SD increase in abdominal adipose tissue measures are shown in Table 1. In summary, higher abdominal adipose tissue, especially in the android (visceral) area, of the abdomen is associated with higher cMetS score. Conclusion: Obesity, especially visceral obesity, is associated with higher metabolic syndrome burden in adolescent population, which may result in increased metabolic syndrome risk in adulthood.

Abstract P105: Sleep Disordered Breathing and Cardiac Autonomic Modulation in Adolescents - Penn State Child Cohort (PSCC) Study

Objectives: To investigate the relationship between sleep disordered breathing (SDB) and cardiac autonomic modulation (CAM) in a population-based sample of adolescents. Methods: We used available data from 400 adolescents who completed the follow up examinations in the population-based PSCC study. 1-night polysomnography was used to assess apnea hypopnea index (AHI). AHI was used to define no-SDB (AHI&lt;1), mild SDB (1≤AHI&lt;5), and moderate SDB (AHI≥5). CAM was assessed by heart rate variability (HRV) analysis of beat-to-beat normal R-R intervals from a 39-hour high resolution Holter ECG. The HRV indices in frequency domain [high frequency power (HF), low frequency power (LF), and LF/HF ratio] and time domain [standard deviation of normal RR intervals (SDNN), and the square root of the mean squared difference of successive normal RR intervals (RMSSD), and heart rate (HR)] were calculated on a 30-minute basis (78 repeated measures). Mixed-effects models were used to assess the SDB and HRV relationship. Results: The mean age was 16.9 yrs (SD=2.19), with 54% male and 77% white. The mean (SD) AHI were 0.52 (0.26), 2.38 (1.03), and 12.27 (14.54) for no-, mild-, and moderate-SDB participants. The age, race, sex, and BMI percentile adjusted mean (SE) HRV indices across three SDB groups are presented in Table 1. In summary, sleep disordered breathing was associated with lower HRV and higher HR in this population-based adolescent sample, with a significant dose-response relationship. Conclusion: moderate SDB in adolescents is already associated with lower HRV, indicative of sympathetic activation and lower parasympathetic modulation, which has been associated with cardiac events in adults.

Prevalence and predictors of PTSD and depression among adolescent victims of the Spring 2011 tornado outbreak

Relatively few studies have examined prevalence and predictors of posttraumatic stress disorder (PTSD) or major depressive episode (MDE) in disaster-affected adolescents. Fewer still have administered diagnostic measures or studied samples exposed to tornadoes, a common type of disaster. Further, methodologic problems limit the generalizability of previous findings. This study addressed prevalence estimates and risk factors for PTSD and MDE among adolescents exposed to the Spring 2011 tornado outbreak in Alabama and Joplin, Missouri. A large (N=2000), population-based sample of adolescents and caregivers, recruited randomly from tornado-affected communities, participated in structured telephone interviews. PTSD and MDE prevalence were estimated for the overall sample, by gender, and by age. Hierarchical logistic regression was used to identify risk factors for PTSD and MDE. Overall, 6.7% of adolescents met diagnostic criteria for PTSD and 7.5% of adolescents met diagnostic criteria for MDE since the tornado. Girls were significantly more likely than boys to meet diagnostic criteria for MDE, and older adolescents were more likely than younger adolescents to report MDE since the tornado. Female gender, prior trauma exposure, and an injured family member were associated with greater risk for PTSD and MDE. Specific incident characteristics (loss of services, concern about others' safety) were associated with greater PTSD risk; prior disaster exposure was associated with lower MDE risk. However, most adolescents were resilient following tornado exposure, roughly 1 in 15 developed PTSD, 1 in 13 developed MDE, and many more endorsed subclinical mental health problems. Information regarding specific risk factors can guide early screening, prevention, and intervention efforts in disaster-affected communities.

Intimate relationship involvement, intimate relationship quality, and psychiatric disorders in adolescents.

Prior research has shown that poor relationship quality in marriage and other intimate relationships demonstrates cross-sectional and longitudinal associations with a variety of psychiatric disorders in adults. In comparison, there has been less research on the covariation between relationship quality and psychiatric disorders in adolescents, a developmental period that is associated with elevated risk of incidence of several disorders and that is important for the acquisition and maintenance of intimate relationships. The present study was conducted to examine the associations between intimate relationship involvement, intimate relationship quality, and psychiatric disorders in a population-based sample of adolescents. The associations between relationship involvement, positive and negative relationship quality, and 12-month prevalence of mood, anxiety, and substance use disorders were evaluated in adolescents from the National Comorbidity Survey-Adolescent Supplement. Participants completed an interview-based assessment of psychiatric disorders and a self-report measure of relationship quality. Results indicated that the prevalence of broad categories of mood, anxiety, and substance use disorders, and several specific disorders were significantly associated with (a) being married, cohabiting, or involved in a serious relationship; and (b) reporting more negative (but not less positive) relationship quality. For several disorders, the association between the disorder and relationship involvement was moderated by age, wherein the strength of the association decreased in magnitude with increasing age. Findings suggest that being in an intimate relationship and reporting higher levels of negative relationship quality are associated with the prevalence of several common psychiatric disorders in adolescents.

The Child Behavior Checklist and Youth Self-Report in adolescents with epilepsy: Testing measurement invariance of the Attention and Thought Problems subscales

The objective of this study was to test for the measurement invariance of the Attention and Thought Problems subscales of the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) in a population-based sample of adolescents with and without epilepsy. Data were obtained from the 14-year follow-up of the Mater University Study of Pregnancy in which 33 adolescents with epilepsy and 1068 healthy controls were included for analysis. Confirmatory factor analysis was used to test for measurement invariance between adolescents with and without epilepsy. Structural equation modeling was used to test for group differences in attention and thought problems as measured with the CBCL and YSR. Measurement invariance was demonstrated for the original CBCL Attention Problems and YSR Thought Problems. After the removal of ambiguous items (“confused” and “daydreams”), measurement invariance was established for the YSR Attention Problems. The original and reduced CBCL Thought Problems were noninvariant. Adolescents with epilepsy had significantly more symptoms of behavioral problems on the CBCL Attention Problems, β=0.51, p=0.002, compared with healthy controls. In contrast, no significant differences were found for the YSR Attention and Thought Problems, β=−0.11, p=0.417 and β=−0.20, p=0.116, respectively. In this population-based sample of adolescents with epilepsy, the CBCL Attention Problems and YSR Thought Problems appear to be valid measures of behavioral problems, whereas the YSR Attention Problems was valid only after the removal of ambiguous items. Replication of these findings in clinical samples of adolescents with epilepsy that overcome the limitations of the current study is warranted.

The association between cortisol and neighborhood disadvantage in a U.S. population-based sample of adolescents

The association between neighborhood conditions and cortisol is rarely studied in children or adolescents and has been hampered by small sample size and racial/ethnic and geographic homogeneity. Our objective was to estimate the association between neighborhood disadvantage and salivary cortisol levels in a large, geographically and racially/ethnically diverse sample of adolescents from the National Comorbidity Survey Replication Adolescent Supplement. Salivary cortisol was collected before and after an interview administered in the adolescent's home. We used a propensity score approach to match adolescents living in disadvantaged neighborhoods with those in non-disadvantaged neighborhoods to create two similar groups based on the time and day of cortisol collection as well as demographic characteristics. Adolescents living in disadvantaged neighborhoods had higher pre-interview cortisol levels and steeper rates of decline in cortisol levels over the course of the interview than similar adolescents in non-disadvantaged neighborhoods. This bolsters the evidence base suggesting that place may influence the stress response system.

Routine Clinical Measures of Adiposity as Predictors of Visceral Fat in Adolescence: A Population-Based Magnetic Resonance Imaging Study

ObjectiveVisceral fat (VF) increases cardiometabolic risk more than fat stored subcutaneously. Here, we investigated how well routine clinical measures of adiposity, namely body mass index (BMI) and waist circumference (waist), predict VF and subcutaneous fat (SF) in a large population-based sample of adolescents. As body-fat distribution differs between males and females, we performed these analyses separately in each sex.Design and MethodsVF and SF were measured by magnetic resonance imaging in 1,002 adolescents (482 males, age 12–18 years). Relationships of BMI and waist with VF and SF were tested in multivariable analyses, which adjusted for potentially confounding effects of age and height.ResultsIn both males and females, BMI and waist were highly correlated with VF and SF, and explained 55–76% of their total variance. When VF was adjusted for SF, however, BMI and waist explained, respectively, only 0% and 4% of VF variance in males, and 4% and 11% of VF variance in females. In contrast, when SF was adjusted for VF, BMI and waist explained, respectively, 36% and 21% of SF variance in males, and 48% and 23% of SF variance in females. These relationships were similar during early and late puberty.Conclusions and RelevanceDuring adolescence, routine clinical measures of adiposity predict well SF but not VF. This holds for both sexes and throughout puberty. Further longitudinal studies are required to assess how well these measures predict changes of VF and SF over time. Given the clinical importance of VF, development of cost-effective imaging techniques and/or robust biomarkers of VF accumulation that would be suitable in everyday clinical practice is warranted.