Sample Of Youth Research Articles

The gender variance scale: developing and piloting a new tool for measuring gender diversity in survey research

ABSTRACT This paper discusses the development and testing of a new composite scale for measuring gender diversity, for use in survey research and statistical analysis: the Gender Variance Scale (GVS). The GVS measures gender diversity on a spectrum and can be used across both cisgender and trans populations to identify experiences of gender beyond a basic male/female sex binary. The GVS was piloted with a sample of 1,776 adolescents and young people ages 14–24 years, in the context of a broader study exploring the relationships between gender variance, young people’s experiences and wellbeing. Analysis of data indicated that the GVS contained both face and construct validity and reliability in the context of the pilot study. In addition, the data revealed some interesting associations between the GVS and other demographic features of the sample of youth surveyed; for example, higher levels of gender variance were associated with being lesbian, gay or bisexual and having a disability. The findings of this study may be of interest for building a stronger empirical understanding of gender diversity and its intersections with other aspects of identity.

Assessing Readiness for Transition From Pediatric to Adult Gender Affirming Care

PurposeTransitioning from pediatric to adult care is a critical juncture in the health of adolescents. Little is known about how best to optimize transition to adult care among transgender and nonbinary (TGNB) youth. While the Transition Readiness and Assessment Questionnaire (TRAQ) has been validated in other pediatric populations, it has not been studied in TGNB youth. Our aims were to pilot the use of the TRAQ for TGNB patients, describe transition readiness patterns, and identify factors associated with transition readiness. MethodsThe TRAQ was introduced into routine clinical care for patients and their caregivers in a large, urban pediatric gender program in the spring of 2021. We performed a retrospective chart review comparing TRAQ responses based on demographic and clinical data. ResultsWe collected TRAQs from 153 adolescents (mean age: 19 years [standard deviation 2.36], range: 11–24). The TRAQ demonstrated good internal reliability with a Cronbach alpha of 0.926. Patients scored highest in the TRAQ subdomains of talking with providers and tracking health issues and lowest in the subdomains of managing medications and appointment keeping. Age and presenting to the appointment alone were associated with higher TRAQ scores. DiscussionWe found that the TRAQ is internally reliable in a sample of TGNB youth. Factors associated with higher TRAQ scores and patterns identified in TRAQ score subdomains provide an insight into the needs of TGNB youth preparing to transition to adult gender-affirming care. Future research should focus on tracking transition readiness longitudinally, developing and evaluating interventions to improve transition readiness, and assessing post-transition outcomes.

Retraction Note: Associations between emotional intelligence and subjective wellbeing in the Lithuanian youth sample

Retraction Note: Associations between emotional intelligence and subjective wellbeing in the Lithuanian youth sample

A Longitudinal Examination of Latinx Students’ Kindergarten Readiness with High School Achievement and Discipline Violations

Understanding achievement and discipline trajectories of Latinx students is critical given disproportionate dropout/pushout rates of Latinx students from schools across the U.S. Using a Critical Race Theory framework, the current study examined longitudinal associations amongst a sample of (N = 1672) Latinx youths’ school readiness at kindergarten entry and their subsequent academic achievement and discipline violation assignments in high school, also examining the associations with gender, socioeconomic status, English language status, and special education status. A moderated mediation analysis found that high school achievement fully mediated the negative association between kindergarten readiness and high school discipline outcomes. Gender, SES, and English language status were all found to have non-significance or poor fit as moderators. The association between kindergarten readiness and high school achievement was significant for students in general education but not in special education. Implications related to these findings, early assessment, intervention, and best school discipline practices are discussed.

82 Single Errors on Trial 1 of the Test of Memory Malingering may be Indicative of Invalid Performance on Neuropsychological Measures in a Sample of Youth Athletes

Objective:The Test of Memory Malingering (TOMM) is a performance validity test (PVT) that aims to assess whether participants are giving adequate effort to perform well on tasks of memory performance (Tombaugh, 1996). Other PVTs, specifically the Forced Choice Recognition Trial in the California Verbal Learning Test, have shown that even single errors may indicate invalid performance (Erdodi et al., 2018). Finally, youth are often understudied in the PVT literature, and athletes are at increased risk of invalid performance on baseline testing due to many wanting to return to play following concussion (Erdal, 2012). Therefore, the objective of the current study is to examine whether single errors on TOMM Trial 1 are indicative of lower, and possibly invalid, cognitive performance in a youth sample, given that cognitive performance declines with even small decreases in effort (Green, 2007).Participants and Methods:Healthy youth athletes (n=174) aged 8-16 years (M=12.07) completed the TOMM as well as other neuropsychological measures during baseline neuropsychological evaluation in a clinical research program for sports concussion. Independent samples t-tests compared youth athletes who scored 49 points on the TOMM (n=28) to youth athletes who scored a perfect 50 (n=50) across several groupings of neuropsychological measures. Participants who scored less than 49 or who didn’t complete the TOMM were excluded from the analyses.Results:Participants scoring 50/50 on TOMM Trial 1 scored significantly higher on Stroop Color Naming task (p=0.036), Verbal Learning Delayed task from the second edition of the Wide Range Assessment of Learning and Memory (WRAML-2, p=0.018), and Letter Number Sequencing task from the Weschler Intelligence Scale for Children (WISC-IV, p=0.025), relative to participants scoring 49/50. Though not statistically significant, results also showed a trend toward participants scoring 50/50 scoring higher on nearly every test in the battery.Conclusions:Participants with a single error on TOMM Trial 1, as compared to participants with a perfect score, performed significantly worse on a processing speed task, a verbal learning task, and a working memory task as part of a comprehensive neuropsychological battery. The single-error group also trended toward scoring lower on nearly all of the remaining attention, processing speed, perceptual ability, memory, and executive functioning tasks in the battery. The results could lead to a more liberal interpretation of TOMM scores, given that the trend towards lower performance may be due to putting forth significantly less effort. These results point to the need for a similar comparison of the TOMM in a larger sample size, as greater power may reveal even more significant differences in performance. Findings also emphasize the importance of viewing performance validity on a continuum rather than as a dichotomous pass/fail. Understanding the TOMM and how single errors may be indicative of poorer performance in a youth sample could help to reframe the way PVT results are interpreted in clinical and forensic settings.

77 Development of Parent- and Teacher-Reported Executive Dysfunction and Inattention in Youth with Spina Bifida

Objective:Youth with spina bifida (SB) are at increased risk of neuropsychological deficits, including executive dysfunction and inattention. While these deficits are well-documented cross-sectionally, little research has considered the development of these difficulties longitudinally. The limited research on executive dysfunction over time in youth with SB has been mixed, with some studies suggesting stable, elevated executive dysfunction (Tarazi et al., 2008) and others demonstrating improvements in inhibition and shifting in particular (Zabel et al., 2011). In contrast, no research has examined inattention over time in SB. Understanding the development of these constructs is critical for early identification of dysfunction and intervention development. This study thus aims to characterize the development of executive dysfunction and inattention in youth with SB.Participants and Methods:One hundred forty youth with SB were recruited as part of a larger, longitudinal study. Mothers, fathers, and teachers of participants (Time 1: Myouth age = 11.4 years, 53.6% female) completed questionnaire-based measures of executive dysfunction (Behavior Rating Inventory of Executive Function, BRIEF; inhibit, shift, working memory, plan/organize subscales) and inattention (Swanson, Nolan, and Pehlam Teacher and Parent Rating Scale - Fourth Edition, SNAP-IV). Data were collected over five time points occurring at two-year intervals. Growth curves were estimated using linear mixed effects models to estimate development over time.Results:Difficulties with inhibition decreased across age in youth with SB according to mother, father, and teacher reports (p=.000-.007). Mother and father reports of shifting problems decreased across age (p=.009), while teacher reports showed no significant change (p=.799). Working memory problems also significantly decreased over time, but only according to fathers and teachers (p=.004-.005). Difficulties with planning/organizing remained stable across age for all reporters (p=.076-.935). With regards to inattention, symptoms decreased across age according to mothers and teachers (p=.000-.017), but not fathers.Conclusions:Overall, inhibition, shifting, and inattention improved across age in this sample of youth with SB according to at least two reporters. Contrary to existing literature, working memory also improved over time in this sample. Planning/organizing was the only area of executive functioning that remained stable over time across reporters. These results support previous findings of improvements in behavioral regulation (i.e., inhibition, shifting), and stable, elevated planning/organizing difficulties. These findings also highlight the importance of considering different contexts and reporters’ perspectives when examining change over time. Predictors of the development of executive dysfunction and inattention should be considered, as this information may aid with increased understanding of neuropsychological function in SB and identifying which individuals may be most likely to benefit from early intervention. Examining predictors may also help explain differences in working memory development demonstrated in the current study compared to extant literature.

Validation of the Spanish ASQ translation: Screening pediatric patients for suicide-risk in Argentina

BackgroundThe high frequency of suicide risk in adolescents necessitates the development and validation of specific tools for systematic screening. To date, there are translated, but not validated suicide risk screening tools in Spanish. ObjectiveTo validate the Spanish version of the Ask Suicide-Screening Questions (ASQ) for suicide risk screening in pediatric patients in Argentina. MethodUsing a cross-sectional multicenter design, a convenience sample of pediatric patients aged 10 to 18 years old were recruited from outpatient/inpatient medical settings and private psychiatric clinics. The Spanish version of the Suicidal Ideation Questionnaire (SIQ) assessment tool was used as a standard criterion to validate the ASQ. ResultsA total of 301/380 pediatric patients were screened for suicide risk. Twentyeight percent of the entire sample (83/301) of youth screened positive on the ASQ, and 21% (62/301) screened positive on the SIQ/SIQ-JR and were considered “at risk” for suicide. Compared with the SIQ, the Spanish ASQ yielded a sensitivity of 96.8% (95% Confidence Interval [CI]: 88.8–99.6%), specificity of 90.4% (95% CI: 85.9–93.8%), positive predictive value of 72.3% (95 CI: 61.4–81.6%), and negative predictive value of 99.1% (95% CI: 96.7–99.9%). The positive Likelihood Ratio (LR) was 10.1 (95% CI: 6.1–14.0), and the negative LR was 0.03 (95% CI: −0.01–0.09). Kappa was 0.77 (95% CI: 0.69–0.86), and the Area Under the Curve was 0.94 (95% CI: 0.91–0.97). ConclusionThe Spanish language ASQ demonstrated strong psychometric properties, providing initial evidence that it is a valid tool for identifying Spanish-speaking youth at risk for suicide.

Great Expectations: The Importance of Procedural Justice and Parenting for Perceptions of Success Among Youth on Probation

Juvenile probation can be a critical inflection point. As such, researchers, policymakers, and practitioners are interested in enhancing youths’ success on probation, especially pertaining to reducing recidivism and promoting their success in education and employment. Informed by the risk–need–responsivity framework, the present study examined how theoretically derived familial/peer (e.g., social bonds, parental monitoring), societal/community (e.g., labeling theory), and individual-level (e.g., impulsivity, procedural justice) factors were associated with youths’ expectations for success on probation as well as more general life course outcomes. Within samples of youth starting probation ( N = 301) and 6 months into probation ( N = 253), we combined cross-sectional data from the jurisdiction’s risk/needs tool with a self-reported survey from youth. Youths’ perceptions of parental monitoring and procedural justice were consistently associated with their self-expectations for completing probation. However, for more general life course success, only perceptions of parental monitoring promoted self-expectations. Implications for theory, policy, and practice are discussed.

Interdependency, Perceived Shame, and Probability of Wrongdoing Among Chinese Students: A Partial Test of the Reintegrative Shaming Theory

Compared with other mainstream criminological theories, Reintegrative Shaming Theory (RST) draws insufficient empirical evaluations. Given RST’s unique attention to non-Western societies and the significance of shaming in Chinese society, China provides a strategic setting for RST’s empirical assessment. Utilizing a Chinese youth sample, this study explores the association between interdependency and the probability of wrongdoing, and the mediating role of perceived shame. We find that strong school attachment is directly associated with the reduced likelihood of wrongdoing, and indirectly via perceived shame. The effects of family and neighborhood attachments on perceived shame and the probability of wrongdoing are insignificant. The results lend partial support to RST and highlight the essential role of school in children’s development in the Chinese context.

Extracurricular Activity Participation Among Autistic Children and Adolescents: Buffer for Internalizing Conditions and Foundation for Friendship?

Internalizing conditions, such as anxiety and depression, and difficulties with developing and maintaining friendships are common among autistic children and adolescents. Participation in extracurricular activities may buffer against these challenges as they provide naturalistic opportunities to bring peers with shared interests and skills together. As such, the purpose of the current study was to examine associations between sport and club participation and (1) friendship success and (2) co-occurring anxiety and depression in a large sample of autistic youth. Secondary analysis was performed using data from the 2018-2019 National Survey of Children's Health. Participants were 562 autistic children (ages 6-11 years) and 818 autistic adolescents (ages 12-17 years). Within each age group, a series of binary logistic regression analyses were conducted. Club participation was not associated with friendship or internalizing conditions. However, participation in sports was positively associated with friendship success among both children (OR = 2.07, p = .006) and adolescents (OR = 2.35, p = .001). Results also found that adolescents who participated in sports were 34% less likely to have diagnosis of depression (p = .048). Findings suggest that participation in sports may play a meaningful role in protecting against depression during adolescence and serve as a context for friendship development across childhood and adolescence. Future research should address barriers to extracurricular activity participation and identify the specific components of sports that are most beneficial to autistic youth to inform activity offerings and the development of interventions targeting friendship formation and mental health outcomes.

Micro-level Factors Associated with Youth Drug Use Among an Urban at-Risk Youth Sample.

Youth drug use has reached global epidemic proportions with unequal distribution among communities with low income, immigrants, or ethnic status. This study seeks to understand the association between micro-level factors and youth drug use behavior among 2693 low-income, ethnic, and immigrant youths in Pomona, CA, USA. The study uneath's unique evidence and intervention elements necessary to resolve youth drug use in Pomona. We used social cognitive theory as a conceptual framework, and performed correlation and multiple linear regression analysis in a cross-sectional design. The results reveal that attitudes, perceptions, and behavior related to friends, participants, family, and adults in the participant's life and ease of access to drugs are associated with youth drug use. Variables related to friends and participants show a relatively stronger association with youth drug use in comparison to variables related to parents and adults in participants' lives. Equally, drug and non-drug antisocial behavior of friends and participants show a stronger association with youth drug use relative to prosocial behavior. Also, when a diverse set of predictor variables are combined together, their association to the outcome variable is stronger than that of a single variable. Future interventions in Pomona should prioritize strategies which target participants and friends over activities targeting parents and adults. Interventions targeting antisocial behavior should be prioritized over prosocial behavior. Program implementers should also develop unique evidence and tools which will help parents influence the drug use behavior of youths in Pomona and similar communities.

Examining area- and individual-level differences in suicide ideation severity and suicide attempt among youth.

Youth suicide is a pressing problem and suicide rates are not equally distributed across geographic areas or socioeconomic status (SES). Death by suicide is often preceded factors including hopelessness and suicide ideation, planning, and attempt. The current study examined area- and individual-level differences in suicide ideation severity and suicide attempt in a state-representative sample of youth from 2019 (N = 78,740) and 2021 (N = 61,396). Youth from higher SES and rural areas showed lower suicide ideation severity and odds of suicide attempt. After including individual-level covariates, SES differences in ideation severity and suicide attempt persisted for 2019 but not 2021. Rural differences for ideation severity persisted across years but not for suicide attempt. Further research on geographic variation in suicide risk is needed.

Impact of poly-victimization and resilience on anxiety: Delinquent and non-delinquent youth samples

Victims of poly-victimization reveal a higher negative impact than victims of a single type of violence. Exposure to multiple types of violence is a stronger predictor of developing worse mental health outcomes. The main objectives of this study are to verify the relationship between poly-victimization, anxiety, and resilience, compare delinquent and non-delinquent adolescents, and identify the predictors of anxiety. The sample comprises 143 adolescents between 12 and 17 years old (M = 14.93, SD = 1.63), of which 97 (67.8 %) were identified as young delinquents and 46 (32.2 %) as non-delinquents. Participants completed a socio-demographic questionnaire, the Juvenile Victimization Questionnaire (JVQ), the Resilience Scale (RS), and the State-Trait Anxiety Inventory (STAIC C-2). Analysis showed a relationship between JVQ, the RS, and the STAIC C-2. Compared to non-delinquents, young delinquents reported more childhood victimization episodes, more anxiety, and less resilience. Additionally, gender, poly-victimization, and resilience are significant predictors of anxiety. The findings showed that poly-victimization and resilience affect anxiety.

Vaccination Attitudes Examination (VAX) Scale: a Bifactor-ESEM approach in a youth sample (15–24 years)

BackgroundThe Vaccination Attitudes Examination (VAX) Scale is a widely used scale designed to measure general attitudes toward vaccinations. However, evidence for the VAX’s structural, convergent, and discriminant validity is still limited, especially in youth samples.MethodsThe present study examined the psychometric multidimensionality and evidence of convergent and discriminant validity of the VAX using the bifactor-exploratory structural equation modeling approach (bifactor-ESEM). Using a sample of 803 Serbian adolescents and young adults (Mage = 18.23, SDage = 2.66, age range = 15–24 years, 59.2% female), we contrasted the original four-factor model of the VAX with alternative solutions (ESEM, bifactor-CFA, and bifactor-ESEM), and investigated associations between vaccination attitudes and a variety of external criteria.ResultsThe results supported the bifactor-ESEM solution with one general factor of vaccination attitudes and four specific factors (Mistrust of vaccine benefit, Worries about unforeseen future effects, Concerns about commercial profiteering, and Preference for natural immunity) as the best representation of the data. The general factor was well-defined, and three specific factors showed good validity and specificity after the general factor was taken into account. The results of convergent validity analyses showed that the general factor of vaccine attitudes and one specific factor (Mistrust of vaccine benefit) were good predictors of vaccine conspiracy beliefs, attitudes towards COVID-19 vaccination, intention to get vaccinated against COVID-19, and trust in healthcare. The remaining three specific factors’ contributions to external criteria were generally weak and nonsignificant. Evidence of the discriminant validity of the VAX scores was supported by weak positive associations of the general factor with medical fears and paranoid worry.ConclusionsThe present findings indicate that distinguishing general and specific components of vaccination attitudes offers a more nuanced assessment and understanding of vaccination attitudes.

Relationship between adiponectin and blood pressure in obese Latino adolescent boys with a family history of type 2 diabetes

introductionAdipokines are associated with several pathological states including, metabolic syndrome, obesity, insulin resistance and type 2 diabetes. One of these adipokines, adiponectin is of particular interest as it has been shown to have numerous anti-inflammatory effects, However, the association between adiponectin and blood pressure remains inconclusive especially in the Latino adolescent with obesity.PurposeTo investigate the relationship between plasma adiponectin and blood pressure in Latino adolescents’ boys with obesity and a with a family history of Type 2 diabetes.MethodsThirty two Latino adolescent males with obesity aged 14–17 years with a family history of type 2 diabetes underwent a frequently sampled glucose tolerance test (FSIVGTT) to measure insulin sensitivity. Body composition was assessed using dual energy x-ray absorptiometry. Obesity was defined as having a BMI percentile ≥95. Blood pressure was assessed using the Dinamap automated blood pressure monitor, and the average of three readings was used in the analysis. Fasting plasma adiponectin was determined using radioimmunoassay.ResultsThere were moderate positive significant correlations for adiponectin and Systolic blood pressure(SBP) (rho = 0.436, p < 0.027) and Diastolic blood pressure(DBP) (rho = 0.41,p < 0.028). A multivariate liner regression showed that plasma adiponectin could significantly detect 19% of the variance in SBP (p = 0.017, and 33% for DBP (p = 0.017). In a simple linear regression adiponectin was not related to any of our variables (p < 0.05).ConclusionIn conclusion, adiponectin was positively and significantly correlated to blood pressure in Latino adolescent with obesity. Future studies should investigate this relationship in a large sample of Latino adolescent youth.

Racial and Ethnic Disparities in Mental Health Problems and Tobacco and Cannabis Use Among US Emerging Adults.

Mental health problems in emerging adulthood are linked to tobacco and cannabis use, but whether race and ethnicity modifies these associations is unclear. We used data from wave 4 of the Population Assessment of Tobacco and Health Study (youth n = 6898, young adult n = 10,304) to conduct latent class analysis (LCA) of six past 30-day tobacco and cannabis use indicators (i.e., cigarettes, electronic nicotine delivery systems (ENDS), cigars, blunts, cannabis vaping, other cannabis). We estimated associations between past 30-day internalizing and externalizing (i.e., low (referent), moderate, high) problems and latent classes of tobacco/cannabis use (vs. never/former use) using adjusted multinomial logistic regression. We explored whether associations varied by race and ethnicity through stratification. We identified four exclusive use latent classes and two dual/poly use latent classes for both youth and young adult samples. Race/ethnicity-stratified models identified associations between internalizing/externalizing problems and most use classes for Hispanic and non-Hispanic White youth/young adults, with mixed results for non-Hispanic Black youth/young adults. For example, Hispanic (OR: 2.50, 95% CI: 1.09-5.74) and non-Hispanic White (OR: 1.90, 95% CI: 1.18-3.06) youth with high internalizing problems had higher odds of ENDS + cannabis vaping. Externalizing problems were not associated with use among non-Hispanic Black youth while internalizing problems were not associated with use among non-Hispanic Black young adults. We observed racial/ethnic variation in mental health problems and tobacco and cannabis use. Understanding mental health problem and tobacco product and cannabis use comorbidity may better inform culturally relevant interventions aimed to prevent and reduce use.

Predicting individual cases of major adolescent psychiatric conditions with artificial intelligence

Three-quarters of lifetime mental illness occurs by the age of 24, but relatively little is known about how to robustly identify youth at risk to target intervention efforts known to improve outcomes. Barriers to knowledge have included obtaining robust predictions while simultaneously analyzing large numbers of different types of candidate predictors. In a new, large, transdiagnostic youth sample and multidomain high-dimension data, we used 160 candidate predictors encompassing neural, prenatal, developmental, physiologic, sociocultural, environmental, emotional and cognitive features and leveraged three different machine learning algorithms optimized with a novel artificial intelligence meta-learning technique to predict individual cases of anxiety, depression, attention deficit, disruptive behaviors and post-traumatic stress. Our models tested well in unseen, held-out data (AUC ≥ 0.94). By utilizing a large-scale design and advanced computational approaches, we were able to compare the relative predictive ability of neural versus psychosocial features in a principled manner and found that psychosocial features consistently outperformed neural metrics in their relative ability to deliver robust predictions of individual cases. We found that deep learning with artificial neural networks and tree-based learning with XGBoost outperformed logistic regression with ElasticNet, supporting the conceptualization of mental illnesses as multifactorial disease processes with non-linear relationships among predictors that can be robustly modeled with computational psychiatry techniques. To our knowledge, this is the first study to test the relative predictive ability of these gold-standard algorithms from different classes across multiple mental health conditions in youth within the same study design in multidomain data utilizing >100 candidate predictors. Further research is suggested to explore these findings in longitudinal data and validate results in an external dataset.

Social disorganization, collective efficacy, bullying perpetration, and victimization: An empirical test

ABSTRACT The current study offers a test of social disorganization theory to assess the effects of neighborhood-level factors on bullying perpetration and victimization. The study offers a quasi-replication the Sampson and Groves (1989) model and integrates proxy measures consistent with prior research to test the theoretical framework on bullying outcomes. Data from the National Survey of Children’s Health (NSCH) 2019 were used to analyze a sample of adolescent youth between the ages 12 and 17 (n = 8,584). Multinomial logistic regression analyses were conducted to assess the effects of indicators consistent with social disorganization and collective efficacy on varying levels of bullying perpetration and bullying victimization. Results suggest that indicators of social disorganization (i.e., low-SES, neighborhood decay) increases the odds of bullying perpetration/victimization. Additionally, collective efficacy reduces the odds of both bullying perpetration and bullying victimization. Ecological factors beyond the context of school environments appear to be influential to bullying outcomes.

Youth and Young Adult Blunt Use Predicts Progression to Other Nicotine Product Use in the United States

Background Little cigars or cigarillos (LCCs) are frequently modified to smoke cannabis (“blunts”) by youth and young adults. This study investigated whether young blunt users who are otherwise nicotine-naïve are more likely to initiate other tobacco products compared to never blunt users. Methods and Materials Data were from four waves of the Truth Longitudinal Cohort (TLC), a national probability-based sample of youth and young adults (aged 15-24 years) in the United States (Wave 1: January—April 2017; Wave 2: February—May 2018; Wave 3: February—May 2019; Wave 4: September—December 2019). The sample was restricted to nicotine naïve respondents at Wave 1 with possible ever use of blunts (N = 5,284). Logistic regression analyses tested whether ever blunt use at Wave 1 predicted initiation of nicotine products by Wave 4, controlling for established risk factors. Results Compared to never-blunt users, ever users of blunts at Wave 1 had significantly higher odds of ever using cigars (OR: 4.74; 95% CI: 1.80-12.47; p = 0.002), e-cigarettes (OR: 4.66; 95% CI: 2.42-8.95; p < 0.001), cigarettes (OR: 3.02; 95% CI: 1.17-7.84, p = 0.023), or hookah (OR: 3.47; 95% CI: 1.07-11.29, p = 0.039) by Wave 4. Cannabis (never blunt) use by Wave 1 predicted ever use of e-cigarettes (OR: 3.45, 95% CI: 2.38-5.02, p < 0.001), cigarettes (OR: 3.81; 95% CI: 2.26-6.43, p < 0.001), or hookah (OR: 2.13; 95% CI: 1.12-4.05, p = 0.021) by Wave 4. Discussion Blunts are a point of nicotine initiation that places users at increased risk of progression to cigars, while the same relationship was not found for cannabis alone.

Correlates of informant discrepancies in self-harm among youth involved in child protective services

Youth involved with child protective services (CPS) are at elevated risk for engaging in self-harm. Participation in interventions or treatments that may reduce youths’ self-harm behaviors often depends on the accurate reporting of their self-injurious behaviors. However, informants often disagree on the presence or severity of self-harm engagement, making the identification of youth in need of treatment more challenging. The current study aims to characterize discrepancies between youth and caregiver reports of children’s self-harm among a sample of youth with a history of CPS involvement, and to identify factors (e.g., demographics, youth and caregiver psychological impairments, aspects of the caregiving environment) associated with these discrepancies. Participants (N = 258) were drawn from a large, nationally representative sample of youth under the age of 18 (mean age = 13.8) and their caregivers who were investigated by CPS. Multinomial logistic regressions were used to examine correlates of discrepancies in caregiver and youth reports of youth self-harm. Results indicated that 10% of caregiver-child dyads agreed on children’s engagement in self-harm. In 33% of cases, only the child reported self-harm and in 57% of cases, only the caregiver reported youth self-harm. Being a biological caregiver, child female sex, higher levels of internalizing symptoms, greater post-traumatic stress disorder (PTSD) symptoms, and greater caregiver alcohol use was associated with a lower likelihood of caregivers reporting self-harm only. Older child age, lower externalizing symptoms, higher PTSD symptoms, and greater levels of caregiver emotional security and structure were linked to lower odds of children reporting self-harm only. These results underscore important factors to consider when assessing self-harm among youth involved with CPS and have potential implications for practice guidelines in this population.