School-based Sample Research Articles

Predicting Self-Control Through Familial and Environmental Factors Among Immigrant and Native-Born Adolescents

The current study addressed a research gap regarding the influence of risk factors in predicting self-control among immigrant and nonimmigrant adolescents. Three research hypotheses were postulated to test the applicability of self-control theory across generational status groups, and the influence of family and environmental factors on youths’ self-control development. The hypotheses were evaluated through hierarchical multiple regression analyses using a school-based sample of 2,056 U.S. adolescents (4% first-generation immigrants, 13% second-generation immigrants, 83% native-born) from the Second International Self-Reported Delinquency Study Dataset. In partial support of self-control theory, the results demonstrated that nearly the same set of variables including family bonding, parental supervision, neighborhood disorganization, school disorganization, and delinquent peer associations significantly predicted self-control for all three generational status groups, but that school climate significantly predicted self-control for only native-born youth. The results also showed that factors across family, neighborhood, school, and peer contexts significantly contributed to immigrant and native-born youths’ self-control. The findings suggest both family and environmental factors shape youths’ self-control. However, the variation in the contribution of those factors on self-control development for immigrant and nonimmigrant youth may be due to cultural differences promoted by acculturation. Implications for future research and delinquency prevention are discussed.

Alcohol intoxication among cannabis users in a school-based adolescent sample

The aim of this study was to investigate whether alcohol intoxication is associated with cannabis use among Norwegian adolescents. The current study was based on a sub-set of data from the Norwegian Ungdata survey. A total of 28,953 adolescents from 33 municipalities responded to an illicit drug use module (response rate 77%). Results showed that a high frequency of alcohol intoxication in the past year was associated with use of cannabis as the sole illicit drug in the past year. The findings further reflected that a high frequency of alcohol intoxication in the past year was strongly associated with the frequency of cannabis use in the same period. Those who solely had used cannabis shared more characteristics with users of additional illicit drugs than with non-illicit drug users. Frequent alcohol intoxication seems to be associated with increased risk of frequent cannabis use. Early interventions could benefit from focussing on these drugs in tandem.

U-Shaped Relationship between Years of Residence and Negative Mental Health Outcomes among Rural-to-Urban Children in Migrant Schools in Beijing, China: The Moderating Effects of Socioeconomic Factors.

This study aimed to test the relationship between length of residence and mental health in a school-based sample of migrant children who studied in migrant schools. A total of 7,296 rural-to-urban migrant children were recruited from 58 schools in Beijing and assessed by the State-Trait Anxiety Inventory and Children's Depression Inventory. A quadratic relationship was found between mental health and length of residence. The results suggested that the scores for anxiety and depression were high during the initial resettlement after migrating and then decreased. However, after approximately 8 years, the scores increased. Our findings also showed a significant moderating effect of family socioeconomic status on the relation between mental health and length of residence. This study provided empirical evidence for a better understanding of psychosocial factors on the mental health of migrant children during the process of urbanization in China.

A school-based epidemiological field survey: difficulties in collecting psychiatric outcome data in a middle-income country

BackgroundLow- and middle-income countries (LMICs) face a lack of epidemiological data. The development of high-quality surveys is a key research priority in countries such as Brazil. Our aim is to discuss the difficulties in conducting a longitudinal epidemiological survey in a pilot study of a school-based sample in São Paulo.MethodsData came from a cohort of school-attending adolescents in two neighborhoods with different levels of urbanicity in São Paulo. Students born in 2002 and in the 7th grade during 2014 were recruited from nine public schools. Adolescents and caregivers were interviewed separately at baseline and at one year follow-up, using several instruments, including the Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL).ResultsAchieving unbiased sampling, keeping an updated register of participants’ contact information, using a full clinical interview without an algorithm for its scoring, and maintaining a highly-trained research team were among the difficulties faced.ConclusionWorking closely with community leaders, organizing group efforts to perform interviews, using a short, easy to understand instrument and providing some reward for participants were identified as alternatives to dealing with these difficulties, useful not only in Brazil, but also in other LMICs.

Risk and Protective Factors in the Lives of Transgender/Gender Nonconforming Adolescents

PurposeResearch suggests that transgender and gender nonconforming (TGNC) youth may be at greatly increased risk of high-risk health behaviors compared with cisgender youth, but existing studies are limited by convenience samples and small numbers. This study uses a large school-based sample of adolescents to describe the prevalence of TGNC identity, associations with health risk behaviors and protective factors, and differences across birth-assigned sex. MethodsThis study analyzes existing surveillance data provided by 9th and 11th grade students in Minnesota in 2016 (N = 81,885). Students who were transgender, genderqueer, genderfluid, or unsure about their gender identity (TGNC) were compared with those who were not, using χ2 and t-tests. Outcome measures included four domains of high-risk behaviors and experiences and four protective factors. ResultsThe prevalence of TGNC identity was 2.7% (n = 2,168) and varied significantly across gender, race/ethnicity, and economic indicators. Involvement in all types of risk behaviors and experiences was significantly higher, and reports of four protective factors were significantly lower among TGNC than cisgender youth. For example, almost two-thirds (61.3%) of TGNC youth reported suicidal ideation, which is over three times higher than cisgender youth (20.0%, χ2 = 1959.9, p < .001). Among TGNC youth, emotional distress and bullying experience were significantly more common among birth-assigned females than males. ConclusionsThis research presents the first large-scale, population-based evidence of substantial health disparities for TGNC adolescents in the United States, highlighting numerous multilevel points of intervention through established protective factors. Health care providers are advised to act as allies by creating a safe space for young people, bolstering protective factors, and supporting their healthy development.

Quality of life in children and adolescents with bipolar I depression treated with olanzapine/fluoxetine combination

BackgroundWe examined the efficacy of olanzapine/fluoxetine combination (OFC) in improving health-related quality of life (QoL) in the treatment of bipolar depression in children and adolescents.MethodsPatients aged 10–17 years with bipolar I disorder, depressed episode, baseline children’s depression rating scale-revised (CDRS-R) total score ≥40, Young Mania Rating Scale (YMRS) total score ≤15, and YMRS-item 1 ≤ 2 were randomized to OFC (6/25–12/50 mg/day olanzapine/fluoxetine; n = 170) or placebo (n = 85) for up to 8 weeks of double-blind treatment. Patients and parents completed the revised KINDL questionnaire for measuring health-related QoL in children and adolescents (KINDL-R) at baseline and endpoint. The mean change in CDRS-R total and item scores were used to compare improvement in symptomatology in patients taking OFC and placebo. Tests were 2-sided using a Type I error cutoff of 0.05, and no adjustments for multiple comparisons were made.ResultsBaseline QoL as measured by the KINDL-R was substantially impaired relative to published norms for a healthy school-based sample. OFC-treated patients demonstrated an improvement over placebo at endpoint with respect to mean change from baseline in the patient-rated KINDL-R Self-esteem subscale score (p = 0.028), and in the parent KINDL-R ratings of emotional well-being (p = 0.020), Self-esteem (p = 0.030), and Family (p = 0.006). At endpoint, OFC-treated patients still had a lower QoL compared to the normative population. OFC showed significant improvement (p ≤ 0.05) versus placebo on the CDRS-R total score and on 7 of the 17 CDRS-R items.ConclusionsPatients aged 10–17 years with an acute episode of bipolar depression and their parents reported greater improvements (parents noticed improvements in more areas than did their offspring) on some aspects of QoL when treated with OFC compared with placebo. However, after 8 weeks of treatment, KINDL-R endpoint scores remained lower than those of the, presumably healthy, control population.Clinical trial registration information A Study for Assessing Treatment of Patients Ages 10–17 with Bipolar Depression; http://www.clinicaltrials.gov; NCT00844857

The Mandarin version of the Kiddie-Schedule for Affective Disorders and Schizophrenia-Epidemiological version for DSM-5 - A psychometric study.

Changes of diagnostic coverage and criteria for psychiatric disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published in 2013 cause a need for updating the Kiddie-Schedule for Affective Disorders and Schizophrenia-Epidemiological version (K-SADS-E). This study examined the preliminary psychometric properties, including inter-rater reliability, and convergent and divergent validity of the modified K-SADS-E for DSM-5. A national survey of a school-based sample of 3242 students in grade 3, 5, and 7 from 44 schools was conducted in Northern, Central, and Southern Taiwan. Psychiatric diagnoses were made by the K-SADS-E interviews. Clinical questionnaires for attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and emotional and behavioral problems were examined using the Chinese version of the Swanson, Nolan, and Pelham IV scale, Social Responsiveness Scale, and Child Behavior Checklist. The K-SADS-E showed satisfactory inter-rater reliability (prevalence adjusted bias adjusted kappa=0.80-1.00) among eight interviewers. The diagnoses of K-SADS-E demonstrated good convergent and divergent validity with most corresponding clinical questionnaires. Our finding suggests that the K-SADS-E is a reliable and valid instrument for diagnosing child and adolescent psychiatric disorders based on DSM-5. Further study will examine the sensitivity, specificity, and test-retest reliability of the K-SADS-E in clinical and community samples.

Predicting Delinquency through Psychosocial and Environmental Variables among Immigrant and Native-Born Adolescents

The present quantitative, cross-sectional study addressed a research gap regarding the differential influence of risk factors in predicting delinquency among immigrant and nonimmigrant adolescents. One research question was evaluated using a school-based sample of 2,091 U.S. adolescents (4% first-generation immigrants, 14% second-generation immigrants, 82% native-born) from the Second International Self-Reported Delinquency Study Dataset. Multiple regression analyses demonstrate that delinquency for each generational status group is predicted by different sets of variables. The findings indicate individual factors such as level of self-control for first-generation immigrants, self-control and environmental factors for second-generation immigrants, and a combination of psychosocial, individual, and environmental factors for native-born youth may serve as critical risk factors of delinquency. Implications of these findings for future research and enhancing the cultural responsiveness of interventions are discussed.

In-home firearm access among US adolescents and the role of religious subculture: Results from a nationally representative study

Religious participation is linked to numerous positive safety outcomes for adolescents. Scant attention, however, has been paid to associations between religious participation and safety risks among adolescents. Using data from Add Health (N = 18,449), a nationally representative school-based sample of US adolescents, this study examines the relationship between adolescents' religious affiliation and easy access to firearms at home. Regression analyses adjust for complex sampling design and compare easy firearm access at home among conservative Protestant adolescents to adolescent firearm access in other religious traditions. Conservative Protestant adolescents have a substantially greater likelihood of easy access to a gun at home compared to adolescents of all other major religious traditions in the United States. Recognizing differences in adolescent firearm access between subcultural groups can help public health interventions more effectively identify and address the needs of vulnerable populations. The paper's conclusion considers suggestions for effective policy and programmatic initiatives.

Moving up matters: Socioeconomic mobility prospectively predicts better physical health.

Low socioeconomic status (SES) in childhood confers risk for poor physical health later in life. This study prospectively examines whether improvements in family SES protect youth from developing physical health problems by adulthood and whether such effects differ by race or age. Participants are a school-based sample of urban Black (53%) and White (47%) men (N = 311). Using latent growth curve modeling, we prospectively examined whether changes in family SES measured annually between Ages 7 and 16 predicted physical health diagnoses in adulthood (Age 32). Family SES was assessed as a weighted composite of parental education and occupational status. Physical health diagnoses were assessed as a count of self-reported medical conditions from a health history interview. Consistent with macroeconomic trends, on average, family SES increased until the early 1990s, then remained flat until rising again in the mid-1990s. During each of 3 independent developmental periods, boys raised in families who experienced more positive changes in SES reported fewer physical health diagnoses in adulthood. These effects did not vary significantly by race and remained after controlling for initial childhood SES, childhood health problems, concurrent adult SES, and weight (Body Mass Index or reported overweight). Initial childhood SES did not predict physical health, whereas relative improvements in SES over a 10-year period did. If the families of Black and White boys were upwardly mobile, it appeared to protect them from developing physical disease, and upward mobility was additively protective across developmental periods examined here. (PsycINFO Database Record

Emotional Symptoms and Dietary Patterns in Early Adolescence: A School-Based Follow-up Study

ObjectiveTo examine the relationship between early emotional symptoms and dietary patterns over 3 years in a school-based sample. DesignThree-year longitudinal prospective study. SettingThirteen schools in Reus, Spain. ParticipantsFrom a sample of 562 preadolescents with and without emotional symptoms, 165 were observed and were classified as either showing (n = 100) or not showing emotional symptoms (n = 65). Main Outcome MeasureEmotional symptoms were assessed at baseline and after 1 and 3 years. In the third year, data were collected on food consumption, adherence to the Mediterranean diet (MD), and physical activity. AnalysisDietary patterns were created by principal component analysis. Multivariate logistic regression was conducted with P < .05 considered significant. ResultsGirls with emotional symptoms scored significantly lower in assessments for MD (score of 5.41 ± 2.19) and physical activity (score of 4.97 ± 2.05) than did girls who had no emotional symptoms (scores: MD, 6.19 ± 1.67; physical activity: 5.86 ± 1.94). Approximately 39.68% of girls with emotional symptoms showed high adherence to a sweet and fatty food pattern. After adjusted logistic regression, girls with emotional symptoms were 4 times as likely to have high adherence to a sweet and fatty food pattern (odds ratio, 4.79; 95% confidence interval, 1.55–15.10). No differences were observed among boys. Conclusions and ImplicationsGirls with emotional symptoms during early adolescence have high adherence to a pattern rich in sweet and fat foods and low adherence to MD, and engage in low levels of physical activity. These findings highlight the importance of managing emotional distress to prevent it from having a negative effect on eating behavior.

High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country.

The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth. To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting. We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth ( n = 120, ages 18-22 years) using a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID)-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments. The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector, and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year. Findings demonstrate a high mental health burden among Haiti's youth and that many youth with MDE and PTSD are not accessing mental health care.

Preliminary Evaluation of the NIAAA/AAP Brief Alcohol Use Screener.

Aims To assess the concurrent validity of the two-item NIAAA/American Academy of Pediatrics Brief Alcohol Use Screener, a developmentally sensitive assessment instrument, in a school-based sample of adolescents. Method The sample consisted of 756 adolescents (53% girls; Mage = 13.7 years; SD = 1.6 years) in the 6th (n = 192), 8th (n = 283), and the 10th (n = 281) grades from Miami-Dade County, FL and Prince George's County, MD. Adolescents completed the NIAAA/AAP Brief Alcohol Use Screener, which consists of two items asking about adolescents' alcohol use and about peers' alcohol use during the last year. Peer-Risk is categorized into 'No Peer-Risk' versus 'Heightened Concern'; Self-Risk is categorized into 'No-Risk,' 'Low-Risk,' 'Moderate-Risk' or 'High-Risk,' based on alcohol use patterns and age. Adolescents also completed measures of recent alcohol use and four previously validated screener instruments. Results Relative to the self-use 'No-Risk' category, adolescents classified into the 'Low-,' 'Moderate-' and 'High-Risk' categories reported progressively greater alcohol use and misuse during the last 90 days. Similar patterns were observed between the Peer-Risk categories. Combined, the two NIAAA/AAP screener items were positively related to recent alcohol use and outperformed the other screeners examined. Conclusions Results from the present study support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments. Short Summary The current results support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments, in a school-based sample of adolescents.

A Successful Strategy for Linking Anonymous Data from Students' and Parents' Questionnaires Using Self-Generated Identification Codes.

We conducted a feasibility study for matching children (N=2571, average age 12years, 50.4% female) and their parents (N=1931, average age 41years, 83.3% female) represented by an anonymous self-generated identification code (SGIC) and assessed its methodological properties. We used a nine-character SGIC with the children and a mirrored version of the same code with the parents. The average overall error rate in generating the SGIC was 9.7% (4.0% in the parents and 13.9% in the children). We were able to link a total of 1765 parents' and children's codes uniquely (94.9% of all possible dyads) with any four-character combination and the employment of the "school" variable. The overall matching quality of linking using the SGIC only is characterized by precision (positive predictive value) of 0.979, recall (sensitivity, true positive rate) of 0.934, and an F-measure (harmonic mean of precision and recall) of 0.956. The analysis of the discrepant characters in the dyads identified the paternal grandmother's name and eye color as those varying most often. This study is the first to look at SGIC match rates and error and omission rates in linking different subjects into dyads in prevention research. We identified a high number of unique child-parent matches while guaranteeing anonymity to the participants. We provided evidence that our SGIC is a suitable tool for between-group linking procedures and has a highly successful matching rate, while maintaining anonymity in the school-based prevention study samples.

Preliminary Evaluation of the NIAAA/AAP Brief Alcohol Use Screener.

To assess the concurrent validity of the two-item NIAAA/American Academy of Pediatrics Brief Alcohol Use Screener, a developmentally sensitive assessment instrument, in a school-based sample of adolescents. The sample consisted of 756 adolescents (53% girls; Mage = 13.7 years; SD = 1.6 years) in the 6th (n = 192), 8th (n = 283), and the 10th (n = 281) grades from Miami-Dade County, FL and Prince George's County, MD. Adolescents completed the NIAAA/AAP Brief Alcohol Use Screener, which consists of two items asking about adolescents' alcohol use and about peers' alcohol use during the last year. Peer-Risk is categorized into 'No Peer-Risk' versus 'Heightened Concern'; Self-Risk is categorized into 'No-Risk,' 'Low-Risk,' 'Moderate-Risk' or 'High-Risk,' based on alcohol use patterns and age. Adolescents also completed measures of recent alcohol use and four previously validated screener instruments. Relative to the self-use 'No-Risk' category, adolescents classified into the 'Low-,' 'Moderate-' and 'High-Risk' categories reported progressively greater alcohol use and misuse during the last 90 days. Similar patterns were observed between the Peer-Risk categories. Combined, the two NIAAA/AAP screener items were positively related to recent alcohol use and outperformed the other screeners examined. Results from the present study support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments. The current results support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments, in a school-based sample of adolescents.

An investigation of the longitudinal relationship between sleep and depressed mood in developing teens.

ObjectiveThe prospective, bidirectional relationship between sleep disturbance and depressed mood was assessed in a school-based sample of adolescents.MethodOne hundred and thirty-eight Australian adolescents (mean age time 1 =15.69, standard deviation =0.92; 64% male) completed questionnaires to assess sleep parameters and depressed mood, on two occasions over 1 year.ResultsCross-sectional associations were observed between depressed mood and sleep duration, as well as wakefulness in bed. Prospective analyses revealed depressed mood predicted less total sleep time on school nights and a longer latency to sleep onset on weekends 1 year later. There was no prospective support for sleep predicting later depressed mood.ConclusionContrary to prediction, our results suggest in this case that depressed mood may act as a precursor to poor sleep rather than the converse.

E-cigarettes and National Adolescent Cigarette Use: 2004-2014.

E-cigarette use is rapidly increasing among adolescents in the United States, with some suggesting that e-cigarettes are the cause of declining youth cigarette smoking. We hypothesized that the decline in youth smoking changed after e-cigarettes arrived on the US market in 2007. Data were collected by using cross-sectional, nationally representative school-based samples of sixth- through 12th-graders from 2004-2014 National Youth Tobacco Surveys (samples ranged from 16 614 in 2013 to 25 324 in 2004). Analyses were conducted by using interrupted time series of ever (≥1 puff) and current (last 30 days) cigarette smoking. Logistic regression was used to identify psychosocial risk factors associated with cigarette smoking in the 2004-2009 samples; this model was then applied to estimate the probability of cigarette smoking among cigarette smokers and e-cigarette users in the 2011-2014 samples. Youth cigarette smoking decreased linearly between 2004 and 2014 (P = .009 for ever smoking and P = .05 for current smoking), with no significant change in this trend after 2009 (P = .57 and .23). Based on the psychosocial model of smoking, including demographic characteristics, willingness to wear clothing with a tobacco logo, living with a smoker, likelihood of smoking in the next year, likelihood of smoking cigarettes from a friend, and use of tobacco products other than cigarettes or e-cigarettes, the model categorized <25% of current e-cigarette-only users (between 11.0% in 2012 and 23.1% in 2013) as current smokers. The introduction of e-cigarettes was not associated with a change in the linear decline in cigarette smoking among youth. E-cigarette-only users would be unlikely to have initiated tobacco product use with cigarettes.

Home Sweet Home: Parent and Home Environmental Factors in Adolescent Consumption of Sugar-Sweetened Beverages

ObjectiveSugar-sweetened beverages (SSBs) are key contributors to obesity among youth. We investigated associations among parental and home-related factors (parental attitudes and consumption; home availability) regarding 3 types of SSBs—soda, sports drinks, and fruit-flavored drinks—with consumption of each type of SSB in a general school-based sample of adolescents. MethodsData were collected across 3 school semesters, from 2009 to 2011. A total of 1313 seventh grade student–parent dyads participated. Students completed in-class surveys across 9 schools in a large Los Angeles school district; their parents completed telephone interviews. Youth were asked about their SSB consumption (soda, sports drinks, and fruit-flavored drinks), and parents were asked about their attitudes, consumption, and home availability of SSBs. ResultsWe estimated expected rates of youth SSB consumption for hypothetical parents at very low (5th) and very high (95th) percentiles for home/parental risk factors (ie, they consumed little, had negative attitudes, and did not keep SSBs in the home; or they consumed a lot, had positive attitudes, and did keep SSBs in the home). Youth of lower-risk parents (at the 5th percentile) were estimated to drink substantially less of each type of beverage than did youth of higher-risk parents (at the 95th percentile). For example, youth with higher-risk parents averaged nearly double the SSB consumption of youth of lower-risk parents (2.77 vs 1.37 glasses on the previous day; overall model significance F22,1312 = 3.91, P < .001). ConclusionsResults suggest a need to focus on parental and home environmental factors when intervening to reduce youths' SSB consumption.

Aggression and related stressful life events among Chinese adolescents living in rural areas: A cross-sectional study

BackgroundAggression is a serious problem for both individuals and society. Despite progress in aggression research, its persistence among adolescents living in rural areas remains to be investigated. We evaluate the prevalence of aggression and the association between stressful life events and aggression in a nationwide, school-based sample of adolescents living in rural areas of China. MethodsA sample of 13,495 Chinese rural students (7065 boys and 6430 girls; 11–20 years old) was selected from 15 representative rural areas from 5 provinces in China using stratified randomized cluster sampling. Aggression, stressful life events, neglect, emotional management, social support, and demographic characteristics were assessed via self-report questionnaires. Multivariate logistic regressions were used to estimate the association of stressful life events and aggression after controlling for confounds. ResultsThe prevalence of aggressive behavior among Chinese adolescents living in rural areas was 24.3%. Regression analyses indicated that the odds of aggression were negatively influenced by chronic long-term stressors related to interpersonal problems (OR=2.03, 95% CI [1.75–2.36]), health adaptation difficulties (OR=1.21, 95% CI [1.09–1.34]), and other troubles (OR=1.93, 95% CI [1.74–2.14]), even after adjustment for parental neglect, emotional management, social support, and other relevant factors. LimitationsThis study was cross-sectional; thus, it is necessary to validate the causal relationship between stressful life events and aggression via follow-up studies. ConclusionsAggression was prevalent among Chinese adolescents living in rural areas, and interpersonal problems, health adaption difficulties, and other troubles were considered potential independent risk factors for aggression.

Different patterns of behavioural and emotional difficulties through adolescence: The influence of prosocial skills

&lt;p&gt;The main purpose of the study was to examine the cluster composition of the analysis on the effect of gender and age of the Strengths and Difficulties Questionnaire (SDQ) in a large school-based sample of high school adolescents ranging from 14 to 18 years old (&lt;em&gt;N&lt;/em&gt; = 1474). In order to do this, a K-means iterative cluster analysis was performed. A five-cluster solution turned out to be the most parsimonious in the differentiation of emotional and behavioural patterns. A five-cluster solution yielded the following patterns: “No difficulties and high prosocial scores” (&lt;em&gt;n &lt;/em&gt;= 418; 28.36%), “high difficulties and low prosocial scores” (&lt;em&gt;n&lt;/em&gt; = 239; 16.21%), “high on hyperactivity, low on the rest of the difficulties subscales, and high in prosocial capabilities” (&lt;em&gt;n&lt;/em&gt; = 302; 20.49%), “high on emotional and peer problems, relatively low on conduct and hyperactivity, and high in prosocial capabilities” (&lt;em&gt;n&lt;/em&gt; = 275; 18.66%), and finally “hyperactivity problems and average in the others difficulties subscales, and in prosocial capabilities” (&lt;em&gt;n&lt;/em&gt; = 239; 16.21%). This cluster solution was replicated attending to the same gender and age groups. Nevertheless, differences in the distribution of the cluster composition suggest that difficulties differ by gender and age. The results allow for the conclusion that men reveal a greater number of problems of an externalizing nature whereas women indicate a greater degree of problems with internalizing difficulties and prosocial skills.&lt;/p&gt;