Spanish Adolescents Research Articles

Twenty-year trend in the prevalence of increased cardiometabolic risk, measured by abdominal obesity, among Spanish children and adolescents across body mass index categories.

Identifying children and adolescents with cardiometabolic risk at an early stage is crucial for effective treatment and prevention. From a practical perspective, this could be accomplished by assessing the presence of abdominal obesity, which serves as a surrogate indicator of increased cardiometabolic risk and is easy to measure. However, the assessment of abdominal obesity via waist circumference has not yet become a standard procedure in pediatric healthcare. The present study aimed to analyze the secular trends in increased cardiometabolic risk, as indicated by waist circumference among Spanish children and adolescents. This study included 4861 children and adolescents aged 8 to 16years from two nationwide representative cross-sectional surveys, the EnKid study and the PASOS study, conducted in 1998-2000 and 2019-2020, respectively. Anthropometric variables were measured in both surveys by trained personnel. Three different waist-to-height (WHtR) cutoffs were used to define abdominal obesity as criteria for cardiometabolic risk. BMI categories were defined according to the IOTF and WHO growth charts. Abdominal obesity [waist to height ratio (cm/cm) > 0.49] significantly increased from 40.7 to 56.1% and 93.8 to 97.2% in participants with overweight and obesity, respectively, between 1998-2000 and 2019-2020 (p < 0.05). Logistic regression analysis, adjusted for sex and age, revealed that the odds of being at increased cardiometabolic risk in 2019-2020 was 1.99 (95% CI 1.48-2.67) in participants with overweight in comparison with 1998-2000. The effect size was comparable among the three WHtR criteria for abdominal obesity or the BMI categories according to IOTF and WHO boundaries. The prevalence of Spanish children with increased cardiometabolic risk, identified by abdominal obesity, significantly increased among those with overweight during the last two decades. This finding underlines the need of including the measurement of waist circumference as a standard procedure in pediatric practice.

Persistence of ADHD into adulthood and associated factors: a prospective study.

BackgroundAttention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders in child and adolescent psychiatry. The aims of this study are to describe the persistence of ADHD into adulthood and to explore factors associated with persistence.Methods: This is a prospective study conducted in a clinical sample of Spanish children and adolescents diagnosed with ADHD. After a baseline interview in which a battery of standardized scales was administered (e.g., Strengths and Difficulties Questionnaire (SDQ). A review of the digital medical history was carried out ten years after recruitment. The persistence of the ADHD diagnosis into adulthood and the end-point diagnoses were described. We carried out logistic regression to explore the factors associated with ADHD persistence.Results: Most of the patients (87.5%) kept the ADHD diagnosis into adulthood. Factors associated with ADHD persistence was high SDQ hyperactivity/inattention subscale scores at baseline (OR = 1.197), high scores on the SDQ peer relationship problems subscale (OR = 0.823), number of diagnoses at baseline (OR = 0.490).Conclusions: Our findings show that ADHD diagnosed in children often persists into adulthood. An appropriate transition between child and adolescent mental health services and adult services needs to be mapped out, as a large proportion of children with ADHD will continue to need mental health care during their adulthood.

Prevalence and correlates of driving under the influence of alcohol and cannabis among Spanish adolescents.

Driving under the influence (DUI) of substances is the first cause of death among young populations. Unfortunately, there is a paucity of research looking at DUI risk factors in adolescents. This study aimed to estimate the past-year prevalence and correlates of DUI of alcohol (DUI-A), cannabis (DUI-C), and both (DUI-A+C) in adolescents who reported past-year alcohol and cannabis use. The study sample comprised 3,175 [(47.9 % females; Mage (SD) = 16.76 (.70)] Spanish adolescents from a national representative survey (ESTUDES) conducted by the Spanish Ministry of Health. Hierarchical regression models were conducted to identify correlates of DUI-A only, DUI-C only, and both behaviors, including sociodemographic, substance use and parental control variables. Past-year prevalence of DUI was 9.9 % among past-year alcohol and cannabis users. Past-year DUI of substances was more likely among males (15.4 %) relative to females (6 %) [χ2 = 73.39, p = <.001, Φ = .152]. Being male, reporting higher past-month days of cannabis use and cannabis-related problems were common risk factors for DUI-C and DUI-A+C. Risk factors of DUI-A were greater money availability for going out, higher past-month frequency of heavy drinking episodes and lower past-month cannabis use days. Specific correlates of DUI-A+C were being 18, past-year simultaneous alcohol and cannabis use, and earlier age of alcohol use initiation. There is a need to address DUI in substance use prevention in school settings. Screening should be particularly focused on adolescent substance users, while interventions should target attitudes and risk of substance use and driving.

Can’t stop scrolling! Adolescents’ patterns of TikTok use and digital well-being self-perception

Digital well-being, which refers to a balanced individual experience of digital consumption, has been gaining attention recently in the study of the effects of digital technology use. Social networks are central in debates over digital well-being, as social media overuse is often identified as a primary issue. Teenagers who spend an average of three hours daily on social media especially draw the attention of researchers. Based on statistical evidence, TikTok is the most popular network among young users worldwide. However, there are not many platform-specific studies on its effects on adolescent well-being. One of the most consistent gaps is the lack of research on how different aspects involved in TikTok use impact adolescents’ digital well-being on the app. In light of this, the study aimed to explore the relationship between time spent on TikTok, content consumption, and self-perception of digital well-being. Given the scientific consensus on social media’s greater impact on girls, this study also sought to examine gender differences. For that purpose, a quantitative cross-sectional study was conducted with 737 Spanish adolescents aged 12 to 18, who completed an online questionnaire with validated scales and items on daily usage time, type of content consumption, and digital well-being. Results showed significant gender differences in TikTok usage and content consumption: girls spent more time on TikTok and notably engaged more with beauty and fashion content, while boys with video games and sports content, suggesting that traditional gender roles are still present in their choices of content consumption. Beyond that, a rather positive self-perception of digital well-being on TikTok by teenagers was observed. Despite this, an increased TikTok usage was associated with a reduced ability to set boundaries and limit their time on the app. These findings highlight the need for measures to limit the time adolescents spend on TikTok, such as mandatory parental controls on electronic devices and educational programs aimed at promoting healthy digital habits.

Adolescents' chronotype and its association with obesity-related outcomes: The EHDLA study.

This study aimed to assess associations between chronotype and obesity-related indicators in a sample of Spanish adolescents. This cross-sectional study used data from The Eating Healthy and Daily Life Activities (EHDLA) Study, which included a representative sample of adolescents from Spain. A total of 820 adolescents (54.7% girls) aged 12-17 years were included in the analyses. The adolescents' chronotype was determined using the Morningness/Eveningness Scale in Children. Obesity-related indicators included body mass index, waist circumference, waist-to-height ratio, triceps and medial calf skinfolds, sum of skinfolds, and body fat percentage. Generalized linear models were used to examine the relationship between the Morningness-Eveningness score and chronotype status and the above-mentioned obesity-related indicators in adolescents. All analyses were adjusted for sex, age, socioeconomic status, sleep duration, physical activity, sedentary behaviour, adherence to the Mediterranean diet, and energy intake. The morningness chronotype was associated with higher abdominal obesity (odds ratio [OR] = 1.67, 95% confidence interval (CI) 1.12 to 2.50; p = 0.001), waist-to-height ratio (unstandardized beta coefficient [B] = 0.01, 95% CI 0.01 to 0.05; p = 0.029) and skinfold calves (B = 1.04 95% CI 0.24 to 1.94; p = 0.011), compared with the intermediate chronotype. Adolescents with a morningness chronotype may be more prone to abdominal obesity than their counterparts with an intermediate chronotype. Effective intervention-related approaches can be applied to those with a morningness chronotype.

Neurocognitive functioning during adolescence: Spanish validation of the Penn Computerized Neurocognitive Battery.

The Penn Computerized Neurocognitive Battery - Child Version (PennCNB-cv) is presented as a brief tool that allows comprehensive and automated assessment of 5 factors (via 14 performance tasks): Executive Control, Episodic Memory, Complex Cognition, Social Cognition, and Sensorimotor Speed. The literature links (dys)functions in these areas with psycho(patho)logical constructs, but evidence is scarce among Spanish-speaking youth. Therefore, this study aims to validate the PennCNB-cv in a community sample of Spanish adolescents. After a process of (back)translation and adaptation by bilingual researchers, the PennCNB-cv was administered in 34 schools. The sample included1506 students, ages 14-19, 44.28% were male. Preliminary treatment of the data included descriptive and correlational statistics. To provide evidence of structural validity, exploratory and confirmatory factor analyses were performed. Results from the exploratory and confirmatory factor analysis showed a four-factor model (Complex Cognition, Executive Control, Episodic Memory, and Social Cognition) as the most appropriate.These findings provide compelling evidence in favor of the a priori theory that underpinned the development​ of the CNB. The study of the psychometric properties showed that the Spanish version of the PennCNB-cv, seems to be an adequate tool for assessing neurocognitive functioning during adolescence.

Dating Violence and the Quality of Relationships through Adolescence: A Longitudinal Latent Class Study.

Dating violence can manifest itself in different ways, with important consequences for both members of the couple. Due to the normalization of certain behaviour and the perceived quality of the relationship, it may be difficult to identify this violent dynamic in its early stages, allowing it to escalate and lead to severe levels of violent behaviour. This study aims to analyse violent profiles using latent class analysis (LCA) and explore the role of relationship quality variables as risk factors for those profiles. A two-stage longitudinal design was used with a sample of 2849 Spanish adolescents between 12 and 18 years old. The LCA produced five different groups: those not involved in violence; those involved in mild forms of violence (with two sub-groups: those involved in psychological-sexual violence and in psychological-physical violence); and those involved in the most severe forms of violence, with a co-occurrence of psychological-physical-sexual violence (with two sub-groups, according to the higher of lower frequency of involvement). Despite the differences between boys and girls, negative-quality variables played a more important role in dating violence. Discussion of the results focuses on both the complex nature of the violence and the multi-probabilistic view of its development.

Influence of Cardiovascular Risk Factors and Metabolic Syndrome on Epicardial Adipose Tissue Thickness in Rural Spanish Children and Adolescents

The presence of visceral adipose tissue implies a higher risk of cardiovascular diseases than subcutaneous adiposity, the most dangerous heart fat. Epicardial adipose tissue (EAT) could have great potential as a detection indicator of cardiovascular diseases, although it has seldom been studied in Spanish children. Objective: The objective of the current research was to describe the values of EAT in a Spanish pediatric population and to investigate the associations between EAT and anthropometric measures, blood pressure, lipid and glucose profiles, and metabolic syndrome. Method: An analytical cross-sectional study of elementary and high school students (aged 6 to 17) measured anthropometrics, blood pressure, lipid and glycemic profiles, and echocardiographic fat thickness. The analysis was based on regression and discriminant analysis. Results: The results of this study (N = 227) showed that the body mass index (BMI) was 20.29 ± 4.54, with an overweight set of 49.77%, and the percentage for metabolic syndrome was 5.3%. EAT was linked to being male, BMI percentile, waist circumference, waist-to-height ratio (p &lt; 0.001), hypertension, higher low-density lipoprotein (LDL) levels, and metabolic syndrome (p &lt; 0.05). Conclusions: This paper argues that in children with higher elevated EAT thickness values, this correlates with cardiovascular risk factors including high blood pressure, elevated LDL levels, and metabolic syndrome.

Phubbing in Adolescents: Spanish Validation of the Phubbing Scale (PS).

The Phubbing Scale (PS) is an instrument used to measure the frequency and extent of the behavior of ignoring someone you are with and giving attention to your mobile phone instead. However, there is insufficient evidence about the psychometric adequacy of the Spanish version of the instrument. The main goal of this research was to analyze the psychometric properties of PS in a representative sample of Spanish adolescents and young adults. A total of 1351 participants comprised the sample (42.78% females, age range = 12-21). Students were selected from different levels of education such as secondary school, high school, vocational training, or university. A convenient sample was used. The reliability of the scores was calculated by means of McDonald's Omega. The evidence of the internal structure of the questionnaire was analyzed by means of confirmatory factor analysis (CFA). The measurement invariance of the instrument by gender and educational level was also calculated. In addition, Pearson's correlations between phubbing and other indicators of mental health were also calculated. The goodness-of-fit indices for the two-factor model were good. The McDonald's Omega coefficient for the total score was 0.787. Measurement invariance both by gender and educational level was found. The phenomenon of phubbing was found to have statistically significant correlations with emotional well-being, other mental health indicators, and with Problematic Internet Use (PIU), with the sole exception of the hyperactivity subscale of the SDQ. This study provided validity evidence for the Spanish version of the Phubbing Scale (PS), suggesting that PS is a reliable tool for quantifying phubbing in Spanish adolescents.

Core self-evaluations and perceived classmate support: Independent predictors of psychological adjustment.

The main aim of this research was to explore the contribution of both core self-evaluations (CSE) and classmate support as unique predictors of positive and negative psychological adjustment among adolescents. In a cross-sectional study, 2,293 Spanish adolescents (Mage = 14.07) completed the Core Self-Evaluations Scale, the Classmate Support subscale, the Satisfaction with Life Scale, the Depression, Anxiety, and Stress Scales and the Frequency of Suicidal Ideation Inventory. Pearson correlations among assessed variables were examined, and three hierarchical regression analyses were conducted to examine the predictive role of CSE and classmate support on life satisfaction, depressive symptomatology, and suicidal ideation. Both CSE and classmate support were positively related to life satisfaction and negatively related to depressive symptoms and suicidal ideation. Hierarchical regression analyses identified CSE and classmate support as independent predictors of both positive and negative psychological outcomes in this sample. These results indicated support for a comprehensive model involving CSE and classmate support as additive predictors of both positive and negative outcomes among adolescents. These findings underscore the unique and additive role of both individual (i.e., CSE) and, to a lower degree, social factors (i.e., classmate support) to augment the prediction model of positive and negative psychological adjustment among adolescents. Practical implications are discussed, focusing on preventive programs that include strategies to increase positive self-appraisals and create a supportive classroom climate.

Psychometric Examination of the PROMIS Parent Proxy Pediatric Sleep Measures from Early Childhood to Adolescence in a Nationally Representative Spanish Sample.

To use a nationally representative sample to (1) evaluate the factor structure of the PROMIS parent proxy pediatric sleep scales (Spanish translation), (2) examine the invariance of these scales across sex and across different developmental periods of childhood and adolescence, (3) confirm the information and precision of the scales using item response theory (IRT), and (4) provide age-based normative information. Parents of a nationally representative sample of 5,525 Spanish children and adolescents ages 5-16 years (56.1% boys) completed the Spanish translation parent proxy short versions of the Sleep Disturbance and Sleep-Related Impairment scales. We conducted confirmatory factor analyses (CFA), invariance analyses, and graded response IRT analyses. CFAs conducted separately on males and females within three age groups (early childhood: ages 5-8 years; middle childhood: ages 9-12 years; adolescence: ages 13-16 years) indicated all items had a substantial loading with one exception (the sleep continuity item ["my child slept through the night"] had a substantially lower loading and was removed for subsequent analyses). The scores on the two scales demonstrated invariance across sex within each age group. Using IRT analyses, both scales showed a high degree of information and precision from slightly below the trait means to slightly above two standard deviations above the trait means. The strong psychometric properties of the short versions of the parent proxy PROMIS pediatric sleep disturbance and sleep-related impairment scales, coupled with age-based norms, suggests these scales are likely to be useful for research and clinical applications.

Antisocial behaviors at school: Analysis of normative and at-risk groups

School plays a crucial role in adolescent development and in the prevention of antisocial behaviors. This study focuses on five common antisocial behaviors within the school environment. Analysis was conducted with various groups of adolescents aged 11–16, including a normative sample of Spanish adolescents, and two samples of adolescents from high psychosocial risk areas: Polígono Sur (Seville, Spain), and IV Municipalità (Naples, Italy). The normative sample consisted of a representative group of Spanish adolescents who responded to the 2014 HBSC questionnaire, whereas data from Polígono Sur and IV Municipalità were collected specifically from these populations. The prevalence of each antisocial behavior was analyzed according to reference group, age, sex, and two key school adjustment variables: feelings about school and perceived school pressure. Additional analysis explored how these variables and their interactions contribute to variations in antisocial behavior. The findings offer valuable insight for designing prevention and intervention programs aimed at addressing antisocial behaviors within the school context.

Social Anxiety Profiles and Psychopathological Symptom Differences in Spanish Adolescents.

Research on social anxiety (SA) over the years has revealed its associations with different psychopathological symptoms. This study aims to characterize SA profiles in a sample of Spanish adolescents and explore their differences in psychopathological symptoms. Data from 1,288 Spanish students in the 15 to 18 age range (M = 16.30, SD = 0.97, 47.5% female) were collected using random cluster sampling. The Social Anxiety Scale for Adolescents (SAS-A) and the Symptom Assessment-45 Questionnaire (SA-45) were employed. Four SA profiles were revealed by the Latent Profile Analysis (LPA): extreme SA, high SA, moderate SA, and low SA. Statistically significant differences in psychopathological symptoms were revealed by the MANOVA (effect sizes from d = -2.13 to d = -0.37). The extreme SA profile exhibited the most severe psychopathological symptoms, whereas the low SA profile displayed the mildest manifestations. Proposed interventions aim to support adolescents with SA risk profiles.

Self-compassion as a moderating variable between attachment, emotional dependence, stress, anxiety, and depression in Spanish adolescents

Attachment is a critical element of the origin of emotional dependence, and one of the most studied consequences of emotional dependence is its role in the development of anxious-depressive symptomatology. Self-compassion has been shown to be a protective factor against anxiety and depression, but no studies have been found that relate it to emotional dependence. Therefore, the three objectives of the present study were to analyse the relationship between these variables; to study whether sociodemographic variables influence these variables; to test whether emotional dependence mediates the relationship between attachment and dysfunctional psychological symptomatology; and to determine whether these relationships are moderated by self-compassion. The sample consisted of 940 adolescents (55.7% female and 44.3% male) from Spain. Emotional dependence was found to mediate the relationship between attachment and dysfunctional psychological symptomatology, and these relationships were moderated by self-compassion. Self-compassion is recognised as having a protective effect on levels of emotional dependence, stress, anxiety and depression.

Future-oriented coping: gender and adolescent stage as modulators of its use, dispositional profile and relationship with emotional adjustment outcomes

The aim of this study was to examine possible differences by sex and stage of adolescence in the use of proactive and preventive coping, its relationships with personality and emotional adjustment. A total of 934 Spanish adolescents participated. No differences were found by sex or stage of adolescence in the use of future-oriented coping or in its relationship with adjustment scores. The differences found were centered on the dispositional profile of future-oriented coping shown by the different subgroups. The dispositional profile of proactive coping was more complex in girls and in late adolescence. In contrast, the dispositional profile of preventive coping was more complex in boys, and the differences by stage of adolescence highlighted the different weight of the personality dimensions involved. These findings point to the importance of developing programs adapted according to sex and stage of adolescence to train adolescents in the use of future-oriented coping skills and to improve their mental health.

Lagged and simultaneous effects of exposure to violence at home on child-to-parent violence: gender differences.

Numerous studies have found that exposure to violence at home is a risk factor for child-to-parent violence. However, most of the available studies do not delimit a time frame for exposure to violence. This aspect is fundamental to differentiating lagged effects (compensation) from simultaneous effects (reciprocal). The purpose of this study is to clarify the relationship between lagged (before the age of 10) and simultaneous (last year) exposure to violence at home (direct victimization: parent-to-child violence and vicarious victimization: exposure to violence between parents) and child-to-parent violence, the possible differential reactive or instrumental motivation of these relationships and whether they differ based on the gender of children and parents. The sample comprised 1,734 Spanish adolescents who lived with both parents (57.3% girls), aged between 13 and 17 years. The instruments used were the Child-to-Parent Violence Questionnaire and the Violence Exposure Scale. Positive and significant relationships were found between child-to-parent violence and exposure to violence at home both during childhood and during the last year; however, the relationships were stronger in the latter. The most important predictors were direct parental victimization during the last year. Boys exerted more reactive violence toward the father concerning exposure to violence by the father toward the mother during the last year. In the case of girls, violence toward both father and mother is more reactive to most victimization experiences. The findings highlight the need to intervene in family contexts of violence to prevent child-to-parent violence.

How can the Social Family Climate Contribute to Emotional Intelligence in Preventing Suicidal Ideation and Promoting Life Satisfaction Among Adolescents?

While findings have documented the association between emotional intelligence, life satisfaction, and suicidal ideation among adolescents, few studies have investigated the moderating effect of family climate on the association. This study examined the moderating effect of family cohesion, expressiveness, and conflict on the relationships between emotional intelligence, life satisfaction, and suicidal ideation among Spanish adolescents. A total of 2,722 adolescents aged 12 to 18 (Mage = 14.11, SD = 1.42, 52.8% girls) formed the sample. The interaction effects were significant, with family conflict mitigating the effects of emotional intelligence on life satisfaction, and family cohesion and expressiveness strengthening the effects of emotional intelligence on suicidal ideation. These findings provide additional evidence for the protective role of family cohesion and expressiveness in adolescent suicidal ideation, and the harmful role of family conflict in adolescent wellbeing. The results imply that enhancing family cohesion and expressiveness and reducing family conflict may be a promising way to boost the link between emotional intelligence and life satisfaction and to prevent suicidal ideation among adolescents.

Are perceived barriers to physical activity related to depression, anxiety and stress among adolescents? The EHDLA study

ObjectiveThe aim of this study was twofold: first, to examine the association between perceived barriers to physical activity (PA) practice and depression, anxiety and stress in a sample of Spanish...

Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents.

This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2-14. Parents or guardians reported the weight and height of participants, used to calculate body mass index (BMI) and BMI z-scores according to the International Obesity Task Force standards. Participants were categorized into "overweight/obesity" and "no overweight/obesity" and further into "obesity" and "no obesity". The rate of poverty rate was determined using data from the National Statistics Institute of Spain, defining it as the percentage of people with income below 60% of the national median. SES was based on the head of household's occupation and categorized into low, medium, and high levels. Adjusted multilevel models showed participants with medium or high SES had lower odds of overweight/obesity compared to those with low SES (medium SES: odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.54-0.73; high SES: OR: 0.59, 95% CI: 0.49-0.70). Participants in the high-poverty group had higher odds of having overweight/obesity (OR: 1.40, 95% CI: 1.13-1.74) compared to the low-poverty group. The study highlights significant socioeconomic disparities in childhood overweight/obesity, emphasizing the potential impact of SES and poverty on health outcomes in Spanish children and adolescents.

Meal Duration and Obesity-Related Indicators among Adolescents: Insights from the EHDLA Study.

This paper aims to examine the association between meal duration and obesity indicators among Spanish adolescents. We conducted a cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) project involving 755 adolescents aged 12 to 17 years (54.8% girls) from three secondary schools in the Valle de Ricote Region of Murcia, Spain. To evaluate overall meal duration, participants were asked how long (on average) breakfast, morning snacks, lunch, afternoon snacks, and dinner typically last. Subsequently, global meal duration was measured, and the participants were categorized into tertiles. Obesity-related indicators, including body mass index (BMI) z score, waist circumference (WC), and skinfold thickness, were assessed. The analyses were adjusted for potential confounders such as sex, age, socioeconomic status, physical activity, sedentary behavior, diet quality, and energy intake. Concerning meal duration status, adolescents with long meal durations had the lowest estimated marginal means of BMI z score, WC, and body fat percentage (using the sum of triceps and calf skinfolds). However, significant differences between adolescents with a long meal duration and those with a short meal duration were observed only for BMI z score (p = 0.008), and WC (p = 0.020). Furthermore, significant differences in BMI z score (p = 0.017) between adolescents with a long meal duration and those with a moderate meal duration were identified. These findings underscore the importance of promoting slower eating habits as part of obesity prevention strategies. Future studies should explore the causality of this association and its potential for behavioral interventions.