Symptoms In Adolescents Research Articles

Dysfunctional attitudes, social support, negative life events, and depressive symptoms in Chinese adolescents: A moderated mediation model

BACKGROUND Depression is a prevalent psychological issue in adolescents that is significantly related to negative life events (NLEs) and dysfunctional attitudes. High levels of social support can significantly buffer NLEs’ effect on depression. Currently, there is limited research on how social support moderates the relationship between NLEs, dysfunctional attitudes, and depression in adolescents in China. It is imperative to investigate this moderating effect to mitigate dysfunctional attitudes in adolescent undergoing depressive mood, ultimately enhancing their overall mental health. AIM To investigate the relationship and underlying mechanisms between specific dysfunctional attitudes, social support, and depression among Chinese adolescents. METHODS This is a cross-sectional study which selected five middle schools in Shandong Province for investigation in March 2022. Participants included 795 adolescents (49.87% male, mage = 15.15, SD = 1.84, age range = 11-18 years old). All participants completed the Dysfunctional Attitude Scale, Adolescent Life Event Scale, Beck Depression Inventory, and Social Support Rating Scale. A moderated mediation model was conducted to examine the relationship between specific dysfunctional attitudes, social support, and depression. RESULTS Results indicated that NLEs affected depression through the mediating role of specific dysfunctional attitudes (autonomy attitudes β = 0.21; perfectionism β = 0.25). Moreover, social support was found to moderate the mediating effect between NLEs, specific dysfunctional attitudes, and depressive symptoms (autonomy attitudes b2 = -0.08; perfectionism b2 = -0.09). CONCLUSION Dysfunctional attitudes mediated and social support moderated the relationship between NLEs and depression. Social support can buffer depression symptoms among adolescents with autonomy attitudes and perfectionism.

Unraveling the complexities of adolescent depression: A call for action

The adolescent years are a period of profound change, both physically and psychologically. For many, these years are marked by excitement and exploration, but for others, they are fraught with challenges that can lead to significant mental health issues. Depression, in particular, has become an increasingly prevalent concern among adolescents worldwide, and its multifaceted etiology requires a comprehensive approach to understanding and intervention. A recent study on the relationships among negative life events, dysfunctional attitudes, social support, and depressive symptoms in Chinese adolescents offers valuable insights into the complex interplay between various factors contributing to adolescent depression. The authors explore a moderated mediation model to better understand how these factors interact with and contribute to the onset of depression. This article aims to delve into the key findings of the study, highlight its implications for clinical practice, and encourage further research in this critical area.

Effects of different exercise modalities on pediatric and adolescent populations with developmental disorders: a network meta-analysis of randomized controlled trials.

Combat sports, ball sports, neurodevelopmental motor training, and aquatic exercise may be effective exercise modalities for improving symptoms in children and adolescents with developmental disorders. However, the degree of improvement can vary among individuals with specific developmental disorders. Therefore, precise assessment of the individual symptoms of children or adolescents is crucial before selecting specific exercise interventions. PROSPERO (CRD42024545673). • Many studies indicate that exercise as an intervention can have positive effects on individuals with developmental disorders, such as ADHD and autism. However, reported effects vary, and there is no clear consensus on the optimal exercise intervention method yet. • Through a comprehensive network meta-analysis, various exercise interventions for children and adolescents with developmental disorders were compared to determine the optimal approach. The study found that combat sports, ball sports, neurodevelopmental motor training, and aquatic exercise could potentially be effective modalities for improving symptoms in this population.

Transdiagnostic Attentional Deficits Are Associated with Depressive and Externalizing Symptoms in Children and Adolescents with Neuropsychiatric Disorders.

Although inattention, impulsivity, and impairments to vigilance are most associated with attention-deficit/hyperactivity disorder (ADHD), transdiagnostic attentional deficits are prevalent across all psychiatric disorders. To further elucidate this relationship, the present study investigated parent-reported neuropsychiatric symptom correlates of attention deficits using the factor structure of the Conners' Continuous Performance Test (CPT-II), a neuropsychological test of attention. Two-hundred and eighteen children and adolescents (7-21years old) completed the CPT-II as part of standard clinical protocol during outpatient pediatric neuropsychology visits. The factor structure of the CPT-II was determined with a principal component analysis (PCA) using Promax rotation. Pearson correlation analyses and regression models examined the relationship between the generated factor structure, parent-reported clinical symptoms, and pre-determined clinical diagnoses. Results from the PCA suggested a three-factor model best supported the structure of the CPT-II, and were subsequently defined as inattention, impulsivity, and vigilance. Performance-based inattention was significantly correlated with parent-reported hyperactivity, aggression, conduct problems, and depression. Parent-reported depressive symptoms and conduct problems were the strongest correlates of performance-based inattention, not hyperactivity or aggression. Performance-based inattention was significantly associated with an ADHD diagnosis but not a depression or anxiety diagnosis. Findings suggest attentional deficits are not specific to any one disorder. To enhance the identification, classification, and treatment of neuropsychiatric disorders, both researchers and clinicians alike must diminish the importance of categorical approaches to child/adolescent psychopathology and continue to consider the dimensionality of transdiagnostic characteristics such as inattention.

Mental Health of Pediatric Patients with Cystic Fibrosis after 18 Months on Elexacaftor-Tezacaftor-Ivacaftor Therapy.

Research studies are conflicting regarding new highly effective modulators and the association with mental health symptoms for adults and adolescents with cystic fibrosis (CF). For younger children, small studies and case reports indicate a wide range of effects, ranging from improvement in mood to the development of neuropsychiatric symptoms. However, a large placebo-controlled study indicated no causal connection. This study evaluates the frequency and severity of mental health symptoms in children and adolescents while taking elexacaftor/tezacaftor/ivacaftor (ETI). The study includes 81 pediatric patients with CF followed at Nationwide Children's Hospital (NCH). Patient Reported Outcomes Measurement Information System (PROMIS)-Anxiety and Depression, Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder Questionnaire (GAD-7) were used to screen for depression and anxiety. Age-appropriate questionnaires were completed over the first 18 months after initiating ETI. At baseline, majority of participants reported mental health symptoms within normal limits (WNL). For participants with elevated baseline measures, depressive and anxiety symptoms significantly decreased throughout the study period. Depending on the metric, patients experiencing depressive and anxiety symptoms dropped to 2-3% (n = 1, on each depressive measure) and 0% (n = 0, on either anxiety measures) respectively by 18 months. Most pediatric patients with CF did not endorse symptoms of depression or anxiety disorders at ETI initiation. Over the first 18 months of ETI usage, the percentage of patients with these symptoms decreased, suggesting that the percentage of patients experiencing severe symptoms of depression and anxiety may decrease with ongoing use of ETI.

The influence of parenting styles and coping strategies on anxiety symptoms in adolescents: a comparative study of groups with and without non-suicidal self-injury behavior

Background During the COVID-19 pandemic, the global incidence of non-suicidal self-injury (NSSI) has been increasing year by year, especially among adolescents, and it is highly correlated with the level of anxiety among teenagers, particularly within Chinese cultural contexts where parenting styles significantly influence adolescent behavior. Objective This study examines the role of culturally-influenced parenting styles and adolescent coping strategies in relation to anxiety and NSSI behavior, aiming to clarify these multivariate interactions for better understanding and intervention. Methods A cross-sectional survey was conducted with NSSI-diagnosed adolescents from Affiliated Kangning Hospital, Ningbo, China, and healthy adolescents from urban schools. Data on background, parenting styles, coping strategies, and anxiety levels were analyzed using chi-square tests, independent sample t-tests, MANOVA, and regression analysis. Results Adolescents with NSSI reported higher anxiety levels, more punishment and interference, and less emotional warmth from their fathers compared to the non-NSSI group (p < 0.001). The NSSI group also relied more on emotion-oriented coping strategies, while the non-NSSI group favored problem-oriented approaches (p < 0.001). Multivariate analyses confirmed significant effects of NSSI behavior, parenting styles, and coping strategies on anxiety levels. Conclusion This study found that the anxiety levels of NSSI adolescents were significantly higher than those of non-NSSI adolescents in China, which was closely related to less emotional warmth from parents, more punishment and interference, and emotion-focused coping strategies. The results demonstrate that family environment and coping strategies play a critical role in NSSI behavior and anxiety levels, highlighting the importance of emphasizing emotional support and positive coping strategies in the prevention and intervention of NSSI behavior.

Associations of generalized anxiety and social anxiety symptoms with sleep duration, amount of intense exercise, and excessive internet use among adolescents.

Among adolescents, symptoms of generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are not only clinically significant but also continuingly increasing. During adolescence, individuals begin to establish distinct, self-determined lifestyle patterns. This study seeks to identify the associations between such lifestyle factors and the prevalence of GAD and SAD symptoms. The analyzable sample was based on a cross-sectional, nationally representative survey of Finnish 14-18 year old students from comprehensive schools, general upper secondary schools, and vocational institutions. The sample consisted of 60,252 boys and 71,118 girls, with the mean age of 16.05 years (standard deviation 1.06). Symptoms were identified using the GAD-7 (cutpoint of 10), the Mini-SPIN (cutpoint of 6), and the PHQ-2 (cutpoint of 3). Logistic regression models for both GAD and SAD symptoms were stratified by comorbidity group variables. GAD symptoms were closely related to excessive internet use and decreased sleep duration among adolescents, regardless of comorbidity with depression or SAD. SAD symptoms were associated with excessive internet use and a lack of intense exercise, independent of comorbid depression or GAD. The findings underscore the importance of considering lifestyle factors when developing interventions to mitigate GAD and SAD symptoms in adolescents. Interventions and policy recommendations aiming at improving adolescents' health behaviour and mental health should take into account the intertwining of these factors.

Prevalence of depressive symptoms in adolescents living with HIV in Johannesburg, South Africa

Background: Adolescents living with HIV (ALWHIV) are more vulnerable to developing depressive symptoms. Despite this knowledge, the screening for depression is not routinely integrated into HIV treatment programmes.Aim: The study aimed to determine the prevalence of depressive symptoms among ALWHIV.Setting: The study was carried out in the primary healthcare clinics and an antiretroviral clinic situated in a district hospital, West Rand District, Johannesburg.Methods: This was a cross-sectional study of 125 ALWHIV. The modified Patient Health Questionnaire for Adolescents (PHQ-A) was used to screen for depressive symptoms with a score of ≥ 5 deemed significant. A distress protocol was used for immediate psychological intervention.Results: The prevalence of depressive symptoms was 44.8% and the majority of ALWHIV reported mild-moderate symptoms (36.8%). Overall, 25.6% of adolescents had suicidal behaviours. Those with psychosocial difficulties and those who reported a previous suicide attempt were 3.6 (adjusted odds ratio [aOR] 3.59, 95% confidence interval [CI]:1.17–11.03) and 6.9 (aOR 6.93, 95% CI:1.39–34.55) times likely to develop depressive symptoms, respectively.Conclusion: A high prevalence of depressive symptoms was found in ALWHIV. Psychosocial difficulties and previous suicide attempts were predictive factors for depressive symptoms. This highlights the unmet need for the integration of mental health screening and overall mental health services into adolescent HIV programmes.Contribution: This study emphasises an urgent need for routine mental health screening and prompt psychosocial support in ALWHIV.

Sequential Dual Mediating Effects of Smartphone Dependence and Aggression on the Relationship Between Negative Parenting Attitudes and Depressive Symptoms Among Adolescents

ABSTRACTThis study examined the sequential dual mediating effects of negative parenting attitudes, smartphone dependence and aggression on depressive symptoms among adolescents. Data were obtained from the 2018 Korean Children and Youth Panel Survey (KCYPS) conducted by the National Youth Policy Institute. Using a multistage stratified cluster sampling method, the 2018 KCYPS comprehensively examined various aspects of the growth and development of children and adolescents. The study sample included a nationally representative sample of 2541 adolescents. PROCESS macro Model 6 was used to examine the sequential dual mediating model that not only examines the effects of negative parenting attitudes on smartphone dependence and aggression but also establishes the sequential causal relationship between smartphone dependence and aggression, ultimately confirming the direct and indirect effects on depressive symptoms of adolescents. The significance of the mediation effect was verified by applying the bootstrapping method. The findings demonstrated that negative parenting attitudes increased smartphone dependence, which, in turn, elevated depressive symptoms among adolescents. Furthermore, negative parenting attitudes increased smartphone dependence, which heightened aggression, ultimately contributing to depressive symptoms among adolescents. Based on these findings, this study has practical and policy implications for preventing depressive symptoms among adolescents. Prioritizing efforts to reduce smartphone dependence and aggression among adolescents while promoting positive parenting attitudes can play a crucial role in addressing this issue.

Association between changes in adherence to the 24-hour movement guidelines with depression and anxiety symptoms among Chinese adolescents: a prospective population-based study

BackgroundThe 24-hour movement guidelines (24-HMG) include screen time (ST), sleep duration, and physical activity. Previous studies have explored the associations of adherence to the 24-HMG with depression and anxiety symptoms among adolescents, ignoring changes in behaviors. This study aimed to examine whether changes in adherence to the 24-HMG were associated with depression and anxiety symptoms among adolescents.MethodsWe recruited adolescents from Shenzhen, China in 2021 and followed them up 1 year later. Changes in adherence to the individual 24-HMG were categorized into four groups: persistent non-adherence, adherence to non-adherence, non-adherence to adherence, and persistent adherence. Changes in the numbers of adherence to the overall 24-HMG were obtained by subtracting the number of guidelines adhered to in wave 2 from that in wave 1.ResultsWe included 12,570 participants aged 9–18 years with 52.2% boys. Compared with persistent non-adherence for the ST/sleep duration guideline, non-adherence to adherence and persistent adherence were associated with lower depression and anxiety symptoms, but adherence to non-adherence was not. Changes in adherence to the physical activity guideline were not related to outcomes. The β coefficients (95% CIs) for each point increase in changes in the numbers of adherence to guidelines were − 0.58 (− 0.69, − 0.47) and − 0.43 (− 0.53, − 0.33) for depression and anxiety symptoms, respectively. The association of persistently adhering to sleep guideline with anxiety symptoms and the associations of changes in the numbers of adherence to the 24-HMG had sex differences.ConclusionsMaintaining and strengthening healthy movement behaviors to meet more guidelines of the 24-HMG, especially sleep and ST, may be beneficial for preventing depression and anxiety symptoms in adolescents.

Associations Between Gender Diversity and Eating Disorder Symptoms in Early Adolescence.

To assess associations between multiple dimensions of gender diversity with eating disorder symptoms in a national cohort of U.S. early adolescents. This cross-sectional study utilized data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,092, Mage = 12.9 years, 2019-2021). Gender diversity was measured using multiple dimensions, including categorical gender identity (e.g., transgender, cisgender), categorical and continuousfelt gender (congruence between gender identity and assigned sex), ordinal gender non-contentedness (dissatisfaction with one's gender), and ordinal gender expression (communication of gender through appearance and mannerisms). Multivariable logistic regression models were used to analyze the associations among gender diversity measures and eating disorder symptoms, adjusting for potential confounders. Greater felt gender diversity was associated with self-worth tied to weight (OR 1.30, 95% CI 1.11-1.53), binge eating (OR 1.24, 95% CI 1.06-1.46), and distress with binge eating (OR 1.32, 95% CI 1.09-1.59). Greater gender expression diversity was associated with self-worth tied to weight (OR 1.16, 95% CI 1.02-1.33), distress with binge eating (OR 1.26, 95% CI 1.04-1.51), and characteristics of binge eating episodes (OR 1.33, 95% CI 1.06-1.66). Gender non-contentedness was associated with self-worth tied to weight (OR 1.38, 95% CI 1.20-1.58) and compensatory behaviors related to weight gain (OR 1.12, 95% CI 1.01-1.26). Transgender identity was not significantly associated with any eating disorder symptoms. We found that greater gender diversity across multiple dimensions was associated with various eating disorder symptoms, and that measures beyond binary gender identity may be important to assess gender diversity in early adolescence.

The prospective relationship between anxiety symptoms and eating disorder symptoms among adolescents: a systematic review and meta-analysis of a bi-directional relationship.

Anxiety symptoms and eating disorder symptoms commonly co-occur in adolescents. However, there is divergent evidence on the prospective relationship between the two factors. This systematic review and meta-analysis summarises the existing literature on the prospective and bi-directional relationship between anxiety symptoms and eating disorder symptoms in adolescence. A systematic search across six databases was conducted on the 11th June 2024. Studies were included if they assessed the prospective relationship between anxiety symptoms and eating disorder symptoms, or vice versa, in adolescence. 19,591 studies were screened, of which 54 studies met inclusion criteria and were included in the full review. Four meta-analyses were conducted. Anxiety symptoms were associated with subsequent eating disorder symptoms, increases in eating disorder symptoms, and higher odds of eating disorders, including their onset. Conversely, eating disorder symptoms were associated with subsequent anxiety symptoms, increases in anxiety symptoms, and higher odds of subsequent anxiety disorders. Current evidence suggests that anxiety symptoms and eating disorder symptoms do not merely co-occur during adolescence, but are prospectively and bi-directionally linked. Further research is needed to understand the underlying mechanisms of this relationship, as well as individual differences in symptom trajectories.

Empirically Derived Dietary Patterns in Association with Asthma Symptoms in Children and Adolescents: A Cross-Sectional Study

Background: Limited data exists regarding the association between dietary patterns and asthma. This study aims to determine the relationship between empirically derived dietary patterns and the likelihood of asthma among a large population of children and adolescents living in central Iran. Methods: A total of 7667 of male and female students aged 6-14 from 48 public and private schools in YAZD urban areas entered the current cross-sectional study. Data on dietary intakes, as well as asthma symptoms and other possible confounders, were collected using a self-administered questionnaire filled by parents. Factor analysis was applied to find major dietary patterns. Multivariate logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for asthma development across quintiles of dietary patterns. Results: Two main dietary patterns were established. A “traditional diet” was determined by meat, fish, fruits, cooked vegetable, raw vegetable, legumes, cereals, bread, macaroni, rice, margarine, butter, olive oil, milk, yogurt, egg, nuts, potato, and a “western-like diet” was characterized by high intakes of simple sugars, fast food(hamburger), fast food (pizza), soft drinks, jelly, chocolate and biscuits of cocoa, ice cream, and sauce. After adjusting for potential confounders, individuals in the top quintile of traditional diet were 0.31 times less likely to have asthma than those in the lowest quintile (OR=0.69; 95% CI: 0.47-1.00). Moreover, individuals in the top quintile of traditional diet were 0.43 times less likely to have wheezing compared with those in the lowest quintile (OR=0.57, 95% CI: 0.46-0.70). However, individuals in the top quintile of the western diet were 0.35 times more likely to have wheezing than those in the lowest quintile (OR=1.35, 95% CI: 1.10-1.66). Conclusions: According to the results, a traditional diet might be associated with lower odds of asthma; however, a western-like diet might be adversely associated with asthma symptoms.

Pathways linking loneliness and depressive symptoms among Chinese adolescents: The mediating role of sleep disturbance

BackgroundDespite growing evidence linking loneliness and depressive symptoms, the underlying pathways remain unclear. This study aims to assess the impact of loneliness on depressive symptoms among Chinese adolescents and investigate the potential mediating role of sleep disturbance. MethodsA cross-sectional study was conducted between November and December 2021. Loneliness, depressive symptoms, and sleep disturbance were assessed using the UCLA Loneliness Scale, the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index questionnaire, respectively. Baron and Kenny's causal steps method and the Karlson-Holm-Breen method were applied to explore the mediating role of sleep disturbance. Subgroup analysis by gender was also conducted. ResultsA total of 6838 adolescents were included, with 52.2 % boys and a mean age of 14.5 (SD = 1.6) years. Approximately 15.8 % of the adolescents reported depressive symptoms. Loneliness was positively associated with depressive symptoms after controlling for covariates (OR = 1.34, 95%CI = 1.31–1.36). After incorporating sleep disturbance into the model, the association was still significant (OR = 1.28, 95%CI = 1.25–1.31). Sleep disturbance partially mediated this association, contributing to 18.89 % of the total effects. The associations and mediation effects were consistent across both genders, with no moderating effect of gender observed. LimitationsThe cross-sectional design limits the ability to establish causality. ConclusionLoneliness was significantly associated with depressive symptoms in Chinese adolescents and this association was partially mediated by sleep disturbance. Interventions aimed at reducing loneliness and improving sleep quality may help lower the risk of depressive symptoms in Chinese adolescents, regardless of genders. Nevertheless, further randomized controlled trials are needed to confirm these findings.

Delaying high school start times impacts depressed mood among students: evidence from a natural experiment.

Delaying high school start times prolongs weekday sleep. However, it is not clear if longer sleep reduces depression symptoms and if the impact of such policy change is the same across groups of adolescents. We examined how gains in weekday sleep impact depression symptoms in 2,134 high school students (mean age 15.16 ± 0.35 years) from the Minneapolis metropolitan area. Leveraging a natural experiment design, we used the policy change to delay school start times as an instrument to estimate the effect of a sustained gain in weekday sleep on repeatedly measured Kandel-Davies depression symptoms. We also evaluated whether allocating the policy change to subgroups with expected benefit could improve the impact of the policy. Over 2 years, a sustained half-hour gain in weekday sleep expected as a result of the policy change to delay start times decreased depression symptoms by 0.78 points, 95%CI (-1.32,-0.28), or 15.6% of a standard deviation. The benefit was driven by a decrease in fatigue and sleep-related symptoms. While symptoms of low mood, hopelessness, and worry were not affected by the policy on average, older students with greater daily screen use and higher BMI experienced greater improvements in mood symptoms than would be expected on average, signaling heterogeneity. Nevertheless, universal implementation outperformed prescriptive strategies. High school start time delays are likely to universally decrease fatigue and overall depression symptoms in adolescents. Students who benefit most with respect to mood are older, spend more time on screens and have higher BMI.

Heart rate variability as a biomarker for transdiagnostic depressive and anxiety symptom trajectory in adolescents and young adults.

Internalizing psychopathology is associated with abnormalities in heart rate variability (HRV). Lower HRV that reflects reduced parasympathetic nervous system activity has been observed in depressive and anxiety disorders. Existing studies predominantly used categorical rather than dimensional approaches, the latter of which better addresses clinical comorbidity and heterogeneity. Moreover, there is little evidence on the role of HRV in longitudinal symptom trajectory in adolescents and young adults. The current study examined the association between HRV and internalizing symptom trajectory using a dimensional approach-the tri-level model of depression and anxiety. Adolescents and young adults (N = 362) were recruited in a 3-year longitudinal study, where they completed electrocardiogram recordings and self-report symptom questionnaires. Multilevel modeling was conducted with high-frequency power bands (HF power) of interbeat intervals at baseline as the predictor, and tri-level symptom factors over 3 years as the outcome. HF power significantly predicted the trajectory of the broad General Distress symptom factor, but not the intermediate Fears or Anhedonia-Apprehension symptom factors. Higher HF power was associated with a decline in General Distress over time. This association was held when neuroticism, other tri-level symptom factors, and demographic variables were covaried. That is, greater parasympathetic nervous system activity at baseline was significantly associated with a greater decline in the broad internalizing symptom factor, but not symptom factors that are more specific to depressive or anxiety disorders. Parasympathetic activity, therefore, may be a transdiagnostic biomarker for internalizing symptoms in adolescents and young adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Correspondence to Thorup et al. Body image and depressive symptoms in Danish adolescents: A cross-sectional national study

Correspondence to Thorup et al. Body image and depressive symptoms in Danish adolescents: A cross-sectional national study

Sex difference in the relationship between environmental unpredictability and depressive symptom in Chinese adolescents: The chain mediating role of sense of control and fast life history strategies.

Adolescents are at a high risk of depressive symptom. A substantial body of literature indicates that early environmental unpredictability (EU) significantly affects the likelihood of developing depressive symptom. However, only a few studies have focused on the mediating mechanisms underlying this relationship. Based on life history (LH) theory and the adaptive calibration model, this study constructed a chain-mediating model to examine whether the association between EU and depressive symptom among Chinese adolescents is mediated by sense of control and fast life history strategies. In total, 1838 Chinese adolescents (47.8% women, mean age=13.17±0.99years) participated in this study and responded to self-report measures of EU, fast LH strategies, sense of control, and depressive symptom. (1) There were significant correlations between EU, sense of control, fast LH strategies, and depressive symptom. (2) After controlling for the effects of sex, age and socioeconomic status, EU still had a significant positive effect on depressive symptom. (3) Adolescent depressive symptom was partly influenced by EU through three different pathways: the mediating role of sense of control, the mediating role of fast LH strategies, and the chain-mediating role of both sense of control and fast LH strategies. (4) There are significant gender differences in the above chain mediation models. The analysis is cross-sectional, which limits causal inference. These findings contribute to a more comprehensive understanding of risk factors for adolescent depressive symptom. The chain-mediating effect of a sense of control and fast LH strategies plays an important role in the occurrence of depressive symptom.

Comparison of oral disease symptoms according to eating habits of adolescents from Korean families and adolescents from multicultural families

Objectives: This study used the 18th Youth Online Health Behavior Data to compare oral disease symptoms according to the eating habits of adolescents from Korean families and adolescents from multicultural families. The total number of subjects was 40,913. Methods: The Rao-Scott chi-square test was used to compare general characteristics, eating habits, and experience with oral disease symptoms. In the final multiple logistic regression analysis, general characteristics and eating habits-related characteristics were used as correction variables to investigate eating habits related to oral disease symptoms in Korean adolescents and adolescents from multicultural families. Results: In Korean family the experience of oral disease symptoms was found to be lower when sweet drink 5-6 times a week 0.89 times, 3-4 times a week 0.77 times, 1-2 times a week 0.65 times, and 0.56 times when not consuming them than when consuming them daily. In multicultural families, the incidence of experiencing oral disease symptoms was 0.47 times lower in those who sweet drink daily than in those who consumed them 1-2 times a week, and 0.32 times lower in those who did not consume them. Conclusions: Based on the above research results, it is thought that customized nutrition education and oral health education programs should be continuously developed and utilized to promote oral health among adolescents from Korean families and multicultural families and to change their eating habits.

A Qualitative Assessment of Adolescent Symptom Report and Caregiver Concordance Following Outpatient Surgery

Objectives: Limited data exist regarding recovery from surgery from the adolescent’s perspective, or data regarding concordance between adolescent and caregiver symptom report preventing appreciation of adolescent needs and hindering the provision of appropriate care. Methods: We conducted semi-structured interviews with adolescents ages 12-17 and a parent caregiver two weeks following a variety of outpatient elective surgeries about recovery symptoms. We used latent manifest content analysis to analyze interview data. Caregiver-adolescent response concordance was assessed using Cohen’s Kappa (κ). Results: Interviews were conducted with 31 adolescent-caregiver pairs (median age: 15y). Fifty-eight percent of adolescents and 84% of caregivers were female; 71% of adolescents were white. Twenty-three percent of children reported severe pain, some of which was not expected given the surgery. Severe pain was associated with nausea (71%, P= 0.002), pain-related sleep disturbance (86%, P= 0.007), and severe anxiety (43%, P= 0.008). Fatigue was also common (58%), but not associated with severe pain (P = 0.484) or sleep disturbance (P = 0.577). Thirty-nine percent reported anxiety; 32% experienced anger/frustration. Caregiver-adolescent concordance was only substantial for severe pain (κ = 0.71) and anger/frustration (κ= 0.67). Caregiver report also often included psychological symptoms not reported by their children, with qualitative evidence supporting caregiver accuracy. Discussion: Adolescents may experience significant physical symptoms such as pain and fatigue, even after minor surgeries. Fatigue symptoms may be unrelated to pain or sleep. Caregiver report of adolescent psychological symptoms may be necessary to gain a complete understanding of those symptoms in this population.