Adolescent Trajectories Research Articles

Parent Education and Adolescent Health Outcomes: The Potential Role of Adolescent Academic Intention

Abstract: Parental educational attainment significantly shapes child socioeconomic status, potentially influencing various aspects of adolescent health. This study aimed to uncover the relationships between parental education and self-reported adolescent health outcomes, including overall health, mental well-being, and body mass index (BMI). Analyzing data from 1,448 participants in the Future of Families and Child Wellbeing Study, we identified notable associations. Our findings revealed that higher maternal and paternal education correlated with reduced odds of adolescent obesity. Furthermore, increased adolescent academic intention was associated with better overall and mental health in adolescents. Notably, it also played a mediating role in lowering adolescent BMI, thereby potentially explaining the association between parent education and adolescent BMI category (overweight vs. obese). These findings emphasize the significant impact of both parent education and adolescent academic intention on adolescent health. Future research should explore interventions leveraging academic intention to positively influence the health trajectory of adolescents.

Trajectories of adolescents' adjustment behaviors across the transition to upper secondary education: The role of individual and environmental factors

This longitudinal study examined the developmental trajectories of 901 Finnish adolescents' (M = 15.3 at T1, SD = 0.37) adjustment behaviors (prosocial behavior and externalizing problems) across the transition to upper secondary education. The role of adolescents' temperament and relationship with parents and teachers were investigated. Four trajectories of adjustment behaviors were distinguished: moderate prosocial and high externalizing (25.8 %), high prosocial and low externalizing (64.9 %), decreasing prosocial and increasing externalizing before the transition (7.4 %), decreasing prosocial and increasing externalizing after the transition (1.9 %). Adolescents' higher negative affectivity, lower effortful control, and less close and conflicting relationship with parents and teachers are positively associated with the trajectory of moderate prosocial behavior and high externalizing problems. In contrast, high effortful control, high closeness, and low conflict are positively associated with the trajectories of high prosocial and low externalizing problems as well as decreasing prosocial and increasing externalizing after the transition.

Trajectory of the body mass index of children and adolescents attending a reference mental health center.

The primary objective was to describe the standardized body mass index (z-BMI) trajectory of children and adolescents admitted to a psychiatric reference center in Mexico City according to their diagnosis and medication use. The secondary objective was to compare z-BMI between antipsychotic users and non-users. This is a retrospective cohort study. The psychiatric diagnosis, prescribed medications, serial heights, and weights were collected from the medical records. The median baseline z-BMI of the 129 analyzed cases was 0.88 (interquartile range [IQR]: 0-1.92), and the prevalence of excessive weight (obesity or overweight) was 46.8 %. At the end of follow-up (median 50.3weeks), the median change in z-BMI was-0.09 (IQR:-0.68 to 0.42). New long-term users of antipsychotics (n=29) had an increase in their z-BMI, in contrast to never-users (median difference 0.73, p=0.01) and to previous users (median difference 0.92, p=0.047). The 59 subjects with excessive weight at admission had a median z-BMI change of-0.39 (IQR:-0.81 to-0.04). Among patients with excessive weight and depression, there was a greater decrease in z-BMI in sertraline users (n=13) compared with fluoxetine users (n=15) (median-0.65 vs. 0.21, p<0.001). New long-term users of antipsychotics showed a significant increase in their z-BMI. Patients with depressive disorders and obesity on sertraline therapy tended to show a decrease in their z-BMI.

Developmental trajectory of depressive symptoms among left-behind adolescents: The effects of parent-adolescent separation and parent-adolescent cohesion.

Left-behind adolescents are vulnerable to depressive symptoms under the context of parent-adolescent separation. However, limited knowledge is available regarding left-behind adolescents' depression trajectory and the protective resources against it. The aim of this longitudinal study was to investigate the depression trajectory and its association with parent-adolescent separation (left-behind status, age of separation and duration of separation) and parent-adolescent cohesion (father-adolescent cohesion, mother-adolescent cohesion) among left-behind adolescents. The participants were 1,107 left-behind adolescents (Mage = 13.23 ± 0.86 years at T1; 45.17% girls; 38.48% both-parent migrant adolescents, 61.52% father-only migrant adolescents) from two rural areas of Shandong Province in China, who were participated in assessment at three time points with 6 months apart from November 2014 to November 2015. The results indicated that the trajectory of left-behind adolescents' depression symptoms showed a decreasing trend. Both-parent migrant adolescents reported a higher initial level of depressive symptoms than father-only migrant adolescents. Duration of separation positively predicted the initial level of left-behind adolescents' depressive symptoms. Mother-adolescent cohesion negatively predicted the initial level and positively predicted the change rate of left-behind adolescents' depressive symptoms. Moreover, mother-adolescent and father-adolescent cohesion buffered the negative effect of parent-adolescent separation on the initial level of left-behind adolescents' depressive symptoms. These findings highlight the protective role of parent-adolescent cohesion for left-behind adolescents, having important implications for interventions targeted toward mitigating the detrimental influence of parent-adolescent separation on left-behind adolescents' depression trajectory.

Contextual predictors of self-management and independence trajectories in adolescents and young adults with spina bifida.

To examine socioeconomic, condition-related, and neuropsychological predictors of self-management trajectories in adolescents and young adults with spina bifida. In this longitudinal study, participants completed the Adolescent/Young Adult Self-Management and Independence Scale interview. Socioeconomic status (SES), shunt status, lesion level, and executive functioning were assessed. Growth in self-management was estimated using linear mixed-effects models. Participants (n = 99) were aged 18 to 27 years. Approximately half (52.5%) were female and White; 15.2% were Black; and 32.3% Hispanic or Latino. Although none of the predictors were associated with growth in self-management from ages 18 to 27 years (p > 0.05), several factors were associated with the intercept at age 18 years for total self-management. Higher SES at baseline predicted a higher total self-management score at age 18 years (b = 0.03, standard error [SE] = 0.01; p < 0.001). On average, participants at age 18 years with a shunt scored lower than those without a shunt (b = -0.90, SE = 0.32; p = 0.01); those with a thoracic lesion scored lower than those with lower lesion levels (lumbar: b = -1.22, SE = 0.34; sacral: b = -1.20, SE = 0.36; p = 0.001 for both). Better parent-reported and teacher-reported executive functions predicted higher total self-management (metacognitive: b = -0.03, SE = 0.01; behavioral regulation: b = -0.04, SE = 0.01; p < 0.05 for both). On average, all participants improved in self-management over time. Additionally, baseline superiority in self-management for adolescents and young adults without a shunt, less severe lesions, better executive functions, and higher SES persisted over time.

Residential Density Is Associated With BMI Trajectories in Children and Adolescents: Findings From the Moving to Health Study

This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents. This retrospective cohort study utilized electronic health records of individuals aged 5-18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure). At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years. Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.

Why So Lonely? The Direct and Indirect Associations between Developmental Trajectories of Fear of Negative Evaluation, Prosocial Behavior and Loneliness in Adolescence.

Fear of negative evaluation and prosocial behavior have been identified as predictive factors influencing the development of loneliness in adolescence, representing typical factors in the cognitive and behavioral processes of re-affiliation. The elucidation of plausible direct and indirect pathways linking these pivotal factors to adolescents' loneliness need further exploration. This study aimed to investigate the direct and indirect relationships between the fear of negative evaluation, prosocial behavior, and adolescents' loneliness through the lens of developmental changes. A total of 533 adolescents (49.0% girls, Mage = 15.18 years, SD = 0.71) participated in this longitudinal study, assessed at three timepoints over a span of two years with 12-month intervals. Latent growth modeling uncovered direct associations between the developmental trajectories of both fear of negative evaluation and prosocial behavior with the developmental trajectory of adolescents' loneliness. The developmental trajectory of fear of negative evaluation exhibited an indirect association with the developmental trajectory of loneliness through the mediating role of prosocial behavior. These findings highlighted the roles of cognitive and behavioral re-affiliation processes, both independently and as mediators, in influencing adolescent loneliness, suggesting that interventions aimed at reducing fear of negative evaluation and promoting prosocial behavior could effectively mitigate adolescents' loneliness.

Developmental Trajectories of Adolescents' Math Motivation: The Role of Mindset and Perceptions of Informal STEM Learning Site Inclusivity.

Motivation is a key factor in engagement, achievement, and career choices in science, technology, engineering, and mathematics (STEM). While existing research has focused on student motivation toward math in formal school programs, new work is needed that focuses on motivation for those involved in informal STEM programs. Specifically, the role of math mindset and perceived inclusivity of informal STEM sites (to those of varying gender and ethnic backgrounds) on longitudinal trajectories of adolescents' math motivation has not been explored. This study investigates longitudinal changes in math expectancy, interest, and utility values and the effects of math fixed mindset, math growth mindset, and perceptions of the inclusivity of informal STEM learning sites on these changes for adolescents participating in STEM programs at these informal sites in the United Kingdom and the United States (n = 249, MT1age = 15.2, SD = 1.59). Three latent growth curve models were tested. The data suggest that math expectancy, interest, and utility values declined over three years. Growth mindset positively predicted changes in utility, while fixed mindset negatively predicted changes in utility. Inclusivity positively influenced the initial levels of utility. Girls reported lower initial expectancy than boys. Age influenced both the initial levels and rate of change for expectancy. Older adolescents had lower levels of expectancy compared to their younger counterparts; however, they had a less steep decline in expectancy over three years. These findings suggest that designing inclusive learning environments and promoting growth mindset may encourage math motivation.

Associations among Motor Competence, Physical Activity, Perceived Motor Competence, and Aerobic Fitness in 10-15-Year-Old Youth.

(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents' health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence (MC), moderate-to-vigorous physical activity (MVPA), perceived motor competence (PMC), and aerobic fitness in children and adolescents and the mediating and moderating effects of PMC, aerobic fitness, and weight status on the MC-MVPA relationship. (2) Methods: Participants included 47 adolescents (12.2 ± 1.6 y; 55% male) who completed the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (MC), Harter's perceived self-competency questionnaire (PMC), and the PACER test (aerobic fitness) and whose MVPA was measured via accelerometry. The body mass index (BMI) was calculated from measured height and weight. (3) Results: There were positive correlations between MC and fitness [rs(47) = 0.469, p < 0.01], PMC and fitness [rs(47) = 0.682, p < 0.01], and PMC and MC [rs(47) = 0.416, p < 0.01]. There were no associations among MVPA and MC, PMC, or fitness (p > 0.05). There were inverse associations between BMI and both MVPA [rs(44) = -0.410, p < 0.01] and fitness [rs(47) = 0.295, p < 0.05]. The association between MC and MVPA was mediated by fitness (β = 0.3984; 95% CI (0.0564-0.7985)). (4) Conclusions: The associations among MC, PMC, and fitness highlight the critical role of MC in health and partially support the proposed developmental model concerning the relationships that exist among MC, MVPA, PMC, fitness, and BMI.

Mental health trajectories in adolescents during Covid‐19: ‘Are we all in this together’?

AbstractThis study used a longitudinal probability sample survey, Understanding Society: Covid‐19, to examine trajectories in adolescents' mental health, via the Strengths and Difficulties Questionnaire, at three timepoints during Covid‐19 with a particular emphasis on vulnerable groups (i.e., young carers, adolescent girls, BAME—Black, Asian and minority ethnic, and adolescents in financially strained households). Generally, self‐reports of emotional and total difficulties remained stable during the pandemic, although adolescents who had limited social support were far more likely to report severe emotional and total difficulties. Young people with pre‐existing mental and physical health conditions appeared more resilient, whereas vulnerable young people were hit the hardest during the pandemic. Compared to their less vulnerable peers, young carers, adolescent girls, Black or mixed‐race young people and adolescents in financially strained households were more likely to report reduced mental health during the pandemic. It is hoped that the findings will contribute to debates about the pandemic unveiling existing mental health inequalities in society, and to public policy in an era of perma‐crises as we currently face a cost of living crisis where public services are under enormous strain to reach those who need them most.

Meaningful bonds and criminal trajectories in adolescents: The intervention experience of expert professionals

Young offenders (YO) have undergone a series of experiences throughout their lives that influence their way of relating to others. Through the report of nine expert professionals, this qualitative study seeks the characterization of different types of bonds established by 20 adolescents between the ages of 15 and 22 admitted to Special Probation Programs (SPP) in the region of La Araucanía, Chile. Through the design of cases by criteria, two categories of sex and criminal trajectory defined by the Multidimensional Model of Differentiated Intervention (MMIDA) are constructed from an analytical-associative perspective. The method of analysis selected for the treatment of the data was the Weighted Hierarchical Content Analysis, which allowed its characterization, frequency distribution, and comparison. As main results, it is found that YOs, from the report of expert interveners, tend to establish meaningful bonds with their environment, through which they satisfy their affective and help needs. These bonds allow them to channel their adaptive or maladaptive potential. The quality of these established bonds differs depending on the criminal trajectory regardless of the sex of the young person, presenting high consistency as described by the MMIDA model for each of the five trajectories. When making the comparison between the sexes, it was found that women present a higher content density in the categories of damaged bonds, mainly referring to unhealthy relationships and altered development.

The effect of childhood depression trajectories on sugar-sweetened beverage habit trajectories in adolescence: Exploring sleep problems as a mediator

Although depression has been linked to the habit of consuming sugar-sweetened beverages (SSBs), little is known about their long-term relationships and the mediating role of sleep problems. This study examines the associations between childhood depressive symptoms trajectories and adolescent SSB-habit trajectories and whether these associations were mediated by sleep problems. Data came from 1560 adolescents participating in a longitudinal study across grades 1 through 12 in northern Taiwan. Group-based trajectory modeling was used to identify development of childhood depressive symptoms and an SSB habit in adolescence. Multinomial logistic regression was conducted to examine the influence of childhood depressive symptoms and adolescent SSB habit. Mediation analysis was conducted to test whether sleep problems mediated the associations examined. Four distinct trajectories of childhood depressive symptoms were identified: low-stable (30.79%), moderate-stable (42.32%), increasing (12.29%), and high-stable (11.60%). Three distinct trajectories of SSB habit in adolescence were identified: low-stable (44.32%), increasing (15.02%), and high-stable (40.65%). Children who had moderate-stable (aOR = 1.35; CI: 1.04–1.77), high-stable (aOR = 2.01; CI: 1.28–3.15), or increasing (aOR = 1.97; CI: 1.26–3.06) trajectories of depressive symptoms relative to those in the low-stable group were significantly more likely to belong to the high-stable trajectory of SSBs than to the low-stable SSBs group. The Z-mediation test showed that sleep problems significantly mediated the associations between trajectories of childhood depressive symptoms and trajectories of SSBs during adolescence (all p < 0.05). Childhood depressive symptoms conferred risks for adolescent SSB habits; and the effects were seen, in part, through increasing sleep problems.

Heterogeneity in glycaemic control in children and adolescents with type 1 diabetes: A latent class trajectory analysis of Danish nationwide data.

Suboptimal glycaemic control in children and adolescents with type 1 diabetes is prevalent and associated with increased risk of diabetes-related complications and mortality later in life. First, we aimed to identify distinct glycated haemoglobin (HbA1c) trajectories in children and adolescents (2-19 years) with type 1 diabetes. Second, we examined their associations with clinical and socio-demographic factors. Data were obtained from the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) comprising all Danish children and adolescents diagnosed with type 1 diabetes from 1996 to 2019. Subgroups of distinct mean trajectories of HbA1c were identified using data-driven latent class trajectory modelling. A total of 5889 children (47% female) had HbA1c measured a median of 6 times (interquartile range 3-8) and contributing to 36,504 measurements. We identified four mean HbA1c trajectories, referred to as 'Stable but elevated HbA1c' (83%), 'Increasing HbA1c' (5%), 'Late HbA1c peak' (7%), and 'Early HbA1c peak' (5%). Compared to the 'Stable but elevated HbA1c' group, the three other groups presented rapidly deteriorating glycaemic control during late childhood or adolescence, had higher HbA1c at study entry, and included fewer pump users, higher frequency of inadequate blood glucose monitoring, more severe hypoglycaemic events, lower proportions with Danish origin, and worse educational status of parents. The groups also represented significant differences by healthcare region. Children and adolescents with type 1 diabetes experience heterogenous trajectories with different timings and magnitudes of the deterioration of HbA1c levels, although the majority follow on average a stable, yet elevated HbA1c trajectory. The causes and long-term health implications of these heterogenous trajectories need to be addressed.

Trajectory of adolescents' nightmares in relation to depression and post-traumatic stress disorder in young adulthood: a 10-year cohort of Chinese Wenchuan earthquake survivors.

This study examined the longitudinal trajectories of adolescent survivors' nightmares after the Wenchuan earthquake and tested whether specific trajectory memberships of nightmares could predict depression and post-traumatic stress disorder (PTSD) in the 10years after earthquake. 610 adolescents exposed to the Wenchuan earthquake were surveyed on nightmares at 18months (T18m), 24months (T24m), and 30months (T30m) after the earthquake. Depression and PTSD were assessed at baseline (T18m) and 10years (T10y) after the catastrophe. Data were analyzed using linear regression analysis. The prevalence rates of frequent nightmares at three time points were 9.8%, 11.5%, and 9.3%, respectively. Five different trajectories of nightmares were identified: resistance (77.0%), recover (8.4%), delayed-dysfunction (7.9%), chronic-dysfunction (1.1%), and relapsing/remitting (5.6%). Additionally, we found that participants in relapsing/remitting, chronic or delayed dysfunction trajectories compared with those in the resistant group were more likely to experience depression and PTSD in young adulthood after adjusting for a wide range of covariates. Nightmares had heterogeneity after a catastrophic earthquake. Timely assessment and targeted interventions on specific nightmares are necessary for reducing the incidence of psychiatric disorders.

Prevalent factors of career uncertainties among Ghanaian senior high school students

Research has shown that career uncertainty is a major issue that distorts the career trajectories of many adolescents, specifically senior high school students, as many of them are unable to make career decisions that will place them on a firm path of career development. The study explored the most prevalent factors of career uncertainty related to Ghanaian high school students. The research design employed was a descriptive survey, and 426 students were selected for participation by means of multi-stage sampling. Data were gathered with a four-point Likert-type scale questionnaire on career uncertainty for senior high school students. Data analysis was done using descriptive statistics. The results depicted that, among all the factors investigated to determine the career uncertainty of senior high school students, self-awareness, fear and anxiety in decision-making, inadequate career information, inadequate career counselling, peer pressure, family interference, and academic accomplishment challenges were the most prevalent factors of career uncertainty. The recommendations made were that school guidance coordinators need to be sensitive to issues of self-awareness, fear, and anxiety in decision-making, inadequate career information, inadequate career counselling, peer pressure, family interference, and academic accomplishment challenges throughout counselling sessions to facilitate well-informed and wise career decisions. It was recommended that all stakeholders in Ghana’s educational sector collaborate to formulate and implement policies that encourage students to plan, develop, and make career choices before the end of their high school years.

Why am I always lonely? The lasting impact of childhood harsh parental discipline on adolescents' loneliness

AbstractObjectiveThis study examined the mechanism of the effect of childhood harsh parental discipline on the developmental trajectory of loneliness among adolescents.BackgroundMore and more adolescents experience the problem of loneliness. The effect of early parenting on the developmental change of adolescent loneliness has not been sufficiently determined.MethodA total of 1,214 Chinese high school adolescents responded to a series of questionnaires about loneliness, childhood harsh parental discipline, and core self‐evaluation three times at intervals of six months. The latent growth modeling and the structural equation model were established to investigate the developmental change of adolescent loneliness and the mechanism of childhood harsh parental discipline that affected the trajectory of adolescents' loneliness.ResultsThere was a linear growth pattern in loneliness among high school adolescents. Childhood parental psychological aggression and corporal punishment positively predicted the initial level of loneliness, and childhood parental corporal punishment negatively predicted the changing slope of loneliness. Core self‐evaluation mediated the effect of childhood parental psychological aggression on the trajectory of loneliness.ConclusionChildhood parental corporal punishment directly affected the trajectory of adolescents' loneliness while childhood parental psychological aggression indirectly affected the trajectory of adolescents' loneliness through core self‐evaluation.ImplicationsThis study further enriched the research content on the developmental change of loneliness among high school adolescents and revealed the long‐term effect and mechanism of childhood harsh parental discipline on the trajectory of adolescent loneliness, providing new ideas for preventing and alleviating loneliness among adolescents.

Debate: The prevention of psychosis in child and adolescent mental health services.

Psychopathological conditions in adolescence and young adulthood often result from an altered neurodevelopment already phenotypically expressed in childhood. Child and adolescent mental health services are ideally placed to intercept in the developmental trajectories of younger adolescents and contribute to the early detection of a risk for psychosis, as proposed by Salazar de Pablo and Arango (2023, Child and Adolescent Mental Health), opening a debate to which we contribute. The early detection of a specific risk for psychosis and of a broader risk for severe mental illness requires an understanding of the clinical staging of psychosis, neurodevelopmental antecedents of severe mental illness and of heterotypic trajectories between childhood phenotypes and adult disorders.

Responses to the Strengths and Difficulties Questionnaire predict HbA1c trajectories in children and adolescents with type 1 diabetes: a population-based study

IntroductionWe aimed to determine whether caregiver responses to the Strengths and Difficulties Questionnaire (SDQ) are predictive of HbA1c trajectory membership in children and adolescents with type 1 diabetes, when adjusting...

Depressive and anxiety symptom trajectories in Polish adolescents during the COVID-19 pandemic and the outbreak of war in Ukraine: uncovering the role of family relations.

The aim of the study was to investigate longitudinal trajectories of change in anxiety and depression symptoms in Polish adolescents during the second year of the COVID-19 pandemic and after the outbreak of the war in Ukraine. Additionally, we aimed to identify risk/protective factors and outcomes associated with these trajectories. We collected data in three waves between November 2021 and May 2022. Adolescents (N = 281 in the first wave) completed the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Filial Responsibility Scale for Youth, and questions related to the COVID-19 pandemic and war in Ukraine. We identified three trajectories of depressive symptoms: resilient with low, stable symptoms (71% of participants), chronically elevated symptoms (11%), and acute symptoms followed by recovery (18%). We distinguished two trajectories of anxiety symptoms: resilient (75%) and chronic (25%). Non-resilient trajectories were predicted by higher levels of familial unfairness (perceived lack of equality and reciprocity in the family), relationship difficulties at school and at home, older age, and poor socioeconomic status. Chronic depressive and anxiety symptoms were associated with higher war-related concerns. These findings can inform preventive and therapeutic interventions for at-risk adolescents to reduce negative long-term outcomes of social crises.

Longitudinal Patterns of HBA1c Trajectories in Patients with Type 1 Diabetes

Introduction: Type 1 diabetes is a chronic condition that affects adolescents’ quality of life and raises the risk of developing mental health concerns and diabetes-related complications. Measuring glycated hemoglobin (HbA1c) over time is the standard of care within the management of type 1 diabetes; however, the determinants of different HbA1c trajectories remain poorly understood. In the secondary analysis of the data collected for the Integrated Care Model (1), we aimed to identify groups of HbA1c trajectories with similar trends and examine the association between these groups and demographic and psychosocial variables. Methods: HbA1c data were collected at 4 consecutive time points with a gap of 3±1 months. We used Leffondré’s method (2) and Group-based trajectory modeling (GBTM) (3) to derive the groups of HbA1c trajectories among 91 adolescents. Baseline characteristics of the adolescents included in the groups were analyzed by univariate analysis. Results: Leffondré’s method identified three groups of trajectories: stable (63%), decreasing (17%), and increasing (20%). The baseline HbA1c levels for the three groups were 8.00±0.93, 10.07±1.63, and 8.21±1.14, respectively. Among the baseline characteristics, only the treatment method distinguished the groups of adolescents with similar trajectories of HbA1c over time (p=0.015). The GBTM method identified similar groups: stable (67%), decreasing (18%) and increasing (15%). The baseline HbA1c levels for the three groups were 7.89±0.88, 9.81±1.61, and 9.00±1.38, respectively. Groups produced by GBTM were also distinguished by treatment modality at baseline (p=0.022). Discussion: We identified three distinct patterns of HbA1c trajectories in adolescents. The only baseline characteristic that significantly distinguished these trajectories was the treatment modality.