Association between Adverse Childhood Experiences and Unmet Health Care Needs among Children in the United States.

Although studies have investigated and found an association between adverse childhood experiences and poor health and mental health outcomes, there is a dearth of studies investigating the association between adverse childhood experiences and unmet health care needs among children. The objective of this study is to examine the association between adverse childhood experiences and unmet health care needs after adjusting for predisposing, enabling, and need factors of health care service utilization. Data for this study came from the 2016-2017 National Survey of Children's Health. An analytic sample of 46,081 children (51.3% males; average age 11.5 years) was analyzed using negative binomial regression. Based on parent reports, about 3.5% of children had unmet health care needs, and half (50%) of the sample had experienced at least one childhood adversity. Controlling for other factors, children who experienced three or more childhood adversities had 4.51 times higher odds of having unmet health care needs (AOR = 4.51, p < .001, 95% CI = 3.15-6.45) when compared to their counterparts with no childhood adversity. Children with parents who have someone to turn to for everyday emotional support were 31% less likely to have unmet health care needs (AOR = .69, p < .01, 95% CI = .54-.89). Adverse childhood experiences have a detrimental effect on unmet health care needs. The findings of this study offer an important opportunity for further research on how best to prevent adverse childhood experiences and mitigate their impact on families.

Mental health outcomes of multiracial individuals: A systematic review between the years 2016 and 2022.

BACKGROUND: Emerging evidence suggests that multiracial individuals are at high risk for mental health problems. Systematic and ongoing synthesis of literature is necessary to understand mental health among multiracial individuals. METHODS: We conducted a systematic review of scholarly articles published during the years 2016-2022. Studies must have focused explicitly on mental health outcomes of biracial/multiracial individuals using quantitative methods. A total of 22 articles met criteria for this review. RESULTS: Studies were mainly from the United States, with one study from the United Kingdom and one from the Netherlands. Sample sizes ranged from 57 to 393,681. Findings revealed a complicated picture between multiracial identity and mental health, which may be a function of how multiracial identity is defined and empirically examined. Among studies comparing multiracial individuals with monoracial groups, multiracial individuals tended to have worse mental health, with notable exceptions depending on the multiracial subgroup, the mental health outcome, and the reference group. Among studies that only examined multiracial individuals, discrimination and ethno-racial identity emerged as complex explanatory factors that can shape mental health, though each of these constructs can be explored more deeply across social milieu. LIMITATIONS: The review focused on studies explicitly examining multiracial mental health, published during a limited time frame. CONCLUSION: Multiracial individuals tended to have worse mental health outcomes compared to their monoracial counterparts, with variations depending on the outcomes, populations/subgroups, contexts, and reference groups. Racial discrimination and ethno-racial identity may shape mental health trajectories of multiracial people, calling for more research to inform targeted interventions.

Maternal childhood adversity and adolescent marijuana use at age 17 years: The role of parental mental health and parenting behaviors.

INTRODUCTION: Children's risk for marijuana use may be linked to their parents' history of childhood adversity, yet little is known about the mechanisms underlying this link. This study examined whether maternal parenting behavior and mental health serve as mechanisms linking maternal childhood adversity to their children's marijuana use at age 17 years, by gender. METHODS: Data were from the Young Women and Child Development Study (59% male), a longitudinal panel study, which began in 1988 and followed mother-child dyads for 17 years (n = 240). Participants were recruited from health and social services agencies located in a metropolitan region of Washington State. Hypotheses were tested using Structural Equation Modeling in Mplus. Multiple-group analysis was conducted to evaluate potential gender differences. RESULTS: Results showed that maternal childhood adversity was associated with their mental health outcomes (ß = .32, p < .001), which in turn was predictive of mothers' harsh parenting (ß = .27, p < .01). Maternal harsh parenting behavior was then associated with their children's marijuana use at age 17 years (ß = .34, p < .001). Multiple group analyses revealed that the path from harsh parenting to adolescent marijuana use differed across genders being only significant for boys (ß = .42, p < .001). CONCLUSIONS: The intergenerational impact of childhood adversity highlights the need for interventions that target both parents and children. This would support teen mothers with a history of childhood adversity to acquire skills and knowledge to help mitigate its impact on their parenting behaviors and offset risks for their children.

Excessive screen time behaviors and cognitive difficulties among adolescents in the United States: Results from the 2017 and 2019 national youth risk behavior survey.

BACKGROUND: The widespread use of digital media by young people has generated speculations that their excessive use may have deleterious cognitive effects. Previous studies examining the association between screen time and cognitive deficits in youth have yielded mixed conclusions. We study this association using a nationally representative sample of school going adolescents in the United States. METHODS: We queried data from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 17,076 adolescents was analyzed using binary logistic regression. Outcome variable was cognitive difficulties (difficulty in concentrating, remembering, or making decisions), and the explanatory variable was excessive screen-time behaviors. RESULTS: Of the 17,076 adolescents, about one in three (34.1%) had cognitive difficulties, and 45% of adolescents engaged in excessive screen-time behaviors on an average school day. After adjusting for covariates, the odds were 1.28 times higher for adolescents who engaged in excessive screen-time behaviors to report serious cognitive difficulties compared to adolescents who did not engage in excessive screen-time behaviors (AOR = 1.28, p < .001, 95% CI = 1.18-1.40). CONCLUSION: Study results support the association between excessive screen behaviors and cognitive difficulties in adolescence. Findings of this study are discussed with implications for practice and research.

Sports- and physical activity-related concussion and mental health among adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey.

This study examined the association between self-reported sports- or physical activity-related concussion and symptoms of depression and suicidal behaviors (suicidal ideation, having a suicide plan, and suicide attempts). This study used data from the 2017 and 2019 Youth Risk Behavior Survey (YRBS), a biennial, school-based, nationally representative survey of U.S. students in grade levels 9 to 12 (N = 14,496). Multivariate logistical regression models assessed the association between self-reported sports-or physical activity-related concussions and suicidal behaviors among students, controlling for a range of demographic and psychosocial variables. Altogether, 13.6% of students reported a sports-or physical activity related concussion in the past 12 months. Among youth, sports-or physical activity related concussions were significantly associated with greater odds of symptoms of depression, suicidal ideation, making a suicide plan, and suicide attempts compared to other youth who did not experience sports- or physical activity-related concussion. Findings highlight increased risk for adverse mental health outcomes among students with sports-or physical activity related concussions. Providing resources for students to engage in physical activity and sports teams may help prevent the onset of depression and suicidal behaviors; however, resources must also be available to monitor any concussions related to these activities to provide support for student emotional well-being.

Using the Theory of Reasoned Action to examine grandparent and maternal substance use on the cannabis use of children of teen mothers.

BACKGROUND: Parental cannabis use is associated with increased risks of cannabis use among offspring, yet few studies have explored the mechanisms influencing intergenerational continuity in cannabis use. To understand the mechanism by which intergenerational cannabis use is influenced, this work explores cannabis use across three generations using a family expansion of the Theory of Reasoned Action (TRA). METHODS: Data come from the Young Women and Child Development Study which began when teen mothers were pregnant and followed mother-child dyads for 17 years (N = 240). Constructs include cannabis use of grandparents, mothers, and teens, and TRA constructs of behavioral and normative beliefs, intention, and behavior. Hypotheses were tested using Structural Equation Modeling. RESULTS: Grandfather's cannabis use was significantly linked to mother's normative beliefs (ß = .22, p = .006), but not attitudes (ß = .12, p = .182). Teen mothers' attitude was associated with intention (ß = .79, p < .001); intention predicted cannabis behavior (ß = .61, p < .001). Teen mothers' cannabis use was predictive of adolescent's attitude (ß = .21, p = .002); attitude predicted intention (ß = .73, p < .001) and intention predicted behavior (ß = .60, p < .001). DISCUSSION: Parents play an influential role in the cannabis use behaviors of adolescents. Future work should consider interventions that target both parent and adolescents, increasing knowledge and skills related to parent-child communication, parental monitoring, and positive parental role modeling to reduce intergenerational continuity of cannabis use.