Race, sex, and physician communication about tobacco as predictors of adolescent smoking trajectories in a primarily African American sample.

This study identified latent classes of adolescent smoking and examined race, gender, and physician communication (PC) as predictors of class membership. Data were drawn from five waves of a large (N = 3,049), diverse (82.9% African American) study. Several latent classes were identified: nonsmoker, quitter, early-onset escalating smoking, early-onset stable high smoking, late-onset smoking, and declining smoking. Males, Whites, and teens who received PC were more likely to be in classes with more smoking. Our study identified several youth smoking patterns and differences in smoking based on race, gender, and receipt of PC.

Subtypes of suicidal ideation in Korean adolescents: A multilevel latent profile analysis.

OBJECTIVE: This study intended to classify subtypes of Korean adolescents with suicidal ideation based on mental health problems and to explore the relationship between such subtypes and individual-, school- and community-level factors. METHOD: Data from high school freshmen who participated in the 2013 school-based mental health screening test and data about school and community variables obtained from public sources were combined and analyzed. A multilevel latent profile analysis using mental health issues as class indicators that included several predictors was conducted. RESULTS: Three latent profiles were identified: Group 1 (6.5%) had high scores for both the internalizing and externalizing problems; Group 2 (40.2%) had high scores for internalizing problems, such as depression and mood related symptoms; and Group 3 (53.3%) had lower scores for all mental health problems compared to Groups 1 and 2. Gender, peer conflict, family conflict and academic problems were significant predictors at the individual level; school dropout rate was a significant school-level variable; and percent of youth in the total population, availability of mental health services, number of social welfare facilities and percentage of the total budget devoted to education/welfare were significant community-level variables. CONCLUSION: The present findings suggest that adolescents with suicidal ideation can be classified into several distinct subtypes based on mental health problems. These profiles and their associated covariates will aid in the establishment of youth suicide prevention policies.

A Six-Year Longitudinal Study of Texting Trajectories During Adolescence.

This study examined growth trajectories of texting (and other media) over a 6-year time period. Participants were 425 adolescents from Washington, USA (age 13 at Time 1, age 18 at Time 6; 48% male, 68% European American). Analyses suggested a curvilinear pattern for texting and social media use, with rates peaking during midadolescence. There was also considerable heterogeneity in trajectories of texting. A growth mixture model revealed four distinct classes of individuals: perpetuals (14%), decreasers (7%), moderates (68%), and increasers (11%). Higher levels of depression, being a male, and coming from a single-parent family predicted being a "perpetual" texter. Perpetuals had the most problematic outcomes compared to other classes, including higher depression, anxiety, aggression, and poor relationships with fathers.

Item Generation and Content Validity of the Child-Adolescent Bullying Scale.

BACKGROUND: Healthcare providers do not uniformly screen young patients for exposure to bullying, and no screening instruments have been developed for widespread use in clinical settings. OBJECTIVES: The objectives of this study were to (a) generate scale items by identifying and eliciting concepts relevant to youths with potential exposure to bullying as well as to professionals who work with bullied youths and (b) assess the content validity of the new Child-Adolescent Bullying Scale (CABS) instrument. METHODS: A mixed-methods design was used to develop an initial pool of 52 items. The study was conducted in four phases: (I) comprehensive review of the existing literature; (II) concept elicitation through the conduct of focus groups with school-age youths and professionals who work with bullied youths; (III) concept selection and item construction; and (IV) content validation assessment of relevance, clarity, and dimension of each item by a panel of 30 international bullying and measurement experts through completion of an online survey. RESULTS: An initial pool of 52 potential items was developed during Phases I-III of the study. During Phase IV, item- and scale-level content validity indices were calculated and were used to refine the item pool. These strategies resulted in a new, 22-item tool, with scale-level content validity indices of .954 for clarity and .920 for representativeness. DISCUSSION: Evaluation of the CABS tool with a sample of youths drawn from healthcare settings will be necessary to assess the performance of the CABS items, further evaluate its psychometric properties, and further refine the tool.

Avoiding antisocial behavior among adolescents: The positive influence of classmates' prosocial behavior.

INTRODUCTION: Prior research has shown that classmates' behavior serves as a descriptive norm for adolescents' individual behavior. While earlier studies primarily focused on negative peer influence, classmates' prosocial behavior might be associated with positive individual development. We hypothesized more classroom-level prosocial behavior predicts a lower likelihood of future antisocial behavior of individual students over and above the effect of classmates' antisocial behavior. We further assumed this effect is mediated by adolescents' attitudes toward antisocial behavior. METHODS: To test our hypotheses, we used three data collection points from a longitudinal study among lower secondary school students in Switzerland (N = 864; mean age at T1: 13.81 years; male gender: 52%). Participants completed self-reported assessments on prosocial behavior, antisocial behavior, and antisocial attitudes. Data were analyzed using multilevel models. RESULTS: Results indicated higher levels of prosocial behavior among classmates predict lower levels of individual students' future antisocial behavior. However, the effect of classmates' prosocial behavior was not mediated by individual attitudes toward antisocial behavior. CONCLUSIONS: While in the context of antisocial behavior the peer group is often assumed a risk, our results indicate that school peers can also exert positive influence. Hereby our finding of an effect of prosocial peer norms over and above antisocial peer norms suggests that building up prosocial behaviors in the classroom may be a promising approach for the prevention of antisocial behavior.

Reciprocal Relationships between Teacher Ratings of Internalizing and Externalizing Behaviors in Adolescents with Different Levels of Cognitive Abilities.

Are internalizing and externalizing behavior problems interrelated via mutually reinforcing relationships (with each behavior leading to increases over time in levels of the other behavior) or mutually suppressing relationships (with each behavior leading to decreases over time in levels of the other behavior)? Past research on the directionality of these relationships has led to ambiguous results, particularly in adolescence. Furthermore, the extent to which prior results will generalize to adolescents with low levels of cognitive abilities remains unknown. This second limit is particularly important, given that these adolescents are known to present higher levels of externalizing and internalizing behaviors than their peers with average-to-high levels of cognitive abilities, and that the mechanisms involved in the reciprocal relationships between these two types of behaviors may differ across both populations. This study examines the directionality of the longitudinal relationships between externalizing and internalizing behavior problems as rated by teachers across three measurement waves (corresponding to Grades 8-10) in matched samples of 138 adolescents (34.78 % girls) with low levels of cognitive abilities and 556 adolescents (44.88 % girls) with average-to-high levels of cognitive abilities. The results showed that the measurement structure was fully equivalent across time periods and groups of adolescents, revealing high levels of developmental stability in both types of problems, and moderately high levels of cross-sectional associations. Levels of both internalizing and externalizing behaviors were higher among adolescents with low levels of cognitive abilities relative to those with average-to-high levels of cognitive abilities. Finally, the predictive analyses revealed negative reciprocal longitudinal relationships (i.e., mutually suppressing relationships) between externalizing and internalizing problems, a result that was replicated within samples of adolescents with low, and average-to-high levels of cognitive ability.

The clinical usefulness of the new LPE specifier for subtyping adolescents with conduct disorder in the DSM 5.

In DSM 5, conduct disorder (CD) has been expanded with a new specifier 'with Limited Prosocial Emotions' (LPE) in addition to the age-of-onset (AoO) subtyping, and is thought to identify a severe antisocial subgroup of CD. However, research in clinical practice has been scarce. Therefore, the current study will examine differences in clinical symptoms between subtypes of CD, based on both subtyping schemes. Subsequently, it will investigate whether the LPE specifier explains unique variance in aggression, added to the AoO subtyping. A sample of 145 adolescents with CD (51 % male, mean age 15.0) from a closed treatment institution participated in this study. CD diagnoses and AoO subtype were assessed using a structured diagnostic interview. The LPE specifier was assessed using the callous-unemotional dimension of the Youth Psychopathy Traits Inventory (YPI). Self-reported proactive and reactive aggression, rule-breaking behavior and internalizing problems within the subtypes were compared. Youth with childhood-onset CD and LPE showed significantly more aggression than adolescent-onset CD without LPE (proactive aggression: F = 3.1, p < 0.05, reactive aggression: F = 3.7, p < 0.05). Hierarchical regression revealed that the LPE specifier uniquely explained 7 % of the variance in reactive aggression, additionally to the AoO subtyping. For proactive aggression, the interaction between AoO and the LPE added 4.5 % to the explained variance. Although the LPE specifier may help to identify a more aggressive subtype of CD in adolescents, the incremental utility seems to be limited. Therefore, clinical relevance of the LPE specifier in high-risk adolescent samples still needs to be investigated thoroughly.

Grouping Youth With Similar Symptoms: A Person-Centered Approach to Transdiagnostic Subgroups.

OBJECTIVES: The present study extracted symptom profiles based on parent and youth report on a broad symptom checklist. Profiles based on parent-reported symptoms were compared to those based on adolescent self-report to clarify discrepancies. METHOD: The current study used archival data from 1,269 youth and parent dyads whose youth received services at a community mental health center. The mean age of the sample was 14.31 years (standard deviation = 1.98), and the youth sample was half male (50.1%) and primarily Caucasian (86.8%). Latent profile analysis was used to extract models based on parent and self-reported emotional and behavioral problems. RESULTS: Results indicated that a 5-class solution was the best fitting model for youth-reported symptoms and an adequate fit for parent-reported symptoms. For 46.5% of the sample, class membership matched for both parent and youth. CONCLUSION: Latent profile analysis provides an alternative method for exploring transdiagnostic subgroups within clinic-referred samples.

Trajectories of childhood neighbourhood cohesion and adolescent mental health: evidence from a national Canadian cohort.

BACKGROUND: The objective of this study was to examine associations between trajectories of childhood neighbourhood social cohesion and adolescent mental health and behaviour. METHOD: This study used data from the National Longitudinal Survey of Children and Youth, a nationally representative sample of Canadian children. The sample included 5577 children aged 0-3 years in 1994-1995, prospectively followed until age 12-15 years. Parental perceived neighbourhood cohesion was assessed every 2 years. Latent growth class modelling was used to identify trajectories of neighbourhood cohesion. Mental health and behavioural outcomes were self-reported at age 12-15 years. Logistic regression was used to examine associations between neighbourhood cohesion trajectories and outcomes, adjusting for potential confounders. RESULTS: Five distinct trajectories were identified: 'stable low' (4.2%); 'moderate increasing' (9.1%); 'stable moderate' (68.5%); 'high falling' (8.9%); and 'stable high' (9.3%). Relative to those living in stable moderately cohesive neighbourhoods, those in stable low cohesive neighbourhoods were more likely to experience symptoms of anxiety/depression [odds ratio (OR) = 1.73, 95% confidence interval (CI) 1.04-2.90] and engage in indirect aggression (OR = 1.62, 95% CI 1.07-2.45). Those with improvements in neighbourhood cohesion had significantly lower odds of hyperactivity (OR = 0.67, 95% CI 0.46-0.98) and indirect aggression (OR = 0.69, 95% CI 0.49-0.96). In contrast, those with a decline in neighbourhood cohesion had increased odds of hyperactivity (OR = 1.67, 95% CI 1.21-2.29). Those in highly cohesive neighbourhoods in early childhood were more likely to engage in prosocial behaviour ('high falling': OR = 1.93, 95% CI 1.38-2.69; 'stable high': OR = 1.89, 95% CI 1.35-2.63). CONCLUSIONS: These results suggest that neighbourhood cohesion in childhood may have time-sensitive effects on several domains of adolescent mental health and behaviour.

Dating violence and suicidal behavior in adolescents.

The aim of this paper is to assess the possible consequences of adolescent physical, emotional and sexual dating violence through a review of the literature on the topic. An electronic search of major biomedical bibliographic databases (Pubmed, ISI, PsycINFO) was used to retrieve articles providing information on the prevalence rates, risk factors, associated consequences and possible preventive measures for adolescent dating violence across different populations. Currently, there have been few longitudinal studies conducted to identify potential risk factors for entering a violent dating relationship in adolescence. Risky behaviors such as early sexual intercourse may predispose someone for victimization. Dating violence itself is also a predictor of future dating violence. Adolescent dating violence was associated with an increase in other violence-related behaviors, substance use, depression, poorer educational outcomes, posttraumatic stress, unhealthy weight control and risky sexual behavior. The association between adolescent dating violence and an increase in suicidal behavior is a major public health concern. Future research should focus on longitudinal studies so that a causal relationship between dating violence and suicidality may be better understood.

Investigating a socially anxious-impulsive subgroup of adolescents: a prospective community study.

Previous research has identified a subgroup of socially anxious adults who are both anxious and impulsive. To date, however, this subgroup has not been identified in adolescence. Therefore, in this study we aimed to identify this subgroup in a sample of adolescents. In addition, we hypothesized that this subgroup would be higher on problem behaviors, and that these processes would be moderated by gender. We used longitudinal data from 714 adolescents who were in the 7th and 8th grades at Time 1. They were followed annually for three years. Cluster analyses identified an anxious-inhibited subgroup as well as an anxious-impulsive subgroup in early adolescence (Time 1). The socially anxious-impulsive adolescent boys were generally higher on both intoxication frequency and delinquency compared with all other adolescents in all clusters at each time point. Findings suggest that social anxiety subgroups may differ on problem behavior, and that early detection of an anxious-impulsive subgroup may be important to prevent maladjustment, especially for adolescent boys.

What does it take to be a smoker? Adolescents' characterization of different smoker types.

INTRODUCTION: Studies have demonstrated that clinical- and research-based definitions of who a smoker is and what constitutes smoking often differ from adolescent-derived definitions, which can be problematic for effective intervention and prevention efforts. We investigated how adolescents define different smoker types (nonsmoker, smoker, regular smoker, addicted smoker, heavy smoker, experimental smoker, casual smoker, and social smoker) using multiple indicators of smoking behaviors, including frequency, amount, place, and length of time cigarette smoking, and whether differences exist by smoking experience. METHODS: Quantitative and qualitative methods were used to analyze data from a cohort of adolescents (N = 372) in northern California. RESULTS: We found differences in how adolescents characterized smoker types based on their own smoking experience. Ever-smokers tended to have a greater flexibility in determining what constituted nonsmoking and heavy smoking, while never-smokers had much narrower definitions. Results also indicated that adolescents may mistakenly associate nicotine addiction with a high frequency and amount of cigarette use as 74.3% characterized an addicted smoker as having smoked for a few years or more. In addition, there was a considerable amount of overlap in definitions between different smoker types, particularly among the smoker-regular smoker, addicted smoker-heavy smoker, and casual smoker-social smoker pairs. CONCLUSION: Health communication strategies for youth smoking prevention need to address the wide variability and overlap in how adolescents define different smoker types. Greater attention should be directed to understanding the nuances of how adolescents define smoking in order to maximize the effectiveness of youth-centered smoking prevention and cessation messages.

Classification of probable online social networking addiction: A latent profile analysis from a large-scale survey among Chinese adolescents.

BACKGROUND AND AIMS: Problematic online social networking use is prevalent among adolescents, but consensus about the instruments and their optimal cut-off points is lacking. This study derived an optimal cut-off point for the validated Online Social Networking Addiction (OSNA) scale to identify probable OSNA cases among Chinese adolescents. METHODS: A survey recruited 4,951 adolescent online social networking users. Latent profile analysis (LPA) and receiver operating characteristic curve (ROC) analyses were applied to the validated 8-item OSNA scale to determine its optimal cut-off point. RESULTS: The 3-class model was selected by multiple criteria, and validated in a randomly split-half subsample. Accordingly, participants were categorized into the low risk (36.4%), average risk (50.4%), and high risk (13.2%) groups. The highest risk group was regarded as "cases" and the rest as "non-cases", serving as the reference standard in ROC analysis, which identified an optimal cut-off point of 23 (sensitivity: 97.2%, specificity: 95.2%). The cut-off point was used to classify participants into positive (probable case: 17:0%) and negative groups according to their OSNA scores. The positive group (probable cases) reported significantly longer duration and higher intensity of online social networking use, and higher prevalence of Internet addiction than the negative group. CONCLUSIONS: The classification strategy and results are potentially useful for future research that measure problematic online social networking use and its impact on health among adolescents. The approach can facilitate research that requires cut-off points of screening tools but gold standards are unavailable.

Future time orientation and temperament: exploration of their relationship to primary and secondary psychopathy.

The present study combines Lykken's theory about the role of reward sensitivity and punishment insensitivity in the development of antisocial behavior with Gjesme's theory of future time orientation. 158 adolescents comprised a target group of 79 adolescents who had defined behavioral problems and a matched referential group of 79 adolescents who did not have notable behavioral problems. The results suggest that attributes related to primary psychopathy are associated with a relatively weak or hyporeactive behavioral inhibition system, behavioral approach reactivity, and low future time orientation. Moreover, attributes related to secondary psychopathy are related to an overly sensitive (hyper-reactive) behavioral approach system and low future time orientation. Robust positive associations for behavioral approach reactivity and low future time orientation with primary and secondary psychopathy suggest that high behavioral approach/low future time orientation may represent a core feature common to the two factors of psychopathy.

[The relationship between tobacco smoking and risk behaviour syndrome among 15-year-old adolescents in Poland and other European countries]. / Zwiazek palenia tytoniu z zespolem zachowan ryzykownych u mlodziezy 15-letniej w Polsce i innych krajach europejskich.

In most of studies on the multiple risk behaviour syndrome, tobacco smoking is consider as one of the main components. In this paper smoking was excluded from this syndrome. On the contrary, a set of behaviours that includes: alcohol abuse, cannabis use and aggressive behaviours (bullying, fighting) was described and its association with smoking related behaviours was evaluated. Data were collected from 15-year-old students (N = 50618) from 28 countries participating in Health Behaviour in School-aged Children (HBSC) survey in 2005/06. Representative samples of pupils completed a standardised questionnaire during school hours in each country. Risk Behaviour Syndrome (RBS) was measured on the scale ranged 0-12 points, categorized into 3 levels. We tried to answer the following questions: 1) is early tobacco onset related with the higher risk of being involved in multiple problem behaviours; 2) what is the prevalence of regular tobacco smoking among adolescents reporting multiple problem behaviours; 3) in what extent gender modifies above relationships; 4) are similar patterns observed in Poland and combined international sample. The results have shown, that in Poland 22.6% of boys and 5.0% of girls reported high level of RBS (6 points or more). The prevalence of every day smoking was equal to 14.9% and 10,1%, in boys and girls, respectively. This percentage increased to 38.8% and 61.0% in the group of boys and girls reporting high score on RBS scale. More boys than girls started to smoke at age 13 yrs or earlier (38.6% vs. 27.1%). Adolescents who begun smoking earlier, were more likely to be regular smokers at age 15, and more likely to report multiple risk behaviors. In all countries the influence of early tobacco onset on the RBS is more evident among girls.

Normative, passionate, or problematic? Identification of adolescent gamer subtypes over time.

BACKGROUND AND AIMS: For most youngsters, gaming is a fun and innocent leisure activity. However, some adolescents are prone to develop problematic gaming behavior. It is therefore important to have a comprehensive understanding of psychosocial and game-related characteristics that differentiate highly engaged gamers from problematic gamers. To that end, this study evaluated the stability and consistency of Internet gaming criteria (as suggested by the DSM-5) and psychosocial characteristics in a two-wave longitudinal study including 1928 young adolescents (mean age = 13.3 years, SD = 0.91, 57% boys). METHODS: A confirmatory factor analysis revealed good stability of the Internet gaming disorder (IGD) construct over time. Latent class analyses revealed three classes for boys (recreational, engaged, and problematic) and two classes for girls (recreational and engaged). RESULTS: Significant differences between classes emerged for problem criteria (conflict and problems in social life), gaming duration, impulsivity, social competence, and attention/hyperactivity. The absence of a problematic gaming class for girls suggests that girls are less likely to develop problematic gaming behavior. DISCUSSION: The IGD criteria as proposed by the DSM-5 are a helpful tool to identify problematic gamers, although the results of this study suggest that using a strict cut-off point might result in false positives, particularly for boys. Problem criteria appeared to be the most sensitive and specific in identifying the problematic gamer, whereas escapism criteria were the least specific and sensitive. Careful consideration of the current proposed criteria to identify problematic gaming behavior could benefit the research and clinical field.

Multiple Trajectories in Anxious Solitary Youths: the Middle School Transition as a Turning Point in Development.

This study aimed to identify divergent patterns of individual continuity and change in anxious solitude (AS) in the last half of elementary school (3rd - 5th grade) and the first two years of middle school (6th - 7th grade), and test predictors and outcomes of these pathways. Participants were 688 youths (girls n = 354, 51.5%; M age at outset = 8.66 years, SD = 0.50). Latent class growth analyses identified two AS trajectory classes in elementary school (moderate-decreasing, high-increasing) and three in middle school (low-stable, low-increasing, high-decreasing). The elementary school moderate-decreasing class was two-and-a-half times more likely than others to end in the middle school low-stable class. In contrast, the elementary school high-increasing class was twice as likely as others to end in the middle school low-increasing class, and four times as likely to end in the middle school high-decreasing class. Peer exclusion predicted membership in increasing AS trajectory classes in both elementary and middle school, whereas the middle school high-decreasing AS trajectory class demonstrated decreasing peer exclusion during middle school. Likewise, inability to defend oneself predicted membership in increasing AS trajectory classes in both elementary and middle school, whereas membership in the middle school high-decreasing AS trajectory class was predicted by inability to defend oneself in elementary but not middle school. High-decreasing AS youths' improved ability to defend themselves in middle school appeared to be related to a cascade of improvements in related domains. In contrast, membership in increasing AS classes in elementary and middle school predicted symptoms of social anxiety and depression.

Unpacking Adultification: Institutional Experiences and Misconduct of Adult Court and Juvenile Court Youth Living Under the Same Roof.

The present study explores the ability of juvenile waiver policy and the resulting adult court status to impact the experiences and behavior of male youth originating from differing jurisdictions but incarcerated together within state-level juvenile correctional facilities. Using official agency data and youth survey data, this research examines how "adult" status influences behavior for waived youth compared with their juvenile court counterparts. Structural equation modeling and multiple group analysis is used to determine the extent to which adult status moderates the measurement structure of models related to individual characteristics, institutional experiences, and institutional misconduct. Results reveal an improvement in model fit to occur when estimated across the two groups of juvenile court and adult court youth, beyond that which occurs when parameters are constrained to be equal for these two groups. This work reveals adult status to be powerful enough to moderate the effects of who a youth is and what that youth experiences, on how that youth behaves during a term of juvenile incarceration.

A Latent Class Analysis of the Co-occurrence of Risk Behaviors among Adolescents.

Objectives: In this study, we examined the co-occurrence of multiple health-risk behaviors to determine whether there are any differences in the pattern of co-occurrence by sex. Methods: We conducted latent class analysis using the national 2013 Youth Risk Behavior Survey data for the overall sample, and separately by sex (N = 13,583). Results: Over half of the sample (53%) belonged to the low risk subgroup (Class 1). Class 2 accounted for 15% of adolescents, and over 40% in this subgroup reported riding with a drunk driver, and 63% reported texting while driving a vehicle. Over 14% belonged to Class 3, which had a higher probability of being depressed and suicidal (81% and 64%, respectively). Class 4 accounted for over 9% of adolescents who reported high probabilities for current cigarette (97%), tobacco (99%), and alcohol use (73%); and over half reported current marijuana use (52%). Class 5 accounted for 8.5% of adolescents identified as high-risk polysubstance users. Analyses showed differences by sex in the pattern of co-occurrences. Conclusion: Several adolescent risk behaviors are interrelated regardless of sex. However, sex differences in the higher probability of depressive symptoms and suicidality among girls highlight the need for interventions that consider the demographic composition of adolescents.

Adolescent Tobacco Uptake and Other Substance Use: A Latent Class Analysis.

Objective: The purpose of this study was to identify patterns of tobacco uptake and other substance use, from early to late adolescence. Methods: We used weighted latent class analysis, conducted separately for 7th, 9th, and 11th graders, to assess patterns of susceptibility, ever and current use of combustible tobacco and e-cigarettes, and other substance use (ie, current alcohol, binge drinking, and marijuana). Data were from Wave 3 of the Texas Adolescent Tobacco and Marketing Surveillance System (n = 2733; N = 461,069), collected in fall 2015. Multinomial regression was used to examine differences in class membership by demographic factors. Results: Two latent classes were identified in 7th grade, 3 classes in 9th grade, and 4 classes in 11th grade models. In each grade, classes included both a "no risk" and a "tobacco susceptible" class. For 9th grade, there was an additional "tobacco ever use" class, and 11th grade had the same additional class as well as an "all products use" class. Conclusion: Distinct patterns of polysubstance use emerged as grade level increased, supporting a stage-sequential model of onset and progression across developmental age groups. Future research can examine other factors affecting transitions across these stages.