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1.
School Psych Rev ; 52(3): 292-315, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37484214

RESUMEN

Black boys have been dying by suicide at an increasing rate. Although the reasons for this increase are unknown, suicide in Black boys is likely influenced by multiple, intersecting risk factors, including historical and ongoing trauma. Schools can serve as an important mechanism of support for Black boys; however, without intentional anti-racist frameworks that acknowledge how intersecting identities can exacerbate risk for suicide, schools can overlook opportunities for care and perpetuate a cycle of racism that compromises the mental health of Black youth. By recognizing their own implicit biases, modeling anti-racist practices, listening to and recognizing the strengths and diversity of Black youth, and fostering school-family-community partnerships, school psychologists can help transform the school environment to be a safe and culturally affirming place for Black youth. This paper outlines how school psychologists can apply a trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-informed approach to suicide prevention in order to more holistically support Black boys, disrupt patterns of aggressive disciplinary procedures, and improve school-based suicide prevention programs. By applying this lens across a multitiered systems of support (MTSS) framework, school psychologists can help to prevent the deaths of Black boys and begin to prioritize the lives of Black boys.

2.
J Adolesc Health ; 73(1): 88-94, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37031093

RESUMEN

PURPOSE: Teen dating violence (TDV) must be addressed as a public health issue due to its prevalence and association with negative health outcomes among victims. To prevent TDV, it is essential to examine the risk factors of dating violence perpetration's applicability to younger samples. Using a population health approach, this study explored the associations among variables that affect emotion regulation and TDV perpetration of multiple types among a diverse sample of high school students. METHODS: Latent profile analysis of four self-reported variables related to emotion regulation (anger regulation, depressive symptoms, impulsivity, and alcohol use) was conducted among a sample of 1,508 students. Next, regression analyses were used to test the relation between latent profile membership and self-reported TDV perpetration across two time points. RESULTS: A three-profile solution was found to be the solution of best fit (profile 1: n = 1,023, profile 2: n = 43, and profile 3: n = 442). Profile one had low means across all indicators; profile two had a high mean of recent alcohol use; and profile three had low to moderate means across all indicators. Profile two was associated with the most frequent lifetime perpetration and perpetration one year later. However, all three profiles were only associated with infrequent perpetration. DISCUSSION: This study found that an emotional regulatory framework was applicable to assess some risks of TDV. These findings justify further research on the relation between emotion regulation and TDV perpetration; however, risk factors at other socio-ecological levels should be incorporated to strengthen existing theories.


Asunto(s)
Conducta del Adolescente , Víctimas de Crimen , Violencia de Pareja , Humanos , Adolescente , Conducta del Adolescente/psicología , Violencia de Pareja/psicología , Factores de Riesgo , Consumo de Bebidas Alcohólicas , Emociones
3.
Arch Sex Behav ; 52(4): 1643-1651, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36757517

RESUMEN

Self-objectification is associated with a number of negative mental and behavioral outcomes. Though previous research has established associations between self-objectification and risky sex, no study to date has examined whether self-objectification affects propensity to engage in risky sex. The current research employed an experimental design to examine the effect of heightened self-objectification on a laboratory analog of risky sex (n = 181). We observed that when college-attending women experienced a heightened state of self-objectification, they were more likely to engage in sex without a condom and less likely to wait to use a condom with a highly desirable partner. Given the frequency of intended and unintended objectifying messages that young women face, this increase in willingness to engage in risky sex behavior represents a consequential health concern.


Asunto(s)
Condones , Conducta Sexual , Humanos , Femenino , Universidades , Asunción de Riesgos , Estudiantes
4.
J Res Adolesc ; 33(2): 530-546, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36564897

RESUMEN

Using family systems theory, this longitudinal study of middle school youth examined the effects of abuse, family conflict, and sibling aggression on sexual harassment perpetration (N = 1563; Mage 11.2, 51% boys; 39% Hispanic, 29% Black, and 19% White). Boys reported more sexual harassment than girls; perpetration increased for both. The association between a hostile home environment and sexual harassment perpetration was moderated by school experiences. School belonging buffered effects of hostile home environment on baseline sexual harassment perpetration for boys who experienced abuse and White adolescents with high sibling aggression. Academic grades moderated change in perpetration over time, but effects differed by sex and race. It is important to understand how early violence exposures relate to sexual violence perpetration during early adolescence.


Asunto(s)
Delitos Sexuales , Acoso Sexual , Masculino , Femenino , Humanos , Adolescente , Niño , Estudios Longitudinales , Ambiente en el Hogar , Instituciones Académicas
5.
J Interpers Violence ; 38(1-2): NP1690-NP1717, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35469485

RESUMEN

Adolescent sexual violence (SV), which includes non-contact verbal sexual harassment (SH) and forced sexual contact (FSC), is a significant public health problem with long-term impacts on health and well-being. Understanding how sports participation is linked to SV can inform prevention efforts; however, the current literature is unclear about the nature of this association. Using data from 20 high schools, we investigate whether athletes in certain sports are at higher risk of SH and FSC perpetration than either other athletes or sports non-participants, and whether the risk is moderated by gender, dismissiveness of SV, or substance use intentions. We also utilize social network data to explore the role of relationships with peers and trusted adults to attenuate SH and FSC perpetration. Second, we incorporate characteristics of friends to further examine the role and composition of peer groups in the association between sports participation and perpetration of SH and FSC. Findings revealed a bivariate association between sport contact level and SH perpetration, but not FSC, and the association disappeared after adjusting for other covariates. Most prominently, dismissiveness of SV, intentions to use substances, and prior perpetration had the strongest association with perpetration regardless of sport contact level. Results also provided some support for the influence of peers and trusted adults in the sports context. Notably, the percentage of friends who perpetrated FSC and the percentage of friends who play a low-contact sport were positively associated with FSC perpetration, and the percentage of friends who play a high-contact sport was positively associated with SH perpetration. The paper concludes with a discussion of the sports context as an important venue for comprehensive prevention efforts, including a focus on changing norms around adolescent SV and substance use.


Asunto(s)
Delitos Sexuales , Acoso Sexual , Deportes , Adolescente , Adulto , Humanos , Participación Social , Delitos Sexuales/prevención & control , Grupo Paritario , Red Social , Acoso Sexual/prevención & control
6.
J Early Adolesc ; 42(9): 1115-1151, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36340294

RESUMEN

Bias-based aggression at school in the form of homophobic name-calling is quite prevalent among early adolescents. Homophobic name-calling is associated with low academic performance, higher risky sexual behaviors, and substance abuse, among other adverse outcomes. This longitudinal study examined risk and protective factors across multiple domains of the social ecology (individual, peer, family, school and community) and levels of analysis (within- and between-person) associated with homophobic name-calling perpetration and victimization. Students from four middle schools in the U.S. Midwest (N = 1,655; X ¯ age = 12.75; range = 10-16 years) were surveyed four times (Spring/Fall 2008, Spring/Fall 2009). For homophobic name-calling perpetration, significant risk factors included impulsivity, social dominance, traditional masculinity, family violence, and neighborhood violence; while empathy, peer support, school belonging, and adult support were significant protective factors. For homophobic name-calling victimization, significant risk factors included empathy (between-person), impulsivity, traditional masculinity, family violence, and neighborhood violence, while empathy (within-person), parental monitoring, peer support, school belonging, and adult support were significant protective factors.

7.
J Interpers Violence ; 37(13-14): NP10512-NP10538, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35259321

RESUMEN

Sexual violence (SV) among adolescents continues to be a major public health concern with numerous consequences. Research, predominantly with male collegiate samples, has suggested an association between sports participation and SV perpetration, and has included other important risk factors such as substance use and attitudes. However, more research is needed in this area among adolescents. The current study uses latent class analysis (LCA) to examine data- driven classes of high school student athletes (N = 665) engaged in three risk factor areas for SV: sport contact level, likelihood of substance use, and attitudes dismissive of SV. Once classes were enumerated and fit separately for male and female samples, pairwise comparisons were conducted on scores on two forms of SV (perpetration of sexual harassment and unwanted sexual contact) as a function of class membership. A 5-class solution was retained for both males and females. In the female sample, regarding SV-harassment, those most likely to perpetrate sexual harassment were those characterized by high likelihood of use of cigarettes, marijuana, alcohol, vape products, and those who played any type of sport. Too few females endorsed perpetration of unwanted sexual contact for pairwise comparisons to be conducted. For males, the classes most likely to perpetrate both forms of SV were those who were likely to endorse high likelihood to use of cigarettes, marijuana, alcohol, vape products, endorse attitudes dismissive of SV, and play any type of sport but especially high contact sports. These findings implicate high school athletic spaces as important venues for sexual violence prevention efforts.


Asunto(s)
Delitos Sexuales , Acoso Sexual , Deportes , Trastornos Relacionados con Sustancias , Adolescente , Atletas , Actitud , Femenino , Humanos , Masculino , Trastornos Relacionados con Sustancias/epidemiología
8.
J Sch Psychol ; 91: 27-49, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35190078

RESUMEN

The extant literature on suicide-related thoughts and behaviors (STB) has highlighted increased patterns of risk among specific minoritized populations, including lesbian, gay, bisexual, transgender, questioning, intersex, two spirit, and queer (LGBTQ+) youth. Compared to their heterosexual and cisgender peers, LGBTQ+ youth are at increased risk for having STB. Identity-specific stressors such as homonegativity and anti-queerness are among the unique factors posited to contribute to this risk and inhibit factors that protect against suicide. The school setting has been a focal point for suicide prevention and intervention and may also play a key role in linking students to care; however, schools also hold the potential to provide supports and experiences that may buffer against risk factors for STB in LGBTQ+ students. This systematic literature review presents findings from 44 studies examining school-related correlates of STB in LGBTQ+ students, informing an ecological approach to suicide prevention for school settings. Findings underscore the importance of school context for preventing STB in LGBTQ+ youth. Approaches that prioritize safety and acceptance of LGBTQ+ youth should span multiple layers of a student's ecology, including district and state level policies and school programs and interventions, such as Gender and Sexuality Alliances and universal bullying prevention programs. Beyond their role as a primary access point for behavioral health services, schools offer a unique opportunity to support suicide prevention by combating minority stressors through promoting positive social relationships and a safe community for LGBTQ+ students.


Asunto(s)
Acoso Escolar , Minorías Sexuales y de Género , Prevención del Suicidio , Adolescente , Acoso Escolar/prevención & control , Femenino , Humanos , Instituciones Académicas , Ideación Suicida
9.
Prev Sci ; 23(1): 154-166, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34480329

RESUMEN

The current study tested differences in social network characteristics of high school students who report perpetrating sexual violence (SV) versus those who do not. N = 4554 students (49% male, 49% female, 2% another gender identity; 45% Hispanic, 43% white, 12% another racial identity) from 20 high schools reported how often they had perpetrated 13 sexually violent behaviors. Using their responses, students were classified as follows: non-perpetrators, sexual harassment perpetrators, low contact perpetrators, or high contact perpetrators. Students named up to 7 close friends and up to 7 trusted adults at their school and answered questions about other behaviors and attitudes. This information was used to assess (1) students' connections with peers, (2) students' connections with trusted adults, and (3) friends' characteristics. Multilevel models indicated that compared to their peers, high contact perpetrators were less involved in the peer networks, less connected to trusted adults, and more likely to have friends who were involved in risky behaviors (e.g., sexual violence, homophobic name-calling, substance use). Low contact perpetrators were as connected to peers and trusted adults as non-perpetrators but were more likely to have friends engaged in sexual violence and homophobic naming-calling perpetration. By contrast, sexual harassment perpetrators were more involved and held higher status in the peer network (e.g., received more friendship nominations) but otherwise had similar friendship characteristics and similar connections to trusted adults as non-perpetrators. Building on these results, social network-informed SV prevention should use opinion leaders to change SV norms throughout the network and encourage new relationships between low- and high-risk students so as to disseminate norms that do not tolerate SV. Promoting connections to trusted adults also may be a useful avenue, especially for isolated adolescents.Trial Registration This study is registered at www.clinicaltrials.gov NCT01672541. Syntax code is available from the authors upon request.


Asunto(s)
Delitos Sexuales , Acoso Sexual , Adolescente , Adulto , Femenino , Amigos , Identidad de Género , Humanos , Masculino , Grupo Paritario , Delitos Sexuales/prevención & control , Red Social
10.
Trauma Violence Abuse ; 23(4): 1358-1370, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-34519239

RESUMEN

Adolescent bullying continues to be a major focus of scholarship across the globe. This article reviews research from 2010 to 2021 with a particular focus on longitudinal studies of the bully-sexual violence pathway (BSVP), where bullying serves as a precursor for sexual violence (SV) (e.g., sexual harassment, sexual coercion, and sexual assault) and teen dating violence via individual and socio-contextual mediators. Articles reviewed consisted of a total of 505, which included 17 meta-analyses and systematic reviews. Databases used for the search were Academic Search Complete, Education Full Text (H. W. Wilson), ERIC, National Criminal Justice Reference Service Abstracts, PsycINFO, PubMed (Medline), and Social Sciences Abstracts (H. W. Wilson). In total, 107 peer-reviewed articles were included in this review. Potential mechanisms underlying the BSVP include social dominance orientation, exposure to sexual education, and alcohol use. Several school-based intervention approaches have evidenced marginal success in reducing rates of bullying and SV by targeting factors undergirding both behaviors. The efficacy of international prevention approaches is summarized. Gaps in the literature are identified and future research is proposed.


Asunto(s)
Conducta del Adolescente , Acoso Escolar , Víctimas de Crimen , Violencia de Pareja , Delitos Sexuales , Acoso Sexual , Adolescente , Humanos
11.
J Interpers Violence ; 37(3-4): 1514-1539, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-32484375

RESUMEN

A number of studies have examined the association between male involvement in sports and sexual violence (SV) perpetration, especially among college-age males. Less is known about the association between sports involvement and SV perpetration for adolescent males and females. To address this gap, the current study examined sports involvement in middle school (no sports, no/low contact, and high contact) among 1,561 students, who were then followed into high school and asked about the frequency of SV perpetration. Results from logistic regression models indicated that, even after controlling for mother's education, race/ethnicity, SV perpetration in middle school, and traditional beliefs about masculinity and substance use, middle school sports participation was significantly associated with risk of SV perpetration in high school. Compared with youth who reported no sports involvement in middle school, youth categorized as no/low contact sports involvement had greater odds of SV perpetration in high school. Sex differences emerged, revealing that no/low contact sports involvement was associated with SV perpetration for females and high contact sports involvement was associated with SV perpetration for males, compared with no sports involvement. These findings suggest potential opportunities to intervene in middle school to improve coaching practices, enhance respectful relationships, and modify athletes' norms, attitudes, and behaviors to reduce risk for SV perpetration in high school.


Asunto(s)
Delitos Sexuales , Deportes , Adolescente , Atletas , Femenino , Humanos , Masculino , Instituciones Académicas , Estudiantes
12.
J Int Neuropsychol Soc ; 28(2): 109-122, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-33745491

RESUMEN

OBJECTIVE: Examine pre-existing learning disorders (LD) and attention deficit/hyperactivity disorders (ADHD) as risk factors for prolonged recovery and increased symptomology following pediatric mild traumatic brain injury (mTBI). METHODS: We conducted a retrospective cohort study of children/adolescents (5-17 years) with mTBI who presented to a Children's Minnesota Concussion Clinic between April 2018 and March 2019. Differences across strata of pre-existing conditions (present vs. absent) in time to recovery measures were estimated via Kaplan-Meier and Cox proportional hazards analyses and differences in symptom trajectories were examined via linear mixed-effects regression models. Regression models were adjusted for age, sex and other confounders. RESULTS: In our cohort of 680 mTBI patients, those with LD (n = 70) or ADHD (n = 107) experienced significantly longer median durations of symptoms (58 and 68 days, respectively) than those without (43 days). Accordingly, LD was significantly associated with delayed symptom recovery (adjusted hazard ratio (aHR) = 1.63, 95% CI: 1.16-2.29), return to school (1.47, 1.08-2.00), and return to physical activity (1.50, 1.10-2.04). Likewise, ADHD was associated with delayed recovery (1.69, 1.28-2.23), return to school (1.52, 1.17-1.97) and physical activity (1.55, 1.19-2.01). Further, patients with LD or ADHD reported, on average, significantly more concussion symptoms and higher vision symptom scores throughout recovery versus those without. There was no evidence that concussion or vision symptom recovery trajectories varied over time between those with/without LD or ADHD (joint P-interactions > 0.05). CONCLUSION: Pre-existing LD and ADHD are risk factors for prolonged and more symptomatic mTBI recovery in youth. These results can inform clinical concussion management and recovery expectations.


Asunto(s)
Traumatismos en Atletas , Trastorno por Déficit de Atención con Hiperactividad , Conmoción Encefálica , Discapacidades para el Aprendizaje , Adolescente , Traumatismos en Atletas/complicaciones , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Conmoción Encefálica/complicaciones , Conmoción Encefálica/diagnóstico , Niño , Humanos , Discapacidades para el Aprendizaje/complicaciones , Estudios Retrospectivos , Factores de Riesgo
13.
J Interpers Violence ; 37(7-8): NP4415-NP4438, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-32954914

RESUMEN

There are consistently high rates of sexual victimization and substance misuse among youth in the United States. Although there is a known relation between sexual victimization and substance use, there is a gap in the research regarding the magnitude and temporality of these associations. This study examined whether latent classes of sexual victimization and help-seeking attitudes longitudinally predict intentions of future substance misuse 7-10 months later. Students from nine Colorado high schools (N = 533; M = age 16 years) completed surveys across two consecutive school semesters. Latent class analysis was used to identify classes of students who experienced at least one form of sexual victimization (e.g., sexual harassment, unwanted sexual contact) according to 13 sexual victimization items, and level of positive attitudes regarding help-seeking for sexual victimization. Classes were compared on demographic characteristics and for distal outcomes of likelihood of future substance misuse (cigarettes, alcohol, cannabis, prescription drugs, and electronic vaping products) using latent class regression, controlling for previous intentions to use. At Time 1, four classes of sexual victimization were identified with two main classes for comparison: low odds of experiencing sexual victimization (60.1% of sample) and high odds of endorsing all forms of sexual victimization (7.7% of sample). The high sexual victimization class had higher proportions of male and transgender students, compared to other classes. At Time 2 (7-10 months later), students in the high sexual victimization class reported a significantly greater likelihood of future cigarette (p = .017) and prescription drug misuse (p = .007) when compared to the low sexual victimization class. There was no evidence that having higher positive attitudes towards help-seeking resulted in lower intentions to use substances in the future. These findings highlight that addressing sexual violence in prevention programming may have crossover effects of reducing substance misuse and other forms of violence among youth.


Asunto(s)
Víctimas de Crimen , Acoso Sexual , Trastornos Relacionados con Sustancias , Adolescente , Colorado/epidemiología , Humanos , Masculino , Instituciones Académicas , Trastornos Relacionados con Sustancias/epidemiología , Estados Unidos
14.
J Adolesc Health ; 69(6): 983-990, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34301468

RESUMEN

PURPOSE: Sexual and gender minority (SGM) youth (e.g., gay, lesbian, bisexual, questioning, transgender) are systemically impacted by victimization and poor mental health because of discrimination in society. To prevent adverse outcomes, we must understand factors that help communities support and protect SGM youth. This study examined to what extent protective factors longitudinally predict outcomes 2 years later in an effort to inform more sensitive prevention efforts. METHODS: Students from nine Colorado high schools (N = 2,744) completed surveys across four consecutive school semesters (T1 to T4). Structural equation modeling was conducted to determine the longitudinal associations between baseline protective factors (access to medical and counseling services, help-seeking beliefs, trusted adults, family support, peer support, spirituality) and distal adverse outcomes (substance use, depression, suicidal ideation, peer victimization, bullying perpetration, sexual violence victimization and perpetration, homophobic name-calling victimization, and perpetration), by sexual orientation. RESULTS: All protective factors examined, except for access to medical services, were associated with lower likelihood of adverse outcomes. Associations differed across sexual orientations. For students identified as questioning or something other than heterosexual, lesbian, gay, or bisexual, family support is a notable protective factor of depression, peer victimization, bullying perpetration, and sexual violence perpetration. Family support was not significantly protective for these outcomes among heterosexual, lesbian, gay, and bisexual students. CONCLUSIONS: There is no singular protective factor or universally impactful intervention for public health. Public health initiatives should recognize intersectional identities of young people and build strategies that are relevant to specific identities to create more comprehensive and effective programing.


Asunto(s)
Acoso Escolar , Víctimas de Crimen , Minorías Sexuales y de Género , Adolescente , Femenino , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Factores Protectores , Salud Pública
15.
Rehabil Psychol ; 66(2): 192-201, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33539137

RESUMEN

PURPOSE/OBJECTIVE: College students with physical disabilities are often at a higher risk for mental health problems. In addition, some universities have created disability community spaces, but it is not known whether these spaces are associated with social support or increased mental health and well-being among students who use them. This study investigated differences in feelings of perceived social support, depressive symptomatology, and well-being between students with physical disabilities who live in general student housing and students with physical disabilities who live in a disability community. Research Methods/Design: A mixed-methods online survey was used to collect data from students with physical disabilities who lived in a disability community and from those who did not. Of the participants, 27 college students self-identified as having a physical disability (n = 27), 11 participants lived in the disability community (n = 11), and 16 did not (n = 16). RESULTS: The quantitative results indicated statistically significant differences between the two groups on all three measures. The open-ended responses revealed that those who lived in the disability community setting felt more connected to other students with physical disabilities. However, the results also showed that many students with physical disabilities felt socially disconnected for a myriad of reasons. CONCLUSIONS/IMPLICATIONS: These findings suggest that living in a disability community may be associated with feeling socially supported and improved mental health outcomes among college students with physical disabilities. Universities and other stakeholders should consider implementing programs to foster disability community among students with physical disabilities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Personas con Discapacidad , Salud Mental , Humanos , Estudiantes , Encuestas y Cuestionarios , Universidades
16.
Psychol Bull ; 147(2): 115-133, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33271024

RESUMEN

The daily challenges resulting from all types of school violence-such as physical aggression, bullying, peer victimization, and general threats-have the potential to affect, longitudinally, students' mental health, school performance, and involvement in criminal or delinquent acts. Across primary and secondary studies, however, variation in how and how much school violence relates to these outcomes, has persisted. The purpose of this systematic review and meta-analysis, therefore, was to clarify this uncertainty by synthesizing the longitudinal relations. We conducted exhaustive searching procedures, implemented rigorous screening and coding processes, and estimated an underused effect size, the partial correlation from multiple regression models, before estimating a random-effects meta-analysis using robust variance estimation. We meta-analyzed 114 independent studies, totaling 765 effect sizes across 95,618 individual participants. The results of the overall analyses found a statistically significant longitudinal relation between school violence, in any role, and the aggregated outcome variables (rp = .06). Given that this effect size inherently controls for multiple potential confounding covariates, we consider the relation's magnitude clinically meaningful. We end by discussing ways practitioners and researchers may use these analyses when implementing prevention programming and how the field of meta-analysis should more frequently utilize the partial correlation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Rendimiento Académico/estadística & datos numéricos , Conducta Criminal , Trastornos Mentales/epidemiología , Instituciones Académicas , Estudiantes/psicología , Violencia/psicología , Humanos , Estudios Longitudinales , Factores de Riesgo
17.
Neurooncol Pract ; 7(4): 428-438, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32765893

RESUMEN

BACKGROUND: Children with high-grade CNS cancers frequently experience malnutrition during treatment. We assessed the effects of proactive enteral tube (ET) placement/enteral tube feedings (ETF) on weight in infants/children with high-grade CNS tumors treated with aggressive chemotherapy. METHODS: We conducted a retrospective study of patients age 0 to 19 years treated for new high-grade CNS tumors between 2002 and 2017 at a tertiary pediatric hospital system. Patients underwent placement of proactive ET (≤ 31 days postdiagnosis; n = 45), rescue ET (> 31 days, due to weight loss; n = 9), or no ET (n = 18). Most received surgically placed ET (98%), with percutaneous endoscopic gastrojejunostomy or gastrojejunostomy tubes favored to allow jejunal feeding. The majority of patients with ET used ETF (91%). Using mixed-effects regression models, we examined differences in mean weights between ET/ETF groups across the first year of treatment. We also evaluated observed weight changes. RESULTS: All infants (n = 22, median age, 1.5 years) had proactive ET placed and 21 of 22 used proactive ETF. Infants showed an initial increase in mean percentage weight change that eventually leveled off, for an estimated increase of 10.4% over the year. For the pediatric cohort (n = 50, median, 8.1 years), those receiving proactive ETF experienced weight increases (+9.9%), those with rescue ETF experienced an initial decline and eventually rebounded for no net change (0.0%), and those with no ETF demonstrated an initial decline that persisted (-11.9%; P interaction < .001). Analysis of observed weights revealed nearly identical patterns. CONCLUSIONS: Proactive ETF was effective at maintaining weight and/or facilitating weight gain over the first year of treatment and was acceptable to patients/families.

18.
J Neurol Neurosurg Psychiatry ; 91(10): 1060-1066, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32788258

RESUMEN

OBJECTIVE: To examine pre-existing anxiety disorders as a risk factor for increased concussion symptomology and prolonged recovery in children and adolescents. METHODS: In this retrospective cohort study, we abstracted medical record data for 637 children/adolescents (5-17 years) presenting to three tertiary concussion clinics between April 2018 and March 2019. Primary outcomes were mean concussion symptom and vision symptom severity scores measured at clinic visits. Linear mixed-effects regression models were employed to investigate differences in average symptom load, vision symptom score and symptom recovery trajectories across anxiety strata, adjusted for random effects (time), age and sex. Secondary outcomes, time to concussion symptom recovery and time to return to academics and sports, respectively, were examined via log-rank tests and multivariable Cox regression. RESULTS: Among 637 eligible concussion patients, 155 (24%) reported pre-existing anxiety. On average, patients with anxiety reported an additional 2.64 (95% CI 1.84 to 3.44) concussion symptoms and 7.45 (95% CI 5.22 to 9.68) higher vision symptom severity scores throughout recovery versus those without, after adjusting for age and sex. There was no evidence that concussion or vision symptom trajectories varied over time between those with/without anxiety after accounting for baseline dissimilarities in symptom scores (all pinteraction >0.05). Anxiety was significantly associated with delayed symptom recovery (adjusted HR 3.34, 95% CI 2.18 to 5.12), return to school (adjusted HR 2.01, 95% CI 1.59 to 2.53) and return to physical activity (adjusted HR 1.88, 95% CI 1.49 to 2.37). CONCLUSIONS: Pre-existing anxiety disorders were associated with more severe symptomology and prolonged recovery after concussion in children and adolescents. These results can be referenced by providers to manage patients' recovery expectations.


Asunto(s)
Trastornos de Ansiedad/psicología , Síndrome Posconmocional/fisiopatología , Recuperación de la Función , Regreso a la Escuela , Volver al Deporte , Trastornos de la Visión/fisiopatología , Adolescente , Trastornos de Ansiedad/complicaciones , Conmoción Encefálica/complicaciones , Conmoción Encefálica/fisiopatología , Conmoción Encefálica/psicología , Estudios de Casos y Controles , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Masculino , Análisis Multivariante , Síndrome Posconmocional/complicaciones , Síndrome Posconmocional/psicología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Factores de Tiempo , Trastornos de la Visión/complicaciones
19.
Am J Orthopsychiatry ; 90(5): 623-632, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32567882

RESUMEN

Decades of research have categorized risk and protective factors for youth gang involvement in social contexts that include individual, family, peer, school, and community factors. However, most studies are cross-sectional and only examine 1 or 2 social-ecological contexts. This study, which used a time-to-event model with time-variant and time-invariant predictors, adds to this literature by using longitudinal social-ecological factors to examine increases in the hazard of gang entry among serious juvenile offenders followed for 7 years during the transition from adolescence to young adulthood. Lower socioeconomic status (SES), higher rates of exposure to violence, self-reported offending, and time spent in jail were associated with higher hazards rates of gang entry. Temperance (suppression of aggression and impulse control) was associated with decreases in the hazard of gang entry. Among family characteristics, higher parental hostility and having a father who had been arrested were associated with increases in the hazard of gang entry. Resistance to peer influence was a protective factor for gang entry. In addition, individuals who reported associating with delinquent peers or who had a higher proportion of friends who had been arrested had significant increases in the hazard for gang entry. School orientation was a significant protective factor, and neighborhood disorganization was associated with increases in the hazard for gang entry. Strategies for early intervention and prevention efforts are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Conducta del Adolescente/psicología , Delincuencia Juvenil/estadística & datos numéricos , Grupo Paritario , Medio Social , Violencia/psicología , Adolescente , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Modelos de Riesgos Proporcionales , Factores Protectores , Características de la Residencia , Factores de Riesgo , Instituciones Académicas , Violencia/prevención & control
20.
Aggress Behav ; 46(5): 370-379, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32510701

RESUMEN

There is a paucity of research on developmental trajectories of bias-based aggression. We examined homophobic bullying victimization trajectories among high school students (N = 3,064; M age = 13.67; Girls = 50.2%) and how these developmental pathways vary as a function of factors like homophobic bullying perpetration, sex assigned at birth, and sexuality. Using data from a 3-wave longitudinal investigation over a 2-year period, we utilized latent growth mixture modeling to explore the aforementioned trajectories. Findings suggested that there were three distinct classes characterized by high initial rates and declines over time, low initial rates, and increases over time, and low, stable, rate across time. Furthermore, results indicated that homophobic bullying perpetration, sex assigned at birth, and sexuality all predicted class membership.


Asunto(s)
Acoso Escolar , Víctimas de Crimen , Sexualidad , Femenino , Humanos , Estudios Longitudinales , Masculino , Conducta Sexual , Adulto Joven
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