Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.

The objective of this study was to present nationally representative findings on sociodemographic and psychopathologic predictors of first incidence of Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) substance, mood and anxiety disorders using the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. One-year incidence rates of DSM-IV substance, mood and anxiety disorders were highest for alcohol abuse (1.02), alcohol dependence (1.70), major depressive disorder (MDD; 1.51) and generalized anxiety disorder (GAD; 1.12). Incidence rates were significantly greater (P<0.01) among men for substance use disorders and greater among women for mood and anxiety disorders except bipolar disorders and social phobia. Age was inversely related to all disorders. Black individuals were at decreased risk of incident alcohol abuse and Hispanic individuals were at decreased risk of GAD. Anxiety disorders at baseline more often predicted incidence of other anxiety disorders than mood disorders. Reciprocal temporal relationships were found between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. Borderline and schizotypal personality disorders predicted most incident disorders. Incidence rates of substance, mood and anxiety disorders were comparable to or greater than rates of lung cancer, stroke and cardiovascular disease. The greater incidence of all disorders in the youngest cohort underscores the need for increased vigilance in identifying and treating these disorders among young adults. Strong common factors and unique factors appear to underlie associations between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder. The major results of this study are discussed with regard to prevention and treatment implications.

Early infant feeding and growth status of US-born infants and children aged 4-71 mo: analyses from the third National Health and Nutrition Examination Survey, 1988-1994.

BACKGROUND: There is controversy over what growth references to use in evaluating breast-fed infants and concern about whether never-breast-fed infants are at risk of overweight in childhood. OBJECTIVE: The objective of this study was to determine whether infants who are exclusively breast-fed for 4 mo differ in average size from infants who are fed in other ways and whether such differences persist through age 5 y. DESIGN: Data from the third National Health and Nutrition Examination Survey (NHANES III) were linked to birth certificates of US-born infants and children. Feeding groups were defined on the basis of feeding patterns over the first 4 mo of life: exclusively breast-fed for 4 mo, partially breast-fed, breast-fed for <4 mo, and never breast-fed. Growth status, indexed as internally derived z scores (SD units) for weight, length (height), weight-for-length (height), midupper arm circumference, and triceps skinfold thickness, was compared among feeding groups. RESULTS: The final sample consisted of 5594 non-Hispanic white, non-Hispanic black, and Mexican American infants and children aged 4-71 mo. Of these, 21% were exclusively breast-fed for 4 mo, 10% were partially breast-fed, 24% were breast-fed for <4 mo, and 45% were never breast-fed. At 8-11 mo, infants who were exclusively breast-fed for4 mo had adjusted mean z scores for weight (-0.21; -0.2 kg), weight-for-length (-0.27), and midupper arm circumference (-0.15) that differed significantly from zero (P < 0. 05). By 12-23 mo, the differences had dissipated; there were no significant differences subsequent to 5 y. Triceps skinfold thickness was not related to early infant feeding. CONCLUSION: Infants who were exclusively breast-fed for 4 mo weighed less at 8-11 mo than did infants who were fed in other ways, but there were few other significant differences in growth status through age 5 y associated with early infant feeding.

Association between infant breastfeeding and overweight in young children.

CONTEXT: It has been suggested that breastfeeding is protective against children becoming overweight, and that there is a dose-dependent effect of its duration. OBJECTIVE: To determine whether breastfeeding and its duration are associated with a reduced risk of being overweight among young children in the United States. DESIGN AND SETTING: Data on infant feeding and child overweight status were taken from the third National Health and Nutrition Examination Survey (NHANES III), a cross-sectional health examination survey conducted from 1988-1994. SUBJECTS: Sample of 2685 US-born children between the ages of 3 and 5 years, with birth certificates, height and weight measures, and information on infant feeding. MAIN OUTCOME MEASURES: A body mass index (BMI) between the 85th and 94th percentile was considered at risk of overweight and a BMI in the 95th percentile or higher was considered being overweight. RESULTS: After adjusting for potential confounders, there was a reduced risk of being at risk of overweight for ever breastfed children (adjusted odds ratio [AOR], 0.63; 95% confidence interval [CI], 0.41-0.96) compared with those never breastfed. There was no reduced risk of being overweight (AOR, 0.84; 95% CI, 0.62-1.13). There was no clear dose-dependent effect of the duration of full breastfeeding on being at risk of overweight or overweight and no threshold effect. The strongest predictor of child overweight status was the mother's concurrent weight. The rate of children being overweight nearly tripled with maternal overweight status (BMI, 25.0-29.9 kg/m(2); AOR, 2.95; 95% CI, 1.35-6.42) and more than quadrupled with maternal obesity status (BMI >/=30.0 kg/m(2); AOR, 4.34; 95% CI, 2.50-7.54). CONCLUSIONS: There are inconsistent associations among breastfeeding, its duration, and the risk of being overweight in young children. Breastfeeding continues to be strongly recommended, but may not be as effective as moderating familial factors, such as dietary habits and physical activity, in preventing children from becoming overweight.

Bullying behaviors among US youth: prevalence and association with psychosocial adjustment.

CONTEXT: Although violence among US youth is a current major concern, bullying is infrequently addressed and no national data on the prevalence of bullying are available. OBJECTIVES: To measure the prevalence of bullying behaviors among US youth and to determine the association of bullying and being bullied with indicators of psychosocial adjustment, including problem behavior, school adjustment, social/emotional adjustment, and parenting. DESIGN, SETTING, AND PARTICIPANTS: Analysis of data from a representative sample of 15 686 students in grades 6 through 10 in public and private schools throughout the United States who completed the World Health Organization's Health Behaviour in School-aged Children survey during the spring of 1998. MAIN OUTCOME MEASURE: Self-report of involvement in bullying and being bullied by others. RESULTS: A total of 29.9% of the sample reported moderate or frequent involvement in bullying, as a bully (13.0%), one who was bullied (10.6%), or both (6.3%). Males were more likely than females to be both perpetrators and targets of bullying. The frequency of bullying was higher among 6th- through 8th-grade students than among 9th- and 10th-grade students. Perpetrating and experiencing bullying were associated with poorer psychosocial adjustment (P<.001); however, different patterns of association occurred among bullies, those bullied, and those who both bullied others and were bullied themselves. CONCLUSIONS: The prevalence of bullying among US youth is substantial. Given the concurrent behavioral and emotional difficulties associated with bullying, as well as the potential long-term negative outcomes for these youth, the issue of bullying merits serious attention, both for future research and preventive intervention.

Stature, weight, and body mass among young US children born at term with appropriate birth weights.

OBJECTIVE: To describe weight, stature, and body mass index (BMI) changes occurring before the age of 7 years, which may influence the prevalence of overweight in adolescence and adulthood. METHODS: Regression models predicting height and weight at ages 2 months to 6. 75 years were based on the third National Health and Nutrition Examination Survey. Birth certificate data were used to adjust ethnic-specific models for birth weight for gestational age. RESULTS: Attained height is higher for non-Hispanic black children than for either non-Hispanic white or Mexican American children (P 85th percentile than either non-Hispanic white or black children (boys = 25.6%, SE = 2.7 compared with 14.1%, SE = 1.7 and 16.5%, SE = 1.7, respectively; girls = 21.9%, SE = 3.6 compared with 13.0%, SE = 1.7 and 13.7%, SE = 2.2, respectively). For non-Hispanic whites and Mexican Americans and for non-Hispanic black boys, BMI decreased slightly between ages 2 and 6.75 years; BMI for non-Hispanic black girls did not. CONCLUSION: Size differences before the age of 7 years may influence later ethnic-specific overweight prevalence, independent of prenatal influences.