ADHD, chronotype, and circadian preference in a multi-site sample of college students.

Attention-deficit/hyperactivity disorder and an evening chronotype are both common among college students, and there is growing interest in understanding the possible link between attention-deficit/hyperactivity disorder and circadian function. However, mixed findings have been reported, and many of the existing studies have used small samples that were unable to examine chronotype across attention-deficit/hyperactivity disorder presentations. Participants were 4751 students (73% female; 80% White), aged 18-29 years (M = 19.28, SD = 1.50), from five universities who completed measures assessing attention-deficit/hyperactivity disorder, depressive and anxiety symptoms, as well as the Morningness-Eveningness Questionnaire to assess chronotype (categorical) and circadian preference (dimensional). Participants with either attention-deficit/hyperactivity disorder predominantly inattentive presentation or attention-deficit/hyperactivity disorder combined presentation had higher rates of being an evening type (47.2% and 41.5%, respectively) than participants without elevated attention-deficit/hyperactivity disorder (28.5%), and participants with attention-deficit/hyperactivity disorder predominantly inattentive presentation also had higher rates of being an evening type than participants with attention-deficit/hyperactivity disorder predominantly hyperactive-impulsive presentation (30.7%). Dimensional analyses indicated that attention-deficit/hyperactivity disorder inattentive symptoms were more strongly associated than hyperactive-impulsive symptoms with eveningness preference. Finally, greater eveningness preference strengthened the association between attention-deficit/hyperactivity disorder inattention and depressive symptoms but not anxiety symptoms. This is the largest study to document that college students with elevated attention-deficit/hyperactivity disorder symptoms are more likely to be evening types than other college students, and inattentive symptoms in particular are associated with later circadian preference.

Training in Cultural Competence for Mental Health Care: A Mixed-Methods Study of Students, Faculty, and Practitioners from India and USA.

Although the need to train clinicians to provide effective mental health care to individuals from diverse backgrounds has been recognized worldwide, a bulk of what we know about training in cultural competence (CC) is based on research conducted in the United States. Research on CC in mental health training from different world populations is needed due to the context-dependent nature of CC. Focusing on India and USA, two diverse countries that provide complementary contexts to examine CC, we explored graduate students', practicing clinicians', and faculty members' perspectives regarding CC training they received/provided and future training needs using mixed-methods. The data were collected using focus groups (n = 25 groups total: 15 in India, 11 in USA), and a survey (n = 800: 450 in India, 350 in USA). Our data highlight the salient social identities in these countries, and the corresponding constituents of CC training. Participants in India described a practical emphasis to their CC training (e.g., learning about CC through life experiences and clinical practice experiences) more so than through coursework, whereas participants in USA described varying levels of coursework related to CC along with practice. Participants in both countries considered enormity of CC as a challenge, while those in the US also identified CC training limited to a white, straight, male perspective, hesitancy in engaging with diversity topics, and limited time and competence of the faculty. Strengths of CC training in India and USA are mutually informative in generating recommendations for enhancing the training in both countries.

Prospective Associations Between Fears of Negative Evaluation, Fears of Positive Evaluation, and Social Anxiety Symptoms in Adolescence.

Fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are independently associated with social anxiety symptoms in adolescence, though no study has tested these relations longitudinally. The current study examined longitudinal relations between FNE, FPE, and social anxiety symptoms using a multi-informant design, in addition to testing adolescent gender as a moderator. Adolescents (N = 113; Mage = 12.39; Girls = 44.2%) and parents completed measures of FNE, FPE, and two ratings of social anxiety approximately 6 months apart. FNE and FPE demonstrated significant stability over time, but neither predicted change in the other construct. Adolescent and parent-reported FNE, but not FPE, predicted increased social anxiety symptoms. Adolescent report of social anxiety symptoms predicted increased FPE over time, whereas parent report of social anxiety symptoms predicted increased FNE. Contrary to hypothesis, gender did not moderate any of the pathways in the model. Findings provide the first evidence that FNE may function as a risk factor for increased social anxiety in adolescence.

Parents' Beliefs, Depressive Symptoms, and Emotion Regulation Uniquely Relate to Parental Responses to Adolescent Positive Affect.

Parents' socialization of positive affect is relevant during adolescence, given that parents play a key role in the development of youth emotional competency. The current study hypothesized that parent characteristics (emotion regulation, belief that positive emotions are costly, and depressive symptoms) would be uniquely related to both dampening and enhancing responses to youth positive affect. Parents (n = 373) of adolescents (youth ages 10-17 years) were recruited through Amazon Mechanical Turk. Parents reported on their own regulation of both positive and negative emotions, depressive symptoms, beliefs about youth emotions, and responses to adolescent expressions of positive affect. The final structural regression model partially supported the hypothesis with respect to parental dampening responses. Depressive symptoms, over-controlled emotion regulation, and beliefs about positive emotions each uniquely related to dampening. Only the coping emotion regulation strategies factor was uniquely associated with parents' enhancing responses. These findings support existing theories of parental emotion socialization, though the final model in this sample provides more insight into parental dampening than parental enhancing responses to positive affect. The finding that emotion regulation strategies (over-controlled and coping) were differentially related to parental responses to youth positive affect suggests a connection between parents' regulation of their own emotions and responses to their offspring's emotion expressions.

La socialización del afecto positivo de los padres es de interés durante la adolescencia, dado que los padres desempeñan un papel clave en el desarrollo de la competencia emocional de los jóvenes. En el presente estudio se planteó la hipótesis de que las características de los padres (la regulación emocional, la creencia de que las emociones positivas son perjudiciales, y los síntomas depresivos) estarían particularmente relacionadas tanto con respuestas atenuadoras como intensificadoras al afecto positivo de los jóvenes. Se convocó a padres (n = 373) de adolescentes (edades de los jóvenes: entre 10 y 17 años) mediante Amazon Mechanical Turk. Los padres informaron sobre su propia regulación de emociones positivas y negativas, síntomas depresivos, creencias acerca de las emociones de los jóvenes y respuestas a las expresiones de afecto positivo de los adolescentes. El modelo de regresión estructural final respaldó parcialmente la hipótesis con respecto a las respuestas de atenuación de los padres. Los síntomas depresivos, la regulación emocional sobrecontrolada y las creencias acerca de las emociones positivas se relacionan cada una particularmente con la atenuación. Solo el factor de afrontamiento de las estrategias de regulación emocional estuvo asociado particularmente con las respuestas intensificadoras de los padres. Estos resultados respaldan las teorías actuales de socialización emocional de los padres, aunque el modelo final de esta muestra profundiza más en las respuestas de atenuación parental que en las de intensificación parental al afecto positivo. El hallazgo de que las estrategias de regulación emocional (sobrecontroladas y de afrontamiento) se relacionaron de manera diferente con las respuestas de los padres al afecto positivo de los jóvenes indica una conexión entre la regulación de los padres de sus propias emociones y las respuestas a las expresiones emocionales de sus hijos.

A longitudinal examination of the relation between academic stress and anxiety symptoms among adolescents in India: The role of physiological hyperarousal and social acceptance.

Academic stress is a critical aspect of adolescent experience around the world, but particularly in countries with dense populations that lead to highly competitive college admissions. With a population of over one billion people, the competition for higher education in India is significantly high. Although research has shown that academic pressures are associated with anxiety in adolescents, this work is primarily cross-sectional. The current study examined academic stress and anxiety symptoms over time and assessed physiological hyperarousal as a mediator and social acceptance as a moderator of this relation in a sample of adolescents from India (N = 282, 13-18 years, 84% female). Adolescents completed measures of academic stress, physiological hyperarousal, social acceptance and anxiety symptoms at two-time points, 5 months apart. Findings demonstrate direct effects of academic stress on changes in symptoms of generalised anxiety and panic, as well as indirect effects through physiological hyperarousal. Social acceptance did not moderate the relation, although it uniquely predicted changes in panic disorder symptoms over time. The findings of this study contribute to the scientific understanding of a potential mechanism through which academic stress leads to anxiety among adolescents in India.

Transactional relations between maternal anxiety and toddler anxiety risk through toddler-solicited comforting behavior.

INTRODUCTION: Transactional developmental and anxiety theories suggest that mothers and toddlers may influence each other's anxiety development across early childhood. Further, toddlers' successful solicitations of comfort during uncertain, yet manageable, situations, may be a behavioral mechanism by which mothers and toddlers impact each other over time. To test these ideas, the current study employed a longitudinal design to investigate bidirectional relations between maternal anxiety and toddler anxiety risk (observed inhibited temperament and mother-perceived anxiety, analyzed separately), through the mediating role of toddler-solicited maternal comforting behavior, across toddlerhood. METHODS: Mothers (n = 174; 93.6% European American) and their toddlers (42.4% female; 83.7% European American) participated in laboratory assessments at child ages 1, 2, and 3 years. Mothers self-reported anxiety symptoms. Toddler anxiety risk was observed in the laboratory as inhibited temperament and reported by mothers. Solicited comforting interactions were observed across standardized laboratory tasks. RESULTS: Direct and indirect bidirectional effects were tested simultaneously in two longitudinal path models. Toddler anxiety risk, but not maternal anxiety, predicted solicited comforting behavior, and solicited comforting behavior predicted maternal anxiety. No convincing evidence for parent-directed effects on toddler anxiety risk emerged. CONCLUSION: Results support continued emphasis on child-elicited effects in child and parent anxiety development in early childhood.

Examining the Relation Between Adolescent Social Anxiety and Positive Affect Regulation: Self-Report vs. Observation.

Social anxiety symptomatology is associated with disruptions in positive affect, though no study has examined deficits in responses to positive affect related to adolescent social anxiety symptoms. The present study tested whether adolescents' self-reported and observed social anxiety symptoms were uniquely associated with specific responses to positive affect. Moreover, we examined whether adolescent gender moderated these relations. Ninety adolescents (ages 11 to 18, Mage = 14.26, SD = 2.03; girls = 62%; white = 79%) completed self-report measures, participated in a social stressor task, and engaged in two positively-valenced interaction tasks with their female caregivers. Adolescent self-reported social anxiety symptoms were not uniquely associated with responses to positive affect. However, observed social anxiety symptoms were uniquely related to greater self-reported inhibiting positive affect responses and fewer observed positive affect maximizing behaviors. These findings highlight the need to examine self-reported and observed social anxiety symptoms in understanding associated disruptions in positive affect regulation.

Family environment moderates the relation of sluggish cognitive tempo to attention-deficit/hyperactivity disorder inattention and depression.

OBJECTIVES: The current study investigated whether a maladaptive family environment would moderate the strength of the relations of sluggish cognitive tempo (SCT) to attention-deficit/hyperactivity disorder inattention (ADHD-IN) and to depressive symptoms in a large sample of college students. METHODS: Participants (n = 3,172), between the ages of 18-29 (M ± SDage = 19.24 ± 1.52; 69.8% women; 80.4% White) and enrolled in five universities in the United States completed self-report measures of symptomatology, interparental conflict, and family expressiveness of emotions. RESULTS: A negative emotional climate strengthened relations of SCT with ADHD-IN and depressive symptoms. Moreover, the lack of a positive emotional climate strengthened the co-occurrence of SCT with depressive symptoms, though not with ADHD-IN. CONCLUSIONS: The current study is the first to demonstrate that the family environment moderates the association between SCT and co-occurring symptomatology in young adults.

Factor Structure and Criterion Validity of the Five Cs Model of Positive Youth Development in a Multi-University Sample of College Students.

There is growing recognition that clinical and developmental outcomes will be optimized by interventions that harness strengths in addition to ameliorating deficits. Although empirically-supported methods for identifying strengths are available for children and adolescents, this framework has yet to be applied to emerging adulthood. This study evaluates the nature of the Five Cs model of Positive Youth Development (PYD) - character, confidence, competence, connection, and caring - in a sample of emerging adults from six universities (N = 4654; 70% female; 81% White). Historically, PYD has been modeled as either separate correlated factors or a second-order factor structure. More recently, the bifactor model has been recommended to determine the degree to which PYD is unidimensional versus multidimensional. The present study examined the multidimensionality of PYD by comparing the model fit of a one-factor, five-correlated factor model, and second-order factor structure with a bifactor model and found support for the bifactor model with evidence of invariance across sex. Criterion validity was also assessed using three criterion measures particularly relevant for adjustment during emerging adulthood: anxiety, depressive symptoms, and emotion regulation difficulties. PYD and the residual Cs tended to correlate negatively with indicators of maladaptive development. Future directions including applications of the PYD framework as a measure of thriving across emerging adulthood are discussed.

Social reward and social punishment sensitivity in relation to dietary restraint and binge/purge symptoms.

Disordered eating symptoms are associated with disrupted sensitivity to reward and punishment, broadly assessed. However, it is unknown how eating pathology is related to sensitivity to social reward and social punishment specifically. Drawing on Reinforcement Sensitivity Theory, the current study utilized a multi-method design to test whether disordered eating symptoms, specifically dietary restraint (DR) and binge/purge (BP), were similarly or uniquely related to sensitivity to social punishment and social reward. Female university students (N = 110, M = 18.66, SD = 0.89) completed self-report measures and a novel behavioral task measuring willingness to work for or to avoid social feedback. DR and BP symptoms were related to increased self-reported and behavioral sensitivity to social punishment, yet only when symptoms were tested in isolation. DR was associated with increased sensitivity to social reward across self-report and behavioral paradigms. BP symptoms were uniquely and positively related to self-reported sensitivity to social reward, but decreased behavioral sensitivity to social reward. Findings suggest that sensitivity to punishment may be a common factor related to DR and BP, whereas sensitivity to social reward may be a key factor differentiating disordered eating symptoms.

Socialization Goals, Parental Psychological Control, and Youth Anxiety in Chinese Students: Moderated Indirect Effects based on School Type.

With rates of adolescent anxiety on the rise in China, it is imperative to investigate whether certain parenting beliefs and practices may be related to anxiety. Specifically, we tested whether parents' socialization goals relate to parental psychological control, and subsequently, adolescents' anxiety. We also tested if attending a "key" school (i.e., more competitive and achievement-oriented) or typical school moderated relations. Two hundred forty-seven high-school students (Mage = 15.62, 57.5% girls) and a caregiver (59.5% mothers) participated. Caregivers completed measures of their socialization goals and their own psychological control. Adolescents reported on their perceptions of parental psychological control and their own anxiety. Psychological control was positively related to youth anxiety. Moderated indirect effects were found. For youth in typical schools, parents who strongly value academic achievement (i.e., achievement oriented goals) and those who strongly value broadening one's experiences in new places and with new people (i.e., self-development in context goals) had youth who experienced more anxiety, and this relation occurred indirectly through greater parental psychological control. For youth in key schools, only parents' achievement oriented goals were related to youth anxiety indirectly through parental psychological control. Parents' interdependence oriented socialization goals were unrelated to either psychological control or anxiety.

Sluggish Cognitive Tempo is Associated With Poorer Study Skills, More Executive Functioning Deficits, and Greater Impairment in College Students.

OBJECTIVES: Few studies have examined sluggish cognitive tempo (SCT) in college students even though extant research suggests a higher prevalence rate of SCT symptoms in this population compared to general adult or youth samples. The current study examined SCT symptoms in relation to two domains related to college student's academic success, study skills and daily life executive functioning (EF), as well as specific domains of functional impairment. METHOD: 158 undergraduate students (Mage = 19.05 years; 64% female) completed measures of psychopathology symptoms, study skills, daily life EF, and functional impairment. RESULTS: After controlling for demographics and symptoms of attention-deficit/hyperactivity disorder (ADHD), anxiety, and depression, SCT remained significantly associated with poorer study skills, greater daily life EF deficits, and global impairment and with greater functional impairment in the specific domains of educational activities, work, money/finances, managing chores and household tasks, community activities, and social situations with strangers and friends. In many instances, ADHD inattentive symptoms were no longer significantly associated with study skills or impairment after SCT symptoms were added to the model. CONCLUSION: SCT is associated with poorer college student functioning. Findings highlight the need for increased specificity in studies examining the relation between SCT and adjustment.

Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children.

BACKGROUND: Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school-aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self-esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk. METHODS: We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk. RESULTS: White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent- and child self-reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk. CONCLUSIONS: This multi-informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology.

Mediating Effect of Psychopathy on the Risk of Social Problems Among Children with ADHD Versus Sluggish Cognitive Tempo Symptoms.

Sluggish cognitive tempo (SCT) has been proposed as a unique syndrome; however research examining how it is different from attention-deficit/hyperactivity disorder (ADHD) is just starting to emerge. The present study extends this research by examining how specific personality features (i.e., psychopathy) may mediate the relation between ADHD and social problems, but not between SCT and social problems. Caregivers of 198 children (6-12 years old) that presented for an inpatient psychiatric evaluation completed standardized measures of childhood behavior problems. Bootstrapped mediational analyses were performed to evaluate the mediating role of psychopathy on the relation between social problems and symptoms of ADHD versus SCT. Two sub-domains of psychopathy--impulsivity and narcissism--emerged as partial mediators for the relation between social problems and ADHD symptoms; whereas SCT symptoms were not found to be related to psychopathy after controlling for ADHD symptoms. These findings provide support for conceptualizing ADHD and SCT as discrete syndromes as well as for the mediating role of psychopathy domains on the risk of social problems among a clinical sample of youth with symptoms of ADHD.

Attention-deficit/hyperactivity disorder dimensions and sluggish cognitive tempo symptoms in relation to college students' sleep functioning.

This study examined separate inattentive, hyperactive, and impulsive dimensions of attention-deficit/hyperactivity disorder (ADHD), as well as sluggish cognitive tempo (SCT) symptoms, in relation to college students' sleep functioning. Participants were 288 college students (ages 17-24; 65 % female; 90 % non-Hispanic White; 12 % self-reported having an ADHD diagnoses) who completed measures of ADHD/SCT symptoms and sleep functioning. Participants reported obtaining an average of 6.8 h of sleep per night (only 26 % reported obtaining ≥8 h of sleep) and having a sleep onset latency of 25 min. 63 % were classified as "poor sleepers," and poor sleepers had higher rates of ADHD and SCT symptoms than "good sleepers". Path analysis controlling for ADHD status and psychiatric medication use was used to determine associations between psychopathology and sleep functioning domains. Above and beyond covariates and other psychopathologies, hyperactivity (but not impulsivity) was significantly associated with poorer sleep quality, longer sleep latency, shorter sleep duration, and more use of sleep medications. SCT symptoms (but not inattention) were significantly associated with poorer sleep quality and increased nighttime sleep disturbance (e.g., having bad dreams, waking up in the middle of the night, feeling too cold or too hot). Both inattention and SCT were associated with greater daytime dysfunction. Regression analyses demonstrated that hyperactivity predicted sleep quality above and beyond the influence of daytime dysfunction, and inattention and SCT predicted daytime dysfunction above and beyond sleep quality. Further studies are needed to examine the interrelations of nighttime sleep functioning, ADHD/SCT, and daytime dysfunction, as well to elucidate mechanisms contributing to related functional impairments.

Perceived maternal and paternal psychological control: relations to adolescent anxiety through deficits in emotion regulation.

The current study compared the differential effects of early adolescents' perceived maternal and paternal psychological control (as well as their discrepancy) on adolescent anxiety. It also tested whether psychological control leads to deficits in youths' ability to regulate their negative emotions, and if, in turn, such deficits lead to anxiety. Sixth- and seventh-grade students (n = 214; 59% girls; 60% Caucasian) completed measures of perceived psychological control, regulation of negative emotions, and anxiety symptoms. The discrepancy between perceived mothers' and fathers' control was also calculated. Although perceptions of mothers' control, fathers' control, and their discrepancy were each bivariately related to adolescent anxiety, when considered together, only a larger discrepancy in parents' psychological control was uniquely associated with higher self-reported anxiety. Further, adolescents' dysregulation of negative emotions partially explained the relation of both maternal psychological control and the discrepancy in parental control to anxiety. Implications for understanding family-based etiological correlates of anxiety are discussed.

Sluggish cognitive tempo is associated with academic functioning and internalizing symptoms in college students with and without attention-deficit/hyperactivity disorder.

OBJECTIVES: The purposes of the present studies were to (a) examine the factor structure of sluggish cognitive tempo (SCT) and attention-deficit/hyperactivity disorder (ADHD) in college students and (b) examine the associations between SCT and academic functioning and internalizing symptoms in college students with and without ADHD. METHOD: In Study 1, a confirmatory factor analysis of the Barkley Adult ADHD Rating Scale-IV (BAARS-IV) was conducted in a sample of 768 college students (aged 17-34 years, 68% female). In Study 2, we examined the relation of SCT to academic functioning and internalizing symptoms in a sample of 72 college students rigorously diagnosed with ADHD (aged 17-35 years, 44% female). RESULTS: Study 1 results supported the factor structure of the BAARS-IV, with the optimal model comprising 4 correlated but distinct factors: SCT, Inattention, Hyperactivity, and Impulsivity. After controlling for correlated demographic variables and ADHD symptoms, SCT was significantly related to academic impairment (including grade point average), anxiety, and depression. In Study 2, SCT again contributed unique variance to internalizing symptoms and academic impairment after controlling for correlated participant characteristics (i.e., sex, age, race, parent education level, family income, ADHD medication use, and mental health service utilization) and ADHD symptom severity. CONCLUSIONS: These results fill an important gap in the literature by (a) confirming SCT to be distinct from ADHD in emerging adulthood, (b) demonstrating SCT to be strongly linked to college student adjustment, and (c) providing support for the hypothesis that SCT is associated with psychosocial functioning in both individuals with and without ADHD.

COVID-19 parent stress in Middle Eastern and North African countries: Relations to family adjustment.

The COVID-19 pandemic has been stressful for individuals worldwide, including parents. Most research investigating stress during the pandemic has focused on single stressors in relation to outcomes and has been conducted in Western countries. Among parents from Middle Eastern and North African (MENA) countries, the present study used latent class analysis to identify specific subgroups of individuals based on combinations of stressful events experienced during the first two waves of the COVID-19 global pandemic. Whether individuals in these classes differed on levels of both adaptive (individual resilience, family cohesion) and maladaptive outcomes (depressive symptoms) was tested. Finally, perceived marital satisfaction was tested as a moderator of relations between class membership and adjustment outcomes. Participants were 545 parents (66.8% women, Mage = 35.79 years) recruited online who indicated presence or absence of experiencing 21 stressors across domains such as a family member contracting COVID, increased caregiving burden, work-related stress, and child adjustment problems. Three latent classes were identified, with one group characterized by work and child adjustment stress, one by child adjustment stress only, and one by low levels of stress across domains. The two higher stress groups reported increased depression. No associations with positive outcomes were found. Martial quality was most important for impacting greater resilience for those individuals experiencing child adjustment stress. This study provides evidence that COVID-related stress had disproportionate impact across parents in MENA countries. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexual abuse is associated with obese children and adolescents admitted for psychiatric hospitalization.

OBJECTIVE: To determine the relationship between a history of child abuse and obesity among children admitted for psychiatric hospitalization. STUDY DESIGN: The charts of 1434 youth consecutively admitted to an inpatient psychiatric facility during a 10-month period were retrospectively analyzed. Rates of physical and sexual abuse, as well as other factors believed to increase the risk of obesity, were compared between children whose body mass index (BMI) percentiles were between 5 and 80 and whose BMI percentiles were >85. RESULTS: After correcting for age, race, gender, and antipsychotic usage, we found that a reported history of sexual abuse was associated with increased probability of being overweight/obese (BMI percentile 85-99) compared with being of typical BMI (aOR 1.41). Reported physical abuse neither increased the risk of obesity nor moderated the association between sexual abuse and increased weight. Antipsychotic treatment and female gender also were associated with increased BMI percentiles, with antipsychotic usage being the only variable associated with increased risk of a BMI percentile >99. CONCLUSIONS: Among youth with significant psychiatric illness, a history of sexual abuse increases the risk of being overweight or obese, an association that warrants further study regarding the temporal relationship between sexual abuse and obesity and may inform future obesity prevention and intervention programs in children.