Salud oral: influencia de los estilos de vida en adolescentes / Adolescent lifestyle and its influence on oral health

INTRODUCCIÓN: la alta prevalencia de patología bucodental en adolescentes, junto con la relación directa o indirecta entre patología y hábitos, hacen necesaria la prevención y promoción oral a nivel escolar, sanitario y familiar. Nuestro objetivo principal fue mediante un cuestionario sobre hábitos de estilo de vida en adolescentes, conocer la prevalencia de estos y su relación con la salud bucodental. MATERIAL Y MÉTODOS: estudio observacional de corte transversal en 39 escolares, preadolescentes y adolescentes de 12 a 17 años. Se realizó un cuestionario de 42 preguntas que fue entregado a los participantes. Los resultados obtenidos se analizaron mediante tablas de contingencia y con un valor de significación p <0,05. RESULTADOS: la prevalencia de escolares con correcta frecuencia de cepillado es del 54% y solo el 48,7% visita al odontólogo una vez al año. Existe relación significativa entre la nacionalidad y las visitas al dentista (p = 0,02) o entre la frecuencia de cepillado con el desayuno (p = 0,005), consumo de bollería industrial o bocadillos (p = 0,02), o refrescos (p = 0,011), utilización de ordenador, televisión y videoconsola (p = 0,049); y el sedentarismo (p = 0,00). CONCLUSIÓN: se obtuvieron resultados estadísticamente significativos al relacionar hábitos de estilo de vida y salud oral. En la adolescencia es fundamental la creación de estrategias de prevención y promoción en salud dental, para instaurar rutinas correctas que no afecten a la salud general del adolescente

INTRODUCTION: the high prevalence of oral disease in adolescents, together with the direct or indirect association between disease and lifestyle habits, call for the implementation of oral health prevention and promotion strategies at the school, household and public health levels. Our main objective was to design a questionnaire on lifestyle habits in adolescents to determine their prevalence and assess their association with oral health. MATERIALS AND METHODS: we conducted a cross-sectional observational study in 39 preadolescent and adolescent students aged 12 to 17 years. We developed a 42-item questionnaire and administered it to participating students. We analysed the obtained responses using contingency tables, defining statistical significance as a p-value of <0.05. RESULTS: we found that the frequency of brushing was correct in 54% of participating students, while only 48.7% visit the dentist every year. We found a significant association between nationality and visits to the dentist (p = 0.02) and between the frequency of brushing with: eating breakfast (p = 0.005), consumption of industrial baked goods or snacks (p = 0.02) and consumption of sugary drinks (p = 0.011), the use of computer, television and gaming consoles (p = 0.049), and a sedentary lifestyle (p = 0.00). CONCLUSION: we found statistically significant associations between lifestyle habits and oral health. The development and implementation of oral health prevention and promotion strategies targeting the adolescent population is essential in order to establish adequate habits that will not have a detrimental effect on the general health of the adolescent

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.

Factores relacionados con la resiliencia de adolescentes en contextos de vulnerabilidad social: revisión integradora / Factors related to the resilience of adolescents in contexts of social vulnerability: integrative review / Fatores relacionados à resiliência de adolescentes em contextos de vulnerabilidade social: revisão integrativa

INTRODUCCIÓN: La resiliencia puede entenderse como un proceso de superación y persistencia contra las fragilidades experimentadas. Los adolescentes en contextos de vulnerabilidad social encuentran obstáculos en el desarrollo de su resiliencia, dificultando la visibilidad de las estrategias de afrontamiento/respuestas a las adversidades de la vida cotidiana. OBJETIVO: Analizar la evidencia científica disponible en la literatura sobre los factores relacionados con la resiliencia de adolescentes en contextos de vulnerabilidad social. MÉTODO: Revisión integradora de los artículos publicados en portugués, inglés o español, desde 2014 a 2018, en bibliotecas/bases Medline/Pubmed, Scopus, Web of Science, LILACS, Cochrane, BDENF IBECS, CINAHL y PsycINFO. Se utilizaron los siguientes descriptores "Psychological Resilience", "Social Vulnerability", "Adolescent" y "Adolescent Health", resultando en 17 artículos. La pregunta guía fue: ¿Cuáles son los factores relacionados con la resiliencia de adolescentes en contextos de vulnerabilidad social?. RESULTADOS: Se han formado cinco clases que representan los factores que contribuyen a la resiliencia en adolescentes en situación de vulnerabilidad social, nombradas como: aspiraciones para el futuro, factores de riesgo, barreras institucionales, exposición y apoyo social. CONCLUSIÓN: Los factores que fortalecen la resiliencia social son el apoyo prestado por familiares, amigos, profesores, aspectos culturales y religiosos y los factores de riesgo son la violencia, la drogadicción, la falta de seguridad y apoyo institucional precario. El entendimiento de la resiliencia y especificidades que describen las condiciones de salud de los adolescentes en situación de vulnerabilidad social deben ser considerados para reorientar actividades interdisciplinarias e intersectoriales para la promoción de la salud de este grupo poblacional

INTRODUCTION: Resilience can be understood as a process of persistence and overcoming against experienced weaknesses. Adolescents in contexts of social vulnerability find obstacles in the development of their resilience, which impair the visibility of coping/answer strategies for the adversities of everyday life. OBJECTIVE: To analyze the scientific evidence available in the literature on the factors related to the resilience of adolescents in contexts of social vulnerability. METHOD: Integrative review of articles published in Portuguese, English or Spanish, from 2014 to 2018, in libraries/databases Medline/Pubmed, Scopus, LILACS, Web of Science, IBECS, Cochrane, BDENF, CINAHL and PsycINFO. The following descriptors were used "Psychological Resilience", "Social Vulnerability", "Adolescent" and "Adolescent Health", resulting in 17 articles. The guiding question was: what are the factors related to the resilience of adolescents in contexts of social vulnerability? RESULTS: Five classes emerged, depicting the factors that contribute to resilience in adolescents in situation of social vulnerability, namely: aspirations for the future, risk factors, institutional barriers, exposure and social support. CONCLUSION: The factors that strengthen resilience are the social support provided by family, friends, teachers, cultural and religious aspects, and risk factors are violence, substance abuse, lack of security and precarious institutional support. The understanding of resilience and specificities that outline the health conditions of adolescents in situation of social vulnerability must be considered to reorient interdisciplinary and intersectoral actions to promote the health of this population group

INTRODUÇÃO: A resiliência pode ser compreendida como um processo de persistência e superação contra as fragilidades vivenciadas. Adolescentes inseridos em contextos de vulnerabilidade social encontram obstáculos no desenvolvimento de sua resiliência, o que compromete a visibilidade de estratégias de enfrentamento/resposta as adversidades do cotidiano. OBJETIVO: Analisar as evidências científicas disponíveis na literatura sobre os fatores relacionados à resiliência de adolescentes em contextos de vulnerabilidade social. MÉTODO: Revisão integrativa de artigos publicados em português, inglês ou espanhol, de 2014 a 2018, nas bibliotecas/bases Medline/Pubmed, Scopus, LILACS, Web of Science, IBECS, Cochrane, BDENF, CINAHL e PsycINFO. Foram utilizados os descritores "Psychological Resilience", "Social Vulnerability", "Adolescent" e "Adolescent Health", resultando em 17 artigos. A pergunta norteadora foi: quais os fatores relacionados à resiliência de adolescentes em contextos de vulnerabilidade social?. RESULTADOS: Foram formadas cinco classes que retratam os fatores que concorrem para a resiliência em adolescentes em situação de vulnerabilidade social, nomeadas como: as aspirações para o futuro, fatores de risco, entraves institucionais, exposição e o apoio social. CONCLUSÃO: Os fatores que fortalecem a resiliência são o apoio social provido pela família, amigos, professores, aspectos culturais e religiosos e os fatores de risco são violência, abuso de substâncias, falta de segurança e apoio institucional precário. O entendimento de resiliência e as especificidades que delineiam as condições de saúde de adolescentes em situação de vulnerabilidade social precisam ser consideradas para reorientar ações intersetoriais e interdisciplinares de promoção à saúde deste grupo populacional

Densidad de los puntos de venta de alcohol y su consumo en jóvenes de Galicia / Alcohol outlet density and alcohol consumption in Galician youth

OBJETIVO: Valorar la influencia que la densidad de los puntos de venta y los de venta y consumo de alcohol ejercen sobre los patrones de consumo de los/las jóvenes preuniversitarios/as de Galicia. MÉTODOS: Se ha llevado a cabo un análisis transversal de la cohorte de estudiantes de la Universidad de Santiago de Compostela (Cohorte Compostela 2016). Se calcularon las prevalencias de consumo para cada uno de los municipios de procedencia de los/las estudiantes de primer ciclo durante el año anterior al ingreso. Se valoró la asociación del consumo de riesgo de alcohol (CRA) y consumo intensivo de alcohol (CIA) con un modelo logístico, considerando como variables independientes la población del municipio, la densidad de locales de venta, la densidad de locales de venta y consumo de alcohol, y la densidad de ambos tipos de locales en el municipio. RESULTADOS: La prevalencia de CRA fue del 60,5% (interval de confianza del 95% [IC95%]: 58,4-62,5) y la de CIA de 28,5% (IC95%: 26,7-30,2). Se observó una gran variabilidad según el municipio de procedencia. El modelo logístico multivariante mostró que los municipios con una densidad de 8,42-9,34 de ambos tipos de locales por mil habitantes presentaban mayor riesgo de CRA (odds ratio [OR]:1.39; IC95%: 1,09-1,78) y de CIA (OR= 1,29; IC95%: 1,01-1,66). CONCLUSIÓN: Estos datos sugieren la importancia de incluir la información del entorno al estudiar el consumo de alcohol. Conocer mejor el entorno podría ayudar a plantear políticas que fomenten en la población conductas más saludables

OBJECTIVE: To assess the influence that alcohol outlet density, off- and on-alcohol premises, and alcohol consumption wield on the consumption patterns of young pre-university students in Galicia (Spain). METHOD: A cross-sectional analysis of a cohort of students of the University of Santiago de Compostela (Compostela Cohort 2016) was carried out. Consumption prevalence were calculated for each of the municipalities from the first-cycle students' home residence during the year prior to admission. The association with risky alcohol consumption (RC) and binge-drinking (BD) was assessed with a logistic model considering as independent variables the municipality population, alcohol outlet density of off- premises, density of off- and on- premises and total density of both types of premises in the municipality. RESULTS: The prevalence of RC was 60.5% (95% confidence interval [95%CI]: 58.4-62.5) and the BD was 28.5% (95%CI: 26.7-30.2). A great variability was observed according to the municipality of provenance. The multivariate logistic model showed municipalities with a density of 8.42-9.34 of both types of premises per thousand inhabitants presented a higher risk of RC (odds ratio [OR]: 1,39; 95%CI: 1.09-1.78) and BD (OR: 1.29; 95%CI: 1.01-1.66). CONCLUSIONS: These data suggest the importance of including environmental information when studying alcohol consumption. Knowing our environment better could help plan policies that encourage healthier behaviour in the population

Criação e validação de um programa promotor de saúde mental positiva em adolescentes / Creation and validation of a program promoter of positive mental health in adolescents

Introduction: The WHO estimates that at least 20% of children and adolescents have at least one mental disorder before reaching the age of 18 years. (PNSE, 2015) Based on the studies of the Multifactorial Model of Teresa Lluch (1999), it was proposed for the present study the conception and validation of a positive mental health promotion program in the field of mental health nursing directed to adolescents who attend the 3rd cycle of studies. Objectives: Elaborate a positive mental health nursing program based on the Multifactorial Model of Teresa Lluch; Implement a positive mental health program within the framework of the primary health care services portfolio, in response to the guidelines of the national school health program (PNSE, 2015); to analyse the effectiveness of the positive mental health program in promoting adolescents' mental health in a school environment; to evaluate the positive mental health levels of adolescents in school settings. Methodology: Mixed, quasi-experimental (through a pilot study) and also observational-descriptive cross-sectional study focused on a Focus Group was chosen. Results: In the pilot group the mean positive mental health questionnaire pre-program, was 94.35, post-program had a decrease, and was at 92.61. Conclusions: Program implementation improved participants' positive mental health. Knowing that mental health is worked on the basis of continuity, it is believed that the time factor was limiting in this study. It would have been an added value to carry out a follow-up at the end of the academic year to analyse positive mental health questionnaire

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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.

El conocimiento de los adolescentes escolarizados sobre el virus del papiloma humano: revisión integrativa / The teenagers' knowledge schooled about the human papilloma virus: integrative review / O conhecimento dos adolescentes escolarizados sobre o papiloma vírus humano: revisão integrativa

Objetivo: Analizar las evidencias encontradas en la literatura científica acerca del virus papiloma humano para la vida sexual y reproductiva del adolescente. Método: Revisión integradora de la literatura mediante la búsqueda de publicaciones en los periódicos indexados en las bases de datos de SciELO, MEDLINE y LILACS. Resultados / Discusión: La muestra final del estudio está constituida de 27 artículos con predominio de los estudios que abordaban adolescencia y virus papiloma humano (37%), seguido de los estudios sobre adolescentes y sexualidad (33%). La mayoría de los estudios ha sido realizada en el continente americano (56%) seguido del continente europeo (22%), evidenciando el nivel deficitario de conocimiento de los adolescentes sobre la transmisión, prevención, rastreo y oncogenicidad del virus papiloma humano en distintas regiones, siendo mayor el conocimiento entre chicas, chicos homosexuales y entre la población vacunada, lo que ha revelado la importancia de la educación. Conclusión: Esta revisión ha mostrado que las acciones que posibilitan el cambio en el escenario actual son fundamentales para mejorar la educación, concienciación, reflexión sobre los riesgos y la promoción de la salud de los adolescentes, construyendo una red de nuevos significados y comportamientos para sus vidas

Objective: To analyze the evidences found in the scientific literature regarding the human papilloma virus for the adolescent sexual and reproductive life. Method: literature integrative review through the search of publications in journals indexed in SciELO, MEDLINE and LILACS databases. Results/Discussion: The final study sample consisted of 27 articles with a predominance of studies addressing adolescence and human papillomavirus (37%), followed by studies on adolescence and sexuality (33%). Most of the studies were carried out in the American continent (56%) followed by the European continent (22%), evidencing the lack of knowledge about the transmission, prevention, screening and oncogenicity of human papilloma virus in different regions, with more knowledge among girls, homosexual boys and the vaccinated population, which revealed the importance of education. Conclusion: This review revealed that actions that make possible changes in the current scenario are fundamental to improve education, awareness, reflection about the risks and health promotion of adolescents, building a network of new meanings and behaviors for their lives

Objetivo: Analisar as evidências encontradas na literatura científica a respeito do papiloma vírus humano para a vida sexual e reprodutiva do adolescente. Método: revisão integrativa da literatura por meio da busca de publicações nos periódicos indexados nas bases de dados da SciELO, MEDLINE e LILACS. Resultados/ Discussão: a amostra final do estudo constituiu-se de 27 artigos com predominância dos estudos que abordavam adolescência e papiloma vírus humano (37%), seguido dos estudos sobre adolescente e sexualidade (33%). A maioria dos estudos foi realizada no continente americano (56%) seguido do continente europeu (22%), evidenciando o nível deficitário de conhecimento dos adolescentes sobre a transmissão, prevenção, rastreamento e oncogenicidade do papiloma vírus humano em diferentes regiões, sendo maior o conhecimento entre meninas, meninos homossexuais e entre a população vacinada, o que revelou a importância da educação. Conclusão: esta revisão revelou que ações possibilitadoras de mudanças no cenário atual são fundamentais para melhorar a educação, conscientização, reflexão sobre os riscos e a promoção de saúde dos adolescentes, construindo uma rede de novos significados e comportamentos para suas vidas

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.

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.

Relación del desayuno con la calidad de la dieta en escolares de educación secundaria obligatoria de un centro escolar de Murcia / Relationship of breakfast with the quality of the diet in compulsory secondary school students of a school in Murcia

FUNDAMENTOS: el desayuno suscita un considerable interés científico como posible parámetro relacionado con el estilo de vida. El objetivo fue analizar la relación del desayuno con la calidad de la dieta, la actividad física y la antropometría en escolares de Educación Secundaria Obligatoria. MÉTODOS: Se realizó un estudio descriptivo (n=217; 13,59 +/- 1,45 años). Los ítems referidos al desayuno y a la calidad de la dieta fueron extraídos del Test Kidmed. Para la valoración de la actividad física se ha utilizado el PAQ-C y PAQ-A. Para el cálculo del índice de masa corporal se empleó el índice de Quetelet. RESULTADOS: un 21,70 % de los escolares de secundaria no desayuna habitualmente. El análisis de regresión logística reveló que tomar el desayuno e incluir un lácteo, cereal y omitir bollería se asocia con una mayor calidad de la dieta global. Sin embargo, no se obtuvieron diferencias significativas con el nivel de actividad física y las variables antropométricas. CONCLUSIONES: el desayuno parece actuar como un elemento diferenciador de la calidad de la dieta pero no en el nivel de actividad física y la antropometría en escolares de secundaria. El contexto educativo y de la salud pública en cooperación con el ambiente familiar deben contribuir a la mejora del hábito de desayunar de manera saludable en estas edades

BACKGROUND: breakfast raises considerable scientific interest as a possible parameter related to lifestyle. The objective was to analyze the relationship of breakfast with the quality of diet, physical activity and anthropometry in secondary school students. METHODS: A descriptive study was conducted (n = 217, 13,59 +/- 1,45 years). The items referring to breakfast and to the quality of the diet were extracted from the KidmedTest. The PAQ-C and PAQ-A was used to assess physical activity and the Quetelet index was used to calculate the body mass index. RESULTS: 21,70 % of high school students do not eat breakfast regularly. The logistic regression analysis revealed that having breakfast and including a dairy, cereal and omitting pastries is associated with a higher quality of the overall diet. However, no significant differences were found with the level of physical activity and anthropometric variables. CONCLUSIONS: breakfast seems to act as a differentiating element of the quality of the diet but not in the level of physical activity and anthropometry in secondary school students. The educational and public health context in cooperation with the family environment should contribute to improving the habit of healthy breakfast at these ages

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.

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.

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.

Development of Aggression Subtypes from Childhood to Adolescence: a Group-Based Multi-Trajectory Modelling Perspective.

The persistence of elevated subtypes of aggression beginning in childhood have been associated with long-term maladaptive outcomes. Yet it remains unclear to what extent there are clusters of individuals following similar developmental trajectories across forms (i.e., physical and indirect) and functions (i.e., proactive and reactive) of aggression. We aimed to identify groups of children with distinct profiles of the joint development of forms and functions of aggression and to identify risk factors for group membership. A sample of 787 children was followed from birth to adolescence. Parent and teacher reports, and standardised assessments were used to measure two forms and two functions of aggressive behaviour, between six and 13 years of age along with preceding child, maternal, and family-level risk-factors. Analyses were conducted using a group-based multi-trajectory modelling approach. Five trajectory groups emerged: non-aggressors, low-stable, moderate-engagers, high-desisting, and high-chronic. Coercive parenting increased membership risk in the moderate-engagers and high-chronic groups. Lower maternal IQ increased membership risk in both high-desisting and high-chronic groups, whereas maternal depression increased membership risk in the high-desisting group only. Never being breastfed increased membership risk in the moderate-engagers group. Boys were at greater risk for belonging to groups displaying elevated aggression. Individuals with chronic aggression problems use all subtypes of aggression. Risk factors suggest that prevention programs should start early in life and target mothers with lower IQ. Strategies to deal with maternal depression and enhance positive parenting while replacing coercive parenting tactics should be highlighted in programming efforts.

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.

Classification of problematic Internet usage types by motives and contexts with elementary and secondary school-aged counseling clients.

BACKGROUND AND AIMS: Past research on the classification of problematic Internet use (PIU) has focused on symptom-based severity and usage motive in order to understand its mechanism. Recently, usage context, such as family or social relationships, has been identified as a key influencing factor of PIU. Therefore, we extended the classification of PIU to include usage context in addition to symptom-based severity and usage motive. METHODS: To classify PIU types, we conducted two studies. First, we performed a clustering analysis, where 265 counseling cases were clustered into usage types in terms of motive and context. After characterizing each usage type, we examined their hierarchical relationships by considering symptoms. Second, we performed a focus group interview with six counselors to increase the transferability of usage types. This transferability was established by matching counselors' quotations to the usage types. When usage types showed consistency between quotations and the clustering analysis, we identified the progression patterns between hierarchical relationships. RESULTS: The clustering analysis of motive and context yielded six usage types with three hierarchical relationships. The focus group interview results verified the transferability of these six types and identified two progression patterns between the hierarchical relationships. DISCUSSION AND CONCLUSION: Although usage motive and context were given equal weight before the clustering analysis, the resulting types revealed that usage context played a greater role in the classification process.

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.

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.

Risk-Taking Behaviors in Iranian Children and Adolescents: A Latent Class Analysis Approach: Caspian IV Study.

BACKGROUND: Risk taking behaviors have several negative consequences. This study aimed to identify the subgroups of students based on risk-taking behaviors and to assess the role of demographic characteristics, depression, anxiety, socioeconomic status (SES), physical inactivity and screen time on membership of specific subgroup. STUDY DESIGN: Cross-sectional study. METHODS: This nationwide survey was conducted in 2011-2012 among 14880 students, aged 6-18 yr, selected by multistage, cluster-sampling method from 30 provinces of Iran. The students completed two sets of anonymous and validated questionnaires, obtained from the World Health Organization-Global School Health Survey questionnaires. Latent class analysis was performed to achieve the study objectives. RESULTS: Overall, 13486 children and adolescents participated were enrolled (response rate 90.6%). They consisted of 50.8% boys, with a mean age of 12.47 ±3.36 year. The prevalence of physical fight, bullying, victimization, active smoking, passive hookah and passive cigarette smoking was 39.7%, 17.4%, 27.2%, 5.9%, 21.1 and 33.8%, respectively. Five latent classes were identified: (a) low risk (46.7%), (b) passive smoker (25.2%), (c violence and aggression taker with passive smoking (13.5%), (d) violence and aggression taker without passive smoking (10.8%) and (e) high risk (3.8%). Higher age (OR=1.41), being male (OR=5.21), depression (OR=4.58), anxiety (OR=3.38) and screen time (OR=3.11) were associated with high-risk class. CONCLUSION: The prevalence of some risk-taking behaviors among Iranian students is high. Our findings emphasize the importance of planning and evaluating preventive interventions by considering different high-risk behaviors simultaneously.

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.