The Stability of Retrospective Child Sexual Abuse Reports and its Association With Problem Avoidance.

Due to reliability problems, use of retrospective measurement to assess child sexual abuse has long concerned researchers. Possible psychosocial causes of these reliability issues-including problem avoidance-have not been thoroughly studied. We tested the reliability of retrospective child sexual abuse measurement in a nationally representative sample of 12,438 adults over two periods (2001-2002, 2007-2008), assessed sex differences in reliability, and examined whether reliability depends on problem avoidance tendencies. Nearly three-fourths of child sexual abuse cases in the former wave were not again reported, and two-thirds of child sexual abuse cases in the latter wave were not previously reported. Females were more likely to report CSA later if reported previously (OR = 5.11). Participants who reported child sexual abuse in the former wave but not the latter were more avoidant than consistent reporters (3.13 versus 2.77). Our findings suggest that females may report child sexual abuse more consistently. Furthermore, inconsistent reporting may indicate problem avoidance. Suggestions for researchers and practitioners are discussed.

The Identification of a Threshold of Long Work Hours for Predicting Elevated Risks of Adverse Health Outcomes.

Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed.

Is there an association between short sleep duration and adolescent anxiety disorders?

OBJECTIVE: The purpose of this study is to provide the first data on the prospective, reciprocal association between short sleep duration and DSM-IV anxiety disorders among adolescents. METHODS: A community-based two-wave cohort study included 4175 youths aged 11-17 years at baseline, with 3134 of these followed up a year later, drawn from a metropolitan area with a population of over 4 million. Anxiety is defined as any DSM-IV anxiety disorder in the past year generalized anxiety: panic disorder, agoraphobia without panic, social phobia, and post-traumatic stress disorder. Short sleep duration is defined as ≤6 h of sleep per night. RESULTS/CONCLUSIONS: In multivariate analyses, short sleep duration every night at baseline predicted anxiety disorders at follow-up, controlling for anxiety at baseline. Examining the reciprocal association, anxiety disorders at baseline did not predict short sleep duration at follow-up. We are the first to examine the reciprocal effects for anxiety disorders and sleep duration among adolescents using prospective data. The data suggest that reduced quantity of sleep may increase risk for anxiety, but anxiety does not increase risk for decreased sleep duration.

Discordance between measured weight, perceived weight, and body satisfaction among adolescents.

OBJECTIVE: To estimate prevalence, trends and persistence of discordance between measured body weight and perceived body weight and body satisfaction, and examine its association with gender, ethnicity, and family income. METHODS: Using two-wave data from a prospective cohort study of adolescents sampled from Houston metropolitan area, aged 11-17years at baseline (n=4175) in 2000, and followed up in 2001 (n=3134). Survey logistic regression was used to compute odds ratios (OR). RESULTS: Females, European Americans, and adolescents in families with higher income were more likely to overestimate their body weight, and to be dissatisfied with their body weight, compared with males, African Americans, or those with a lower family income, respectively. Healthy weight females had significantly elevated odds of perceiving themselves as overweight compared with healthy weight males: OR=1.82 (1.27-2.61) in Wave 1, OR=2.81 (1.82-4.34) in Wave 2, and OR=3.85 (1.58-9.38) in both waves. Similarly, healthy weight European Americans had about two times higher odds of perceiving themselves as overweight than healthy weight African Americans. Healthy weight females had over 1.5 odds of being dissatisfied with their body compared to healthy weight males. Compared with African Americans, European Americans were more likely to be dissatisfied with their body even they were within healthy weight range. CONCLUSIONS: There was a high prevalence of discordance between actual weight and perceived weight and body satisfaction among adolescents. Discordances differed by gender, ethnicity, and family income, and should be taken into account in interventions for preventing overweight and obesity, and other undesired outcomes in adolescents.

Dose-Response Relation Between Work Hours and Cardiovascular Disease Risk: Findings From the Panel Study of Income Dynamics.

OBJECTIVES: The aim of this study was to examine the presence of a dose-response relationship between work hours and incident cardiovascular disease (CVD) in a representative sample of U.S. workers. METHODS: A retrospective cohort study of 1926 individuals from the Panel Study of Income Dynamics (1986 to 2011) employed for at least 10 years. Restricted cubic spline regression was used to estimate the dose-response relationship of work hours with CVD. RESULTS: A dose-response relationship was observed in which an average workweek of 46 hours or more for at least 10 years was associated with an increased risk of CVD. Compared with working 45 hours per week, working an additional 10 hours per week or more for at least 10 years increased CVD risk by at least 16%. CONCLUSION: Working more than 45 work hours per week for at least 10 years may be an independent risk factor for CVD.

Do Anxiety Disorders Play a Role in Adolescent Obesity?

BACKGROUND: There have been few prospective studies on the association between anxiety disorders and adolescent obesity; none examine potential reciprocal effects. PURPOSE: The purpose of this paper is to examine the prospective association between anxiety disorders and obesity among adolescents. METHODS: Using data from a two-wave, prospective study of 3134 adolescents, we examined reciprocal effects between body weight and DSM-IV anxiety disorders. RESULTS: Weight status did not increase future risk of anxiety disorders nor did anxiety disorders at baseline increase risk of future obesity in the overall sample. Stratifying by gender revealed an increased risk of overweight and obesity in males with anxiety disorders, but not for females. Major depression did not mediate these associations. CONCLUSION: Similar to prospective studies of depression, it appears anxiety disorders may increase risk of obesity. However, more research is needed on the role of psychopathology in adolescent obesity, in particular anxiety disorders and possible moderators (such as gender) and mediators.

Does major depression affect risk for adolescent obesity?

OBJECTIVE: The purpose of this paper is to reexamine the association between major depression and obesity in adolescents, testing the hypothesis that body image mediates this association. This is the first paper to examine this question using DSM-IV diagnosis of depression and data from a two-wave cohort of adolescents. METHODS: Participants were 4175 youths 11-17 years of age sampled from the community who were followed up a year later (n=3134). Major depression was assessed using DSM-IV diagnostic criteria. Body image was measured with perceived weight. Obesity was defined as BMI ≥95th percentile using measured height and weight. RESULTS: When we examined a model which included obesity, perceived weight, major depression and covariates, there was no association between major depression at baseline and obesity at follow-up. We found no independent association between major depression and body weight. LIMITATIONS: The study was limited in that it is not a national sample, BMI was the only measure of adiposity, perceived weight was the only measure of body image, and there were no data on lifetime trajectories of depression, obesity, or body image. CONCLUSIONS: If there is an etiologic link between major depression and body weight among adolescents, it most likely operates through processes involving components of body image, since controlling for body image eliminated the association between depression and obesity. Clinically, addressing body image in depressed patients who are obese may improve outcomes.

Is there an association between adolescent sleep restriction and obesity.

OBJECTIVE: This is the first prospective study of the reciprocal association between sleep restriction and weight among adolescents. Evidence on sleep duration and obesity in youth is sparse and the results have been equivocal. METHODS: Data are from a community-based, two-wave cohort study. The setting was a metropolitan area with a population of over 4 million. The cohort consisted of 4175 youths 11-17 at baseline and 3134 of these followed up a year later. Obesity was defined as body mass index >95th percentile for children of the same age and sex. Sleep restriction was defined as 6 or fewer hours of sleep per night on weeknights or on both weekends and weeknights. Covariates examined were age, gender, family income and depression. RESULTS: Results clearly demonstrated that there was no association between sleep restriction and obesity at baseline. In prospective analyses, sleep restriction did not increase future risk of obesity, nor did obesity increase risk of future sleep restriction. CONCLUSIONS: These findings call into question previous research based primarily on cross-sectional data suggesting a positive correlation between sleep restriction and obesity. However, the results for adolescents in this study are supported by one study of adolescents and by studies of adults using prospective designs. At this point, there appears to be little evidence for a temporal relation between sleep duration and obesity among adults or adolescents.

Estimating the burden of psychiatric disorders in adolescence: the impact of subthreshold disorders.

PURPOSE: We examine the impact of including subthreshold disorders on estimating psychiatric morbidity burden in adolescents. To more fully understand this burden it is important to focus on both full syndrome and subthreshold disorders and the impairment associated with each, since evidence suggests prevalence of subthreshold disorders is substantial as is impairment. METHODS: Data were analyzed from a probability sample of 4,175 youths 11-17 years of age. We examine the prevalence of DSM-IV disorders (FS) and subthreshold (SUB) disorders, with and without impairment. Diagnostic categories examined were anxiety, mood, attention deficit hyperactivity disorder, disruptive, and substance use disorders in the past year. RESULTS: The prevalence of any FS disorders was 16.1 and 42.3 % for SUB. The combined prevalence was 58.4 %. By requiring impairment, the prevalence of any FS in the past year dropped to 8 % and for SUB to 15.7 %, with a combined overall rate of 23.7 %. For FS disorders, 49.6 % met criteria for moderate to severe impairment, compared to 37.8 % for SUB. One in four adolescents had either an FS or SUB disorder with impairment. CONCLUSION: The results indicate that SUB disorders constitute a major public health burden in terms of psychiatric morbidity among adolescents. Given their substantial impairment and their high prevalence, consideration should be given to including SUB disorders in estimates of the public health burden psychiatric morbidity. Doing so would provide a more accurate estimate of psychiatric morbidity.

The prospective association between sleep deprivation and depression among adolescents.

STUDY OBJECTIVES: To examine the prospective, reciprocal association between sleep deprivation and depression among adolescents. DESIGN: A community-based two-wave cohort study. SETTING: A metropolitan area with a population of over 4 million. PARTICIPANTS: 4,175 youths 11-17 at baseline, and 3,134 of these followed up a year later. MEASUREMENTS: Depression is measured using both symptoms of depression and DSM-IV major depression. Sleep deprivation is defined as ≤ 6 h of sleep per night. RESULTS: Sleep deprivation at baseline predicted both measures of depression at follow-up, controlling for depression at baseline. Examining the reciprocal association, major depression at baseline, but not symptoms predicted sleep deprivation at follow-up. CONCLUSION: These results are the first to document reciprocal effects for major depression and sleep deprivation among adolescents using prospective data. The data suggest reduced quantity of sleep increases risk for major depression, which in turn increases risk for decreased sleep.

Perceived weight in youths and risk of overweight or obesity six years later.

OBJECTIVE: To examine the association between perceived overweight in adolescents and the development of overweight or obesity later in life. METHODS: This paper uses data from a prospective, two-wave cohort study. Participants are 2445 adolescents 11-17years of age who reported perceived weight at baseline and also had height and weight measured at baseline and at follow-up six years later sampled from managed care groups in a large metropolitan area. RESULTS: Youths who perceived themselves as overweight at baseline were approximately 2.5 times as likely to be overweight or obese six years later compared to youths who perceived themselves as average weight (OR=2.45, 95% CI=1.77-3.39), after adjusting for weight status at baseline, demographic characteristics, major depression, physical activity and dieting behaviors. Those who perceived themselves as skinny were less likely to be overweight or obese later (OR=0.36, 95% CI=0.27-0.49). CONCLUSIONS: Perceived overweight was associated with overweight or obesity later in life. This relationship was not fully explained by extreme weight control behaviors or major depression. Further research is needed to explore the mechanism involved.

Perceived weight, not obesity, increases risk for major depression among adolescents.

UNLABELLED: This study examined the association between major depression, obesity and body image among adolescents. METHODS: Participants were 4175 youths 11-17 years of age sampled from the community who were interviewed using the Diagnostic Interview Schedule for Children and Adolescents, Version IV, completed a self-report questionnaire, and had their weight and height measured. There were 2 measures of body image: perceived weight and body satisfaction. Obesity was associated with increased risk of depression, with no controls for covariates. However, when the association was examined in models which included weight, major depression, and body image measures and covariates, there was no association between major depression and body weight, nor between body satisfaction and major depression. Perceived overweight was strongly and independently associated with body weight (O.R. = 2.62). We found no independent association between major depression and body weight. If there is an etiologic link between major depression and body weight among adolescents, it most likely operates through processes involving components of body image. Future research should focus on the role of depression and body image in the etiology of obesity.

Obesity has few effects on future psychosocial functioning of adolescents.

We reexamine the effects of obesity on a wide range (n=17) of indicators of functioning drawn from five broad domains: interpersonal problems, psychological problems, suicidal behaviors, academic performance, and psychiatric disorders. Evidence on this question is mixed. Data are analyzed from a large community sample of adolescents 11-17 at baseline (n=4175) who were followed up a year later (n=3134). Using measured height and weight, overweight was defined as 95th>BMI≤85th percentile and obese as BMI >95th percentile. At baseline, obesity was associated with increased odds only for any mood disorder and poor perceived mental health. For boys, there were no significant associations, but girls had higher odds of problems at school, poor perceived mental health, and mood disorders. Results from the two-wave cohort reveal obesity increased future risk only for poor perceived mental health. For boys, the same pattern was observed, but for girls there were no significant associations. Overall, we found that weight status had few deleterious effects on adolescent social functioning, in multivariate, prospective analyses. If there is an effect of obesity on functioning, it may operate through mediators such as body image.

Heterogeneous trajectories of depressive symptoms: adolescent predictors and adult outcomes.

BACKGROUND: Depressive symptoms display heterogeneous trajectories across adolescence and early adulthood. Identifying risk and protective factors for distinct trajectory groups, and their respective outcomes, may provide insight into the etiological underpinnings of different symptom courses and inform the targets and timing of intervention. METHODS: A school-based sample of 719 adolescents completed four diagnostic evaluations and up to 7 annually mailed questionnaires assessing psychiatric symptoms and psychosocial risk and protective factors. Parental history of psychiatric disorder was assessed. Growth mixture modeling (GMM) was used to identify latent depressive symptom trajectories from mid-adolescence through age 30, as well as their predictors in mid-adolescence and adult outcomes. RESULTS: A three class model consisting of high stable (32%), moderate decreasing (44%), and low decreasing (24%) depressive symptom trajectories emerged as the preferred solution. Demographic, psychosocial, and psychiatric characteristics differentiated the low and high symptom classes, and provided support for interpersonal models of depression chronicity. Members of the moderate and high symptom classes evidenced the worst psychosocial and psychiatric outcomes by age 30, with members of the high symptom class showing the greatest levels of impairment. LIMITATIONS: Cross-sectional measurement and floor effects of several predictor variables may have obscured the relations between those predictors and trajectory class membership. CONCLUSION: These findings suggest that prevention and intervention strategies may specifically target young women and those who experience poor interpersonal functioning in an effort to alter the course of depressive symptoms through early adulthood.

Depression and insomnia among adolescents: a prospective perspective.

BACKGROUND: No studies of adolescents have examined the prospective, reciprocal association between insomnia and major depression. METHODS: A two-wave, community-based cohort of 3134 youths aged 11-17 at baseline. Major depression was assessed using DSM-IV criteria. Three measures of insomnia were used also following DSM-IV: P1, any symptom of insomnia; P2, any symptom plus impairment; P3, P2 with no comorbid mood, anxiety or substance use disorders. RESULTS: In general, the association between insomnia and depression was stronger and more consistent for major depression than for symptoms of depression. Baseline insomnia (P1 and P2) increased subsequent risk of major depression 2-3-fold and P1 2-fold in multivariate analyses. Major depression increased risk for subsequent insomnia 2-3-fold for P1 and P2 2-fold for P2 in multivariate analyses. Results varied by measure of insomnia used. LIMITATIONS: Only symptoms of insomnia were assessed, so we could not examine the effects of comorbid sleep disorders nor did we have objective or biological measures of disturbed sleep. We also did not collect data on parental reports of youth depression nor insomnia or sleep problems. CONCLUSION: Our results provide the first prospective data on insomnia and major depression among adolescents indicating the two are reciprocally related. More studies are needed examining trajectories of insomnia and major depression in childhood and adolescence.

Treatment or else: coerced treatment for drug-involved California parolees.

This study evaluated a community-based correctional program in California, in which parolees tested positive on illicit drugs were given the option of going into a treatment program or having their parole revoked and returned to prison in California. Two comparison groups were constructed to assess the treatment effect-a propensity-based comparison group extracted from the general parolee population and program dropouts. Although implicitly coercive, some parolees who finished the program were less likely to be reincarcerated 12 months following release than both comparison groups. However, the observed treatment advantage quickly eroded in the second observation year. Savings realized from the incarcerations avoided were more than enough to pay for the program. Findings from this study suggest that boosting participation in reentry services through coercive measures may yield currently unrealized individual and societal benefits. However, systemic efforts are needed to extend the short-term treatment effects. Design and data limitations in the study weaken the persuasiveness of these findings. Methodological implications and policy issues about coerced treatment are discussed.

Hostility, physical aggression and trait anger as predictors for suicidal behavior in Chinese adolescents: a school-based study.

PURPOSE: This study explored the extent to which trait aggression is associated with suicidal behavior in a nationwide school-based sample of adolescents. METHODS: A nationwide sample of 14,537 high school students in urban areas of China was recruited. Information concerning suicide ideation, plans, attempts, trait aggression and other risk factors was collected by a self-reported questionnaire. Multivariate regression analyses were employed to predict suicidal behavior. RESULTS: Approximately 18.5% of students reported suicide ideation, 8.7% reported suicide plans, and 4.1% reported attempts during the past one year. Hostility and trait anger had a significant positive association with suicidal ideation. Hostility and physical aggression were positively related to suicide plans. Hostility had a positive correlation with suicide attempts, while trait anger was inversely associated with suicide attempts. CONCLUSIONS: This study suggests that hostility, physical aggression and trait anger may be able to be used to predict suicidal behavior among adolescents. Suicide prevention programs should target at attenuating the severity of hostility, anger and physical aggression. But teachers and parents should also give close attention to students with low trait anger.

Developmental relations between perceived social support and depressive symptoms through emerging adulthood: blood is thicker than water.

Longitudinal trajectories of depressive symptoms, perceived support from family, and perceived support from friends were examined among 816 emerging adults (480 women; 59%). In the context of a larger longitudinal investigation on the predictors and course of depression, data were drawn from eight self-report questionnaire assessments that roughly spanned the third decade of life. An age-based scaling approach was used to model trajectories of depressive symptoms and perceived social support between the ages of 21 and 30. Associative models of the relations between depressive symptoms and perceived social support from family and friends were tested. Results indicated that depressive symptoms decreased and perceived social support increased during the study period. Associative models suggested that among women, higher initial levels of perceived support from family predicted slower decreases in depressive symptoms (b = .34, p < .01). Among men, higher initial levels of depressive symptoms predicted slower increases in perceived family support (b = -.23, p < .05). Cross-domain predictive effects were not observed for perceived support from friends and depressive symptoms. Implications of the findings are discussed.

Restricted sleep among adolescents: prevalence, incidence, persistence, and associated factors.

The objective is to examine incidence, prevalence, and persistence of restricted or short sleep among adolescents and associated risk factors. Data are from a sample of 4,175 youths aged 11 to 17 at baseline and 3,134 followed up 1 year later. Restricted sleep was defined as 6 hr or less per night. Prevalence was 20%, 1-year incidence was 17%, and chronicity was 54%. Analyses identified few independent predictors: female, older age, schoolwork, extracurricular activities, and life stress. Odds ratios for incidence of sleep restriction on weeknights were 10 for 8 or more factors and 17 for persistence with 8 or more risk factors. This prospective study documents that incidence of sleep restriction was high. Restricted sleep also was prevalent and chronic and, like many other health problems, has multifactorial origins. Having multiple risk factors substantially increased risk of restricted sleep. Given the importance of sleep in this population, more focus is clearly needed, both clinically and epidemiologically.