Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

BACKGROUND: Adverse childhood experiences (ACE) have been documented to have long-term impacts on sleep disturbances. However, less is known about how ACE co-occurs with positive childhood experiences (PCE) and modulate their effects on adult sleep disturbances, particularly in the context of persistent insomnia. Building on resilience theory, this study aims to examine the interplay between ACE and PCE and their effects on persistent insomnia during emerging adulthood. METHODS: A total of 2,841 emerging adults were recruited from the Taiwan Youth Project. Persistent insomnia during emerging adulthood was assessed using two adult surveys (mean age = 19.8 and 21.9). The ACE (10 items) and PCE (7 items) were obtained from the baseline survey (mean age = 13.8). A series of logistic regression analyses were conducted. RESULTS: Among the emerging adults, 29.22% had persistent insomnia. Consistent with the compensatory model, ACE and PCE exerted opposing effects on persistent insomnia during emerging adulthood. In line with the protective model, the negative effect of ACE is mitigated when individuals have high PCE. However, consistent with the challenge model, the protective effect of PCE on persistent insomnia was inhibited in individuals with four or more ACE. CONCLUSIONS: PCE serves as a protective factor, shielding emerging adults from the adverse effects of ACE on persistent insomnia. It is essential to prioritize positive experiences during early life to promote lifelong sleep health.

Adverse childhood experience and young adult's problematic Internet use: The role of hostility and loneliness.

BACKGROUND: Few studies have explored the relationship between adverse childhood experiences (ACEs) and problematic Internet use (PIU) during young adulthood. Moreover, even fewer studies have explored the roles of loneliness (social and emotional) and hostility in this relationship. METHODS: This study used data from the Taiwan Youth Project (2011-2017). The analytical sample included 1885 participants (mean age = 31.3 years). PIU was measured using the short form of Chen's Internet Addiction Scale (2017). ACEs were assessed at the baseline of the adolescent phase (mean age = 14.3 years); this indicator has undergone recent revision. Hostility (three items from the Symptom Checklist-90-Revised) and loneliness (six items from the De Jong Gierveld scale) were measured in 2011 and 2014, respectively. RESULTS: ACEs were associated with hostility and loneliness (emotional and social). Additionally, hostility (ß = 0.62, p < .01) and emotional loneliness (ß = 0.44, p < .01) were significantly associated with PIU. Most mediating paths (e.g., ACE → hostility → PIU) were significant, based on the bootstrapping results. CONCLUSIONS: This study suggests that ACEs have a long-term shadow effect on PIU in young adults. ACEs show an indirect association with PIU through both hostility and loneliness, as well as involving the relationship between them.

Associations between forced non-consensual first-sex and HIV among sexually active women in the Kingdom of Eswatini.

Studies continue to underscore the profound impact of sexual violence on women's health. Yet, little is known about the impact, via a complex matrix of behavioural and social factors, of first intercourse, namely forced non-consensual on HIV status, particularly among sexually active women (SAW) in low-income countries where HIV prevalence remains high. Using a national sample from Eswatini, we employed multivariate logistic regression modelling to estimate the associations between forced first-sex (FFS), subsequent sexual behaviour and HIV status among 3555 SAW aged from 15 years to 49 years. The results found that women who experienced FFS had a greater number of sexual partners compared to those who had never experienced FFS (aOR = 2.79, p < .01), although there were no significant differences in condom use, early sexual debut and casual sex involvement between these two groups. FFS remained significantly associated with a higher risk of having HIV (aOR = 1.70, p < .05) even after controlling for risky sexual behaviours and various other factors. These findings further reinforce the relationship between FFS and HIV, and suggest that addressing sexual violence is a critical component of HIV prevention among women in low-income countries.

Relationship between adverse childhood experiences and problematic internet use among young adults: The role of the feeling of loneliness trajectory.

Backgrounds and aims: Given problematic Internet usage's (PIU) negative impact on individual health, this study evaluates how adverse childhood experiences (ACEs) affect young adults' PIU and the possible underlying mechanism of the "feeling of loneliness" (FOL) trajectory. Methods: Analyzing a retrospective cohort sample from the Taiwan Youth Project, 2,393 adolescents were interviewed from the average ages of 14-28. We constructed ACE in 2000 using six categories (e.g., abuse and low family socioeconomic status) and 5-item PIU in 2017 from Chen's Internet Addiction Scale. FOL trajectories measured eight times, at average ages 14, 16, 17, 18, 20, 22, 25, 28 years-old. Results: Overall, 12.65% of the participants did not have ACEs, and 12.78% exhibited PIU. FOL trajectory analyses yielded three groups: "constant low" (reference group: 53.25%); "moderate decline" (36.81%); and "increasing" (9.94%). Regression models showed a dose-response association between ACE and young adults' PIU (adjusted odds ratio = 1.12; 95% confidence interval [CI] = 1.02-1.23) and the two risky loneliness groups (moderate decline: relative risk ratio [RRR] = 1.42, 95% CI = 1.32-1.54; increasing: RRR = 1.52, 95% CI = 1.37-1.71). Structural equation modeling further found that ACEs increase young adults' risk of being in the increasing group, and consequently, the risk of PIU. Discussion and conclusions: We demonstrated that ACE may be associated with 1) adults' PIU, 2) FOL from adolescence to emerging adulthood, and 3) young adults' PIU through its association with FOL trajectories.

The Relationship Between Adverse Childhood Experience and Heavy Smoking in Emerging Adulthood: The Role of Not in Education, Employment, or Training Status.

PURPOSE: The purpose of this study was to examine the relationship between adverse childhood experiences (ACEs) in early adolescence and heavy smoking in emerging adulthood, focusing on the mediating role of individuals' not in education, employment, or training (NEET) status. METHODS: Using a retrospective cohort sample from the Taiwan Youth Project, 2,903 participants from the age of 14 years until the age of 22 years were surveyed. Respondents' ACEs were assessed at the age of 14 years, their NEET status was assessed at the age of 20 years, and heavy smoking was measured at the age of 22 years. Regression and mediation analyses with resampling were conducted. RESULTS: In a separate model, cumulative ACEs, three or more ACEs, and family dysfunction during early adolescence were significantly related and emerging adults' heavy smoking (adjusted odds ratio [AOR] = 1.32; AOR = 2.91; and AOR = 2.31, respectively) and NEET status (AOR = 1.27; AOR = 2.99; and AOR = 2.09, respectively). In the final model (including both ACE and NEET), these three ACE measures were still significantly related to heavy smoking and NEET status was also significantly related to heavy smoking. Finally, bootstrapping results indicated that the indirect effects from ACEs on heavy smoking through NEET were significant, which indicated significant indirect effects. CONCLUSIONS: ACEs have a profound impact on emerging adults' heavy smoking, both directly and indirectly, through their NEET status. Thus, future research should focus on individuals' NEET status and its association with unhealthy behaviors in emerging adulthood.

Loneliness in older parents: marital transitions, family and social connections, and separate bedrooms for sleep.

OBJECTIVES: This research innovatively analyzed the marital transitions (i.e., divorce and widowhood) of older Taiwanese parents, their sleep problems and spousal specific characteristics (i.e., separate bedrooms for sleep and marital relationships) as well as their social and family connections, all of which were simultaneously reflected in emotional and social domains of loneliness. METHODS: Data are from 1645 older parents from Northern Taiwan. Loneliness was assessed by a De Jong-Gierveld short scale with emotional and social domains. We conducted multivariate logistic regression to examine the associations of marital transitions and family/social connections regarding sleep problems and psychological well-being with loneliness in social and emotional domains. Besides sleep problems and individual socioeconomic status, we included data on couples' sleeping arrangements and marital relationships. RESULTS: Social loneliness was significantly associated with being divorced (AOR = 1.80, 95% CI 1.13-2.86) and living alone (AOR = 1.50, 95% CI 1.02-2.23). In contrast, strong family cohesion and frequent weekly contact with friends were associated with lower social loneliness. Married parents who slept in separate bedrooms were more likely than bed-sharing couples to feel emotional and social loneliness, despite adjusting for their sleep problems. Furthermore, satisfactory spousal relationships significantly decreased the magnitude of associations in the social domain. DISCUSSION: Our findings support significant associations between loneliness in later life and major marital transitions, family and social connections and sleep problems which differ in social and emotional domains. Independent of relationship satisfaction, separate bedrooms relate to higher risks of emotional loneliness in older adults.

Adolescents' Physical Activity and the Association With Perceived Social Support of Parents and Peers in Indonesia.

This study examined the trends of adolescents' physical activity (PA) and its association with parental and peer support, based on the Indonesia Global School-Based Health Survey. Between 2007 and 2015, prevalence of PA in adolescents declined from 24.4% to 16.5%. Prevalence of active transportation (AT) decreased from 47.2% to 32.3%. Prevalence of sedentary leisure behavior (SLB) declined from 33.6% to 27.2%. Girls' SLB was inversely associated with parental supervision SLB in 2007 (odds ratio [OR] = 0.49; 95% CI = 0.30-0.80) and in 2015 (adjusted OR [AOR] = 0.55; 95% CI = 0.43-0.71), and so was boys' SLB in 2015 (OR = 0.75; 95% CI = 0.59-0.95). Boys' AT was inversely associated with peer support in 2015 (OR = 0.73; 95% CI = 0.59-0.91). Parental control was associated with PA in girls (OR = 1.71; 95% CI = 1.23-2.37), in boys (OR = 1.65; 95% CI = 1.07-2.54), and with SLB among girls in 2015 (OR = 1.28; 95% CI = 1.11-1.47). Hence, adolescents' PA was associated with perceived social support.

Education tracking and adolescent smoking: a counterfactual and prospective cohort study.

BACKGROUND AND AIMS: Adolescent smoking is a health issue and a potential health inequality issue. Education tracking, which is the placement of students into different school types and curricula based on their learning needs or abilities, is an indicator of inequality and risk factor of adolescent smoking. We examined the effect of educational tracking, dividing students into vocational and academic high school tracks, on adolescent smoking in Taiwan. DESIGN AND SETTING: Longitudinal panel data, collected annually from 2000 over a period of 6 years as part of the Taiwan Youth project, were used. PARTICIPANTS: Adolescents (aged 13-18 years) from the first six waves of the Taiwan Youth Project were included in the project, of whom 2147 had clear information on track attendance in 10th grade, control variables in 7th/8th grades and smoking behavior in 8th grade (before track placement). Post-track smoking behavior was measured at 10th, 11th and 12th grades. MEASUREMENTS: The outcome variable was the self-reported smoking status in the 8th grade and between 10th and 12th grades. The treatment variable of interest was education tracking (vocational versus academic), which was conducted when the student was in 10th grade. Several important confounders were used for the difference-in-differences propensity score matching (e.g. parents' education and same classroom peer smoking). FINDINGS: Placement of a student in the vocational track increased the proportion of smokers by 3.3 percentage points in 10th grade (P = 0.039). The effect was even more pronounced in 11th grade (6.2 percentage points; P = 0.000) and 12th grade (5.9 percentage points; P = 0.003). CONCLUSIONS: Education tracking (placement of students into different school curricula based on learning needs or abilities) appears to be a risk factor for adolescent smoking among Taiwanese adolescents.

Adverse adolescence experiences, feeling lonely across life stages and loneliness in adulthood / Experiencias adversas en la adolescencia, sentirse solo en las etapas de la vida y soledad en la edad adulta

BACKGROUND/OBJECTIVE: Loneliness is a mental health issue emerging over the life course. This study examines the latent structure of adult loneliness in a non-Western society and its association with adverse adolescence experiences (AAEs) as well as feeling lonely during middle school, high school, and college. METHOD: A cohort sample living in Northern Taiwan (N = 2,289) was analyzed from adolescence to adulthood. The de Jong Gierveld Loneliness Scale operationalized loneliness by a three-cluster model to present the latent structure of loneliness: emotional, serious emotional, and severe emotional/social loners. AAEs (e.g., abuse, neglect, and dysfunctional family) were measured by seven items. Multivariate multinomial logistic regression models were used to explore the longitudinal effects of AAEs and feeling lonely reported during middle school, high school, and college on adult loneliness. RESULTS: AAEs and feeling lonely during adolescence were significantly associated with serious emotional loneliness and severe emotional/social loneliness during adulthood, even after adjusting for the individual’s characteristics. Attendance at a 4-year college was associated with decreased odds of serious emotional loneliness and severe emotional/social loneliness. CONCLUSIONS: Adults with AAEs and feelings of loneliness over life stages are more likely to report loneliness in the emotional and social domains

ANTECEDENTES/OBJETIVO: La soledad es un problema de salud mental que emerge a lo largo de la vida. Se examina la estructura latente de la soledad de adultos en una sociedad no occidental y su asociación con experiencias adversas en la adolescencia (EAAs), además de sentirse solo durante la Secundaria y la Universidad. MÉTODO: Se analizó una muestra de cohorte de Taiwán (N = 2.289) desde la adolescencia hasta la edad adulta. La Jong Gierveld Loneliness Scale operacionalizó la soledad mediante un modelo de tres grupos para presentar la estructura latente de la soledad: emocional, emocional grave y soledad emocional/social severa. Las EAAs (e.g., abuso, negligencia y familia disfuncional) se midieron con siete ítems. Se utilizaron modelos de regresión logística multinomial multivariante para explorar los efectos longitudinales de EAAs y sentirse solo informado durante la Secundaria y la Universidad sobre la soledad adulta. RESULTADOS: Las EAAs y sentirse solo durante la adolescencia se asociaron significativamente con soledad emocional grave y emocional/social severa durante la adultez, incluso después de ajustarse a las características del individuo. Asistir a la Universidad durante cuatro años se asoció con una disminución de las probabilidades de soledad emocional grave y emocional/social severa. CONCLUSIONES: Adultos con EAAs y sentimientos de soledad durante las etapas de la vida tienen más probabilidades de informar soledad en ámbitos emocional y social

Adverse adolescence experiences, feeling lonely across life stages and loneliness in adulthood.

Loneliness is a mental health issue emerging over the life course. This study examines the latent structure of adult loneliness in a non-Western society and its association with adverse adolescence experiences (AAEs) as well as feeling lonely during middle school, high school, and college. METHOD: A cohort sample living in Northern Taiwan (N = 2,289) was analyzed from adolescence to adulthood. The de Jong Gierveld Loneliness Scale operationalized loneliness by a three-cluster model to present the latent structure of loneliness: emotional, serious emotional, and severe emotional/social loners. AAEs (e.g., abuse, neglect, and dysfunctional family) were measured by seven items. Multivariate multinomial logistic regression models were used to explore the longitudinal effects of AAEs and feeling lonely reported during middle school, high school, and college on adult loneliness. RESULTS: AAEs and feeling lonely during adolescence were significantly associated with serious emotional loneliness and severe emotional/social loneliness during adulthood, even after adjusting for the individual's characteristics. Attendance at a 4-year college was associated with decreased odds of serious emotional loneliness and severe emotional/social loneliness. CONCLUSIONS: Adults with AAEs and feelings of loneliness over life stages are more likely to report loneliness in the emotional and social domains.

ANTECEDENTES/OBJETIVO: La soledad es un problema de salud mental que emerge a lo largo de la vida. Se examina la estructura latente de la soledad de adultos en una sociedad no occidental y su asociación con experiencias adversas en la adolescencia (EAAs), además de sentirse solo durante la Secundaria y la Universidad. MÉTODO: Se analizó una muestra de cohorte de Taiwán (N = 2.289) desde la adolescencia hasta la edad adulta. La Jong Gierveld Loneliness Scale operacionalizó la soledad mediante un modelo de tres grupos para presentar la estructura latente de la soledad: emocional, emocional grave y soledad emocional/social severa. Las EAAs (e.g., abuso, negligencia y familia disfuncional) se midieron con siete ítems. Se utilizaron modelos de regresión logística multinomial multivariante para explorar los efectos longitudinales de EAAs y sentirse solo informado durante la Secundaria y la Universidad sobre la soledad adulta. RESULTADOS: Las EAAs y sentirse solo durante la adolescencia se asociaron significativamente con soledad emocional grave y emocional/social severa durante la adultez, incluso después de ajustarse a las características del individuo. Asistir a la Universidad durante cuatro años se asoció con una disminución de las probabilidades de soledad emocional grave y emocional/social severa. CONCLUSIONES: Adultos con EAAs y sentimientos de soledad durante las etapas de la vida tienen más probabilidades de informar soledad en ámbitos emocional y social.

Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood.

BACKGROUND: Sexually explicit media exposure during early adolescence has been found to be associated with risky sexual behavior. However, previous study suffered from methodological issue, such as selection bias. Furthermore, little is known about the effect of multi-modality sexually explicit media exposure on risky sexual behavior, and how this relationship can be applied to non-western societies. OBJECTIVES: This study aimed to improve upon previous studies by using instrumental variable estimation. In addition, this study also included multi-modality of sexually explicit media and three risky sexual behavior measure from a sample of Taiwanese adolescents. METHODS: Participants were recruited from a prospective longitudinal study (Taiwan Youth Project). All were in 7th grade (mean age = 13.3) when the study was initiated in 2000. Sexually explicit media exposure, including ever-exposure and number of modalities exposed to, was measured in wave 2 (8th grade). Risky sexual behavior was measured in waves 8 (mean age = 20.3) and 10 (mean age = 24.3). A two-stage least squares regression was employed, with pubertal timing as the instrumental variable. RESULTS: About 50% of participants had been exposed to sexual media content by 8th grade, from an average of one modality. Sexually explicit media exposure predicted early sexual debut, unsafe sex, and multiple sexual partners (all: p < .05). Furthermore, exposure to more media modalities increased the likelihood of risky sexual behaviors. However, only the effect on early sexual debut was gender invariant. CONCLUSIONS: Exposure to sexually explicit media in early adolescence had a substantive relationship with risky sexual behavior in the emerging adulthood. Knowledge of this causal like effect provides a basis for building better preventive programs in early adolescence. One prominent way is early education on media literacy, and physicians themselves may need to be familiar with such content to initiate it.

"Happiness in the air?" the effects of air pollution on adolescent happiness.

BACKGROUND: We aimed to examine the effect of ambient air pollution at the district level on adolescents' happiness and their change in happiness over time in a cohort sample from Taiwan. METHOD: A cohort from the Taiwan Youth Project was evaluated. The adolescents (n = 2571) were in the 7th grade (mean age = 14.3 years) when the study was initiated and resided in 40 districts in three cities and counties in northern Taiwan. We examined the effects of the concentration level of air pollution, including PM2.5, PM10, and NO2, at the district level on adolescents' happiness and their change in happiness over time (7th to 9th grade). Due to the high correlations of the three pollutants, we examined each separately with similar covariates. The analyses were based on both multilevel modeling and latent growth curve modeling. RESULTS: Higher concentration levels of each of the three air pollutants measured were associated with adolescent happiness such that a higher level of concentration was related to lower levels of adolescents' happiness. These results were observed after controlling for important individual- and district-level covariates. However, further analyses did not reveal that the concentration level of air pollution was associated with the change in happiness in the study period (after 3 years). Some sensitivity checks (e.g., adjusting district size) did not change the substantive results. CONCLUSION: Many previous studies have shown the influence of air pollution on physical health and negative emotions, but only a few using adult samples have shown that air pollution is inversely related to positive wellbeing. This study may be the first to examine the effects of air pollution on adolescents' positive affect. Our results echo recent research on the consequent health burden of air pollution. Given that positive affect has been linked to future adult health, the results of the current study provide empirical grounds for early intervention concerning environmental factors.

Strain, Negative Emotions, and Level of Criminality Among Chinese Incarcerated Women.

General strain theory (GST) has been one of the most frequently tested criminological theories. According to GST, strain tends to generate negative emotions, which create pressures for corrective action, such as crime and delinquency. Although GST has received strong empirical support, one under-addressed issue is the lack of diversity in sampling population in assessing the generalizability of the theory. Using survey data collected from 335 incarcerated women in four Chinese prisons, this study examined the impact of strain and negative emotions on the level of female criminality. The strain variable, physical abuse, and discrimination, exerted a positive effect on female inmates' levels of criminality, whereas negative emotions were not significantly related to female criminality. Two control variables, age of current offense and educational attainment, were predictive of female criminality, with younger and less-educated women having more serious criminality. Implications for future research and policy are discussed.

Educational Tracking and Juvenile Deviance in Taiwan: Direct Effect, Indirect Effect, or Both.

Educational tracking in Chinese society is quite different from that in Western society, in that the allocation to either the vocational or academic track is based on a national entrance examination, which happens at ninth grade (age 14-15). Hence, students in many Asian countries (e.g., China and Taiwan) have to face academic tracking in early adolescence. Because of cultural emphasis on education in Taiwan, the impact of tracking on deviance is profound and can be seen as a crucial life-event. With this concept in mind, we examine how educational tracking influences adolescent deviance during high school. In addition, we also examine how educational tracking may indirectly influence deviance through other life domains, including depression, delinquent peer association, and school attachment. By using longitudinal data (the Taiwan Youth Project), we find that educational tracking increases deviance not only directly but also indirectly through delinquent peers and low school attachment. Some implications and limitations are also discussed.

Unhealthy sleep practices, conduct problems, and daytime functioning during adolescence.

Although sleep has been linked to activities in various domains of life, one under-studied link is the relationship between unhealthy sleep practices and conduct problems among adolescents. The present study investigates the influence of adolescents' unhealthy sleep practices-short sleep (e.g., less than 6 h a day), inconsistent sleep schedule (e.g., social jetlag), and sleep problems-on conduct problems (e.g., substance use, fighting, and skipping class). In addition, this study examines unhealthy sleep practices in relationship to adolescent emotional well-being, defiant attitudes, and academic performance, as well as these three domains as possible mediators of the longitudinal association between sleep practices and conduct problems. Three waves of the Taiwan Youth Project (n = 2,472) were used in this study. At the first time-point examined in this study, youth (51% male) were aged 13-17 (M = 13.3). The results indicated that all three measures of unhealthy sleep practices were related to conduct problems, such that short sleep, greater social jetlag, and more serious sleep problems were concurrently associated with greater conduct problems. In addition, short sleep and sleep problems predicted conduct problems one year later. Furthermore, these three unhealthy sleep practices were differently related to poor academic performance, low levels of emotional well-being, and defiant attitudes, and some significant indirect effects on later conduct problems through these three attributes were found. Cultural differences and suggestions for prevention are discussed.

Strain, negative emotions, and juvenile delinquency: the United States versus taiwan.

General strain theory (GST) is an established criminological theory. Although the theory has been examined by many and enjoys empirical support, some limitations of previous studies need to be addressed. Many previous studies rely heavily on samples from Western countries, mostly the United States; thus, possible cultural influences are ignored. Although a few studies have moved forward by using subjects from Asia (e.g., China, Korea), these studies only provide empirical results regarding whether GST is applicable in other cultures. However, these studies do not directly compare Western and Eastern countries. The present study used two samples from the United States and Taiwan to directly compare and contrast central GST propositions. Although most of the GST propositions are found to be similar between the U.S. and Taiwanese juveniles, some differences were also discovered. Explanation of these similarities and differences from their cultural perspectives are offered in this study.

Direct and vicarious violent victimization and juvenile delinquency: an application of general strain theory.

Using a national probability sample of adolescents (12­17), this study applies general strain theory to how violent victimization, vicarious violent victimization, and dual violent victimization affect juvenile violent/property crime and drug use. In addition, the mediating effect and moderating effect of depression, low social control, and delinquent peer association on the victimization­delinquency relationship is also examined. Based on SEM analyses and contingency tables, the results indicate that all three types of violent victimization have significant and positive direct effects on violent/property crime and drug use. In addition, the expected mediating effects and moderating effects are also found. Limitations and future directions are discussed.