Polygenic Effects on Individual Rule Breaking, Peer Rule Breaking, and Alcohol Sips Across Early Adolescence in the ABCD Study.

Alcohol use emerges during early adolescence and is strongly associated with individual and peer risky, delinquent, and rule breaking behaviors. Genetic predisposition for risky behavior contributes to individual rule breaking in adolescence and can also evoke peer rule breaking or lead youth to select into delinquent peer groups via gene-environment correlations (rGE), collectively increasing risk for alcohol use. Little research has examined whether genetic predisposition for risky behavior contributes to individual and peer rule breaking behavior in developmental pathways to alcohol use in early adolescence or in large diverse racial/ethnic populations. To address this, polygenic scores for risky behavior were considered predictors of individual rule breaking, peer rule breaking, and alcohol sips using data from the Adolescent Brain Cognitive Development (ABCD) study at age 11-12 and 12-13 in a cross-time cross-lagged model. This was examined separately in European American (EA; n = 5113; 47% female), African American (AA; n = 1159; 50% female), and Hispanic/Latinx (Latinx; n = 1624; 48% female) subgroups accounting for sociodemographic covariates and genetic ancestry principal components. Polygenic scores were positively associated with all constructs in EAs, with individual rule breaking at age 11-12 in AAs and Latinx, and with alcohol sips at age 11-12 in Latinx. Individual and peer rule breaking were associated with one another across time only in the EA subgroup. In all subgroups, peer rule breaking at 12-13 was associated with alcohol sips at 12-13. Results indicate that alcohol sips in early adolescence are associated with individual and peer rule breaking with rGE implicated in EAs.

Imagem corporal e autoestima em adolescentes da rede pública estadual de Salvador-Bahia / Imagen corporal y autoestima en adolescentes de la red pública estatal de Salvador-Bahía / Body image and self-esteem in adolescents from the state public network of Salvador-Bahia

RESUMO. Objetivo: Analisar a associação entre insatisfação com a imagem corporal e autoestima de adolescentes matriculados na rede pública estadual de ensino fundamental em Salvador-Bahia. Método: Participaram deste estudo de corte transversal 860 adolescentes de 10 a 19 anos de idade, de ambos os sexos, matriculados do 7º sétimo ao 9º nono ano em 12 escolas de médio porte da rede pública estadual do ensino fundamental em turno integral, do município de Salvador, Bahia. A autoestima foi avaliada por meio da Escala de Autoestima de Rosenberg e a insatisfação com a imagem corporal pelo Body Shape Questionnaire. Dados demográficos e socioeconômicos, maturação sexual, estado antropométrico, nível de atividade física e sedentarismo foram também avaliados. A associação entre insatisfação com a imagem corporal e autoestima foi analisada pela regressão multinominal para variáveis politômicas utilizando o programa estatístico SPSS, versão 23.0. Resultados: Entre os adolescentes, 24,8% tinham moderada autoestima e 27,3% apresentaram os menores escores desse constructo. A insatisfação com a imagem corporal foi identificada em 25,2% dos adolescentes. A análise de associação revelou que adolescentes com insatisfação com a imagem corporal possuem 5,61 (IC 95% 3,08-10,24) vezes maior chance em manifestar baixa autoestima para o sexo feminino e 3,83 (IC 95% 2,03-7,25) vezes para o sexo masculino. Ainda entre as meninas, a insatisfação com a imagem corporal permaneceu associada positivamente à moderada autoestima após ajuste do modelo (OR: 2,31; IC 95% 1,21-4,41). Conclusão: Foi observada alta prevalência de níveis baixos e moderados de autoestima e que a insatisfação com a imagem corporal influenciou a baixa autoestima em ambos os sexos e a moderada entre as meninas.

RESUMEN. Objetivo: Analizar la asociación entre la insatisfacción con la imagen corporal y la autoestima en adolescentes matriculados en escuelas públicas estatales en Salvador - Bahía. Métodos: Participó en esta sección transversal un total de 860 adolescentes de 10 a 19 años, de ambos sexos, de 7º a 9º grado, matriculados en doce escuelas medianas en instituiciones públicas estatales de enseñanza a tiempo completo, en la ciudad de Salvador, Bahía. La Escala de autoestima de Rosenberg y el Body Shape Questionnaire evaluarón, respectivamente, la autoestima y la insatisfacción con la imagen corporal. También se evaluaron los datos demográficos y socioeconómicos, la maduración sexual, el estado antropométrico, el nivel de actividad física y la inactividad física. La asociación entre la insatisfacción con la imagen corporal y la autoestima se analizó mediante regresión multinominal para variables politómicas utilizando el programa estadístico SPSS Versión 23.0. Resultados: Entre los adolescentes, el 24,8% tenían una moderada autoestima y el 27,3% tenían las puntuaciones más bajas de este constructo. La insatisfacción con la imagen corporal se identificó en el 25,2% de los adolescentes. El análisis de asociación reveló que las chicas y los chicos con la insatisfacción con la imagen corporal tenían, respectivamente, 5,61 (IC 95% 3,08 - 10,24) veces y 3,83 (IC 95% 2,03 - 7,25) veces en tener más chances de tener baja autoestima. También entre las chicas, la insatisfacción con la imagen corporal se mantuvo positivamente asociada con uma moderada autoestima después del ajuste del modelo (OR: 2,31; IC del 95%: 1,21 a 4,41). Conclusión: Se observó una alta ocurrencia de baja y moderada autoestima y que la insatisfacción con la imagen corporal influyó en la baja autoestima en ambos sexos y en la moderada autoestima entre las chicas.

ABSTRACT. Objective: To analyze an association between dissatisfaction with body image and self - esteem of adolescents enrolled in the public elementary school system in Salvador - Bahia. Methods: Participated in this cross-sectional study 860 adolescents aged 10 to 19, of both sexes from the 7th to the 9th year, enrolled in twelve medium-sized schools of the public elementary school system in full shift, in the city of Salvador, Bahia. Self-esteem was assessed through the Rosenberg Self-esteem Scale and body image dissatisfaction by the Body Shape Questionnaire. Demographic and socioeconomic data, sexual maturation, anthropometric status, physical activity level and sedentary lifestyle were evaluated. The association between dissatisfaction with body image and self-esteem was analyzed by multinominal regression for polytomic variables using the statistical program SPSS Version 23.0. Results: Among the adolescents, 24.8% had moderate self-esteem and 27.3% had the lowest scores of this construct. Body image dissatisfaction was identified in 25.2% of the adolescents. The association analysis revealed that adolescents with body image dissatisfaction have 5.61 (95%ci 3.08-10.24) times greater chance of manifesting low self-esteem for females and 3.83 (95%ci 2.03-7.25) times for males. Still among girls, dissatisfaction with body image remained positively associated with moderate self-esteem after adjusting the model (OR: 2.31; 95%ci 1.21-4.41). Conclusion: It was concluded that the prevalence of low and moderate self-esteem was high, and dissatisfaction with body image influenced low self-esteem in both sexes and a moderate among girls.

Smaller putamen volumes are associated with greater problems in external emotional regulation in depressed adolescents with nonsuicidal self-injury.

The functions of nonsuicidal self-injury (NSSI) consist of social and emotional aspects (Social influence, Sensation seeking, Internal and External emotion regulation). Previous studies have indicated that dysfunction in reward-related brain structures especially the striatum might drive this habitual behavior. However, no studies to date have investigated the associations between striatum and different functions for adolescents engaging in NSSI behaviors. Here, we recruited 35 depressed adolescents with recent NSSI behaviors and 36 healthy controls and acquired structural brain images, depressive symptoms, social, academic and family environments assessments, in addition to NSSI functions in patients only. Subcortical volumes and cortical thickness were estimated with FreeSurfer. Mixed linear regressions were performed to examine associations between striatal structures (caudate, putamen, nucleus accumbens, pallidum) and NSSI functions, with age, sex, total intracranial volume, hemisphere and depression severity included as covariates. Effect of environmental factors and potential associations with cortical thickness and other subcortical volumes were also tested. We found that, among the four functions, external emotional regulation represented the main function for NSSI engagement. Increased external emotion regulation was significantly associated with smaller putamen volume. No environmental factors biased the association with putamen. No associations with other cortical or subcortical regions were observed. Our findings suggested that smaller putamen might be a biomarker of NSSI engagement for depressed adolescents when they regulated frustrated or angry emotions. The results have potentially clinical implications in early identification and brain intervention of NSSI in youth.

Distrust Moderates the Effect of Deviant Peer Affiliation on Increased Externalizing in Adolescents.

Deviant peer affiliation predicts externalizing behavior in adolescence, but no research explores how having negative or suspicious expectations of others (i.e., distrust) may evoke or buffer against the relationship between deviant peer affiliation and externalizing behavior. The current study used data across two timepoints to investigate the impact of deviant peer affiliation and distrust on externalizing behavior 3 years later and whether race/ethnicity moderated this relationship. The sample consisted of 611 adolescents from the Project on Human Development in Chicago Neighborhoods Study (48% male; Mage = 15.5 years, SD = 1.6; 17% White; 34% Black; 49% Hispanic). Higher levels of distrust buffered against the influence of deviant peer affiliation on externalizing behaviors. Further, this buffering was evident in Black compared to White adolescents. Understanding externalizing behavior warrants considering the intersection between the person and their environment.

Neural connectivity underlying adolescent social learning in sibling dyads.

Social learning theory posits that adolescents learn to adopt social norms by observing the behaviors of others and internalizing the associated outcomes. However, the underlying neural processes by which social learning occurs is less well-understood, despite extensive neurobiological reorganization and a peak in social influence sensitivity during adolescence. Forty-four adolescents (Mage = 12.2 years) completed an fMRI scan while observing their older sibling within four years of age (Mage = 14.3 years) of age complete a risky decision-making task. Group iterative multiple model estimation (GIMME) was used to examine patterns of directional brain region connectivity supporting social learning. We identified group-level neural pathways underlying social observation including the anterior insula to the anterior cingulate cortex and mentalizing regions to social cognition regions. We also found neural states based on adolescent sensitivity to social learning via age, gender, modeling, differentiation, and behavior. Adolescents who were more likely to be influenced elicited neurological up-regulation whereas adolescents who were less likely to be socially influenced elicited neurological down-regulation during risk-taking. These findings highlight patterns of how adolescents process information while a salient influencer takes risks, as well as salient neural pathways that are dependent on similarity factors associated with social learning theory.

Are Peripheral Biomarkers Determinants of Eating Styles in Childhood and Adolescence Obesity? A Cross-Sectional Study.

Disturbances in eating behaviors have been widely related to obesity. However, little is known about the role of obesity-related biomarkers in shaping habitual patterns of eating behaviors (i.e., eating styles) in childhood. The objective of the present study was to explore the relationships between several biomarkers crucially involved in obesity (ghrelin, insulin resistance, and leptin/adiponectin ratio) and eating styles in children and adolescents with obesity. Seventy participants aged between 8 and 16 (56.2% men) fulfilled the Spanish version of the Dutch Eating Behavior Questionnaire for Children to measure external, emotional, and restrained eating styles. In addition, concentrations of ghrelin, leptin, adiponectin, insulin, and glucose were obtained through a blood test. Hierarchical multiple regression analyses controlling for age and sex were computed for each eating style. Results indicated that individuals with higher ghrelin concentration levels showed lower scores in restrained eating (ß = -0.61, p < 0.001). The total model explained 32% of the variance of the restrained pattern. No other relationships between obesity-related biomarkers and eating behaviors were found. This study highlights that one of the obesity-risk factors, namely lower plasma ghrelin levels, is substantially involved in a well-known maladaptive eating style, restraint eating, in childhood obesity.

Tracking of physical activity and sedentary behavior of adolescents in different domains

This study aimed to verify the tracking of physical activity and sedentary behavior in different domains during adolescence. This longitudinal study involved 265 subjects (boys: 52.8%) with an initial mean age of 13.9 (± 1.2) years. Physical activity and sedentary behavior were verified using a questionnaire. The achievement of ≥ 150 min. week-1of moderate-to-vigorous intensity sport and/or physical exercise for ≥ 1 month was adoptedas sufficiently active. The data were collected on 2 occasions, with an average interval of 3 years. The description of the results used the relative frequency and Binary Logistic Regression was used to estimate the crude and adjusted odds ratios (95% confidence intervals). Current physical activity (adjusted odds ratios = 3.05; 95% confidence intervals: 1.77 -5.26) and sedentary behavior (adjusted odds ratios = 1.81; 95% confidence intervals: 1.03 -3.19) appear to be significantly influenced by previousbehavior, except for light-intensity physical activity. Only 12.8% of the participants remained sufficiently active for sport and/or physical exercise. Practice for at least one month of sport and/or physical exercise at baseline was a predictor of practice in the follow-up, both considering participation for at least one month (adjusted odds ratios = 2.81; 95% confidence intervals: 1.37 -5.79) and for four months (adjusted odds ratios = 2.47; 95% confidence intervals: 1.17 -5.24) in the follow-up. Beingsufficiently active at baseline increased the chance of being sufficiently active in the follow-up during adolescence. Interventions providing sufficient sport and/or physical exercise could positively influence the chances of practice in the future. For light-intensity physical activity interventions, strategies targeting adherence seem especially relevant.

Battle of the Appraisals: Pain-Related Injustice Versus Catastrophizing as Mediators in the Relationship Between Pain Intensity and 3-Month Outcomes in Adolescents with Chronic Pain.

Pain appraisals are closely tied to pain and functional outcomes. Pain-related injustice and pain catastrophizing appraisals have both been identified as important cognitive-emotional factors in the pain experience of youth. Although pain-related injustice and catastrophizing have been linked to worse pain outcomes - as primary predictors and intermediary variables - little is known about whether they operate as independent or parallel mediators of the relationship between pain and functioning in youth. We tested pain-related injustice and catastrophizing appraisals as candidate mediators of the relationship between baseline pain intensity and 3-month functional outcomes in adolescents. Youth with chronic pain (N = 89, 76% female, 89% White, average age = 15 years) completed measures assessing pain intensity, pain-related injustice, and catastrophizing at baseline, as well as measures assessing functional disability and overall quality of life 3 months later. Multiple mediation analyses indicated that injustice mediated the relationship between pain intensity and 3 month quality of life. Exploratory analyses of specific quality of life domains indicated that injustice mediated the relationship between pain intensity and 3 month emotional functioning, whereas catastrophizing mediated the relationship between pain intensity and 3 month social functioning. The findings suggest these pain-related appraisals play different intermediary roles in the relationships among pain and future psychosocial outcomes. PERSPECTIVE: Pain-related injustice and catastrophizing appraisals play different intermediary roles in the relationships among pain and future psychosocial outcomes in youth with chronic pain. Treatments targeting pain-related injustice appraisals in pediatric populations are needed to complement existing treatments for catastrophizing.

Onset of substance use: Deviant peer, sex, and sympathetic nervous system predictors.

We evaluated whether the association between deviant peer affiliation and onset of substance use is conditional upon sex and sympathetic nervous system (SNS) reactivity as measured by pre-ejection period (PEP). Community-sampled adolescents (N = 251; M = 15.78 years; 53% female; 66% White, 34% Black) participated in three waves. PEP reactivity was collected during a mirror star-tracer stress task. Alcohol, marijuana, tobacco, or any substance use, as well as binge drinking and sexual activity involving substance use were outcomes predicted by affiliation with deviant peers and two- and three-way interactions with sex and PEP reactivity. Probability of substance use increased over time, but this was amplified for adolescents with greater deviant peer affiliation in conjunction with blunted PEP reactivity. The same pattern of results was also found for prediction of binge drinking and sexual activity involving substance use. Findings are discussed in the context of biosocial models of adolescent substance use and health risk behaviors.

Anger as a Mechanism of Injustice Appraisals in Pediatric Chronic Pain.

Mechanisms explaining the relationship between pain-related injustice appraisals and functional outcomes in youth with chronic pain have yet to be examined. In studies of adults, greater pain-related injustice is associated with worse depressive symptoms and greater pain through greater anger. No study to date has examined anger expression as a mediator in the relationships between pain-related injustice appraisals and physical and psychosocial functioning in youth with chronic pain. The current sample consisted of 385 youth with varied pain conditions (75% female, 88% White, Mage=14.4 years) presenting to a university-affiliated pain clinic. Patients completed self-report measures assessing anger expression (anger-out and anger-in), pain-related injustice, pain intensity, functional disability, and emotional, social, and school functioning. Bootstrapped mediation analyses indicated that only anger-out (indirect effect= -.12, 95% CI: -.21, -.05) mediated the relationship between pain-related injustice and emotional functioning, whereas both anger-out (indirect effect= -.17, 95% CI: -.27, -.09) and anger-in (indirect effect= -.13, 95% CI: -.09, -.001) mediated the relationship between pain-related injustice and social functioning. Neither mode of anger expression mediated the relationship between pain-related injustice and pain intensity, functional disability, or school functioning. Collectively, these findings implicate anger as one mechanism by which pain-related injustice impacts psychosocial outcomes for youth with chronic pain. PERSPECTIVE: Anger expression plays a mediating role in the relationship between pain-related injustice appraisals and psychosocial outcomes for youth with chronic pain. Anger represents one target for clinical care to decrease the deleterious impact of pain-related injustice on emotional and social functioning.

Risk Behaviors in Youth With and Without Tourette Syndrome.

BACKGROUND: Specific health-risk behaviors are present in older adolescents and young adults wtih Tourette syndrome (TS), but little is known about health-risk behaviors in youth with TS. METHODS: We compared responses on the Youth Risk Behavior Surveillance System (YRBS) in youth with TS with those in a concurrent community control group. The YRBS evaluates risk behaviors most closely associated with morbidity and mortality in young people. Tic severity, presence of comorbid attention-deficit/hyperactivity disorder (ADHD), measures of ADHD symptom severity, and whether or not the individual had been bullied in school were also compared between the groups. RESULTS: Data from 52 youth with TS and 48 control youth were included. We did not detect any differences between control youth and youth with TS in the reporting of risky behaviors. Tic severity was not significantly associated with high-risk behavior. However, ADHD was significantly more common in youth with TS (P < 0.0002), and youth with TS who identified themselves as victims of bullying had significantly higher ADHD symptom severity scores (P = 0.04) compared with those who were not bullied. CONCLUSIONS: Risk behaviors are not reliably or clinically different in youth with TS compared with control youth. ADHD severity, but not tic severity, was associated with being bullied in youth with TS.

Genetically-predicted prefrontal DRD4 gene expression modulates differentiated brain responses to food cues in adolescent girls and boys.

The dopamine receptor 4 (DRD4) in the prefrontal cortex (PFC) acts to modulate behaviours including cognitive control and motivation, and has been implicated in behavioral inhibition and responsivity to food cues. Adolescence is a sensitive period for the development of habitual eating behaviors and obesity risk, with potential mediation by development of the PFC. We previously found that genetic variations influencing DRD4 function or expression were associated with measures of laboratory and real-world eating behavior in girls and boys. Here we investigated brain responses to high energy-density (ED) and low-ED food cues using an fMRI task conducted in the satiated state. We used the gene-based association method PrediXcan to estimate tissue-specific DRD4 gene expression in prefrontal brain areas from individual genotypes. Among girls, those with lower vs. higher predicted prefrontal DRD4 expression showed lesser activation to high-ED and low-ED vs. non-food cues in a distributed network of regions implicated in attention and sensorimotor processing including middle frontal gyrus, and lesser activation to low-ED vs non-food cues in key regions implicated in valuation including orbitofrontal cortex and ventromedial PFC. In contrast, males with lower vs. higher predicted prefrontal DRD4 expression showed minimal differences in food cue response, namely relatively greater activation to high-ED and low-ED vs. non-food cues in the inferior parietal lobule. Our data suggest sex-specific effects of prefrontal DRD4 on brain food responsiveness in adolescence, with modulation of distributed regions relevant to cognitive control and motivation observable in female adolescents.

Longitudinal associations between adolescents' sleep and adjustment: Respiratory sinus arrhythmia as a moderator.

Sleep and autonomic nervous system functioning are important bioregulatory systems. Poor sleep and low baseline respiratory sinus arrhythmia (RSA), a measure of parasympathetic nervous system activity, are associated with externalizing behaviors and depressive symptoms in youth. Rarely, however, have measures of these systems been examined conjointly. The present study examined baseline RSA (RSA-B) as a moderator of longitudinal relations between adolescent sleep and adjustment. Participants were 256 adolescents (52% girls, 66% White/European American, 34% Black/African American) from small towns and surrounding rural communities in the southeastern United States. Sleep (minutes, efficiency, variability in minutes and efficiency) was assessed at age 15 via actigraphs across seven nights. RSA-B was derived from electrocardiogram data collected at rest. Adolescents self-reported externalizing problems and depressive symptoms at ages 15 and 17. Controlling for age 15 adjustment, findings generally demonstrated that sleep predicted age 17 adjustment particularly at higher (rather than lower) levels of RSA-B, such that adolescents with good sleep (more minutes and lower variability) and high RSA-B were at lowest risk for maladjustment. The results highlight the value of examining multiple bioregulatory processes conjointly and suggest that promoting good sleep habits and regulation of physiological arousal should support adolescent adjustment.

Home-Based Monitoring of Eating in Adolescents: A Pilot Study.

OBJECTIVES: To investigate eating episodes in a group of adolescents in their home-setting using wearable electromyography (EMG) and camera, and to evaluate the agreement between the two devices. APPROACH: Fifteen adolescents (15.5 ± 1.3 years) had a smartphone-assisted wearable-EMG device attached to the jaw to assess chewing features over one evening. EMG outcomes included chewing pace, time, episode count, and mean power. An automated wearable-camera worn on the chest facing outwards recorded four images/minute. The agreement between the camera and the EMG device in detecting eating episodes was evaluated by calculating specificity, sensitivity, and accuracy. MAIN RESULTS: The features of eating episodes identified by EMG throughout the entire recording time were (mean (SD)); chewing pace 1.64 (0.20) Hz, time 10.5 (10.4) minutes, episodes count 56.8 (39.0), and power 32.1% (4.3). The EMG device identified 5.1 (1.8) eating episodes lasting 27:51 (16:14) minutes whereas the cameras indicated 2.4 (2.1) episodes totaling 14:49 (11:18) minutes, showing that the EMG-identified chewing episodes were not all detected by the camera. However, overall accuracy of eating episodes identified ranged from 0.8 to 0.92. SIGNIFICANCE: The combination of wearable EMG and camera is a promising tool to investigate eating behaviors in research and clinical-settings.

Health effects of COVID-19 for vulnerable adolescents in a randomized controlled trial.

Emerging evidence suggests the coronavirus disease 2019 (COVID-19) pandemic is adversely affecting adolescents' mental health and health behaviors, particularly among those with preexisting mental health conditions and from lower socioeconomic backgrounds. However, direct tests of changes in health outcomes among vulnerable adolescents from before to during COVID-19 are limited. In addition, little is known about how to buffer adolescents, particularly those who are most vulnerable, against stress-related decrements in health. This randomized controlled trial begins to fill these gaps in the literature by exploring changes in mental health, health behaviors, executive function, emotion regulation, and mindfulness among vulnerable adolescents involved in a mentoring program during the COVID-19 pandemic. It also examined to what extent there were protective benefits of incorporating mindfulness training within a mentoring program for buffering adolescents from negative pandemic health effects. Thirty-five adolescents (Mage = 12.9, 37% female) and 32 parents (Mage = 44.75, 80% female) completed questionnaires at baseline (February 2020) and follow-up (July 2020). There were few significant reductions in health; instead, on average, youth reported improvements in sleep, emotion regulation, executive function, and mindfulness over time. Adolescents randomized to mentoring + mindfulness displayed significantly less posttraumatic stress disorder (PTSD) symptomatology and emotional impulsivity at follow-up, compared to the mentoring-as-usual condition. These pilot findings suggest that mentoring with a mindfulness training component may offer an effective strategy for protecting adolescents from deteriorations in health outcomes during COVID-19. Further, there may be unique benefits of mindfulness training for vulnerable youth as a way to adapt to stressful events. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Determinantes de la salud en la adolescencia: capacidad cardiorrespiratoria y composición corporal / Determinants of health in adolescence: cardiorespiratory fitness and body composition

Introducción: la capacidad cardiorrespiratoria y la composición corporal son indicadores determinantes del estado de salud durante la adolescencia. El objetivo del estudio fue analizar la relación de ambos parámetros con indicadores de salud mental y psicosocial, hábitos de vida y variables sociodemográficas, estableciendo sus factores predictores. Método: se llevó a cabo un estudio transversal sobre una muestra representativa de 761 estudiantes de Educación Secundaria Obligatoria de todos los centros educativos de La Rioja. Para ello se valoraron el índice de masa corporal, el consumo máximo de oxígeno, la calidad de vida relacionada con la salud, la autoestima, las horas de sueño nocturno, la adherencia a la dieta mediterránea, el nivel de actividad física, el rendimiento académico y diferentes factores sociodemográficos. Resultados: los resultados determinaron que ser chico, tener una menor edad, dormir menos horas por la noche y presentar un rendimiento académico inferior son predictores de padecer obesidad, mientras que una menor edad y ser migrante lo fueron de poseer sobrepeso. Por su parte, un menor nivel de actividad física, un peor rendimiento académico, ser migrante y la no realización de actividades deportivas extraescolares fueron factores predictores de una capacidad cardiorrespiratoria en zona de riesgo. Además, el entorno para la realización de la actividad física y el nivel socioeconómico también demostraron asociaciones con dicha capacidad cardiorrespiratoria. Conclusiones: dada la influencia de la composición corporal y la capacidad cardiorrespiratoria sobre la salud física y psicosocial de los adolescentes, se precisan estrategias de promoción que tengan en consideración los predictores identificados, con especial atención al fomento de estilos de vida saludables. (AU)

Introduction: cardiorespiratory fitness and body composition are determining indicators of health status during adolescence. The objective of the study was to analyze the relationship of both parameters with indicators of mental and psychosocial health, lifestyle habits, and sociodemographic variables, establishing their predictive factors. Method: a cross-sectional study was conducted with a representative sample of 761 students (14.51 ± 1.63 years old) from 25 educational centers in a northern region of Spain. Body mass index, maximum oxygen uptake, health-related quality of life, self-esteem, hours of nightly sleep, adherence to the Mediterranean diet, physical activity engagement, academic performance, and different sociodemographic factors were analyzed for all participants. Results: the results determined that being a boy, being younger, sleeping fewer hours at night, and presenting a lower academic performance were predictors of suffering from obesity, while being younger and being a migrant were predictors of being overweight. On the other hand, lower physical activity engagement, poorer academic performance, being a migrant, and not practicing extracurricular sports activities were predictive factors of cardiorespiratory fitness in the risk zone. In addition, the environment for performing physical activity and socioeconomic level also showed associations with cardiorespiratory fitness. Conclusions: given the influence of body composition and cardiorespiratory fitness on the physical and psychosocial health of adolescents, promotion strategies are required that take into account the identified predictors, with special attention to promoting healthy lifestyles. (AU)

Research on influencing factors of adolescents' sports health behaviors in social ecology / Pesquisa sobre fatores que influenciam os comportamentos de saúde esportiva de adolescentes em ecologia social / Investigación sobre los factores que influyen en los comportamientos de salud deportiva de los adolescentes en la ecología social

ABSTRACT Introduction: Physical exercise has a positive effect on the health of individuals. Long-term sedentary behavior can induce coronary heart disease, hypertension, diabetes, and other chronic diseases. Lack of physical exercise has become the fourth leading cause of death worldwide. Therefore, youth sports are very important for physical health. Objective: To systematically reveal the influencing factors of adolescents' physical exercise and improve the effectiveness of interventions on adolescents' physical exercise behaviors, this article is based on social ecology theory to study the structural model of adolescents' physical exercise factors. Methods: The thesis considers factors affecting adolescent physical exercise as the research object and uses literature method, questionnaire survey, mathematical statistics, etc., to construct a structural model of factors affecting youth physical exercise, including four primary indicators and 19 secondary indicators. Results: Adolescent physical exercise is affected by the school, family, social and personal factors. Among them, family factors have the greatest impact on young people's physical exercise. Personal factors rank second, school factors, and social factors rank third. Among the family factors, the major influences on youth physical exercise are "parental support," "parents' cognition of physical exercise," and "parental exercise habits." Conclusions: The influencing factors of adolescent physical exercise involve four aspects: family, society, school, and self. Family factors have the greatest impact on adolescent physical exercise, and personal factors are the second, school factors, and social factors are the third. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: o exercício físico tem um efeito positivo na saúde das pessoas. O comportamento sedentário de longo prazo pode induzir doenças coronárias, hipertensão, diabetes e outras doenças crônicas. A falta de exercício físico tornou-se a quarta causa de morte em todo o mundo. Portanto, os esportes juvenis são muito importantes para a saúde física. Objetivo: Desvendar sistematicamente os fatores que influenciam o exercício físico de adolescentes e melhorar a eficácia das intervenções sobre os comportamentos de exercício físico de adolescentes, este artigo se baseia na teoria da ecologia social para estudar o modelo estrutural dos fatores do exercício físico de adolescentes. Métodos: a tese considera os fatores que afetam o exercício físico do adolescente como objeto de pesquisa e usa o método da literatura, questionário, estatística matemática, etc., para construir um modelo estrutural de fatores que afetam o exercício físico do jovem, incluindo quatro indicadores primários e 19 indicadores secundários. Resultados: O exercício físico dos adolescentes é afetado por fatores escolares, familiares, sociais e pessoais. Dentre eles, os fatores familiares são os de maior impacto sobre a prática de exercícios físicos dos jovens. Fatores pessoais estão em segundo lugar, fatores escolares e fatores sociais vêm em terceiro. Entre os fatores familiares, as principais influências sobre a prática de exercícios físicos dos jovens são "apoio dos pais", "conhecimento dos pais sobre a prática de exercícios físicos" e "hábitos de exercício dos pais". Conclusões: Os fatores que influenciam a prática de exercícios físicos no adolescente envolvem quatro aspectos: família, sociedade, escola e eu. Os fatores familiares têm maior impacto sobre o exercício físico dos adolescentes, e os pessoais em segundo lugar, os escolares e os sociais em terceiro. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.

RESUMEN Introducción: el ejercicio físico tiene un efecto positivo en la salud de las personas. El comportamiento sedentario a largo plazo puede inducir enfermedades coronarias, hipertensión, diabetes y otras enfermedades crónicas. La falta de ejercicio físico se ha convertido en la cuarta causa de muerte en todo el mundo. Por tanto, los deportes juveniles son muy importantes para la salud física. Objetivo: Revelar sistemáticamente los factores que influyen en el ejercicio físico de los adolescentes y mejorar la efectividad de las intervenciones sobre las conductas de ejercicio físico de los adolescentes, este artículo se basa en la teoría de la ecología social para estudiar el modelo estructural de los factores de ejercicio físico de los adolescentes. Métodos: La tesis considera factores que afectan el ejercicio físico adolescente como objeto de investigación y utiliza el método de la literatura, cuestionario, estadística matemática, etc., para construir un modelo estructural de factores que afectan el ejercicio físico juvenil, incluyendo cuatro indicadores primarios y 19 indicadores secundarios. Resultados: El ejercicio físico de los adolescentes se ve afectado por factores escolares, familiares, sociales y personales. Entre ellos, los factores familiares tienen el mayor impacto en el ejercicio físico de los jóvenes. Los factores personales ocupan el segundo lugar, los factores escolares y los factores sociales ocupan el tercer lugar. Entre los factores familiares, las principales influencias sobre el ejercicio físico de los jóvenes son el "apoyo de los padres", el "conocimiento de los padres sobre el ejercicio físico" y los "hábitos de ejercicio de los padres". Conclusiones: Los factores que influyen en el ejercicio físico adolescente involucran cuatro aspectos: familia, sociedad, escuela y yo. Los factores familiares tienen el mayor impacto en el ejercicio físico de los adolescentes, y los factores personales son el segundo, los factores escolares y los factores sociales el tercero. Nivel de evidencia II; Estudios terapéuticos- investigación de los resultados del tratamiento.

Change and development law of adolescents' physical health exercise behavior / Lei de mudança e desenvolvimento do comportamento de exercício de saúde física de adolescentes com base nos antecedentes da ecologia social / Investigación sobre la ley de cambio y desarrollo de la conducta de ejercicio de salud física de los adolescentes basada en los antecedentes de la ecología social

ABSTRACT Background: The generation of individual behavior is closely related to the environment in which it is located and is easily affected by environmental factors. Objective: The thesis takes the social ecology model theory as the starting point, applies the five different levels of influencing factors in the theoretical model to the field of youth physical exercise behavior, and seeks the interrelationship between the various influencing factors. Methods: Using questionnaire surveys, interviews, and other research methods, the paper makes a simple theoretical combing and analysis of the healthy behavior ecology model, seeks the interrelationship between the influencing factors, propose complementary intervention strategies, and promote the development of adolescents' physical exercise habits through effective ways. Results: The motivation of sports participation, the protection of physical health, family health awareness, economic and educational environment, professional quality of physical education teachers and school exercise environment and community facilities affect the direction of the development of adolescents' physical exercise behavior. Conclusions: Only by comprehensively considering the relationship between various related factors can we better understand adolescent physical exercise development characteristics, propose complementary intervention strategies, and promote physical exercise habits effectively. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Antecedentes: A geração do comportamento individual está intimamente relacionada ao ambiente em que está inserida e é facilmente afetada por fatores ambientais. Objetivo: A tese toma como ponto de partida a teoria do modelo da ecologia social, aplica os cinco diferentes níveis de fatores influenciadores do modelo teórico ao campo do comportamento de exercício físico juvenil e busca a inter-relação entre os vários fatores influenciadores. Métodos: Utilizando questionários, entrevistas e outros métodos de pesquisa, o artigo faz uma análise teórica simples do modelo de ecologia do comportamento saudável, busca a inter-relação entre os fatores que influenciam, propõe estratégias de intervenção complementares e promove o desenvolvimento físico dos adolescentes. hábitos de exercício através de formas eficazes. Resultados: A motivação para a prática de esportes, a proteção da saúde física, a conscientização sobre a saúde da família, o ambiente econômico e educacional, a qualidade profissional dos professores de educação física e o ambiente de exercício escolar e as instalações comunitárias afetam a direção do desenvolvimento do comportamento de exercício físico dos adolescentes. Conclusões: Somente considerando de forma abrangente a relação entre vários fatores relacionados podemos entender melhor as características do desenvolvimento de exercícios físicos em adolescentes, propor estratégias de intervenção complementar e promover hábitos de exercícios físicos de forma eficaz. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Antecedentes: La generación del comportamiento individual está íntimamente relacionada con el entorno en el que se ubica y es fácilmente afectado por factores ambientales. Objetivo: La tesis toma como punto de partida la teoría del modelo de ecología social, aplica los cinco niveles diferentes de factores de influencia en el modelo teórico al campo de la conducta de ejercicio físico juvenil y busca la interrelación entre los diversos factores de influencia. Métodos: Mediante cuestionarios, entrevistas y otros métodos de investigación, el trabajo realiza un simple peinado y análisis teórico del modelo de ecología del comportamiento saludable, busca la interrelación entre los factores influyentes, propone estrategias de intervención complementarias y promueve el desarrollo de la física de los adolescentes. Hábitos de ejercicio de forma eficaz. Resultados: La motivación de la participación deportiva, la protección de la salud física, la conciencia de la salud familiar, el entorno económico y educativo, la calidad profesional de los profesores de educación física y el entorno de ejercicio escolar y las instalaciones comunitarias afectan la dirección del desarrollo de la conducta de ejercicio físico de los adolescentes. Conclusiones: Solo considerando de manera integral la relación entre varios factores relacionados podemos comprender mejor las características del desarrollo del ejercicio físico en los adolescentes, proponer estrategias de intervención complementarias y promover los hábitos de ejercicio físico de manera efectiva. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Alexithymia Is Associated With Internalizing Disorders in a Clinical Adolescent Outpatient Sample.

ABSTRACT: The aim of this study was to investigate alexithymic traits in an adolescent clinical sample with internalizing and externalizing disorders. The study group consisted of 125 adolescents aged between 12 and 17 years who applied at our outpatient unit and diagnosed with an internalizing or externalizing disorder. The healthy control group consisted of 53 adolescents with no psychiatric disorder. All subjects fulfilled the Alexithymia Questionnaire for Children (AQC). Total AQC scores were higher in the study group than in the control group. When we divided the study group into two groups as internalizing and externalizing disorders, total AQC scores, AQC-difficulty identifying feelings, and AQC-difficulty describing feelings were significantly higher in the internalizing disorder group than in the externalizing disorder group. AQC-externally oriented thinking scores were significantly higher in the externalizing disorder group than in the internalizing disorder group. In future research, it would be useful to further increase understanding of alexithymia and its association with psychiatric disorders in adolescence.