A multidimensional appraisal of early menstrual pain experience.

BACKGROUND: Symptomatic dysmenorrhea is a global problem, affecting more than 40% of menstruating persons. Cross-sectional studies have implicated psychosocial, biological, and sensory factors in dysmenorrhea but the mechanisms are not fully understood. Only a few prospective longitudinal studies have evaluated such factors in relation to the emergence and course of dysmenorrhea at menarche. OBJECTIVE: This study aimed to describe the initial menstruation experience and to evaluate the association of premenarchal psychosocial and sensory factors with the intensity of dysmenorrhea during the period in the fourth month. STUDY DESIGN: This was a prospective cohort study of adolescents who completed premenarchal assessments and postmenarchal daily menstrual diaries for their first (n=149) and fourth month periods (n=114). They were recruited shortly before menarche and completed baseline assessments, including psychosocial questionnaires and experimental pain sensitivity (pressure testing, bladder provocation), and their parents completed related pain questionnaires. The relation between the hypothesized premenarchal factors and month 4 dysmenorrhea intensity was evaluated using Kruskal-Wallis and chi-square tests for low (<3 on a 0-10 scale) vs higher (≥3) menstrual pain groups based on maximal pain ratings recorded in a daily diary. RESULTS: Low levels of dysmenorrhea characterized the first (median, 1; interquartile range, 0-2) and fourth month periods (1; 0-3). Maximal pain ratings increased from the first to the fourth period (3; 1-5 vs 4; 1-6; P=.007). The distribution of dysmenorrhea was multimodal at month 4 with 31.6% of the participants having low levels of maximal pain (1; 0-1) and 68.4% having higher levels (5; 4-6; Hartigan's dip test P<.001). The baseline demographic, psychosocial, and parental pain characteristics were not associated with the development of worse dysmenorrhea. The baseline experimental pain sensitivity, based on pressure pain thresholds, did not differ between the low (15.7 N; 12.5-22.3) and higher (15.0 N; 10.9-21.4]) level dysmenorrhea groups. Baseline bladder pain at first urge also did not differ (low, 6; 0-20 vs higher, 7; 0-19). CONCLUSION: By their fourth month period, two-thirds of adolescents fell into the higher group for maximal dysmenorrhea, half reported some related impairments in physical activity, and one-seventh reported some related school absence. Premenarchal factors (experimental pain sensitivity, psychosocial profile, parental pain experience) linked to chronic pain emergence in the adult literature did not predict dysmenorrhea intensity, suggesting the dominant factor at menarche may be peripheral afferent activation. Further research is needed to understand the evolution of psychosocial and sensory mechanisms in the development and course of dysmenorrhea.

A developmental perspective on sleep consistency: Preschool age through emerging adulthood.

OBJECTIVE/BACKGROUND: Beyond sleep duration, the regularity of sleep patterns (e.g., sleep consistency), including variability in sleep timing (e.g., bedtime, wake time) and duration, is a critical marker of sleep health. Sleep consistency is captured using a variety of methods within the literature (e.g., sleep intraindividual variability, social jetlag), but most of the research focuses on adolescents. METHODS: Drawing on a developmental perspective, this narrative review highlights how normative changes at the individual (e.g., biological, cognitive, and social) and contextual (e.g., home, school, sociocultural) levels may contribute to inconsistent sleep patterns across development. RESULTS AND CONCLUSIONS: This review emphasizes how inconsistent sleep may increase across pivotal transitions throughout development (e.g., elimination of naps, puberty, summertime, entering college). Finally, recommendations for measuring sleep consistency and areas to address in future research are discussed.

Sleep, Affect, and Emotion Reactivity in First-Year College Students: A Daily Diary Study.

BACKGROUND: Sleep is an important factor in well-being, especially during the transition to college when academic and social commitments increase. Identifying factors that contribute to poor sleep (including short duration and increased variability in duration) can support development of interventions. Affect and emotion reactivity are factors that could contribute to sleep, and have not been studied in relation to sleep variables among first-year college students during their adjustment to the college environment. This adjustment might be difficult for some students, and therefore elicit affect fluctuations that contribute to poor sleep. Alternatively, sleep could contribute to daily affect. The present daily diary study examined bidirectional relations between daily sleep and affect, as well as between emotion reactivity and sleep (duration and variability) and affect (daily and overall variability) in first-year college students. METHOD: First-year college students (n = 244; 86.1% female) completed a baseline survey including measures of emotion reactivity and anxiety and depressive symptoms, followed by 7 days of a once-per-day diary, reporting on their affect and sleep duration. RESULTS: On days when individuals reported increased sleep duration, they also tended to experience greater positive affect the following day (p = .01). Those who experienced high levels of emotion reactivity also experienced more negative affect (p < .001) and negative affect variability (p < .001). CONCLUSION: Emotion reactivity might identify college students who experience more negative affect and are possibly at risk to develop mental health disorders. The importance of sleep health should continue to be emphasized to students as they transition to college.

Delicious and difficult to resist?: Inhibitory control differs in young women after exposure to food and non-food commercials.

Unhealthy food marketing, a ubiquitous food stimulus, may impact response inhibition, making it more difficult to maintain healthy eating behaviors. Individuals with disordered eating may be particularly susceptible to altered inhibition responses to food stimuli, making them more vulnerable to unhealthy food marketing, which could perpetuate their disordered eating behaviors. The present study examined response inhibition following exposure to food commercials in young women who reported either high levels of disordered eating (HEC) or low/no disordered eating (LEC) (N = 27; age: M = 19.28, SD = 1.01) by measuring event related potentials (ERPs) during a stop-signal task embedded with food stimuli. Results indicated that participants had significantly higher accuracy on stop trials displaying unhealthy food stimuli than trials displaying healthy food stimuli after viewing non-food commercials but displayed no difference after viewing food commercials. LEC individuals displayed a smaller N200/P300 amplitude in response to food stimuli on the stop-signal task after watching food commercials as compared to non-food commercials, but this difference did not exist for HEC individuals. Results indicate that unhealthy food commercials may impact behavioral and electrophysiological correlates of response inhibition evoked by food stimuli in young women, and individuals with disordered eating might actually be less responsive to food marketing than those without disordered eating.

Green schoolyard renovations in low-income urban neighborhoods: Benefits to students, schools, and the surrounding community.

Green schoolyards may buffer against the effects of urbanization through increasing access to nature and its benefits. The present study was a community-academic partnership that examined the effects of green schoolyard renovations on utilization, physical activity (PA), and social interactions as well as perceptions of safety, neighborhood climate, and social cohesion among those living in low-income, urban neighborhoods. Utilizing behavioral mapping techniques and multi-informant surveys (i.e., caregivers, teachers, and community members), changes from pre- to postrenovation were assessed at two low-income, urban schools. Behavioral mapping results demonstrated increases in utilization and prosocial interactions among youth from pre- to postrenovation. Levels of moderate-to-vigorous PA also increased from pre- to postrenovation at one school. Survey data from community stakeholders revealed improvements in the perception of schoolyard safety and school-community relationships as well as reductions in bullying postrenovation. Green schoolyards may offer a safe space for children and adults to engage in social, outdoor activities, particularly in low-income, urban neighborhoods.

Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis.

PURPOSE: The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity - such as physical activity - are more favorable on days that contain more 'structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. METHODS: Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. RESULTS/FINDINGS: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. CONCLUSIONS: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

Variability of Sleep and Relations to Body Weight Among First-Year College Students.

BACKGROUND: Existing research suggests that greater sleep variability may increase risk for weight gain. College often marks a transition to a less consistent daily schedule, which may adversely impact sleep routines and further increase risk for weight gain. The current study is among the first to explore relations between nighttime sleep variability and daytime sleep (napping) and body weight among first-year college students. METHODS: Using daily diary methods, first-year college students (N = 307; 84.7% female) self-reported their sleep for seven days. Several indices were created to capture sleep variability for reported bedtime, wake time, and sleep duration, including weekday versus weekend differences (WvW), day to day differences (D2D), and overall standard deviation (SD). Napping was also assessed. Based on body mass index (BMI), individuals were categorized as underweight, healthy weight, overweight, and obese. RESULTS: Across indices, students' sleep varied over an hour on average across the week. Hierarchical regressions revealed that greater differences in wake time D2D, wake time SD, and sleep duration WvW were all associated with higher BMI, after accounting for gender, depressive symptoms, and sleep duration. Longer napping was also associated with higher BMI, using the same covariates. Finally, greater sleep variability was reported by overweight and obese than healthy weight individuals. CONCLUSION: These findings suggest that sleep variability, particularly wake times and napping may be important modifiable sleep behaviors to investigate in future studies. More longitudinal research is needed to explore relations between multiple facets of sleep variability and weight gain, including possible mechanisms.

Executive function and dietary intake in youth: A systematic review of the literature.

Despite increasing evidence that childhood obesity may be related to impairments in executive function, the evidence supporting the relation between executive function (EF) and dietary intake, a key factor linked to obesity, is mixed. Although research from the obesity literature often interprets EF as a factor that may influence dietary intake, there is also evidence that dietary intake may influence EF. Drawing on a developmental perspective, this systematic review examines the literature on the link between executive function (i.e., inhibition, working memory, and cognitive flexibility) and dietary intake in youth through the inclusion of cross-sectional, longitudinal, and intervention studies aimed at altering either dietary intake or EF as a way to influence the other. In total, 5650 studies were screened for eligibility. Twenty-six studies met inclusion criteria and were included in the review. Results indicated that the relation between executive function and dietary intake is equivocal. Although there is some support for a cross-sectional relation between executive function and dietary intake, the lack of longitudinal studies makes it difficult to make conclusions about directionality. Findings from intervention studies do not support the effectiveness of short-term manipulations on dietary intake to change subsequent EF, and few intervention studies exist that explicitly aim to "train" EF to change subsequent dietary intake. Furthermore, the wide variety of measures used to assess EF and dietary intake, and the lack of consideration of the role that weight status may play in the relation between EF and dietary intake, make overall interpretation of the literature more difficult. In sum, there is a need for more prospective research examining a variety of ages, domains of EF, and weight statuses, taking into account developmental factors.

Chronic Stress and Food Insecurity: Examining Key Environmental Family Factors Related to Body Mass Index Among Low-Income Mexican-Origin Youth.

Low-income children of Mexican immigrants are at high risk for obesity. Drawing on a sample of 104 Mexican American children (Mage = 8.39 years; 61% female), this longitudinal study considered relations between food insecurity and chronic stress (ie, parent report and hair cortisol measurement) on body mass index (BMI) and examined whether stress moderated associations between food insecurity and BMI. Analyses revealed that undocumented status was associated with food insecurity and chronic stress but not when accounting for poverty. Food insecurity was only associated with higher BMI for children with the highest hair cortisol. Results suggest that chronic stress may impact body weight among food-insecure children.

Organized Activity Involvement among Urban Youth: Understanding Family- and Neighborhood- Level Characteristics as Predictors of Involvement.

Research examining factors that predict youth's involvement in organized activities is very limited, despite associations with positive outcomes. Using data from 1043 youth (49% female; 46.4% Hispanic, 35.4% African American, 14.0% Caucasian, and 4.2% other) from the Project on Human Development in Chicago Neighborhoods, this study examined how characteristics of parents (supervision, warmth) and neighborhoods (perceived neighborhood safety and collective efficacy) predict patterns of adolescents' involvement in organized activities concurrently (i.e., intensity) and longitudinally (i.e., type and breadth). Parental supervision predicted adolescents' participation in organized activities across multiple waves. Neighborhood violence was positively associated with concurrent participation in organized activities after controlling for socioeconomic status (SES), whereas higher neighborhood collective efficacy predicted greater breadth in organized activity participation across time. These findings have important implications regarding how to attract and sustain organized activity participation for low-income, urban youth.

Dimensions of organized activity involvement among Latino youth: Impact on well-being.

Well-being, including self- and academic perceptions, is a key element of Latino adolescents' experiences. One factor that may be related to well-being among Latino adolescents is organized activity (OA) involvement. Drawing on a risk and resilience framework and utilizing principles of positive youth development, the current study aimed to examine this relation using hierarchical linear modeling (HLM) with nested data from 660 Latino-identified youth in the National Education Longitudinal Study: 88 (NELS:88). Furthermore, home language, sex, and family SES were explored as possible moderators of relations between dimensions of OA and well-being. After accounting for prior levels of well-being, results suggest that OA participation, particularly OA intensity, is related to greater self-worth, locus of control, and educational expectations, and that the4se relations may be even stronger for youth from low-SES backgrounds. Implications for future research and policy are discussed.

Sleep is in for Summer: Patterns of Sleep and Physical Activity in Urban Minority Girls.

OBJECTIVE: Urban minority girls are at risk for summertime weight gain, and may also experience insufficient summertime sleep. Few studies have objectively measured sleep in this population or examined correlates, including physical activity (PA). This study is the first to objectively describe summertime sleep among urban minority girls. METHODS: Data were collected at a community-based summer program that promoted PA (n = 60 girls, ages 10-14 years), at two time points: before beginning programming (T1; unstructured context) and during the final week of programming (T2; structured context). RESULTS: At both time points, participants experienced shorter nighttime sleep than the recommended amount for girls their age. African American girls recorded significantly less sleep than Latina girls in the unstructured context. Findings also suggest that sleep schedules have an influential role in youths' abilities to obtain adequate sleep. CONCLUSION: Overall, summertime sleep is an understudied health behavior that may be important to consider among minority youth.

Understanding affluent adolescent adjustment: The interplay of parental perfectionism, perceived parental pressure, and organized activity involvement.

This cross-sectional study examined relations between affluent adolescent adjustment and culturally salient factors within parent-child relationship and extracurricular domain. Bootstrapping techniques evaluated mediated effects among parental perfectionism, perceived parental pressure, intensity of organized activity (OA) involvement, and adolescent adjustment (i.e., depressive and anxiety symptoms, life satisfaction) within a sample of 10th graders and their parents (n = 88 parent-child pairs) from four high schools in affluent communities. Findings indicated that adolescents with more perfectionistic parents perceived more parental pressure and experienced poorer adjustment. Results also demonstrated that affluent adolescents who perceived more parental pressure were more intensely involved in OAs, but that higher OA intensity was linked to better adjustment. Findings highlight the importance of considering parental perfectionism when understanding adolescent behaviors and psychological outcomes, confirm the negative direct effects of parental pressure on adjustment, and corroborate prior research dispelling that highly intense OA involvement is linked to adolescent maladjustment.

Moving beyond attendance: lessons learned from assessing engagement in afterschool contexts.

Youth engagement is the least researched, but potentially most important, aspect of participation in afterschool programs. The level of youth engagement can vary across programs, across youth within a program, and within individual youth over time. Engagement is important for both recruiting and retaining participants, and has been associated with more positive academic outcomes over time. This chapter integrates perspectives from practitioners, researchers, and the school engagement literature. Reasons why engagement is an important dimension of afterschool programming, different methods for assessing engagement, key features of engaging afterschool programs, and implications for practice are also outlined.

Active summers matter: evaluation of a community-based summertime program targeting obesogenic behaviors of low-income, ethnic minority girls.

Low-income minority females are disproportionately affected by obesity. The relevance of summer months to weight gain is often overlooked. Some evidence suggests that summer programming, such as day camps, may offer increased opportunities for structured physical activities resulting in less weight gain. This study examined the effectiveness of Girls in the Game, a six-hour four-week sports and fitness summer camp program, in increasing physical activity (PA) and reducing body mass index and media use. Statistically significant increases were observed in four physical activity measures including total PA, MVPA, average number of ten-minute bouts of MVPA, and minutes participants spent in bouts of at least ten minutes of MVPA. This chapter highlights the importance of investigating the potential relationships among weight, physical activity, sedentary time, media use, and participation in summer camp programming.

Brief report: adolescent adjustment in affluent communities: the role of motivational climate and goal orientation.

Researchers now recognize that affluent youth experience tremendous achievement pressures, yet contributing factors or outcomes are rarely explored. Using a sample of affluent adolescents, the present study investigates the mediating role of goal orientation (GO) on relations between school motivational climate (MC) and adolescent adjustment. Adolescents from four high schools completed measures of MC (i.e., Performance and Mastery), GO (i.e., Ego and Task), and adjustment (i.e., depressive symptoms, anxiety, and life satisfaction). Performance climates were associated with more adjustment problems while Mastery climates were associated with fewer adjustment problems. Adolescents with higher Ego orientation reported more depressive and anxiety symptoms, while adolescents with higher Task orientation indicated fewer depressive symptoms and greater life satisfaction. Adolescent Task orientation mediated the relations between Mastery climate and two adjustment outcomes (i.e., depressive symptoms and life satisfaction). Results suggest the importance of non-competitive achievement-oriented values and collaborative school contexts in adolescent adjustment.

Regrouping: organized activity involvement and social adjustment across the transition to high school.

Although organized activities (OAs) have been established as important contexts of development, limited work has examined the role of OAs across the high school transition in buffering adolescents' social adjustment by providing opportunities for visibility and peer affiliation. The transition to high school is characterized by numerous changes and OAs may provide an important setting for establishing and maintaining peer relationships during this tumultuous time. This study included 151 8th grade U.S. students (58% male) who were assessed across the transition to high school (spring of 8th and 9th grade). Continuous involvement in academic activities across the transition and becoming involved (i.e., initiation) in community/service activities following the transition was associated with fewer depressive symptoms in the spring of 9th grade. Continuous involvement in sports and initiation of academic activities was associated with having more friendships. In addition, links between OAs and loneliness were only evident among females. There appear to be significant social benefits for OA involvement.

Generalized sensory sensitivity is associated with comorbid pain symptoms: a replication study in women with dysmenorrhea.

ABSTRACT: Dysmenorrhea is characterized by high rates of transition to chronic pain. In a previous study using structural equation modeling, we demonstrated that several symptom domains associated with the emerging concept of nociplastic pain can be described using 2 symptom groups: generalized sensory sensitivity (GSS; composed of widespread pain, interceptive sensitivity, and environmental sensitivity) and SPACE (composed of unrefreshing sleep, pain, affective disturbances, cognitive issues, and reduced energy). Here, we perform a secondary cross-sectional analysis examining the same symptoms groups in a cohort of patients with dysmenorrhea without a diagnosis of chronic pain. Our purpose is to determine if the same symptom patterns are apparent and if they are associated with the presence and severity of comorbid pain. Participants were 201 women with dysmenorrhea. We replicated the hypothesized 2-factor structure in this cohort (comparative fit index = 0.971 and root mean square error of approximation =0.055; 90% CI: 0.000-0.097). Generalized sensory sensitivity was associated with the severity of bladder, bowel, and overall pain in multivariable models including SPACE, patient age, and BMI (all ß > 0.32, all P < 0.05). Sleep, pain, affective disturbances, cognitive issues, and reduced energy were associated with menstrual pain during nonsteroidal anti-inflammatory drug use, whereas GSS was associated with the same in the absence of nonsteroidal anti-inflammatory drug use (both P < 0.05). This 2-factor model of symptoms seems to be replicable and valid in a cohort of women at risk for developing chronic pain conditions. These symptom groups are promising potential markers of future pain chronification and may point to patients in need of earlier or more aggressive intervention.

Understanding threshold effects of organized activity involvement in adolescents: sex and family income as moderators.

The current study examined the curvilinear links between involvement in organized activities (OA) and sport activities specifically and various indicators of psychological and social development. Participants included 150 9th and 10th graders (57% females) from an urban, selective-enrollment high school. Eligibility for admission is based on city residence, high GPA, and high scores on standardized tests and an admission exam. Findings indicated that benefits of OA involvement leveled off at approximately 5-7 h/week, with diminishing returns for adolescents participating in more than 10 h/week. Results also suggest that OA involvement uniquely impacts male and lower-income participants. Males reported threshold effects in terms of perceived friendship competence and depressive symptoms. Male sport participants and lower-income adolescents reported a similar pattern for loneliness. Findings suggest that among a high achieving sample of urban adolescents, social and psychological benefits are linked to moderate but not intense involvement in OAs and sports.

Daily relations between nap occurrence, duration, and timing and nocturnal sleep patterns in college students.

OBJECTIVE/DESIGN: Sleep patterns change during college, and students may nap to compensate for lost sleep. Despite the increased prevalence of napping among students, few studies have investigated daily relations between napping and nocturnal sleep, as well as how timing of naps and nocturnal sleep might influence one another. The present study used daily diaries to capture the occurrence, timing, and duration of napping and relation to nocturnal sleep. SETTING/PARTICIPANTS: Daily diary data, collected for 4-7 days, from 654 college students from a mid-sized midwestern university (81.5% female). MEASUREMENT: Participants reported nightly sleep durations, bedtimes, and wake times as well as nap durations and nap start times. RESULTS: Multilevel modeling (MLM) and multi-level logistic regressions revealed bidirectional relations between nocturnal sleep and napping. Regarding nocturnal sleep and its relation to next day napping, nocturnal sleep (including shorter duration and later bedtime) was associated with increased odds of napping and longer napping the following day. Shorter sleep duration was also associated with taking an earlier nap, while later bedtime was associated with a later nap the following day. Regarding napping and its association with same-night nocturnal sleep, taking a nap was associated with longer sleep duration that night, however, later nap start times and longer nap durations were associated with later bedtimes that night. CONCLUSIONS: Findings provide evidence for bidirectional associations between napping and nocturnal sleep. Future studies are needed to explore how naps could be optimized to promote nocturnal sleep among college students, as well as for whom naps might be most beneficial.