Reliability and Concurrent Validity of the GAIN Short Screener Among Youth Utilizing Integrated Health Services.

OBJECTIVES: There is increasing interest in the identification of mental disorders among youth through routine screening in integrated health services. One tool currently being used in Canada is the Global Appraisal of Individual Needs Short Screener (GAIN-SS). The aims of this study were to (1) estimate the internal consistency of the GAIN-SS and its internalizing disorder screener (IDScr) (2) examine concurrent validity of the GAIN-SS and IDScr in an integrated youth health service centre, and (3) identify clinical cut-points for youth aged 17-24 years. METHOD: Participants [n=201, gender=44% women, median age 21 (min,max: 17,24) years] were recruited from an integrated youth health service in Vancouver, British Columbia. Participants completed the GAIN-SS and three reference measures: Kessler Psychological Distress Scale (K10), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7). Cronbach's alpha, sensitivity, and specificity of the GAIN-SS and IDScr were examined using the K-10, PHQ-9 and GAD-7 as reference measures. Receiver operator characteristic curves were generated to identify optimal cut-points for the GAIN-SS and IDScr. RESULTS: A cut-point of seven for the GAIN-SS optimized sensitivity (90%) and specificity (42%) with Cronbach's alpha of 0.91. A similar pattern of results was found for the IDScr and the reference measures it was tested against. CONCLUSION: The results indicate that the GAIN-SS and IDScr have acceptable sensitivity but poor specificity that could be improved via the optimal cut-points identified in this study. This low specificity may be acceptable within an integrated youth health service that provides follow-up diagnostic assessments by a clinician.

OBJECTIFS: Il y a un intérêt croissant pour l'identification des troubles mentaux chez les jeunes au moyen d'un dépistage routinier dans les services de santé intégrés. Un outil présentement en usage au Canada est l'Évaluation globale des besoins individuels - Filtrage court (GAIN-SS). La présente étude avait pour buts (1) d'estimer la cohérence interne du GAIN-SS et son dépistage de trouble internalisant (IDScr) (2) d'examiner la validité concourante du GAIN-SS et du IDScr) dans un centre de service de santé intégré pour les jeunes et (3) d'identifier les seuils d'inclusion cliniques pour les jeunes de 17 à 24 ans. MÉTHODE: Les participants [n = 201, sexe = 44 % de femmes, âge moyen 21 (min, max, : 17 à 24) ans] ont été recrutés dans un centre de service de santé intégré pour les jeunes de Vancouver, Colombie-Britannique. Les participants ont répondu au GAIN-SS et à trois mesures de référence : l'échelle de détresse psychologique de Kessler (K10), le questionnaire sur la santé du patient (PHQ-9), et l'échelle du trouble d'anxiété généralisée (GAD-7). L'alpha de Cronbach, la sensibilité, et la spécificité du GAIN-SS et d'IDScr ont été examinés à l'aide de K-10, PHQ-9 et GAD-7 comme mesures de référence. Des courbes caractéristiques de fonctionnement du récepteur ont été générées pour identifier les seuils d'inclusion optimaux pour les GAIN-SS et IDScr. RÉSULTATS: Un seuil de sept pour le GAIN-SS optimisait la sensibilité (90 %) et la spécificité (42 %) avec un alpha de Cronbach de 0,91. Un modèle de résultats semblable a été constaté pour l'IDScr et les mesures de référence contre lesquelles il a été testé. CONCLUSION: Les résultats indiquent que le GAIN-SS et l'IDScr ont une sensibilité acceptable mais une spécificité médiocre qui pourrait être améliorée par les seuils d'inclusion optimaux identifiés dans cette étude. Cette faible spécificité peut être acceptable dans un service de santé intégré pour les jeunes qui offre des évaluations diagnostiques de suivi par un clinicien.

Chronic sleep disturbance, not chronic sleep deprivation, is associated with self-rated health in adolescents.

Improving our understanding of the cumulative effects of persistent sleep problems on adolescent health has been identified as an important area of research. This prospective study aimed to ascertain prospectively gender-specific associations between quantity and quality of sleep and self-reported health. Data from a cohort of 3104 adolescents (13-18 y) with repeated measures of sleep deprivation and sleep disturbance (2011 fall, 2012 spring, 2012 fall), and self-reported health (SRH) (2011 fall, 2012 fall) were analysed with multivariable logistic regression models adjusted for confounders. The results of the regression models indicated that cumulative exposure to sleep disturbance was monotonically associated with SRH in both genders, however cumulative sleep deprivation was not associated with self-reported health among young people. Young women reporting chronic exposure to sleep disturbance had over twice the odds of reporting sub-optimal health at follow-up (OR 2.18 [CI95: 1.13, 4.22]), compared to those with no history. Similar results were found in chronically sleep disturbed young men (OR 2.41 [1.05, 5.51]). These findings suggest that chronic exposure to impaired quality of sleep, such as difficulty falling or staying asleep, is related to adolescent self-reported health and thus may be an important determinant of young people's wellbeing.

Gender, stressful life events and interactions with sleep: a systematic review of determinants of adiposity in young people.

OBJECTIVES: Overweight and obesity among young people are high and rising. Social stressors and sleep are independently associated with obesity, but are rarely studied together or examined for gender-specific effects. The literature regarding adolescent populations is especially lacking. This review assesses whether experiencing stressful life events results in greater adiposity in young women and young men compared with those who do not experience stressful life events, and whether the relationship is modified by sleep problems. DESIGN: We systematically searched six bibliometric databases (Web of Science, Embase Ovid, PsycINFO, CINHAL, PubMed, ProQuest Dissertations) supplemented by hand searches. Longitudinal prospective studies or reviews were eligible for inclusion when they examined gender-specific changes in adiposity in young adults (age 13-18 years) as a function of stressful life event alone or in combination with sleep problems. RESULTS: We found one study eligible for inclusion reporting mixed impact of stressful life events on body mass index (BMI) between genders. The study assessed specific life events and showed significantly lower BMI at follow-up among young men who experienced a residence change, but significantly higher BMI among young women who experienced setting up a family and who reported internal locus of control. CONCLUSIONS: Despite ample research on social stressors or sleep problems and weight, we still know little about the role of stressful life events, or combined effects with sleep, on obesity risk in adolescents from a gender perspective. Existing evidence suggests specific life events affect weight differently between the genders. Robust, high-quality longitudinal studies to decipher this dual burden on obesity during adolescence should be prioritised, as firm conclusions remain elusive.

Chronic sleep deprivation and gender-specific risk of depression in adolescents: a prospective population-based study.

BACKGROUND: Chronic exposure to sleep deprivation may increase the risk of depression in young people who are particularly vulnerable to changes in sleep and mental health. Sleep deprivation and incident depression may also differ by gender. We investigated the prospective association between cumulative sleep deprivation and subsequent levels of depressive symptomatology among adolescents from a gender perspective. METHODS: A longitudinal study of 3071 young people in the British Columbia Adolescent Substance Use Survey (BASUS) cohort with three sleep time and two depression measures over 12 months (2011-12). Multivariable linear regression models with interaction terms estimated gender-specific associations between self-reported chronic sleep deprivation and changes in depressive symptomatology; post-estimation analysis calculated adjusted mean depression scores for each level of cumulative sleep deprivation. RESULTS: Cumulative sleep deprivation was associated with a monotonic increase in depression scores at follow-up in young women, but no consistent pattern was seen in young men. During follow-up, 15% of young women were chronically sleep deprived and 29% were depressed (CESD ≥24). Young women reporting chronic exposure to sleep deprivation had higher CESD scores at follow-up (21.50 points, [CI95 19.55-23.45]), than those reporting no history (16.59 [15.72-17.45]); that remained after multivariable adjustment (19.48 [17.59-21.38]). CONCLUSION: Results suggested that chronic sleep deprivation increases the risk of major depression among young women. Mental health promotion for young people should include relevant strategies to ensure young women can achieve recommended amounts of sleep.

Examining the relationship between personality and affect-related attributes and adolescents' intentions to try smoking using the Substance Use Risk Profile Scale.

Assessments of adolescents' smoking intentions indicate that many are susceptible to smoking initiation because they do not have resolute intentions to abstain from trying smoking in the future. Although researchers have developed personality and affect-related risk factor profiles to understand risk for the initiation of substance use and abuse (e.g., alcohol), few have examined the extent to which these risk factors are related to the tobacco use intentions of adolescents who have yet to try tobacco smoking. The objective of this study was to examine the relationships between personality and affect-related risk factors measured by the Substance Use Risk Profile Scale (SURPS) and smoking intentions in a sample of adolescents who have not experimented with tobacco smoking. Data is based on responses from 1352 participants in the British Columbia Adolescent Substance Use Survey (56% female, 76% in Grade 8) who had never tried smoking tobacco. Of these 1352 participants, 29% (n=338) were classified as not having resolute intentions to not try smoking. Generalized estimating equations were used to examine the relationship between each SURPS dimension (Anxiety Sensitivity, Hopelessness, Impulsivity and Sensation Seeking) and the intention to try cigarettes in the future. Hopelessness (AOR 1.06, 95% CI [1.03, 1.10], p<.001), Impulsivity (AOR 1.07 [1.03, 1.11], p<.001) and Sensation Seeking (AOR 1.05 95% CI [1.02, 1.09], p<.01) had independent statistically significant associations with having an intention to try smoking. These findings may be used to inform a prevention-oriented framework to reduce susceptibility to tobacco smoking.

Gender-based measurement invariance of the substance use risk profile scale.

Gender may influence the psychometric properties of psychological and affect-related measures. The American Psychological Association has made recommendations to conduct tests of group-level measurement invariance (MI) before comparing scores between groups. Gender-based measurement invariance has been examined in many well-known psycho-social scales such as the CES-D and the Big Five Inventory. The Substance Use Risk Profile is a 23-item scale measuring affective- and personality-related traits known to increase risk for substance use, with 4 dimensions: anxiety sensitivity, hopelessness, sensation seeking and impulsivity. Despite similarities in the constructs assessed by the SURPS, the CES-D and the Big Five Inventory, gender-based measurement invariance of the SURPS has not yet been published. Multi-group confirmatory factor analysis was used to assess the measurement invariance of the four dimensions of the SURPS across gender. MI was conducted with M-Plus 6.2 using a 2-step analysis for ordinal variables suggested by Muthén and Muthén, and model fit was assessed using the comparative fit index (CFI) criteria recommended by Cheung and Rensvold. A single group confirmatory factor analysis (CFA) was also conducted. The sample was composed of 1352 adolescents (56% female, mean age of 14years) participating in the BC Adolescent Substance Use Survey, an online survey capturing substance use and psychosocial trends in secondary students across British Columbia, Canada. Measurement invariance across gender was demonstrated for the SURPS (ΔCFI=0.003), and the single group CFA supported a four-dimensional structure for the SURPS items (CFI=0.92, RMSEA=061, 95% CI=0.058-0.065).

Arabidopsis mutants lacking long chain base phosphate lyase are fumonisin-sensitive and accumulate trihydroxy-18:1 long chain base phosphate.

The sphingoid long chain bases (LCBs) and their phosphorylated derivatives (LCB-Ps) are important signaling molecules in eukaryotic organisms. The cellular levels of LCB-Ps are tightly controlled by the coordinated action of the LCB kinase activity responsible for their synthesis and the LCB-P phosphatase and lyase activities responsible for their catabolism. Although recent studies have implicated LCB-Ps as regulatory molecules in plants, in comparison with yeast and mammals, much less is known about their metabolism and function in plants. To investigate the functions of LCB-Ps in plants, we have undertaken the identification and characterization of Arabidopsis genes that encode the enzymes of LCB-P metabolism. In this study the Arabidopsis At1g27980 gene was shown to encode the only detectable LCB-P lyase activity in Arabidopsis. The LCB-P lyase activity was characterized, and mutant plant lines lacking the lyase were generated and analyzed. Whereas in other organisms loss of LCB-P lyase activity is associated with accumulation of high levels of LCB/LCB-Ps and developmental abnormalities, the sphingolipid profiles of the mutant plants were remarkably similar to those of wild-type plants, and no developmental abnormalities were observed. Thus, these studies indicate that the lyase plays a minor role in maintenance of sphingolipid metabolism during normal plant development and growth. However, a clear role for the lyase was revealed upon perturbation of sphingolipid synthesis by treatment with the inhibitor of ceramide synthase, fumonisin B(1).