Association between adolescent rough-and-tumble play and conduct problems, substance use, and risk-taking behaviors: Findings from a school-based sample.

Rough-and-tumble play (RTP), also known as play fighting, is a common form of play frequently reported and studied by researchers. However, one important limitation of past research in the area of RTP has been the neglect of the adolescence period. Consequently, little is known about the function of adolescent RTP as well as about clinical characteristics of youth who engage in this activity after childhood. In a school-based sample of 1,771 middle school students (ages 9-16 years), the current study sought to address this gap by examining, via bivariate and multivariate logistic regression analyses, the potential cross-sectional associations of adolescent RTP with (a) selected demographic variables, (b) conduct problem symptoms, (c) substance use, and (d) risk-taking behaviors, including adjustment for several demographic confounders. Results indicated that adolescents reporting higher rates of conduct problem symptoms were more likely to report a recent participation in RTP. In addition, substance use (experimentation and current consumption of tobacco, alcohol, and marijuana) and risk behaviors assessed all were strongly associated with an increased likelihood of reporting an engagement in RTP. This finding suggests that participation in this activity probably implicates particular phenotypic characteristics including the propensity to engage in health-damaging behaviors. But the most profound issue raised by this research concerns the strong relationship between RTP and great levels of conduct disorder symptoms, suggesting a possible significant change in the functional significance of RTP in the adolescence period.

Adolescent Mental Health and the Choking Game.

OBJECTIVES: To examine the demographic and health risk factors associated with participation in the choking game (CG), a dangerous and potentially fatal strangulation activity in which pressure is applied to the carotid artery to temporarily limit blood flow and oxygen. METHODS: We obtained data from 2 cross-sectional studies realized respectively in 2009 and 2013 among French middle school students. The 2009 (n = 746) and 2013 (n = 1025) data sets were merged (N = 1771), and multivariate modeling was conducted to examine demographic and clinical characteristics of youth reporting a lifetime participation in the CG. The 2 studies included questions about risk-taking behaviors and substance use, and standardized assessments were used to collect conduct disorder symptoms and depressive symptoms. RESULTS: In the merged 2009 and 2013 data set, the lifetime prevalence of CG participation was 9.7%, with no statistically significant differences between boys and girls. A multivariate logistic regression revealed that higher levels of conduct disorder symptoms (odds ratio: 2.33; P < .001) and greater rates of depressive symptoms (odds ratio: 2.18; P < .001) were both significantly associated with an increased likelihood of reporting CG participation. CONCLUSIONS: The significant relationship between elevated levels of depressive symptoms and participation in the CG sheds new light on the function of self-asphyxial activities. However, with the finding that higher rates of conduct disorder symptoms were the most important predictor of CG participation, it is suggested that the profile and the underlying motivations of youth who engage in this activity should be reexamined.

ADHD Symptomatology and Perceived Stress Among French College Students.

Objective: The objective of this study was to examine the independent association between inattention and hyperactivity/impulsivity symptoms and perceived stress among French college students. Method: Participants (N = 6,951) completed self-report surveys assessing ADHD symptoms, perceived stress, and sociodemographic characteristics. Multinomial logistic regression models were used to evaluate the association between ADHD symptoms and perceived stress. Results: Participants had a mean age of 20.8 years, and 75.6% were female. We found significant associations between increasing levels of inattention and hyperactivity/impulsivity symptoms and high level of perceived stress after adjustment for confounding variables. The association was stronger for inattention (odds ratio [OR] = 4.58, 95% confidence interval [CI] = [4.02, 5.22]) than for hyperactivity/impulsivity symptoms (OR = 1.21, 95% CI = [1.05 to 1.39]). Conclusion: Higher levels of inattention and hyperactivity/impulsivity were independently associated with perceived stress in French college students. This association was mainly driven by inattention. Screenings to better detect ADHD symptoms should be implemented in universities.

Childhood trajectories of peer victimization and prediction of mental health outcomes in midadolescence: a longitudinal population-based study.

BACKGROUND: Exposure to peer victimization is relatively common. However, little is known about its developmental course and its effect on impairment associated with mental illnesses. We aimed to identify groups of children following differential trajectories of peer victimization from ages 6 to 13 years and to examine predictive associations of these trajectories with mental health in adolescence. METHODS: Participants were members of the Quebec Longitudinal Study of Child Development, a prospective cohort of 2120 children born in 1997/98 who were followed until age 15 years. We included 1363 participants with self-reported victimization from ages 6 to 13 years and data available on their mental health status at 15 years. RESULTS: We identified 3 trajectories of peer victimization. The 2 prevailing groups were participants with little or moderate exposure to victimization (441/1685 [26.2%] and 1000/1685 [59.3%], respectively); the third group (244 [14.5%]) had been chronically exposed to the most severe and long-lasting levels of victimization. The most severely victimized individuals had greater odds of reporting debilitating depressive or dysthymic symptoms (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.27-5.17), debilitating generalized anxiety problems (OR 3.27, CI 1.64-6.51) and suicidality (OR 3.46, CI 1.53-7.81) at 15 years than those exposed to the lowest levels of victimization, after adjustment for sex, childhood mental health, family hardship and victimization perpetration. The association with suicidality remained significant after controlling for concurrent symptoms of depression or dysthymia and generalized anxiety problems. INTERPRETATION: Adolescents who were most severely victimized by peers had an increased risk of experiencing severe symptoms consistent with mental health problems. Given that peer victimization trajectories are established early on, interventions to reduce the risk of being victimized should start before enrolment in the formal school system.

Is emotional lability a marker for attention deficit hyperactivity disorder, anxiety and aggression symptoms in preschoolers?

BACKGROUND: Emotional lability (EL) is frequent in school-aged children with attention deficit hyperactivity disorder (ADHD) and is associated with more frequent comorbidities and more severe impairment. However, little research has investigated the association between EL, ADHD and comorbid symptoms in preschoolers. This study assessed dimensional EL in preschoolers and its link with ADHD symptoms (e.g. hyperactivity-impulsivity and inattention) and behavioural and emotional problems (e.g. aggression and anxiety). METHOD: One hundred and fifty-four preschoolers aged 3-6 years old were rated on questionnaires by parents. EL was assessed with the index from the Conners Rating Scale-Revised and behavioural and emotional problems with an adapted version of the Social Behavior Questionnaire. Multiple linear regressions analyses were conducted. RESULTS: Higher EL was associated with higher hyperactivity-impulsivity, inattention, anxiety and aggression problems. After controlling for other behavioural and emotional problems and sociodemographic variables, EL remained associated with hyperactivity-impulsivity and anxiety. CONCLUSIONS: Emotional lability seems to be a potential marker for ADHD symptoms with internalizing problems in preschoolers and could be a target for diagnosis and early interventions. This finding should be treated with caution as the study was limited by the low response rate of the participants and consequently the small sample size.

Poverty and behavior problems trajectories from 1.5 to 8 years of age: Is the gap widening between poor and non-poor children?

PURPOSE: Poverty has been associated with high levels of behavior problems across childhood, yet patterns of associations over time remain understudied. This study aims: (a) to examine whether poverty predicts changes in behavior problems between 1.5 and 8 years of age; (b) to estimate potential selection bias for the observed associations. METHODS: We used the 1998-2006 waves of the Quebec Longitudinal Study of Child Development (N = 2120). Main outcomes were maternal ratings of hyperactivity, opposition and physical aggression from 1.5 to 8 years of age. Linear mixed-effects models were used to assess the longitudinal association between poverty and behavior problems. Models were re-estimated adjusting for wave nonresponse and using multiple imputation to account for attrition. RESULTS: Poverty predicted higher levels of behavior problems between 1.5 and 8 years of age. Poverty predicted hyperactivity and opposition in a time dependent manner. Hyperactivity [Bpoverty*age = 0.052; CI 95 % (0.002; 0.101)] and opposition [Bpoverty*age = 0.049; CI 95 % (0.018; 0.079)] increased at a faster rate up to age 5 years, and then decreased at a slower rate for poor than non-poor children. Physical aggression decreased at a steady rate over time for all children [Bpoverty*age = -0.030; p = 0.064). Estimates remained similar when accounting for attrition. CONCLUSION: Poverty predicted higher levels of behavior problems between 1.5 and 8 years of age. The difference between poor and non-poor children was stable over time for physical aggression, but increased with age for hyperactivity and opposition. Attrition among poor children did not compromise the validity of results.

Childhood trajectories of inattention-hyperactivity and academic achievement at 12 years.

Few prospective studies spanning early childhood to early adolescence have examined separately the contribution of inattention and hyperactivity to academic achievement. The aim of the present study was to investigate whether the developmental trajectories of inattention and hyperactivity symptoms during early and middle childhood are independently associated with academic achievement at age 12 years. The independent associations between inattention and hyperactivity trajectories during early and middle childhood and academic performance at age 12 years were examined in a population-based longitudinal birth cohort (n = 2120). In adjusted analyses, high early childhood inattention trajectories were associated with teacher-rated academic performance in reading, writing and mathematics and with government exam score in writing. High and moderate inattention trajectories during middle childhood predicted lower performance on both teacher-rated academic performance and government exam scores in reading, writing, and mathematics. Hyperactivity was not a consistent predictor of educational outcomes. Childhood inattention symptoms rather than hyperactivity carry risk of poor educational outcomes at age 12 years. Children with high levels of inattention can be identified during the preschool years. Prevention programs supporting the development of attentional capacities and executive functions could help reduce the negative consequences of inattention.