Longitudinal associations between high school sleep characteristics and young adult health outcomes.

STUDY OBJECTIVES: Short sleep duration and evening chronotype are independently associated with negative health outcomes. However, it is unclear how adolescent sleep duration and chronotype are longitudinally associated with health outcomes during early adulthood. METHODS: Participants from the NEXT Generation Health Study (n = 2,783; 54.5% female) completed measures of sleep duration (scheduled day and unscheduled day) and chronotype in high school. Sleep duration, chronotype, general health, depressive symptoms, and psychosomatic symptoms were also assessed 4 years after high school. Latent variables estimated high school scheduled-day sleep duration, unscheduled-day sleep duration, and chronotype using the during high school measures. Two path analyses tested the prospective associations between high school sleep duration (separate models for scheduled and unscheduled days) and chronotype with 4 years after high school health outcomes as mediated by concurrent sleep duration and chronotype. RESULTS: In the scheduled-day model, longer high school sleep duration and later chronotype were associated with longer duration and later chronotype in early adulthood. Longer high school sleep duration was directly associated with fewer psychosomatic symptoms and indirectly associated with fewer depressive and psychosomatic symptoms through longer sleep duration in early adulthood. Later chronotype in high school was indirectly associated with poorer general health, greater depressive symptoms, and greater psychosomatic symptoms in early adulthood through later chronotype. CONCLUSIONS: Findings highlight the roles of scheduled-day sleep duration and evening chronotype in shaping health outcomes and suggest the importance of chronotype and optimal sleep habits among adolescents. CITATION: Maultsby KD, Temmen CD, Lewin D, et al. Longitudinal associations between high school sleep characteristics and young adult health outcomes. J Clin Sleep Med. 2022;18(11):2527-2536.

Three Dimensions of Sleep, Somatic Symptoms, and Marijuana Use in U.S. High School Students.

PURPOSE: This study aimed to investigate potential bidirectional relations between key sleep characteristics and somatic symptoms with past 30-day marijuana use in high school students. METHODS: Participants from the NEXT Generation Health Study (n = 2,770) reported on 10th and 11th grade (W1 and W2) sleep characteristics and somatic symptoms and 12th grade (W3) past 30-day marijuana. Multivariate logistic regressions and path analyses were conducted. RESULTS: Sleep duration was not associated with marijuana use. However, later W1 chronotype, greater W1 social jetlag, W1 trouble falling asleep, W1 trouble staying asleep, and W1 somatic symptoms were associated with increased odds of W3 past 30-day marijuana use. Path models indicated direct associations between W1 chronotype and W3 past 30-day marijuana use, and W1 social jetlag and W3 past 30-day marijuana use. CONCLUSIONS: Later sleep timing was longitudinally associated with past 30-day marijuana use. Improved understanding of sleep health, specifically chronotype and social jetlag as risk factors for marijuana use is warranted, which may inform additional screening targets and interventions that address these associated domains.

Sexual Orientation and Sleep Behaviors in a National Sample of Adolescents Followed Into Young Adulthood.

STUDY OBJECTIVES: Sexual minority adolescents experience mental and physical health disparities attributable to increased discrimination and minority stress. These same factors may also impair sleep health, although available literature on this topic is limited. This study examined longitudinal associations between adolescent sexual minority status and seven sleep behaviors in young adulthood and tested depressive symptoms and overweight as mediators. METHOD: Data were drawn from Waves 2 (11th grade) to 7 (4 years after high school) of the NEXT Generation Health Study, a national longitudinal cohort study of US adolescents (n = 1946; 6.3% sexual minorities). RESULTS: There were no significant sexual orientation disparities in sleep duration, trouble falling asleep, trouble staying asleep, or trouble waking up during young adulthood. Relative to heterosexual females, sexual minority females had higher odds of snoring/stop breathing (36.6% versus 19.2%; adjusted odds ratio = 2.57; 95% confidence interval = 1.30, 5.09) and reported more frequent daytime sleepiness (b = 0.66, 95% confidence interval = 0.05, 1.27). Mediation analyses revealed that female sexual minority status was associated with increased risk of snoring/stop breathing though overweight status (mediated 43.6% of total effect) and was also associated with increased daytime sleepiness through higher depressive symptoms (mediated 70.8% of total effect). CONCLUSIONS: Among US youth, no sexual orientation disparities were found except for snoring/stop breathing and daytime sleepiness among females. Sexual orientation disparities in these aspects of sleep are partially due to worse mental and physical health among sexual minority females, highlighting depressive symptoms and overweight problems as potential intervention targets. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Title: Health Behavior in School-Aged Children: NEXT Longitudinal Study 2009-2016; Identifier: NCT01031160.

Does It Matter Whether You or Your Brain Did It? An Empirical Investigation of the Influence of the Double Subject Fallacy on Moral Responsibility Judgments.

Despite progress in cognitive neuroscience, we are still far from understanding the relations between the brain and the conscious self. We previously suggested that some neuroscientific texts that attempt to clarify these relations may in fact make them more difficult to understand. Such texts-ranging from popular science to high-impact scientific publications-position the brain and the conscious self as two independent, interacting subjects, capable of possessing opposite psychological states. We termed such writing 'Double Subject Fallacy' (DSF). We further suggested that such DSF language, besides being conceptually confusing and reflecting dualistic intuitions, might affect people's conceptions of moral responsibility, lessening the perception of guilt over actions. Here, we empirically investigated this proposition with a series of three experiments (pilot and two preregistered replications). Subjects were presented with moral scenarios where the defendant was either (1) clearly guilty, (2) ambiguous, or (3) clearly innocent while the accompanying neuroscientific evidence about the defendant was presented using DSF or non-DSF language. Subjects were instructed to rate the defendant's guilt in all experiments. Subjects rated the defendant in the clearly guilty scenario as guiltier than in the two other scenarios and the defendant in the ambiguously described scenario as guiltier than in the innocent scenario, as expected. In Experiment 1 (N = 609), an effect was further found for DSF language in the expected direction: subjects rated the defendant less guilty when the neuroscientific evidence was described using DSF language, across all levels of culpability. However, this effect did not replicate in Experiment 2 (N = 1794), which focused on different moral scenario, nor in Experiment 3 (N = 1810), which was an exact replication of Experiment 1. Bayesian analyses yielded strong evidence against the existence of an effect of DSF language on the perception of guilt. Our results thus challenge the claim that DSF language affects subjects' moral judgments. They further demonstrate the importance of good scientific practice, including preregistration and-most critically-replication, to avoid reaching erroneous conclusions based on false-positive results.

Cyber Behaviors Among Heterosexual and Sexual Minority Youth: Subgroup Differences and Associations with Health Indicators.

To examine the associations of adolescent sexual orientation with cyber behaviors and health indicators 5 years later during young adulthood and test whether cyber behaviors contribute to sexual orientation health disparities. Data were drawn from Waves 2 and 7 from the NEXT Generational Health Study, a nationally representative cohort of U.S. adolescents (n = 2012). Multiple linear regressions were used to examine differences between sexual orientation subgroups (defined based on sexual attraction) in five cyber behaviors and five health indicators. Mediation analyses were conducted to examine whether cyber behaviors mediated the associations between bisexual attraction and health indicators. Relative to heterosexual peers, bisexual youth spent more time engaging in cyber behaviors and social media, and reported more psychosomatic symptoms and poorer general health. Gay and questioning males spent less time playing video games than heterosexual males. Bisexual females reported more depressive symptoms and less optimism and happiness than heterosexual females. Time spent on cyber behaviors and social media was a significant mediator of adolescent bisexual attraction and worse health outcomes in young adulthood. Frequency of cyber behaviors differed between sexual minority subgroups. Bisexual youth in particular had more psychosomatic symptoms and poorer general health. Engagement in cyber behaviors and social media use contributed to increased health disparities among bisexual youth.

Distracted Driving, Visual Inattention, and Crash Risk Among Teenage Drivers.

INTRODUCTION: Distracted driving resulting from secondary task engagement is a major contributing factor to teenage drivers' crash risk. This study aims to determine the extent to which visual inattention while engaging in distracting secondary tasks contributes to teenage drivers' crash risk. METHODS: Real-world driving data were collected from a cohort of 82 newly licensed teenagers (average age 16.48 years, SD=0.33) recruited in Virginia. Participants' private vehicles were equipped with data acquisition systems that documented driving kinematics and miles driven, and made video recordings of the driver and driving environment. Data were collected from 2010 to 2014 and analyzed in 2017. The analysis of secondary task engagement was based on 6-second video segments from both crash and random samples of normal driving. RESULTS: Of a wide range of secondary tasks, only manual cellphone use (OR=2.7, 95% CI=1.1, 6.8) and reaching/handling objects while driving (OR=6.9, 95% CI=2.6, 18.6) were associated with increased crash risk. Drivers' duration of eyes off the road accounted for 41% of the crash risk associated with manual cellphone use and 10% of the risk associated with reaching/handling objects while driving. CONCLUSIONS: Secondary tasks vary in the risk they introduce to the teenage driver. Manual cellphone use and reaching for objects were found to be associated with increased crash risk. These findings objectively quantify the effect of visual inattention resulting from distracting secondary tasks on teenage drivers' crash risk. Teenage drivers may benefit from technologic and behavioral interventions that will keep their eyes on the road at all times and discourage engagement in distracting secondary tasks.

Adolescent Sexual Orientation and Developmental Transition in Emerging Adulthood: Disparities in School, Work, Residence, and Transportation.

PURPOSE: To examine associations between adolescent sexual minority status and developmental transitions in school, work, residence, and transportation 5 years later. METHOD: We analyzed data from Waves 2 (Mean age = 17.2) and 7 (Mean age = 22.6) of the NEXT Generation Health Study (n = 2,000). Relative risks were estimated using Poisson regressions. RESULTS: Relative to heterosexual females, sexual minority females were more likely to report not attending school (relative risk [RR] = 1.27, 95% confidence interval [CI] = 1.02, 1.59), not anticipating college completion (RR = 1.60, 95% CI = 1.27, 2.01), and not having a driver's license (RR = 2.64, 95% CI 1.38, 5.05) at Wave 7. Relative to heterosexual males, sexual minority males were more likely to report living in three or more places in the past year (RR = 2.98, 95% CI = 1.31, 6.76). CONCLUSIONS: Adolescent sexual minority status predicted worse educational outcomes among females and more unstable living environment among males.

Crash Risk and Risky Driving Behavior Among Adolescents During Learner and Independent Driving Periods.

PURPOSE: Novice adolescents' crash rates are highly elevated early in licensure, despite substantial practicedriving during the learner period. The objectives of this study were to examine the variability in measures of driving risk among adolescents during the learner and early independent driving periods and evaluate how risk varies by driving experience, gender, time of day, and road surface conditions. METHODS: Objective driving data were collected in a naturalistic cohort study of 90 adolescent drivers with learner driving permit and 131 experienced adult drivers. Participants' private vehicles were equipped with data acquisition system documenting driving kinematics, miles driven, and video recordings of the driver and the driving environment. Crash/near-crash (CNC) and kinematic risky driving (KRD) rates were calculated during the learner and early independent driving periods by gender (female/male), time of day (day/night), and road surface conditions (wet/dry) for adolescents and adults. RESULTS: CNC and KRD rates of adolescents were similar to adult drivers during the learner period (CNC: incident rate ratio [IRR] = 1.67, confidence interval [CI] = .98-2.82 and KRD: IRR = 1.04, CI = .78-1.40, respectively), but dramatically higher in the first year of independent driving (CNC: IRR = 6.51, CI = 4.03-10.51 and KRD: IRR = 3.95, CI = 2.96-5.26, respectively), and particularly elevated the first 3months of licensure. Adolescent KRD rates were higher for males than females and invariably higher than adult rates during day and night, wet and dry conditions. CONCLUSIONS: While the learner driving period was relatively safe for adolescents, the transition to independent driving was typified by a dramatic increase in risk among adolescents that was higher than adult rates overall and under varying driving conditions.

U.S. Adolescent Street Racing and Other Risky Driving Behaviors.

PURPOSE: We examined demographic characteristics and risky driving behaviors associated with street racing among adolescents in the NEXT Generation Health Study (N = 2,395). METHOD: Binomial logistic regression tested associations between demographics and driving in a street race (DSR) or being a passenger in a street race (PSR). Sequential logistic regression tested the robustness of the association between DSR and crashes. RESULTS: Hispanic/Latino, non-Hispanic Black/African-American, and mixed-race participants were more likely to engage in DSR. Males were more likely and teens with moderate socioeconomic status were less likely to engage in DSR and PSR. DSR was associated with other risky driving behaviors in bivariate models but was not independently associated with crashes after sequential modeling. CONCLUSIONS: Among adolescents, those who are male, racial/ethnic minorities, or low socioeconomic status may be at higher risk of DSR. However, overall driving risk might explain the association between DSR engagement and higher crash risk.