Psychological pain and sociodemographic factors classified suicide attempt and non-suicidal self-injury in adolescents.

This study aimed to utilize machine learning to explore the psychological similarities and differences between suicide attempt (SA) and non-suicidal self-injury (NSSI), with a particular focus on the role of psychological pain. A total of 2385 middle school students were recruited using cluster sampling. The random forest algorithm was used with 25 predictors to develop classification models of SA and NSSI, respectively, and to estimate the importance scores of each predictor. Based on these scores and related theories, shared risk factors (control feature set) and distinct risk factors (distinction feature set) were selected and tested to distinguish between NSSI and SA. The machine learning algorithm exhibited fair to good performance in classifying SA history [Area Under Curves (AUCs): 0.65-0.87] and poor performance in classifying NSSI history (AUC: 0.61-0.68). The distinction feature set comprised pain avoidance, family togetherness, and deviant peer affiliation, while the control feature set included pain arousal, painful feelings, and crisis events. The distinction feature set slightly but stably outperformed the control feature set in classifying SA from NSSI. The three-dimensional psychological pain model, especially pain avoidance, might play a dominant role in understanding the similarities and differences between SA and NSSI.

The unique role of adolescent internalizing and externalizing problems, and maternal-adolescent communication in their association with attachment in early adulthood.

Attachment styles influence mental health and relationships through life. Few studies examine the adolescent factors associated with adult attachment styles. This paper examines the association between adolescent emotional and behavioral problems and maternal-adolescent communication with attachment style in early adulthood. Data from 3423 participants in a birth cohort study were examined. At 14-years, participants' mothers completed the Parent-Adolescent Communication Scale. Participants completed the Youth Self-Report at 14-years which measures internalizing and externalizing symptoms, and the Attachment Style Questionnaire (ASQ) at 21-years. The ASQ comprises five domains of internal working models of interpersonal relationships and attachment style: confidence (security), discomfort with closeness and relationships as secondary (avoidance), need for approval and preoccupation with relationships (anxiety). Associations were examined using general linear models. After adjustments, internalizing symptoms score was associated with all domains of attachment and externalizing symptoms score was associated with four domains of attachment insecurity, but not attachment security. Low openness in maternal-adolescent communication was most strongly associated with decreased confidence and high problem maternal-adolescent communication was associated with viewing relationships as secondary. Adolescents with emotional and behavioral problems and maternal-adolescent communication may benefit from attachment-based interventions to support the development of healthy relationships and attachments in young adulthood.

Peer cybervictimization and cyberaggression as a function of developmental stage during adolescence: A preliminary study.

Peer cybervictimization and cyberaggression are educational and social concerns which have been extensively studied during adolescence but there is less research conducted specifically across all stages of adolescence (early, middle, late, and emerging adulthood). The objective was to analyse the prevalence of cybervictimization and cyberaggression, the roles, and the associated behaviors, depending on the stages of adolescence. The sample was composed of 7295 non-university Spanish adolescents, between 11 and 22 years old from 47 schools. The frequency of cybervictimization and cyberaggression was 22.5 % and 15 %, respectively. The highest frequencies are found in late adolescence and the lowest in emerging adulthood. Mainly, involvement increases from early to late adolescence and decreases in emerging adulthood. The magnitude of cybervictimization and cyberaggression behaviors for the roles of pure cybervictim and pure cyberaggressor is similar through all stages.

Promoting adolescent sleep and circadian function: A narrative review on the importance of daylight access in schools.

Adolescent sleep disturbances and circadian delays pose significant challenges to mood and daytime functioning. In this narrative review, we explore the impact of light on sleep and highlight the importance of monitoring and managing light exposure in adolescents throughout the day and night. The benefits of daylight exposure in mitigating sleep and circadian disruptions are well-established; however, interventions targeting access to daylight in adolescents remain understudied and underutilized. The primary aim of this narrative review is to bring attention to this gap in the literature and propose the need for institutional-level interventions that promote access to daylight, especially considering adolescents' early school start times and substantial time spent indoors on weekdays. School-led interventions, such as active commuting to school and outdoor curriculums, have promising effects on sleep and circadian rhythms. Additionally, practical measures to optimize natural light in classrooms, including managing blinds and designing conducive environments, should also be considered. While future studies are necessary to facilitate the implementation of interventions, the potential for these school-level interventions to support adolescent sleep health is evident. Aiming for integration of individual-level regulation and institutional-level intervention of light exposure is necessary for optimal outcomes.

Neural Tracking of Perceived Parent, but Not Peer, Norms Is Associated with Longitudinal Changes in Adolescent Attitudes about Externalizing Behaviors.

Adolescents' perceptions of parent and peer norms about externalizing behaviors influence the extent to which they adopt similar attitudes, yet little is known about how the trajectories of perceived parent and peer norms are related to trajectories of personal attitudes across adolescence. Neural development of midline regions implicated in self-other processing may underlie developmental changes in parent and peer influence. Here, we examined whether neural processing of perceived parent and peer norms in midline regions during self-evaluations would be associated with trajectories of personal attitudes about externalizing behaviors. Trajectories of adolescents' perceived parent and peer norms were examined longitudinally with functional neuroimaging (n = 165; ages 11-16 years across three waves; 86 girls, 79 boys; 29.7% White, 21.8% Black, 35.8% Latinx, 12.7% other/multiracial). Behavioral results showed perceived parent norms were less permissive than adolescents' own attitudes about externalizing behaviors, whereas perceived peer norms were more permissive than adolescents' own attitudes, effects that increased from early to middle adolescence. Although younger adolescents reported less permissive attitudes when they spontaneously tracked perceived parent norms in the ventromedial and medial pFCs during self-evaluations, this effect weakened as they aged. No brain-behavior effects were found when tracking perceived peer norms. These findings elucidate how perceived parent and peer norms change in parallel with personal attitudes about externalizing behaviors from early to middle adolescence and underscore the importance of spontaneous neural tracking of perceived parent norms during self-evaluations for buffering permissive personal attitudes, particularly in early adolescence.

Multivariate association between psychosocial environment, behaviors, and brain functional networks in adolescent depression.

BACKGROUND: Adolescent depression shows high clinical heterogeneity. Brain functional networks serve as a powerful tool for investigating neural mechanisms underlying depression profiles. A key challenge is to characterize how variation in brain functional organization links to behavioral features and psychosocial environmental influences. METHODS: We recruited 80 adolescents with major depressive disorder (MDD) and 42 healthy controls (HCs). First, we estimated the differences in functional connectivity of resting-state networks (RSN) between the two groups. Then, we used sparse canonical correlation analysis to characterize patterns of associations between RSN connectivity and symptoms, cognition, and psychosocial environmental factors in MDD adolescents. Clustering analysis was applied to stratify patients into homogenous subtypes according to these brain-behavior-environment associations. RESULTS: MDD adolescents showed significantly hyperconnectivity between the ventral attention and cingulo-opercular networks compared with HCs. We identified one reliable pattern of covariation between RSN connectivity and clinical/environmental features in MDD adolescents. In this pattern, psychosocial factors, especially the interpersonal and family relationships, were major contributors to variation in connectivity of salience, cingulo-opercular, ventral attention, subcortical and somatosensory-motor networks. Based on this association, we categorized patients into two subgroups which showed different environment and symptoms characteristics, and distinct connectivity alterations. These differences were covered up when the patients were taken as a whole group. CONCLUSION: This study identified the environmental exposures associated with specific functional networks in MDD youths. Our findings emphasize the importance of the psychosocial context in assessing brain function alterations in adolescent depression and have the potential to promote targeted treatment and precise prevention.

Relationship between Traumatic Experiences, Circadian Preference and ADHD Symptoms in Adolescents with ADHD Residing in Institutional Care: A Controlled Study.

Circadian preference, describes biological and behavioural characteristics that influence the ability to plan daily activities according to optimal waking times. It is divided into three main categories: morning, evening and intermediate. In particular, the evening chronotype is associated with conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Post Traumatic Stress Disorder (PTSD). This study was conducted in three groups aged 14-18 years: The first group consisted of 34 adolescents diagnosed with ADHD who had been in institutional care for at least two years and had not used medication in the last six months. The second group included 29 adolescents with ADHD living with their families who had not used medication in the last six months. The third control group consisted of 32 healthy adolescents. The study utilized sociodemographic data forms, the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) to measure ADHD symptoms, the Childhood Chronotype Questionnaire (CCQ), and the Childhood Trauma Questionnaire (CTQ). In institutionalized adolescents with diagnosed ADHD, ADHD and disruptive behavior symptoms were more severe. Increased trauma scores were associated with higher ADHD and disruptive behaviour symptom severity and evening chronotype. In the conducted mediation analysis, evening chronotype was identified as a full mediator in the relationship between trauma symptoms and ADHD symptoms, while it was determined as a partial mediator in the relationship between trauma symptoms and PTSD symptoms. In conclusion, traumatic experiences in institutionalized adolescents with diagnosed ADHD may exacerbate ADHD and disruptive behavior symptoms. Evening chronotype is associated with ADHD and disruptive behavior symptoms, and therefore, the chronotypes of these adolescents should be assessed. Chronotherapeutic interventions may assist in reducing inattention, hyperactivity, and behavioral problems.

Influencia de los hábitos deportivos en el conocimiento, calidad e higiene del sueño adolescente / Influence of sports habits on adolescent sleep knowledge, quality and hygiene

El hábito deportivo resulta esencial para el descanso nocturno del adolescente de Bachillerato. Este estudio analiza la influencia de la práctica deportiva sobre tres variables: conocimiento, calidad e higiene del sueño. Los 145 adolescentes (M = 16.72; DE = 0.74) que componen la muestra reportaron un deficiente conocimiento en nociones del sueño (SBS = 12.04), una pobre calidad del sueño (AYA-PSQI-S = 8.36) y una perfectible higiene del sueño (ASHSr = 4.26). Sin embargo, el 83.6% de los estudiantes que realizaban actividad física demostraron puntuaciones medias totales más altas en las tres variables, asumiendo diferencias significativas (p < 0.05) en las dimensiones de duración y eficiencia del sueño, en comparación al alumnado sedentario. Además, según el estudio, el ejercicio actúa como protector ante la deficitaria calidad de sueño y como impulsor de la higiene del sueño. Por su parte, la alta intensidad de la práctica de ejercicio físico está relacionada con un mejor desempeño en la dimensión de duración de sueño y un mayor autoconcepto, teniendo en cuenta que horas de práctica tardías están relacionadas negativamente con la hora de cenar, postergando el descanso. El hábito deportivo influye positivamente en el conocimiento, la calidad y la higiene del sueño adolescente; apostando por el ejercicio de fuerza, a intensidades submáximas y alejadas en la medida posible de la hora de dormir (AU)

Sports habits are essential for the sleep of the adolescent in the high school. This study analyses the influence of sports practice on three variables: sleep knowledge, sleep quality and sleep hygiene. The 145 adolescents (M = 16.72; SD = 0.74) in the sample reported low sleep knowledge (SBS = 12.04), poor sleep quality (AYA-PSQI-S = 8.36) and improvable sleep hygiene (ASHSr = 4.26). However, 83.6% of physically active students showed higher total scores on all three variables, assuming significant differences (p < 0.05) in sleep duration and sleep efficiency compared to sedentary students. Moreover, exercise prevents poor sleep quality and enhance sleep hygiene. On the other hand, high intensity of physical activity correlates with better performance in the sleep duration dimension and a higher self-concept, considering that late practice hours are negatively related to dinner time, delaying rest. The sporting habit has a positive influence on the sleep knowledge, quality and hygiene of adolescents, betting on strength exercise, at submaximal intensities and as far as possible away from bedtime (AU)

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.

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.

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.

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.

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.

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.