The Role of Social Position Within Peer Groups in Distress-Motivated Smoking Among Adolescents.

OBJECTIVE: The relationship between smoking and adolescents' peer relationships is complex, with studies showing increased risk of smoking for adolescents of both very high and very low social position. A key question is whether the impact of social position on smoking depends on an adolescent's level of coping motives (i.e., their desire to use smoking to mitigate negative affect). METHOD: We assessed how social position predicts nicotine dependence in a longitudinal sample (N = 3,717; 44.8% male; mean age = 13.41 years) of adolescent lifetime smokers measured between 6th and 12th grades. Using both social network analysis and multilevel modeling, we assessed this question at the between-person and within-person level, hypothesizing that within-person decreases in social position would lead to increased risk of nicotine dependence among those with high levels of coping motives. RESULTS: In contrast to our hypotheses, only interactions with the between-person measures of social position were found, with a slight negative relationship at low levels of coping motives. In addition, the main effect of coping motives was considerably stronger than that of social position at the between-person level, and social position had no significant within-person main effect on nicotine dependence risk. CONCLUSIONS: These results suggest that adolescents with higher overall levels of social position among their peers may have slightly decreased risk for nicotine dependence, but only when coping motives are low. Counter to expectations, higher levels of nicotine dependence risk were not linked to fluctuations in social position.

A Multidimensional Model of Sexual Empowerment Among Young Black Men Who have Sex with Men: A Latent Profile Analysis.

Sexual empowerment is a key strategy in HIV prevention intervention design, yet its measurement has been conceptualized as homogeneous. To date, no studies have examined whether young Black men who have sex with men (YBMSM) exhibit heterogeneity across sexual empowerment. Using baseline data from a randomized controlled trial (N = 275, HIV-negative YBMSM), we classified YBMSM into sexual empowerment profiles based on five indicators using a latent profile analysis and assessed the associations between the sexual empowerment profiles and stigma-related experiences using multinomial logistic regression. Three profiles were identified: psychologically empowered with safer sex intentions (profile 1); psychologically disempowered with safer sex intentions (profile 2); and psychologically disempowered without safer sex intentions (profile 3). YBMSM reporting fewer stigma-related experiences were more likely to be profile 1 than profile 2 and profile 3. To empower YBMSM, interventions based on sexual empowerment profile targeting the psychological/behavioral aspects of empowerment and addressing stigma are needed.

Sexual Empowerment Among Young Black Men Who Have Sex with Men.

Sexual empowerment represents an important HIV intervention strategy, yet limited attention has examined the multidimensional nature of sexual empowerment in prior studies. Using a sample (n = 465) of young Black men who have sex with men (MSM), we used confirmatory factor analysis (CFA) to test a multifactorial operationalization of sexual empowerment. CFA indicated that a bifactor model was best suited to characterize the sexual empowerment factor (SEF), suggesting that items for four sub-constructs (self-efficacy to refuse sexual behavior, emotional support, condom use self-efficacy, and social norms on condom use) contributed to their respective constructs, while also contributing to a latent sexual empowerment construct. We then examined the association between SEF and mental health outcomes (anxiety and depression symptoms) and safer sex intentions. SEF was negatively associated with mental health outcomes and positively associated with safer sex intentions. Ultimately, individuals with greater sexual empowerment might be better equipped to develop strategies to buffer their vulnerability to HIV. We discuss the implications of SEF as a bifactor during the design and evaluation of HIV risk-reduction interventions seeking to address sexual empowerment among MSM.

Codevelopment of Delinquency, Alcohol Use, and Aggression Toward Peers and Dates: Multitrajectory Patterns and Predictors.

We aimed to characterize developmental patterns of involvement in alcohol use, delinquency, and interpersonal aggression in a normative sample of adolescents by applying multitrajectory group-based modeling. Using seven waves of data from a cohort sequential study spanning the 6th to 12th grades (n = 2,825; 50% girls), we identified four distinct trajectory groups: low risk (33%), declining peer aggressors (44%), peer and dating aggressors (13%), and multidomain high risk (10%). Across all comparisons, girls were more likely than boys to be members of the peer and dating aggressor group and less likely to be members of the multidomain high-risk group. Moreover, individual (self-control, negative emotionality), family (family violence, parental monitoring), and peer (substance use norms) distinguished class membership.

A Latent Variable Approach to Measuring Social Dynamics in Adolescence.

In the study of adolescent health, it is useful to derive indices of social dynamics from sociometric data, and to use these indices as predictors of health risk behaviors. In this manuscript, we introduce a flexible latent variable model as a novel way of obtaining estimates of social integration and social status from school-based sociometric data. Such scores provide the flexibility of a regression-based approach while accounting for measurement error in sociometric indicators. We demonstrate the utility of these factor scores in testing complex hypotheses through a combination of structural equation modeling and survival models, showing that deviance mediates the relationship between social status and smoking onset hazard at the transition to high school.

Social network isolation mediates associations between risky symptoms and substance use in the high school transition.

The current study examined whether social status and social integration, two related but distinct indicators of an adolescent's standing within a peer network, mediate the association between risky symptoms (depressive symptoms and deviant behavior) and substance use across adolescence. The sample of 6,776 adolescents participated in up to seven waves of data collection spanning 6th to 12th grades. Scores indexing social status and integration were derived from a social network analysis of six schools and subsequent psychometric modeling. Results of latent growth models showed that social integration and status mediated the relation between risky symptoms and substance use and that risky symptoms mediated the relation between social standing and substance use during the high school transition. Before this transition, pathways involving deviant behavior led to high social integration and status and in turn to substance use. After this transition, both deviant behavior and depressive symptoms led to low social integration and status and in turn greater substance use. These findings suggest that the high school transition is a risky time for substance use related to the interplay of increases in depressive symptoms and deviant behavior on the one hand and decreases in social status and integration on the other.

Alcohol trajectories among biracial black subgroups: Testing the intermediate substance use hypothesis.

OBJECTIVE: This study tests the intermediate biracial substance use hypothesis, which suggests that the prevalence of substance use among biracial individuals fall intermediate to their corresponding mononoracial counterparts. Using National Longitudinal Study of Adolescent and Adult Health (Add Health) data, we examine alcohol-use trajectories of a de-aggregated sample of biracial Black youth and compare them with the trajectories of the corresponding monoracial counterparts. METHOD: The sample consists of 9421 adolescents and young adults who self-identified as 1 of 4 monoracial groups (i.e., Black, White, Hispanic, American Indian) or 1 of 3 biracial Black groups (i.e., Black-American Indian, Black-Hispanic, and Black-White). Study hypotheses are tested using latent growth curve modeling for first use, number of drinks, and binge drinking. RESULTS: We found partial support for the intermediate substance use hypothesis, with the alcohol use rates of biracial Blacks more closely resembling the non-Black corresponding group than the monoracial Black group. Black-American Indians face particularly high risk of problematic drinking. CONCLUSIONS: These findings demonstrate the need for additional research clarifying the onset and maintenance of alcohol use and misuse among biracial individuals and subgroups.

Patterns of adolescent aggression and victimization: Sex differences and correlates.

This study identified heterogenous patterns of peer and dating aggression and victimization among boys and girls and examined their relation to risk and protective correlates. Girls (n=1648) and boys (n=1420) in grades 8-10 completed surveys assessing 14 indicators of violence involvement. Latent class analyses indicated a four-class solution, though a test of measurement invariance indicated the nature of the classes differed by sex. Among boys and girls, three classes emerged: Uninvolved (45% of girls, 61% of boys), Peer Aggressor-Victims (23% of girls, 21% of boys), and Cross-Context Aggressor-Victims (12% of girls, 5% of boys). Those in the Peer Aggressor-Victims class were likely to report involvement in peer aggression only; however, girls in this class were likely to be involved only in moderate violence, whereas boys were likely to be involved in moderate and severe violence. Those in the Cross-Context Aggressor-Victims class were likely to report involvement in all forms of violence except sexual and controlling aggression, which was likely only among boys. Among girls, but not boys, a Verbal Dating Aggressor-Victims class (21% of girls) emerged that was characterized by involvement in occasional verbal dating aggression only. Among boys, but not girls, a Cross-Context Physical Victims class (13% of boys) emerged that was characterized by being only a victim of moderate physical peer and dating violence. Unique and shared risk and protective factors distinguished class membership for girls and boys. Findings suggest the pathways leading to violence may differ by sex and result in different patterns of violence involvement.

Child Maltreatment and Body Mass Index over Time: The Roles of Social Support and Stress Responses.

An unhealthy body mass index (BMI) trajectory can exacerbate the burdens associated with child maltreatment. However, we have yet to explain why the relationship between maltreatment and BMI trajectories exists and what allows individuals to attain healthy BMI trajectories despite adversity. Guided by the Transactional Model of Stress and Coping, we evaluated (1) if peer friendship and adult mentors moderate, and (2) if impulsivity and depressive symptoms mediate, the relationship between maltreatment experiences and average excess BMI. We used data from four waves of the National Longitudinal Study of Adolescent to Adult Health (n = 17,696), following adolescents from ages 13-21 (Wave I) to 24-31 years (Wave IV). We did not find evidence of significant moderation or mediation of the maltreatment experience to average excess BMI relationship. However, models did demonstrate a relationship between peer friendship quality and average excess BMI, such that higher quality protected against higher average excess BMI (B = -0.073, s.e. = 0.02, p < 0.001). Age of maltreatment onset was also associated with average excess BMI, such that maltreatment onset in adolescence was associated with a higher average excess BMI (B = 0.275-0.284, s.e. = 0.11, p = 0.01). Although we found no evidence of moderation by social support or mediation by stress responses of the relationship between maltreatment experiences and average excess BMI, peer friendship appears to protect against higher average excess BMI from adolescence to young adulthood for all adolescents. Future public health interventions should consider how to leverage friendship in obesity prevention efforts.

Sensitive Periods for the Association Between Childhood Maltreatment and BMI.

INTRODUCTION: Although previous research has suggested a positive association between child maltreatment and BMI over the life course, it is unclear when this develops. METHODS: The authors used time-varying effect models and data from a nationally representative, longitudinal, cohort study (Add Health), to test how childhood physical, sexual, and emotional abuse uniquely varied in associations with BMI from age 13 to 28 years, and whether different patterns existed for male and female participants. Add Health collected data from 1994 to 2008, and the present analyses took place in 2018. RESULTS: Age 18 years was the earliest that a relationship between maltreatment and BMI emerged for either sex. Child sexual abuse was negatively associated with BMI among male participants from 18.5 to 20 years, but positively associated with BMI among female participants from 19 to 24.5 years, and childhood emotional abuse was positively associated with BMI among female participants from 18 to 28 years. CONCLUSIONS: The relationship between child maltreatment and BMI varies as a function of type of maltreatment, sex, and time. Notably, associations between maltreatment and BMI did not emerge until young adulthood. Future research should investigate mechanisms by which the association between maltreatment and BMI changes over time to identify trauma-informed intervention targets for improving weight outcomes.

Maltreatment experience in childhood and average excess body mass from adolescence to young adulthood.

BACKGROUND: Prior studies have suggested maltreatment is a strong predictor of later weight outcomes, such that maltreatment experiences in childhood increase the likelihood of being overweight or obese in adulthood. Estimates of this relationship may be biased due to: 1) inadequate selection of covariates; 2) improper operationalization of child maltreatment; and 3) restricting analyses to cross-sectional outcomes. OBJECTIVES: Evaluate how latent classes of child maltreatment experiences are associated with a longitudinal BMI measure from adolescence to adulthood. PARTICIPANTS: Data from the National Longitudinal Study of Adolescent to Adult Health. METHODS: We evaluated how previously developed latent classes of child maltreatment experiences were associated with average excess BMI from adolescence to adulthood using multivariate linear regression. RESULTS: In the unadjusted model, individuals in the poly-maltreatment class (b = 0.46, s.e. = 0.20) and individuals who experienced adolescent-onset maltreatment (b = 0.36, s.e. = 0.11) had higher average excess BMI compared to individuals in the no maltreatment class. After adjusting for confounders, the relationship between poly-maltreatment and average excess BMI abated, whereas the relationship between adolescent-onset maltreatment and average excess BMI sustained (b = 0.28, s.e. = 0.11). CONCLUSIONS: Contrary to previous findings, our analyses suggest the association between maltreatment experiences and longitudinal weight outcomes dissipates after controlling for relevant confounders. We did find a relationship, however, between adolescent-onset maltreatment and average excess BMI from adolescence to adulthood. This suggests the importance of maltreatment timing in the relationship between maltreatment and weight.

A Person-Centered Approach to the Study of Black Adolescent Religiosity, Racial Identity, and Sexual Initiation.

Decreasing the number of adolescents who have never had sexual intercourse is one way to address sexual health disparities. We used intersectionality to explore the joint effects of religiosity and racial identity on Black adolescent sexual initiation. Data originated from the National Survey of American Life-Adolescent (n = 1,170), a nationally representative study of Black adolescents. Latent profile analysis and survival analysis were used to evaluate study hypotheses. Results showed four distinct profiles of religiosity and racial identity. These profiles explained 19% of the variability in sexual initiation. Additional analyses revealed sociodemographic differences in profile membership. Findings contribute to understanding ethnic heterogeneity among Black adolescents and racial identity and religiosity as sociocultural factors that influence sexual initiation; and support reconceptualizing Black adolescent religiosity.

Simplifying the implementation of modern scale scoring methods with an automated R package: Automated moderated nonlinear factor analysis (aMNLFA).

When generating scores to represent latent constructs, analysts have a choice between applying psychometric approaches that are principled but that can be complicated and time-intensive versus applying simple and fast, but less precise approaches, such as sum or mean scoring. We explain the reasons for preferring modern psychometric approaches: namely, use of unequal item weights and severity parameters, the ability to account for local dependence and differential item functioning, and the use of covariate information to more efficiently estimate factor scores. We describe moderated nonlinear factor analysis (MNLFA), a relatively new, highly flexible approach that allows analysts to develop precise factor score estimates that address limitations of sum score, mean score, and traditional factor analytic approaches to scoring. We then outline the steps involved in using the MNLFA scoring approach and discuss the circumstances in which this approach is preferred. To overcome the difficulty of implementing MNLFA models in practice, we developed an R package, aMNLFA, that automates much of the rule-based scoring process. We illustrate the use of aMNLFA with an empirical example of scoring alcohol involvement in a longitudinal study of 6998 adolescents and compare performance of MNLFA scores with traditional factor analysis and sum scores based on the same set of 12 items. MNLFA scores retain more meaningful variation than other approaches. We conclude with practical guidelines for scoring.

Does a parsimonious measure of complex body mass index trajectories exist?

BACKGROUND: A single measure that distills complex body mass index (BMI) trajectories into one value could facilitate otherwise complicated analyses. This study creates and assesses the validity of such a measure: average excess BMI. METHODS: We use data from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health (n = 17,669). We calculate average excess BMI by integrating to find the area above a healthy BMI trajectory and below each subject-specific trajectory and divide this value by total study time. To assess validity and utility, we (1) evaluate relationships between average excess BMI from adolescence to adulthood and adult chronic conditions, (2) compare associations and fit to models using subject-specific BMI trajectory parameter estimates as predictors, and (3) compare associations to models using BMI trajectory parameter estimates as outcomes. RESULTS: Average excess BMI from adolescence to adulthood is associated with increased odds of hypertension (OR = 1.56; 95% CI: 1.47, 1.67), hyperlipidemia (OR = 1.36; 95% CI: 1.26, 1.47), and diabetes (OR = 1.57; 95% CI: 1.47, 1.67). The odds associated with average excess BMI are higher than the odds associated with the BMI intercept, linear, or quadratic slope. Correlations between observed and predicted health outcomes are slightly lower for some models using average excess BMI as the focal predictor compared to those using BMI intercept, linear, and quadratic slope. When using trajectory parameters as outcomes, some co-variates associate with the intercept, linear, and quadratic slope in contradicting directions. CONCLUSIONS: This study supports the utility of average excess BMI as an outcome. The higher an individual's average excess BMI from adolescence to adulthood, the greater their odds of chronic conditions. Future studies investigating longitudinal BMI as an outcome should consider using average excess BMI, whereas studies that conceptualize longitudinal BMI as the predictor should continue using traditional latent growth methods.

Demographic Moderation of the Prediction of Adolescent Alcohol Involvement Trajectories.

Several school- and family-based preventive interventions target and effectively reduce adolescent alcohol misuse. However, whether demographic groups achieve equal success with these interventions is unclear. In particular, most interventions target younger adolescents, and program effectiveness tends to be measured with majority White samples; subgroup analyses are rarely reported. We analyze longitudinal data from a sample of N = 6189 adolescents (40% Black, 60% White; 50% female) in 6th through 12th grade to quantify the degree to which age, race, and gender moderate the associations between seven well-known risk and protective factors (RPFs) that serve as common intervention targets. The RPFs that we study are drawn from social learning theory, problem behavior theory, and social control theory, including individual factors (positive alcohol expectancies and deviant behavior), family context (perceived parental involvement, perceived parent alcohol use, and access to alcohol), and peer context (descriptive and injunctive norms). Multilevel growth models allow us to conduct the demographic subgroup moderation analysis. Results suggest that these well-studied RPFs explain alcohol involvement to varying degrees, but they explain substantially more variation in alcohol involvement by White adolescents compared with Black adolescents. We find differential patterns of significance and of leading predictors of alcohol involvement as a function of age, race, and gender and the interactions thereof. These results indicate that the prevention field needs to better understand the RPFs affecting minority and high school youth in order to provide a stronger basis for alcohol prevention efforts.

A qualitative study of women's network social support and facility delivery in rural Ghana.

Similar to many sub-Saharan African countries, maternal mortality in Ghana ranks among the highest (39th) globally. Prior research has demonstrated the impact of social network characteristics on health facility delivery in sub-Saharan Africa. However, in-depth examination of the function of all members in a woman's network, in providing various types of support for the woman's pregnancy and related care, is limited. We qualitatively explore how women's network social support influences facility delivery. Qualitative data came from a mixed methods evaluation of a Maternal and Newborn Health Referral project in Ghana. In 2015 we conducted in-depth interviews with mothers (n = 40) and husbands (n = 20), and 4 focus group interviews with mothers-in-law. Data were analyzed using narrative summaries and thematic coding procedures to first examine women's network composition during their pregnancy and childbirth experiences. We then compared those who had homebirths versus facility births on how network social support influenced their place of childbirth. Various network members were involved in providing women with social support. We found differences in how informational and instrumental support impacted women's place of childbirth. Network members of women who had facility delivery mobilized resources to support women's facility delivery. Among women who had homebirth but their network members advocated for them to have facility delivery, members delayed making arrangements for the women's facility delivery. Women who had homebirth, and their network members advocated homebirth, received support to give birth at home. Network support for women's pregnancy-related care affects their place of childbirth. Hence, maternal health interventions must develop strategies to prioritize informational and instrumental support for facility-based pregnancy and delivery care.

Teen Social Networks and Depressive Symptoms-Substance Use Associations: Developmental and Demographic Variation.

OBJECTIVE: The current study examined whether an adolescent's standing within a school-bounded social network moderated the association between depressive symptoms and substance use across adolescence as a function of developmental and demographic factors (gender, parental education, and race/ethnicity). METHOD: The sample of 6,776 adolescents participated in up to seven waves of data collection spanning 6th to 12th grade. RESULTS: Results of latent growth models showed that lower integration into the social network exacerbates risk for depression-related substance use in youth, particularly around the high school transition, but social status acted as both a risk factor and a protective factor at different points in development for different youth. Findings also varied as a function of youth gender and parental education status. CONCLUSIONS: Together these findings suggest that lower integration into the social network exacerbates risk for depression-related substance use in youth, particularly around the high school transition in general as well as just before the high school transition in those with lower parental education or just after the high school transition in males. Thus, the risky impact of social isolation appears more consistent across this period. Social status, however, showed a more varied pattern and further study is needed to understand the sometimes risky and sometimes protective effects of social status on depression-related substance use.

Depressive Symptomology as a Moderator of Friend Selection and Influence on Substance Use Involvement: Estimates from Grades 6 to 12 in Six Longitudinal School-Based Social Networks.

Although the contributions of friend selection and friend influence to adolescent homophily on substance use behaviors has been of enduring research interest, moderators of these processes have received relatively little research attention. Identification of factors that dampen or amplify selection and influence on substance use behaviors is important for informing prevention efforts. Whereas prior research has examined adolescent drinking, smoking, and marijuana use, the current study examined whether friend selection and friend influence operated on substance use involvement, an indicator of problematic use, and whether depressive symptomology moderated these processes. In addition, it examined whether these relationships varied from grade 6 to 12. The study used a cohort-sequential design in which three cohorts of youth (first surveyed in grades, 6, 7, and 8) in six school-based longitudinal social networks were surveyed up to seven times, yielding N = 6817 adolescents (49% female). Stochastic actor-oriented models were applied to test hypothesized relationships in the six networks, then results were synthesized in a meta-analysis. Depressive symptoms did not moderate selection or influence on substance use involvement at any grade level, but indirectly contributed to diffusion of substance use involvement through school networks via patterns of network ties. Research is needed on contextual factors, particularly in schools, that might account for when, if at all, depressive symptoms condition friend selection and influence on substance use.

Consequences of Involvement in Distinct Patterns of Adolescent Peer and Dating Violence.

Typological theoretical perspectives suggest that the consequences of involvement in peer and dating violence may depend on the particular pattern of violent behaviors that youth experience and/or engage in. Yet few studies have examined whether distinct patterns of dating and peer violence involvement differentially predict developmental outcomes. Using two waves of data, the current study examined the prospective associations between distinct patterns of peer and dating aggression and victimization, identified using latent class analysis, and a range of potential developmental outcomes in a general population sample of adolescents in the 8th to 10th grades (n = 3068; 46% female, 58% White, 31% Black, 11% other race/ethnicity). The findings suggest that, compared to youth involved in other patterns of violence, youth involved in peer and dating violence as aggressors and victims are at greatest risk for negative sequelae, although results differed considerably for girls and boys and on the outcome variable and comparison groups being examined.

Contextual Risk Profiles and Trajectories of Adolescent Dating Violence Perpetration.

Social ecological and developmental system perspectives suggest that interactions among factors within and across multiple contexts (e.g., neighborhood, peer, family) must be considered in explaining dating violence perpetration. Yet, to date, most extant research on dating violence has focused on individual, rather than contextual predictors, and used variable-centered approaches that fail to capture the configurations of factors that may jointly explain involvement in dating violence. The current study used a person-centered approach, latent profile analysis, to identify key configurations (or profiles) of contextual risk and protective factors for dating violence perpetration across the neighborhood, school, friend and family contexts. We then examine the longitudinal associations between these contextual risk profiles, assessed during middle school, and trajectories of psychological and physical dating violence perpetration across grades 8 through 12. Five contextual risk profiles were identified: school, neighborhood, and family risk; school and family risk; school and friend risk; school and neighborhood risk; and low risk. The highest levels of psychological and physical perpetration across grades 8 through 12 were among adolescents in the profile characterized by high levels of school, neighborhood, and family risk. Results suggest that early interventions to reduce violence exposure and increase social regulation across multiple social contexts may be effective in reducing dating violence perpetration across adolescence.