Prospective relations between organized activity participation and psychopathology during adolescence

Associations of screen time with symptoms of stress, anxiety, and depression in adolescents

OBJECTIVE

To examine the associations between self-reported screen time and symptoms of stress, anxiety, and depression in adolescents.

METHODS

A cross-sectional study was conducted with 982 adolescents aged between 12 and 15 years, enrolled in public schools in Jacarezinho (PR), Brazil. Screen time was assessed by the question "Considering a typical day, how much time do you spend watching TV, playing videogame, using computer or smartphone?" The DASS-21 questionnaire (short form) was used to assess symptoms of depression, anxiety, and stress. Crude and adjusted analyses (age, sex, and maternal level of education) between screen time and mental disorders symptoms were performed using general linear regression models, with Poisson distribution, with significance level at p<0.05.

RESULTS

Higher depressive symptoms were observed in adolescents who reported screen time of 4-6 hours/day (PR 1.35, 95%CI 1.13-1.61) and ≥6 hours/day (PR 1.88, 95%CI 1.62-2.19), compared with their pairs with <2 hours/day. The same was observed for anxiety symptoms with screen time of 4-6 hours/day (PR 1.23, 95%CI 1.04-1.46) and ≥6 hours/day (PR 1.50, 95%CI 1.28-1.77); and stress, with 4-6 hours/day (PR 1.25, 95%CI 1.08-1.44) and ≥6 hours/day (PR 1.49, 95%CI 1.30-1.71), also compared with their pairs with <2 hours/day.

CONCLUSIONS

Screen time was positively associated with depressive, anxiety, and stress symptoms in adolescents. Special attention should be given to those who spend more than four hours a day in front of a screen.

Parents' clinical depression and children's problem behaviors: A multi-level meta-analytic examination

BACKGROUND

Previous meta-analyses considering associations between parental depression (PD) and child symptoms have considered PD based primarily on self-report of depression symptoms. The present meta-analysis, in contrast, evaluated the effect of parents' clinically-diagnosed depressive disorders (PDD) on child internalizing and externalizing symptoms and considered both family- and study-level variables that influenced the strength of these effects.

METHODS

We examined 111 effect sizes nested in 40 studies including a clinical assessment of parents' major or persistent depressive disorder and measures of children's internalizing or externalizing behaviors published between 2000 and 2020. We used a multi-level meta-analytic framework to account for nesting of multiple effect sizes within studies.

RESULTS

PDD was associated with children's internalizing (weighted mean r = 0.211) and externalizing (weighted mean r = 0.204) behaviors. Family- and study-level variables moderated these relations, including the inclusion of fathers in the sample, the specific measure of internalizing behavior, reporting of diagnostic reliability, and informant for problem behaviors.

LIMITATIONS

Limitations include exclusive consideration of internalizing and externalizing symptoms (versus other symptom types or problems) and the limited number of father-only studies from which to base conclusions about the relative effect of maternal vs. paternal depression.

CONCLUSIONS

The similarity between the current findings and previous meta-analyses suggests that researchers studying the effects of PD may be able to bypass more exhaustive clinical interviews for less burdensome depression symptom inventories. Furthermore, our findings suggest that researchers and clinicians should consider how PD impacts not just child depressive symptoms, but myriad problem behaviors.

Patterns of unhealthy lifestyle and their associations with depressive and anxiety symptoms among Chinese young adults: A latent class analysis

BACKGROUND

There is little evidence on the association between patterns of unhealthy lifestyle and mental health among young adults.

METHOD

This study included a total of 28,978 young adults aged 18 to 44 years old in Guangdong province in south China, which was conducted from September to December in 2022. We used latent class analysis to classify the patterns of unhealthy lifestyle among young adults and used multiple logistic regression to explore their associations with depressive and anxiety symptoms.

RESULT

The weighted prevalence of depressive and anxiety symptoms were 28.0 % and 19.5 %, respectively. The cumulative effect of unhealthy lifestyles on depressive and anxiety symptoms was significant. Five patterns of unhealthy lifestyle were classified. Compared to the relatively healthy lifestyle class, the class with more unhealthy lifestyles (OR = 6.54, 95 % CI: 5.70-7.51) and insufficient sleep (OR = 6.16, 95 % CI: 4.92-7.70) had higher risk for depressive and anxiety symptoms. Meaningfully, having adequate mental health literacy could reduce the risk of depressive and anxiety symptoms from unhealthy lifestyle by half.

LIMITATIONS

The cross-section design study limited causal inferences, and the self-report information may lead to recall bias.

CONCLUSIONS

Unhealthy lifestyles have a negative impact on depressive and anxiety symptoms through independent, cumulative and combined effects, and they could be interrelated. Unhealthy lifestyle patterns differed in younger population by socio-demographic characteristics and mental health literacy. Health-care professionals and policymakers may provide programs to intervene multiple unhealthy lifestyles and improve mental health literacy by integrating healthy lifestyle education to promote youngers' mental health.

Sleep quality as a mediator of the relationship between screen time and negative emotions among Chinese college freshmen

College freshmen are special populations facing great challenges in adapting to the brand new environment, and their lifestyle and emotional states are worthy of attention. Especially during the COVID-19 pandemic, their screen time and prevalence of negative emotions were significantly increased, but few studies have focused on such situation of college freshmen and illustrated relevant mechanisms. Thus, based on a sample of Chinese college freshmen during the COVID-19 pandemic, the current study aimed to investigate the association between their screen time and negative emotions (depression, anxiety and stress), and further explore the mediating effects of sleep quality. Data from 2,014 college freshmen was analyzed. The screen time was self-reported by participants using predesigned questionnaires. The Pittsburgh Sleep Quality Index (PSQI) and Chinese Version of Depression Anxiety and Stress Scale-21 (DASS-21) were used to assess sleep quality and emotional states, respectively. The mediation analysis was conducted to examine the meditation effect. Results indicated that participants with negative emotions tended to have longer daily screen time and worse sleep quality, sleep quality partially mediated the association between screen time and negative emotions.The critical role of sleep quality and related intervention measures should be recognized and implemented.

The multifaceted consequences and economic costs of child anxiety problems: A systematic review and meta-analysis

Background

Over a quarter of people have an anxiety disorder at some point in their life, with many first experiencing difficulties during childhood or adolescence. Despite this, gaps still exist in the current evidence base of the multiple consequences of childhood anxiety problems and their costs.

Methods

A systematic review of Medline, PsycINFO, EconLit and the National Health Service Economic Evaluation Database was conducted for longitudinal and economic studies reporting on the association between childhood anxiety problems and at least one individual-, family- or societal-level outcome or cost. All studies were synthesised narratively. For longitudinal studies, 'effect direction' was used as a common metric, with random effects meta-analysis undertaken where possible.

Results

Eighty-three studies met inclusion criteria and were synthesised narratively. We identified 788 separate analyses from the longitudinal studies, which we grouped into 15 overarching outcome domains. Thirteen of the studies were incorporated into 13 meta-analyses, which indicated that childhood anxiety disorders were associated with future anxiety, mood, behaviour and substance disorders. Narrative synthesis also suggested associations between anxiety problems and worse physical health, behaviour, self-harm, eating, relationship, educational, health care, employment, and financial outcomes. 'Effect direction' was conflicting in some domains due to a sparse evidence base. Higher economic costs were identified for the child, their families, healthcare providers and wider society, although evidence was limited and only covered short follow-up periods, up to a maximum of 2 years. Total annual societal costs per anxious child were up to £4040 (2021 GBP).

Conclusions

Childhood anxiety problems are associated with impaired outcomes in numerous domains, and considerable economic costs, which highlight the need for cost-effective interventions and policies to tackle them. More economic evidence is needed to inform models of the long-term, economic-related, consequences of childhood anxiety problems.

Association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students: a cross-sectional study in Zhejiang Province, China

Background

Existing literature on the association of electronic screen use duration with depression among adolescents is contradictory. The current study aimed to elucidate the association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students in Zhejiang Province, China.

Methods

A cross-sectional study of 27,070 students in grades 7-12 from 376 middle and high schools was conducted through an anonymous self-administered questionnaire between April and June 2022. Poisson regression was utilized to examine the association between electronic screen use duration for non-educational purposes and depression symptoms.

Results

Of the 27,006 eligible students, 51.6% (13932) were boys and the mean (SD) age was 15.6(1.7) years. The overall prevalence of symptoms of depression was 22.4% (95%CI 21.4-23.4); girls (27.6%, 26.2-29.0) had a higher prevalence than boys (17.7%, 16.7-18.8). After adjustment for socio-demographic status, lifestyle factors, self-perceived health, academic performance, loneliness and sadness, compared to those who did not use electronic screens for non-educational purposes, the prevalence ratios (PRs) for depression symptoms were 1.03 (95% CI 1.02-1.04) for those exposed to electronic screens for <1 h/day, 1.07 (1.05-1.09) for 1.0-1.9 h/day, 1.10 (1.07-1.13) for 2.0-2.9 h/day, 1.14 (1.10-1.18) for 3.0-3.9 h/day, 1.18 (1.12-1.23) for 4.0-4.9 h/day, and 1.21 (1.15-1.29) for ≥5 h/day.

Conclusion

Duration of electronic screen use for non-educational purposes was positively associated with symptoms of depression among middle and high school students, even with a relatively short daily duration of use.

Lifestyle Behaviors and Depressive Symptoms in Chinese Adolescents Using Regression and fsQCA Models

The study was to compare the performance of the regression models and fuzzy set qualitative comparative analysis (fsQCA) models in analyzing the possible effects of sociodemographic variables (age and sex) and lifestyle behaviors (physical activity, sedentary time, sleep duration, physical education class and screen time) on depressive symptoms in adolescents. This cross-sectional surgery was conducted among 726 adolescents in Jilin Province of China, selected by random cluster sampling. The regression model showed that age, physical education (PE) class and sleep duration were associated with depressive symptoms. Meanwhile, the fsQCA models showed that shorter physical activity, PE class and sleep duration as well as longer sedentary and screen time were related to higher levels of depressive symptoms. Both regression and fsQCA models indicated that promoting lifestyle behaviors could affect depressive symptoms. Considering the differences between the two methods, they are not superior to the other method, but complementary and should be used in other studies at the same time.

Associations between organised leisure-time activities and mental health problems in children

Previous studies conducted mainly among adolescents have found associations between participation in sport organised leisure-time activities (OLTAs) and mental health problems (MHP). Fewer research studies have been performed to primary school-aged children and to organised non-sport OLTAs. Therefore, the objective is to examine whether there is an association between participation in sport and non-sport OLTAs and a high risk of MHP in 4- to 12-year-olds. Data were used on 5010 children from a cross-sectional population-based survey conducted between May and July 2018 in Rotterdam, the Netherlands. Associations between sport OLTAs, non-sport OLTAs and breadth of OLTAs and a high risk of MHP were explored using logistic regression models adjusting for sociodemographic characteristics, stressful life events and physical activity. Of all children, 58% participated in sport OLTAs and 22% in non-sport OLTAs. The proportion of children with high risk of MHP among participants in sport OLTAs is smaller than among non-participants (OR 0.66, 95% CI: 0.53, 0.81). The proportion of children with high risk of MHP among participants in non-sport OLTAs is smaller than among non-participants (OR 0.69, 95% CI: 0.53, 0.91). The proportion of children with a high risk of MHP among participants in 1 category of OLTAs (OR 0.61, 95% CI: 0.49, 0.76) and in 2-5 categories of OLTAs (OR 0.48, 95% CI: 0.32, 0.71) is smaller than among non-participants.  Conclusion: The proportion of children with high risk of MHP among participants in OLTAs is smaller than among non-participants. What is Known: • Around 10--20% of children and adolescents experiences mental health problems. • Sport organised leisure-time activities have been found to be associated with a lower risk of mental health problems in adolescents. What is New: • The proportion of children with a high risk of mental health problems in participants in organised leisure-time activities is smaller than among non-participants. • The proportion of children with a high risk of mental health problems in participants with a higher breadth of organised leisure-time activities is smaller compared to non-participants.

Sleep duration does not mediate the association between screen time and adolescent depression and anxiety: findings from the 2018 National Survey of Children's Health

OBJECTIVE/BACKGROUND

Adolescence is a crucial time period in which individuals are at high risk for depression and anxiety. Associations between screen time and adolescent depression and anxiety have been inconclusive. We examined 1) the associations of screen time with adolescent depression and anxiety and 2) whether sleep duration mediates these relationships.

METHODS

This study utilized data from the 2018 US. National Survey of Children's Health, a large cross-sectional population representative dataset with parent/caregiver responses. Multivariable logistic regression was used to estimate the associations between screen time and depression and anxiety in separate models. Path models were used to test the mediating role of sleep duration. Confounders, as sex, age, and sociodemographic variables were included in our adjusted models.

RESULTS

Data of 10,907 adolescents aged 13 to 17 were included in this study. The average screen time was 3.76 h daily. Compared to no screen time, adolescents who used over 4 h of screen time per day had higher odds of depression (OR = 2.23, 95% CI:1.27-3.91) and anxiety (OR = 1.85, 95% CI: 1.26-2.72). Sleep duration did not mediate the associations between screen time and depression and anxiety.

CONCLUSIONS

Further research is necessary to examine the associations of screen time content with depression and anxiety, as well as the effects of sleep quality in conjunction with sleep duration on the relationships of screen time and depression and anxiety.

Childhood adversity and adolescent psychopathology: evidence for mediation in a national longitudinal cohort study

BACKGROUND

Childhood adversity is a well-established risk factor for psychopathology; however, many who experience adversity do not go on to develop psychopathology. Poor self-concept and poor parental support are known risk factors for adolescent psychopathology, which may account for some of this mechanism.

AIMS

To investigate candidate mediators in the relationship between childhood adversity and psychopathology.

METHOD

We used data from the age 9 and 13 waves of the child-cohort of the Growing Up in Ireland study. We undertook mediation analysis by path decomposition of the relationship between childhood adversity and psychopathology (internalising and externalising problems) at age 13 and persistent psychopathology. Candidate mediators were self-concept, parent-child relationship and hobby participation at age 9.

RESULTS

Childhood adversity was reported by 28.2% of participants, and was significantly associated with internalising and externalising problems. Parent-child conflict mediated the relationship between childhood adversity and both age 13 and persistent psychopathology, accounting for 52.4% of the relationship between childhood adversity and persistent externalising problems (indirect odds ratio, 1.30; 95% CI 1.19-1.43) and 19.2% for persistent internalising problems (indirect odds ratio, 1.24; 95% CI 1.15-1.34). There was a small mediating effect of self-concept. Hobby participation and positive parent-child relationship did not mediate these relationships.

CONCLUSIONS

Parent-child conflict explains almost half the relationship between childhood adversity and persisting externalising problems in adolescence, and a fifth of the relationship with persisting internalising problems. This suggests parent-child conflict is a good target for interventions in childhood to prevent adolescent psychopathology.

DECLARATION OF INTEREST

None.

Organized Activity Involvement among Urban Youth: Understanding Family- and Neighborhood- Level Characteristics as Predictors of Involvement

Research examining factors that predict youth's involvement in organized activities is very limited, despite associations with positive outcomes. Using data from 1043 youth (49% female; 46.4% Hispanic, 35.4% African American, 14.0% Caucasian, and 4.2% other) from the Project on Human Development in Chicago Neighborhoods, this study examined how characteristics of parents (supervision, warmth) and neighborhoods (perceived neighborhood safety and collective efficacy) predict patterns of adolescents' involvement in organized activities concurrently (i.e., intensity) and longitudinally (i.e., type and breadth). Parental supervision predicted adolescents' participation in organized activities across multiple waves. Neighborhood violence was positively associated with concurrent participation in organized activities after controlling for socioeconomic status (SES), whereas higher neighborhood collective efficacy predicted greater breadth in organized activity participation across time. These findings have important implications regarding how to attract and sustain organized activity participation for low-income, urban youth.

School connectedness and high school graduation among maltreated youth

Maltreated youth have higher rates of school dropout than their non-maltreated peers. School connectedness is a modifiable predictor of school success. We hypothesized maltreated youth's school connectedness (supportive relationships with adults at school and participation in school clubs) would be positively associated with high school graduation. We included youth with at least one Child Protective Services (CPS) report by age twelve from Longitudinal Studies of Child Abuse and Neglect, a prospective cohort study. Participation in extracurricular activities and adult relationships reported at age 16, high school graduation/General Education Development (GED) status reported at age 18, and demographics were provided by youth and caregivers. Maltreatment data were coded from CPS records. The outcome was graduation/receipt of GED. Multivariable logistic regressions examined the association between school connectedness and graduation/receipt of GED, controlling for confounders. In our sample of 318 maltreated youth, 73.3% graduated. School club was the only activity with a statistically significant association with graduation in bivariate analysis. Having supportive relationships with an adult at school was not significantly associated with graduation, though only 10.7% of youth reported this relationship. Maltreated youth who participated in school clubs had 2.54 times the odds of graduating, adjusted for study site, gender, poverty status, caregiver high school graduation status, and age at first CPS report (95% CI: [1.02, 6.33]). Few maltreated youth reported relationships with adults at school, and additional efforts may be needed to support these vulnerable youth. School club participation may represent an opportunity to modify maltreated youth's risk for school dropout.

Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description

The Adolescent Brain and Cognitive Development (ABCD) Study incorporates a comprehensive range of measures assessing predictors and outcomes related to both mental and physical health across childhood and adolescence. The workgroup developed a battery that would assess a comprehensive range of domains that address study aims while minimizing participant and family burden. We review the major considerations that went into deciding what constructs to cover in the demographics, physical health and mental health domains, as well as the process of selecting measures, piloting and refining the originally proposed battery. We present a description of the baseline battery, as well as the six-month interim assessments and the one-year follow-up assessments. This battery includes assessments from the perspectives of both the parent and the target youth, as well as teacher reports. This battery will provide a foundational baseline assessment of the youth's current function so as to permit characterization of stability and change in key domains over time. The findings from this battery will also be utilized to identify both resilience markers that predict healthy development and risk factors for later adverse outcomes in physical health, mental health, and substance use and abuse.

The impact of extracurricular activities participation on youth delinquent behaviors: An instrumental variables approach

The purpose of this study was to examine the association between extracurricular activities (EA) participation and youth delinquency while tackling an endogeneity problem of EA participation. Using survey data of 12th graders in South Korea (n = 1943), this study employed an instrumental variables approach to address the self-selection problem of EA participation as the data for this study was based on an observational study design. We found a positive association between EA participation and youth delinquency based on conventional regression analysis. By contrast, we found a negative association between EA participation and youth delinquency based on an instrumental variables approach. These results indicate that caution should be exercised when we interpret the effect of EA participation on youth delinquency based on observational study designs.

Participation in organized leisure-time activities and risk behaviors in Czech adolescents

Objectives

The study aimed to assess the associations between participation in organized leisure-time activities (OLTA) and risk behaviors, and whether the associations differed by gender, age, and pattern of OLTA involvement.

Methods

Data from the 2013/2014 Health Behaviour in School-Aged Children study on 10,279 11-, 13-, and 15-year-old Czech adolescents (49.2% boys) were used. We assessed the associations between OLTA participation and risk behaviors, and modification by age and gender.

Results

OLTA participants were less likely to smoke, get drunk repeatedly, or skip school and, in contrast, more likely to get injured and fight repeatedly. The associations with lower occurrence of risk behaviors were the strongest for artists, while none was significant for adolescents participating only in team sports. Girls participating in OLTA had lower odds to smoke, get drunk, or skip school than boys, and these boys had higher odds to get injured or fight.

Conclusions

OLTA participation is associated with lower occurrence of repeated substance use and truancy and inversely with higher odds for physical fights and injuries. Girls, in general, are at lower risk when participating in OLTA than boys.

Post-Disaster Mental Health Among Parent-Child Dyads After a Major Earthquake in Indonesia

The interdependent adjustment of children and their parents following disasters has been well documented. We used the Actor-Partner Interdependence Model (APIM) to provide an appropriate analytical framework for examining how family members may contribute to each other's post-disaster mental health. Independent self-reports were collected from parent-child dyads (n = 397) residing in a rural community in Indonesia that was devastated by a major earthquake. Elementary school children (M = 10 years; 51 % female) and one of their parents (M = 41 years; 73 % female) each reported on their disaster exposure, posttraumatic stress (PTS) symptoms, and general distress. The APIM was used to examine mental health within dyads and moderation by gender across dyads. Children reported lower disaster exposure and fewer PTS symptoms, but similar general distress levels, as their parents. Children's and parents' disaster-specific PTS symptoms were the strongest predictor of their own general distress. Parents' PTS symptoms were associated with children's general distress (b = 0.14, p < 0.001), but children's PTS symptoms were not associated with parents' general distress (b = -0.02, p > 0.05). Findings were not moderated by parents' or children's gender. Although children and parents may respond differently to natural disasters, they may be best understood as a dyad. APIM analyses provide new evidence suggesting a unidirectional path of influence from parents' disaster-related symptomatology to children's general mental health. Dyadic approaches to understanding mental health and treating symptoms of distress among disaster survivors and their families following trauma are encouraged.

Trajectories of Organized Activity Participation Among Urban Adolescents: An Analysis of Predisposing Factors

Organized activity participation provides important opportunities for adolescents to develop assets and resources related to positive youth development. Predisposing factors, in addition to sociodemographics and self-selection factors, may influence how youth participate over time. In this study, we used growth mixture modeling with longitudinal data from African American adolescents attending urban high schools in Flint, MI to identify subgroups of participation trajectories (Wave 1 N = 681, mean age at Wave 1 = 14.86 years, 51% female). We measured activity participation using psychological and behavioral engagement across multiple contexts over the 4 years of high school. We examined how predisposing risk and promotive factors were related to these trajectories, accounting for sociodemographic and self-selection factors. The results indicated three participation trajectories: a low group decreasing over time (74%), a moderate, consistent participation group (21%) and a moderate, increasing group (5%). More substance use was associated with lower odds of being in the moderate/consistent versus low/decreasing participation group. More parental support was associated with lower odds of being in the moderate/increasing versus the moderate/consistent group. Our results suggest that addressing predisposing factors such as substance use may help facilitate participation over time.

Family interventions in traumatized immigrants and refugees: A systematic review

The importance of the family as a unit in the aftermath of trauma necessitates the use of family interventions among immigrants and refugees. While abundant clinical material suggests that family-based trauma interventions are applicable across cultures, very little is known about the extent to which family treatment modalities are effective for immigrants and refugees. We conducted a systematic review of intervention studies that have been designed or modified specifically for traumatized immigrant and refugee families. The terms "trauma," "family," and "immigrants/refugees/culture" were used along with different terms for "intervention." Studies with no research methodology were excluded. Only 6 experimental studies met our inclusion criteria; 4 of them describe school-based interventions and 2 present multifamily support groups. The shortage of research in this area does not allow clear conclusions about the effectiveness of family interventions for traumatized immigrants or refugees. The complexity of employing methodologically rigorous research in small communities is discussed. Future trials should go beyond the individualistic approach and focus on posttraumatic stress disorder to address family-level processes, such as family relationship, communication, and resilience.

High School Sports Involvement Diminishes the Association Between Childhood Conduct Disorder and Adult Antisocial Behavior

PURPOSE

Life course-persistent antisocial behavior manifests as a display of aggressive and antisocial behavior beginning in childhood (conduct disorder [CD]) and lasting through adulthood (adult antisocial personality disorder). This study aimed to build on prior research by evaluating whether involvement in high school sports helped attenuate the association between CD and subsequent adult antisocial behavior (AAB).

METHODS

A prospective sample of 967 male and female adolescents (56% adopted) was used. Structured interviews were used to assess CD (symptoms before the age of 15 years), involvement in sports during high school, and past-year adult antisocial personality disorder symptoms in young adulthood (M age = 22.4 years).

RESULTS

As expected, the association between CD and AAB was significantly less for those involved in sports (β = .28; p < .001) compared with those not involved in sports (β = .49; p < .001), χ(2)(1) = 4.13; p = .04. This difference remained after including known covariates of antisocial behavior in the model (age, gender, adoption status), and results were consistent across males and females. Involvement in other extracurricular activities (e.g., student government, plays, clubs) did not significantly moderate the relationship between CD and AAB.

CONCLUSIONS

Although selection effects were evident (those with more CD symptoms were less likely to be involved in sports), findings nevertheless suggest high school sports involvement may be a notable factor related to disrupting persistent antisocial behavior beginning in childhood and adolescence and lasting through young adulthood. Implications are discussed.

Relations of participation in organized activities to smoking and drinking among Japanese youth: contextual effects of structural social capital in high school

OBJECTIVES

This cross-sectional study examined the effect of school-level structural social capital on smoking and drinking among Japanese youth.

METHODS

Self-administered anonymous questionnaires were distributed to 3248 students at 29 high schools across Okinawa, Japan in 2008. Structural social capital was measured by students' participation in organized activities: student council, extracurricular activities, volunteer activities, community sports clubs, and youth associations. Contextual-level social capital was measured by aggregated school-level individual responses.

RESULTS

At the individual level, extracurricular activity participation was negatively associated with smoking and drinking, whereas participation in youth associations was positively associated with smoking and drinking. School-level extracurricular activity participation was negatively associated with smoking among boys, whereas school-level participation in youth associations was positively associated with smoking among boys and girls and drinking among boys.

CONCLUSIONS

This study suggests that structural social capital measured by participation in organized activities, especially extracurricular activities, might be an important way for youths to attain good health. This study also supports the idea that particular type of activities, such as youth associations, can lead to the so-called "dark side of social capital".

Patterns of time use among low-income urban minority adolescents and associations with academic outcomes and problem behaviors

Time budgets represent key opportunities for developmental support and contribute to an understanding of achievement gaps and adjustment across populations of youth. This study assessed the connection between out-of-school time use patterns and academic performance outcomes, academic motivations and goals, and problem behaviors for 504 low-income urban African American and Latino adolescents (54% female; M = 16.6 years). Time use patterns were measured across eight activity types using cluster analysis. Four groups of adolescents were identified, based on their different profiles of time use: (1) Academic: those with most time in academic activities; (2) Social: those with most time in social activities; (3) Maintenance/work: those with most time in maintenance and work activities; and (4) TV/computer: those with most time in TV or computer activities. Time use patterns were meaningfully associated with variation in outcomes in this population. Adolescents in the Academic cluster had the highest levels of adjustment across all domains; adolescents in the Social cluster had the lowest academic performance and highest problem behaviors; and adolescents in the TV/computer cluster had the lowest levels of intrinsic motivation. Females were more likely to be in the Academic cluster, and less likely to be in the other three clusters compared to males. No differences by race or gender were found in assessing the relationship between time use and outcomes. The study's results indicate that time use patterns are meaningfully associated with within-group variation in adjustment for low-income minority adolescents, and that shared contexts may shape time use more than individual differences in race/ethnicity for this population.

Screen time is associated with depression and anxiety in Canadian youth

OBJECTIVE

This study examined the relationships between screen time and symptoms of depression and anxiety in a large community sample of Canadian youth.

METHOD

Participants were 2482 English-speaking grade 7 to 12 students. Cross-sectional data collected between 2006 and 2010 as part of the Research on Eating and Adolescent Lifestyles (REAL) study were used. Mental health status was assessed using the Children's Depression Inventory and the Multidimensional Anxiety Scale for Children-10. Screen time (hours/day of TV, video games, and computer) was assessed using the Leisure-Time Sedentary Activities questionnaire.

RESULTS

Linear multiple regressions indicated that after controlling for age, sex, ethnicity, parental education, geographic area, physical activity, and BMI, duration of screen time was associated with severity of depression (β=0.23, p<0.001) and anxiety (β=0.07, p<0.01). Video game playing (β=0.13, p<.001) and computer use (β=0.17, p<0.001) but not TV viewing were associated with more severe depressive symptoms. Video game playing (β=0.11, p<0.001) was associated with severity of anxiety.

CONCLUSION

Screen time may represent a risk factor or marker of anxiety and depression in adolescents. Future research is needed to determine if reducing screen time aids the prevention and treatment of these psychiatric disorders in youth.

Cigarette smoking, problem-gambling severity, and health behaviors in high-school students

Introduction

Smoking and gambling are two significant public health concerns. Little is known about the association of smoking and gambling in adolescents. The current study of high-school adolescents examined: (1) smoking behavior by problem-gambling severity and (2) health-related variables by problem-gambling severity and smoking status.

Methods

Analyses utilized survey data from 1591 Connecticut high-school students. Adolescents were classified by problem-gambling severity (Low-Risk Gambling [LRG], At-Risk/Problem Gambling [ARPG]) and smoking status (current smoker, non-smoker). Analyses examined the smoking behavior of ARPG versus LRG adolescents as well as the smoking-by-problem-gambling-severity interactions for health and well-being measures (e.g., grades, substance use). Chi-square and logistic regression analyses were used; the latter controlled for gender, race/ethnicity, school grade, and family structure.

Results

More adolescents with ARPG than LRG reported regular smoking, heavy smoking, early smoking onset, no smoking quit attempts, and parental approval of smoking. ARPG and LRG adolescents who smoked were more likely to report poor grades, lifetime use of marijuana and other drugs, current heavy alcohol use, current caffeine use, depression, and aggressive behaviors and less likely to report participation in extracurricular activities. The association between not participating in extracurricular activities and smoking was statistically stronger in the LRG compared to the ARPG groups. Post-hoc analyses implicated a range of extracurricular activities including team sports, school clubs, and church activities.

Conclusions

Smoking was associated with poorer health-related behaviors in both ARPG and LRG groups. Interventions with adolescents may benefit from targeting both smoking and gambling.

•

We examined adolescent health behaviors by smoking status and gambling severity.

•

Smoking was associated with poorer health behaviors for adolescent gamblers.

•

Considering smoking may be helpful in interventions with adolescent gamblers.

Parent-adolescent joint projects involving leisure time and activities during the transition to high school

Leisure research to date has generally overlooked planning and organizing of leisure time and activities between parents and adolescents. This investigation examined how a sample of Canadian adolescents and their parents jointly constructed and acted on goals related to adolescents' leisure time during the move from elementary to high school. Using the Qualitative Action-Project Method, data were collected over an 8-10 month period from 26 parent-adolescent dyads located in two urban sites, through video-taped conversations about leisure time, video recall interviews, and telephone monitoring interviews. Analysis of the data revealed that the joint projects of the 26 dyads could be grouped into three clusters: a) governance transfer or attempts to shift, from parent to adolescent, responsibility over academic demands, organizing leisure time, and safety with peers, b) balancing extra-curricular activities with family life, academics, and social activities, and c) relationship adjustment or maintenance.

Breadth of participation in organized and unstructured leisure activities over time and rural adolescents' functioning

Discretionary time outside of school offers a distinct context that can promote adolescent development; however, potential for growth depends in part on how this time is used. In this study, person-centered analyses were used to examine patterns of breadth of participation in both organized and unstructured leisure activities among rural adolescents (N = 276, 49% female) across grades 7, 8, and 10. Adjusting for self-selection factors, the study associated these patterns with 10th grade outcomes. Three profiles of participation emerged: consistently low breadth, consistently average breadth, and consistently high breadth of involvement in both organized and unstructured leisure activities over time. The most popular activity types across profile groups were hanging out with friends, team sports, and outdoor activities. Adolescents involved in a greater breadth of organized activities reported the greatest breadth of involvement in unstructured leisure and the best functioning. Adolescents with low breadth of involvement in both organized and unstructured leisure activities consistently showed poorer outcomes. Adolescents in the high breadth of involvement profile were engaged in all activity types at higher rates than adolescents in the average and low breadth of involvement profiles. We advocate for continued efforts to increase adolescent participation in a variety of different types of out-of-school activities.

Extracurricular activity availability and participation and substance use among American Indian adolescents

School-based extracurricular activity involvement has been associated with lower levels of substance use among adolescents from various populations; however, these associations have only been slightly examined among American Indian (AI) adolescents. Building from various theoretical perspectives, it was hypothesized that AI adolescents' perceived access to and the intensity (i.e., frequency) of participation in extracurricular activities would be associated with lower substance use and less engagement in risky substance use behaviors (i.e., being drunk or high at school, riding/driving with an intoxicated driver, and selling drugs). The moderating influences of sex, age, reservation residence, and metropolitan status also were examined. Data from the 2010 Arizona Youth Survey were analyzed for 5,701 8th, 10th, and 12th grade AI adolescents (49.1% female). The expected protective effects of extracurricular participation were demonstrated, such that high levels of perceived availability and intensity of participation consistently predicted low levels of all outcomes. Some of these associations were moderated by one or more demographic factors, with unique patterns emerging for each behavior. Ultimately, the findings suggest that AI adolescents benefit from the availability of extracurricular activities and intensity of participation in them, but the degree of the effect is contingent upon other individual and contextual characteristics.

Can Organized Youth Activities Protect Against Internalizing Problems Among Adolescents Living in Violent Homes?

Using longitudinal data from a subsample of Hispanic, African American, and white youth enrolled in the Project on Human Development in Chicago Neighborhoods (N = 1,419), we examined the effects of both parental involvement in domestic violence and youth participation in organized out-of-school-time activities on internalizing symptoms during adolescence. We also examined the extent to which participation in organized activities protected youth against the internalizing consequences of domestic violence. We found that intensive participation in either afterschool programs or extracurricular activities was inversely associated with youth internalizing problems. Moreover, we found that intensive participation in afterschool programs weakened the association between parents' domestic violence and youths' internalizing problems.

The Over-Scheduling Hypothesis Revisited: Intensity of Organized Activity Participation During Adolescence and Young Adult Outcomes

Concern exists that youth who spend a lot of time participating in organized out-of-school activities (e.g., sports) are at-risk for poor developmental outcomes. This concern - called the over-scheduling hypothesis - has primarily been assessed in terms of adolescent adjustment. This longitudinal study of a nationally representative sample of 1,115 youth (ages 12-18) assessed long-term relations between intensity of participation during adolescence and adjustment at young adulthood (ages 18-24). Time diaries measured intensity as hours per week of participation. Results showed that, controlling for demographic factors and baseline adjustment, intensity was a significant predictor of positive outcomes (e.g., psychological flourishing, civic engagement, educational attainment) and unrelated to indicators of problematic adjustment (e.g., psychological distress, substance use, antisocial behavior) at young adulthood.

A network method of measuring affiliation-based peer influence: assessing the influences of teammates' smoking on adolescent smoking

Using a network analytic framework, this study introduces a new method to measure peer influence based on adolescents' affiliations or 2-mode social network data. Exposure based on affiliations is referred to as the "affiliation exposure model." This study demonstrates the methodology using data on young adolescent smoking being influenced by joint participation in school-based organized sports activities with smokers. The analytic sample consisted of 1,260 American adolescents from ages 10 to 13 in middle schools, and the results of the longitudinal regression analyses showed that adolescents were more likely to smoke as they were increasingly exposed to teammates who smoke. This study illustrates the importance of peer influence via affiliation through team sports.

Time use differences in activity participation among children 4-5 years old with and without the risk of developing conduct problems

Conduct problems in childhood are associated with the way in which children engage in daily activities. Research, to date, on conduct problems in relation to time use has primarily focused on school aged children and their participation in discrete activities such as watching TV and sport. The purpose of the present study is to determine if children at risk of developing conduct problems have different activity patterns compared to those not at risk. Specifically aspects of time use which concern involvement in activities that provide physical exertion, structure, rest and social engagement were examined. Data for this investigation were drawn from the Longitudinal Study of Australian Children (Wave 1) and focused on 4936 children aged 4-5 years. Findings indicate that children at risk of developing conduct problems spend significantly more time in: physical activities such as "riding a bike", and "in the company of adults only" than children not at risk of developing conduct problems but less time "with peers under adult supervision". Gender differences were also found in the same activities with boys participating in more "bike riding" and activities "without peers under adult supervision" than girls. Young children generally participated in more physical activities and spend more time "with peers while supervised by adults" on weekend days, and more time in "structured activities" and "in the company of adults only" on weekdays. These findings are discussed in respect of the potentially risky nature of physical activity choice and the contribution of adult supervision in the context of peer group participation for children at risk of developing conduct problems.

Beyond participation: the association between school extracurricular activities and involvement in violence across generations of immigration

Participation in extracurricular activities is purported to protect the broad spectrum of youth from a host of behavioral risks. Yet, empirical research on the extent to which this assumption holds for involvement in violence by immigrant youth is limited. Thus, using data for 13,236 (51.8% female) adolescents from the National Longitudinal Study of Adolescent Health, this study explores how the relationship between extracurricular activities and youth violence varies by type of extracurricular activity profile (sports alone, non-sports alone, and a combination of sports and non-sports) and by generations of immigration (first, second, and third-plus). The sample is composed of 9.3% (n = 1,233) first-generation youth, 15.7% (n = 2,080) second generation, and 74.9% (n = 9,923) third-plus generation. The results reveal that adolescents from the third-plus generation (i.e., non-immigrant youth) who participate in non-sports alone or sports plus non-sports have lower odds of involvement in violence than adolescents from the same generation who do not participate in extracurricular activities. However, for first- and second-generation adolescents, participation in extracurricular activities is associated with higher rather than lower odds of violence compared to their non-participating counterparts. These findings challenge the viewpoint that participation in mainstream extracurricular activities as afforded by US schools is equally beneficial for all youth. They also call for additional research that explores why immigrant youth are less likely than non-immigrant youth to gain violence-reducing benefits when they participate in extracurricular activities.

Creating nurturing environments: a science-based framework for promoting child health and development within high-poverty neighborhoods

Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods Research Consortium describes a science-based framework for the promotion of child health and development within distressed high-poverty neighborhoods. We lay out a model of child and adolescent developmental outcomes and integrate knowledge of potent and malleable influences to define a comprehensive intervention framework to bring about a significant increase in the proportion of young people in high-poverty neighborhoods who will develop successfully. Based on a synthesis of research from diverse fields, we designed the Creating Nurturing Environments framework to guide community-wide efforts to improve child outcomes and reduce health and educational inequalities.

Using ecological momentary assessment to determine media use by individuals with and without major depressive disorder

OBJECTIVE

To use ecological momentary assessment techniques to measure the association of major depressive disorder (MDD) with media use.

DESIGN

Data were collected using an ecological momentary assessment protocol with cellular telephone-based brief interviews.

SETTING

Participants received as many as 60 telephone calls from a trained staff member during 5 extended weekends in an 8-week period.

PARTICIPANTS

One hundred six adolescent participants who were part of a larger neurobehavioral study of depression in Pittsburgh from January 1, 2003, through December 31, 2008.

MAIN EXPOSURE

At each call, participants were asked whether they were using the following 5 types of media: television or movies, music, video games, Internet, and print media, such as magazines, newspapers, and books.

MAIN OUTCOME MEASURES

We developed multivariable models to determine the independent association of each type of media use with MDD, controlling for sociodemographic variables.

RESULTS

Of the 106 participants, 46 were diagnosed as having MDD. In multivariable models controlling for age, sex, and race, each increasing quartile of audio use was associated with an 80% increase in the odds of having MDD (odds ratio, 1.8; 95% confidence interval, 1.1-2.8; P = .01 for trend). Conversely, each increasing quartile of print media use was associated with a 50% decrease in the odds of having MDD (odds ratio, 0.5; 95% confidence interval, 0.3-0.9; P = .009 for trend).

CONCLUSIONS

Major depressive disorder is positively associated with popular music exposure and negatively associated with reading print media such as books. Further research elucidating the directionality and strength of these relationships may help advance understanding of the relationships between media use and MDD.

Longitudinal Modeling of Adolescents' Activity Involvement, Problem Peer Associations, and Youth Smoking

Longitudinal associations among different types of organized activity involvement, problem peer associations, and cigarette smoking were examined in a sample of 1,040 adolescents (mean age = 15.62 at baseline, 16.89 at 15-month assessment, 17.59 at 24 months) enriched for smoking experimentation (83% had tried smoking). A structural equation model tested longitudinal paths between three categories of involvement (team sports, school clubs and activities, and religious activities, measured at baseline and 15 months), problem peer associations (baseline and 15 months), and cigarette smoking behavior (baseline and 24 months). Multi-group analyses indicated pathways differed by type of activity and adolescent gender. Boys' baseline team sports and religious involvement predicted lower levels of smoking at 24 months via continued activity involvement at 15 months. Girls' involvement in school clubs and activities and religious activities indirectly predicted lower levels of smoking at 24 months via reduced exposure to problem peers at 15 months.

Brain activation while thinking about the self from another person's perspective after traumatic brain injury in adolescents

Deficits in self awareness and taking the perspective of others are often observed following traumatic brain injury (TBI). Nine adolescents (ages 12-19 years) who had sustained moderate to severe TBI after an average interval of 2.6 years and nine typically developing (TD) adolescents underwent functional MRI (fMRI) while performing a perspective taking task (D'Argembeau et al., 2007). Participants made trait attributions either from their own perspective or from that of the significant other. The groups did not differ in reaction time or on a consistency criterion. When thinking of the self from a third-person perspective, adolescents with TBI demonstrated greater activation in posterior brain regions implicated in social cognition, the left lingual gyrus (BA 18) and posterior cingulate (BA 31), extending into neighboring regions not generally associated with social cognition, that is, cuneus (BA 31) and parahippocampal gyrus, relative to TD adolescents. We postulate that adolescents with moderate to severe TBI recruited alternative neural pathways during perspective-taking because traumatic axonal injury disrupted their fronto-parietal networks mediating social cognition.

Association between media use in adolescence and depression in young adulthood: a longitudinal study

CONTEXT

Although certain media exposures have been linked to the presence of psychiatric conditions, few studies have investigated the association between media exposure and depression.

OBJECTIVE

To assess the longitudinal association between media exposure in adolescence and depression in young adulthood in a nationally representative sample.

DESIGN

Longitudinal cohort study.

SETTING AND PARTICIPANTS

We used the National Longitudinal Survey of Adolescent Health (Add Health) to investigate the relationship between electronic media exposure in 4142 adolescents who were not depressed at baseline and subsequent development of depression after 7 years of follow-up. Main Outcome Measure Depression at follow-up assessed using the 9-item Center for Epidemiologic Studies-Depression Scale.

RESULTS

Of the 4142 participants (47.5% female and 67.0% white) who were not depressed at baseline and who underwent follow-up assessment, 308 (7.4%) reported symptoms consistent with depression at follow-up. Controlling for all covariates including baseline Center for Epidemiologic Studies-Depression Scale score, those reporting more television use had significantly greater odds of developing depression (odds ratio [95% confidence interval], 1.08 [1.01-1.16]) for each additional hour of daily television use. In addition, those reporting more total media exposure had significantly greater odds of developing depression (1.05 [1.0004-1.10]) for each additional hour of daily use. We did not find a consistent relationship between development of depressive symptoms and exposure to videocassettes, computer games, or radio. Compared with young men, young women were less likely to develop depression given the same total media exposure (odds ratio for interaction term, 0.93 [0.88-0.99]).

CONCLUSION

Television exposure and total media exposure in adolescence are associated with increased odds of depressive symptoms in young adulthood, especially in young men.