Evidence of an active role of dreaming in emotional memory processing shows that we dream to forget

Dreaming is a universal human behavior that has inspired searches for meaning across many disciplines including art, psychology, religion, and politics, yet its function remains poorly understood. Given the suggested role of sleep in emotional memory processing, we investigated whether reported overnight dreaming and dream content are associated with sleep-dependent changes in emotional memory and reactivity, and whether dreaming plays an active or passive role. Participants completed an emotional picture task before and after a full night of sleep and they recorded the presence and content of their dreams upon waking in the morning. The results replicated the emotional memory trade-off (negative images maintained at the cost of neutral memories), but only in those who reported dreaming (Dream-Recallers), and not in Non-Dream-Recallers. Results also replicated sleep-dependent reductions in emotional reactivity, but only in Dream-Recallers, not in Non-Dream-Recallers. Additionally, the more positive the dream report, the more positive the next-day emotional reactivity is compared to the night before. These findings implicate an active role for dreaming in overnight emotional memory processing and suggest a mechanistic framework whereby dreaming may enhance salient emotional experiences via the forgetting of less relevant information.

Navigating menopause at work: a preliminary study about challenges and support systems

OBJECTIVE

Women's increasing workforce participation necessitates understanding unique life phases like menopause for enhanced workplace inclusivity. This research investigates the challenges and needs of peri-menopausal women in work settings, using the Job Demands-Resources model as a foundation.

METHODS

A cross-sectional survey was administered to 351 working women aged 40 to 65 years in the United States. Hierarchical multiple regression models were employed to assess the relationship between the severity of menopausal symptoms, emotional exhaustion, work engagement, and turnover intentions.

RESULTS

Most of the respondents reported moderate (38.46%) to severe (35.9%) menopausal symptoms. Notably, 54% of the women were caregivers for children or adults. About 77.7% of participants reported work-related challenges due to menopause, with a perceived reduction in productivity (56.8%) being the most common issue. The severity of menopausal symptoms was found to significantly predict more emotional exhaustion ( P < 0.001), less work engagement ( P < 0.001), and greater turnover intentions ( P = 0.03). Concerns about being perceived as less capable in the workplace due to menopausal symptoms were reported by 51.2% of respondents. A striking gap exists between the workplace measures desired by women, such as formal menopause policies and managerial training (65.4%-68%), and their actual implementation (2%-6.3%).

CONCLUSIONS

This study reveals an exigent need for increased awareness and structural changes to support working women going through menopause. The findings have far-reaching implications for not just promoting gender equity and well-being but are also pivotal for maintaining a diversified, engaged, and effective workforce.

Prospective association of screen time with binge-eating disorder among adolescents in the United States: The mediating role of depression

OBJECTIVE

Screen time has been reported to be associated with binge-eating disorder (BED) among adolescents in the US; however, potential mediators remain unclear. This study aimed to evaluate depression symptoms as a mediator of the prospective association between screen time and BED.

METHOD

We utilized data from 9465 children (aged 9-11 years at baseline) from the Adolescent Brain Cognitive Development (ABCD) study (2016-2021). A generalized structural equation model was used to examine the prospective association between average daily screen time at baseline and BED at year 2, adjusting for baseline BED diagnosis, and other potential covariates (e.g., age, sex, and income). Mediation was examined using bias-corrected (BC) 95% confidence intervals for the indirect effect of baseline screen time on year 2 BED through depression symptoms (change from baseline to year 1).

RESULTS

One hundred and one participants (42.7% male, 49.4% racial/ethnic minority) met the criteria for BED in year 2. Participants were 9.9 years of age on average at baseline, 51.3% identified as male, and 43.1% identified as a racial/ethnic minority. Adjusting for covariates, screen time was prospectively associated with BED (OR = 1.09, 95% CI [1.03, 1.14], p = .005). Depression symptoms (B = .19, BC 95% CI [0.10, 0.28]) partially mediated (9.2%) the prospective association between screen time and BED.

DISCUSSION

Among US adolescents, higher baseline screen time was prospectively associated with BED diagnosis at year 2, and this relationship was partially mediated by increased depression symptoms. Preventive approaches targeting high screen use may have utility for reducing BED risk among adolescents.

PUBLIC SIGNIFICANCE

Among U.S. adolescents, higher screen time was prospectively associated with the incidence of BED. This association was partially mediated by the change in depressive symptoms. Preventive approaches targeting high screen use may have utility for reducing BED risk among adolescents.

Social Media Use and Alcohol Sipping in Early Adolescents: A Prospective Cohort Study

BACKGROUND

Social media can influence alcohol initiation behaviors such as sipping, which can lead to future adverse alcohol-related outcomes. Few studies have examined the role of problematic social media use, characterized by addiction, mood modification, tolerance, withdrawal, conflict, and relapse, especially in early adolescence.

OBJECTIVE

To examine the prospective association between social media use and sipping alcohol in a nationwide sample of early adolescents, and the extent to which problematic social media use mediates the association.

METHODS

We analyzed prospective data from the Adolescent Brain Cognitive Development Study (N = 7514; ages 9-10 years at baseline; 2016-2018) to estimate associations between social media time (Year 1) and alcohol sipping (Year 3) using modified Poisson regression, adjusting for confounders and testing problematic social media use (Year 2) as a mediator.

RESULTS

Social media time (Year 1) was prospectively associated with 1.31 (95% confidence interval 1.20-1.43) times higher risk of new-onset sipping (Year 3). The association between social media time and new-onset alcohol sipping was partially mediated by problematic social media use at Year 2 (25.0% reduction in the association between the former two factors after adding problematic social media use, p = 0.002).

CONCLUSIONS

Time spent on social media was associated with a higher risk of alcohol sipping in a diverse national sample of early adolescents, and the association was partially mediated by problematic social media use. Media literacy education and family media use plans could advise early adolescents about exposure to alcohol content on social media and warning signs for problematic use.

Sociodemographic Associations With Blood Pressure in 10-14-Year-Old Adolescents

PURPOSE

To determine the association between sociodemographic characteristics and blood pressure among a demographically diverse population-based sample of 10-14-year-old US adolescents.

METHODS

We conducted cross-sectional analyses of data from the Adolescent Brain Cognitive Development Study (N = 4,466), year two (2018-2020). Logistic and linear regression models were used to determine the association between sociodemographic characteristics (sex, race/ethnicity, sexual orientation, household income, and parental education) with blood pressure among early adolescents.

RESULTS

The sample was 49.3% female and 46.7% non-White. Overall, 4.1% had blood pressures in the hypertensive range. Male sex was associated with 48% higher odds of hypertensive-range blood pressures than female sex (95% confidence interval [CI], 1.02; 2.14), and Black race was associated with 85% higher odds of hypertensive-range blood pressures compared to White race (95% CI, 1.11; 3.08). Several annual household income categories less than $100,000 were associated with higher odds of hypertensive-range blood pressures compared to an annual household income greater than $200,000. We found effect modification by household income for Black adolescents; Black race (compared to White race) was more strongly associated with higher odds of hypertensive-range blood pressures in households with income greater than $75,000 (odds ratio 3.92; 95% CI, 1.95; 7.88) compared to those with income less than $75,000 (odds ratio 1.53; 95% CI, 0.80; 2.92).

DISCUSSION

Sociodemographic characteristics are differentially associated with higher blood pressure in early adolescents. Future research could examine potential mediating factors (e.g., physical activity, nutrition, tobacco) linking sociodemographic characteristics and blood pressure to inform targeted interventions.

Sleep, brain systems, and persistent stress in early adolescents during COVID-19: Insights from the ABCD study

PURPOSE

The first year of the COVID-19 pandemic constituted a major life stress event for many adolescents, associated with disrupted school, behaviors, social networks, and health concerns. However, pandemic-related stress was not equivalent for everyone and could have been influenced by pre-pandemic factors including brain structure and sleep, which both undergo substantial development during adolescence. Here, we analyzed clusters of perceived stress levels across the pandemic and determined developmentally relevant pre-pandemic risk factors in brain structure and sleep of persistently high stress during the first year of the COVID-19 pandemic.

METHODS

We investigated longitudinal changes in perceived stress at six timepoints across the first year of the pandemic (May 2020-March 2021) in 5559 adolescents (50 % female; age range: 11-14 years) in the United States (U.S.) participating in the Adolescent Brain Cognitive Development (ABCD) study. In 3141 of these adolescents, we fitted machine learning models to identify the most important pre-pandemic predictors from structural MRI brain measures and self-reported sleep data that were associated with persistently high stress across the first year of the pandemic.

RESULTS

Patterns of perceived stress levels varied across the pandemic, with 5 % reporting persistently high stress. Our classifiers accurately detected persistently high stress (AUC > 0.7). Pre-pandemic brain structure, specifically cortical volume in temporal regions, and cortical thickness in multiple parietal and occipital regions, predicted persistent stress. Pre-pandemic sleep difficulties and short sleep duration were also strong predictors of persistent stress, along with more advanced pubertal stage.

CONCLUSIONS

Adolescents showed variable stress responses during the first year of the COVID-19 pandemic, and some reported persistently high stress across the whole first year. Vulnerability to persistent stress was evident in several brain structural and self-reported sleep measures, collected before the pandemic, suggesting the relevance of other pre-existing individual factors beyond pandemic-related factors, for persistently high stress responses.

Brain structural covariance network features are robust markers of early heavy alcohol use

BACKGROUND AND AIMS

Recently, we demonstrated that a distinct pattern of structural covariance networks (SCN) from magnetic resonance imaging (MRI)-derived measurements of brain cortical thickness characterized young adults with alcohol use disorder (AUD) and predicted current and future problematic drinking in adolescents relative to controls. Here, we establish the robustness and value of SCN for identifying heavy alcohol users in three additional independent studies.

DESIGN AND SETTING

Cross-sectional and longitudinal studies using data from the Pediatric Imaging, Neurocognition and Genetics (PING) study (n = 400, age range = 14-22 years), the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) (n = 272, age range = 17-22 years) and the Human Connectome Project (HCP) (n = 375, age range = 22-37 years).

CASES

Cases were defined based on heavy alcohol use patterns or former alcohol use disorder (AUD) diagnoses: 50, 68 and 61 cases were identified. Controls had none or low alcohol use or absence of AUD: 350, 204 and 314 controls were selected.

MEASUREMENTS

Graph theory metrics of segregation and integration were used to summarize SCN.

FINDINGS

Mirroring our prior findings, and across the three data sets, cases had a lower clustering coefficient [area under the curve (AUC) = -0.029, P = 0.002], lower modularity (AUC = -0.14, P = 0.004), lower average shortest path length (AUC = -0.078, P = 0.017) and higher global efficiency (AUC = 0.007, P = 0.010). Local efficiency differences were marginal (AUC = -0.017, P = 0.052). That is, cases exhibited lower network segregation and higher integration, suggesting that adjacent nodes (i.e. brain regions) were less similar in thickness whereas spatially distant nodes were more similar.

CONCLUSION

Structural covariance network (SCN) differences in the brain appear to constitute an early marker of heavy alcohol use in three new data sets and, more generally, demonstrate the utility of SCN-derived metrics to detect brain-related psychopathology.

Performance evaluation of the open-source Yet Another Spindle Algorithm sleep staging algorithm against gold standard manual evaluation of polysomnographic records in adolescence

GOAL AND AIMS

To evaluate an automatic sleep scoring algorithm against manual polysomnography sleep scoring.

FOCUS METHOD/TECHNOLOGY

Yet Another Spindle Algorithm automatic sleep staging algorithm.

REFERENCE METHOD/TECHNOLOGY

Manual sleep scoring.

SAMPLE

327 nights (151 healthy adolescents), from the NCANDA study.

DESIGN

Participants underwent one-to-three overnight polysomnography recordings, one consisting of an event-related-potential paradigm.

CORE ANALYTICS

Epoch by Epoch and discrepancy analyses (Bland Altman plots) were conducted on the overall sample.

ADDITIONAL ANALYTICS AND EXPLORATORY ANALYSES

Epoch by Epoch and discrepancy analysis were repeated separately on standard polysomnography nights and event-related potential nights. Regression models were estimated on age, sex, scorer, and site of recording, separately on standard polysomnography nights and event-related potential nights.

CORE OUTCOMES

The Yet Another Spindle Algorithm sleep scoring algorithm's average sensitivity of 93.04% for Wake, 87.67% for N2, 84.46% for N3, 86.02% for rapid-eye-movement, and 40.39% for N1. Specificity was 96.75% for Wake, 97.31% for N1, 88.87% for N2, 97.99% for N3, and 97.70% for rapid-eye-movement. The Matthews Correlation Coefficient was highest in rapid-eye-movement sleep (0.85) while lowest in N1 (0.39). Cohen's Kappa mirrored Matthews Correlation Coefficient results. In Bland-Altman plots, the bias between Yet Another Spindle Algorithm and human scoring showed proportionality to the manual scoring measurement size.

IMPORTANT ADDITIONAL OUTCOMES

Yet Another Spindle Algorithm performance was reduced in event-related-potential/polysomnography nights for N3 and rapid-eye-movement. According to the Matthews Correlation Coefficient, the Yet Another Spindle Algorithm performance was affected by younger age, male sex, recording sites, and scorers.

CORE CONCLUSION

Results support the use of Yet Another Spindle Algorithm to score adolescents' polysomnography sleep records, possibly with classification outcomes supervised by an expert scorer.

Cyberbullying and eating disorder symptoms in US early adolescents

OBJECTIVE

The objective of this study was to determine the association between cyberbullying and eating disorder symptoms in a national sample of 10-14-year-old early adolescents.

METHOD

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2, 2018-2020, N = 10,258/11,875, 49% female, 46% non-White). Data were collected using multi-stage probability sampling. Modified Poisson regression analyses examined the association between cyberbullying and self-reported eating disorder symptoms based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5).

RESULTS

Cyberbullying victimization was associated with worry about weight gain (prevalence ratio [PR] 2.41, 95% confidence interval [CI] 1.48-3.91), self-worth tied to weight (PR 2.08, 95% CI 1.33-3.26), inappropriate compensatory behavior to prevent weight gain (PR 1.95, 95% CI 1.57-2.42), binge eating (PR 1.95, 95% CI 1.59-2.39), and distress with binge eating (PR 2.64, 95% CI 1.94-3.59), in models adjusting for potential confounders. Cyberbullying perpetration was associated with worry about weight gain (PR 3.52, 95% CI 1.19-10.37), self-worth tied to weight (PR 5.59, 95% CI 2.56-12.20), binge eating (PR 2.36, 95% CI 1.44-3.87), and distress with binge eating (PR 2.84, 95% CI 1.47-5.49).

DISCUSSION

Cyberbullying victimization and perpetration in early adolescence are associated with eating disorder symptoms. Clinicians may consider assessing for cyberbullying and eating disorder symptoms in early adolescence and provide anticipatory guidance.

PUBLIC SIGNIFICANCE STATEMENT

Eating disorders often onset in adolescence and have among the highest mortality rates of any psychiatric disorder. In addition, cyberbullying has increased in prevalence among adolescents and significantly impacts mental health. In a national study of early adolescents, we found that cyberbullying victimization and perpetration are associated with eating disorder symptoms. Screening for and providing anticipatory guidance on cyberbullying and eating disorder symptoms in early adolescents may be warranted.

The Menstrual Cycle and Sleep

Aspects of sleep change across the menstrual cycle in some women. Poorer sleep quality in the premenstrual phase and menstruation is common in women with premenstrual symptoms or painful menstrual cramps. Although objective sleep continuity remains unchanged across the regular, asymptomatic menstrual cycle, activity in the sleep electroencephalogram varies, with a prominent increase in sleep spindle activity in the postovulatory luteal phase, when progesterone is present, relative to the follicular phase. Menstrual cycle phase, reproductive stage, and menstrual-related disorders should be considered when assessing women's sleep complaints.

Identification and characterization of screen use trajectories from late childhood to adolescence in a US-population based cohort study

Screen use is a known risk factor for adverse physical and mental health outcomes during childhood and adolescence. Moreover, racial/ethnic disparity in screen use persists among adolescents. However, limited studies have characterized the population sharing similar longitudinal patterns of screen use from childhood to adolescence. This study will identify and characterize the subgroups of adolescents sharing similar trajectories of screen use from childhood to adolescence. Study participants of the Adolescent Brain Cognitive Development Study (2016-2021) in the U.S with non-missing responses on self-reported screen use at each year of the study were included in the analysis. Growth mixture modeling was used to identify the optimal number of subgroups of adolescents with similar trajectories. Subsequently, socio-demographic characteristics, familial background, and perceived racism and discrimination during childhood was assessed for each subgroup population. Perceived discrimination was measured using the Perceived Discrimination Scale. There were two major subgroups of individuals sharing similar trajectories of screen use: Drastically Increasing group (N = 1333); Gradually Increasing group (N = 10336). Higher proportions of the Drastically Increasing group were racial/ethnic minorities (70%) as compared to the Gradually Increasing group (45%). Moreover, the Drastically Increasing group had higher proportions of individuals reporting perceived racism and discrimination during childhood.

Parental knowledge/monitoring and adolescent substance use: A causal relationship?

OBJECTIVE

Many studies have shown that parental knowledge/monitoring is correlated with adolescent substance use, but the association may be confounded by the many preexisting differences between families with low versus high monitoring. We attempted to produce more rigorous evidence for a causal relation using a longitudinal design that took advantage of within-family fluctuations in knowledge/monitoring during the COVID-19 pandemic.

METHOD

Youth (N = 8,780, age range = 10.5-15.6 years) at 21 sites across the United States completed up to seven surveys over 12 months. Youth reported on their parents' knowledge/monitoring of their activities and their substance use in the past month. Regressions were fit to within-family changes in youth-perceived knowledge/monitoring and substance use between survey waves. By analyzing within-family changes over time, we controlled for all stable, a priori differences that exist between families with low versus high levels of youth-perceived knowledge/monitoring.

RESULTS

Youth initially denying substance use were significantly more likely to start reporting use when they experienced a decrease in the level of perceived knowledge/monitoring (relative risk [RR] = 1.18, p < .001). Youth initially endorsing substance use were significantly more likely to stop reporting use when they experienced an increase in the level of perceived knowledge/monitoring (RR = 1.06; p < .001). Associations were similar or larger when adjusting for several time-varying potential confounders.

CONCLUSION

In a large, sociodemographically diverse sample, within-family changes in youth-perceived parental knowledge/monitoring over time were robustly associated with changes in youths' engagement in substance use. Findings lend support to the hypothesis that parent knowledge/monitoring is causally related to substance involvement in early adolescence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of the COVID-19 pandemic on screen time and sleep in early adolescents

OBJECTIVE

During the COVID-19 pandemic, adolescents and families have turned to online activities and social platforms more than ever to maintain well-being, connect remotely with friends and family, and online schooling. However, excessive screen use can have negative effects on health (e.g., sleep). This study examined changes in sleep habits and recreational screen time (social media, video gaming), and their relationship, before and across the first year of the pandemic in adolescents in the Adolescent Brain Cognitive Development (ABCD) Study.

METHOD

Mixed-effect models were used to examine associations between self-reported sleep and screen time using longitudinal data of 5,027 adolescents in the ABCD Study, assessed before the pandemic (10-13 years) and across six time points between May 2020 and March 2021 (pandemic).

RESULTS

Time in bed varied, being higher during May-August 2020 relative to pre-pandemic, partially related to the school summer break, before declining in October 2020 to levels lower than pre-pandemic. Screen time steeply increased and remained high across all pandemic time points relative to pre-pandemic. Higher social media use and video gaming were associated with shorter time in bed, later bedtimes, and longer sleep onset latency.

CONCLUSIONS

Sleep behavior and screen time changed during the pandemic in early adolescents. More screen time was associated with poorer sleep behavior, before and during the pandemic. While recreational screen usage is an integral component of adolescent's activities, especially during the pandemic, excessive use can have negative effects on essential health behaviors, highlighting the need to promote balanced screen usage. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Association between Family Environment and Subsequent Risk of Cyberbullying Victimization in Adolescents

BACKGROUND

Family environment and parental monitoring have long been recognized as two important factors associated with adolescents' psychological development. Studies have suggested a potential link between parenting style/parental engagement and the likelihood of bullying victimization among adolescents. Nonetheless, no studies to date have investigated the association between family environment and the subsequent risk of cyberbullying victimization among adolescents. In this study, we assessed the association between family environment (eg, parental monitoring and family conflict) and subsequent risk of cyberbullying victimization using data from the Adolescent Brain Cognitive Development (ABCD).

METHODS

We used multivariable logistic regressions to assess the association between parental monitoring and family conflict at year 1 and the subsequent risk of cyberbullying victimization at year 2 in 10,410 eligible ABCD study participants.

RESULTS

Adjusting for sociodemographic characteristics, study sampling weights and study site, higher levels of parental monitoring at year 1 were associated with a lower reported past 12-month (OR: 0.61, 95% CI: 0.50-0.75) history of cyberbullying victimization at year 2. Higher levels of family conflict at year 1 were associated with a higher risk of reported past 12-month history (OR: 1.10, 95% CI: 1.04-1.16) of cyberbullying victimization one year later.

CONCLUSION

Higher levels of parental monitoring and lower levels of family conflict are associated with a subsequent lower risk of cyberbullying victimization among adolescents. Cyberbullying victimization preventive programs should advocate for increased parental monitoring and minimize family conflict at home to reduce the risks of cyberbullying victimization among adolescents.

Social epidemiology of Fitbit daily steps in early adolescence

BACKGROUND

Sociodemographic disparities in adolescent physical activity have been documented but mostly rely on self-reported data. Our objective was to examine differences in device-based step metrics, including daily step count (steps d-1), by sociodemographic factors among a diverse sample of 10-to-14-year-old adolescents in the US.

METHODS

We analyzed prospective cohort data from Year 2 (2018-2020) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 6460). Mixed-effects models were conducted to estimate associations of sociodemographic factors (sex, sexual orientation, race/ethnicity, household income, parental education, and parental marital status) with repeated measures of steps d-1 over the course of 21 days.

RESULTS

Participants (49.6% female, 39.0% racial/ethnic minority) accumulated an average of 9095.8 steps d-1. In mixed-effects models, 1543.6 more steps d-1 were recorded for male versus female sex, Black versus White race (328.8 more steps d-1), heterosexual versus sexual minority sexual orientation (676.4 more steps d-1), >$200,000 versus <$25,000 household income (1003.3 more steps d-1), and having married/partnered parents versus unmarried/unpartnered parents (326.3 more steps d-1). We found effect modification by household income for Black adolescents and by sex for Asian adolescents.

CONCLUSIONS

Given sociodemographic differences in adolescent steps d-1, physical activity guidelines should focus on key populations and adopt strategies optimized for adolescents from diverse backgrounds.

IMPACT

Sociodemographic disparities in physical activity have been documented but mostly rely on self-reported data, which can be limited by reporting and prevarication bias. In this demographically diverse sample of 10-14-year-old early adolescents in the U.S., we found notable and nuanced sociodemographic disparities in Fitbit steps per day. More daily steps were recorded for male versus female sex, Black versus White race, heterosexual versus sexual minority, >$100,000 versus <$25,000 household income, and having married/partnered versus unmarried/unpartnered parents. We found effect modification by household income for Black adolescents and by sex for Asian adolescents.

Associations Between Adverse Childhood Experiences and Early Adolescent Physical Activity in the United States

OBJECTIVE

To determine the associations between the number of adverse childhood experiences (ACEs) and objectively-measured physical activity (PA) in a population-based, demographically diverse cohort of 9-14-year-olds and to determine which subtypes of ACEs were associated with physical activity levels.

METHODS

We analyzed data (n = 7046) from the Adolescent Brain Cognitive Development (ABCD) Study 4.0 release at baseline and year 2 follow-up. ACE (cumulative score and subtypes) and physical activity (average Fitbit daily steps assessed at Year 2) were analyzed using linear regression analyses. Covariates included race and ethnicity, sex, household income, parent education, body mass index, study site, twins/siblings, and data collection period.

RESULTS

Adjusted models suggest an inverse association between number of ACEs and Fitbit daily steps, with ≥4 (compared to 0) ACEs associated with 567 fewer daily steps (95% CI -902.2, -232.2). Of the ACEs subtypes, emotional abuse (B = -719.3, 95% CI -1430.8, -7.9), physical neglect (B = -423.7, 95% CI -752.8, -94.6), household mental illness (B = -317.1, 95% CI -488.3, -145.9), and household divorce or separation (B = -275.4, 95% CI -521.5, -29.2) were inversely and statistically significant associated with Fitbit daily steps after adjusting for confounders.

CONCLUSIONS

Our results suggest that there is an inverse, dose-dependent relationship between cumulative number of ACEs and physical activity as measured by daily steps. This work highlights the importance of screening for ACEs among young people at an early age to help identify those who could benefit from interventions or community programs that support increased physical activity.

The social epidemiology of binge-eating disorder and behaviors in early adolescents

BACKGROUND

Binge-eating disorder (BED) is the most common eating disorder phenotype and is linked to several negative health outcomes. Yet, little is known about the social epidemiology of BED, particularly in early adolescence. The objective of this study was to examine the associations between sociodemographic characteristics and BED and binge-eating behaviors in a large, national cohort of 10-14-year-old adolescents in the United States (U.S.) METHODS: We conducted a cross-sectional analysis of two-year follow-up data from the Adolescent Brain Cognitive Development (ABCD) Study (2018 - 2020) that included 10,197 early adolescents (10 - 14 years, mean 12 years) in the U.S. Multivariable logistic regression models were used to assess the associations between sociodemographic characteristics and BED and binge-eating behaviors, defined based on the Kiddie Schedule for Affective Disorders and Schizophrenia.

RESULTS

In this early adolescent sample (48.8% female, 54.0% White, 19.8% Latino/Hispanic, 16.1% Black, 5.4% Asian, 3.2% Native American, 1.5% Other), the prevalence of BED and binge-eating behaviors were 1.0% and 6.3%, respectively. Identifying as gay or bisexual (compared to heterosexual; adjusted odds ratio [AOR]: 2.25, 95% CI 1.01-5.01) and having a household income of less than $75,000 (AOR: 2.05, 95% CI: 1.21-3.46) were associated with greater odds of BED. Being male (AOR: 1.28, 95% CI: 1.06-1.55), of Native American (AOR: 1.60, 95% CI: 1.01-2.55) descent, having a household income less than $75,000 (AOR: 1.34, 95% CI: 1.08-1.65), or identifying as gay or bisexual (AOR for 'Yes' Response: 1.95, 95% CI: 1.31-2.91 and AOR for 'Maybe' Response: 1.81, 95% CI: 1.19-2.76) were all associated with higher odds of binge-eating behaviors.

CONCLUSION

Several sociodemographic variables showed significant associations with binge-eating behaviors, which can inform targeted screening, prevention, and education campaigns for BED among early adolescents.

Good sleep is a mood buffer for young women during menses

STUDY OBJECTIVES

We sought to elucidate the interaction between sleep and mood considering menstrual cycle phase (menses and non-menses portions of the cycle) in 72 healthy young women (18-33 years) with natural, regular menstrual cycles and without menstrual-associated disorders. This work fills a gap in literature of examining mood in context of sleep and menstrual cycle jointly, rather than individually.

METHODS

Daily subjective measures of sleep and mood, and date of menses were remotely, digitally collected over a 2-month period. Each morning, participants rated their sleep on the previous night, and each evening participants rated the extent of positive and negative mood for that day. Objective sleep was tracked with a wearable (ŌURA ring) during month 2 of the study. Time-lag cross-correlation and mixed linear models were used to analyze the significance and directionality of the sleep-mood relationship, and how the interaction between menstrual cycle status and sleep impacted mood levels.

RESULTS

We found that menstrual status alone did not impact mood. However, subjective sleep quality and menstrual status interacted to impact positive mood (p < .05). After a night of perceived poor sleep quality, participants reported lower positive mood during menses compared to non-menses portions of the cycle, while after a night of perceived good sleep quality participants reported equivalent levels of positive mood across the cycle.

CONCLUSIONS

We suggest that the perception of good sleep quality acts as a mood equalizer, with good sleep providing a protective buffer to positive mood across the menstrual cycle.

Association of cyberbullying victimization and substance initiation: The Adolescent Brain Cognitive Development (ABCD) study

BACKGROUND

Evidence shows that cyberbullying is an important risk factor for various adverse mental health outcomes, such as substance use. However, there is limited evidence from longitudinal studies that assessed whether cyberbullying victimization is associated with substance use initiation, especially among adolescent population.

METHODS

Using data from the Adolescent Brain Cognitive Development Study, we assessed the association between cyberbullying victimization and substance use initiation among adolescents. In the cross-sectional analysis at year 2, multivariable logistic regressions were used to assess the association between cyberbullying victimization history and substance use initiation. Additionally, the association between year 2 cyberbullying victimization in the past 12 months/lifetime and year 3 substance use initiation was assessed using multivariable logistic regression.

RESULTS

Adjusting for sociodemographic characteristics and the presence of depression/anxiety symptoms, lifetime history of cyberbullying victimization was significantly associated with substance use initiation (OR= 2.17, 95% CI: 1.68, 2.81). Recent cyberbullying victimization in the past 12 months was associated with two-times higher odds of initiating substances (OR= 2.31, 95% CI: 1.71, 3.12). In addition, both lifetime history of cyberbullying victimization and recent cyberbullying victimization at year 2 were associated with two times increased risk in substance use initiation at year 3 (OR = 2.22, 95% CI: 1.68, 2.93; OR = 2.34, 95% CI: 1.68, 3.26).

CONCLUSION

There is a significant relationship between cyberbullying victimization and substance use initiation among adolescents. Cyberbullying victims are at an increased risk of initiating substance use later in life.

Associations between alcohol use and sex-specific maturation of subcortical gray matter morphometry from adolescence to adulthood: Replication across two longitudinal samples

Subcortical brain morphometry matures across adolescence and young adulthood, a time when many youth engage in escalating levels of alcohol use. Initial cross-sectional studies have shown alcohol use is associated with altered subcortical morphometry. However, longitudinal evidence of sex-specific neuromaturation and associations with alcohol use remains limited. This project used generalized additive mixed models to examine sex-specific development of subcortical volumes and associations with recent alcohol use, using 7 longitudinal waves (n = 804, 51% female, ages 12-21 at baseline) from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA). A second, independent, longitudinal dataset, with up to four waves of data (n = 467, 43% female, ages 10-18 at baseline), was used to assess replicability. Significant, replicable non-linear normative volumetric changes with age were evident in the caudate, putamen, thalamus, pallidum, amygdala and hippocampus. Significant, replicable negative associations between subcortical volume and alcohol use were found in the hippocampus in all youth, and the caudate and thalamus in female but not male youth, with significant interactions present in the caudate, thalamus and putamen. Findings suggest a structural vulnerability to alcohol use, or a predisposition to drink alcohol based on brain structure, with female youth potentially showing heightened risk, compared to male youth.

Morning perception of sleep, stress, and mood, and its relationship with overnight physiological sleep: findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study

This cross-sectional study investigated objective-subjective sleep discrepancies and the physiological basis for morning perceptions of sleep, mood, and readiness, in adolescents. Data collected during a single in-laboratory polysomnographic assessment from 137 healthy adolescents (61 girls; age range: 12-21 years) in the United States National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study were analysed. Upon awakening, participants completed questionnaires assessing sleep quality, mood, and readiness. We evaluated the relationship between overnight polysomnographic, electroencephalographic, sleep autonomic nervous system functioning measures, and next morning self-reported indices. Results showed that older adolescents reported more awakenings, yet they perceived their sleep to be deeper and less restless than younger adolescents. Prediction models including sleep physiology measures (polysomnographic, electroencephalographic, and sleep autonomic nervous system) explained between 3% and 29% of morning sleep perception, mood, and readiness indices. The subjective experience of sleep is a complex phenomenon with multiple components. Distinct physiological sleep processes contribute to the morning perception of sleep and related measures of mood and readiness. More than 70% of the variance (based on a single observation per person) in the perception of sleep, mood, and morning readiness is not explained by overnight sleep-related physiological measures, suggesting that other factors are important for the subjective sleep experience.

Effects of emerging alcohol use on developmental trajectories of functional sleep measures in adolescents

STUDY OBJECTIVES

Adolescence is characterized by significant brain development, accompanied by changes in sleep timing and architecture. It also is a period of profound psychosocial changes, including the initiation of alcohol use; however, it is unknown how alcohol use affects sleep architecture in the context of adolescent development. We tracked developmental changes in polysomnographic (PSG) and electroencephalographic (EEG) sleep measures and their relationship with emergent alcohol use in adolescents considering confounding effects (e.g. cannabis use).

METHODS

Adolescents (n = 94, 43% female, age: 12-21 years) in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study had annual laboratory PSG recordings across 4-years. Participants were no/low drinkers at baseline.

RESULTS

Linear mixed effect models showed developmental changes in sleep macrostructure and EEG, including a decrease in slow wave sleep and slow wave (delta) EEG activity with advancing age. Emergent moderate/heavy alcohol use across three follow-up years was associated with a decline in percentage rapid eye movement (REM) sleep over time, a longer sleep onset latency (SOL) and shorter total sleep time (TST) in older adolescents, and lower non-REM delta and theta power in males.

CONCLUSIONS

These longitudinal data show substantial developmental changes in sleep architecture. Emergent alcohol use during this period was associated with altered sleep continuity, architecture, and EEG measures, with some effects dependent on age and sex. These effects, in part, could be attributed to the effects of alcohol on underlying brain maturation processes involved in sleep-wake regulation.

Bedtime screen use behaviors and sleep outcomes: Findings from the Adolescent Brain Cognitive Development (ABCD) Study

OBJECTIVES

To determine associations between bedtime screen time behaviors and sleep outcomes in a national study of early adolescents.

METHODS

We analyzed cross-sectional data from 10,280 early adolescents aged 10-14 (48.8% female) in the Adolescent Brain Cognitive Development Study (Year 2, 2018-2020). Regression analyses examined the association between self-reported bedtime screen use and self- and caregiver-reported sleep measures, including sleep disturbance symptoms, controlling for sex, race/ethnicity, household income, parent education, depression, data collection period (pre- vs. during COVID-19 pandemic), and study site.

RESULTS

Overall, 16% of adolescents had at least some trouble falling or staying asleep in the past 2 weeks and 28% had overall sleep disturbance, based on caregiver reports. Adolescents who had a television or an Internet-connected electronic device in the bedroom had a greater risk of having trouble falling or staying asleep (adjusted risk ratio 1.27, 95% CI 1.12-1.44) and overall sleep disturbance (adjusted risk ratio 1.15, 95% CI 1.06-1.25). Adolescents who left their phone ringer activated overnight had more trouble falling/staying asleep and greater overall sleep disturbance compared to those who turned off their cell phones at bedtime. Streaming movies, playing video games, listening to music, talking/texting on the phone, and using social media or chat rooms were all associated with trouble falling/staying asleep and sleep disturbance.

CONCLUSIONS

Several bedtime screen use behaviors are associated with sleep disturbances in early adolescents. The study's findings can inform guidance for specific bedtime screen behaviors among early adolescents.

Cyberbullying and Sleep Disturbance Among Early Adolescents in the U.S

OBJECTIVE

To determine the association between cyberbullying (victimization and perpetration) and sleep disturbance among a demographically diverse sample of 10-14-year-old early adolescents.

METHODS

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2, 2018-2020) of early adolescents (10-14 years) in the US. Modified Poisson regression analyses examined the association between cyberbullying and self-reported and caregiver-reported sleep disturbance measures.

RESULTS

In a sample of 9,443 adolescents (mean age 12.0 years, 47.9% female, 47.8% white), 5.1% reported cyberbullying victimization, and 0.5% reported cyberbullying perpetration in the past 12 months. Cyberbullying victimization in the past 12 months was associated with adolescent-reported trouble falling/staying asleep (risk ratio [RR] 1.87, 95% confidence interval [CI] 1.57, 2.21) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.16 95% CI 1.00, 1.33), in models adjusting for sociodemographic factors and screen time. Cyberbullying perpetration in the past 12 months was associated with trouble falling/staying asleep (RR 1.95, 95% CI 1.21, 3.15) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.49, 95% CI 1.00, 2.22).

CONCLUSIONS

Cyberbullying victimization and perpetration are associated with sleep disturbance in early adolescence. Digital media education and counseling for adolescents, parents, teachers, and clinicians could focus on guidance to prevent cyberbullying and support healthy sleep behavior for early adolescents.

Pandemic-Related Changes in the Prevalence of Early Adolescent Alcohol and Drug Use, 2020-2021: Data From a Multisite Cohort Study

PURPOSE

Evaluate changes in early adolescent substance use from May 2020 to May 2021 during the coronavirus disease 2019 pandemic using data from a prospective nationwide cohort: the Adolescent Brain Cognitive Development Study.

METHODS

In 2018-2019, 9,270 youth aged 11.5-13.0 completed a prepandemic assessment of past-month alcohol and drug use, then up to seven during-pandemic assessments between May 2020 and May 2021. We compared the prevalence of substance use among same-age youth across these eight timepoints.

RESULTS

Pandemic-related decreases in the past-month prevalence of alcohol use were detectable in May 2020, grew larger over time, and remained substantial in May 2021 (0.3% vs. 3.2% prepandemic, p <.001). Pandemic-related increases in inhalant use (p = .04) and prescription drug misuse (p < .001) were detectable in May 2020, shrunk over time, and were smaller but still detectable in May 2021(0.1%-0.2% vs. 0% pre-pandemic). Pandemic-related increases in nicotine use were detectable between May 2020 and March 2021 and no longer significantly different from prepandemic levels in May 2021 (0.5% vs. 0.2% prepandemic, p = .09). There was significant heterogeneity in pandemic-related change in substance use at some timepoints, with increased rates among youth identified as Black or Hispanic or in lower-income families versus stable or decreased rates among youth identified as White or in higher-income families.

DISCUSSION

Among youth ages 11.5-13.0 years old, rates of alcohol use remained dramatically reduced in May 2021 relative to prepandemic and rates of prescription drug misuse and inhalant use remained modestly increased. Differences remained despite the partial restoration of prepandemic life, raising questions about whether youth who spent early adolescence under pandemic conditions may exhibit persistently different patterns of substance use.

Higher blood pressure and weight observed among early adolescents during the COVID-19 pandemic

The COVID-19 pandemic led to significant disruptions in the lifestyle behaviors of adolescents; however, there is a paucity of data on objective changes in health indicators of adolescents such as blood pressure, hypertension, and weight. The aim of this study is to quantify differences in blood pressure and weight before and during the COVID-19 pandemic among a demographically diverse national sample of early adolescents. We analyzed cross-sectional data from 2018 to 2020, corresponding to the second follow-up year (Year 2) of the Adolescent Brain Cognitive Development (ABCD) Study. Among 4,065 early adolescents (mean age 12.00, 49.4% female, 55.5% white), 3.4% vs 6.4% of adolescents had hypertension pre-pandemic vs during the pandemic (p < 0.001). The pandemic was associated with a 4.65 percentile (95% CI 2.65, 6.66) higher diastolic blood pressure, and a 1.68 kg (95% CI 0.51, 2.85) higher weight when adjusting for covariates. The pandemic was associated with a 1.97 higher odds of hypertension (95% CI 1.33, 2.92) compared to pre-pandemic when adjusting for covariates. Future studies should explore mechanisms and longitudinal trends in blood pressure among adolescents as they return to pre-pandemic lifestyle behaviors.

Optimizing sleep across the menopausal transition

Women frequently experience sleep disturbances, particularly night-time awakenings, as they transition menopause and enter postmenopause. Sleep is essential for optimal functioning and health. Persistent and distressing sleep disturbances across menopause can negatively impact daytime functioning and productivity, and increase risk for mental and physical health conditions. While multiple factors can disturb sleep, two unique factors in the context of menopause are vasomotor symptoms and the changing reproductive hormone environment. Vasomotor symptoms are associated with sleep disturbances and contribute significantly to awakenings and amount of time spent awake during the night. Even after accounting for vasomotor and depressive symptoms, lower estradiol and higher follicle stimulating hormone levels, indicative of menopause, are associated with sleep disturbance, particularly awakenings, suggesting that the hormone environment may directly affect sleep. Management strategies for clinically significant menopausal sleep disturbances include cognitive behavioral therapy for insomnia, which is effective and durable in treating menopausal insomnia. Hormone therapy alleviates sleep disturbances, particularly in the presence of disruptive vasomotor symptoms. Sleep disturbances have a significant impact on women's functioning and health, and there is a need for further research of the underlying mechanisms to advance effective preventative and treatment strategies that ensure optimal health and well-being of midlife women.

Researching COVID to enhance recovery (RECOVER) pediatric study protocol: Rationale, objectives and design

Importance

The prevalence, pathophysiology, and long-term outcomes of COVID-19 (post-acute sequelae of SARS-CoV-2 [PASC] or "Long COVID") in children and young adults remain unknown. Studies must address the urgent need to define PASC, its mechanisms, and potential treatment targets in children and young adults.

Observations

We describe the protocol for the Pediatric Observational Cohort Study of the NIH's RE searching COV ID to E nhance R ecovery (RECOVER) Initiative. RECOVER-Pediatrics is an observational meta-cohort study of caregiver-child pairs (birth through 17 years) and young adults (18 through 25 years), recruited from more than 100 sites across the US. This report focuses on two of five cohorts that comprise RECOVER-Pediatrics: 1) a de novo RECOVER prospective cohort of children and young adults with and without previous or current infection; and 2) an extant cohort derived from the Adolescent Brain Cognitive Development (ABCD) study ( n =10,000). The de novo cohort incorporates three tiers of data collection: 1) remote baseline assessments (Tier 1, n=6000); 2) longitudinal follow-up for up to 4 years (Tier 2, n=6000); and 3) a subset of participants, primarily the most severely affected by PASC, who will undergo deep phenotyping to explore PASC pathophysiology (Tier 3, n=600). Youth enrolled in the ABCD study participate in Tier 1. The pediatric protocol was developed as a collaborative partnership of investigators, patients, researchers, clinicians, community partners, and federal partners, intentionally promoting inclusivity and diversity. The protocol is adaptive to facilitate responses to emerging science.

Conclusions and Relevance

RECOVER-Pediatrics seeks to characterize the clinical course, underlying mechanisms, and long-term effects of PASC from birth through 25 years old. RECOVER-Pediatrics is designed to elucidate the epidemiology, four-year clinical course, and sociodemographic correlates of pediatric PASC. The data and biosamples will allow examination of mechanistic hypotheses and biomarkers, thus providing insights into potential therapeutic interventions.

Clinical Trialsgov Identifier

Clinical Trial Registration: http://www.clinicaltrials.gov . Unique identifier: NCT05172011.

Stress, hypothalamic pituitary adrenal axis activity and autonomic nervous system function in adolescents with insomnia

INTRODUCTION

Abnormal stress responses have been linked to the etiology of insomnia. We investigated the relationship between insomnia, stress, hypothalamic-pituitary-adrenal (HPA) axis activity, and autonomic nervous system (ANS) function in adolescence.

METHODS

Forty-seven post-pubertal adolescents (16-20 years old, 28 female) with (N = 16; insomnia group) and without (N = 31; control group) DSM-5 insomnia symptoms were assessed for stress levels and stress reactivity and underwent a standardized stress protocol (Trier Social Stress Test (TSST)), after an overnight laboratory stay. Cortisol was measured upon awakening and 30-minutes later to calculate the cortisol awakening response (CAR). During the TSST, perceived stress, salivary cortisol (HPA activity), heart rate (HR) and blood pressure (BP) measures were collected.

RESULTS

Participants in the insomnia group reported more stress from school performance and work overload, with insomnia girls experiencing more stress from peer pressure and future uncertainty than control girls (p < 0.05). No group differences were detected in the CAR and pre-TSST stress levels. All participants showed significant increases in perceived stress (~19 %), HR (~33 %), systolic (~13 %), and diastolic (~15 %) BP in response to the TSST (p < 0.05). Overall HR stress response did not differ between groups, but was lower in boys with insomnia than in girls with insomnia (p < 0.05). Cortisol stress responses were inconclusive, possibly due to a masking effect of CAR, as the task was performed shortly after awakening and larger CARs were associated with blunted cortisol stress responses.

DISCUSSION

Results mostly show no group difference in physiological stress responses, although some interaction effects suggest a potential sex by insomnia interaction. Larger samples are needed to understand the physiological disturbances of insomnia in adolescence.

Risk for depression tripled during the COVID-19 pandemic in emerging adults followed for the last 8 years

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has significantly increased depression rates, particularly in emerging adults. The aim of this study was to examine longitudinal changes in depression risk before and during COVID-19 in a cohort of emerging adults in the U.S. and to determine whether prior drinking or sleep habits could predict the severity of depressive symptoms during the pandemic.

METHODS

Participants were 525 emerging adults from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), a five-site community sample including moderate-to-heavy drinkers. Poisson mixed-effect models evaluated changes in the Center for Epidemiological Studies Depression Scale (CES-D-10) from before to during COVID-19, also testing for sex and age interactions. Additional analyses examined whether alcohol use frequency or sleep duration measured in the last pre-COVID assessment predicted pandemic-related increase in depressive symptoms.

RESULTS

The prevalence of risk for clinical depression tripled due to a substantial and sustained increase in depressive symptoms during COVID-19 relative to pre-COVID years. Effects were strongest for younger women. Frequent alcohol use and short sleep duration during the closest pre-COVID visit predicted a greater increase in COVID-19 depressive symptoms.

CONCLUSIONS

The sharp increase in depression risk among emerging adults heralds a public health crisis with alarming implications for their social and emotional functioning as this generation matures. In addition to the heightened risk for younger women, the role of alcohol use and sleep behavior should be tracked through preventive care aiming to mitigate this looming mental health crisis.

Adverse childhood experiences and early adolescent cyberbullying in the United States

INTRODUCTION

With the increasing use of social media and online platforms among adolescents, the relationship between traumatic life events and cyberbullying remains unclear. This study aimed to determine the associations between adverse childhood experiences (ACEs) and cyberbullying victimization among a racially/ethnically and socioeconomically diverse sample of early adolescents.

METHODS

We analyzed longitudinal data from 10,317 participants in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016-2018, ages 9-10 years) to Year 2. Logistic regression analyses were used to estimate associations between ACEs and cyberbullying victimization, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site.

RESULTS

In the sample (48.7% female, 46.0% racial/ethnic minority), 81.3% of early adolescents reported at least one ACE, and 9.6% reported cyberbullying victimization. In general, there was a dose-response relationship between the number of ACEs and cyberbullying victimization, as two (adjusted odds ratio [AOR]: 1.45, 95% confidence interval [CI]: 1.13-1.85), three (AOR: 2.08, 95% CI: 1.57-2.74), and four or more (AOR: 2.37, 95% CI: 1.61-3.49) ACEs were associated with cyberbullying victimization in adjusted models. In models examining the specific type of ACE, sexual abuse (AOR: 2.27, 95% CI: 1.26-4.11), physical neglect (AOR: 1.61, 95% CI: 1.24-2.09), and household mental health problems (AOR: 1.39, 95% CI: 1.18-1.65) had the strongest associations with cyberbullying victimization.

CONCLUSION

Adolescents who have experienced ACEs are at greater risk for experiencing cyberbullying. Interventions to prevent cyberbullying could use a trauma-informed framework, including inter-peer interventions to break this cycle of trauma.

Screen time and suicidal behaviors among U.S. children 9-11 years old: A prospective cohort study

Suicide is a leading cause of death among adolescents. Emerging literature has described relationships between excessive screen time and suicidal behaviors, though findings have been mixed. The objective of this study is to determine the prospective associations between screen time and suicidal behaviors two-years later in a national (U.S.) cohort of 9-11-year-old-children. We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,633). Logistic regression analyses were estimated to determine the associations between baseline self-reported screen time (exposure) and suicidal behaviors (outcome) based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at two-year-follow-up. Participants reported an average of 4.0 h of total screen time per day at baseline. At two-year-follow-up, 1.38% of the sample reported at least one suicidal behavior. Each additional hour of total screen time was prospectively associated with 1.09 higher odds of suicidal behaviors at 2-year-follow-up (95% CI 1.03-1.14), after adjusting for covariates. For specific screen time modalities, each additional hour of texting (aOR 1.36, 95% CI 1.06-1.74), video chatting (aOR 1.30, 95% CI 1.03-1.65), watching videos (aOR 1.21, 95% CI 1.04-1.39), and playing video games (aOR 1.18, 95% CI 1.01-1.38) was associated with higher odds of subsequent suicidal behaviors. Higher screen time is associated with higher odds of reporting suicidal behaviors at two-year-follow-up. Future research should seek to identify how specific screen time experiences may influence suicidal behaviors.

Sexual Orientation Disparities in Early Adolescent Sleep: Findings from the Adolescent Brain Cognitive Development Study

Purpose: The purpose of this study was to examine associations between sexual minority status (e.g., gay or bisexual) and sleep problems in a demographically diverse, national sample of U.S. early adolescents. Methods: We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (Year 2, 2018-2020) to estimate associations between sexual orientation and sleep problems or disturbance, adjusting for confounders and testing potential mediators (depressive problems, stress problems, family conflict, and parental monitoring). Results: In a sample of 8563 adolescents 10- to 14-years-old, 4.4% identified as sexual minority individuals. Sexual minority status was associated with self-reported trouble falling or staying asleep (risk ratio [RR] = 2.24, 95% confidence interval [CI] = 1.88-2.68) and caregiver-reported sleep disturbance (RR = 1.50, 95% CI = 1.29-1.75). The association between sexual minority status and trouble falling or staying asleep was partially mediated by greater depressive problems, more family conflict, and less parental monitoring, whereas the association between sexual minority status and caregiver-reported sleep disturbance was partially mediated by greater depressive problems, higher stress, and greater family conflict. Conclusions: Our results indicate that sexual minority status may be linked to sleep disturbance in early adolescence. Depressive problems, stress, family conflict, and less parental monitoring partially mediate disparities in sleep health for sexual minority youth. Future research could test interventions to promote family and caregiver acceptance and mental health support for sexual minority youth to improve their sleep and other health outcomes.

Family Well-Being During the COVID-19 Pandemic: The Risks of Financial Insecurity and Coping

During the COVID-19 pandemic, families have experienced unprecedented financial and social disruptions. We studied the impact of preexisting psychosocial factors and pandemic-related financial and social disruptions in relation to family well-being among N = 4091 adolescents and parents during early summer 2020, participating in the Adolescent Brain Cognitive DevelopmentSM Study. Poorer family well-being was linked to prepandemic psychosocial and financial adversity and was associated with pandemic-related material hardship and social disruptions to routines. Parental alcohol use increased risk for worsening of family relationships, while a greater endorsement of coping strategies was mainly associated with overall better family well-being. Financial and mental health support may be critical for family well-being during and after a widespread crisis, such as the COVID-19 pandemic.

Screen Time and Obsessive-Compulsive Disorder Among Children 9-10 Years Old: A Prospective Cohort Study

PURPOSE

The aim of this study is to determine the prospective associations between baseline screen time and obsessive-compulsive disorder (OCD) at 2-year follow-up in a national (United States) cohort of 9- to 10-year-old children.

METHODS

We analyzed prospective cohort data from the Adolescent Brain Cognitive Development study (n = 9,208). Logistic regression analyses were used to determine the associations between baseline self-reported screen time (exposure) and OCD, based on the Kiddie Schedule for Affective Disorders and Schizophrenia (outcome), at 2-year-follow-up, adjusting for race/ethnicity, sex, household income, parent education, family history of psychopathology, and study site, excluding participants with baseline OCD.

RESULTS

The sample was 48.9% female and racially and ethnically diverse (43.5% non-White). Each additional hour of total screen time was prospectively associated with 1.05 higher odds of OCD at 2-year follow-up (95% confidence interval [CI] 1.01-1.09). For specific screen time modalities, each additional hour of playing video games (adjusted odds ratio 1.15, 95% CI 1.03-1.28) and watching videos (adjusted odds ratio 1.11, 95% CI 1.01-1.23) was associated with a subsequent OCD diagnosis.

CONCLUSION

Video games and watching videos are prospectively associated with new-onset OCD in early adolescents. Future research should examine mechanisms linking these specific screen modalities to OCD development to inform future prevention and intervention efforts.

Association of Demographic and Socioeconomic Indicators With the Use of Wearable Devices Among Children

Importance

The use of consumer-grade wearable devices for collecting data for biomedical research may be associated with social determinants of health (SDoHs) linked to people's understanding of and willingness to join and remain engaged in remote health studies.

Objective

To examine whether demographic and socioeconomic indicators are associated with willingness to join a wearable device study and adherence to wearable data collection in children.

Design, Setting, and Participants

This cohort study used wearable device usage data collected from 10 414 participants (aged 11-13 years) at the year-2 follow-up (2018-2020) of the ongoing Adolescent Brain and Cognitive Development (ABCD) Study, performed at 21 sites across the United States. Data were analyzed from November 2021 to July 2022.

Main Outcomes and Measures

The 2 primary outcomes were (1) participant retention in the wearable device substudy and (2) total device wear time during the 21-day observation period. Associations between the primary end points and sociodemographic and economic indicators were examined.

Results

The mean (SD) age of the 10 414 participants was 12.00 (0.72) years, with 5444 (52.3%) male participants. Overall, 1424 participants (13.7%) were Black; 2048 (19.7%), Hispanic; and 5615 (53.9%) White. Substantial differences were observed between the cohort that participated and shared wearable device data (wearable device cohort [WDC]; 7424 participants [71.3%]) compared with those who did not participate or share data (no wearable device cohort [NWDC]; 2900 participants [28.7%]). Black children were significantly underrepresented (-59%) in the WDC (847 [11.4%]) compared with the NWDC (577 [19.3%]; P < .001). In contrast, White children were overrepresented (+132%) in the WDC (4301 [57.9%]) vs the NWDC (1314 [43.9%]; P < .001). Children from low-income households (<$24 999) were significantly underrepresented in WDC (638 [8.6%]) compared with NWDC (492 [16.5%]; P < .001). Overall, Black children were retained for a substantially shorter duration (16 days; 95% CI, 14-17 days) compared with White children (21 days; 95% CI, 21-21 days; P < .001) in the wearable device substudy. In addition, total device wear time during the observation was notably different between Black vs White children (β = -43.00 hours; 95% CI, -55.11 to -30.88 hours; P < .001).

Conclusions and Relevance

In this cohort study, large-scale wearable device data collected from children showed considerable differences between White and Black children in terms of enrollment and daily wear time. While wearable devices provide an opportunity for real-time, high-frequency contextual monitoring of individuals' health, future studies should account for and address considerable representational bias in wearable data collection associated with demographic and SDoH factors.

Wearable and mobile technology to characterize daily patterns of sleep, stress, presleep worry, and mood in adolescent insomnia

OBJECTIVES

Characterizing daily patterns of sleep, stress, presleep worry, and mood in adolescents with and without insomnia symptomatology.

DESIGN

Two months of continuous wearable tracking and daily diary ratings.

SETTING

Free-living conditions.

PARTICIPANTS

Ninety-three adolescents (59 girls; 16-19 years old) with (N = 47; 26 with clinical and 21 with sub-clinical) and without (N = 46; control) DSM-5 insomnia symptomatology.

MEASUREMENTS

Fitbit Charge 3 tracked sleep, heart rate, and steps. Evening electronic diaries collected ratings of daily stress, presleep worry, and mood.

RESULTS

While sleep duration (control: 6.88 ± 1.41 hours; insomnia: 6.92 ± 1.28 hours), architecture, timing, and night-to-night variability were similar between groups, the insomnia group reported higher levels of stress and worry, being mainly related to "school". At the intraindividual level, stress and worry predicted shorter sleep duration and earlier wake up times, which, in turn, predicted higher stress the following day. Moreover, higher-than-usual stress predicted higher sleep-time heart rate, with a more consistent effect in adolescents with insomnia. Results were overall consistent after controlling for covariates and several robustness checks.

CONCLUSIONS

There is a bidirectional relationship between daily stress and sleep, with daily stress negatively impacting sleep, which in turn leads to more stress in adolescents with and without insomnia symptoms. Findings also highlight the complexity of insomnia in adolescence, in which the core clinical features (perceived sleep difficulties) and the critical factors (stress/worry) implicated in the pathophysiology of the disorder are not necessarily reflected in objective sleep indicators.

Association of Physical Activity and Screen Time With Body Mass Index Among US Adolescents

IMPORTANCE

The Physical Activity Guidelines Advisory Committee Scientific Report identified important research gaps to inform future guidance for adolescents, including limited evidence on the importance of sedentary behaviors (screen time) and their interactions with physical activity for adolescent health outcomes, including overweight and obesity.

OBJECTIVE

To identify the independent associations of physical activity and screen time categories, and the interactions between physical activity and screen time categories, with body mass index (BMI) and overweight and obesity in adolescents.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) Study collected from September 10, 2018, to September 29, 2020. Data were analyzed from July 8 to December 20, 2022. A total of 5797 adolescents aged 10 to 14 years from 21 racially and ethnically diverse study sites across the US were included in the analysis.

EXPOSURES

Categories of total step count per day (with 1000 to 6000 steps per day indicating low, >6000 to 12 000 steps per day indicating medium, and >12 000 steps per day indicating high), as measured by a wearable digital device (Fitbit), and categories of self-reported screen time hours per day (with 0 to 4 hours per day indicating low, >4 to 8 hours per day indicating medium, and >8 hours per day indicating high).

MAIN OUTCOMES AND MEASURES

Participant BMI was calculated as weight in kilograms divided by height in meters squared and converted into sex- and age-specific percentiles in accordance with the Centers for Disease Control and Prevention growth curves and definitions. Individuals were classified as having overweight or obesity if their BMI was in the 85th percentile or higher for sex and age.

RESULTS

Among 5797 adolescents included in the analytic sample, 50.4% were male, 61.0% were White, 35.0% had overweight or obesity, and the mean (SD) age was 12.0 (0.6) years. Mean (SD) reported screen time use was 6.5 (5.4) hours per day, and mean (SD) overall step count was 9246.6 (3111.3) steps per day. In models including both screen time and step count, medium (risk ratio [RR], 1.24; 95% CI, 1.12-1.37) and high (RR, 1.29; 95% CI, 1.16-1.44) screen time categories were associated with higher overweight or obesity risk compared with the low screen time category. Medium (RR, 1.19; 95% CI, 1.06-1.35) and low (RR, 1.30; 95% CI, 1.11-1.51) step count categories were associated with higher overweight or obesity risk compared with the high step count category. Evidence of effect modification between screen time and step count was observed for BMI percentile. For instance, among adolescents with low screen use, medium step count was associated with a 1.55 higher BMI percentile, and low step count was associated with a 7.48 higher BMI percentile. However, among those with high screen use, step count categories did not significantly change the association with higher BMI percentile (low step count: 8.79 higher BMI percentile; medium step count: 8.76 higher BMI percentile; high step count: 8.26 higher BMI percentile).

CONCLUSIONS AND RELEVANCE

In this cross-sectional study, a combination of low screen time and high step count was associated with lower BMI percentile in adolescents. These results suggest that high step count may not offset higher overweight or obesity risk for adolescents with high screen time, and low screen time may not offset higher overweight or obesity risk for adolescents with low step count. These findings addressed several research gaps identified by the Physical Activity Guidelines Advisory Committee Scientific Report and may be used to inform future screen time and physical activity guidance for adolescents.

The complexities of the sleep-pain relationship in adolescents: A critical review

Chronic pain is a common and disabling condition in adolescents. Disturbed sleep is associated with many detrimental effects in adolescents with acute and chronic pain. While sleep and pain are known to share a reciprocal relationship, the sleep-pain relationship in adolescence warrants further contextualization within normally occurring maturation of several biopsychological processes. Since sleep and pain disorders begin to emerge in early adolescence and are often comorbid, there is a need for a comprehensive picture of their interrelation especially related to temporal relationships and mechanistic drivers. While existing reviews provide a solid foundation for the interaction between disturbed sleep and pain in youth, we will extend this review by highlighting current methodological challenges for both sleep and pain assessments, exploring the recent evidence for directionality in the sleep-pain relationship, reviewing potential mechanisms and factors underlying the relationship, and providing direction for future investigations. We will also highlight the potential role of digital technologies in advancing the understanding of the sleep and pain relationship. Ultimately, we anticipate this information will facilitate further research and inform the management of pain and poor sleep, which will ultimately improve the quality of life in adolescents and reduce the risk of pain persisting into adulthood.

Adolescent alcohol use is linked to disruptions in age-appropriate cortical thinning: an unsupervised machine learning approach

Cortical thickness changes dramatically during development and is associated with adolescent drinking. However, previous findings have been inconsistent and limited by region-of-interest approaches that are underpowered because they do not conform to the underlying spatially heterogeneous effects of alcohol. In this study, adolescents (n = 657; 12-22 years at baseline) from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study who endorsed little to no alcohol use at baseline were assessed with structural magnetic resonance imaging and followed longitudinally at four yearly intervals. Seven unique spatial patterns of covarying cortical thickness were obtained from the baseline scans by applying an unsupervised machine learning method called non-negative matrix factorization (NMF). The cortical thickness maps of all participants' longitudinal scans were projected onto vertex-level cortical patterns to obtain participant-specific coefficients for each pattern. Linear mixed-effects models were fit to each pattern to investigate longitudinal effects of alcohol consumption on cortical thickness. We found in six NMF-derived cortical thickness patterns, the longitudinal rate of decline in no/low drinkers was similar for all age cohorts. Among moderate drinkers the decline was faster in the younger adolescent cohort and slower in the older cohort. Among heavy drinkers the decline was fastest in the younger cohort and slowest in the older cohort. The findings suggested that unsupervised machine learning successfully delineated spatially coordinated patterns of vertex-level cortical thickness variation that are unconstrained by neuroanatomical features. Age-appropriate cortical thinning is more rapid in younger adolescent drinkers and slower in older adolescent drinkers, an effect that is strongest among heavy drinkers.

Contemporary screen time modalities and disruptive behavior disorders in children: a prospective cohort study

BACKGROUND

Cross-sectional studies have demonstrated associations between screen time and disruptive behavior disorders (conduct disorder and oppositional defiant disorder); however, prospective associations remain unknown. This study's objective was to determine the prospective associations of contemporary screen time modalities with conduct and oppositional defiant disorder in a national cohort of 9-11-year-old children.

METHODS

We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,875). Modified Poisson regression analyses were conducted to estimate the associations between baseline child-reported screen time (total and by modality) and parent-reported conduct or oppositional defiant disorder based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at 1-year follow-up, adjusting for potential confounders.

RESULTS

Participants reported an average of 4 hr of total screen time per day at baseline. Each hour of total screen time per day was prospectively associated with a 7% higher prevalence of conduct disorder (95% CI 1.03-1.11) and a 5% higher prevalence of oppositional defiant disorder (95% CI 1.03-1.08) at 1-year follow-up. Each hour of social media per day was associated with a 62% higher prevalence of conduct disorder (95% CI 1.39-1.87). Each hour of video chat (prevalence ratio [PR] 1.21, 95% CI 1.06-1.37), texting (PR 1.19, 95% CI 1.07-1.33), television/movies (PR 1.17, 95% CI 1.10-1.25), and video games (PR 1.14, 95% CI 1.07-1.21) per day was associated with a higher prevalence of the oppositional defiant disorder. When examining thresholds, exposure to >4 hr of total screen time per day was associated with a higher prevalence of conduct disorder (69%) and oppositional defiant disorder (46%).

CONCLUSIONS

Higher screen time was prospectively associated with a higher prevalence of new-onset disruptive behavior disorders. The strongest association was between social media and conduct disorder, indicating that future research and interventions may focus on social media platforms to prevent conduct disorder.

Network Analysis of Neurobehavioral Symptom Patterns in an International Sample of Spanish-Speakers with a History of COVID-19 and Controls

(1) Background: Psychometric network analysis provides a novel statistical approach allowing researchers to model clusters of related symptoms as a dynamic system. This study applied network analysis to investigate the patterns of somatic, cognitive, and affective neurobehavioral symptoms in an international sample of Spanish-speaking individuals with a history of COVID-19 positivity and non-COVID controls; (2) methods: the sample (n = 1093) included 650 adults from 26 countries who reported having previously tested positive for COVID-19 (COVID+) through a viral and/or antigen test (average of 147 days since diagnosis). The control group (COVID-) was comprised of 443 adults from 20 countries who had completed the survey prior to the COVID-19 pandemic; (3) results: relative to the COVID- network, the COVID+ network was very well-connected, such that each neurobehavioral symptom was positively connected to the network. The organize-to-headache and dizzy-to-balance connections in the COVID+ network were stronger than in the COVID- network. The hearing, numbness, and tense symptoms were more central to the COVID+ network with the latter connected to the sleep, fatigue, and frustrated symptoms. The COVID- network was largely disjointed, with most of the somatosensory symptoms forming their own cluster with no connections to other symptom groups and fatigue not being connected to any other symptom. The cognitive and affective symptoms in the COVID- network were also largely connected to symptoms from within their own groups; (4) conclusions: These findings suggest that many of the long-term neurobehavioral symptoms of COVID-19 form a discernable network and that headaches, frustration, hearing problems, forgetfulness, and tension are the most central symptoms. Cognitive and behavioral rehabilitation strategies targeting these central symptom network features may hold promise to help fracture the lingering symptom network of COVID-19.

An international study of post-COVID sleep health

OBJECTIVES

COVID-19 has infected millions of people worldwide, with growing evidence that individuals with a history of infection may continue to show persistent post-COVID symptoms (long COVID). The aim of this study was to investigate sleep health in an international sample of individuals who reported previously testing positive for COVID-19.

DESIGN

Cross-sectional.

SETTING

Online survey distributed online between March and June 2021.

PARTICIPANTS

A total of 1001 individuals who reported a positive diagnosis of COVID-19 across different geographical regions, including North and South America, Sub-Saharan Africa, and Europe.

MEASUREMENTS

Self-reported sleep health, using the Regulatory Satisfaction Alertness Timing Efficiency Duration scale, as recalled before a COVID-19 diagnosis and also reported currently.

RESULTS

Individuals reported worse overall current sleep health, with lower ratings across the 6 dimensions of sleep health (sleep regularity, satisfaction, alertness, timing, efficiency, and duration) compared to their ratings as recalled before COVID-19 infection. Greater severity of COVID-19 symptoms was the strongest predictor of poor current sleep health (P < .001), independent of demographics, presence of a pre-existing chronic health condition, and time since infection. Poor current sleep health was associated with poorer current quality of life (P < .001).

CONCLUSIONS

Poor current sleep health is evident in individuals with a history of COVID-19, particularly those with more severe symptoms at the time of their COVID-19 infection and is associated with a poorer quality of life. Clinicians and researchers should assess sleep health in COVID-19 patients and investigate long-term associations with their mental and physical health, as well as potential benefits of improving sleep in this population.

Recommendations for Identifying Valid Wear for Consumer-Level Wrist-Worn Activity Trackers and Acceptability of Extended Device Deployment in Children

BACKGROUND

Self-reported physical activity is often inaccurate. Wearable devices utilizing multiple sensors are now widespread. The aim of this study was to determine acceptability of Fitbit Charge HR for children and their families, and to determine best practices for processing its objective data.

METHODS

Data were collected via Fitbit Charge HR continuously over the course of 3 weeks. Questionnaires were given to each child and their parent/guardian to determine the perceived usability of the device. Patterns of data were evaluated and best practice inclusion criteria recommended.

RESULTS

Best practices were established to extract, filter, and process data to evaluate device wear, r and establish minimum wear time to evaluate behavioral patterns. This resulted in usable data available from 137 (89%) of the sample.

CONCLUSIONS

Activity trackers are highly acceptable in the target population and can provide objective data over longer periods of wear. Best practice inclusion protocols that reflect physical activity in youth are provided.

Social Epidemiology of Early Adolescent Cyberbullying in the United States

OBJECTIVE

To determine the prevalence and sociodemographic correlates of cyberbullying victimization and perpetration among a racially, ethnically and socioeconomically diverse population-based sample of 11-12-year-old early adolescents.

METHODS

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2; N = 9429). Multiple logistic regression analyses were used to estimate associations between sociodemographic factors (sex, race/ethnicity, sexual orientation, country of birth, household income, parental education) and adolescent-reported cyberbullying victimization and perpetration.

RESULTS

In the overall sample, lifetime prevalence of cyberbullying victimization was 9.6%, with 65.8% occurring in the past 12 months, while lifetime prevalence of cyberbullying perpetration was 1.1%, with 59.8% occurring in the past 12 months. Boys reported higher odds of cyberbullying perpetration (AOR 1.71, 95% CI 1.01-2.92) but lower odds of cyberbullying victimization (AOR 0.80, 95% CI 0.68-0.94) than girls. Sexual minorities reported 2.83 higher odds of cyberbullying victimization (95% CI 1.69-4.75) than nonsexual minorities. Lower household income was associated with 1.64 (95% CI 1.34-2.00) higher odds of cyberbullying victimization than higher household income, however household income was not associated with cyberbullying perpetration. Total screen time, particularly on the internet and social media, was associated with both cyberbullying victimization and perpetration.

CONCLUSIONS

Nearly one in 10 early adolescents reported cyberbullying victimization. Pediatricians, parents, teachers, and online platforms can provide education to support victims and prevent perpetration for early adolescents at the highest risk of cyberbullying.