Comorbid anxiety disorders alter the association between cardiovascular diseases and depression: the German National Health Interview and Examination Survey

Purpose

This study aims to examine whether specific anxiety disorder comorbidity alters the purported association between depression and specific cardiovascular diseases (CVDs).

Methods

In 4,181 representative German participants of the general population, 12-month prevalence of psychiatric disorders was assessed through the Composite International Diagnostic Interview and CVDs by physician verified diagnosis. Adjusting for conventional risk factors logistic regression analyzed the association between CVDs (peripheral vascular disease (PVD), hypertension, cerebrovascular disease and heart disease) and combinations of comorbidity between depression and anxiety disorder types (panic disorder, specific phobia, social phobia and generalized anxiety).

Results

There were 770 cases of hypertension (18.4 %), 763 cases of cerebrovascular disease (18.2 %), 748 cases of PVD (17.9 %), and 1,087 cases of CVD (26.0 %). In adjusted analyses phobia comorbid with depression was associated with cerebrovascular disease (odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.04–2.50) as was panic disorder (OR 2.89; 95 % CI 1.47–5.69). PVD was significantly associated with panic disorder (adjusted OR 2.97; 95 % CI 1.55–5.69). Panic disorder was associated with CVDs (adjusted OR 2.28; 95 % CI 1.09–4.77) as was phobia (adjusted OR 1.35; 95 % CI 1.04–1.78).

Conclusions

Classification of anxiety and depression according to comorbidity groups showed discrete effects for panic disorder and specific phobia with CVDs, independent from covariates and depression.     

Diet quality and mental health problems in adolescents from East London: a prospective study

Purpose

In this study, we aimed to examine the relationship between diet quality and depression in a prospective study of adolescents from varied ethnic and cultural backgrounds.

Design

In this prospective cohort study, data were collected at two time points (2001 and 2003) from nearly 3,000 adolescents, aged either 11–12 years or 13–14 years, participating in RELACHS, a study of ethnically diverse and socially deprived young people from East London in the UK. Diet quality was measured from dietary questionnaires, and mental health assessed using the Strengths and Difficulties Questionnaire (SDQ) and the Short Mood and Feelings Questionnaire (SMFQ).

Results

In cross-sectional analyses, we found evidence for an association between an unhealthy diet and mental health problems. Compared to those in the lowest quintile of Unhealthy diet score, those in the highest quintile were more than twice as likely to be symptomatic on the SDQ (OR 2.10, 95 %CI 1.38–3.20) after taking all identified confounders into account. There was also some evidence for a cross-sectional inverse association between a measure of healthy diet and mental health problems. A prospective relationship between the highest quintiles of both Healthy (OR 0.63, 95 %CI 0.38–1.05) and Unhealthy (OR 1.75, 95 %CI 1.00–3.06) diet scores and SDQ scores at follow-up was also evident, but was attenuated by final adjustments for confounders.

Conclusion

This study is concordant with previous observational studies in describing relationships between measures of diet quality and mental health problems in adolescents.     

The long-lasting impact of adolescents’ deviant friends on suicidality: a 3-year follow-up perspective

Background

During adolescence, friends are increasingly important for support and values. Do friends also have a long-term impact on suicidality? This study explored the role of friendship problems (e.g., social isolation) and deviant friends during late adolescence on suicidal ideation and behavior 3 years later.

Method

Participants were 295 community adolescents (59 % Mexican-American; 41 % European-American) from the United States. Information about their suicidal ideation and behavior, depression, friendship problems, and deviant friends was collected at baseline and at a 3-year follow-up.

Results

Having deviant friends was a better predictor of suicidality than having friendship problems, with variability by sex and ethnicity. Having deviant friends predicted suicidal ideation among Mexican-American adolescents. Having friends who were disconnected from school was a risk factor for suicidal ideation among European-American adolescents but a protective factor for suicidal behavior among Mexican-American adolescents, especially boys. Depression played more of a mediating role between friendship factors and suicidality for European-American than for Mexican-American adolescents.

Conclusions

This study’s findings suggest an influence of adolescents’ deviant friends on suicidality 3 years later. They also call for the cultural and gender grounding of suicide theory, research and prevention.     

Service use in adolescents at risk of depression and self-harm: prospective longitudinal study

Purpose

Although depression and self-harm are common mental health problems in adolescents, there are barriers to accessing help. Using a community-based sample, this study investigates predictors of service contacts for adolescents at high risk of depression and self-harm.

Methods

Three thousand seven hundred and forty-nine (3,749) 12- to 16-year-olds in UK secondary (high) schools provided baseline and 6 months’ follow-up data on mood, self-harm and service contacts with a range of primary and secondary healthcare services.

Results

Although most adolescents at high risk of depression or self-harm had seen their general practitioner (GP) in the previous 6 months, less than one-third had used primary or secondary healthcare services for emotional problems. 5 % of adolescents who reported self-harm had seen specialist child and adolescent mental health services in the previous 6 months. In longitudinal analyses, after adjustment for confounders, both depression and self-harm predicted the use of any healthcare services [adjusted odds ratio (AOR) = 1.34 (95 % CI 1.09, 1.64); AOR = 1.38 (95 % CI 1.02, 1.86), respectively] and of specialist mental health services [AOR = 5.48 (95 % CI 2.27, 13.25); AOR = 2.58 (95 % CI 1.11, 6.00), respectively]. Amongst those with probable depression, 79 % had seen their GP and 5 % specialist mental health services in the preceding year.

Conclusions

Most adolescents at high risk of depression or self-harm see their GP over a 6-month period although only a minority of them access specialist mental health services. Their consultations within primary care settings provide a potential opportunity for their identification and for signposting to appropriate specialist services.     

Patterns of victimization,suicide attempt,and posttraumatic stress disorder in Greenlandic adolescents: a latent class analysis

Aim

The current study had two main aims. The first was to identify groups of adolescents based on their similarity of responding across a number of victimizing and potentially traumatic events (PTEs). In doing so, we employed the statistical technique of Latent Class Analysis (LCA). The second aim was to assess the relationship between our resultant classes and the covariates of gender, suicide attempt, and PTSD.

Methods

Two hundred and sixty-nine Greenlandic school students, aged 12–18 (M = 15.4, SD = 1.84) were assessed for their level of exposure to PTEs. In addition, adolescents were assessed for the psychological impact of these events. A LCA was performed on seven binary indicators representing PTEs. Logistic regression was subsequently implemented to ascertain the relationships between latent classes and covariates.

Results

Three distinct classes were uncovered: a violence, neglect, and bullying class (class 1), a wide-ranging multiple PTE class (class 2), and a normative/baseline class (class 3). Notably, classes 1 and 2 were largely separated by the presence or absence of sexual PTEs. Individuals who reported having previously attempted suicide were almost six times more likely to be members of class 1 (OR = 5.97) and almost four times more likely to be members of class 2 (OR = 3.87) compared to the baseline class (class 3). Individuals who met the diagnostic criteria for PTSD were five times as likely to be members of class 1 and class 2 (OR = 5.09) compared to the baseline class. No significant associations were found between classes and gender.

Conclusion

The results underline the complexity of the interplay between multiple victimization experiences, traumatization, and suicide attempts.     

Somatic symptoms in adolescence as a predictor of severe mental illness in adulthood: a long-term community-based follow-up study

Background

Somatic symptoms are common and costly for society and correlate with suffering and low functioning. Nevertheless, little is known about the long-term implications of somatic symptoms. The objective of this study was to assess if somatic symptoms in adolescents with depression and in their matched controls predict severe mental illness in adulthood by investigating the use of hospital-based care consequent to different mental disorders.

Methods

The entire school population of 16–17-year-olds in the city of Uppsala, Sweden, was screened for depression in 1991–1993 (n?=?2300). Adolescents with positive screenings (n?=?307) and matched non-depressed controls (n?=?302) participated in a semi-structured diagnostic interview for mental disorders. In addition, 21 different self-rated somatic symptoms were assessed. The adolescents with depression and the matched non-depressed controls were engaged in follow-up through the National Patient Register 17–19 years after the baseline study (n?=?375). The outcome measures covered hospital-based mental health care for different mental disorders according to ICD-10 criteria between the participants’ ages of 18 and 35 years.

Results

Somatic symptoms were associated with an increased risk of later hospital-based mental health care in general in a dose–response relationship when adjusting for sex, adolescent depression, and adolescent anxiety (1 symptom: OR?=?1.63, CI 0.55–4.85; 2–4 symptoms: OR?=?2.77, 95% CI 1.04–7.39;?≥?5 symptoms: OR?=?5.75, 95% CI 1.98–16.72). With regards to specific diagnoses, somatic symptoms predicted hospital-based care for mood disorders when adjusting for sex, adolescent depression, and adolescent anxiety (p?<?0.05). In adolescents with depression, somatic symptoms predicted later hospital-based mental health care in a dose–response relationship (p?<?0.01). In adolescents without depression, reporting at least one somatic symptom predicted later hospital-based mental health care (p?<?0.05).

Conclusions

Somatic symptoms in adolescence predicted severe adult mental illness as measured by hospital-based care also when controlled for important confounders. The results suggest that adolescents with somatic symptoms need early treatment and extended follow-up to treat these specific symptoms, regardless of co-occurring depression and anxiety.

     

Trajectory and predictors of depressive symptoms among adolescent survivors following the Wenchuan earthquake in China: a cohort study

Objective

To investigate the trajectory of depressive symptoms among adolescents exposed to the Wenchuan earthquake as well as predictors after the earthquake.

Methods

A cohort of students (N = 1,573) in the 7th and 10th grades from Dujiangyan city was followed-up periodically for 2 years. Participants were assessed at 6, 12, 18, and 24 months after the earthquake. Adolescents completed the Depression Self-rating Scale for Children, Adolescent Self-Rating Life Event Checklist, Resilience Scale, and earthquake exposure questionnaire.

Results

The prevalence rates of depressive symptoms at 6, 12, 18 and 24 months were 27.4, 41, 31.9, and 38.3 %, respectively. The number of adolescents who kept no depressive symptoms and persistent depressive symptoms at each stage was stable, accounted for almost 50 and 20 % of the total, respectively. Adolescents turning no depressive symptoms to depressive symptoms were mostly in 6–12 months, followed by 18–24 months. Additionally, girls (OR 1.24–1.37), post-disaster negative life events (OR for high vs. low = 5.54–15.06), resilience (OR for low vs. high = 9.40–13.69), and depressive symptoms at previous stage (OR 4.96–6.03) had a long-term effect on depressive symptoms, while the impact of earthquake exposure diminished with the passage of time and could not predict depressive symptoms after one and a half years after the earthquake.

Conclusions

Among adolescent survivors, the resistance and persistence of depressive symptoms were common. Moreover, depressive symptoms tended to outbreak close to the anniversary date, showing the anniversary reaction. Adolescent girls, adolescents who encountered high levels of life events, had low levels of resilience and a history of depressive symptoms should be provided with psychological intervention.     

The relationship between cognitive ability and depression: a longitudinal data analysis

Purpose

There is literature indicating cognitive ability and depression are related, but few studies have examined the direction of the relationship. This study examined the relationship between depression levels and cognitive abilities from adolescence to early adulthood.

Methods

Using the National Longitudinal Study of Adolescent Health (n = 14,322), this study used path modeling to investigate the relationship between depression and cognitive ability at baseline and again 8 years later.

Results

After controlling for initial levels of depression, cognitive ability, and other covariates, depressive symptoms in adolescence are related to cognitive ability in early adulthood, but adolescent cognitive ability is not related to adult depression levels. Moreover, after controlling for adolescent levels of depression and cognitive ability, the cognitive ability–depression relationship disappears in adulthood.

Conclusions

The cognitive ability–depression relationship appears early in life, and it is likely that the presence of depressive symptoms leads to lower cognitive ability. Thus, intervening at early signs of depression not only can help alleviate depression, but will likely have an effect of cognitive ability as well.     

Early Adolescent Relationship Predictors of Emerging Adult Outcomes: Youth With and Without Type 1 Diabetes

Background

Emerging adulthood is a high-risk period for mental health problems and risk behaviors for youth generally and for physical health problems among those with type 1 diabetes.

Purpose

The purpose of this study was to examine whether adolescents’ relationships with parents and friends predict health and risk behaviors during emerging adulthood.

Method

Youth with and without diabetes were enrolled at average age 12 and followed for 7 years. Parent and friend relationship variables, measured during adolescence, were used to predict emerging adulthood outcomes: depression, risk behavior, and, for those with diabetes, diabetes outcomes.

Results

Parent relationship quality predicted decreased depressive symptoms and, for those with diabetes, decreased alcohol use. Parent control predicted increased smoking, reduced college attendance, and, for control participants, increased depressive symptoms. For those with diabetes, parent control predicted decreased depressive symptoms and better self-care. Friend relationship variables predicted few outcomes.

Conclusions

Adolescent parent relationships remain an important influence on emerging adults’ lives.     

Social phobia,depression and eating disorders during middle adolescence: longitudinal associations and treatment seeking

Background: Longitudinal associations between social phobia (SP), depression and eating disorders (EDs), and the impact of antecedent SP and depression on subsequent treatment seeking for EDs have rarely been explored in prospective adolescent population studies.

Aim: We aimed to examine these associations in a large-scale follow-up study among middle adolescents.

Method: We surveyed 3278 Finnish adolescents with a mean age of 15 years for these disorders. Two years later, 2070 were reached and again surveyed for psychopathology and treatment seeking. Longitudinal associations between the self-reported disorders and treatment-seeking patterns for self-acknowledged ED symptoms were examined in multivariate analyses, controlling for SP/depression comorbidity and relevant socioeconomic covariates.

Results: Self-reported anorexia nervosa (AN) at age 15 years predicted self-reported depression at age 17 years. Furthermore, self-reported SP at age 15 years predicted not seeking treatment for bulimia nervosa (BN) symptoms, while self-reported depression at age 15 years predicted not seeking treatment for AN symptoms during the follow-up period.

Conclusions: Adolescents with AN should be monitored for subsequent depression. Barriers caused by SP to help seeking for BN, and by depression for AN, should be acknowledged by healthcare professionals who encounter socially anxious and depressive adolescents, especially when they present with eating problems.     

The association between physical activity and depression among individuals residing in Brazil

Purpose

There is very limited literature investigating the association between physical activity (PA) and depression in South American countries such as Brazil. The purpose of the current study was to evaluate the prevalence of depression and its association with PA in a very large, representative sample of young adults (ages 18–39 years) (YA), middle-aged adults (ages 40–59 years) (MAA) and older adults (ages ≥ 60 years) (OA) residing in Brazil.

Methods

The sample for this cross-sectional study was based on the Brazilian National Health Survey conducted in 2013. The Personal Health Questionnaire depression scale (PHQ-8) was applied to measure current (past 2 weeks) depression as the outcome of interest, and the exposure was self-reported PA for leisure. Multivariable weighted logistic regression models were conducted to investigate the association between PA and depression while adjusting for socio-demographic characteristics and number of health comorbidities among YA, MAA and OA.

Results

The final study sample size was 59,399 (33,480 females; 25,919 males). After adjusting for the covariates of interest, the lack of PA for leisure was associated with a significant increase in depression only among males (YA: OR 1.45, 95% CI 1.02–2.06; MAA: OR 2.38, 95% CI 1.40–4.03; OA: OR 5.35, 95% CI 2.14–13.37). There was no significant association between PA for leisure and depression among females of all age groups.

Conclusions

Although PA for leisure is not associated with depression among Brazilian females, the obtained results suggest that this association is significant among Brazilian males, who may be able to benefit from PA for leisure to reduce their symptoms of depression.

     

Physical activity patterns and risk of depression in young adulthood: a 20-year cohort study since childhood

Purpose

Little is known about how physical activity patterns during childhood and adolescence are associated with risk of subsequent depression. We examined prospective and retrospective associations between leisure physical activity patterns from childhood to adulthood and risk of clinical depression in young adulthood.

Methods

Participants (759 males, 871 females) in a national survey, aged 9–15 years, were re-interviewed approximately 20 years later. Leisure physical activity was self-reported at baseline (1985) and follow-up (2004–2006). To bridge the interval between the two time-points, historical leisure activity from age 15 years to adulthood was self-reported retrospectively at follow-up. Physical activity was categorized into groups that, from a public health perspective, compared patterns that were least beneficial (persistently inactive) with those increasingly beneficial (decreasing, increasing and persistently active). Depression (major depressive or dysthymic disorder) was assessed using the Composite International Diagnostic Interview.

Results

Compared with those persistently inactive, males who were increasingly and persistently active had a 69 and 65 % reduced risk of depression in adulthood, respectively (all p < 0.05). In retrospective analyses, females who were persistently active had a 51 % reduced risk of depression in adulthood (p = 0.01). Similar but non-significant trends were observed for leisure physical activity in females and historical leisure activity in males. Results excluded those with childhood onset of depression and were adjusted for various sociodemographic and health covariates.

Conclusions

Findings from both prospective and retrospective analyses indicate a beneficial effect of habitual discretionary physical activity since childhood on risk of depression in young adulthood.     

Major depression in young girls is related to altered cortisol awakening response

Background

There is evidence that clinical depression is associated with elevated basal cortisol levels in adult patients.

Objective

The present investigation tries to find out, whether this relationship also holds true in adolescents with major depression.

Methods

For 131 female subjects (63 MDD, 68 controls) the cortisol awakening response (CAR) was measured at 0, 30, 45, and 60 min after awakening. All subjects provided saliva cortisol.

Results

A significantly higher CAR was found in patients. The global mean difference was due to differences 60 and 45 min after awakening.

Limitations

A causal interpretation of the data is restricted, because of its cross-sectional nature. The effect size of the mean differences is rather small.

Conclusion

The observed HPA hyperactivity may be a cause as well as a consequence of depression in childhood.     

The longitudinal association between external locus of control,social cognition and adolescent psychopathology

Purpose

To investigate the longitudinal associations between social cognitive ability an external locus of control (externality) and adolescent psychopathology.

Methods

7058 participants from a prospective population-based cohort provided data on externality, social communication, and emotion perception between 7 and 16 years and psychotic experiences and depressive symptoms at 12 and 18 years. Bivariate probit modelling was used to investigate associations between these risk factors and psychopathological outcomes.

Results

Externality was associated with psychopathology at 12 (psychotic experiences OR 1.23 95% CI 1.14, 1.33; depression OR 1.12 95% CI 1.02, 1.22) and 18 years (psychotic experiences OR 1.38 95% CI 1.23, 1.55; depression OR 1.40 95% CI 1.28, 1.52). Poor social communication was associated with depression at both ages (12 years OR 1.22 95% CI 1.11, 1.34; 18 years OR 1.21 95% CI 1.10, 1.33) and marginally associated with psychotic experiences. There was marginal evidence of a larger association between externality and psychotic experiences at 12 years (p?=?0.06) and between social communication and depression at 12 years (p?=?0.03).

Conclusions

Externality was more strongly associated with psychotic experiences. At 18 years change in externality, between 8 and 16 years were associated with a larger increase in the risk of depression. Poor social communication was more strongly associated with depression.

     

Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the Young-HUNT study

Purpose

This study investigated the symptoms of anxiety and depression in adolescence, their associations with lifestyle and resilience and the possibility that resilience factors can attenuate the associations between unhealthy lifestyle and symptoms of anxiety and depression.

Methods

Adolescents (n = 7,639) aged 13–18 years completed a questionnaire regarding lifestyle and health. Symptoms of anxiety and depression were measured by the SCL-5, a five-item shortened version of the Hopkins Symptom Checklist. Resilience factors included questions on friends and family relations and two sub-scales of the Resilience Scale for Adolescents; Family cohesion and Social competence.

Results

Of the total population, 13 % reported symptoms of anxiety and depression. Resilience characteristics were associated with lower symptom levels (ORs ranging from 0.2 to 0.6), and substance use and infrequent physical activity with higher symptom levels (ORs ranging from 2.1 to 4.0). The associations with substance use were strengthened by social competence, but attenuated by family cohesion. The association with physical activity was attenuated by both social competence and family cohesion.

Conclusion

Symptoms of anxiety and depression were frequent in adolescents and were associated with unhealthy lifestyle factors as substance use and low physical activity. Resilience characteristics seemed to protect against symptoms and markedly influenced the associations between lifestyle factors and symptoms of anxiety and depression. The importance of family and other supportive relationships should be emphasized in treatment and prevention of anxiety and depression in adolescence.     

Accuracy of Weight Perception Among Urban Early Adolescents with Uncontrolled Asthma and Their Caregivers

Background

Obesity is associated with poor asthma outcomes; weight loss improves such outcomes. Inaccurate recognition of obesity may impede weight control.

Purpose

We examined perception of weight by early adolescents with uncontrolled asthma and their caregivers, and tested the relationship between medical visit frequency and accuracy of perceived weight status.

Methods

A total of 373 adolescents and their caregivers reported the adolescent’s height/weight and weight perception; caregivers reported healthcare utilization. We measured height/weight. Logistic regression modeled accuracy of weight perception.

Results

A total of 43.7 % of the overweight/obese adolescents and caregivers accurately perceived weight status. BMI percentile [odds ratio (OR)?=?1.19, confidence interval (CI)?=?1.10–1.28] and total medical visits (OR?=?1.18, CI?=?1.05–1.33) were associated with higher accuracy in caregivers. Total medical visits (OR?=?0.84, CI?=?0.74–0.96) was associated with lower accuracy in adolescents.

Conclusions

Accurate perception of weight status was poor for overweight adolescents with uncontrolled asthma and their caregivers. Frequent medical visits were associated with improved caregivers’ but not adolescents’ perceptions.     

Depression and Anxiety Following Myocardial Infarction and Their Inverse Associations with Future Health Behaviors and Quality of Life

Background

Post-myocardial infarction (MI) depression and anxiety were found to predict prognosis and quality of life.

Purpose

The purpose of this study was to test a behavioral pathway from post-MI depression/anxiety to future quality of life.

Methods

This is a longitudinal cohort study. Five hundred forty patients (≤65 years old) filled out questionnaires after a first MI, including socio-demographics, pre-MI health status and behaviors, MI severity, social support, sense of coherence, depression, and anxiety. Reports of health behaviors were obtained 5 years and of quality of life 10 years later.

Results

A structural equations model confirmed that depression and anxiety were directly related to poorer quality of life 10 years later. These relationships were partly mediated by a positive association between anxiety and health behaviors at 5 years and a negative one between depression and health behaviors.

Conclusions

The opposite effects of anxiety and depression underscore the need to attend to both emotional reactions to MI while encouraging preventive health behaviors.     

Bouncing back: remission from depression in a 12-year panel study of a representative Canadian community sample

Purpose

This study sought to investigate time to remission from depression in a community-based sample of adults followed for 12 years.

Methods

Data were derived from the National Population Health Survey (1994/5–2006/7 and 1996/7–2008/9). Fully 1,128 adults were included who were depressed at baseline according to DSM-III/CIDI-SF criteria. Kaplan–Meier and Cox proportional hazards procedures were used to determine time to remission and the demographic (e.g., gender and marital status), psychosocial (e.g., social support and adverse childhood experience) and health-related (e.g., pain, health conditions and alcohol use) factors with which it is associated.

Results

More than three quarters of the sample (77 %) no longer screened positive for depression at 2 years, and nearly the entire sample (94 %) had remitted by 12 years. Adverse childhood experiences (i.e., childhood abuse and parental additions), lack of social support, the presence of pain and health conditions (i.e., migraines, arthritis and back pain) each predicted more time to remission. The only factor associated with time to remission in the multivariate analysis was a history of childhood physical abuse.

Conclusions

Most community members with depression get better after 2 years and nearly all will have remitted, at least once, by 12 years. The results of this study may help guide the development of interventions for chronic depression that focus on early prevention of childhood abuse.     

Value of Transcranial Doppler,Perfusion-CT and Neurological Evaluation to Forecast Secondary Ischemia after Aneurysmal SAH

Introduction

This study was conducted to prospectively evaluate the diagnostic value of detailed neurological evaluation, transcranial Doppler sonography (TCD) and Perfusion-CT (PCT) to predict delayed vasospasm (DV) and delayed cerebral infarction (DCI) within the following 3 days in patients with aneurysmal subarachnoid hemorrhage (SAH).

Methods

A total of 61 patients with aneurysmal SAH were included in the study. All patients were amenable for neurological evaluation throughout the critical phase to develop secondary ischemia after SAH. The neurological status was assessed three times a day according to a detailed examination protocol. Mean flow velocities (MFV) in intracranial vessel trunks were measured daily by TCD. Native CT and PCT were routinely acquired at 3-day intervals and, in addition, whenever it was thought to be of diagnostic relevance. The predictive values of abnormal PCT and accelerations in TCD (MFV > 140 cm/s) to detect angiographic DV and DCI within the following 2 days were calculated and compared to the predictive value of delayed ischemic neurological deficits (DIND).

Results

The accuracy of TCD and PCT to predict DV or DCI was 0.65 and 0.63, respectively. In comparison, DIND predicted DV or DCI with an accuracy of 0.96. Pathological PCT findings had a higher sensitivity (0.93) and negative predictive value (0.98) than TCD (0.81 and 0.96).

Conclusion

Neurological assessment at close intervals is the most accurate parameter to detect DV and DCI in the following 3 days. However, DIND may not be reversible. The routine acquisition of PCT in addition to daily TCD examinations seems reasonable, particularly in patients who are not amenable to a detailed neurological examination since it has a higher sensitivity and negative predictive value than TCD and leaves a lower number of undetected cases of vasospasm and infarction.     

A Longitudinal Study of the Effects of Instrumental and Emotional Social Support on Physical Activity in Underserved Adolescents in the ACT Trial

Background

Few previous studies have examined the influence of instrumental and emotional social support on physical activity (PA) longitudinally in underserved adolescents.

Purpose

This longitudinal study was a secondary analysis of the Active by Choice Today (ACT) trial examining whether instrumental social support predicts increases in PA in underserved adolescents, above and beyond emotional social support provided by family or peers.

Methods

Students in the sixth grade (N?=?1,422, 73 % African American, 54 % female, M _age?=?11 years) in the ACT trial participated. At baseline and 19 weeks, previously validated measures of social support (family instrumental, family emotional, and peer emotional) were completed and moderate-to-vigorous PA (MVPA) was assessed using 7-day accelerometry estimates.

Results

A mixed ANCOVA demonstrated that baseline (p?=?0.02) and change in family instrumental support (p?=?0.01), but not emotional support from family or peers, predicted increases in MVPA across a 19-week period.

Conclusions

Future interventions in underserved adolescents should enhance opportunities for instrumental support for PA.