Social Media and Mental Health Among Early Adolescents in Sweden: A Longitudinal Study With 2-Year Follow-Up (KUPOL Study)

PurposeThe aim of this study is to assess the longitudinal associations between the frequency of social media use and symptoms of mental ill-health among Swedish adolescents.MethodsData came from KUPOL, a Swedish school-based longitudinal cohort accrued in 101 participating schools in 8 regions of Sweden. The study sample consisted of 3,501 adolescents in grade 8 (14–15 years, 51.5%, n = 1,765 girls) followed for 2 consecutive years. Daily social media use was measured as weighted average of self-reported use in weekdays and weekend days. Mental health was measured with the Strength and Difficulties Questionnaire (SDQ). A Random-Intercept Cross-Lagged Panel Model was applied to distinguish between-person from within-person associations between social media use and symptoms of mental ill-health.ResultsMedian SDQ score at baseline was 9 (interquartile range [IQR] 6–14). Median social media use was 1.7 hours at baseline (interquartile range .6–3.0) and increased over the 3-year period. Adolescents with more social media use also reported higher SDQ scores, B (95% confidence interval [CI]) = 2.40 (2.03–2.77). On a within-person level, no cross-lagged associations were found between changes in social media use and subsequent changes in symptoms of mental ill-health after 1 year, B (95% CI) = .02 (?.12 to .16) or vice versa B (95% CI) = .00 (?.02 to .02). Weak cross-sectional associations were found between changes in social media use and concurrent changes in symptoms of mental ill-health, B (95% CI) = .24 (.00–.48).ConclusionsAdolescents with higher use of social media report more symptoms of mental health problems, but there is no evidence for a longitudinal association between increased use and mental health problems. This suggests that social media may be rather an indicator than a risk factor for symptoms of mental ill-health.     

Perception of Neighborhood Crime and Drugs Increases Cardiometabolic Risk in Chilean Adolescents

PurposeStudies report an association between neighborhood risk and both obesity and cardiometabolic risk factors (CMR) among adolescents. Here we describe the effect of perceived neighborhood risk on adiposity and CMR among Chilean adolescents.MethodsParticipants were 523 low- to middle-income Chilean adolescents. We assessed neighborhood risk in early adolescence, adiposity in childhood and in early and later adolescence, and blood pressure and fasting glucose in later adolescence. Neighborhood risk profiles were estimated using latent profile analysis (LPA) and based on reported perceptions of crime and drug sales/use. Using linear and logistic regression, we examined the effect of neighborhood risk on adiposity and CMR.ResultsMean age in early and later adolescence was 14 and 17 years, respectively. Participants were 52% male, with a mean BMI z-score of .67, and 8% met criteria for metabolic syndrome. LPA identified two neighborhood profiles: 61% low risk and 39% high risk. In later adolescence, being in the high risk profile predicted a higher BMI z-score, waist-to-height ratio, and fat mass index (p < .05). Adolescents in the high risk profile had three times greater odds of meeting criteria for metabolic syndrome (OR = 3.1, 95% CI: 1.5, 5.8) compared with those in the low risk profile.ConclusionsOur findings suggest that there are physiological responses to living in a neighborhood perceived as “risky,” which may contribute to obesity and CMR even in adolescence. For Chilean neighborhoods with high crime and drugs, targeted public health interventions and policies for youth could be beneficial.     

Trajectories of maternal leisure-time physical activity and sedentary behavior during adolescence to young adulthood and offspring birthweight

PurposeThe objectives of the study were to determine the extent to which trajectories of maternal preconception leisure-time physical activity (LTPA) and leisure-time sedentary behavior (LTSB) during adolescence and young adulthood are associated with offspring birth weight (BW) and to test if these associations differ by offspring sex or maternal pre-pregnancy overweight–obese status.MethodsParticipants with one or more birth (n = 1408) were identified from the National Longitudinal Study of Adolescent to Adult Health. Group-based trajectory modeling was used to characterize trajectories of LTPA (frequency/week) and LTSB (hours/week) which were measured, on average, over 7 years between age 15 and 22 years. Weighted regression and Wald tests were used to estimate and test mean differences and odds ratios for BW, small for gestational age, and large for gestational age (LGA).ResultsThree trajectories were identified for LTPA and five for LTSB. Associations differed by offspring sex for continuous BW and LGA (interaction P = .10 and .008, respectively). Among female offspring, participants with high followed by decreasing LTPA delivered offspring with 90 g greater BW (95% confidence interval [CI]: −4 to 184) and 72% greater risk of LGA (95% CI: 0.94–3.14), compared with participants with low LTPA. Among male offspring, LTPA patterns were not associated with BW. A pattern of high then decreasing LTPA among normal weight, but not overweight–obese women, was associated with 2.03 times greater risk of LGA (95% CI: 1.06–3.88). LTSB trajectories were not associated with BW.ConclusionsAssociations of preconception trajectories of LTPA with offspring BW may differ by offspring sex and maternal pre-pregnancy overweight–obese status.     

The Impact of Social Media Use and Gaming on Initiation of Smokeless Tobacco Use Among Rural Male Youth

PurposeSmokeless tobacco (SLT) use is more common among White male youth in rural locations than among other youth. Previous literature documents risk factors for SLT use (e.g., perceived harm). However, no research has examined whether SLT initiation is associated with the use of social media and video games, despite the high prevalence of those behaviors among adolescent males.MethodsAs part of the evaluation of “The Real Cost” smokeless prevention campaign, we conducted a baseline survey of a cohort of US males aged 11–16 in 2016 and four follow-up surveys conducted approximately every 8 months. We used discrete-time survival analysis to examine factors associated with SLT initiation. Logistic regression estimated the odds of initiation as a function of lagged values of key predictors (social media use in tertiles and frequency of gaming) and other baseline and lagged correlates. The model controlled for campaign exposure.ResultsRelative to the lowest tertile of social media use, moderate (odds ratio [OR] = 1.80) or high use (OR = 2.77) was associated with increased risk of SLT initiation at the subsequent survey wave. Relative to playing every few weeks or less, playing video games once a day (OR = 0.50) or several times a day (OR = 0.33) was associated with decreased risk of SLT initiation.DiscussionSLT initiation was positively associated with social media use and negatively associated with gaming. Future research should explore reasons for the protective nature of gaming (e.g., social support, improved mood) and whether parental supervision of social media use could mitigate its negative impact.     

Stroke Rehabilitation Use and Caregiver Psychosocial Health Profiles in Singapore: A Latent Profile Transition Analysis

ObjectivesTo identify and describe caregiver profiles based on their psychosocial health characteristics over a 12-month period and transitions among these profiles, to determine if stroke rehabilitation use at 12 months post-stroke differed by caregiver profile transition patterns, and to investigate if caregiver profiles at 3 months post-stroke moderate the association of stroke rehabilitation use at 3 months and 12 months post-stroke after accounting for covariates.DesignLatent profile transition analysis of caregiver psychosocial health with stroke rehabilitation use at 12 month post-stroke as outcome.Setting and ParticipantsA total of 149 stroke patient-caregiver dyads from the Singapore Stroke Study.MethodsCross-sectional latent profile analyses were conducted on caregiver psychosocial health indicators of burden, depression, health status, quality of relationship with patient, and social support. Changes in latent profile classification over 3 time points (baseline, 3 months, and 12 months post-stroke) were analyzed using latent transition analysis. A transition model with stroke rehabilitation use at 12 months post-stroke as the outcome was tested after accounting for covariates.ResultsTwo distinct caregiver psychosocial health latent profiles were found across time: nondistressed and distressed. Most caregivers were classified as nondistressed and remained nondistressed over time. Distressed caregivers at baseline were 76% likely to become nondistressed at 12 month post-stroke. Regardless of profile transition patterns, nondistressed caregivers at 12 months post-stroke tended to have cared for stroke rehabilitation nonusers at 12 months post-stroke. Patient depression explained profile classification at 3 months and 12 months post-stroke. After accounting for covariates, rehabilitation users at 3 months post-stroke tended to continue using rehabilitation at 12 months post-stroke only when they had nondistressed caregivers at 3 months post-stroke.Conclusions and ImplicationsWhether caregiver adaptation explains the associations between the latent profile transition patterns and rehabilitation use at 12 months post-stroke should be examined. Early psychosocial health assessment and sustained support should be made available to stroke caregivers to enhance their well-being and subsequent patient rehabilitation participation.     

Years Participating in Sports During Childhood Predicts Mental Health in Adolescence: A 5-Year Longitudinal Study

PurposeSport participation promotes mental health and prevents mental illness. However, the association between specific sport profiles and mental health has not been examined. We investigate the longitudinal association between number of years with a recreational or performance sport profile and mental health during adolescence and whether these associations differ by sex.MethodsParticipants (n = 318, 58.2% female) reported participation in sport every 4 months over 5 years, from ages 10–11 to 14–15 years. Each year, they were categorized as recreational or performance sport participants or as nonparticipants. Mental health was assessed at age 15–16 years. Multivariate linear regression was used to model the association between number of years (0–5) with a recreational and performance sport profile and mental health, controlling for sex, age, income, and age at puberty.ResultsA recreational sport profile for ≥2 years was associated with better mental health compared with 0 years of recreational sport participation; the strongest association was observed for a recreational sport profile of 4–5 years ($\widehat{\text{β}}$ [95% confidence interval]: 10.29 [2.60, 17.98]). A performance sport profile for ≥1 year was associated with better mental health in late adolescence compared with 0 years of performance sport participation; the strongest association was observed for a performance sport profile of 4–5 years ($\widehat{\text{β}}$ [95% confidence interval]: 19.48 [9.50, 29.46]). No differences by sex were observed.ConclusionBoth recreational and performance sport profiles in childhood and early adolescence are positively associated with mental health in late adolescence. To promote mental health, strategies to encourage youth to engage and remain involved in sport are warranted.     

Relationships between physical activity across lifetime and health outcomes in older adults: Results from the NuAge cohort

This study aims to (1) describe participation in four physical activity (PA) domains across life and (2) examine the influence of PA during adolescence, early, middle, and later adulthood on health variables at older age.This observational study was conducted in 1378 generally healthy older adults (age 67–84 at baseline in 2003–2005; 52% women) in Quebec, Canada. Using a modified version of the interviewer-administered Lifetime Total Physical Activity Questionnaire (LTPAQ) and life events calendar to facilitate the recall, participants reported the frequency, duration, and intensity of occupational (OPA), commuting (CPA), household (HPA), and leisure time (LTPA) they participated in at age 15, 25, 45, and 65, and at the first follow-up (age 68–85 in 2005–2006). Fat mass, lean body mass, body mass index, waist-to-hip ratio, fasting glucose, systolic and diastolic blood pressures, self-reported chronic diseases, and socio-demographic data were assessed at baseline.Changes in PA over time differed by sex in each domain. However, there was a general decline in all PA domains in both sexes after age 65. In multiple regression analyses, LTPA at first-follow-up was associated with more favourable waist-to-hip ratio in both sexes, fat mass in women and fat mass percentage in men, whereas CPA, OPA, and HPA across life were not consistently associated with health variables.Older adults' LTPA at first follow-up was related to health variables, but PA recalled during adolescence, early adulthood, and mid-life was not. Results support the idea that current PA is positively related to better health outcomes.     

Electronic Media Use and Sleep Among Preschoolers: Evidence for Time-Shifted and Less Consolidated Sleep

ABSTRACT

This study examined the association between electronic media use and sleep among preschoolers, using a national sample of 402 mothers of 3- to 5-year-olds. Participants completed an online survey assessing preschoolers’ electronic media use, bedtime and wake time, sleep time, napping behaviors, and sleep consolidation. Results showed that heavier television use and tablet use, both overall and in the evening, were associated with later bedtimes and later wake times, but not with fewer hours of sleep, providing evidence for a time-shifting process. In addition, heavier daily television use and evening smartphone use were associated with increased daytime napping. Moreover, heavier daily television use, daily and evening smartphone use, and evening tablet use were associated with poorer sleep consolidation, suggesting less mature sleep patterns. These findings indicate that media effects on the timing of sleep and the proportion of sleep that occurs at night are important to consider when assessing the health risks of electronic media on children.     

Association of after school sedentary behaviour in adolescence with mental wellbeing in adulthood

ObjectiveSedentary behaviour is associated with poorer mental health in adolescence but no studies have followed participants into mid-life. We investigated the association between after-school sedentary behaviours (screen time and homework) in adolescence with mental wellbeing in adulthood when participants were aged 42.MethodsParticipants (n = 2038, 59.2% female) were drawn from The 1970 British Cohort Study (BCS70). At age 16 respondents were asked separate questions about how long they spent in three types of screen based activities (TV, video films, computer games) and homework ‘after school yesterday’. Mental well-being and psychological distress were assessed at the age 42 sweep in 2012 using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and Malaise Inventory, respectively.ResultsAfter adjustment for all covariates, participants reporting more than 3 h of after school screen time as an adolescent had − 1.74 (95% CI, − 2.65, − 0.83) points on the WEMWBS compared with adults reporting less than 1 h screen time as an adolescent. Participants that reported high screen time both at age 16 (≥ 3 h/d) and age 42 (≥ 3 h/d TV viewing) demonstrated even lower scores (− 2.91; − 4.12, − 1.69). Homework was unrelated to wellbeing after adjustment for covariates. The longitudinal association between adolescent screen time and adult psychological distress was attenuated to the null after adjustment for covariates.ConclusionsScreen time in adolescence was inversely associated with mental wellbeing in adulthood.     

The Longitudinal Association Between Poor Sleep Quality and Cyberbullying,Mediated by Anger

ABSTRACT

Adolescents tend to go to bed later and sleep less as they grow older, although their need for sleep stays the same throughout adolescence. Poor sleep has negative consequences on personal and interpersonal functioning, including increased aggressive tendencies. With adolescents’ social life increasingly including interactions via digital media, these interactions may also become more aggressive when adolescents’ sleep problems increase. One of the ways in which online aggression may be enacted is through cyberbullying. Although previous research has examined the role of sleep disruptions in offline bullying, the role of sleep in cyberbullying has not yet been addressed. Therefore, this study examines the longitudinal effect of poor sleep quality on later cyberbullying behavior. Thirteen- to fourteen-year-old adolescents completed self-report measures on sleep quality, anger, cyberbullying perpetration, and frequency of digital media use. Because one of the pathways through which sleep is proposed to be linked to aggression is an affective pathway, namely via angry affect, a mediation model of poor sleep quality predicting cyberbullying via feelings of anger was tested. Results from structural equation modeling and a bootstrap test indicated that poor sleep quality was indeed indirectly associated with later cyberbullying behavior through heightened feelings of anger, even when taking the effects of the use of digital media and previous cyberbullying behavior into account. This finding provides support for the proposed affective pathway linking sleep problems to aggression. As sleep problems and anger seem to play a predicting role in cyberbullying behavior, suggestions for cyberbullying intervention and prevention strategies are formulated.     

Older Versus Newer Media and the Well-being of United States Youth: Results From a National Longitudinal Panel

PurposeTo determine the effects of both older and newer media use on academic, social, and mental health outcomes in adolescents and young adults.MethodsWe interviewed a nationally representative panel of youth ages 14–24 years (N = 719) twice 1 year apart to determine time spent with television, the Internet, videogames, and book reading, as well as the purpose of those uses. A cluster analysis identified major combinations of media use. Regression models tested hypotheses regarding changes in self-reported school grades, participation in clubs and sports, and symptoms of depression, as predicted by recent media use and differences in cluster membership.ResultsUse of older media was related to grades, with television inversely and book reading positively related to performance. Moderate use of the Internet was positively related to participation in both sports and clubs. Although heavy use of the Internet and videogames was associated with an increase in depression, increased depression also predicted greater use of these media as well as withdrawal from sports and clubs. Clusters that used media in moderation with an emphasis on information gathering were most associated with healthy outcomes.ConclusionsDespite concerns that excessive use of new media is harmful to adolescent development, the findings reinforce previous conclusions that television detracts from academic performance and book reading supports it. Heavy use of the Internet and video gaming may be more a symptom of mental health problems than a cause. Moderate use of the Internet, especially for acquiring information, is most supportive of healthy development.     

Psychosocial moderators of associations between life events and changes in physical activity after leaving high school

ObjectivesTo examine 1) associations between life events and changes in leisure-time physical activity (LTPA) in school leavers and 2) whether these associations are moderated by psychosocial factors.MethodsFinal year students (n = 440) from high schools in rural Western Australia completed annual telephone interviews on three occasions; baseline (T1), one-year follow-up (T2; n = 440) and two-year follow-up (T3; n = 374). LTPA was measured using the Minnesota Leisure-time Physical Activity Questionnaire. Life events included moving out of home, working full-time and studying full-time. Psychosocial factors included enjoyment, self-efficacy, outcome expectations, club membership, and support from family and friends. Mixed linear regression models examined the effect of life events on changes in LTPA from T1 to T2 and T1 to T3.ResultsA decline in LTPA across all time points was observed. Those who continued full-time education had a smaller LTPA decline than those who did not. Those who were not a member of a sporting club at T1 had greater LTPA decline if they worked full-time at T2.ConclusionsThere is a need for interventions to prevent declines in LTPA among school leavers, especially those who do not enter tertiary education. Encouraging sporting club membership during high school might be important.     

睡眠状况与儿童青少年心理行为问题关联研究

目的 分析儿童青少年睡眠不足、周末睡眠社会时差等睡眠问题与心理行为问题之间的相关性,为预防和改善儿童青少年心理行为问题提供参考依据。方法 2019年4-5月采用立意抽样按照街道—学校类型—学校3个阶段在深圳市宝安区辖区内6个街道选取14所学校,对30 188名1~12年级儿童青少年进行问卷调查。心理行为问题评定采用父母版与学生版困难与长处问卷进行,夜间睡眠时间、周末上床和起床推迟时间、午睡情况等采用自编的《中小学生成长轨迹及健康指数调查问卷》。调整性别、年龄、父母文化程度、学习成绩、学习负担和噪声等混杂因素,采用多因素logistic回归分析睡眠问题与心理行为问题之间的关联强度（OR值）及其95％CI。结果 小学低年级、小学高年级、初中和高中学生睡眠不足分别占90.4％、90.1％、98.2％和98.4％,有19.9％的学生不午睡,19.6％的学生周末推迟起床时间≥2 h,35.1％的学生晚上不固定时间睡觉,15.5％的学生每天不固定时间起床。与夜间睡眠时长8~9 h相比,小学低年级学生夜间睡眠时长≤7 h、7~8 h增加心理行为问题发生风险,睡眠时间>9 h与心理行为问题呈负向关联;小学高年级学生夜间睡眠时长≤7 h增加心理行为问题发生风险;初、高中生夜间睡眠≤6 h者心理行为问题增加,OR值（95％CI）分别为2.53（1.85~3.47）、2.41（1.11~5.25）,而夜间睡眠>9 h者心理行为问题也增加,OR值（95％CI）分别为2.37（1.40~4.01）、5.38（1.79~16.1）。与午睡时间0.5~1 h相比,不午睡及午睡时间<0.5 h都是中小学生出现心理行为问题的危险因素,午睡时间1~2 h还是高中生出现心理行为问题的危险因素。早上不固定时间起床、晚上不固定时间睡觉、周末推迟起床≥2 h是中小学生出现心理行为问题的危险因素。周末夜间推迟入睡≥2 h,小学低年级和高年级、初中、高中学生出现心理行为问题的OR值（95％CI）分别为2.07（1.45~2.97）、1.57（1.09~2.26）、2.66（2.06~3.44）、2.48（1.96~3.15）。结论 儿童青少年夜间睡眠不足、不午睡以及睡觉与起床时间不固定与心理行为问题呈正向关联,但夜间睡眠长也是中学生心理行为问题的危险因素。同时,睡眠的社会时差增加了儿童青少年心理行为问题发生风险,小学低年级学生周末入睡推迟0.5 h即与不良心理行为增加有关联。     

Anxiety and Depressive Disorders Are Associated with Smoking in Adolescents with Asthma

PurposeTo evaluate the association between mental health indicators (including meeting criteria for one or more DSM-IV [Diagnostic and Statistical Manual of Mental Disorders—fourth edition] anxiety or depressive disorders) and susceptibility to smoking or current smoking among youth with asthma and to evaluate the impact of smoking on asthma symptoms and self-management.MethodsWe conducted telephone interviews with a population-based sample of 11- to 17-year-old youth and their parents (n = 769). Interview content included questions on smoking behaviors, asthma symptoms and treatment, externalizing behavior, and a structured psychiatric interview to assess DSM-IV anxiety and depressive disorders.ResultsFive percent of youth were smokers and 10.6% indicated that they were “susceptible to smoking.” Smoking was more common among youth with mental health disorders. Anxiety/depressive disorders were present in 14.5% of nonsmokers, 19.8% of susceptible nonsmokers, and 37.8% of smokers. After controlling for important covariates, youth with more than one anxiety and depressive disorder were at over twofold increased risk for being a smoker. Similarly, for each one-point increase in externalizing disorder symptoms, youth had a 10% increase in likelihood of being a smoker and a 4% increase in risk for “susceptibility to smoking.” Youth who were smokers reported more asthma symptoms, reduced functioning due to asthma, less use of controller medicines, and more use of rescue medications.ConclusionsComorbid mental health disorders are associated with increased risk of smoking in youth with asthma. Smoking is associated with increased asthma symptom burden and decreased controller medication use. Interventions for youth with asthma should consider screening for and targeting these behavioral concerns.     

“I never really thought that a virtual ride would be that good!”: Experiences of participants with disabilities in online leisure-time physical activity during COVID-19

BackgroundThe COVID-19 pandemic has exacerbated the sedentary behavior and inactivity of people, including individuals with disability, who were already less active than their able-bodied counterparts. Therefore, it is particularly important to think about how to maintain and increase their leisure-time physical activity (LTPA). Online adaptive programs may represent a useful tool to do so. However, there is a little research focused on the health impacts of online LTPA.ObjectiveThis mixed-methods study aimed to explore the experiences of people with disabilities who participated in online adaptive LTPA along with the factors contributing to or limiting participation.MethodFirst, semi-structured interviews were conducted with 10 individuals participating in online adaptive LTPA offered by a community organization. Based on these interviews, a survey was developed and completed by 104 participants.ResultsThe results of the study suggested that people with disabilities can get a variety of physical and emotional health benefits when participating in adaptive online LTPA, including a strong social benefit. Staff attitude and knowledge as well as the staff's ability to adapt to participant needs played important roles in facilitating participation. Greater access to equipment was needed.ConclusionThis study offers insights into how online LTPA could support the health-promoting behavior of people with disabilities during the pandemic and beyond.     

The relationship between physical activity facility proximity and leisure-time physical activity in persons with spinal cord injury

BackgroundWithin the general able-bodied population, proximity of one's home to physical activity facilities is modestly associated with physical activity behavior. Currently, no research has examined whether facility proximity is related to physical activity among persons living with disabilities.ObjectiveTo examine (1) the level of agreement between perceived and actual proximity to accessible physical activity facilities and (2) the relationship between facility proximity (perceived and actual) and leisure-time physical activity (LTPA) among persons with spinal cord injury (SCI). It was hypothesized that (1) perceived and actual proximity measures would exhibit low agreement and (2) a small, positive relationship would emerge between proximity (perceived and actual) and LTPA.MethodsData from 50 Ontario residents living with SCI (70% male; 52% tetraplegia) were collected for proximity and LTPA. Perceived facility proximity was determined by a self-report “YES” versus “NO” presence measure, while actual facility proximity was assessed using Geographical Information Systems. An SCI-specific instrument, the PARA-SCI, was used to measure LTPA.ResultsLow agreement levels were found between perceived and actual proximity. LTPA status (active versus inactive) was shown to moderate the relationship, with higher agreement levels found for participants who reported engaging in mild or heavy LTPA versus their inactive counterparts, but only for the 30-minute wheeling boundary. Contrary to hypothesis, people living within a 30-minute wheel from an accessible facility were less likely to engage in heavy LTPA than were people who did not have an accessible facility located within a 30-minute wheel. No significant associations were found between LTPA and perceived proximity.ConclusionsLiving in close proximity to a facility that provides accessible programming and equipment does not necessarily translate into greater physical activity behavior.     

Effects of reallocating physical activity,sedentary behaviors,and sleep on mental health in adolescents

ObjectivePhysical activity, sedentary behavior, and sleep are associated with mental health in adolescents. Mental health may depend not only on the amount of time spent in a specific activity, but also on the activity it displaces. The aim of this study was to examine the impact of reallocating 15 min of time spent in one health behavior with 15 min in another on adolescent mental health.MethodsCross-sectional data from the students participating in the COMPASS Study (2018–2019) were analyzed (N = 46,413). Participants self-reported the amount of time they spent engaged in moderate-to-vigorous physical activity (MVPA), doing homework and using screens, and their sleep duration on average each day, depressive symptoms, anxiety, and flourishing. Data were analyzed using isotemporal substitution modeling.ResultsAmong adolescents getting less than the recommended amount of sleep, replacing any behavior with sleep was generally associated with better mental health outcomes. Conversely, among adolescents getting adequate sleep, the findings did not support replacing other behaviors with sleep with the exception of screen time. Replacing homework and MVPA with sleep was associated with less flourishing regardless of sleep duration.ConclusionsReplacing screen time with any behavior may be better for mental health outcomes. Results provide further support for the critical role of sleep in promoting healthy development during adolescence, though more sleep than is recommended may confer little benefit for mental health. The findings demonstrate that mental health benefits may be obtainable at intervals as short as 15 min.     

Risk factors for intimate partner violence initiation and persistence among high psychosocial risk Asian and Pacific Islander women in intact relationships

PurposeThe present study identifies risk factors for intimate partner violence (IPV) initiation and persistence over three years in a high psychosocial risk Asian American and Pacific Islander (AAPI) sample of women with children living in Hawaii.MethodsWe included 378 women in a 3-year relationship with the same partner who reported IPV experiences at baseline and 3 years later. Baseline risk factors included characteristics of each woman, her partner, and their relationship. Bivariate and multivariate regression models were conducted to assess the influence of risk factors on the likelihood of experiencing IPV initiation and persistence.FindingsOf women who experienced no physical violence at baseline, 43% reported IPV initiation. Of women who did experience physical violence at baseline, 57% reported IPV persistence. Being unemployed and reporting poor mental health at baseline are important risk factors for experiencing IPV initiation. Reporting frequent physical violence at baseline increases the likelihood of experiencing IPV persistence. Asian women were significantly less likely to report IPV persistence than other groups of women.ConclusionsOur study indicates that among a high psychosocial risk sample of AAPI women there are different risk factors for IPV initiation and persistence. Future prevention and screening efforts may need to focus on these risk factors.     

Experiencing Sexual Assault and/or Stalking-Related Behavior is Associated with Binge Drinking and Substance Use Consequences in Deployed U.S. Servicewomen

BackgroundBeing deployed is a risk factor for poor postdeployment mental health outcomes in U.S. servicewomen, including harmful drinking. However, to our knowledge, no studies have examined deployment-related sexual assault and exposure to stalking-related behavior in relation to binge drinking and substance use consequences in this population.MethodsA community sample of post-9/11 servicewomen from the Midwest, including both veterans and those actively serving (N = 991), completed computer-assisted telephone interviews after deployment. Logistic regression models examined associations between deployment-related sexual assault (attempted or completed) and stalking-related behavior (e.g., being left unwanted things, having property vandalized), and the likelihood of reporting binge drinking and substance use consequences after controlling for covariates.ResultsU.S. servicewomen experiencing deployment-related sexual assault and/or stalking-related behavior were more likely to report binge drinking in the past 4 weeks and at least one negative consequence of substance use in the past year. Also, 21.56% of the sample reported experiencing any deployment-related sexual assault and/or stalking-related behavior, 17.34% reported any stalking-related behavior and no sexual assault, 2.42% reported both sexual assault and stalking-related behavior, and 1.80% reported sexual assault and no stalking-related behavior. The most commonly endorsed behaviors were being followed or spied on (9.09%), receiving unsolicited correspondence (8.34%–8.74%), and having someone show up at places you were (6.90%).ConclusionsU.S. servicewomen experiencing sexual assault and/or stalking-related behavior during deployment may be at higher risk for binge drinking and experiencing negative consequence of substance use when compared with their peers not reporting these stressors.     

Nonsuicidal Self-Injury as a Gateway to Suicide in Young Adults

PurposeTo investigate the extent to which nonsuicidal self-injury (NSSI) contributes to later suicide thoughts and behaviors (STB) independent of shared risk factors.MethodsOne thousand four hundred and sixty-six students at five U.S. colleges participated in a longitudinal study of the relationship between NSSI and suicide. NSSI, suicide history, and common risk/protective factors were assessed annually for three years. Analyses tested the hypotheses that the practice of NSSI prior to STB and suicide behavior (excluding ideation) reduced inhibition to later STB independent of shared risk factors. Analyses also examined factors that predicted subsequent STB among individuals with NSSI history.ResultsHistory of NSSI did significantly predict concurrent or later STB (AOR 2.8, 95%, CI 1.9–4.1) independent of covariates common to both. Among those with prior or concurrent NSSI, risk of STB is predicted by > 20 lifetime NSSI incidents (AOR 3.8, 95% CI, 1.4–10.3) and history of mental health treatment (AOR 2.2, 95% CI, 1.9–4.6). Risk of moving from NSSI to STB is decreased by presence of meaning in life (AOR .6, 95% CI, .5–.7) and reporting parents as confidants (AOR, .3, 95% CI, .1–.9).ConclusionsNSSI prior to suicide behavior serves as a “gateway” behavior for suicide and may reduce inhibition through habituation to self-injury. Treatments focusing on enhancing perceived meaning in life and building positive relationships with others, particularly parents, may be particularly effective in reducing suicide risk among youth with a history of NSSI.