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This study examines how key demographic variables and specific child sexual assault (CSA) incident characteristics were related to whether adolescents reported that they had told anyone about an alleged sexual assault. The study also investigates whether there were differences in the correlates of CSA disclosure as a function of gender and race/ethnicity. A national household probability sample of 4,023 adolescents was interviewed by telephone about childhood experiences, including CSA history. Significant gender and racial/ethnic differences were obtained in rates of CSA disclosure: Sexually abused boys and African American youth were less likely to report telling anyone they had been sexually abused. Separate regression models examining correlates of CSA disclosure yielded differences as a function of gender and race/ethnicity.  相似文献   

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BACKGROUND: Oppositional defiant disorder (ODD) is a leading cause of referral for youth mental health services; yet, many uncertainties exist about ODD given it is rarely examined as a distinct psychiatric disorder. We examined the lifetime prevalence, onset, persistence, and correlates of ODD. METHODS: Lifetime prevalence of ODD and 18 other DSM-IV disorders was assessed in a nationally representative sample of adult respondents (n = 3,199) in the National Comorbidity Survey Replication. Retrospective age-of-onset reports were used to test temporal priorities with comorbid disorders. RESULTS: Lifetime prevalence of ODD is estimated to be 10.2% (males = 11.2%; females = 9.2%). Of those with lifetime ODD, 92.4% meet criteria for at least one other lifetime DSM-IV disorder, including: mood (45.8%), anxiety (62.3%), impulse-control (68.2%), and substance use (47.2%) disorders. ODD is temporally primary in the vast majority of cases for most comorbid disorders. Both active and remitted ODD significantly predict subsequent onset of secondary disorders even after controlling for comorbid conduct disorder (CD). Early onset (before age 8) and comorbidity predict slow speed of recovery of ODD. CONCLUSIONS: ODD is a common child- and adolescent-onset disorder associated with substantial risk of secondary mood, anxiety, impulse-control, and substance use disorders. These results support the study of ODD as a distinct disorder. Prospective and experimental studies are needed to further delineate the temporal and causal relations between ODD and related disorders.  相似文献   

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Background: Each homicide leaves behind several friends and family members, or homicide survivors. However, limited information is available on the impact of homicide on adolescent survivors. The purpose of the current study was to identify the prevalence of homicide survivorship and to determine mental health outcomes within a sample of US adolescent survivors. Methods: A nationally representative sample of American adolescents (N = 3,614) between the ages of 12 and 17 completed structured telephone interviews assessing homicide survivorship and mental health consequences including posttraumatic stress disorder (PTSD), depression, drug use, and alcohol abuse. Results: Reported prevalence within this sample of losing a loved one to criminal homicide was 9%, losing a loved one to vehicular homicide was 7%, and losing a loved one to both types of homicide was 2%. Logistic regression analyses found that adolescents who reported being homicide survivors were significantly more likely to report depression, drug use, and alcohol abuse after controlling for demographic factors and other violence exposure. Conclusions: If the results from this study are generalizable to the US population, roughly 1 in 5 American adolescents may be impacted by homicide. Further, adolescents exposed to such a loss are at increased risk for mental health sequelae. Results suggest that greater attention needs to be paid to address the needs of these often underserved victims.  相似文献   

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OBJECTIVES: To assess cardiorespiratory fitness levels in youth aged 12 to 19 years and to examine associations between fitness and age, sex, race/ethnicity, and self-reported physical activity in this age group. DESIGN: Cross-sectional study. SETTING: The National Health and Nutrition Examination Survey's mobile examination center, throughout the United States from 1999-2002. PARTICIPANTS: A representative sample of 4732 youth aged 12 to 19 years was examined; 3287 completed the treadmill test and were included in the analysis. The National Center for Health Statistics conducted the survey.Main Exposures Age, sex, race/ethnicity, weight status, self-reported physical activity, and television viewing.Main Outcome Measure Estimated maximal oxygen uptake (VO2max) determined by a submaximal treadmill exercise test. RESULTS: Estimated VO2max (mL.kg(-1) . min(-1)) was higher in males (mean +/- SE, 46.4 +/- 0.4) than in females (mean +/- SE, 38.7 +/- 0.3) but did not differ across race/ethnicity groups. Among males, older participants had higher VO2max values, while in females, younger participants had higher values. For both males and females, those in the normal weight group had higher fitness levels than those in the at risk for overweight and overweight groups. Approximately one third of both males and females failed to meet recommended standards for cardiorespiratory fitness. CONCLUSIONS: In US youth, cardiorespiratory fitness is lower in males and females who are overweight than in those of normal weight, but fitness is not related to race/ethnicity. Youth who have low levels of physical activity and high levels of sedentary behavior are also more likely to have lower cardiorespiratory fitness.  相似文献   

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Aim: To examine the rate of Internet victimization in a nationally representative sample of adolescents aged 14–17 and to analyze predictors and protective factors for victimization. Methods: Data were collected for 3707 pupils in Danish schools in 2008, using a multimedia computer‐based self‐interviewing programme. Family characteristics, alcohol and drug abuse, exposure to physical/sexual abuse, emotional problems, social conduct and own risky Internet behaviour were included in the analyses. Results:  Any online victimization was reported by 27% of the adolescents, most frequently a rumour spread online (9% of boys and 15% of girls) and sexual solicitation (5% of boys and 16% of girls). Parental surveillance of adolescents’ Internet use significantly reduced their risk of online victimization. Roughly half of the adolescents had met Internet acquaintances face to face, with few instances resulting in forced sex (five boys and nine girls). Female gender, parental physical violence, previous exposure to sexual abuse, alcohol abuse in the family, self‐reported emotional problems and antisocial behaviour and high Internet use were all weakly and risky online behaviour strongly associated with online victimization. Conclusions: Danish adolescents are generally aware of the principles of ‘safe chatting’; however, online harassment is relatively frequent, but offline victimization based on Internet acquaintances is rare.  相似文献   

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A survey of developmental-behavioral pediatricians was conducted to obtain data and insights on their current practice. As part of the Future of Pediatric Education (FOPE) II Survey of Sections Project, questionnaires were sent to individuals who were most likely to represent those pediatricians engaged in the subspecialty of developmental-behavioral pediatrics. Four groups of physicians were compared within the survey: developmental-behavioral fellowship group (n = 272), developmental disabilities fellowship group (n = 139), general academic pediatrics or other fellowship group (n = 57), and a nonfellowship group (n = 224). A majority of respondents indicated a need for an increased number of subspecialists in developmental-behavioral pediatrics in their community during the next 3 to 5 years. There were significant differences in the survey results of a variety of practice issues between those who had and had not received formal fellowship training. The survey data illustrate a developmental-behavioral pediatrician workforce that is becoming increasingly fellowship trained, receiving more referrals, and encountering constraints to seeing more patients in an era of declining reimbursement for services. To overcome these obstacles, stakeholders in child health, including health care payers, will need to be educated about the unique skills and clinical expertise of physicians in developmental-behavioral pediatrics and neurodevelopmental disabilities.  相似文献   

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Background  

The prevalence of childhood obesity has increased dramatically in the last two decades and numerous efforts to understand, intervene on, and prevent this significant threat to children's health are underway for many segments of the pediatric population. Understanding the prevalence of obesity in populations of children with developmental disorders is an important undertaking, as the factors that give rise to obesity may not be the same as for typically developing children, and because prevention and treatment efforts may need to be tailored to meet their needs and the needs of their families. The goal of the current study was to estimate the prevalence of obesity in children and adolescents with autism.  相似文献   

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Great progress has been made in treating childhood cancers over the past 40 years. Along with second malignancies, a major complication of anti-cancer therapies is adverse cardiovascular effects, especially cardiomyopathy and coronary artery disease. The pathophysiology and characteristics of cardiomyopathy associated with radiation therapy and anthracycline therapy are distinctive. We describe each type of cardiomyopathy, along with its risk factors. These distinctive cardiomyopathies require different screening tests. Appropriate screening of the entire cardiovascular system should be performed because radiation and chemotherapy affect the entire system. Prevention recommendations focus on cardiomyopathy and coronary artery disease.  相似文献   

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KA Daly  RE Selvius  B Lindgren 《Pediatrics》1997,100(6):931-936
OBJECTIVES: To investigate maternal knowledge and attitudes about otitis media (OM) risk, to estimate the prevalence of risk factors in the first year of life, and to identify barriers to the reduction of risk factors (eg, formula feeding, day care attendance, and exposure to passive smoke). METHODS: Questionnaires mailed to a systematic sample of 504 Minnesota women >/=18 years old identified through 1994 birth certificates. RESULTS: Eighty percent returned a completed survey. According to maternal report, 29% of infants (age 8 to 13 months) had recurrent OM (>/=3 episodes) and 2% had tympanostomy tubes. Forty-six percent attended day care, 29% had >/=1 smoking parent, and 49% breastfed for 相似文献   

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