父母温暖抚育对持续欺凌受害经历儿童内化症状的缓冲效应

探讨持续欺凌受害经历与儿童内化症状的纵向关联及父母温暖抚育方式在其中的可能效应,为改善特殊儿童人群心理健康水平提供参考.方法 于2017年10月对马鞍山市3所小学自愿参加研究的1 198名四至五年级学生进行身高、体重和青春期发育评估,2018年10月开展随访.基线和随访均采用《MacArthur健康行为问卷儿童报告版》评估内化症状和同伴欺凌受害经历.将青少年分为持续性、无持续性和无同伴欺凌受害经历3组,采用多元线性回归分析不同温暖抚育组儿童同伴欺凌受害累积性对内化症状的影响.结果 Dunnett-t检验结果显示,持续和非持续欺凌受害经历组儿童基线及1年后随访内化症状均高于无欺凌组(P值均<0.01);持续、非持续和中等温暖抚育组儿童基线和1年后随访内化症状水平均低于无温暖抚育组(P值均<0.01).多元线性回归分析显示,在非持续温暖抚育组、中等温暖抚育组和无温暖抚育组儿童中,持续性与非持续性同伴欺凌与随访1年后内化症状评分呈正相关,持续性欺凌β值分别为0.66(95%CI=0.33~ 0.99),0.37(95%CI=0.15~0.59)和0.58(95%CI=0.31~0.84),非持续性欺凌β值分别为0.33(95%CI=0.18~0.47),0.28(95%CI=0.13~0.41)和0.29(95% CI=0.08 ~ 0.51).相比之下,持续温暖抚育组中,持续性与非持续性同伴欺凌受害经历与随访后1年内化症状间的关联无统计学意义.结论 同伴欺凌受害经历增加儿童内化症状发生风险,但父母持续温暖抚育方式对持续同伴欺凌受害经历儿童内化症状具有明显的缓冲效应.     

早期童年不良经历对小学生青春发育过程的持续影响

  目的  探讨童年不良经历对男女童青春发育过程的持续影响,为青春发育规律研究提供基础资料。  方法  采用分层整群抽样方法,于2018年9月抽取黄山市城区和乡镇寄宿制和公立小学各1所的三、四年级共1 156名学生,采用儿童期虐待问卷(CTQ)和青春发育问卷(PDS)进行自我评定的基线调查,根据儿童期虐待问卷不同维度得分将童年不良经历分为无暴露组、轻度暴露组和重度暴露组,2年后再次进行PDS问卷的自我评定,分析童年不良经历类型及严重程度对男女童青春发育的持续影响。  结果  基线调查中,女童发育提前53名(11.32%),男童发育提前51名(7.41%),差异有统计学意义(χ2=5.21,P < 0.05)。单因素分析显示,童年不良经历虐待类型及严重程度对青春发育的影响在基线和随访中都具有性别差异,童年不良经历不同暴露组基线和随访时发育提前检出率存在性别差异。多元线性回归分析显示,女童情感虐待、情感忽视和性虐待程度越重,PDS得分越高(B值分别为0.22,0.15,0.08);男童情感虐待越重PDS得分越高,躯体虐待越重PDS得分越低(B值分别为0.20,0.04)(P值均 < 0.05)。  结论  在男女童青春发育过程中要重视童年不良经历的影响及性别差异。应进行更为长期的时间效应观测。     

童年期不良经历与青春期发育的前瞻性研究

探讨童年期不良经历对青春期发育的影响,为针对性开展早期干预提供参考.方法 于2017年10月在安徽省马鞍山市3所小学,采用整群抽样的方法以班级为单位抽取1 057名三至四年级学生为调查对象,自我报告童年期不良经历(adverse childhood experiences,ACEs),包括躯体、情感与性虐待和躯体、情感忽视.客观评估男生睾丸容积和女生乳房Tanner发育分期.1年后随访再次评价ACEs与青春期发育.根据儿童基线与随访暴露情况,将ACEs分为无暴露组、短暂暴露组和持续暴露组.采用多元线性回归模型分析各组ACEs与随访1年后青春期发育的关联.结果 持续情感虐待与女生乳房Tanner分期和男生睾丸容积均呈正相关(β值分别为0.36,1.07,95%CI值分别为0.09~0.63,0.47~ 1.66,P值均<0.01);持续躯体虐待与男生睾丸容积呈负相关(β=-0.83,95%CI=-1.58~-0.08,P<0.05);性虐待与女生乳房Tanner分期呈负相关(持续β=-1.43,95%CI=-2.86~-0.02;短暂β=--0.45,95%CI=-0.73-0.19,P值均<0.05);持续情感忽视与女生乳房Tanner分期呈正相关(β=0.33,95% CI=0.06~0.61,P<0.05),与男生睾丸容积呈负相关(β=-0.19,95%CI=-1.38~-0.09,P<0.01).结论 青春期发育与童年期不良经历相关.不同ACEs青春期发育效应差异的具体机制和相同ACEs青春期发育效应的性别差异仍需进一步探讨.     

兰州市社区40～75岁人群非酒精性脂肪性肝病发病与消退影响因素研究

目的分析兰州市社区40～75岁人群非酒精性脂肪性肝病(NAFLD)发病和消退情况及其影响因素。方法 2011年对兰州市社区40～75岁人群进行NAFLD患病基线调查,于2014年进行随访调查,均完成问卷调查,测量身高及体质量,检测糖化血红蛋白(HbA1c)、血糖、血脂等,并行上腹部B超检查。结果基线无脂肪肝人群NAFLD 3年发病率为27.85%(291/1045);基线NAFLD患者3年消退率为26.98%(92/341)。NAFLD新发组比无脂肪肝组基线甘油三酯(TG)、空腹血糖、餐后血糖、HbA1c、ALT、γ-谷氨酰基转移酶、体质量指数(BMI)、收缩压升高,而高密度脂蛋白胆固醇(HDL-C)降低(均P0.05)。NAFLD消退组较NAFLD持续组基线ALT、AST、BMI降低,HDL-C升高(均P0.05)。随着基线BMI水平逐渐升高,NAFLD发病率持续升高(P0.01),而NAFLD消退率不断降低(P0.05);在各基线BMI水平,BMI差值0者中NAFLD新发率高于BMI差值≤0者(P0.01)。基线BMI、BMI差值、基线TG和基线HbA1c、HbA1c差值是NAFLD发病的独立危险因素,呈正相关;基线BMI、BMI差值和HbA1c差值是NAFLD消退的独立影响因素,呈负相关。结论兰州市社区40～75岁人群NAFLD发病率及消退率均较高,基线BMI及BMI随访较基线的变化与NAFLD发病和消退密切相关。     

清晨皮质醇与体脂水平在同伴欺凌与乳房早发育关联间的中介效应

  目的  探讨同伴欺凌与女童乳房早发育间的关联及潜在机制,为预防女童性早熟提供新策略。  方法  选取来自马鞍山市市区3所小学950名女童[平均年龄为(9.0±1.2)岁]进行研究,使用修订版《欺凌/受害者调查问卷》(BVQ)评估同伴欺凌,由1名儿童内分泌女医生评估受试女童乳房Tanner分期。使用Salivette?唾液采集器采集所有女童清晨起床唾液样本,体脂率使用生物电阻抗分析法测量。通过逐步Logistic回归分析同伴欺凌与乳房早发育之间的关联,用Logistic回归估算中介系数。  结果  受试女童中,23.2%(220/950)报告自今年年初以来在学校经历过同伴欺凌。同伴欺凌组的乳房早发育女童占比(24.1%,53名)高于未经历过同伴欺凌组(13.7%,100名)。Logistic回归分析表明,调整体脂率和清晨皮质醇水平后,同伴欺凌与乳房早发育相关(OR=1.74,95%CI=1.16~2.59)。中介分析表明,高皮质醇水平和高体脂率在同伴欺凌和乳房早发育之间都有间接影响,中介效应值分别为0.37,0.45。  结论  在女童中,同伴欺凌与乳房早发育显著相关,可能与HPA轴异常活动和高体脂水平有关。     

剖宫产分娩对男女童青春期发育影响的队列研究

探讨在控制青春期发育遗传背景后,剖宫产分娩方式对男女童青春期发育的前瞻性影响,为选择有利于青春期发育正常进程的分娩方式提供参考依据.方法 采用整群抽样方法于2016年在安徽省蚌埠市2所小学招募一至三年级学生997名,建立儿童青春期发育队列.采用父母问卷调查收集儿童分娩方式、出生体重、胎龄、早期喂养方式、家庭经济状况和父母文化程度等信息,每年评估儿童身高、体重和青春期发育(女童乳房发育Tanner分期和男童睾丸容积).基于青春期相关17个单核苷酸多态性(SNP)位点计算青春期发育多基因遗传风险评分(PRS).采用Kaplan-Meier生存分析探讨剖宫产分娩与男女童青春期发育的关联.结果 调查对象基线年龄为(8.01±0.84)岁,体质量指数(BMI)为(17.96±2.96) kg/m2.男女童剖宫产比例分别为43.30%和32.47%.基线和随访结束,剖宫产女童乳房发育启动检出率(39.89%,95.21%)高于自然分娩组女童(4.39%,68.48%)(x2值分别为118.65,51.42,P值均<0.01).控制PRS、年龄、BMI、早期喂养方式等因素发现,剖宫产与女童乳房发育启动年龄提前有关(风险比HR=1.98,95%CI=1.67~2.34,P<0.01).结论 剖宫产分娩可能增加女童乳房发育提前风险.需要更多研究证实自然分娩或为儿童青春期发育提前的预防途径之一.     

身高增长与超重肥胖联合作用对儿童血压的影响

  目的  分析不同身高增长幅度与超重肥胖联合作用对儿童新发血压偏高的影响,为探索防控儿童血压偏高的策略提供科学依据。  方法  基于厦门市青春期发育队列研究,采用整群抽样方法,选取2017年基线和2019年随访时身高、体重和血压数据完整的1 313名小学生作为研究对象。采用多因素Logistic回归模型分析不同身高增长幅度与超重肥胖的联合作用对儿童血压偏高的影响。  结果  1 313名小学生基线时(2017年)血压偏高检出率为25.2%;随访2年后,未发生血压偏高的人群中有19.7%的儿童新发了血压偏高,男生血压偏高新发率为23.4%,女生为16.6%。多因素Logistic回归模型分析显示,在调整年龄、性别、高血压家族史、睡眠时间、水果、蔬菜、含糖饮料及肉制品摄入情况后,总体及男生身高增长高水平超重肥胖组血压偏高新发的风险高于身高增长低水平非超重肥胖组(总体:RR=2.41,95%CI=1.44~4.04;男生:RR=2.69,95%CI=1.45~5.02);女生身高增长低水平联合超重肥胖组血压偏高检出率也显著增加(RR=4.47,95%CI=1.45~13.75)。  结论  身高增长幅度较高和超重肥胖是儿童血压偏高发病的影响因素,尤其是在男生中。在青春期身高突增前对儿童进行肥胖的预防和干预可能有益于降低儿童期高血压的发生。     

家庭因素与儿童青春发动时相关系的前瞻性队列研究

探索不同家庭因素与儿童青春发动时相的关系,为进一步开展儿童青春期发育研究提供参考.方法 采用目的性抽样方法,对重庆市九龙坡区1 237名儿童进行为期5年的前瞻性队列随访,采用Cox回归分析家庭因素与儿童青春发动时相的关系.结果 单因素分析结果显示,基线年龄和体质量指数(BMI)是男女童青春发动时相提前的影响因素(P值均<0.01);顺产相较于剖宫产的女童更早观察到乳房发育(HR=1.27,95%CI=1.04~1.54);自觉家庭经济条件好是女童月经初潮(HR=0.81,95%CI=0.66~0.99)、阴毛发育(HR=0.80,95%CI=0.65~0.97)和男童青春发动时相提前(睾丸发育HR=0.69,95%CI=0.58~0.83;首次遗精HR=0.62,95%CI=0.49~0.78;外生殖器发育HR=0.70,95%CI=0.56~0.87;阴毛发育HR=0.66,95%CI=0.54~0.80)的保护因素;留守男童更晚观察到睾丸发育(HR=0.74,95%CI=0.57~0.96)、首次遗精(HR=0.71,95%CI=0.50~0.99)、阴毛发育(HR=0.68,95%CI=0.51~0.91);自觉父母关系好的男童更早观察到睾丸发育(HR=1.26,95%CI=1.01~1.58)(P值均<0.05).多因素分析结果显示,流动女童阴毛发育的时间更晚(HR=0.79,95%CI=0.65~0.96),家庭因素与男童青春发动时相无关.结论 是否留守、自觉父母关系、自觉家庭经济条件是儿童青春发动时相的影响因素,但在调整年龄和BMI等因素后,这种联系主要体现在女童阴毛青春发育指标上,对于家庭因素与其他青春发育事件的关系仍需要进一步随访调查加以证实.     

风险决策同伴影响抵抗对青少年问题网络使用预测效应的随访研究

探讨同伴影响抵抗和风险决策对青少年问题网络使用的预测效应,为早期发现青少年网络成瘾高危人群及制定有针对性干预措施提供参考依据.方法 在广州和沈阳两市分别抽取5所和3所初中.每所初中选取初一年级全体学生为研究对象,对其随访调查12个月.采用同伴影响抵抗问卷(RPIS)和风险决策问卷(YDMQ)评价青少年同伴影响抵抗和风险决策水平及其对问题网络使用的影响.结果 基线调查2 103名青少年,问题网络使用发生率为14.3%.1 a后随访1 853名,失访率为11.9%.新发PIU为307名(16.6%),持续PIU为150名(8.1%),116名(6.3%)青少年在基线时报告PIU,1 a随访后报告无PIU(终止组).与对照组相比,PIU新发组和持续组风险决策得分高、同伴影响抵抗得分低(P值均<0.01).Logistic回归模型中控制基线PIU、性别、地区、父母文化程度和家庭经济后,风险决策高、同伴影响抵抗低均是随访PIU和新发PIU的危险性预测因素(B值分别为0.904,0.650,0.936,0.741,P值均<0.01),同伴影响抵抗高是PIU中止的保护性预测因素(B=-0.625,P<0.05).结论 同伴影响抵抗能力较差和风险决策较高的青少年可作为健康危害行为早期筛查和干预的重点人群.     

青春期前及青春期不同发育模式对儿童甲状腺形态的影响

探讨不同发育变化模式对不同性别、不同时期儿童甲状腺容积增大趋势的影响以及女性青春发育启动是否存在协同效应,为降低成年后甲状腺异常的风险提供理论依据.方法 采用分阶段整群抽样方法,分别在上海市闵行区、江苏省海门市、浙江省玉环市各选定1所小学,将所有8~10岁儿童共784名纳入“8~10岁学龄儿童队列”;同时,分别在上述3地各选定1所初中,将所有11~13岁初一年级女生共491名纳入“11~13岁青春期女童队列”.基线及1年后随访时,采用B超法测定儿童甲状腺容积,测量身高、体重、腰围(WC)等体格发育指标,收集清晨随机尿样并检测其中尿碘含量.计算体质量指数(BMI)、腰围及甲状腺容积(V)等指标的变化.根据BMI和WC的变化高低(差值d),将研究对象归为“BLWL(BMI低、WC低)”“BLWH(dBMI低、dWC高)”“BHWL(dBMI高、dWC低)”及“BHWH(dBMI高、dWC高)”4类发育变化模式.结果 经偏相关分析,基线或随访时甲状腺容积大小和BMI,WC均有较强关联(P值均<0.05);8~ 10岁男生组中甲状腺容积变化与BMI及WC变化均有关(P值均<0.05),8~10岁女生组中甲状腺容积变化仅与WC变化有关(P=0.03),11~13岁女生组中未发现关联(P>0.05).经多因素Logistic回归分析,在不同模型中校正基线年龄、地区、尿碘差值等变量后,8~10岁男生中BHWH类儿童甲状腺容积增大的可能性是BLWL的2.70(95%CI=1.29~5.66)倍;11~13岁女生中,BLWH,BHWL及BHWH类研究对象甲状腺容积增大的风险分别是BLWL的2.46(95%CI=1.31~4.61)、2.16(95%CI=1.15~4.03)及1.79(95%CI=1.07 ~ 2.99)倍;初潮年龄及发育变化模式对甲状腺容积变化趋势的影响无交互作用(P-0.49).结论 儿童青少年甲状腺容积随体格发育的进展而增大,不同发育变化模式对于甲状腺形态变化有影响.要避免儿童期的肥胖(尤为关注中心性肥胖),及时识别并有效干预甲状腺形态异常,以降低成年期甲状腺疾病发生的风险.     

重庆市某主城区中小学生青春发动时相与抑郁的关系

探讨重庆市某主城区中小学生青春发动时相与抑郁症状的关系,为提高青少年生活质量提供建议.方法 采用分层整群抽样方法,于2016年11-12月在重庆市某主城区共8所中小学校3 351名中小学生,采用青春发育量表(PDS)与同伴比较法评价青春发动时相,采用儿童抑郁量表(CDI)进行抑郁调查.结果 重庆市某主城区学生抑郁症状检出率为25.1%,不同年级、居住地、家庭经济情况、家庭关系、自我评价体型和学习成绩的学生抑郁症状检出率差异均有统计学意义(x2值分别为11.098,5.446,88.941,286.346,38.089,261.513,P值均<0.01).PDS评价与同伴比较法评价青春发动时相不同分组抑郁症状检出率差异均有统计学意义(x2值分别为20.027,47.019,P值均<0.01).控制年级、居住地、家庭经济等协变量,PDS评价青春发动时相,男生提前组抑郁症状检出率是适时组的1.406(95%CI=1.039~1.902)倍,女生延迟组更不容易检出抑郁(OR=0.632,95% CI=0.433~ 0.924);同伴比较法评价青春发动时相,男生提前组和延迟组抑郁症状检出率分别是适时组的1.733(95%CI=1.289~ 2.330)和1.464(95%CI=1.112~1.929)倍,女生提前组和延迟组抑郁症状检出率分别是适时组的1.518(95%CI=1.122~2.134)和1.403 (95% CI=1.033~1.905)倍.结论 重庆市某主城区中小学抑郁症状检出率较高,青春发动时相提前或延迟与抑郁症状检出有关.     

Measurement of Pubertal Status with a Chinese Self-report Pubertal Development Scale

This cross sectional study of 290 Chinese children aged 8–18 years, evaluated a Chinese version of the self-reported Pubertal Development Scale (PDS) against both raters’ and self-reported Tanner assessment of pubertal status. Children completed both the self-reported PDS and self-reported Tanner pubertal questionnaire prior to physical examination through visual depiction by a same gender rater. Puberty Category Scores (PCS) which were derived from the PDS, was used to categorize children into one of five pubertal development stages. Tanner derived composite stage (TDCS) which was derived from the Tanner pubertal questionnaires, was used to compare with PCS to obtain the inter-rater agreement. Moderately high agreements were found between raters’ TDCS and PCS in girls [weighted kappa (WK) 0.57 (0.44, 0.71); Kendallτ-b 0.60 (0.51, 0.69)] and in boys [WK 0.58 (0.47, 0.69), Kendallτ-b 0.50 (0.38, 0.62)]. The correlation between self-reported PDS and rater’s assessment was substantial in girls [Kendallτ-b 0.61 (0.54, 0.69)] and moderate in boys [Kendallτ-b 0.49 (0.38, 0.61)]. The Hong Kong Chinese children and adolescents were able to reliably estimate their own sexual maturation status (SMS) using a Chinese version PDS. This instrument may be useful in epidemiological studies when cost, privacy and other concerns preclude the use of other SMS assessment tools.     

Peer Group Status of Gender Dysphoric Children: A Sociometric Study

In this sociometric study, we aimed to investigate the social position of gender-referred children in a naturalistic environment. We used a peer nomination technique to examine their social position in the class and we specifically examined bullying and victimization of gender dysphoric children. A total of 28 children (14 boys and 14 girls), referred to a gender identity clinic, and their classmates (n = 495) were included (M age, 10.5 years). Results showed that the gender-referred children had a peer network of children of the opposite sex. Gender-referred boys had more nominations on peer acceptance from female classmates and less from male classmates as compared to other male classmates. Gender-referred girls were more accepted by male than by female classmates and these girls had significantly more male friends and less female friends. Male classmates rejected gender-referred boys more than other boys, whereas female classmates did not reject the gender-referred girls. For bullying and victimization, we did not find any significant differences between the gender-referred boys and their male classmates nor between the gender-referred girls and their female classmates. In sum, at elementary school age, the relationships of gender dysphoric children with opposite-sex children appeared to be better than with same-sex children. The social position of gender-referred boys was less favorable than that of gender-referred girls. However, the gender-referred children were not more often bullied than other children, despite their gender nonconforming behavior.     

青少年青春发动时相和超重肥胖与进食障碍之间的关系

目的 了解蚌埠市青少年超重肥胖、青春发动时相和进食障碍情况及其相互关系,为预防青少年肥胖的发生提供依据。方法 在蚌埠市方便抽取2所九年制学校,从五至八年级随机抽取683名学生,采用青春发育量表(PDS)和进食障碍量表(EDI-C)的分量表进行问卷调查,并测量身高、体重等指标,分析超重肥胖、青春发动时相与进食障碍的关系。结果 男生超重肥胖率高于女生,女生青春发动时相提前率、瘦身倾向得分、体型不满得分和进食障碍总分高于男生(χ²/t值分别为28.69,57.99,3.47,2.59,3.30,P值均<0.05);不同年级学生超重肥胖率、贪食得分和进食障碍总分差异均有统计学意义(χ²/F值分别为28.39,5.11,3.95,P值均<0.01)。超重肥胖与青春发动时相提前、进食障碍之间呈正相关,青春发动时相提前与进食障碍呈正相关(r值分别为0.18,0.17,0.14,P值均<0.01)。青春发动时相提前在超重肥胖与进食障碍之间起的部分中介效应对总效应的贡献率为14.25%。结论 青少年超重肥胖与进食障碍相关,青春发动时相提前在超...     

Moderators of the Effect of Peer Victimization During Fifth Grade on Subsequent Symptoms of (Anxious) Depression: The Roles of Engagement in Bullying and Baseline Symptomatology

Two hypothesized moderators of the effect of peer victimization during fifth grade on subsequent symptoms of (anxious) depression in sixth grade were examined: engagement in bullying and baseline fifth grade symptoms of (anxious) depression. Analyses were conducted on longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Interview data from 1,081 fifth grade participants assessed peer victimization and engagement in bullying classmates during the school year. Self-reported symptoms of depression were measured in fifth and sixth grade with the Child Depression Inventory Short form. Additionally, maternal reports of child anxious depression were measured with the Child Behavior Checklist. Engagement in bullying and concurrent depression symptoms moderated the effect of peer victimization in fifth grade on child-reported symptoms of depression in sixth grade. The adverse effect of peer victimization was stronger for children with high levels of concurrent depression symptoms or engagement in bullying. Concurrent symptomatology also moderated the effects of peer victimization on mother-reported child anxious depression 1 year later.     

Adolescent obesity,overt and relational peer victimization,and romantic relationships

OBJECTIVE: To examine associations between obesity and peer relations in adolescents, specifically testing the hypotheses that obese adolescents are more frequent victims of peer aggression and are less likely to develop romantic relationships. RESEARCH METHODS AND PROCEDURES: Measures of overt and relational victimization, as well as dating status and satisfaction, were collected for a group of 416 ninth- through twelfth-grade students (51.7% girls). Body mass index was computed for each teen based on self-reported height and weight data. RESULTS: Results revealed that obese boys reported more overt victimization and obese girls reported more relational victimization compared with their average-weight peers. Obese girls were also less likely to date than their peers. However, both obese boys and girls reported being more dissatisfied with their dating status compared with average-weight peers. DISCUSSION: The results suggest that obese adolescents are at greater risk for mistreatment by peers and may have fewer opportunities to develop intimate romantic relationships; this may contribute to the psychological and health difficulties frequently associated with obesity.     

Violence perpetration across peer and partner relationships: co-occurrence and longitudinal patterns among adolescents.

PURPOSE: To examine the co-occurrence and consistency over time of peer violence, sexual aggression, and dating violence among European American and Mexican-American adolescent boys and girls. METHODS: One-hundred-twelve girls and 135 boys who were either European American or Mexican-American were recruited from a large health maintenance organization. They were interviewed by telephone at baseline (at ages 16 to 20 years) and at one-year follow-up. Variable-centered and person-centered analyses examined the co-occurrence of violent behavior across domains, and whether adolescents who engaged in violent behavior at baseline also engaged in violent behavior during the following year. RESULTS: Results indicated that adolescent boys who engaged in violence in one domain were more likely to engage in violence in other domains during the same time period. Results for girls were less consistent. For boys but not girls, perpetration of either sexual aggression or peer violence was a significant predictor of the same behavior at follow-up. Person-centered analyses indicated that boys who perpetrated both peer violence and sexual aggression at baseline were most likely to perpetrate later violence. CONCLUSIONS: These results suggest that adolescent boys who engage in peer violence are also at risk for perpetrating sexual aggression or dating violence. Boys who perpetrate peer violence and sexual aggression are at high risk for later violence. Interventions with a dual focus on peer and partner violence may be valuable.