Depressive Symptoms Among Hong Kong Adolescents: Relation to Atypical Sexual Feelings and Behaviors, Gender Dissatisfaction, Pubertal Timing, and Family and Peer Relationships

A representative community sample of Hong Kong boys (n = 1,024) and girls (n = 1,403), age 14-18 years, provided information regarding same-sex attraction, gender dissatisfaction, pubertal timing, early experience with sexual intercourse, and depressive symptoms. They also rated the quality of their family and peer relationships and self-perceived attractiveness. Depressive symptoms were higher in youths reporting same-sex attraction, gender dissatisfaction, early pubertal maturation, and early sexual intercourse. Family relationships were less satisfactory for those who reported same-sex attraction, gender dissatisfaction, and early sexual intercourse, and peer relationships were also worse for those who reported gender dissatisfaction. In multivariate analyses, same-sex attraction, early sexual intercourse, and early pubertal maturation were unique and direct contributors to depressive symptoms; however, gender dissatisfaction's association with depressive symptoms was largely accounted for by shared correlations with negative family and peer relationships. The multivariate model explained 11% of the variance of depressive symptoms. These findings offer a preliminary documentation of the prevalence and correlates of atypical sexual self-assessments and behavior among adolescents in Hong Kong. Such information is important if theories of sexual identity and risk factors for depressive symptoms are to have cross-cultural utility.     

Sociodemographic differences in depressed mood: results from a nationally representative sample of high school adolescents

BACKGROUND: Research on adolescent mental health suggests that prevalence rates for depressed mood are not uniformly distributed across all populations. This study examined demographic difference in depressed mood among a nationally representative sample of high school adolescents. METHODS: The 2003 National Youth Risk Behavior Survey was utilized to examine the association between depressed mood and demographic variables. To examine demographic associations, chi-square and follow-up logistic regression models were created for the sample of high school adolescents (N = 15,214). RESULTS: Caucasians and African Americans were significantly less likely to report depressed mood when compared to Hispanics and Others. Women were also more likely than men to report depressed mood. No significant differences were observed among levels of urbanicity and age. CONCLUSIONS: An understanding of the difference in the prevalence and correlates of depressed mood among adolescents of various ethnic/racial and gender groups deserves increased attention. Given the fact that challenges with depressed mood in adolescents can be substantial and relatively unrecognized, there is an increased need to identify these adolescents early and intervene with culturally appropriate interventions.     

Alcohol use and abuse amongst adolescents in Hong Kong

This paper discusses alcohol use and abuse amongst adolescents in Hong Kong on the basis of a thorough literature review of official statistics and empirical research. The review highlights four major observations. Firstly, the alcohol culture of Hong Kong adolescents is basically positive and social-oriented. The existing legal constraint on the use of alcohol by those aged under 18 seems to exist in name only. Secondly, the past decade has seen a rising trend in alcohol use by adolescents, both in terms of those who have ever consumed it and those who do so currently. Thirdly, several demographic variables associated with alcohol use have been identified, including gender, age, and school mode. Fourthly, peer interactions (such as involvement in organized criminal groups) and family factors (such as lack of maternal support) are also related to alcohol use in young people. The paper closes by making some observations on the gaps in the research and sets forth some ideas for future policy development.     

Adolescent suicide attempters in Hong Kong and the United States

Using a nested case-control design drawing from a larger sample of 2272 adolescents, this study examined the characteristics of adolescents from Hong Kong (n = 99) and the United States (US) (n = 60), who indicated that they had made a suicide attempt at least once in the past, compared to their equally depressed sex- and age-matched counterparts who had not attempted suicide. The cross-cultural literature suggested three hypotheses which were tested: (a) depressive symptoms would differentiate between suicide attempters compared to non-attempters less in Hong Kong and more in the US; (b) discord in interpersonal relationships would be a more important distinguishing factor in suicide attempts in Hong Kong than in the US and (c) cognitive variables such as hopelessness would be less associated with suicide attempts in Hong Kong compared to the US. There were strong similarities in the two cultures with regard to characteristics that distinguished between attempters and matched controls. Hypotheses regarding cultural differences between attempters in Hong Kong and the US were not supported. Depression, current and lifetime suicide ideation, hopelessness, poor interpersonal relationships and exposure to suicide attempters and completers distinguished attempters from controls equally in the two cultures and in both genders. These findings do not support the proposition that depression is a less relevant variable in suicide attempts in Chinese versus western groups.     

中国内地城市和香港9～18岁学生心肺耐力及肌肉素质的比较研究

为了比较中国内地城市和香港青少年儿童的心肺耐力和肌肉素质，对两地的青少年儿童体质调查数据进行了比较研究。结果发现：内地各年龄组男女生的心肺耐力均优于香港同龄者；香港青少年儿童的肌肉素质除立定跳远外，其他项目的成绩均弱于内地青少年儿童。提示：随着生活水平的提高，应重视青少年儿童对体育活动的参与。     

Reconceptualizing adolescent sexual behavior: beyond did they or didn't they?

CONTEXT: Adolescent sexual behavior is typically studied as a dichotomy: Adolescents have had sex or they have not. Broadening this view would lead to a greater understanding of teenagers' sexual behavior. METHODS: Interview data from 907 high school students in Alabama, New York and Puerto Rico were used to examine the relationships between sexual experience and a variety of social, psychological and behavioral variables. Four groups of teenagers are compared: those who did not anticipate initiating sex in the next year (delayers), those who anticipated initiating sex in the next year (anticipators), those who had had one sexual partner (singles) and those who had had two or more partners (multiples). RESULTS: Compared with delayers, anticipators reported more alcohol use and marijuana use; poorer psychological health; riskier peer behaviors; and looser ties to family school and church. Similarly, multiples reported more alcohol and marijuana use, riskier peer behaviors and looser ties to family and school than singles. Risk behaviors, peer behaviors, family variables, and school and church involvement showed a linear trend across the four categories of sexual behavior. CONCLUSIONS: The traditional sex-no sex dichotomy obscures differences among sexually inexperienced teenagers and among adolescents who have had sex. Prevention efforts must be tailored to the specific needs of teenagers with differing sexual experiences and expectations, and must address the social and psychological context in which sexual experiences occur.     

Negative mood states and related factors in a sample of adolescent secondary-school students in Barcelona (Spain)

INTRODUCTION: Poor mental health is a common problem in adolescence. Little information is available, however, about the factors influencing negative mood states in otherwise healthy adolescents. We aimed to describe the mood states and related factors in a sample of adolescents in the city of Barcelona (Spain). METHODS: We administered a health survey to a sample of 2,727 students from public, subsidized, and private schools in Barcelona, aged approximately 14, 16, and 18 years old. To analyze the associations among moods and related factors, we used bivariate logistic regression, and fitted multivariate logistic regressions using the statistically significant variables from the bivariate analysis. To examine the possible group effects of the school on individual students, we employed multilevel analysis. RESULTS: The frequencies of negative mood states increased with age, with girls consistently reporting more frequent negative mood states than boys. The factors associated with negative mood states were problematic alcohol use, perceived mistreatment or abuse, antisocial behavior, intention to use or current use of illegal drugs (not including cannabis), lower perceived academic performance, and feeling isolated. CONCLUSIONS: Mood states are influenced by lifestyle and social factors, about which there is little local information. To plan and implement appropriate public health interventions, more complete information about the possible areas of influence is required. To complement the information obtained from studies such as the present study, longitudinal and qualitative studies would be desirable.     

Association Between Depressed Mood and Perceived Weight in Middle and High School Age Students: Texas 2004–2005

Research exploring the relationship between weight perception and depressed mood among adolescents is limited in the United States. The purpose of this study is to examine the association of perceived versus actual body weight and depressed mood in a representative sample of 8th and 11th grade public school students in Texas. Using data from the 2004–2005 School Physical Activity and Nutrition (SPAN) study, logistic regression analyses were conducted to assess the association of weight perception with depressed mood. Healthy weight students who perceived themselves to be a healthy weight were the reference group for all analyses. A high prevalence of misperception of body weight was observed. Overweight and obese 8th grade girls and boys who perceived themselves to be overweight had increased odds of depressed mood [Girls: OR 1.70 (95% CI: 1.07–2.69), Boys: OR 2.05 (95% CI: 1.16–3.62)]. Healthy weight 8th grade girls who perceived themselves to be overweight had 2.5 times greater odds of depressed mood (OR 2.63, 95% CI: 1.54–4.50). Healthy weight boys who perceived themselves to be underweight had more than twice the odds (OR 2.18, 95% CI: 1.23–3.89) of depressed mood. No weight category was significantly associated with depressed mood in boys or girls in 11th grade. The present study suggests that weight misperceptions are associated with depressed mood in young adolescents. Education about healthy body size is necessary to correct the common weight misperceptions observed. The high prevalence rates of depressed mood suggest a greater need for research into understanding factors that may contribute to depressed mood in adolescents.     

Public service announcement perceptions: a quantitative examination of anti-violence messages

CONTEXT: In recent years, anti-violence public service announcements (PSAs) have been broadcast on commercial and cable networks. OBJECTIVE: This study examined if and how teenagers' demographics and background variables were related to the perceptions of several anti-violence PSAs. DESIGN: This was a pencil-and-paper survey that had teenagers provide information about their demographics and knowledge of, attitudes about, and experience with violence. Then, teenagers screened and responded to several PSAs, indicating their levels of interest in, comprehension of, credibility given, and perceived effect for each message. SETTING AND PARTICIPANTS: In public school settings, data were collected from a sample of 1,480 urban, suburban, and rural midwestern teenagers. MAIN OUTCOME MEASURES: Interest in, comprehension of, credibility given, and perceived effect of PSAs. RESULTS: Using bivariate and multivariate analyses, we found significant but weak relationships between teenagers' characteristics and perceptions of anti-violence PSAs. CONCLUSION: This study suggests that audience segmentation be based not only on demographics but also on factors specifically related to the presented topic.     

Prevalence and correlates of smoking and sexual activity among Hong Kong adolescents.

PURPOSE: To report on the prevalence and correlates of smoking and sexual activity in a community sample of Hong Kong Chinese adolescents. METHODS: Participants (N = 4116) aged 13 to 18 years were surveyed regarding smoking and physical heterosexual activity, relationships with family members, family involvement, social support, school performance and emotional adjustment. Data were analyzed using logistic regression analyses. RESULTS: About 30% of participants reported ever smoking and 3.5% reported sexual intercourse. Current smoking was correlated with age, school performance and quality of relationship with mother. Sexual intercourse was correlated with age, gender, family involvement and social support. Smoking and sexual activity were significantly correlated with each other. Smoking and increasing levels of heterosexual physical contact were negatively correlated with emotional adjustment, even after controlling for common predictors to health-endangering behaviors and emotional adjustment. CONCLUSIONS: Smoking and sexual activity among adolescents are far less common in Hong Kong than in the West and their presence in a Hong Kong adolescent should alert the health practitioner to the possibility of significant psychosocial stress and maladjustment.     

Adolescent suicide in Hong Kong during 1980-2000

Analyses of adolescent suicide statistics in Hong Kong for the period 1980 to 2000 revealed several phenomena. First, while adolescent suicide rates (10-24 age group) in Hong Kong were relatively stable for the period under study, there was a gradual rising trend where adolescent suicide rates in the 1990s were higher than those in the 1980s. Second, suicide rates for adolescents aged 10-24 were lower than those of other adult age groups. Third, while adolescent suicide rates in Hong Kong were lower than those reported in some English-speaking countries and Mainland China, the figures were higher than those reported in Taiwan. Fourth, suicide rates among teenagers in early adolescence were lower than those among adolescents in late adolescence. Fifth, although male adolescent suicide rates were in general higher than female adolescent suicide rates (10-24 age group), gender differences in suicide rates appeared to be moderated by age. Sixth, there was a gradual rising trend in adolescent proportional mortality rates for suicide in the 1990s. Seventh, proportional mortality rates for suicide among teenagers in early adolescence were lower than those among adolescents in late adolescence. Finally, while jumping from a height was a common method of adolescent suicide, there was a rising trend of using other methods such as taking drugs, hanging and charcoal burning. The observed adolescent suicide phenomena are discussed with reference to the socio-cultural context of Hong Kong.     

Prospective Analysis of Peer and Parent Influences on Smoking Initiation Among Early Adolescents

The nature and relative importance of psychosocial influences on smoking initiation among early adolescents are topics of substantial research interest. Students (N = 1081) from four middle schools were surveyed at the beginning and end of the sixth grade. Baseline predictors were regressed on smoking initiation at end of sixth grade. In bivariate, logistic regression analyses association with problem behaving peers, perceived prevalence, and depression were positively associated and adjustment to school, perceived social competence, parent expectations, parental monitoring, and parental involvement were negatively associated with smoking initiation. In multivariate logistic regression analyses controlling for sex, race, and school, peer affiliation and perceived prevalence were positively associated, whereas social competence and parental monitoring were negatively associated with smoking initiation. A significant interaction between parental involvement and peer affiliation indicated that among teens with problem behaving friends only those with parents who were relatively uninvolved were are at increased risk for smoking initiation. This finding held for boys, girls, Whites, Blacks, and teens living in single parent families. These findings provide evidence that antecedent parenting behaviors may protect early adolescents against smoking even in the context of negative peer affiliation.     

LINKING PSYCHOLOGICAL ATTRIBUTES TO ADDICTION AND IMPROPER USE OF THE MOBILE PHONE AMONG ADOLESCENTS IN HONG KONG

The purpose of this study is to (1) identify addiction symptoms that are uniquely associated with mobile phone use among adolescents in Hong Kong; (2) examine how demographics and psychological attributes (such as leisure boredom, sensation seeking, and self‐esteem) of individuals are related to the addiction symptoms; and (3) explore how these attributes, mobile phone addiction symptoms, and social capital can predict improper use of the mobile phone. Data were gathered from a probability sample of 402 teenagers and young adults aged 14–20 in Hong Kong. Exploratory factor analysis identified four addiction symptoms: “losing control and receiving complaints,” “anxiety and craving,” “withdrawal/escape,” and “productivity loss.” Results show that the higher one scored on leisure boredom and sensation seeking, the higher the likelihood one was addicted. Conversely, subjects who scored high on self‐esteem demonstrated less of such tendency. As hypothesized, subjects who scored low on self‐esteem but high on sensation seeking reported the most improper use of the mobile phone (especially in snapping pictures stealthily when nobody notices).     

Changing hepatitis A epidemiology among Hong Kong Chinese adolescents: what are the implications?

OBJECTIVE: To study the sero-epidemiology of hepatitis A virus (HAV) among adolescents in Hong Kong and analyse the changing patterns of the infection rates. DESIGN: Cross sectional study. Setting: Secondary school students. SUBJECTS: One thousand, five hundred and eighty students were randomly selected from 12 schools in four regions of Hong Kong. MAIN OUTCOME MEASURES: Anti-HAV status. RESULTS: The overall prevalence of anti-HAV is 7%. The sero-prevalence for age group 11-20 y has fallen compared with 44.8% in 1978, 17.1% in 1987 and 11.2% in 1989. Those adolescents born in mainland China, who are frequent travellers and had a longer period of residence in mainland China were shown to have a higher prevalence of anti-HAV. CONCLUSION: The changing epidemiology of HAV indicates that Hong Kong will have a large proportion of susceptible young adults. Because of its geographic situation and import of most its food supplies from less developed countries, for epidemiological purposes the inhabitants can be compared to western travellers staying in a five star hotel in a less developed country. The risk of an outbreak of HAV is to be expected. Vaccination has the potential to serve as an effective prevention for adolescents living in countries whose circumstances are similar to Hong Kong.     

A Prospective Study of Childhood and Adolescent Antecedents of Homelessness among a Community Population of African Americans

Much is known about contemporaneous correlates of homelessness from studies of homeless individuals. However, few studies have prospectively examined early antecedents and prevalence of homelessness in community populations. We use data from a 35-year study of a community population of African Americans to examine relationships between homelessness and prior structural, family, school, and behavioral influences. Nearly 22% of males and 16% of females reported homelessness between ages 15 and 42, providing a rare estimate within an African American urban community population. In bivariate analyses, lower school bonds, depressed mood, violent behavior, and running away in adolescence are predictive for both males and females. Teen parenting and angry mood are unique influences for females, while for males, poor first grade classroom conduct and adolescent substance use are unique risks. In multivariate analyses, poor classroom conduct and weaker school bonds predict homelessness among males, while teen parenting does so for females. Running away before age 15 is strongly predictive of later homelessness for both males and females. These results reveal the relative influence of multiple, interrelated early risks on homelessness and confirm our hypothesis that factors linked to other poor outcomes also relate to homelessness, underscoring another benefit to early prevention efforts.     

Peer Reviewed: Risk and Protective Factors for Tobacco Use Among 8th- and 10th-Grade African American Students in Virginia

Introduction

Few studies have simultaneously examined the influence of multiple domains of risk and protective factors for smoking among African Americans. This study identified individual-peer, family, school, and community risk and protective factors that predict early cigarette use among African American adolescents.

Methods

Data from 1,056 African American 8th and 10th graders who completed the 2005 Community Youth Survey in Virginia were analyzed by using logistic regression.

Results

The prevalence of smoking among the weighted sample population was 11.2%. In univariate analyses, the strongest predictors of smoking were low academic achievement, peer drug use, and early substance use (individual domain). In multivariate analyses, these factors and being in the 10th grade were significant predictors. The single protective factor in multivariate analyses was in the school domain (rewards for prosocial behavior in the school setting). When family and community variables were entered into a model in which individual-peer and school factors were controlled for, these variables were not significantly associated with smoking, and they failed to improve model fit.

Conclusion

These findings suggest that tobacco prevention programs that aim to increase school connectedness while decreasing youth risk behaviors might be useful in preventing cigarette use among African American adolescents. Given the relative importance of peer drug use in predicting smoking among African American youth, more work is needed that explores the accuracy of youths'' perceptions of their friends'' cigarette use and how family factors may moderate this risk.     

Psychosocial correlates of depressive symptoms among Japanese high school students.

PURPOSE: To determine the psychosocial factors associated with the presence and persistence of depressive symptoms among high school students in Okinawa, Japan. METHODS: The study sample was 3202 students from 12 public senior high schools. Students completed self-administered questionnaires from October through December 1997. We measured depressive symptomatology using the Center for Epidemiologic Studies Depression Scale. We asked students to report whether they had depressive symptoms at any time in the immediate past week, and whether those symptoms persisted for 5-7 days. The psychosocial variables examined were life stressors, perceived social support, health practices, self-esteem, and Locus of Control. The relationship between the psychosocial factors and depressive symptoms was examined using hierarchical multiple regression analyses. RESULTS: After controlling for the effects of demographic and other psychosocial variables, presence of depressive symptoms was positively associated with life stressors in the domains of friends, family, and teachers. Similarly, persistence of depressive symptoms was also positively associated with life stressors in the domains of friends and teachers. Presence and persistence of depressive symptoms were negatively associated with positive health practices, more social support, high self-esteem, and internal Locus of Control. CONCLUSIONS: The psychosocial variables associated with presence and persistence of depressive symptoms were remarkably consistent. Life stressors might be risk factors; on the contrary, positive health practices, perceived social support, high self-esteem, and internal Locus of Control might be protective factors of depressive symptoms among Japanese adolescents.     

Associations between juvenile delinquency and weight-related variables: analyses from a national sample of high school students

OBJECTIVE: This study examined direct and conditional associations between juvenile delinquency and weight-related variables in a national sample of high school students. METHOD: Data from the 2003 Youth Risk Behavior Survey (YRBS) of 12,713 high school students aged 14 to 17 were examined. Logistic regression analyses were used to analyze the data. RESULTS: Bivariate and multivariate analyses indicated that juvenile delinquents were more likely than nondelinquents to use fasting, vomiting, and drugs to lose weight or to keep from gaining weight. Multivariate analyses also showed that delinquents were more likely than nondelinquents to perceive themselves as overweight, but the two groups did not differ in regard to actual overweight status. Tests of interactions in multivariate analyses indicated that the associations between delinquent status and specific, weight-related variables were stronger among younger than among older adolescents, as well as among female than among male adolescents. CONCLUSIONS: Future research should examine risk and protective factors for unhealthy weight control behaviors and perceptions among delinquents.     

Protective and Vulnerability Factors Predicting New-Onset Depressive Episode in a Representative of U.S. Adolescents

PURPOSE: Depressive episodes cause considerable morbidity and mortality in adolescents. We sought to identify factors predicting new onset depressive episode in a representative sample of U.S. adolescents. METHODS: We conducted logistic regression analyses to identify baseline individual, family, school/peer and community factors predicting new-onset depressive episode at a 1-year follow-up in a longitudinal cohort study of 4791 U.S. adolescents. Potential protective and vulnerability factors included individual (sociodemographics, general health and maturity, coping behavior, self-concept, and affect regulation), family (connectedness and conflict), school/peers (acceptance and performance), and community (engagement, delinquency, and adverse events). RESULTS: African American and Hispanic ethnicity, female gender, and low-income status predicted higher risk of onset of a depressive episode. Active coping and positive self-concept, predicted lower risk, whereas poor affect regulation and greater depressed mood predicted higher risk. Family "connectedness," parental warmth, peer acceptance, better school performance, and religious activities were protective, whereas parental conflict, delinquent activities, and greater numbers of adverse events increased risk of depressive episodes. CONCLUSIONS: Female gender, nonwhite ethnicity, low-income status, poor health, and parental conflict, increase risk of a depressive episode. Physicians should consider recommending behaviors that enhance perceived fitness, favorable self-concept, family connectedness, peer acceptance, and community engagement to youth as means a of mitigating this risk for developing a depressive episode.