Extensive television viewing and the development of attention and learning difficulties during adolescence

OBJECTIVE: To investigate the association of television viewing with educational and intellectual outcomes during adolescence and early adulthood. DESIGN: Prospective epidemiological study. SETTING: Families participating in the Children in the Community Study, a prospective longitudinal investigation, were interviewed at mean offspring ages 14, 16, and 22 years. PARTICIPANTS: A community-based sample of 678 families from upstate New York. MAIN EXPOSURES: Television viewing, attention difficulties, learning difficulties, and educational achievement during adolescence and early adulthood. MAIN OUTCOME MEASURES: The Disorganizing Poverty Interview and age-appropriate versions of the Diagnostic Interview Schedule for Children. RESULTS: Frequent television viewing during adolescence was associated with elevated risk for subsequent attention and learning difficulties after family characteristics and prior cognitive difficulties were controlled. Youths who watched 1 or more hours of television per day at mean age 14 years were at elevated risk for poor homework completion, negative attitudes toward school, poor grades, and long-term academic failure. Youths who watched 3 or more hours of television per day were the most likely to experience these outcomes. In addition, youths who watched 3 or more hours of television per day were at elevated risk for subsequent attention problems and were the least likely to receive postsecondary education. There was little evidence of bidirectionality in the association of television viewing with attention and learning difficulties. CONCLUSION: Frequent television viewing during adolescence may be associated with risk for development of attention problems, learning difficulties, and adverse long-term educational outcomes.     

Comorbid personality disorder and treatment use in a community sample of youths: a 20-year follow-up

OBJECTIVE: The impact of comorbid personality disorder (PD) on subsequent treatment and psychotropic drug use was examined in a representative sample of over 700 individuals. METHOD: Axis I disorders and PD were assessed by self- and mother-report at mean ages 13 and 22 years, and by self-report at mean age 33. Mothers reported treatment use by participants before mean age 33; participants reported treatment and psychotropic drug use at mean age 33. RESULTS: Individuals with multiple axis I disorders without PD, axis I disorder-PD comorbidity, and single disorders were compared simultaneously to individuals not diagnosed. Overall, odds of subsequent and past year treatment or psychotropic drug use or both were highest when PD co-occurred with a mood, an anxiety, a disruptive, or a substance use disorder. CONCLUSION: Co-occurring personality pathology may contribute to elevated mental health service use, including use of psychotropic drugs, among young adults in the community.     

Normative nasalance scores for Estonian children

Normative nasalance scores are essential for the treatment and assessment purposes for clinicians. Till date, no studies have been done on nasalance in Estonia. This research was conducted to develop Estonia-specific optimized speech stimuli for Nasometer II and establish the normative nasalance scores. Ninety-two randomly selected healthy and 14 cleft palate Estonian monolingual children, aged four to seven years, were included as participants. Estonian language-specific test material was developed. The Estonian test material consisted of 24 speech stimuli. Based on the phoneme content, the stimuli were divided into three groups: (1) sentences that included oral and nasal phonemes and targeted the same phoneme distribution as in spontaneous speech, (2) sentences that included only oral phonemes and (3) sentences that were loaded with nasal phonemes. Nasometer II software was used to calculate the nasalance scores for each child and each sentence. Results indicated that there were significant differences in nasalance scores for oronasal and oral stimuli scores, and no significant differences were found in nasal stimuli scores between the study and control group. The threshold for oronasal stimuli was 42.1–18.9, oral stimuli was 27.9–3.9 and nasal stimuli was 69.4–46.2. In conclusion, Estonia-specific optimized speech stimuli were developed and normative nasalance scores were established. These normative scores can be used for the diagnosis and follow-up treatment of patients with resonance disorders, especially for patients with cleft palate.     

Factors associated with AIDS risk behaviors among high school students in an AIDS epicenter.

BACKGROUND. A greater understanding of the determinants of risky behaviors is an essential precursor to the development of successful AIDS prevention programs for adolescents. METHODS. A survey measuring AIDS-related behaviors, beliefs, and knowledge was administered to a sample of 531 10th-grade students residing in an AIDS epicenter. RESULTS. Of the 56.8% of students reporting past-year involvement in sexual intercourse, 67.3% reported unprotected intercourse with low-risk partners, 1.3% reported unprotected intercourse with high-risk partners, and 6.6% reported a past-year history of a sexually transmitted disease. Students whose friends had intercourse and never or inconsistently used condoms, who personally sanctioned intercourse involvement, who believed that the majority of their peers had intercourse, and who perceived low preventive action self-efficacy, were 5.1, 3.0, 2.1, 3.7, and 2.8 times more likely, respectively, to score in the riskier categories of an AIDS behavior index. CONCLUSIONS. These findings suggest that addressing socioenvironmental influences on risky and preventive behaviors may prove to be the most effective AIDS prevention strategy among adolescents.     

Dissociative disorders among adults in the community, impaired functioning, and axis I and II comorbidity

OBJECTIVE: To investigate the association of dissociative disorder (DD) with impaired functioning and co-occurring Axis I and personality disorders among adults in the community. METHOD: Psychiatric interviews were administered to a sample of 658 adult participants in the Children in the Community Study, a community-based longitudinal study. RESULTS: Depersonalization disorder (prevalence: 0.8%), dissociative amnesia (prevalence: 1.8%), dissociative identity disorder (prevalence: 1.5%), and dissociative disorder not otherwise specified (prevalence: 4.4%), evident within the past year, were each associated with impaired functioning, as assessed by the clinician-administered Global Assessment of Functioning Scale. These associations remained significant after controlling for age, sex, and co-occurring disorders. Individuals with anxiety, mood, and personality disorders were significantly more likely than individuals without these disorders were to have DD, after the covariates were controlled. Individuals with Cluster A (DD prevalence: 58%), B (DD prevalence: 68%), and C (DD prevalence: 37%) personality disorders were substantially more likely than those without personality disorders were to have DD. CONCLUSIONS: DD is associated with clinically significant impairment among adults in the community. DD may be particularly prevalent among individuals with personality disorders.     

Association of maladaptive parental behavior with psychiatric disorder among parents and their offspring

BACKGROUND: A longitudinal study was conducted to investigate the role of maladaptive parental behavior in the association between parent and offspring psychiatric disorder. METHODS: Psychosocial and psychiatric interviews were administered to a representative community sample of 593 biological parents and their offspring from 2 counties in the state of New York in 1975, 1983, 1985 to 1986, and 1991 to 1993. In 1975, the offspring were a mean age of 6 years. Maladaptive parental behavior was assessed in 1975, 1983, and 1985 to 1986. Parent and offspring psychiatric symptoms were assessed in 1983, 1985 to 1986, and 1991 to 1993. RESULTS: Maladaptive parental behavior substantially mediated a significant association between parental and offspring psychiatric symptoms. Parents with psychiatric disorders had higher levels of maladaptive behavior in the household than did parents without psychiatric disorders. Maladaptive parental behavior, in turn, was associated with increased offspring risk for psychiatric disorders during adolescence and early adulthood. Most of the youths that experienced high levels of maladaptive parental behavior during childhood had psychiatric disorders during adolescence or early adulthood, whether or not their parents had psychiatric disorders. In contrast, the offspring of parents with psychiatric disorders were not at increased risk for psychiatric disorders unless there was a history of maladaptive parental behavior. CONCLUSIONS: Maladaptive parental behavior is associated with increased risk for the development of psychiatric disorders among the offspring of parents with and without psychiatric disorders. Maladaptive parental behavior appears to be an important mediator of the association between parental and offspring psychiatric symptoms.     

Childhood depression and adult personality disorder: alternative pathways of continuity

BACKGROUND: This study extends previous findings of the risks posed by childhood major depressive disorder and other psychopathological features for later personality disorder (PD) in a random sample of 551 youths. METHODS: Self-reports and mother reports were used to evaluate DSM-III-R (Axes I and II) psychiatric disorders at mean ages of 12.7, 15.2, and 21.1 years. Logistic regression was used to examine the independent effects of major depressive disorder in childhood or adolescence on 10 PDs in young adulthood. RESULTS: Odds of dependent, antisocial, passive-aggressive, and histrionic PDs increased by more than 13, 10, 7, and 3 times, respectively, given prior major depressive disorder. Those effects were independent of age, sex, disadvantaged socioeconomic status, a history of child maltreatment, nonintact family status, parental conflict, preexisting PD in adolescence, and other childhood or adolescent Axis I psychopathological features, including disruptive and anxiety disorders. In addition, odds of schizoid and narcissistic PD increased by almost 6 times and odds of antisocial PD increased by almost 5 times given a prior disruptive disorder, and odds of paranoid PD increased by 4 times given a prior anxiety disorder. CONCLUSION: Personality disorders may represent alternative pathways of continuity for major depressive disorder and other Axis I disorders across the child-adult transition.     

Dual work and family roles and depressive symptoms in two birth cohorts of women

Abstract Background Rising depression rates in more recent cohorts of women have been attributed in part to their increased participation in dual family and work roles. Method This study examined associations among depressive symptoms, age, and work and marital status in two cohorts of women, all mothers, born between 1931 and 1944 (preboomers) or between 1945 and 1958 (baby boomers), assessed at comparable ages. Results Being married (vs. divorced) was related to less depression within and across cohorts, whereas working was related to more depression in preboomers only. Moreover, divorced working preboomers were significantly more depressed than women in most other role status groups within and across cohorts. Depression scores declined across age among working women in the combined cohorts; however, that association held only for baby boomers when cohorts were analyzed separately. Among divorced working women, that decline was significantly greater in baby boomers than preboomers. Conclusions These cohort differences support a call for new social policies that address the mental health needs of women and their children.     

Association between television viewing and sleep problems during adolescence and early adulthood

BACKGROUND: Although research has suggested that extensive television viewing may be associated with sleep problems, the direction of this association has not yet been determined. OBJECTIVE: To investigate directional hypotheses regarding the association between television viewing and sleep problems during adolescence and early adulthood. DESIGN: The Children in the Community Study, a prospective longitudinal investigation.Participants and SETTING: A community-based sample of 759 mothers from upstate New York and their offspring were interviewed during the early adolescence (mean age, 14 years), middle adolescence (mean age, 16 years), and early adulthood of the offspring (mean age, 22 years). MAIN OUTCOME MEASURES: Television viewing and sleep problems during adolescence and early adulthood measured using the Disorganizing Poverty Interview and the age-appropriate versions of the Diagnostic Interview Schedule for Children. RESULTS: Adolescents who watched 3 or more hours of television per day during adolescence were at a significantly elevated risk for frequent sleep problems by early adulthood. This elevation in risk remained significant after offspring age, sex, previous sleep problems, offspring psychiatric disorders, offspring neglect, parental educational level, parental annual income, and parental psychiatric symptoms were controlled statistically. Adolescents who reduced their television viewing from 1 hour or longer to less than 1 hour per day experienced a significant reduction in risk for subsequent sleep problems. Sleep problems during adolescence were not independently associated with subsequent television viewing when prior television viewing was controlled. CONCLUSION: Extensive television viewing during adolescence may contribute to the development of sleep problems by early adulthood.