Forecasting Length of Stay in Child Residential Treatment

A sample of 126 consecutively admitted residential treatment children (mean age = 9.86, SD=1.84; 70.6% male; 42.1% African American; 50% Caucasian) were studied over a five-year period to identify predictors of length-of-stay. Cox regression was the primary statistical method used to analyze psychiatric and behavioral rating data for children assessed by teachers and treatment staff using the Devereux Scales of Mental Disorders (DSMD). Parental alcohol abuse, and children’s age, medication status, race, initial DSMD total and critical pathology scores, were predictive of length-of-stay. Residential length-of-stay was strongly linked to initial levels of psychiatric symptomatology. Models that can help forecast length of stay are vital tools in helping to improve both clinical and utilization management strategies.This research supported by a grant from the Ohio Department of Mental Health     

Cross-informant correlations on social competence and behavioral problems in Sami and Norwegian preadolescents

In a community-based birth cohort from Arctic Norway, correlations between parents and teachers on child competence and behavioral problems were determined for Sami and Norwegian 11–12 year-olds, using as instruments the child behavior checklist (CBCL), teacher report form (TRF), and the impact supplement of the extended strength and difficulties questionnaire (SDQ). Parent–teacher correlations on child behavioral problems were generally high in the Norwegian group, but low in the Sami group. Cross-cultural differences in cross-informant correlations were highest regarding externalizing and attention problems. Parent–teacher correlations on total impact of child difficulties also differed between the ethnic groups. Once again, a lower correlation was found for the Sami children. The discrepancy between parents’ and teachers’ perception of problems that needed attention was highest for the Sami, and lowest for the Norwegians. The Sami parents reported fewer perceived difficulties and less impact of problems than did the Norwegian parents. In contrast, no ethnic differences emerged for teachers’ ratings. The paper discusses how cultural norms might influence the reports of child problems. It demonstrates the importance of combining parent and teacher reports of child behavior problems in minority and indigenous children, who often live under different cultural norms in home and school contexts.     

A Test of the Integration of the Hopelessness and Self-Esteem Theories of Depression in Schoolchildren

This prospective study tested the diathesis-stress and symptom components of the integration of the hopelessness and self-esteem theories of depression in a sample of third- and seventh-grade children. The procedure involved an initial assessment of depressive symptoms, self-esteem, and depressogenic inferential styles about causes, consequences, and the self. The procedure also involved a follow-up assessment, 6 weeks later, in which depressive symptoms and the occurrence of negative events were assessed. In line with the integrative theory, depressogenic inferential styles interacted with negative events to predict increases in hopelessness but not nonhopelessness depression symptoms in boys with low but not high self-esteem. At the same time, contrary to the integrative theory, depressogenic inferential styles interacted with negative events to predict increases in hopelessness but not nonhopelessness depression symptoms in girls with high but not low self-esteem.     

Doping prevalence among preadolescent athletes: a 4-year follow-up

Objective

To describe the prevalence of doping and its progression in a cohort of preadolescent athletes during a 4‐year follow‐up.

Design and settings

Prospective cohort study. Self‐questionnaire survey.

Participants

All of the pupils entering the first year of secondary school (sixth grade) in the Vosges Département (east France) and followed for 4 years.

Main outcome measurements

Drug use (prohibited substances, tobacco, alcohol, cannabis), intention to use, reported health hazards, perceived drug effectiveness, self‐esteem, trait anxiety.

Results

At the beginning of the study, 1.2% (95% CI 0.8 to 1.6) stated that they had taken doping agents at least once in the preceding 6 months, and this had risen to 3.0% (95% CI 2.3–3.7) 4 years later (p<0.001). Of those who had used doping agents, 4% reported that they had experienced a health problem related to doping, and 44% reported that they had won at least one sports event as a result of using the drug. Use of doping agents is linked to the number of hours of practice per week, intention to use, use of other drugs, self‐esteem and trait anxiety.

Conclusions

The results show that doping does exist in preadolescent athletes who train every day. This fact should to be taken into account in preventive actions.     

Preadolescents' Perceptions of AIDS Before and After Earvin Magic Johnson's Announcement

Compared sixth graders' AIDS concerns before and after MagicJohnson announced that he tested HIV-positive. Examined perceptionsof self other vulnerability (optimistic bias) using questionnaires(Study A) and interviews (Study B). Also examined AIDS worriesmentioned in open-ended interviews (Study C). Studies A andB revealed a substantial degree of optimistic bias. Study Cshowed that AIDS is a prime concern of school-age students,mentioned under free or context-cued conditions by about 50%.There was little detectable effect of the publicity; the solebefore-after difference in three studies was one increase inself- and other-vulnerability to AIDS-an increase attributable,with marginal significance, only to girls. Discussed implicationsfor health promotion and differences between assessment approaches.     

Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents: The Toyama birth cohort study

Objectives To analyze the path to dieting behavior in Japanese preadolescents. Methods A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12–13) born in Toyama prefecture. Results While increasing with body mass index (BMI), the percentage of those who had tried dieting was higher in those who perceived themselves fat than in those who perceived themselves thin or average. Of those who wanted to be thinner, 16.1% of boys and 26.8% of girls had tried dieting. Path analysis in nonobese subjects (2,116 boys and 2,334 girls) showed that (1) body image was primarily based on BMI, (2) body image led to body dissatisfaction, and (3) body dissatisfaction led to dieting behavior. Pubertal changes had a significant effect on body image (path coefficient <0)for boys and body satisfaction (path coefficient >0) for girls, in addition to that on BMI. Maternal BMI had a significant effect on BMI but not on body image, body satisfaction, or dieting behavior. Conclusions Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents. Pubertal changes may reinforce dieting behavior, but the mechanism may differ by sex.     

Co-existence of severe insulin resistance and hyperinsulinaemia in pre-adolescent obese children

Summary To determine the time course of changes in insulin action and secretion that occur early during the development of obesity, we studied children before the onset of puberty. The reason for choosing the prepubertal stage of development is that it is metabolically characterized by both a high sensitivity to insulin and low glucose stimulated insulin responses. Fifteen obese preadolescents (8 male/7 female, age 10 ± 0.4 years, body mass index (BMI) 31 ± 1.2 kg/m² Tanner Stage I) with a duration of obesity of less than 5 years and 10 non-obese preadolescents (6 male/4 female, age 10 ± 0.4 years, BMI 18 ± 0.9 kg/m²) matched for gender were studied. In a cross-sectional analysis, we compared responses in obese preadolescents, with those in obese adolescents and obese adults with a longer duration of obesity. The euglycaemic hyperinsulinaemic clamp with 1-¹³C-glucose (Hot Ginf) and indirect calorimetry were used to quantitate insulin action and the hyperglycaemic clamp used to assess beta-cell function. Insulin-stimulated glucose uptake measured at two physiological levels of hyperinsulinaemia ( ∼ 180 and 480 pmol) was reduced by 20 and 45 % in all three groups of obese compared to non-obese subjects (p < 0.01). Defects in oxidative and non-oxidative glucose metabolism were observed in all three groups of obese subjects at the higher insulin infusion rate. The ability of insulin to inhibit lipid oxidation was impaired in all three obese groups at both levels of hyperinsulinaemia. Increases in basal and glucose-stimulated insulin levels during the hyperglycaemic clamp mirrored the reductions in glucose uptake during the insulin clamp in all obese groups. These results indicate that insulin resistance and hyperinsulinaemia co-exist in preadolescent children with moderate to severe obesity. [Diabetologia (1996) 39: 1489–1497] Received: 23 March 1996 and in revised form: 16 July 1996     

Finnish mother's and father's attachment representations during child's first year predict psychosocial adjustment in preadolescence

The aim of the longitudinal study was to examine, for the first time in a Nordic country, whether autonomous parenting in infancy affects psychosocial adjustment in preadolescence. Attachment representations of mothers and fathers were investigated with the Adult Attachment Interview in a community sample of two-parent Finnish families. Most mothers and fathers were classified as autonomous, a finding which is in line with normative Western distributions. Moreover, the ratio of dismissing versus preoccupied adults was similar to Western norms. Demographic characteristics such as family structure and years of education differentiated autonomous from non-autonomous mothers. In preadolescence, the children who had experienced at least one autonomous parent were more empathic and had fewer problems in social relationships and thought processes compared to children of two non-autonomous parents. The findings suggest that autonomous parenting has long-term parent gender specific influences on children's psychosocial adjustment.