Browsing by Subject "Adolescent"

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A cross-sectional pilot study in adolescents to evaluate determinants of health regarding e-cigarette, or vaping, product use
(2021-11-19) Gilmore, Bretton Alex; Frei, Christopher R.; Reveles, Kelly R.; Koeller, Jim M.; Flores, Bertha E. "Penny"; Spoor, Jodi H.
Purpose. It is estimated that five million United States adolescents vape.¹⁻³ Throughout the literature, assumptions have been made regarding adolescents’ vaping knowledge, attitudes, and beliefs. Gaps exist establishing evidence that adolescents believe vaping is the same things as cigarette smoking. This study evaluated adolescent vaping to 1.) tabulate the number of respondents self-reporting to vape regularly, 2.) gauge the age of initiation, 3.) identify trends in attitudes and beliefs regarding the health of common activities of daily living 4.) consider perceptions of vaping equivalence to smoking cigarettes or using traditional tobacco products, and 5.) assess reporting of vaping associated negative health outcomes. Methods. A cross-sectional study design was created, and novel electronic survey developed to gather anonymous data via Google Forms. The survey included a Variable Activity Perception Evaluation (VAPE) Scale and direct questions related to vaping. The instrument was circulated amongst students aged 12 to 20 years enrolled at 10 greater San Antonio area schools (six middle and four high schools) across three districts over a 90-day period. Responses came in from 11 schools across six districts. Descriptive and comparative statistics, including nonparametric methodology (e.g., Chi-square, Kruskal-Wallis, and Wilcoxon Rank Sum) were used. Results. Eligible respondents’ (N=267) mean age was 16 (SD=1.6) years. Females (61%) predominantly made up the sample. Seven percent (N=264) reported they vaped regularly and 20% (N=245) had tried vaping with the majority of those experimenting by age 16. There were statistically significant differences on 14 of 40 VAPE Scale prompts when comparing vapers to non-vapers (35%). Respondents reported that they did not think vaping was the same as smoking (63% “No”) or traditional tobacco use (38% “No”, 21% “Maybe”). Ninety percent (N=17) of those who vaped reported experiencing negative health outcomes, as indicated by greater than or equal to one sign or symptom. Conclusions. Texas adolescents reported similar vaping trends when compared to national samples. However, Texas adolescents did not view vaping as cigarette smoking or traditional tobacco use. Perceptions of the health of routine activities of daily living might be predictive of future vape initiation and use. Prospective studies should be designed to evaluate negative health outcomes and implications associated with vaping.
An analysis of the literature on self-compassion, self-esteem, and body image as predictors of adolescent reckless behavior
(2009-12) Holder, Christen Marie; Schallert, Diane L.; Tharinger, Deborah
Adolescent reckless behavior is a major concern for society because it leads to the three most common causes of mortality for this age group. Body image and self-esteem have been proposed as constructs that have an effect on adolescents’ participation in reckless behavior. Self-esteem, however, has been garnering criticism in recent years for promoting narcissism and downward social comparison with others. Self-compassion is an alternative to self-esteem that focuses on accepting oneself and having feelings of common humanity. This report proposes a study that would measure reckless behavior in adolescents, and look at the effect self-compassion, self-esteem, and body image has on it. In addition, self-compassion will be examined to see if it moderates the effect body image has on self-esteem.
Concordance and discordance in parents’ and adolescents’ perceptions of parenting : a meta-analytic study
(2018-07-31) Hou, Yang; Kim, Su Yeong; Benner, Aprile D.; Hazen, Nancy; Varner, Fatima; Beretvas, Natasha
Researchers and clinicians often rely on multiple informants (e.g., parents and children) to report on child mental health problems and parenting behaviors; yet, different informants often provide inconsistent information (De Los Reyes et al., 2015; Korelitz & Garber, 2016). Such informant discordance creates challenges for clinicians in delivering services to patients and for researchers in drawing conclusions from study findings. Extant studies are inconsistent regarding the extent and sources of parent-adolescent discordance in perceptions of parenting and whether discordance relates to more positive or more negative adolescent outcomes. The current meta-analytic study aimed to shed light on these issues by examining potential moderators (e.g., adolescent, parent, and family characteristics) on (1) the relation between parent- and adolescent-reported parenting and (2) the relation between parent-adolescent parenting discordance and adolescent outcomes. By systematically synthesizing 313 studies involving both parent- and adolescent-reported parenting, the current study demonstrated that the correlation between parent- and adolescent-reported parenting was generally small, although it was significantly different from zero (r = .276, 95% CI [.262, .290]); on average, parents perceived parenting more positively than adolescents, with a mean-level difference that was small but significantly different from zero (g = .242, 95% CI [0.188, 0.296]). Meta-regression analyses demonstrated that there were higher levels of parent-adolescent discordance for younger (versus older) and male (versus female) adolescents, for non-clinical parents (versus parents with internalizing symptoms), in more individualistic societies such as the United States, and in ethnic minority (versus White), low (versus high) socioeconomic status, and non-intact (versus intact) families among U.S. samples. By meta-analyzing 24 studies that examined how parent-adolescent parenting discordance relates to adolescent outcomes, the current study found that parents’ more positive perceptions of parenting relative to adolescents negatively related to adolescent outcomes (r = -.083, 95% CI [-.129, -0.036]). This negative association was stronger among ethnic minority families than White families in the United States. Together, the current meta-analyses provide comprehensive information regarding (1) who are most likely to experience parent-adolescent discordance in reports of parenting and (2) whether and for whom parent-adolescent parenting discordance relates to more negative outcomes. These findings have important implications for research and clinical practice, including what future studies need to be done and what populations should be particularly targeted for intervention.
Considering social cognitive processes in trajectories of adolescent self-esteem development : lay theories of self-diagnostic salience
(2019-12-09) O'Brien, Joseph Michael; Yeager, David S.; Brummelman, Eddie; Echols, Catharine H.; Woolley, Jacqueline D.
Adolescents experience varying trajectories of self-esteem development. While self-esteem grows rapidly and stabilizes for most adolescents, around 1 in 5 show continued self-esteem lability and decline—a pattern that predicts enduring problems with mental health and life-course success. Unfortunately, theories to explain or predict these diverging self-esteem trajectories are lacking. This dissertation proposes and tests a novel theoretical framework of self-esteem development. Differing trajectories may be in part explained by variation in adolescents’ lay theories of self-diagnostic salience, defined as a belief that experiencing more salient thoughts and feelings—those that are more intense, frequent, spontaneous, or persistent—serve as evidence that experiences contain self-diagnostic information about “who they really are.” Normative biological changes from puberty provide highly salient experiences in abundance, and negative experiences tend overall to be more salient than positive ones. Thus, adolescents who more strongly endorse a self-diagnostic theory of salience may tend to attribute greater personal importance to negative experiences, leading to increased self-esteem contingency on those experiences. Over time, this pattern of response may tend to undermine healthy self-esteem development compared to those adolescents holding more non-diagnostic theories. To test this proposed account, Chapter 2 describes the construction and initial validation of a novel measure of the lay theory of self-diagnostic salience, also demonstrating wide variation in endorsement among adolescents. Chapter 3 demonstrates that, when faced with particularly intense and therefore salient negative daily events, adolescents with strongly self-diagnostic theories also appraise those events as having increased levels of personal importance and likely stability. Chapter 4 uses a moderated random-intercept cross-lag design to show that theory endorsement predicts both lasting harm to state self-esteem and greater emotional inertia on days following more intense experiences of sadness. Finally, Chapter 5 incorporates 9-month follow-up data to show that theory endorsement at the start of 9th grade predicts more negative self-esteem change at 9th grade’s end, as well as increases in depression symptoms indirectly through self-esteem decline. Chapter 6 reviews the findings in support of this novel account of self-esteem development, describes potential future work, and considers broader implications.
Coping and resilience among Syrian refugee adolescents : a mixed methods approach
(2020-07-17) Arango, Sarah Christina; Sanchez, Delida; Ainslie, Ricardo C; Awad, Germine H; Barrett, Kerrin
Much of the literature on refugee youths’ mental health has focused on psychological distress, leaving a gap in our understanding of what contributes to psychological well-being among this population. To address this gap, this mixed methods study employed a resilience framework to explore the links between exposure to potentially traumatic events (PTEs), daily stressors, coping flexibility, well-being, and psychological distress among Syrian refugee adolescents living in Jordan. The qualitative section of this study included eleven individual interviews and one focus group with three adolescents. The study used constructivist-interpretivist grounded theory and the critical incident technique, to identify stressors, coping strategies, coping flexibility, and resilience processes among Syrian refugee youth. Stressors reported by youth, included separation from family and friends, access to basic needs, and discrimination and systemic oppression. Coping strategies used by youth, included spending time with family and friends, getting emotional support, distraction, and spending time alone. Coping flexibility emerged as a developmental process that aided resilience and helped youth cope with discrimination. Finally, key resilience processes that emerged, included education, independence, and hopes for the future. The quantitative section of this study included one hundred and thirteen youth. An exploratory factor analysis with the Kidcope scale revealed two factors (positive and negative coping strategies). Structural equation modeling (SEM) was used to analyze two models; one model included psychological distress as an outcome and one model included well-being as an outcome. Mediation models were run to examine relationships between PTEs, daily stressors, coping flexibility, and mental health outcomes. Results demonstrated that daily stressors fully mediated the relationship between PTEs and distress and were associated with negative coping techniques. Daily stressors did not mediate the relationship between PTEs and well-being. Coping flexibility did not mediate PTEs and mental health outcomes, however, negative coping strategies were associated with distress and positive coping strategies were associated with well-being. The findings from the current study highlight unique resilience processes and coping mechanisms used by Syrian refugee youth and demonstrate the need to develop interventions that are culturally- and contextually-grounded. Theoretical and practical implications of these findings are discussed.
The development and implementation of a self-compassion intervention for adolescents : a pilot study
(2010-08) McGehee, James Pittman; Rude, Stephanie Sandra; Neff, Kristin; Ainslie, Ricardo; Rochlen, Aaron; Brownson, Chris
The adolescent stage of development is particularly challenging. Because of the biological, cognitive, and social transitions of adolescence, this stage of development is seen as an important time for interventions promoting well-being (Steinberg, 1999). Recent research suggests that self-compassionate teens experience greater psychological health than those without self-compassion (Neff & McGehee, in press). To date, however, there have been no self-compassion interventions targeted at the adolescent population. This dissertation is a pilot study investigating the development, implementation and assessment of a self-compassion intervention for an adolescent population. The intervention took the form of a weekend “Self-Compassion Retreat” for high-school students, ages 14-17. Over a two day period, 17 subjects participated in the intervention focused on helping the students to understand and begin to incorporate the three dimensions of self-compassion – self kindness, common humanity and mindfulness. The intervention attempted to deepen student understanding of self-compassion by focusing on experiential and contemplative learning strategies (Kabat-Zinn, 1997; Hart, 2004). The 17 students were introduced to the concept of self-compassion through presentations, small group and contemplative exercises as well as individual interviews. The self-compassion intervention was assessed by testing participants along five different dimensions: self-compassion, depression, anxiety, social connectedness, and happiness at three different time points. The intervention was also assessed through individual interviews following the intervention. Though the quantitative results from the pilot study yielded no significant data for the current sample, the qualitative data provided promising information for future interventions aimed at increasing self-compassion.
Development and validation of the cognitive vulnerability schemas questionnaire for anxious youth
(2014-12) Winton, Samantha Marie; Stark, Kevin Douglas
According to cognitive theories of anxiety, anxiogenic schemata are a set of beliefs, rules, and assumptions that influence how those with anxiety make inferences and interpret threat. It is hypothesized that each anxiety disorder has a unique anxiogenic schema. This report describes the development of the Cognitive Vulnerability Schemas Questionnaire for Anxious Youth, an instrument used to measure anxiogenic schemata in youth aged 7-17 years old. Factor analyses of the scale demonstrated two empirically distinct and relatively stable dimensions of anxiogenic schema. The two identified factors of anxiogenic schema were: (1) Generalized Anxiety and Social Phobia Schema, and (2) Separation Anxiety Schema. The measure demonstrated good psychometric properties on a range of indices of reliability and validity. Results indicated that scores on the questionnaire subscales predicted anxiety symptomology. Regression analyses showed that both factors were predictors of anxiety symptomology, however did not predict anxiety diagnosis. Significant differences in the Cognitive Vulnerability Schemas Questionnaire for Anxious Youth subscales were demonstrated between patients with clinically significant Generalized Anxiety Symptoms, Social Phobia Symptoms, and Separation Anxiety Symptoms. The implications of these findings for theories of cognitive vulnerability and schema development in youth are discussed.
Dietary fiber linked to decreased inflammation in overweight minority youth
(2015-05) Miller, Samantha Jean; Davis, Jaimie Nicole; Bray, Molly S
Objective: To examine the relationship between diet and inflammation, and adiposity in minority youth. Design and Methods: A cross-sectional analysis of 142 overweight (≥85th BMI percentile) Hispanic and African American adolescents (14-18 y) with the following measures: anthropometrics, adiposity via magnetic resonance imagine (MRI), dietary intake via 24-hour dietary recalls, and inflammation markers from fasting blood draws utilizing a multiplex panel. Partial correlations were estimated and ANCOVA models fit to examine the relationship between dietary variables, inflammation markers, and adiposity measures with the following a priori covariates: Tanner stage, ethnicity, sex, total energy intake, total body fat, and total lean mass. Results: Inference based on ANCOVA models showed that the highest tertile of fiber intake (mean intake of 21.3 ± 6.1 g/d) versus the lowest tertile of fiber intake (mean intake of 7.4 ± 1.8 g/d) was associated with 36% lower plasminogen activator inhibitor-1 (PAI-1) (P = 0.02) and 43% lower resistin (P = 0.02), independent of covariates. Similar results were seen for insoluble fiber. No other dietary variables included in this study were associated with inflammation markers. Conclusions: These results suggest that increases in dietary fiber could play an important role in lowering inflammation and therefore metabolic disease risk in high-risk minority youth.
Early life peer victimization : associated neural structure and reactivity to social-emotional stimuli, drinking motives, and alcohol use in young adulthood
(2023-06-16) Tretyak, Valeria; Smits, Jasper A. J.; Lippard, Elizabeth; Fromme, Kim; Church-Lang, Jessica
Peer victimization—otherwise known as bullying victimization—is a known risk factor for increased alcohol use, however the neural correlates of this association remain unknown. Early life peer victimization may impact neural affect reactivity, which may contribute to alcohol use as a maladaptive coping mechanism later in life. Peer victimization has been associated with differential structure and/or function of the orbitofrontal, anterior cingulate and insula cortices, and amygdala. These neural networks have also been implicated in affect reactivity and regulation, heavy drinking, and addiction. Whether differential structure and/or function of these neural regions is associated with greater alcohol use in young adults with history of peer victimization has not been directly investigated. This dissertation comprised a secondary data analysis in IMAGEN—a multinational European research project. This study aimed to investigate whether greater early life peer victimization (ages:14-22) is associated with differential structure and function (Angry-Neutral-Faces Task) in orbitofrontal, anterior cingulate and insula cortices, and amygdala in 674 young adults (53% female, mean age:22 [SD:1]). Additionally, this study investigated whether increased alcohol use associated with peer victimization is mediated by greater endorsement of coping anxiety and depression drinking motives, and whether this mediation is, in turn, moderated by differences in gray matter volume and/or functional activation in a priori regions of interest. Higher peer victimization scores were associated with greater gray matter volume in left anterior insula, and lower functional activation in left orbitofrontal cortex when viewing angry compared to neutral faces. Coping anxiety and depression drinking motives fully mediated relations between most severe peer victimization scores and greater frequency and quantity of recent alcohol use. Additionally, most severe peer victimization scores were associated with greater coping depression drinking motives in participants with lower gray matter volume in left anterior insula, and in young adult females with lower functional activation in left orbitofrontal cortex. Follow-up studies are needed to replicate—and expand upon—these findings. Identifying biomarkers of greater alcohol use in young adults with history of peer victimization may provide the foundation for future clinical trials and development of prevention initiatives aimed at decreasing risk of alcohol misuse.
Effectiveness of culturally adapted substance use interventions for Latino adolescents : a systematic review and meta-analysis
(2015-08) Robles, Eden Hernandez; DiNitto, Diana M.; Padilla, Yolanda; Salas-Wright, Chris; Cynthia Franklin; Maynard, Brandy
Cultural factors have been shown to have a moderating effect on substance use, thus an increasing number of substance use interventions with Latino adolescents seek to incorporate culture in an attempt to positively impact outcomes. Research on the effectiveness of culturally adapted substance use interventions, however, has produced a body of ambiguous evidence. The purpose of this systematic review is to examine the characteristics and effects of culturally adapted substance use interventions with Latino adolescents on substance use outcomes. The research question guiding this study is: What are the effects of culturally adapted interventions on substance use outcomes with Latino adolescents? A systematic search of thirteen electronic databases, five research registers, five research affiliated websites, reference lists, and a comprehensive gray literature search were undertaken to locate randomized (RCT) or quasi-experimental (QED) studies conducted between 1990 and December 2014 examining substance use outcomes of culturally adapted interventions with Latino adolescents. The search yielded 35,842 titles and abstracts, and the full texts of 108 articles were screened for inclusion. The final sample included 10 studies (7 RCT and 3 QED). Program participants were comprised of 56.5% males; 74.2% were U.S. born; and their mean age was 13.13 years. Meta-analytic results suggest significant effects of moderate magnitude on substance use outcomes at posttest (g=0.328; 95% CI 0.015 to 0.640, p<0.04), and an overall positive and moderate effect at follow-up (g=0.516; 95% CI 0.149 to 0.883, p<.006). Homogeneity analysis revealed the effect size distribution was highly heterogeneous at posttest and follow-up, indicating significant variance in magnitude of effects across studies. Moderator analysis revealed differences in mean effects on study and intervention characteristics. The risk of bias assessment revealed that most studies were at high risk for performance bias and selection bias. While culturally adapted substance use interventions demonstrated positive impacts on substance use overall, there was significant variability across studies. These findings emphasize the need for rigorously conducted studies to better discern the benefits of utilizing culturally adapted interventions for reducing substance use among Hispanic adolescents.
Elaborative processing biases associated with vulnerability and maintenance of depression : evidence across levels of analysis
(2014-08) Clasen, Peter Cunningham; Beevers, Christopher G.
Major depressive disorder (MDD) will soon represent the most costly and debilitating disorder in the world. Yet, a clear model of the mechanisms underlying MDD remains elusive. This lack of clarity obscures efforts to prevent and treat MDD more effectively. This dissertation seeks to advance an integrated model of the mechanisms underlying MDD across cognitive, neural, and genetic levels of analysis. Building on the empirical foundation of cognitive theories of MDD, the dissertation includes three studies that help address questions about the cognitive mechanisms underlying depression vulnerability and maintenance. Specifically, the three studies focus on identifying 1) how elaborative processing biases, including attentional biases and rumination, give rise to specific symptoms of MDD and 2) elucidating biological mechanisms that may give rise to these biases. Together, these studies help advance an integrated model of MDD that, ultimately, may help facilitate the prevention and treatment of this costly and debilitating disorder.
Evidence based practice for adolescent reading comprehension instruction : a guide for SLPs in an expanded school role
(2015-05) Mussmann, Jacob Ryan; Booth, James R.; Franco, Jessica
Following a brief description of the adolescent reading comprehension problem in the U.S., this paper presents five evidence based practices (EBP) sufficient to begin addressing the problem on a large scale. The five intervention practices are as follows: 1) explicit vocabulary instruction, 2) explicit comprehension strategy instruction, 3) extended discussion opportunities, 4) motivation and engagement promotion, and 5) intensive and individualized intervention. The first four are recommended for all students within the context of general content courses such as science and history. The fifth should be a supplemental practice for students who persistently fail to exhibit comprehension improvements from the first four. Research suggests that a combination of these practices can result in improved reading comprehension for both students with typical development (TD) and those with a learning disorder (LD). Unfortunately, the research is limited in that the optimal sequence, intensity, subcomponents, and weighting of these practices has yet to be determined. Furthermore, much of the literature, particularly with respect recommendations 2-4, includes few studies with norm-referenced reading comprehension outcome measures. Consequently, it is difficult to make any strong conclusions with respect to long-term maintenance or generalization effects. Also, the abundance of researcher-developed outcomes often inflates effect sizes and limits the ability to make valid between-study comparisons in meta-analyses. Future research efforts should focus on building upon the 5 EBP foundation and filling in the considerable literature gaps within this foundation. Meanwhile, SLPs in their expanded secondary school role should use their language expertise to evaluate students’ literacy strengths and weaknesses in order to create individualized reading profiles that will help determine which combination of the 5 EBPs will be most efficacious.
Health promotion : predicting physical activity in normal weight and overweight rural adolecents
(2014-05) McAdams, Cynthia Ann Brooks; Rew, Lynn; García, Alexandra Anne, 1964-; Brown, Adama; Brown, Sharon A; Walker, Lorraine
Adolescent obesity is ubiquitous and is often antecedent to adverse physical and psychosocial health outcomes. Physical activity is a leading modality for preventing and treating overweight and obesity. A modified resilience framework was used in this study to examine six empirically supported risk factors for physical inactivity and low activity (i.e., body mass index, media use, parental activity, Hispanic ethnicity, minority race, and female sex) along with moderating protective resources (i.e., sense of ethnic identity, health awareness, and social connectedness). The study sample consisted of 251 adolescents, in Grades 8 and 9, recruited from three rural and economically disadvantaged school districts in the southwestern U.S. Data were retrieved from the Longitudinal Health Risk Behaviors in Youth (LongHerby; Grade 8) and Developing Health Behaviors in Middle Adolescence (DHBMA; Grade 9) databases for this secondary analysis of extant longitudinal data. One parent of each participant contributed data used in the study. Demographic analysis revealed the sample was mostly of female sex (56%), White race (81%), and non-Hispanic ethnicity (55%). A descriptive, correlational design was used to examine relationships among variables. Data analysis included correlation, linear regression, and hierarchical multiple regression techniques. The findings showed the outcome of physical activity in Grade 8 was the most statistically significant predictor of physical activity in Grade 9, using two different measures for the outcome (i.e., the Youth Risk Behavior Surveillance Scale [YRBSS] and the Adolescent Lifestyle Questionnaire [ALQ]). Two hierarchical multiple regression models explained 20% (YRBSS) and 21% (ALQ) of the variances in adolescent physical activity practices with female sex (R2Δ = .101, p < .001; YRBSS) and health awareness (R2Δ = .114, p < .001; ALQ) contributing the largest proportion to the hierarchical variances. Body mass index percentiles were not correlated with physical activity (YRBSS or ALQ), but did show a small inverse correlation with female sex (r = -151, p = ≤ .005) and a small positive relationship with Hispanic ethnicity (r = .168, p = ≤ .001). Findings of this study are congruent with previous research and could be used in planning health promotion strategies to improve adolescent physical activity.
Health self-management for adolescents with autism spectrum disorder
(2021-05-05) Rock, Jamie L.; Becker, Heather Brenz; Johnson, Karen; Zuniga, Julie; Magaña , Sandra
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition with differences in communication, social, and behavioral abilities diagnosed in 1 in 54 youth in the United States. Upwards of 95% of individuals with ASD have at least one co-occurring health condition, which may lead to early mortality in this population. Additionally, less than 14% of adolescents with ASD receive guided health transition services aimed to teach youth to self-manage their health throughout life. The gap in health transition services has left many parents with this responsibility. Therefore, given the dearth of research examining transition of health responsibility from parent to adolescent with ASD this study had three specific aims: to explore factors associated with adolescent health self-management (HSM) behavior, compare differences in parent and adolescent perspective, and examine the nature of social facilitation between parent and adolescent that contribute to HSM behavior. Forty adolescents with ASD and parent dyads completed the online survey. Guided by the new Adolescent Health Self-Management (AHSM) Model, results of this descriptive correlational study found many adolescents with ASD were receiving some form of transitional support from parents and report engaging in HSM behavior regardless of receiving guided transition services. However, gaps in health transition may exist during parent and adolescent social facilitation regarding health promoting activities (monitoring health and emotions) and managing existing health conditions (scheduling appointments, managing medications, completing a treatment regiment, etc.). Many conceptual relationships were well explained by the AHSM model in this study. Hierarchical regression analysis found contextual domain variables (parents’ marital status, executive function deficits, age at ASD diagnosis) and process domain variables (health knowledge and self-efficacy) explained 43% of the variance in adolescent HSM behavior in this sample. Furthermore, differences in adolescent and parent perspective of beliefs and abilities further reinforce the need for family-centered and coordinated health transition guidance. This is the first known study to examine HSM behavior for adolescents with ASD. Findings of the study suggest many implications addressing practice, research, and policy alike.
Influence of the home environment on diet quality and weight status of adolescents : a social ecological framework
(2015-12-02) Tabbakh, Tamara; Freeland-Graves, Jeanne H.; Finnell, Richard; Jolly, Christopher; Lewis, Karron; Steinhardt, Mary
The home environment is a critical setting for the development of weight status in adolescence. At present a limited number of valid and reliable tools are available to evaluate the weight-related comprehensive home environment of this population. Aim 1a was to develop and validate the Multidimensional Home Environment Scale (MHES), which measures multiple components of the home. This scale includes psychological, social, and environmental domains from the perspective of adolescents and their mothers. After establishing content validity via an expert panel in nutrition, a validation sample of 218 mother-adolescent dyads completed a demographics survey and original version of the MHES. A focus group with the target population of adolescents (n=7) was conducted and feedback regarding item difficulty, content, bias, and relevance was incorporated. Principal components analysis yielded a 12-factor structure for adolescents and 14-factor structure for mothers. Internal consistency reliability was achieved for the majority of subscales, with α=0.5-0.9 for adolescents and α=0.7-0.9 for mothers. In addition, the MHES showed test-retest reliability for both adolescents (r=0.90) and mothers (r=0.91). Aim 1 b was to develop and validate a Nutrition Knowledge scale using the same sample as Aim 1a. Nutrition knowledge was assessed in this sample of 114 dyads. A 20-item scale was modified from previous version developed by the author. This instrument was composed of multiple-choice questions classified into four categories of knowledge: macronutrient, micronutrient, healthy eating and physical activity recommendations and fast-food nutrition. Content validity of the scale was established using feedback from an expert panel in nutrition (n=10) and a focus group of the sample population tested (n=7). The scale demonstrated high internal consistency reliability (adolescents: α=0.70, mothers: α=0.78) and test-retest reliability (adolescents: r=0.47, p=0.01, mothers: r=0.77, p=0.00). Aim 2 was to examine the impact of the comprehensive home environment on diet quality and weight status of adolescents using the MHES. A sample of 206 mothers and adolescents were recruited from local middle schools in the Austin area and completed a demographics survey, final version of the MHES, Food Frequency Questionnaire, and a Nutrition Knowledge scale online. Weight and height of adolescents were measured by the author using a standard protocols. Body Mass Index (BMI)-for-age percentiles were determined using the Center for Disease Control growth charts. Diet quality was estimated using the Healthy Eating Index-2010. Two models were created and reported in this dissertation. The first univariate model included each of the home environment factors as independent variables, and diet quality and BMI as dependent variables. The second model was developed using significant variables only from the initial model. Availability of healthy foods (p=0.00), healthy eating attitude (p=0.01), and accessibility to unhealthy foods (p=0.04) in the home were the strongest predictors of diet quality. Self-efficacy (p=0.02) and availability of healthy foods (p=0.02) emerged as significant predictors of BMI. Aim 3 of this dissertation research was to determine the effect of nutrition knowledge on the home environment and diet quality using the Healthy Eating Index-2010. This aim was accomplished using the same sample as Aim 2. It was hypothesized that the comprehensive home, with its psychological, social, and environmental features, would mediate the relationship between maternal nutrition knowledge and diet quality. A non-linear relationship between nutrition knowledge of the mother and diet quality of the adolescent was observed. Inclusion of the mediator in the model yielded significant estimates of the indirect effect (β=0.61, 95% CI: 0.3-1.0), with a 65.2% reduction in the model. This suggests that the home environment functioned as a partial mediator of the influence of nutrition knowledge on diet quality. Then, mediation analysis with the combination of psychological, social, and environmental factors was conducted in three separate regressions. Psychological (β=0.46), social (β=0.23), and environmental (β=0.65) variables were all significant mediators of nutrition knowledge on diet quality. Collectively, these results suggest that the MHES is an appropriate tool for measurement of the nutritional home environment of adolescents. The home environment appeared to significantly modulate diet quality and BMI of adolescents, particularly with respect to availability of healthy foods, healthy eating attitudes, and self-efficacy.
An Introduction to the Personality Assessment Inventory – Adolescent (PAI-A) : understanding applicability for use with forensic adolescent males and investigation of clinical correlates
(2011-12) Farwell, Lauren Lee; Sherry, Alissa René; McCarthy, Christopher
Published in 2007, the Personality Assessment Inventory – Adolescent (PAI-A) is rapidly becoming a widely used adolescent personality measure in psychological assessment, particularly with forensic/delinquent adolescents. The literature indicates forensic adolescent males differ in many domains from non-forensic adolescent males. It is important in adolescent forensic assessment research to align the PAI-A with the empirical literature. The goal of this literature review is understand the utility of the PAI-A for use with forensic adolescent males and provide a foundation for future research with the PAI-A and adolescent males. Particularly, this literature review seeks to identify particular PAI-A scales that are potentially descriptive of one’s forensic status and combine prior research findings to delineate among inherent characteristics of forensic violent, forensic non-violent and non-forensic community adolescent males.
Mental Health Implications of Adolescent Scoliosis: Analysis of Current Practices and Proposal of a Mindfulness-Based Intervention
(2023-04-26) Villarreal, Ingrid; Young, Cara
Scoliosis is a disease most often diagnosed during adolescence (normally between the ages of 12-17). The most common type of scoliosis diagnosed in this age range is adolescent idiopathic scoliosis (AIS). This type of scoliosis is idiopathic due to its manifestation without a known cause. During the adolescent stage of life, patients are dealing with normal pubescent stresses. A diagnosis of scoliosis adds another layer of burden as it requires managing the stigma of the physical scoliosis deformity and, oftentimes, treatment that includes a bulky orthotic back brace or corrective spine surgery. Patients experience scoliosis stigma that can affect self-esteem, self-worth, self-image, stress, anxiety, and social friendships. As such, patients may experience additional challenges to their mental well-being which can continue into their adult life even once the treatment has concluded. Current standards for scoliosis do not consider the negative mental health implications of the disease. An adjunctive intervention, specifically based on mindfulness, could teach patients with scoliosis to process these negative feelings and thoughts in a more positive way from the start of the treatment and aid the patients in their journey with scoliosis. Mindfulness skills could give them the tools to successfully overcome and/or experience the stressors in a less stressful way. Moreover, mindfulness-based interventions may also help to increase a patient's orthotic bracing treatment compliance which could aid in the overall improved progression of scoliosis.
Obesity-specific health related quality of life assessment : examining caregiver-child agreement
(2013-12) Lotz, Elijah John Strong; Keith, Timothy, 1952-
The proposed study seeks to add to the literature surrounding the assessment of obesity-specific health related quality of life (HRQOL) among youth. Assessing this construct provides valuable information regarding the impacts of obesity on quality of life in childhood and adolescence. However, discrepant reports between caregivers and children can lead to difficulty in interpreting assessment data. Using multiple regression, this study will explore whether observed differences in caregiver and child reports of obesity-specific HRQOL can be predicted by caregiver and child variables in a treatment-seeking sample. Variables of interest include parenting stress, body mass index (BMI), age, and gender. Significant results may help clinicians develop hypotheses about the causes of discrepancies when conceptualizing cases.
Perceptions of prenatal care in older adolescent Latinas
(2014-05) Torres, Rosamar; Rew, Lynn; Brown, Adama; Garcia, Alexandria; Padilla, Yolanda; Walker, Lorraine
The knowledge that initiation of prenatal care after the first trimester of pregnancy is associated with poor fetal and maternal outcomes has led to increased efforts to improve access to prenatal care in the U.S. Despite these efforts, Latinas continue to underutilize these services and enter care late. Pregnant adolescent Latinas are at increased risk for morbidity and mortality during pregnancy and labor, thereby increasing risks for mortality, blindness, deafness, mental retardation, and cerebral palsy in their the neonates. The current literature surrounding perceptions of prenatal care focuses on women overall without taking into account culture, ethnicity or age. Thus, little is known about adolescent Latinas’ perceptions of prenatal care and why they enter care late. Hence the purpose of this study was to critique the literature regarding Latinas and their perceptions of prenatal care; to determine the psychometric properties of The Perceptions of Prenatal Care Survey which was piloted in the Phase I of the dissertation; to identify perceptions of prenatal care in older adolescent Latinas utilizing the Access Barriers to Care Index and the Perceptions of Prenatal Care Survey in Phase II of the study; and to determine if relationships exist between variables in the conceptual model and participants’ adequacy of and timely entry into prenatal care. Phase I revealed the survey had good internal consistency (Cronbach’s alpha = 0.88) and validity (S-CVI =0.81). Phase II revealed that a majority (94.5%) of participants perceived that timely prenatal care as important; however, only 55.6% entered care on time. Over 70% of the sample had experienced personal and healthcare imposed barriers when accessing prenatal care. Social support from partners and friends was associated with adequate prenatal care; and having some college education was associated with timely prenatal care. Influence from healthcare workers did not have a statistically significant effect on timely or adequate prenatal care. Due to sampling issues and possible response bias, the study is limited. Future research on this topic calls for more stringent sampling measures that will take race, acculturation, nativity and immigration status into consideration.
Physical activity in early adolescent girls : an examination of biological, affective, interpersonal and sociocultural influences
(2013-08) Standiford, Anne Elizabeth; García, Alexandra Anne, 1964-; Rew, Lynn
Pediatric overweight is defined as a body mass index (BMI) for age of 85th-95th percentile, and occurs in approximately 33.6% of adolescents 12-19 years of age. Hispanic adolescents are disproportionately at risk for overweight. Excess weight can predispose adolescents to develop diabetes mellitus type 2, coronary artery disease, hypertension, hypercholesterolemia, sleep apnea, osteoporosis, asthma, and certain types of cancer, whereas physical activity can help prevent and treat these diseases. Little is known about the factors that contribute to physical activity in Hispanic adolescent girls. The purpose of this study was to examine and compare the influence of personal characteristics, perceptual influences, interpersonal influences and sociocultural influences on physical activity in White and Hispanic adolescent girls. The theoretical framework for this study was self-designed--the Physical Activity Lifestyle Model. Data for this cross-sectional study was collected from girls age 11-14 who presented to the Children's Wellness Center in Del Valle, TX (N = 121) in the summers of 2011 and 2012. Most participants self-identified as Hispanic (n = 106). Participants completed a survey consisting of a 1-day physical activity recall, a demographic questionnaire, and several validated (primarily Likert-type) questionnaires. Height and weight were measured in the clinic. Data analysis began with descriptive analysis (mean, standard deviation and percentage) of demographic characteristics, dependent and independent variables, then Pearson correlations, and finally multiple linear regression to determine the influence of the independent variables on physical activity. No significant differences were found between ethnic groups on age, grade or school (p > .05). Physical activity was significantly related to body image (r = .189, p < .05), friend social support (r = .279, p < .01), and family social support (r = .401, p < .01). In addition, physical activity significantly predicted BMI percentile (B = -.043, SE = .019, t = -2.249, p = .027), appearance-related media messages (B = .259, SE = .127, t = 2.038, p = .044), pressures to be thin (B = .311, SE = .149, t = 2.082, p = .040), family social support for physical activity (B = .089, SE = .042, t = 2.139, p = .035), body image (B = .367, SE = .123, t = 2.987, p = .004), and physical activity enjoyment (B = .083, SE = .040, t = 2.089, p = .040). When designing an intervention to promote physical activity, health care providers and educators should consider that multiple external factors influence physical activity participation in Hispanic adolescent girls. Healthcare providers should involve parents and siblings in physical activity interventions for overweight adolescent girls. Interventions should be tailored to work with the adolescent girls' physical and social environment. Public health nurses should work with schools and communities to increase physical activity opportunities for adolescent girls in physical education classes, girls' sports, and after-school programs.