Clinical quiz.
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Diagnosis, Differential↗
Biomedical subjects
F M Costa
Publications and source records attributed to F M Costa.
Adolescent cigarette smoking: health-related behavior or normative transgression?
Relations among measures of adolescent behavior were examined to determine whether cigarette smoking fits into a structure of problem behaviors-behaviors that involve normative transgression-or a structure of health-related behaviors, or both. In an ethnically and socioeconomically diverse sample of 1782 male and female high school adolescents, four first-order problem behavior latent variables-sexual intercourse experience, alcohol abuse, illicit drug use, and delinquency-were established and together were shown to reflect a second-order latent variable of problem behavior. Four first-order latent variables of health-related behaviors-unhealthy dietary habits, sedentary behavior, unsafe behavior, and poor dental hygiene-were also established and together were shown to reflect a second-order latent variable of health-compromising behavior. The structure of relations among those latent variables was modeled. Cigarette smoking had a significant and substantial loading only on the problem-behavior latent variable; its loading on the health-compromising behavior latent variable was essentially zero. Adolescent cigarette smoking relates strongly and directly to problem behaviors and only indirectly, if at all, to health-compromising behaviors. Interventions to prevent or reduce adolescent smoking should attend more to factors that influence problem behaviors.
Adolescent↗
Adolescent problem drinking: stability of psychosocial and behavioral correlates across a generation.
OBJECTIVE: Research conducted in the 1970s demonstrated that Problem Behavior Theory could account for approximately 40% of the variance in problem drinking in both local and national sample studies. The present analyses sought to determine whether the personality, perceived environment, and behavior variables of the framework continue to contribute to the explanation of problem drinking among contemporary American youth. METHOD: Correlational and multiple regression analyses were performed on six separate databases collected at different times between 1972 and 1992. Due to sociodemographic differences among the samples, separate analyses were performed for male and female adolescents, and age, ethnicity and socioeconomic status were statistically controlled. RESULTS: There was considerable consistency across the samples in both the partial correlations and the partial multiple correlations, and this result held for both genders. Not only did the framework account for the same percentage of the variance (40%) in problem drinking in the 1992 data as it did in the 1972 data, but the results for the intervening years were consistent as well. CONCLUSIONS: The consistency of results over a 20-year period confirms that the social-psychological meaning of adolescent involvement in problem drinking has remained stable despite changes in the larger sociohistorical context.
Adolescent↗
Transition into adolescent problem drinking: the role of psychosocial risk and protective factors.
OBJECTIVE: To establish the role of psychosocial risk and protective factors in cross-sectional variation in adolescent problem drinking, and in the transition into problem drinking over time. METHOD: The data were from a four-wave (1989-1992) longitudinal study of 1,591 adolescents in a large, urban school district. School district officials selected schools for the study with an aim toward maximizing representation of minority students from inner-city areas. At Wave 1, all students in Grades 7, 8, and 9 were asked to participate. RESULTS: Both psychosocial risk factors (such as low expectations for success, peer models for substance use, and poor school performance) and psychosocial protective factors (such as intolerance of deviance, peer models for conventional behavior, and involvement in prosocial activities) account for significant cross-sectional variation in adolescents' involvement in problem drinking, as indicated by more frequent drunkenness and more numerous instances of alcohol-related problems. They also account for significant variation in the timing of transition into problem drinking during adolescence. Higher risk and lower protection are each associated with greater problem use of alcohol. Among adolescents who are not problem drinkers, higher risk and lower protection accelerate the likelihood of becoming a problem drinker in subsequent years. Protection also moderates the impact of risk in the cross-sectional account of involvement in problem drinking, but protective factors appear not to play a moderating role in the longitudinal account of the transition into problem drinking. Findings were similar for males and females and among white, black and Hispanic adolescents. CONCLUSIONS: Protective factors play an independent role in accounting for adolescent involvement in problem drinking and in the transition into problem drinking in adolescence. Intervention efforts to enhance protection, especially for adolescents who are exposed to risk, should supplement efforts to reduce risk.
Achievement↗
Protective factors in adolescent health behavior.
The role of psychosocial protective factors in adolescent health-enhancing behaviors--healthy diet, regular exercise, adequate sleep, good dental hygiene, and seatbelt use--was investigated among 1,493 Hispanic, White, and Black high school students in a large, urban school district. Both proximal (health-related) and distal (conventionality-related) protective factors have significant positive relations with health-enhancing behavior and with the development of health-enhancing behavior. In addition, in cross-sectional analyses, protection was shown to moderate risk. Key proximal protective factors are value on health, perceived effects of health-compromising behavior, and parents who model health behavior. Key distal protective factors are positive orientation to school, friends who model conventional behavior, involvement in prosocial activities, and church attendance. The findings suggest the importance of individual differences on a dimension of conventionality-unconventionality. Strengthening both proximal and distal protective factors may help to promote healthful behaviors in adolescence.
Adolescent↗
Contraceptive behavior and adolescent lifestyles: a structural modeling approach.
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Adolescent↗
Psychosocial conventionality, health orientation, and contraceptive use in adolescence.
PURPOSE: The purpose of this paper is to determine psychosocial and behavioral factors that are associated with variation in contraceptive use among adolescents. Because regular use of contraception may be seen both as a conventional behavior and as a health-protective behavior, analyses assess the association between psychosocial conventionality and health orientation, on the one hand, and variation in contraceptive use, on the other. METHODS: Analyses are based on an urban sample of 971 white, African-American, and Hispanic male and female sexually active high school students. Study participants filled out a 38-page questionnaire that included a wide range of measures derived from Problem-Behavior Theory. RESULTS: Correlational analysis and hierarchical regression analysis indicate that more regular contraceptive use is associated with greater psychosocial conventionality and also with greater orientation toward health for both male and female adolescents. These relationships hold when the sociodemographic characteristics of race/ethnicity, socioeconomic status, grade in school, family composition, and pregnancy experience are controlled. The linkages of psychosocial conventionality and health orientation to contraceptive behavior are stronger for African-American than for white and Hispanic adolescents. CONCLUSIONS: The present findings establish a more comprehensive and more distal set of influences on regularity of contraceptive use. In its negative relationship to problem behavior and its positive linkage with health behavior, contraceptive behavior may be seen as part of a larger, organized system of behavior in this stage of development (i.e., a more conventional adolescent lifestyle).
Adolescent↗
Structure of health-enhancing behavior in adolescence: a latent-variable approach.
The structure of the interrelations among a variety of health-enhancing behaviors was examined using structural equation modeling analyses of questionnaire data from 1,280 middle school students and 2,219 high school students. The health-enhancing behaviors included seat belt use, adequate hours of sleep, attention to healthy diet, adequate exercise, low sedentary behavior, and regular toothbrushing. In the middle school sample, all of the health-enhancing behaviors correlated significantly but modestly with each other, except for sleep with toothbrushing. In the high school sample, all but three of the 15 correlations among the behaviors were significant. The results further show that a single underlying factor can account for the modest correlations among these health-enhancing behaviors in both samples. The generality of the single-factor model was also established for male, female, White, Hispanic, and Black students at each school level. These findings provide some support for the existence of health-related lifestyles in adolescence.
Adolescent↗
Adolescent health behavior and conventionality-unconventionality: an extension of problem-behavior theory.
Examined the relation of psychosocial and behavioral conventionality-unconventionality to health-related behavior in cross-sectional data from 1,588 male and female 7th to 12th graders. Conventionality-unconventionality was represented by personality, perceived social environment, and behavior variables selected from the social-psychological framework of problem-behavior theory (R. Jessor & S. L. Jessor, 1977). Greater psychosocial conventionality correlates with more regular involvement in health-related behavior (regular physical activity, adequate sleep, safety belt use, attention to healthy diet). Greater behavioral conventionality (less involvement in problem behaviors such as marijuana use, problem drinking, delinquent-type behavior, and greater involvement in conventional behaviors such as church attendance) was also associated with greater involvement in health-maintaining behavior. The overall findings provide support for the extension of problem-behavior theory to the domain of adolescent health behavior and for the relevance of the dimension of conventionality-unconventionality.
Adolescent↗
Syndrome of problem behavior in adolescence: a replication.
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Adolescent↗
Serum and urinary magnesium, calcium and copper levels in insulin-dependent diabetic women.
Eighteen insulin-dependent diabetic (IDD) and 15 healthy control women participated in a study of the relationship between glycemic control or renal function measurements and the levels of magnesium, calcium and copper in the serum and urine. In the IDD women glycosylated hemoglobin averaged 9.8 +/- 0.5% and the fasting plasma glucose was 1.89 +/- 0.19 g/L. The glomerular filtration rate, approximated from creatinine clearance, averaged 125 +/- 16 ml/min in the IDD women in comparison to 82 +/- 4 ml/min in the controls. IDD women had lower serum (p less than 0.001) and higher urinary (p less than 0.01) magnesium levels than did the controls; serum and urinary copper levels and serum ceruloplasmin levels all were higher (p less than 0.01) in the IDD women. There was no difference in either serum or urinary calcium levels between the two groups. In the IDD women serum magnesium was related to urinary glucose (r = -0.758, p less than 0.01) and to glycosylated hemoglobin (r = -0.603, p less than 0.01); none of the other measurements of serum or urinary minerals was related to measures of glucose control. Urinary calcium and copper levels, but not urinary magnesium, were correlated with the glomerular filtration rate (r = 0.476, p less than 0.05 and r = 0.554, p less than 0.05, respectively). The results of this study suggest that IDD alters the utilization of magnesium, calcium, and copper, but that these three minerals are not affected in the same way by physiological changes associated with the disease.
Adolescent↗
Integumentary loss of calcium.
Integumentary calcium loss was studied in 16 healthy young men. The daily loss by the 16 ambulatory but relatively sedentary young men in 52 determinations of 6-day periods each was 8.7 +/- 1.9 mg/m2 per day (average 15.8 mg/man per day). The amount lost was not influenced by calcium intake (0.1 to 2.3 g/day). In contrast to urinary calcium excretion, which is directly related to protein intake, there was no significant change in integumentary calcium loss with varying protein intakes (1 to 96 g nitrogen per day). No compensatory relationship between urinary and integumentary calcium excretion was noted. During strenuous exercise calcium loss increased to an average of 25 mg in 40 min. There was no compensatory decrease in urinary excretion on the day of strenuous exercise. It was also noted that integumentary calcium loss was not affected by general calcium balance.
Adult↗
Studies in calcium metabolism. II. Effects of low calcium and variable protein intake on human calcium metabolism.
Six healthy males consumed diets containing about 0.1 g calcium/day at three levels of protein intake: 0.9, 12, and 24 g nitrogen/day. Daily urinary calcium excretion on the 0.9 nitrogen diet was 51 mg, 99 mg on the 12 g nitrogen diet, and 161 mg on the 24 g nitrogen diet. A calcium supplement of 0.9 g for four subjects on the 12 g nitrogen diet caused an increase in urinary calcium from 68 to 160 mg/day. Varying the calcium and protein intake had no effect on dermal calcium loss or serum calcium. Five subjects had the least negative calcium balance on the 12 g nitrogen diet. Increase in urinary calcium is not likely to result solely from enhancement of intestinal calcium absorption. Our data suggest that increased glomerular filtration with possible inhibition of renal tubular reabsorption of calcium may be an additional mechanism responsible for the calciuretic effect during high-protein intake.
Adult↗
Hyperzincuria in IDDM women. Relationship to measures of glycemic control, renal function, and tissue catabolism.
Eighteen women with insulin-dependent diabetes mellitus (IDDM) and 15 nondiabetic women participated in a study of the relationship of zincuria to measures of glycemic control, renal function, and tissue catabolism. In the IDDM women, mean +/- SE glycosylated hemoglobin was 9.8 +/- 0.5%, and fasting plasma glucose was 189 +/- 19 mg/dl; duration of diabetes averaged 15 yr. In comparison with control women, the IDDM women excreted four times as much zinc in the urine. However, the total plasma zinc concentration was significantly higher in the IDDM than in the control women (14.7 vs. 13.4 microM). The increased urinary zinc loss in the IDDM women was not related to urine volume, urinary glucose excretion, fasting plasma glucose concentration, percent glycosylated hemoglobin, or an increased glomerular filtration rate. Total urinary protein losses were four times higher in the IDDM women than in the control women, and these urinary protein losses correlated with the urinary zinc losses (P less than .007). There was no relationship between urinary zinc and the excretion of any of the amino acids, urea, or ammonia. The results of this study show that hyperzincuria in diabetes is not associated with lower plasma zinc levels. An increased zinc absorption, decreased intestinal zinc excretion, or increased tissue catabolism may support higher plasma zinc levels.
Amino Acids↗