Close ties to parents, school improve adolescents' lives.
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Adolescent↗
Biomedical subjects
M D Resnick
Publications and source records attributed to M D Resnick.
Sexual orientation and prevalence of body dissatisfaction and eating disordered behaviors: a population-based study of adolescents.
OBJECTIVE: The hypothesis that homosexual orientation would be associated with higher rates of body dissatisfaction, dieting, and eating disordered behaviors in males, but lower rates in females, relative to those of heterosexual orientation, was examined. METHODS: A population-based sample of 36,320 students in Grades 7 through 12 completed a health behavior survey that included questions on sexual orientation, body satisfaction, and weight control behaviors. A subset of heterosexual males (N = 212) and females (N = 182) were selected for comparison with the adolescents who self-identified as homosexual (N = 81 males and N = 38 females) or bisexual (N = 131 males and N = 144 females). RESULTS: Homosexual males were more likely to report a poor body image (27.8% vs. 12.0%), frequent dieting (8.9% vs. 5.5%), binge eating (25.0% vs. 10.6%), or purging behaviors (e.g., vomiting: 11.7% vs. 4.4%) compared with heterosexual males. Homosexual females were more likely than heterosexual females to report a positive body image (42.1% vs. 20.5%). However, they were not less likely to report frequent dieting (20.8% vs. 23.7%), binge eating (25.0% vs. 31.8%), or purging behaviors (e.g. vomiting: 19.4% vs. 12.1%). DISCUSSION: These results support the hypothesis that homosexual orientation is associated with greater body dissatisfaction and problem eating behaviors in males, but less body dissatisfaction in females. The possible role of sociocultural influences or gender identification on these relationships is discussed.
Adolescent↗
Sexual behavior of adolescents with chronic disease and disability.
PURPOSE: This study aimed to assess sexual behaviors, sexual orientation, pregnancy, and abuse history among adolescents with and without chronic conditions. METHODS: Analyses were based on a statewide survey of 36,284 young people in the 7th through 12th grades for analytic purposes; subsets were defined using a specialized cohort design including adolescents with visible and nonvisible conditions plus controls. Principle outcome measures included self report of ever having sexual intercourse, age of sexual debut, reasons for not having intercourse, ever causing or having a pregnancy, ever having a sexually transmitted disease (STD), contraceptive use and reasons for their nonuse, history of sexual abuse, and sexual orientation. RESULTS: No differences were evident between adolescents with and without chronic conditions in the proportion ever having intercourse, age of sexual debut, pregnancy involvement, patterns of contraceptive use, or sexual orientation. No differences were evident among girls or boys with visible compared with invisible conditions. A significantly greater proportion of girls and boys with invisible conditions than controls reported a history of sexual abuse. More index boys than controls reported ever having an STD, whereas more girls with visible conditions than controls reported this. CONCLUSIONS: Adolescents with chronic conditions are at least as sexually involved as their peers, and significantly more likely to have been sexually abused. Visibility of chronic conditions does not appear to affect the sexual behaviors of adolescents. The need for comprehensive sexuality education in this population is high, and discussion of sexuality, contraception and abuse must be part of standard psychosocial assessment and anticipatory guidance for all teenagers, including those with chronic conditions.
Adolescent↗
Gender-specific outcomes for sexually abused adolescents.
This study examined the gender differences in outcomes related to school performance, suicidal involvement, disordered eating behaviors, sexual risk taking, substance use, and delinquent behaviors of male (n = 370) and female teenagers (n = 2,681) who self-reported a history of sexual abuse. It was found that female adolescents, by and large, engaged in internalizing behaviors and males in externalizing behaviors. Male adolescents were found to be at higher risk than females in poor school performance, delinquent activities, and sexual risk taking. Female adolescents, on the other hand, showed higher risk for suicidal ideation and behavior as well as disordered eating. Females showed more frequent use of alcohol. However, male adolescents exhibited more extreme use of alcohol and more frequent and extreme use of marijuana. Among index female adolescents, protective factors against adverse correlates included a higher emotional attachment to family, being religious or spiritual, presence of both parents at home, and a perception of overall health. Factors that augmented adverse correlates for them included a stressful school environment due to perceived high levels of substance use in and around school, worry of sexual abuse, maternal alcohol consumption, and physical abuse. For male adolescents, maternal education and parental concern appeared to be protective factors.
Achievement↗
Psychosocial predictors of binge eating and purging behaviors among adolescents with and without diabetes mellitus.
PURPOSE: This study aims to compare dieting, binge eating, and purging behaviors, and to examine predictors of binge eating and purging behaviors among adolescents with and without Diabetes Mellitus (DM). METHODS: The index group included 310 adolescents who reported that they had DM on a statewide population survey of 36,284 adolescents in grades 7-12 in Minnesota. The comparison group included a random sample matched for socioeconomic status (SES), of 850 adolescents without chronic illness. Disordered eating behaviors assessed in the present study included binge eating, vomiting, laxative use, and diuretic use. Potential predictor variables assessed included weight loss behaviors, body image, sexual abuse, sexual attractions, emotional well-being, family connectedness, poor school performance, age, race, Body Mass Index (BMI), and SES. RESULTS: Binge eating and purging were significantly more prevalent among adolescents with DM than among the comparison group. Different risk profiles were found for adolescents with and without DM and for males and females. Predictors of binge eating and purging among females with DM included weight dissatisfaction, bisexual/homosexual attractions, and younger age. Predictors among males with DM included bisexual/homosexual attractions, younger age, sexual abuse, and an interaction between sexual abuse and emotional well-being. CONCLUSIONS: Adolescents with DM should be screened for unhealthy weight control practices and eating disorders. If disordered eating is present, clinicians need to be sensitive to the variety of factors possibly associated with these behaviors among different individuals.
Adolescent↗
Translating research into action: the critical role of adolescent health surveys.
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Adolescent↗
Patterns of health-compromising behaviors among Minnesota adolescents: sociodemographic variations.
OBJECTIVES: This study compared prevalence rates of health-compromising behaviors among boys and girls from different ethnic backgrounds in early, middle, and late adolescence and compared co-occurrences of such behaviors across gender and ethnic groups. METHODS: The study population included 123 132 adolescents in grades 6, 9, and 12. Adolescents completed a classroom-administered statewide survey focusing on high-risk behaviors, including unhealthy weight loss, substance abuse, suicide risk, delinquency, and sexual activity. RESULTS: Prevalence rates of most health-compromising behaviors differed by gender, increased with age, and tended to be highest among American Indian youth and lowest among Asian Americans. Strong associations were found between substance abuse and delinquency across all ethnic groups. Substance abuse and delinquency were associated with suicide risk across most ethnic groups. Covariations with sexual activity and unhealthy weight loss behaviors showed more ethnic variation. CONCLUSIONS: Prevention interventions should take into account the tendency for health-compromising behaviors to co-occur and should be sensitive to demographic and socioeconomic differences in behavior patterns.
Adolescent↗
Don't ask, they won't tell: the quality of adolescent health screening in five practice settings.
OBJECTIVES: This study examined the extent to which comprehensive, age-appropriate adolescent health screening is undertaken in the clinical setting and whether the extent of such screening varies by setting. METHODS: Charts of adolescents 13 to 17 years old (n = 788) were randomly selected from five practice settings in Minneapolis, Minn. Each was assessed for the number of biomedical and sociobehavioral health risks screened. RESULTS: In no practice setting was there screening to the level recommended. The two teen clinics screened more extensively for behavioral, psychosocial, substance use and sexual behavior risks than the community family practice setting, which, in turn, screened more extensively than either the private family practice or private pediatric practice settings, which did not differ from each other. Age differences and gender accounted for only small amounts of variance in total number of health risks screened, whereas differences among practice settings accounted for a larger amount. CONCLUSIONS: Results suggest substantive deficiencies in private practice settings' implementation of preventive care screening protocols for adolescents.
Adolescent↗
Body dissatisfaction and unhealthy weight-control practices among adolescents with and without chronic illness: a population-based study.
OBJECTIVE: To compare body dissatisfaction and unhealthy weight-loss practices among adolescents with and without chronic illness. DESIGN: Survey. PARTICIPANTS: The sample consisted of 2149 adolescent boys and girls with diabetes, asthma, attention deficit disorder, physical disabilities, or seizure disorders; and a comparison group of 1381 adolescents without chronic illness. MAIN OUTCOME MEASURES: Body concerns, binge eating, frequent dieting, vomiting, and laxative or diuretic use among adolescents. RESULTS: Adolescents with chronic illness reported higher body dissatisfaction and engaged in more high-risk weight-loss practices than adolescents without chronic illness. This trend was consistent across the different conditions and was not limited to those with a nutrition-related condition such as diabetes. The trend remained after conducting logistic regression and controlling for age, race, socioeconomic status, and body mass index. CONCLUSIONS: Adolescents with chronic illness are at high risk for engaging in unhealthy weight-loss practices and should be screened and targeted for prevention and treatment.
Adolescent↗
Female adolescents of alcohol misusers: disordered eating features.
Studies show that children of alcohol-abusing parents constitute an at-risk population. This study attempted to understand the impact of parental alcohol misuse on the disordered eating behaviors of their female adolescent children, based on a sample of 532 teenagers from alcohol-misusing parents in Minnesota. These female adolescents had significantly higher prevalence rates of all the seven eating disordered symptoms that were studied. The study also identified a few protective factors: Those who did not develop any of the disordered eating symptoms were more satisfied with their present weight. Further, they worried less about abuse from parents and perceived that their school personnel cared about them.
Adolescent↗
Ethnic/racial and socioeconomic differences in dieting behaviors and body image perceptions in adolescents.
This study examined differences in perceptions of body weight, dieting, unhealthy eating behaviors, and weight control methods among adolescent males and females of various racial/ethnic and socioeconomic (SES) subgroups. Data were derived from a comprehensive health survey administered to 36,320 students in grades 7 through 12 in Minnesota. Differences among ethnic/racial and SES groups were assessed using multivariate logistic regression controlling for grade and body mass index (BMI). Results showed that unhealthy weight control behaviors are not confined to upper SES white females. Compared to white females, Hispanic females reported greater use of diuretics; Asians reported more binge eating; and blacks reported higher rates of vomiting. Black and American Indian females were more likely to be satisfied with their body. Among males and females, higher SES was associated with greater weight satisfaction and lower rates of pathological weight control behaviors. Findings from this study suggest that future research should focus on the validity of self-reports of dieting and weight control behaviors in different ethnic subgroups.
Body Image↗
Frequent dieting among adolescents: psychosocial and health behavior correlates.
OBJECTIVES: The present study examined correlates of frequent dieting in 33,393 adolescents. It was hypothesized that frequent dieting would be correlated with negative psychosocial and health behavior outcomes. METHODS: A comprehensive, school-based health behavior survey was administered in 1987 to public school students in grades 7 through 12 in Minnesota. Students self-reported dieting behavior; substance use; suicidal, sexual, and delinquent behavior; family and peer concerns; sick days; and abuse history. Differences on psychosocial and health behavior risk factors by dieting frequency and by purging status were assessed with multivariate logistic regression, with body mass index and demographic variables controlled. RESULTS: Dieting frequency was associated with history of binge eating (females: odds ratio [OR] = 1.46, males: OR = 1.53); poor body image (females: OR = 0.56, males: OR = 0.63); lower connectedness to others (females: OR = 0.79); greater alcohol use (females: OR = 1.17); and greater tobacco use (females: OR = 1.08). Purging status was independently associated with negative risk factors in both males and females. CONCLUSIONS: These findings suggest that frequent dieting efforts in adolescents should not be viewed in isolation, but rather in the broader context of health and risk-taking behaviors.
Adolescent↗
Weight perceptions and weight control practices in American Indian and Alaska Native adolescents. A national survey.
OBJECTIVE: To assess weight perceptions and weight control practices among American Indian-Alaska Native adolescents. DESIGN: Survey. SETTING: Nonurban schools from eight Indian Health Service areas. PARTICIPANTS: A total of 13,454 seventh- through 12th-grade American Indian-Alaska Native youths. MAIN OUTCOME MEASURES: A revised version of the Adolescent Health Survey, a comprehensive, anonymous self-report questionnaire with eating- and body image-related questions. RESULTS: Forty-one percent of the adolescent girls reported feeling overweight, 50% were dissatisfied with their weight, and 44% worried about being overweight. Almost half (48%) had been on a weight-loss diet in the past year, with 27% reporting that they had self-induced vomiting at some time to try to lose weight. Eleven percent reported using diet pills. Girls who reported feeling overweight were more likely to engage in unhealthy weight control practices than were those who felt they were of normal weight or underweight. A larger proportion of boys were satisfied with their weight (68%), with 22% worrying about being overweight. However, compared with rural Minnesota youth, both American Indian girls and boys had greater dissatisfaction with body weight. CONCLUSIONS: Our study shows that American Indian youth, particularly girls, are dissatisfied with their weight and are worried about being overweight, and that unhealthy weight control practices are common. More attention needs to be placed on developing culturally appropriate weight management programs for Indian youths.
Adolescent↗
The fate of the non-marital child: a challenge to the health system.
Non-marital births present serious social and economic issues to American communities. This study examined attitudes and behaviors of low income unmarried young parents toward paternity establishment and the role of health care professionals in promoting paternity establishment. One hundred twenty-six matched dyads of young, impoverished unmarried fathers and mothers with a child age one year or less participated in face-to-face interviews, focusing on family, peer and community influences on paternity decision making. The representative sample was derived from a metropolitan county's AFDC and paternity files in Minnesota. While less than one-third of fathers lived with the mother and child, two-thirds were present at the child's birth. Eighty-five percent of fathers acknowledged fathering the child, 80% provided care and nurturance of the baby, and 86% indicated that the father's name on the birth certificate was important. Only 29% of White fathers and 20% of African-American fathers regarded marriage to the mother as a possibility, and less than one-third sought to establish paternity through the courts. Nonetheless, 52% of White and 63% of African-American fathers had signed the Declaration of Parentage at the hospital, although presentation of the Declaration by health personnel was haphazard. Presentation of the Declaration should become standard procedure within health settings, with paternity establishment removed from the court setting and permitted through signing of the Declaration. This would capitalize on the high level of interest in paternity establishment expressed by fathers, other than through formal court procedures, around the time of the baby's birth.
Black or African American↗
Emotional well-being among adolescents with and without chronic conditions.
PURPOSE: To investigate whether adolescents with chronic conditions differ from adolescents without chronic conditions in several psychological outcomes. An additional purpose was to explore whether adolescents with chronic conditions differ as a function of the visibility of their conditions. METHODS: By means of the Adolescent Health Survey, 1683 students (grades 7-12) with a variety of chronic conditions were compared with 1650 students without chronic conditions in regard to emotional well-being, worries and concerns, and body image. Differences in emotional well-being were examined as a function of perception of family connectedness. Comparisons were also made between adolescents with visible and invisible conditions. RESULTS: Adolescents with chronic conditions had lower emotional well-being scores, worried more about dying soon and about school or future work, and had poorer body image. For students with and without chronic conditions, higher emotional well-being scores were significantly related to higher levels of family connectedness. The best explanatory variables of emotional well-being were body image, family connectedness, concerns about school and future work, having a disability, and worry about peer relationships, accounting together for 36% of the variance in the outcome variable. No differences were found between adolescents with visible and invisible conditions. CONCLUSIONS: Although adolescents with chronic conditions do less well than adolescents without chronic conditions, having a disability is not the most influential factor on emotional well-being. Family connectedness is of fundamental importance for adolescents' emotional health.
Adolescent↗
Patterns of consultation among adolescent minors obtaining an abortion.
Interviews with 184 adolescents revealed that all had consulted at least one individual before obtaining an abortion, although one-quarter, primarily the older adolescents, did not consult an adult prior to pregnancy counseling. At both the time of the abortion and one year later, the adolescents perceived their mother and their male partner as the two most important and helpful people in reaching a decision.
Abortion, Induced↗
Formal help-seeking behavior of adolescents identifying themselves as having mental health problems.
OBJECTIVE: In response to evidence of poorly met mental health needs, a study of formal help-seeking behavior of adolescents was conducted. METHOD: Responses (n = 17,193) to a school-based survey were examined. Overall, 24.9% identified themselves as having a serious problem. Students who felt they "needed professional help" were contrasted to those who did not. Among students who felt they needed help, those who did not seek it were contrasted to those who did. RESULTS: Deciding professional help was needed was most strongly associated with history of abuse, physical health, suicidal ideation, and gender. Obtaining help was associated with suicidal ideation, informal help-seeking behavior, the interaction between race and socioeconomic status, parental marital status, and having a checkup within the previous year. CONCLUSIONS: This study establishes that different factors influence adolescents' identifying a need and actually obtaining help.
Adolescent↗
Disordered eating among adolescents whose parents misuse alcohol: protective and risk factors.
Studies show that children of alcoholics constitute an at-risk population. This study attempted to understand the impact of parental alcohol misuse on the disordered eating behaviors of children, based on a sample of 838 teenagers from alcohol-misusing parents in Minnesota. These teenagers had significantly higher prevalence rates of all the seven eating disordered symptoms that were studied. The study also identified a few protective factors: those who did not develop any of the disordered eating symptoms were more satisfied with their present weight and proud of their body. Further, they had less worry of being sexually abused and perceived that their schools were relatively alcohol-free.
Adolescent↗