Biomedical subjects

R H DuRant

Publications and source records attributed to R H DuRant.

At least 19 recordsLinked to original sources

PubMed2001

Exposure to violence and intentions to engage in moralistic violence during early adolescence.

This study examined young adolescents'intentions to use moralistic violence and their violence exposure, examining male-female differences. Sixth-grade students (n=702) from Georgia middle schools servicing impoverished communities participated. Data were obtained on the students' exposure to violence, family structure and education level, church attendance, gang interest, drug use, and depression status. The dependent variable, intention to use moralistic violence, was measured with an 11-item scale. Linear regression models were run separately for males and females. Males had significantly higher mean intention to use moralistic violence than females (p=0.002). Males reported being exposed to violence more than females, but exposure decreased as attendance to religious services increased. For these 11-12-year-olds, unconventional peer social norms, such as witnessing violence, increased their intention to use violence while involvement in conventional activities, such as church attendance, decreased it. The protective effect was greater for males than females.

Alcohol Drinking↗

PubMed2001

Reliability of the Problem Oriented Screening Instrument for Teenagers (POSIT) in adolescent medical practice.

PURPOSE: To determine the internal consistency and 1-week test-retest reliability of the Problem Oriented Screening Instrument for Teenagers (POSIT) among adolescent medical patients. METHODS: A research assistant administered the POSIT to a consecutive sample of 15- to 18-year-old patients arriving for routine medical care at a hospital-based adolescent medical practice. Each subject returned for a retest 1 week later. Internal consistency for each scale on test and retest was calculated using Cronbach alpha, and 1-week test-retest reliability by the intraclass correlation coefficient (r) and the kappa coefficient (kappa). RESULTS: The Substance Use/Abuse, Mental Health Status, Educational Status, and Aggressive Behavior/Delinquency scales had favorable alpha scores (>.70). Others, including Physical Health Status, had lower alpha scores. High intraclass correlation coefficients were found for all 10 POSIT scales (r =.72 to.88), although (r) was lower for males on two of the scales. Kappa coefficients for all scales indicated good reproducibility beyond chance (kappa =.42 to.73). CONCLUSIONS: This study provided supportive evidence for the reliability of the POSIT in primary care medical settings, although some POSIT scales could likely be improved. The 20- to 30-min administration time is most practical in settings that are dedicated to adolescent medicine, and computerized administration and scoring are needed.

Adolescent↗

PubMed2001

The effect of late doses on the achievement of seroprotection and antibody titer levels with hepatitis b immunization among adolescents.

OBJECTIVE: To determine the effect of varying dosing schedules and predictor variables on the seroprotection rates and geometric mean titer levels resulting from the hepatitis B vaccination series among adolescents. METHODS: Adolescents received the hepatitis B vaccination series at varying schedules according to their natural adherence patterns. Data collected included participants' medication use; chronic illness; use of cigarettes, alcohol, and marijuana; age; race/ethnicity; and body mass index. Participants' dates of vaccinations were recorded and titer levels for hepatitis B surface antibody were drawn ~12 and 24 months after study enrollment. The data for 498 participants were analyzed using chi(2) tests, Student t tests, logistic regression models, and analysis of variance. RESULTS: Seroprotection rates among adolescents were not affected by late vaccinations. The only factors affecting the achievement of seroprotection ~12 and 24 months after the first vaccination were body mass index and the number of immunizations received. Increased time between doses 1 and 2 and doses 2 and 3 showed a trend toward correlating with increasing titer levels. CONCLUSIONS: Although adolescents at risk of acquiring hepatitis B should receive the hepatitis B vaccination series in a timely fashion, late doses are not detrimental, and may be beneficial, to achieving high antibody levels against the hepatitis B virus.

Adolescent↗

PubMed2000

The association between adolescent spirituality and voluntary sexual activity.

PURPOSE: The purpose of this study was to describe the spectrum of adolescent spirituality and to determine the association between dimensions of spirituality and voluntary sexual activity (VSA) in adolescents. DESIGN: A sample of 141 consecutive youth aged 11-25 years presenting to an urban, hospital-based adolescent medicine clinic completed a 153-item instrument assessing sociodemographics, psychosocial parameters, and eight specific aspects of spirituality including: (1) religious attendance, (2) religious importance, (3) intrinsic and (4) extrinsic religious motivation, (5) belief in God, (6) belief in divine support, (7) existential aspects of spirituality, and (8) spiritual interconnectedness. Adolescents were also asked about VSA. RESULTS: Sixty-one percent of respondents were African-American and 67.4%, female; mean age was 16.0+/-2.4 years. Adolescent religious attendance was equally distributed across the categories from "none" to "weekly or greater" attendance. Over 90% felt religion was somewhat important in their lives. Over 85% reported belief in God. Fifty-six percent of respondents reported a history of VSA. Greater importance of religion (p = 0.035) and higher spiritual interconnectedness with friends (p = 0.033) were inversely associated with VSA. A multiple logistic regression model including age, gender, race, socioeconomic status, and specific denomination of religious faith, importance of religion, and spiritual interconnectedness found that spiritual interconnectedness with friends (OR = 0.92, 95% CI = 0.85, 0.99) and age (OR = 1.75, 95% CI = 1.34, 2.28) were independent predictors of VSA. CONCLUSIONS: Spirituality is a common facet of adolescents' lives. Younger age and higher spiritual interconnectedness, particularly interconnectedness among spiritual friends, are independently associated with a lower likelihood of VSA.

Adolescent↗

PubMed2000

Reliabilities of short substance abuse screening tests among adolescent medical patients.

OBJECTIVE: To determine the internal consistency and 1-week test-retest reliability of the Simple Screening Instrument for Alcohol and Other Drug Abuse (SSI-AOD), the CAGE-AA (CAGE questions adapted for adolescents), and 4 modified items from the Drug and Alcohol Problem QuickScreen (DAP-4) among adolescents. METHODS: Fifteen- to 18-year-old medical patients (n = 173) completed screening tests during a routine medical visit and then again 1 week later. Internal consistency for each test and retest was calculated using Cronbach's alpha, and 1-week test-retest reliability was calculated by using Winer's unbiased estimate of the intraclass correlation coefficient (r). RESULTS: The SSI-AOD has good internal consistency (alpha =.83) and the CAGE-AA questions acceptable internal consistency (alpha =.60). Alpha varied with gender and race, and item analysis indicated the CAGE-AA test could be improved. As expected, the DAP-4 had a lower alpha score (.46). All screening instruments studied had high 1-week test-retest reliabilities (range r =.82-.90). CONCLUSIONS: The SSI-AOD is a reliable substance abuse screening instrument among adolescent medical patients. The CAGE-AA questions must be further revised and tested before their use can be recommended. The DAP-4 questions are likely measuring different, but important, constructs.

Adolescent↗

PubMed2000

Endocrinologic and psychological effects of short-term dexamethasone in anorexia nervosa.

Patients with anorexia nervosa (AN) have hyperactivity of their hypothalamic-pituitary-adrenal (HPA) axis, sometimes accompanied by elevations of cortisol. We examined whether the normal effects of short-term dexamethasone treatment upon HPA axis suppression and appetite stimulation are observed in these patients. Five young women with AN and ten healthy female controls received one week of high-dose oral dexamethasone (2 mg/m2/d) preceded and followed by hormonal evaluation of sensitivity to glucocorticoids and psychological assessments. No differences in hormone levels of the HPA axis were observed between the two groups and control groups at baseline, after dexamethasone suppression, or following ACTH stimulation testing. However, fasting insulin levels were significantly lower in the AN group, both before and after dexamethasone therapy and their serum leptin levels were also significantly lower. The AN group had significantly lower scores on the Anorexia Nervosa Subtest and the Beck Depression Inventory after dexamethasone compared to controls. On daily analog scales, AN patients had higher anxiety scores while on dexamethasone. Normal sensitivity to glucocorticoids was observed in all parameters examined except for mild abnormalities in pancreatic beta-cell function. These data suggest that AN may represent a state of partial glucocorticoid resistance, as in other states of restricted food intake. Furthermore, these pilot data, including the effects of dexamethasone upon psychological outlook in AN, suggest that glucocorticoids are not an effective therapy for these patients.

Adolescent↗

PubMed1999

Weapon carrying on school property among middle school students.

OBJECTIVE: To examine the association between carrying a weapon at school and the age of onset of substance use, other indicators of violence, and other health risk behaviors among middle school students. DESIGN: In 1995, a modified version of the Centers for Disease Control and Prevention Youth Risk Behavior Survey was administered to 2227 students (49% were female) attending 53 (of 463) randomly selected middle schools in North Carolina. Weapon carrying on school property during school hours was measured with 2 questions assessing carrying a gun and carrying other weapons such as knives or clubs. The Youth Risk Behavior Survey also assessed other indicators of violence, drug use, suicide plans and attempts, and being threatened with a weapon at school. Variables significantly (P< or =.001) associated with gun and other weapon carrying by chi2 tests were analyzed with stepwise logistic regression using the likelihood ratio approach. Odds ratios (ORs) were adjusted for all other variables in the model and 95% confidence intervals (CIs) were computed. RESULTS: Our study showed that 3% of students had carried a gun and 14.1% had carried a knife or club to school. Gun carrying was associated with increased age (OR, 1.57 [95% CI, 1.15-2.14]); male sex (OR, 5.62 [95% CI, 2.42-13.03]); minority ethnicity (OR, 3.30 [95% CI, 1.55-5.05]); and earlier age of onset of cigarette (OR, 0.85 [95% CI, 0.74-0.97]), alcohol (OR, 0.81 [95% CI, 0.71-0.94]), marijuana (OR, 0.81 [95% CI, 0.71-0.92]), and cocaine use (OR, 0.73 [95% CI, 0.62-0.86]). Knife or club carrying was associated with age (OR, 1.32 [95% CI, 1.14-1.53]); male sex (OR, 2.39 [95% CI, 1.77-2.32]); and ear-lier age of onset of cigarette (OR, 0.88 [95% CI, 0.84-0.94]), alcohol (OR, 0.81 [95% CI, 0.76-0.86]), and marijuana use (OR, 0.77 [95% CI, 0.72-0.83]). Gun carrying was also associated with frequency of cigarette (OR, 1.34 [95% CI, 1.14-1.57]), alcohol (OR, 4.59 [95% CI, 1.27-16.58]), cocaine (OR, 2.96 [95% CI, 1.29-6.82]), and marijuana use (OR, 3.66 [95% CI, 1.67-8.06]) after adjusting for male sex and minority ethnicity. Carrying a knife or club was associated with carrying a gun (OR, 1.83 [95% CI, 1.31-2.55]); being threatened with a weapon at school (OR, 1.65 [95% CI, 1.10-2.49]); fighting (OR, 4.62 [95% CI, 2.56-8.37]); frequency of alcohol (OR, 2.91 [95% CI, 1.88-4.50]) and cigarette use (OR, 1.20 [95% CI, 1.10-1.31]); and a suicide plan (OR, 1.54 [95% CI, 1.07-2.20]). CONCLUSIONS: Middle school students are more likely to carry a knife or club (14.1%) than a gun (3%) to school. Young adolescents who initiate substance use early and engage in it frequently are more likely to carry guns and other weapons to school, after adjusting for age, sex, and ethnicity. Being threatened with a weapon at school and fighting were only associated with knife or club carrying at school. These findings suggest that school-based prevention programs targeting both violence prevention and substance use should be introduced in elementary school.

Adolescent↗

PubMed1999

The relationship between early age of onset of initial substance use and engaging in multiple health risk behaviors among young adolescents.

BACKGROUND: Previous research based on problem-behavior theory has found that early age of onset of substance use is associated with engaging in multiple health risk behaviors among high school students. It is unknown whether these relationships begin during early adolescence. OBJECTIVE: To examine the relationships between early age of onset of cigarette, alcohol, marijuana, and cocaine use and engaging in multiple risk behaviors among middle school students. METHODS: A modified version of the Centers for Disease Control and Prevention Youth Risk Behavior Survey was administered to 2227 sixth through eighth grade students attending 53 randomly selected middle schools in North Carolina. A Health Risk Behavior Scale was constructed from 16 behaviors, including indicators of violence and weapon carrying; current substance use; nonuse of helmets when biking, in-line skating or skateboarding; not wearing a seat belt; riding with a driver who had been drinking; and suicide plans. Among this sample of middle school students, the scale had a mean (SD) of 4.1 (2.7) (range=O-15), and had a high internal reliability coefficient (alpha(=0.74). The independent variables included first time use of cigarettes, alcohol, marijuana, and cocaine at age 11 years or earlier; actual age of onset of each substance; race and ethnicity; family composition; sex; school grade; academic ranking; and older age for school grade. These data were analyzed with analysis of variance, Spearman r, and multiple linear regression. RESULTS: All the independent variables were found to be associated (P<.005) with the Health Risk Behavior Scale during the bivariate analyses. When each of these significant variables were entered into a multiple regression model, having smoked at age 11 years or younger accounted for 21.9% of the variation in the Health Risk Behavior Scale. Male sex, early marijuana or cocaine use, older age, lower academic rank, white race, and living in a 1-parent family explained an additional 19.1% of variation in the model (adjusted R2=0.41, P<.001). When the actual ages of onset of the use of substances were analyzed, in order of magnitude; age of onset of smoking; male sex; age of onset of alcohol and marijuana use; age; lower academic ranking; age of onset of cocaine use; white race; and lower academic rating accounted for 52.8% (P<.001) of the variation in the Health Risk Behavior Scale. CONCLUSION: Even when considering sociodemographic factors, early age of onset of cigarette use was the strongest correlate of the number of health risk behaviors in which these young adolescents had engaged. Early onset of use of other substances was also associated with a clustering of health risk behaviors among this sample of middle school students. The findings suggest that screening for early experimentation with tobacco and other substance use will help identify young adolescents at increased risk for engaging in multiple health risk behaviors.

Adolescent↗

PubMed1999

Adolescent tobacco use and cessation.

Over one third of high school students in the United States smoke cigarettes, and close to 10% use spit tobacco. Tobacco use clusters with alcohol use, other substance abuse, and other health risk behaviors among teenagers. Public health and law enforcement policy changes, combined with effective substance use prevention programs in both elementary and middle school, are needed to prevent the early age of onset of tobacco use by youth. Primary care providers can play a key role in identifying children and adolescents who smoke or use spit tobacco and helping them discontinue their tobacco use.

Adolescent↗

PubMed1999

Choice of feeding method of adolescent mothers: does ego development play a role?

STUDY OBJECTIVES: The purpose of this study was to determine whether, among childbearing adolescents, ego development was associated with intention to breast-feed and with actual breast-feeding behavior at birth and at 2 weeks postpartum. In addition, we sought to determine whether positive attitudes toward breast-feeding influenced pregnant adolescents' intentions to breast-feed and actual breast-feeding at the hospital and at 2 weeks postpartum. We hypothesized that adolescents with higher levels of ego development and positive attitudes toward breast-feeding would be more likely to intend to breast-feed and to actually breast-feed. DESIGN: Prospective cohort study of pregnant adolescents who completed questionnaires, Loevinger's Sentence Completion Tests, and attitudes toward breast-feeding scales before delivery and a follow-up questionnaire at 2 weeks postpartum assessing feeding practice in the hospital and at 2 weeks postpartum. SETTING: Two adolescents' clinics and two "teen-and-tot" clinics in urban teaching hospitals. PARTICIPANTS: Fourteen- to 22-year-old pregnant adolescents who had never given birth and who planned to carry their pregnancy to term and parent their children. MAIN OUTCOME MEASURES: 1) Intended feeding practice during pregnancy, 2) feeding method in the hospital, and 3) feeding method at 2 weeks postpartum. RESULTS: Of the 125 subjects enrolled in the study, 106 were at 2 weeks postpartum or more. Of these 106 participants, 75% (n = 78) completed more than 75% of the attitudes toward breast-feeding scale and Loevinger's Sentence Completion Test and are included in these analyses. Mean age at entry was 17.8 +/- 1.5 years (range, 14.3 to 21.8 years). Mean gestational age at enrollment was 21.2 +/- 11.6 weeks (range, 4 to 41 weeks). Of the 78 participants, 12% (n = 9) were at the preconformist, 85% (n = 66) at the conformist, and 4% (n = 3) at the postconformist level of ego development as determined by the Sentence Completion Test. Attitudes toward breast-feeding, intention to breast-feed, breast-feeding in the hospital, and breast-feeding at 2 weeks postpartum were not significantly associated with adolescents' stages of ego development. Almost three fourths of the adolescents intended to breast-feed, and 85% tried breast-feeding in the hospital. A total of 97% (56 of 58) of those who intended to breast-feed tried breast-feeding in the hospital compared with 40% (4 of 10) of those who did not intend to breast-feed (P < .0001). At 2 weeks postpartum, 58% of the participants were still breast-feeding. Of those participants who intended to breast-feed, 67% (39 of 58) were breast-feeding at 2 weeks postpartum compared with 10% (1 of 10) who did not intend to breast-feed (P = .001). The mean breast-feeding attitude score was 53.7 +/- 11.6 (range, 25 to 72). The mean breast-feeding attitude score was higher for those who intended to breast-feed than for those who intended to formula-feed (P = .009), but the score was not associated with breast-feeding in the hospital or at 2 weeks postpartum. CONCLUSION: Adolescent mothers were predominantly in ego stages 4 and 5, the conformist level. Because ego development was not associated with outcome measures in this study, ego development may not be a crucial factor when designing interventions to facilitate breast-feeding among adolescents. Attitudes toward breast-feeding were associated with the intention to breast-feed but not behaviors; the intention to breast-feed was significantly associated with breast-feeding behaviors.

Adolescent↗

PubMed1999

Primary care physicians' use of screening echocardiography.

OBJECTIVE: To survey primary care physicians to understand their reasons for using echocardiography to screen for congenital heart disease in children and to assess their understanding of the costs associated with cardiology services. DESIGN: A questionnaire. PARTICIPANTS: Eight hundred sixty-seven pediatricians and family physicians in our region were surveyed, 494 (57%) responded and 466 were used for the analysis. RESULTS: The majority of pediatricians and family physicians in our area do not know the relative costs associated with cardiology consultation and echocardiography. They also believe it likely that a cardiologist will routinely obtain an echocardiogram as part of their evaluation of a child with a murmur, although this is not the case. The availability and convenience of specialist appointments was found to significantly influence the decision to order an echocardiogram. Family physicians were significantly more likely than pediatricians to order an echocardiogram for a variety of clinical indications. CONCLUSIONS: Improving primary care physicians' knowledge of the costs associated with cardiology services and current cardiology practice patterns, in addition to improving the availability of cardiology referrals, may reduce the number of expensive and unnecessary echocardiograms. echocardiography, heart murmur, congenital heart disease, cost-effectiveness.

Cardiology↗

PubMed1999

Gender differences in risk behaviors among adolescents who experience date fighting.

OBJECTIVE: Although dating violence frequently begins during adolescence, few studies have focused on date fighting in middle and high school students. Fewer studies have studied gender differences in date violence. This study examines whether gender-specific patterns of risk behaviors exist among adolescents who report date fighting. DESIGN: The study was conducted on data collected from 21 297 students in grades 8 through 12 participating in the Vermont 1995 Youth Risk Behavior Survey. Data were analyzed on 20 724 students (females = 50.1%) who reported: 1) never having been involved in a physical fight (n = 8737); 2) that their last physical fight was with a girlfriend, boyfriend, or other dating partner (n = 432); and 3) that their last fight was with someone other than a dating partner (n = 11 555). Indicators of violence (weapon carrying, being threatened, and fighting), suicide attempts, substance use, sexual behavior, and pregnancy were analyzed with chi(2) tests. Significant variables were analyzed with stepwise logistic regression. RESULTS: Of the males, 1.8% and of the females, 4.2% reported that their last fight was with a boyfriend, girlfriend, or dating partner. Risk behaviors significantly associated among females who only experienced date fighting included the number of male sexual partners in the past 3 months (adjusted odds ratio: 1. 48; 95% confidence interval: 1.26-1.74), number of suicide attempts in the past 12 months (1.55; 1.30-1.85), riding in a car with a drinking driver (1.23; 1.10-1.37), injection of illegal drugs (2.87; 1.10-7.50), use of alcohol before last sexual encounter (1.53; 1. 27-1.86), number of pregnancies (1.66; 1.26-2.21), forced sex (2.92; 2.18-3.91), and inhalant use (1.19; 1.06-1.34). Risk behaviors significantly associated among males who experienced only date fighting were sexual activity (4.11; 2.24-7.53), number of male partners in the past 3 months (1.40; 1.12-1.75), number of times of getting someone pregnant (1.68; 1.17-2.40), experiencing forced sex (2.38; 1.11-5.13), and the number of times threatened with physical violence in past 12 months (1.82; 1.53-2.17). When compared with adolescents who reported fighting with someone other than a date, risk factors significantly associated with date fighting among females were the number of male sexual partners in the past 3 months (1.21; 1.10-1.34), older age (1.21; 1.10-1.34), carrying a weapon in the past 30 days (.77;.66-.90), experiencing forced sex (1.70; 1. 30-2.22), condom non-use (1.96; 1.60-2.41), and number of times of being threatened with physical violence in past 12 months (1.11; 1. 01-1.22). The risk factors among males were the number of male sexual partners in the past 3 months (1.43; 1.28-1.60), experiencing forced sex (1.91; 1.02-3.60), and older age (1.34; 1.14-1.57). CONCLUSIONS: The patterns of risk behaviors differed among male and female adolescents reporting dating violence. Females who reported date fighting were more likely than were nonfighters to have attempted suicide, to engage in sexual and human immunodeficiency virus risk behaviors (use of injectable drugs), to have been pregnant, experienced forced sex, and to have ridden in a car with a drinking driver. Sexual behaviors, including same-gender sexual partners, forced sex, and having been threatened with physical violence, were associated with date fighting among males. These findings are important in screening adolescents at risk for date violence.date fighting, adolescence, risk behaviors, gender.

Adolescent↗

PubMed1998

Gender differences in risk behaviors associated with forced or pressured sex.

OBJECTIVE: To determine whether gender-specific patterns of risk behaviors are associated with a self-reported history of ever having been forced or pressured to have sexual intercourse among sexually active adolescents. SUBJECTS AND METHODS: In 1995, 21,297 eighth- through 12th-grade students in 79 public and private schools in Vermont were anonymously surveyed. Data were analyzed for 7884 sexually active students (3931 girls and 3953 boys). Demographic variables and indicators of violence, suicide, recent substance use, sexual behavior, pregnancy, and weight control behavior were assessed. Data were analyzed with multiple logistic regression. RESULTS: Of the sexually active students, 30.3% of the girls and 9.9% of the boys reported ever being forced or pressured to have sexual intercourse. Among sexually active girls, being in 1 or more physical fights in the past year (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.40-1.94), seriously considering suicide (OR, 1.97; CI, 1.69-2.31), more years of sexual activity (OR, 1.52; CI, 1.43-1.61), not using a condom at last sexual intercourse (OR, 1.28; CI, 1.09-1.49), and having been pregnant more often (OR, 1.40; CI, 1.16-1.69) were associated with having been forced or pressured to have sex. For sexually active boys, seriously considering suicide (OR, 1.64; CI, 1.23-2.20), more years of sexual activity (OR, 1.21; CI, 1.12-1.31), more male partners in the past 3 months (OR, 1.30; CI, 1.14-1.48), more female partners in the past 3 months (OR, 1.09; CI, 1.01-1.18), not using a condom at last sexual intercourse (OR, 1.37; CI, 1.03-1.82), having been involved in more pregnancies (OR, 1.64; CI, 1.29-2.08), and having vomited or used laxatives (OR, 3.44; CI, 2.18-5.43) were associated with having been forced or pressured to have sex. CONCLUSIONS: Patterns of risk behaviors differed among sexually active male and female adolescents reporting being forced or pressured to have sex. Having been forced or pressured to have sex was associated with externalizing behavior, such as fighting, among girls and with internalizing behavior, such as bulimia, among boys. These unexpected associations have notable implications for screening adolescents for a history of having been forced or pressured to have sex.

Adolescent↗

PubMed1998

Problem dieting behaviors among young adolescents.

OBJECTIVE: To examine dieting, eating and exercise behaviors, use of diet pills, and vomiting or use of laxatives to lose weight among younger adolescents. DESIGN: Analysis of data from a modified version of the Youth Risk Behavior Survey administered to middle school students in North Carolina in 1995. SETTING: Fifty-three randomly selected middle schools in North Carolina. SUBJECTS: Two thousand three hundred thirty-one students in the sixth, seventh, and eighth grades. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Responses to questions regarding weight control practices, including vomiting or laxative use, dieting, exercise, or diet pill use. RESULTS: Of the students surveyed, 110 (9.7%) of the girls and 46 (4.0%) of the boys reported vomiting or using laxatives to lose weight. Among the girls, vomiting or laxative use was associated with feeling overweight, other weight loss practices, older age, being a poor student, smoking, eating more salads or vegetables, and eating more candy or other sweets (P< or =.01). A logistic regression model consisting of diet pill use, dieting to lose weight, lower academic achievement, and currently trying to lose weight correctly classified 92% of female students who had or had not vomited or used laxatives. Among boys, vomiting or laxative use was associated with feeling overweight, other weight loss practices, minority racial status, smoking, frequency of eating hamburgers or other high-fat meats, and frequency of eating french fries or potato chips (P< or =.01). A model consisting of diet pill use, minority race, dieting to lose weight, smoking, feeling overweight, and number of servings of hamburgers, hot dogs, or barbecue correctly classified 97% of the boys who had or had not vomited or used laxatives. CONCLUSION: Younger adolescents trying to lose weight engage in a variety of problem dieting and weight loss behaviors that can compromise health and may be associated with eating disorders.

Adolescent↗

PubMed1998

Victimization, use of violence, and drug use at school among male adolescents who engage in same-sex sexual behavior.

OBJECTIVE: To examine the relationship between the number of male sexual partners of adolescent males and the frequency of victimization at school, missed school because of fear, used drugs at school, and engagement of fighting and weapon carrying both in and out of school. STUDY DESIGN: Sexually active male adolescents (N = 3886) in 8th through 12th grades were administered the 1995 Vermont Youth Risk Behavior Survey. RESULTS: A total of 8.7% of male adolescents reported one or more male sexual partners. Alcohol, marijuana, and smokeless tobacco use at school, not attending school because of fear, having been threatened or injured with a weapon at school, and weapon carrying at school accounted for 15.8% of the variation in the number of male sexual partners (p < 0.0001). Suicide attempts, school absence because of fear, cigarette smoking, alcohol use, and smokeless tobacco use at school, frequency of fighting requiring medical treatment, carrying a weapon,aand carrying a weapon at school accounted for 17.2% out of 100% of the variation in the number of male sexual partners (p < or 0.00001). CONCLUSION: The number of male sexual partners reported by sexually active male adolescents correlated with a higher frequency of victimization, use of violence and drug use at school. Frequency of suicide attempts and fighting outside of school were also correlated with the number of same-sex sexual partners.

Adolescent↗

PubMed1998

Adolescent males involved in pregnancy: associations of forced sexual contact and risk behaviors.

PURPOSE: To determine whether sexually active adolescent males who report being the victim of forced sexual contact and engaging in health risk and problem behaviors are more likely to report getting someone pregnant. METHODS: In 1995, 4159 students in Grades 9-12 in 59 randomly selected public high schools in Massachusetts were anonymously surveyed using the Youth Risk Behavior Survey (YRBS). Data were analyzed for 824 sexually active males. Demographic variables and indicators of sexual behavior, pregnancy, violence, and suicide were assessed. Data were analyzed with multiple logistic regression. RESULTS: A total of 12.0% of sexually active males reported having been involved in a pregnancy. The proportion of males who reported getting a partner pregnant increased with age. Of the sample, 8.1% gave a history of having had sexual contact against their will. Of those who reported forced sexual contact, 36.4% reported having been involved in a pregnancy; of the males who did not report a history of forced sexual contact, 9.4% were involved in a pregnancy (CV = 0.23; p < 0.00001). Based on multiple logistic regression, forced sexual contact [odds ratio (OR) 3.56; 95% confidence interval (CI) 1.79-7.09], frequency of weapon carrying on school property (OR 1.39; 95% CI 1.18-1.64), number of cigarettes smoked per day (OR 1.22; 95% CI 1.08-1.38), number of sexual partners in the previous 3 months (OR 1.43; 95% CI 1.25-1.65), and condom nonuse at last intercourse (OR 1.80; 95% CI 1.06-3.02) correctly classified 89.9% of the males who were involved in a pregnancy. CONCLUSION: This study highlights the association between health-risk and problem behaviors, forced sexual contact, and involvement in pregnancy among sexually active male high school students. In our analysis, a history of forced sexual contact was associated with a higher risk of high school males' involvement in pregnancy. These results strongly suggest the importance of screening sexually active males for a history of forced sexual intercourse and health risk and problem behaviors in the effort to prevent teenage pregnancy and childbearing.

Adolescent↗

PubMed1998

Aggressors or victims: gender and race in music video violence.

OBJECTIVE: To examine portrayals of violence in popular music videos for patterns of aggression and victimization by gender and race. DESIGN AND SETTING: Content analysis of 518 music videos broadcast over national music television networks, Black Entertainment Television (BET), Country Music Television (CMT), Music Television (MTV), and Video Hits-1 (VH-1) during a 4-week period at randomly selected times of high adolescent viewership. MAIN OUTCOME MEASURES: Differences in the genders and races portrayed as aggressors and victims in acts of violence. RESULTS: Seventy-six (14.7%) of the analyzed music videos contained portrayals of individuals engaging in overt interpersonal violence, with a mean of 6.1 violent acts per violence-containing video. Among the 462 acts of violence, the music video's main character was clearly the aggressor in 80.1% and the victim in 17.7%. In 391 (84.6%) of the violence portrayals, the gender of the aggressor or victim could be determined. Male gender was significantly associated with aggression; aggressors were 78.1% male, whereas victims were 46.3% female. This relationship was influenced by race. Among whites, 72.0% of the aggressors were male and 78.3% of the victims were female. Although blacks represent 12% of the United States population, they were aggressors in 25.0% and victims in 41.0% of music video violence. Controlling for gender, racial differences were significant among males; 29.0% of aggressors and 75.0% of victims were black. A logistic regression model did not find direct effects for gender and race, but revealed a significant interaction effect, indicating that the differences between blacks and whites were not the same for both genders. Black males were more likely than all others to be portrayed as victims of violence (adjusted odds ratio = 28.16, 95% confidence interval = 8.19, 84.94). CONCLUSIONS: Attractive role models were aggressors in more than 80% of music video violence. Males and females were victims with equivalent frequency, but males were more than three times as likely to be aggressors. Compared with United States demographics, blacks were overrepresented as aggressors and victims, whereas whites were underrepresented. White females were most frequently victims. Music videos may be reinforcing false stereotypes of aggressive black males and victimized white females. These observations raise concern for the effect of music videos on adolescents' normative expectations about conflict resolution, race, and male-female relationships.

Black or African American↗

PubMed1998

The association between health risk behaviors and sexual orientation among a school-based sample of adolescents.

OBJECTIVE: This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. DESIGN: This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: "Which of the following best describes you?" A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models. RESULTS: GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10.6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03-3.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual partners (1.27; 1.06-1.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1. 20-1.59) and number of sexual partners in the previous 3 months (1. 47; 1.31-1.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08-1.40) and using marijuana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 +/- 4.49) compared with the overall student population (mean = 3.45 +/- 3.15). CONCLUSION: GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.

Adolescent↗