Erin K. O'Loughlin

Prevalence and Correlates of Exergaming in Youth

OBJECTIVES: Less than 15% of children and adolescents participate regularly in physical activity (PA) and, with ever-increasing obesity, strategies to improve PA levels in youth are urgently needed. Exergaming offers a PA alternative that may be especially attractive in our increasingly technophilic society. However, there are no observational studies of exergaming in population-based samples of adolescents. The purpose of this study was to investigate potential sociodemographic, lifestyle, psychosocial, weight-related, and mental health correlates of exergaming as well as describe the type, timing, and intensity of exergaming in a population-based sample of adolescents. METHODS: Data on exergame use and potential sociodemographic, lifestyle, psychosocial, weight-related, and mental health correlates of exergaming were collected in mailed self-report questionnaires completed by 1241 grade 10 and 11 students from the Montreal area with a mean age of 16.8 years (SD = 0.05 years; 43% male) participating in the AdoQuest study. The independent correlates of exergaming were identified in multivariable logistic regression models. RESULTS: Nearly one-quarter (24%) of participants reported exergaming. Exergamers played 2 days per week on average, for ∼50 minutes each bout; 73% of exergamers played at a moderate or vigorous intensity. Exergamers were more likely than nonexergamers to be girls, to play nonactive video games, to watch ≥2 hours of television per day, to be stressed about weight, and to be nonsmokers. CONCLUSIONS: Many adolescents exergame at intensity levels that could help them achieve current moderate-to-vigorous PA recommendations. Interventions that encourage exergaming may increase PA and decrease sedentary behavior in select youth subgroups, notably in girls.

Incidence and Determinants of Cigarette Smoking Initiation in Young Adults

PURPOSE To describe the incidence and identify predictors of smoking initiation in young adults. METHODS Data were collected in self-report questionnaires in 22 cycles over 13 years in a prospective cohort investigation of 1,293 students recruited in 1999-2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Participants were 12.7 years of age on average at cohort inception and 24.0 years of age in cycle 22. Independent predictors of smoking initiation in young adulthood (post-high school) were identified in multivariable logistic regression analysis using generalized estimating equations. RESULTS Of 1,293 participants, 75% initiated smoking by cycle 22. Of these, 44%, 43%, and 14% initiated before high school, during high school, and in the 6 years after high school, respectively. The incidence density rate of initiation was .33, .13, .14, .11, and .12 initiation events per person-year in grade 7, 8, 9, 10, and 11, respectively, and .05 post-high school. Independent predictors of smoking initiation in young adults included alcohol use, higher impulsivity, and poor academic performance. CONCLUSIONS A total of 14% of smokers who initiated smoking before age 24 years did so after high school. The predictors of initiation in young adults may provide direction for relevant preventive interventions.

Linking depression symptom trajectories in adolescence to physical activity and team sports participation in young adults

OBJECTIVE The objective of this study is to examine depressive symptom trajectories during adolescence as predictors of physical activity (PA) in young adulthood. METHODS Adolescents residing in Montreal, Canada (n=860) reported their depressive symptoms every 3-4 months during high school in 20 data collections. Three years later, participants reported engaging in moderate and vigorous intensity PA and team sports participation. Trajectories of depressive symptoms were estimated using latent growth modeling and examined as predictors of PA outcomes. RESULTS Three depression symptom trajectory groups were identified during adolescence: low and declining depressive symptom scores (group 1; 37.8%); moderate and stable depressive symptom scores (group 2; 41.6%); and high increasing depressive symptom scores (group 3; 20.6%). In multivariable analyses, group 2 and group 3 participated in less moderate-intensity PA and were less likely to participate in team sports compared to group 1. CONCLUSIONS The importance of examining intensity and type of PA as outcomes of depressive symptoms is highlighted. Targeted approaches are needed to encourage adolescents with moderate to high depression symptoms to engage in PA and team sports to improve their health and well-being.

The association between past and current physical activity and depressive symptoms in young adults: a 10-year prospective study.

PURPOSE The objectives of this study were to assess (1) the longitudinal associations of past moderate-to-vigorous physical activity (MVPA) and involvement in team sports during secondary school with depressive symptoms in early adulthood, and (2) the cross-sectional associations of current MVPA and involvement in team sports with depressive symptoms during young adulthood. METHODS Data were drawn from the Nicotine Dependence in Teens study, which is an ongoing prospective cohort study of 1293 adolescents aged 12-13 years at baseline (52% female). Data analyses involved latent growth curve modeling and multiple hierarchical linear regression models. RESULTS Current MVPA (β = -0.12), but not past MVPA, participation was significantly negatively related to depressive symptoms during young adulthood (P < .05). Both current and past involvement in team sports were significantly negatively related to depressive symptoms (β ≥ -0.09; P < .05); however, these associations were no longer significant (P = .08) when covariates were controlled for. CONCLUSIONS Findings provide insight about the unique associations between the timing and type of physical activity and depressive symptoms, suggesting that physical activity within team sport contexts should be encouraged so that young adults may experience less depressive symptoms.

Determinants of Sustained Binge Drinking in Young Adults

BACKGROUND Binge drinking occurs frequently among young adults, posing risks to health and safety. Little is known, however, about which drinkers continue to binge later into adulthood. We sought to identify predictors of sustained binge drinking behaviors in young adulthood. METHODS Participants from the Nicotine Dependence in Teens (NDIT) cohort (n = 609, 53% female) completed self-report questionnaires in 20 survey cycles (SCs) during secondary school between 1999 and 2005, and in 2 postsecondary school SCs in 2007 to 2008 (SC 21; Mage = 20 years) and 2011 to 2012 (SC 22; Mage = 24 years). Participants reporting past-year binge drinking in both SCs 21 and 22 were categorized as sustainers (n = 517). Using multivariable logistic regression, we investigated 25 potential predictors of sustained binge drinking, binge-drinking frequency, and change in frequency over time among sustainers. RESULTS Compared with stoppers, sustainers (85% of participants) were more likely to be younger, male, and to have no college/university education. Sustainers began drinking alcohol and binge drinking earlier, drank at least monthly during more secondary school grades, binged more frequently at age 20, and scored higher on impulsivity and novelty seeking in adolescence. Among sustainers, frequent binge drinkers were more likely to be male, to be nonstudents, to score higher on novelty seeking, and to have reported more depressive symptoms in adolescence. Sustainers who decelerated their binge frequency between SCs 21 and 22 were more likely to be female, to have achieved a higher level of education, and to report more depressive symptoms in SC 21. CONCLUSIONS The determinants of sustained binge drinking are similar to predictors of binge drinking reported in the literature. Early identification of, and intervention with, youth who are impulsive, inclined toward novelty seeking, and who report higher levels of early sub clinical depressive symptoms might forestall their involvement in risky alcohol use.

Symptoms of depression are longitudinally associated with sedentary behaviors among young men but not among young women.

OBJECTIVE A habitual sedentary lifestyle is associated with adverse health outcomes; however, the predictors of sedentary behaviors have not been sufficiently explored to inform the development and delivery of effective interventions to reduce sedentary behaviors. This study examined whether reports of symptoms of depression could predict weekly time spent in sedentary behaviors (i.e., television watching, computer use) 4years later. METHOD Self-reported symptoms of depression were assessed at age 20years (2007-08), and television watching time and computer use were assessed at age 24years (2011-12) in 761 adults (45% men) participating in the Nicotine Dependence in Teens study. Data were analyzed using linear regression analysis, with separate models for men and women. RESULTS After controlling for past sedentary behavior, symptoms of depression at age 20years predicted more computer use 4years later in men (R(2)=.21, β=.13, p<.05), but not in women. Symptoms of depression did not predict television watching. CONCLUSIONS Results highlight the need to distinguish between types of sedentary behaviors as their predictors may differ. Further, they provide support for the hypothesis that psychological factors, in this case symptoms of depression, may relate to select sedentary behaviors in young men.

Physical activity motivation mediates the association between depression symptoms and moderate-to-vigorous physical activity

OBJECTIVE To test if motivational regulations (i.e., amotivation, external, introjected, identified, and intrinsic) mediate the association between depression symptoms and moderate-to-vigorous physical activity (MVPA) in young adults. METHOD A total of 319 young adults from Montreal, Quebec participating in the Nicotine Dependence in Teens (NDIT) study provided self-report data on depression symptoms at age 20 (SD=0.7 years) and motivational regulations at age 24 (SD=0.7 years). MVPA was assessed using a self-report questionnaire at age 20 (i.e., at the same time motivation was measured) and using accelerometers one month later. Multiple mediation analysis with bootstrapping was employed to analyze the data. RESULTS Controlling for age, sex and self-reported MVPA at age 20 years; introjected regulation was a significant mediator of the association between depression symptoms and MVPA (R(2) adj=0.12; point estimate=-0.0011; BCa CI=-0.15 to -0.01). CONCLUSION Depression symptoms may undermine controlling forms of motivation, resulting in decreased MVPA. Intervention strategies may be needed to address depression symptoms in young adults to promote sustained MVPA.

Sustained Waterpipe Use Among Young Adults

INTRODUCTION Waterpipe smoking is increasingly popular among North American youth. However, the extent to which waterpipe use is sustained over time is not known. The objective of this study was to describe the frequency and the predictors of sustained waterpipe use over 4 years among young adults. METHODS Data were available in a prospective cohort investigation of 1,293 seventh-grade students recruited in a convenience sample of 10 secondary schools in Montreal, Canada, in 1999. Data on past-year waterpipe use were collected from 777 participants when they were age 20 years on average (in 2007-2008) and again when they were age 24 years (in 2011-2012) in mailed self-report questionnaires. Twenty potential predictors of sustained waterpipe use were tested, each in a separate multivariable logistic regression model. RESULTS About 51% of 182 waterpipe users at age 20 reported waterpipe use 4 years later. Most sustained users (88%) smoked a waterpipe less than once a month. Parental smoking, being currently employed, less frequent cigarette smoking, and more frequent marijuana use were associated with sustained waterpipe use. CONCLUSIONS Half of the young adults who used waterpipe during young adulthood reported use 4 years later. Young adults who sustain waterpipe use appear to do so as an activity undertaken occasionally to socialize with others.

Nicotine dependence and sleep quality in young adults

INTRODUCTION More cigarette smokers report poor sleep quality than non-smokers, but the association between nicotine dependence (ND) and sleep quality has not been well-characterized. The objective of this study was to describe the associations among frequency and intensity of cigarette smoking, ND symptoms, and sleep quality in young adults. METHODS Data on past-year smoking frequency, number of cigarettes smoked in the past month, five ND indicators (i.e., withdrawal, craving, self-medication symptoms, mFTQ, ICD-10 criteria for tobacco dependence), and sleep quality (measured with the Pittsburgh Sleep Quality Index (PSQI)) were collected in 2011-12 in self-report questionnaires completed by 405 young adult smokers (mean age 24 (0.6) years; 45% male; 45% daily smokers) participating in a longitudinal investigation of the natural course of ND. Associations between indicators of cigarette smoking, ND symptoms, and sleep quality were examined in multivariable logistic regression analyses controlling for age, sex, mothers education, and alcohol use. RESULTS Thirty-six percent of participants reported poor sleep quality (PSQI>5). Higher cigarette consumption (OR(95% CI), 1.03(1.001-1.05)) but not frequency of past-year smoking, more frequent withdrawal symptoms (1.05(1.004-1.10)), more frequent cravings (1.05(1.004-1.10)), higher mFTQ scores (1.14(1.02-1.27)), and endorsing more ICD-10 criteria for tobacco dependence (1.19(1.04-1.36)) were also associated with poor sleep quality. CONCLUSION Cigarette smoking and ND symptoms are associated with poor sleep quality in young adult smokers. Advice from practitioners to cut back on number of cigarettes smoked per day and treatment of ND symptoms may improve sleep quality in young adult smokers.

Screen and nonscreen sedentary behavior and sleep in adolescents

OBJECTIVE This study examined the associations between screen (computer, videogame, TV) and nonscreen (talking on the phone, doing homework, reading) sedentary time, and sleep in adolescents. PARTICIPANTS Data were drawn from AdoQuest, a prospective investigation of 1843 grade 5 students aged 10-12 years at inception in the greater Montreal (Canada) area. METHODS Data for this cross-sectional analysis on screen and nonscreen sedentary time, sleep duration, and daytime sleepiness were collected in 2008-2009 from 1233 participants (67% of 1843) aged 14-16 years. RESULTS Computer and videogame use >2 hours per day was associated with 17 and 11 fewer minutes of sleep per night, respectively. Computer use and talking on the phone were both associated with being a short sleeper (<8 hour per night) (odds ratio =2.2 [1.4-3.4] and 3.0 [1.5-6.2], respectively), whereas TV time was protective (odds ratio=0.5 [0.3-0.8]). Participants who reported >2 hours of computer use or talking on the phone per day had higher daytime sleepiness scores (11.9 and 13.9, respectively) than participants who reported d2 hours per day (9.7 and 10.3, respectively). CONCLUSIONS Computer use and time spent talking on the phone are associated with short sleep and more daytime sleepiness in adolescents. Videogame time is also associated with less sleep. Clinicians, parents, and adolescents should be made aware that sedentary behavior and especially screen-related sedentary behavior may affect sleep duration negatively and is possibly associated with daytime sleepiness.