Frank J. Elgar

The ‘Freshman 5’: A Meta-Analysis of Weight Gain in the Freshman Year of College

Abstract Objective: (1) To use the available research to estimate the amount of weight gained by college freshman during their first year of college. (2) To identify potential predictors of freshman weight gain. Methods: A meta-analysis was conducted in November 2008. The analysis focused on articles published in English scientific journals between 1985 and 2008 available on the MEDLINE, Web of Science, and PsycINFO databases and excluded studies of weight change over periods beyond freshman year. Results: Twenty-four studies met the inclusion criteria. Based on a pooled sample of 3,401 cases, mean weight gain was 3.86 (95% confidence intervals [CI] = 3.81–3.91) lbs. Potential contributors to gain were recent dieting, high baseline weight, and psychological stress. Conclusions: The first year of college is a period of vulnerability for weight problems. Further research is needed to better understand freshman weight gain and devise appropriate prevention strategies based on predictors of gain.

Stress, social support, and emotional distress in a community sample of pregnant women

Emotional distress in women during pregnancy has been shown to increase the risk of adverse outcomes for women and newborns. Increasingly, assessment and management of mood and anxiety problems during pregnancy entail consideration of life stress and interpersonal relationships with partners, friends, and family members. This study describes cross-sectional relations between life stress, perceived social support, and symptoms of depression and anxiety as well as the mediating influence of social support on relations between stress and symptoms. A community sample of women (N = 2,052) provided self-report data during their second trimester of pregnancy. Empirical fit was found for a structural equation model that depicted the combined influences of sociodemographic factors (i.e., socioeconomic status, age, parity), stress (partner conflict and life events), and social support on symptoms of depression and anxiety, χ2 (df 51) = 310.65, p < .05; CFI = .91. Women who reported low levels of social support showed stronger relations between stress and symptoms than women who reported high levels of social support - indicative of a mediating effect of social support. Consistent with previous studies, results suggest that dyadic psychosocial assessment of pregnant women and their partners may facilitate interventions to augment support networks, thereby reducing the risk of emotional distress.

Socioeconomic inequalities in adolescent health 2002–2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study

BACKGROUND Information about trends in adolescent health inequalities is scarce, especially at an international level. We examined secular trends in socioeconomic inequality in five domains of adolescent health and the association of socioeconomic inequality with national wealth and income inequality. METHODS We undertook a time-series analysis of data from the Health Behaviour in School-aged Children study, in which cross-sectional surveys were done in 34 North American and European countries in 2002, 2006, and 2010 (pooled n 492,788). We used individual data for socioeconomic status (Health Behaviour in School-aged Children Family Affluence Scale) and health (days of physical activity per week, body-mass index Z score [zBMI], frequency of psychological and physical symptoms on 0-5 scale, and life satisfaction scored 0-10 on the Cantril ladder) to examine trends in health and socioeconomic inequalities in health. We also investigated whether international differences in health and health inequalities were associated with per person income and income inequality. FINDINGS From 2002 to 2010, average levels of physical activity (3·90 to 4·08 days per week; p<0·0001), body mass (zBMI -0·08 to 0·03; p<0·0001), and physical symptoms (3·06 to 3·20, p<0·0001), and life satisfaction (7·58 to 7·61; p=0·0034) slightly increased. Inequalities between socioeconomic groups increased in physical activity (-0·79 to -0·83 days per week difference between most and least affluent groups; p=0·0008), zBMI (0·15 to 0·18; p<0·0001), and psychological (0·58 to 0·67; p=0·0360) and physical (0·21 to 0·26; p=0·0018) symptoms. Only in life satisfaction did health inequality fall during this period (-0·98 to -0·95; p=0·0198). Internationally, the higher the per person income, the better and more equal health was in terms of physical activity (0·06 days per SD increase in income; p<0·0001), psychological symptoms (-0·09; p<0·0001), and life satisfaction (0·08; p<0·0001). However, higher income inequality uniquely related to fewer days of physical activity (-0·05 days; p=0·0295), higher zBMI (0·06; p<0·0001), more psychological (0·18; p<0·0001) and physical (0·16; p<0·0001) symptoms, and larger health inequalities between socioeconomic groups in psychological (0·13; p=0·0080) and physical (0·07; p=0·0022) symptoms, and life satisfaction (-0·10; p=0·0092). INTERPRETATION Socioeconomic inequality has increased in many domains of adolescent health. These trends coincide with unequal distribution of income between rich and poor people. Widening gaps in adolescent health could predict future inequalities in adult health and need urgent policy action. FUNDING Canadian Institutes of Health Research.

Income Inequality and School Bullying: Multilevel Study of Adolescents in 37 Countries

PURPOSE To examine the association between income inequality and school bullying in an international sample of preadolescents and to test for mediation of this association by the availability of social support from families, peers, and schools. METHODS The study used economic data from the 2006 United Nations Development Program Human Development Report and survey data from the 2005/2006 Health Behavior in School-aged Children (HBSC) study which included 66,910 11-year-olds in 37 countries. Ecological correlations tested associations between income inequality and bullying among countries. Multilevel linear and ordinal regression analyses tested the effects of income inequality on perceived social support and bullying others at school. RESULTS Income inequality was associated with rates of bullying among the 37 countries (r = .62). Multilevel analyses indicated that each standard deviation increase in income inequality corresponded with more frequent bullying by males (odds ratio = 1.17) and females (odds ratio = 1.24), less family support and school support but more peer support. Social support from families and schools was associated with less bullying after differences in wealth were taken into account; however, social support did not account for the association between income inequality and bullying. CONCLUSIONS Countries with high income inequality have more school bullying among preadolescents than countries with low income inequality. Further study is needed to understand the mechanisms that account for this association. Findings suggest that adolescents in areas of wide income inequality-not only those in deprived schools and neighborhoods- should be a focus of anti-bullying campaigns.

Income inequality, trust and homicide in 33 countries

BACKGROUND Theories of why income inequality correlates with violence suggest that inequality erodes social capital and trust, or inhibits investment into public services and infrastructure. Past research sensed the importance of these causal paths but few have examined them using tests of statistical mediation. METHODS We explored links between income inequality and rates of homicide in 33 countries and then tested whether this association is mediated by an indicator of social capital (interpersonal trust) or by public spending on health and education. Survey data on trust were collected from 48 641 adults and matched to country data on per capita income, income inequality, public expenditures on health and education and rate of homicides. RESULTS Between countries, income inequality correlated with trust (r = -0.64) and homicide (r = 0.80) but not with public expenditures. Trust also correlated with homicides (r = -0.58) and partly mediated the association between income inequality and homicide, whilst public expenditures did not. Multilevel analysis showed that income inequality related to less trust after differences in per capita income and sample characteristics were taken into account. CONCLUSION Results were consistent with psychosocial explanations of links between income inequality and homicide; however, the causal relationship between inequality, trust and homicide remains unclear given the cross-sectional design of this study. Societies with large income differences and low levels of trust may lack the social capacity to create safe communities.

Stress, coping, and behavioural problems among rural and urban adolescents

Rural/urban differences were studied in self-reported stress (life events, daily hassles and conflict), coping and behavioural problems in a community sample of adolescents. Despite challenging socioeconomic conditions in rural areas, levels of stress and ways of coping were similar in rural and urban adolescents. However, urban males reported more conflict and externalizing behaviours than females and rural males. Stress, coping, and behavioural problems were interrelated but approach coping did not moderate the influence of stress on psychological functioning. Results suggest that adolescents may utilize many coping strategies that serve little benefit in terms of behavioural outcomes.

Antecedent-Consequence Conditions in Maternal Mood and Child Adjustment: A Four-Year Cross-Lagged Study

Examined the mutual influence on maternal depressive symptoms and child adjustment problems and their antecedent-consequence conditions across 3 cycles of panel data collected over a 4-year period in the National Longitudinal Survey of Children and Youth (NLSCY). Results indicated stability in, and relations between, maternal and child outcomes. Cross-lagged panel correlations showed that maternal depressive symptoms tended to precede child aggression and hyperactivity but tended to follow child emotional problems. Temporal relations were interpreted in the context of mechanisms that transmit risk between mothers and children. Logistic regression analysis showed bidirectional risk between maternal mood and child adjustment after earlier symptoms were statistically controlled. These findings indicate that maternal depression increases the risk of adjustment problems in children, and vice versa, underscoring the intergenerational transmission of psychopathology.

Social capital, health and life satisfaction in 50 countries.

We explored links between social capital and self-rated health and life satisfaction in a diverse sample of rich and developing countries. A four-factor measure of social capital was developed using data on 69,725 adults in 50 countries that were collected in the World Values Survey. Multilevel analyses showed links between country social capital and health and life satisfaction. However, cross-level interactions indicated that the benefits of social capital were greater in women than men, in older adults and in more trusting, affiliated individuals. Social inequalities in the contributions of social capital to population health are worthy of further study.

Income inequality, trust, and population health in 33 countries.

OBJECTIVES I examined the association between income inequality and population health and tested whether this association was mediated by interpersonal trust or public expenditures on health. METHODS Individual data on trust were collected from 48 641 adults in 33 countries. These data were linked to country data on income inequality, public health expenditures, healthy life expectancy, and adult mortality. Regression analyses tested for statistical mediation of the association between income inequality and population health outcomes by country differences in trust and health expenditures. RESULTS Income inequality correlated with country differences in trust (r = -0.51), health expenditures (r = -0.45), life expectancy (r = -0.74), and mortality (r = 0.55). Trust correlated with life expectancy (r = 0.48) and mortality (r = -0.47) and partly mediated their relations to income inequality. Health expenditures did not correlate with life expectancy and mortality, and health expenditures did not mediate links between inequality and health. CONCLUSIONS Income inequality might contribute to short life expectancy and adult mortality in part because of societal differences in trust. Societies with low levels of trust may lack the capacity to create the kind of social supports and connections that promote health and successful aging.

Cyberbullying Victimization and Mental Health in Adolescents and the Moderating Role of Family Dinners

IMPORTANCE This study presents evidence that cyberbullying victimization relates to internalizing, externalizing, and substance use problems in adolescents and that the frequency of family dinners attenuate these associations. OBJECTIVES To examine the unique association between cyberbullying victimization and adolescent mental health (after controlling differences in involvement in traditional, face-to-face bullying) and to explore the potential moderating role of family contact in this association. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, observational study used survey data on 18,834 students (aged 12-18 years) from 49 schools in a Midwestern US state. Logistic regression analysis tested associations between cyberbullying victimization and the likelihood of mental health and substance use problems. Negative binomial regression analysis tested direct and synergistic contributions of cyberbullying victimization and family dinners on the rates of mental health and substance use problems. EXPOSURES Frequency of cyberbullying victimization during the previous 12 months; victimization by traditional (face-to-face) bullying; and perpetration of traditional bullying. MAIN OUTCOMES AND MEASURES Five internalizing mental health problems (anxiety, depression, self-harm, suicide ideation, and suicide attempt), 2 externalizing problems (fighting and vandalism), and 4 substance use problems (frequent alcohol use, frequent binge drinking, prescription drug misuse, and over-the-counter drug misuse). RESULTS About one-fifth (18.6%) of the sample experienced cyberbullying during the previous 12 months. The frequency of cyberbullying positively related to all 11 internalizing, externalizing, and substance use problems (odds ratios from 2.6 [95% CI, 1.7-3.8] to 4.5 [95% CI, 3.0-6.6]). However, victimization related more closely to rates of problems in adolescents that had fewer family dinners. CONCLUSIONS AND RELEVANCE Cyberbullying relates to mental health and substance use problems in adolescents, even after their involvement in face-to-face bullying is taken into account. Although correlational, these results suggest that family dinners (ie, family contact and communication) are beneficial to adolescent mental health and may help protect adolescents from the harmful consequences of cyberbullying.