Robert F. Valois

Aggression, Substance Use, and Suicidal Behaviors in High School Students.

OBJECTIVES We sought to analyze the frequency and correlates of suicidal behaviors in a community sample of adolescents. METHODS Information concerning suicidal thoughts and acts, aggressive behaviors, substance use and physical recklessness were collected with the 70-item self-report Youth Risk Behavior Survey from a statewide sample of 3764 South Carolina public high school students. RESULTS Seventy-five percent of students reported no suicidal behaviors, 11% reported serious suicidal thoughts, 6.4% reported specific suicidal plans, 5.9% reported attempts not requiring medical care, and 1.6% reported attempts requiring medical care. All types of suicidal behaviors occurred more frequently in females than males. Odds ratios for aggressive behaviors and cigarette use were elevated across all categories of suicide behaviors, increasing in magnitude with severity of reported suicidal behavior. Substance use was associated with some but not all categories of suicidal behaviors. The relationships were most pronounced with the use of potentially more dangerous drugs. CONCLUSIONS The results suggest that suicidal behaviors are not infrequent occurrences among adolescents and that they often coexist with other high-risk behaviors. Interventions designed to reduce suicidal behaviors should simultaneously address coexisting high-risk behaviors.

Severe Dating Violence and Quality of Life Among South Carolina High School Students

BACKGROUND Little research has addressed the impact of dating violence and forced-sex victimization and perpetration on adolescent well-being. In this cross-sectional study, we provide (1) estimates of severe dating violence (SDV) by victimization and perpetration status, (2) estimates of lifetime forced-sex victimization and perpetration, (3) demographic and health behaviors correlated with SDV, and (4) associations between SDV and forced sex and well-being as assessed by (1) health-related quality of life (H-R QOL) and (2) life satisfaction measures. METHODS We used a stratified cluster sample of 5414 public high school students, grades 9 through 12, who responded to the 1997 self-administered South Carolina Youth Risk Behavior Survey. RESULTS Nearly 12% of adolescents self-reported SDV as a victim (7.6%) or a perpetrator (7.7%), and SDV rates (victimization/perpetration combined) are higher in girls (14.4%) than boys (9.1%). Race, aggressive behaviors, substance use, and sexual risk-taking are correlates of SDV. Among young women, SDV victimization, not perpetration, was associated with recent poor H-R QOL and suicide ideation or attempts, but not lower life-satisfaction scores. Among young men, SDV perpetration, not victimization, was strongly associated with poor H-R QOL and suicide attempts, and lower scores for all domains of life satisfaction. CONCLUSIONS This research provides evidence that SDV and forced sex are associated with poor H-R QOL, low life-satisfaction scores, and adverse health behaviors in adolescent female victims and male perpetrators. Screening for dating violence is needed to identify and intervene early to reduce the impact of dating violence.

Relationship between perceived life satisfaction and adolescents' substance abuse

PURPOSE To explore the relationship between perceived global life satisfaction and selected substance use behaviors among 5032 public high school students. METHODS The 1997 South Carolina Youth Risk Behavior Survey substance abuse and life satisfaction variables were used. An adjusted polychotomous logistic regression analysis utilizing SAS/SUDAAN, revealed a significant race/gender interaction. Subsequent multivariate models were constructed individually for four race/gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to assess the magnitude of risk for selected substance abuse behaviors and their association with reduced global life satisfaction. RESULTS Cigarette smoking, chewing tobacco, marijuana, cocaine, regular alcohol use, binge drinking, injection drug, and steroid use were significantly (p < .05) associated with reduced life satisfaction for specific race/gender groups (white males; black males; white females; and black females). In addition, age (< or = 13 years) of first alcohol drink, first marijuana use, first cocaine use, and first cigarette smoked were also significantly (p < .05) associated with reduced life satisfaction. CONCLUSION Longitudinal studies are needed to determine whether dissatisfaction with life is a consequence or determinant of substance abuse behavior for adolescents.

Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents.

PURPOSE To examine the relationship between number of sexual partners and selected health risk behaviors in a statewide sample of public high school students. METHODS The Centers for Disease Control and Prevention Youth Risk Behavior Survey was used to secure usable sexual risk-taking, substance use, and violence/aggression data from 3805 respondents. Because simple polychotomous logistic regression analysis revealed a significant Race x Gender interaction, subsequent multivariate models were constructed separately for each race-gender group. Odds ratios and 95% confidence intervals was calculated from polychotomous logistic regression models for number of sexual intercourse partners and their potential risk behavior correlates. RESULTS An increased number of sexual intercourse partners were correlated with a cluster of risk behaviors that place adolescents at risk for unintended pregnancy, human immunodeficiency virus/acquired immunodeficiency syndrome, and other sexually transmitted infections. For Black females, alcohol, tobacco, marijuana use, and dating violence behaviors were the strongest predictors of an increased number of sexual partners; white females had similar predictors with the addition of physical fighting. For white males, alcohol, tobacco, marijuana use, physical fighting, carrying weapons, and dating violence were the strongest predictors of an increased number of sexual intercourse partners. Black males had similar predictors with the addition of binge alcohol use. CONCLUSION Prevention of adolescent sexual and other health risk behaviors calls for creative approaches in school and community settings and will require long-term intervention strategies focused on adolescent behavior changes and environmental modifications.

Correlates of aggressive and violent behaviors among public high school adolescents

PURPOSE This study analyzed the types and predictors of violent behaviors reported by 4,137 South Carolina adolescents, grades nine through twelve. METHODS The 70 item self-report Youth Risk Behavior Survey developed and piloted by the Centers for Disease Control and Prevention was utilized in 57 of the states public high schools. A series of logistic regression analyses were performed for each race/gender group to explore the relation of the demographic and potential risk variables to fighting and carrying weapons. RESULTS Results indicate that 38 percent of males and 11 percent of females reported carrying a weapon. Eleven percent of males and five percent of females reported fights resulting in an injury. The strongest predictors of fighting were binge drinking and sexual activity for males, any alcohol use and illegal drug use for white females, and sexual activity for black females. For carrying a weapon, the strongest predictors included alcohol use and sexual activity in all but white females, and illegal drug use among whites, but not blacks. CONCLUSION Prevention of adolescent violence calls for creative approaches in school and community settings and will require long-term intervention strategies, focused on adolescent behavior change and environmental modifications.

Relationship between life satisfaction and violent behaviors among adolescents.

OBJECTIVE To explore relationships between life satisfaction and violent behaviors among 5,032 adolescents. METHODS Adjusted polychotomous logistic regression analyses and multivariate models were used via SUDAAN with the 1997 CDC YRBS. RESULTS Carrying a weapon; carrying a gun; carrying a weapon at school; physical fighting; physical fighting at school; physical fighting that required physician treatment; drinking and driving; riding with a drinking driver; having property stolen/damaged at school; feeling unsafe while at, going to or returning from school; and being injured/ threatened with a weapon were associated (p=.05) with reduced life satisfaction. CONCLUSION Measures of life satisfaction as a component of comprehensive assessments of adolescent violence/aggression in field-work, research, and program-evaluation efforts should be considered.

Risk Factors and Behaviors Associated with Adolescent Violence and Aggression.

OBJECTIVE To explore risk factors and behaviors associated with aggressive and violent behaviors among adolescents. METHODS A comprehensive review of research literature from various disciplines associated with improving the health and well-being of adolescents. RESULTS Risk factors and behaviors associated with adolescent aggression and violence are discussed via 6 major factor categories: individual, family, school/academic, peer-related, community and neighborhood, and situational. CONCLUSION Adolescent aggression and violence develops and manifests within a complex constellation of factors. Prevention intervention efforts should be theory based, multicomponent, and multisystem; they should begin in middle school and continue into high school with a comprehensive evaluation design.

Adolescent health-related quality of life and perceived satisfaction with life.

Purpose: To explore the relationship between perceived satisfaction with life and health-related quality of life (HRQOL) in a state-wide sample of 13–18-year-old adolescents (n=4914) in South Carolina, USA. Methods: Questions were added to the self-report Centers for Disease Control (CDC) Youth Risk Behavior Survey (YRBS) asking about perceived life satisfaction in six domains (self, family, friends, living environment, school, and overall) and HRQOL (self-rated health; and the number of poor physical health days, poor mental days, and activity limitation days during the past 30 days). Results: Adjusted logistic regression analyses and multivariate models constructed separately revealed that self-rated health, poor physical days (past 30 days), poor mental health days (past 30 days), and activity limitation days (past 30 days) were significantly related (p < 0.05) to reduced life satisfaction, regardless of race or gender. Moreover, as the number of reported poor health days increased, the greater the odds of reporting life dissatisfaction. Conclusions: This is the first study to document the relationship between poor physical health and perceived life satisfaction. This adds to the mounting evidence that life satisfaction is related to a variety of adolescent health behaviors and that life satisfaction may add additional information in longitudinal databases that track adolescent health because it appears to be related to HRQOL.

Life Satisfaction and Suicide Among High School Adolescents

Relationships between perceived life satisfaction, poor mental health, suicide ideation and suicide behaviors were examined in a statewide sample of 13 to 18 year old public high school students (n = 4,758) using the self-report CDC Youth Risk Behavior Survey (YRBS). Adjusted logistic regression analyses and multivariate models constructed separately (via SUDAAN), revealed that poor mental health (past 30 days), poor mental/physical health (past 30 days) serious suicide consideration (past 12 months), planning for suicide (past 12 months), attempted suicide (past 12 months) and suicide attempt requiring medical care (past 12 months) were significantly related to reduced life satisfaction. Also, differences across gender and race were demonstrated. Measures of life satisfaction as a component of comprehensive assessments of adolescent mental health, suicide ideation and suicide behavior in fieldwork, research, and program-evaluation efforts should be considered.

Selected Health Behaviors that Influence College Freshman Weight Change.

Objective and Participants: The authors investigated the effect of physical activity (PA), fruit and vegetable intake, and alcohol use on 6-month weight change in 193 college freshmen (78.8% white, 88.2% women, 94.5% on a meal plan). Methods: The authors administered a Web-based survey in fall 2002 (baseline) and spring 2003 (follow-up). Results: There was an overall average weight gain of 2.5 lbs (p < .05), although only 57% reported weight gain (M = 7.1 lbs). Fruit and vegetable intake decreased (p = .034), alcohol use increased (p > .05), and PA was unchanged. Weight gain for students with body mass indexes (BMI) ≥25 kg/m2 was nearly twice that of students with BMIs < 25 (p < .05). Students with low-frequency baseline PA were twice as likely to be overweight. Follow-up data showed that students reporting ≥ 4 sessions per week (ie, high frequency) of low-intensity PA were twice as likely to have healthy BMIs as students engaging in low- and moderate-frequency PA. Conclusions: PA interventions should target freshmen with BMIs ≥ 25.