Tilda Farhat

Recent Findings on Peer Group Influences on Adolescent Smoking.

This review addresses peer group influences on adolescent smoking with a particular focus on recently published longitudinal studies that have investigated the topic. Specifically, we examine the theoretical explanations for how social influence works with respect to adolescent smoking; discuss the association between peer and adolescent smoking; consider socialization and selection processes with respect to smoking; investigate the relative influence of best friends, close friends, and crowd affiliations; and examine parenting behaviors that could buffer the effects of peer influence. Our review indicates the following with respect to adolescent smoking: (a) substantial peer group homogeneity of smoking behavior; (b) support for both socialization and selection effects, although evidence is somewhat stronger for selection; (c) an interactive influence of best friends, peer groups, and crowd affiliation; and (d) an indirect protective effect of positive parenting practices against the uptake of adolescent smoking. We conclude with implications for research and prevention programs.

Overweight, Obesity, Youth, and Health-Risk Behaviors

BACKGROUND The prevalence and severity of obesity have increased among children and adolescents. Although the medical and psychosocial consequences of youth obesity have been well documented, comparatively less information exists on the association of overweight/obesity with health-risk behaviors, which are considered to be a primary threat to adolescent health. PURPOSE This study aims to examine the association of overweight and obesity with health-risk behaviors among U.S. youth. METHODS Self-reported height and weight, substance use, violence, and bullying were assessed in a nationally representative sample of students aged 11-17 years (N=7825) who participated in the 2005-2006 Health Behaviors in School-Aged Children survey. Data were analyzed in 2009. RESULTS Significant gender and age differences in the relationship of overweight/obesity with risk behaviors were observed. Overweight and obesity were significantly associated with substance use among girls only: Frequent smoking and drinking were associated with overweight and obesity among younger girls, whereas these behaviors were associated with obesity among older girls. Frequent smoking and cannabis use were associated with overweight among younger girls only. Relationships between violent behavior and overweight/obesity were mainly observed among boys: Younger obese boys were more likely to be victims of bullying, whereas older obese boys were more likely to carry weapons compared to boys of normal weight. CONCLUSIONS Overweight and obese young people are at risk of developing health-compromising behaviors that may compound medical and social problems associated with excess weight.

Cultural and Gender Convergence in Adolescent Drunkenness: Evidence From 23 European and North American Countries

OBJECTIVE To investigate time-trend changes in the frequency of drunkenness among European and North American adolescents. DESIGN Cross-sectional surveys in the 1997/1998 and 2005/2006 Health Behaviour in School-Aged Children Study (HBSC). SETTING High schools in 23 countries. PARTICIPANTS A sample of 77 586 adolescents aged 15 years was analyzed by means of hierarchical linear modeling. MAIN OUTCOME MEASURE The frequency of drunkenness. RESULTS We observed a significant increase of about 40% in the mean frequency of drunkenness in all 7 participating Eastern European countries. This increase was evident among both genders, but most consistently among girls. Meanwhile, it declined in 13 of 16 Western countries, about 25% on average. Declines in Western countries were particularly notable among boys and in North America, Scandinavia, the United Kingdom, and Ireland. Despite this gender convergence, with few exceptions (Greenland, Norway, United Kingdom) boys continued to have a higher frequency of drunkenness in 2005/2006 than girls. CONCLUSIONS The confirmed cultural convergence implies that adoption and implementation of evidence-based measures to mitigate the frequency of adolescent drunkenness such as tax increases and restricting alcohol access and advertisement should get the same priority in Eastern European countries as in Western countries. Policy measures that might facilitate decreases in drunkenness such as server training and the promotion of alcohol-free leisure-time activities should be reinforced in Western countries. The gender convergence implies that prevention policy should be less exclusively focused on male adolescents.

Dating Violence Perpetration and Victimization Among U.S. Adolescents: Prevalence, Patterns, and Associations With Health Complaints and Substance Use

PURPOSE This research identified conceptually cohesive latent classes of youth dating violence (DV) and examined associations between covariates and classes by gender. METHODS A nationally representative sample of 2,203 10th grade students completed assessments of physical and verbal DV victimization and perpetration, depressive symptoms, health complaints, and substance use. A Factor Mixture Model was used to identify patterns of DV. Gender differences among classes were examined for depressive symptoms, health complaints, and substance use. RESULTS Prevalence of DV victimization was 35% and perpetration was 31%. A three-class model fit adequately and provided conceptual cohesion: Class 1 = non-involved (65%); Class 2 = victims/perpetrators of verbal DV (30%); and Class 3 = victims/perpetrators of verbal and physical DV (5%). Compared with Class 1 adolescents, those in Classes 2 and 3 were more likely to report depressive symptoms, psychological complaints, and alcohol use. Females in Classes 2 and 3 were also more likely to report physical complaints, cigarette use, and marijuana use. Among females involved in DV, those in Class 3 compared with Class 2 reported more depressive symptoms, physical and psychological complaints, and cigarette and marijuana use. CONCLUSIONS The three-class model distinguished involvement in verbal acts from involvement in verbal and physical acts. Adolescents involved in DV had similar probabilities of reporting perpetration and victimization, suggesting violence within relationships may be mutual. Involvement in DV was associated with more health issues and concurrent problem behaviors. For females in particular, the increased involvement in DV was associated with other health indicators.

Early Adolescent Sexual Initiation as a Problem Behavior: A Comparative Study of Five Nations

PURPOSE Using a Problem Behavior Theory framework, this article examines the extent to which psychosocial correlates of early sexual initiation (before age 16) vary across developed nations. METHODS Fifteen-year-old participants (n = 5,624) in the 1997-1998 World Health Organization collaborative Health Behavior in School-Aged Children survey (Finland, Scotland, France, and Poland) and the 1996 U.S. Add Health survey self-reported substance use (alcohol and tobacco), school attachment, positive parental communication, and early sexual intercourse experience. Stratifying by gender, we performed univariate, bivariate, and multivariable analyses controlling for family socioeconomic status, family structure, and nation fixed effects. RESULTS Self-reported early sexual experience, substance use, school attachment, and positive communication with parents varied significantly across nations for both boys and girls. In both crude and adjusted analyses, substance use was positively associated with early sexual experience among boys and girls across nations, although associations were stronger in Europe than in the United States (adjusted odds ratio [AOR]; range, 1.56-3.74). School attachment was similarly inversely related to early sexual experience among boys and girls across nations (AOR range, .63-.94). However, positive parent communication was significantly inversely related to early sexual experience only among U.S. females (AOR .50). CONCLUSIONS Findings overall supported the fit of early adolescent sexual initiation as a risk behavior within a Problem Behavior Theory framework cross-nationally, suggesting that similar factors could be targeted to prevent early sexual initiation across some developed nations. However, further research is warranted examining the temporality of these relationships.

Parent-child communication and substance use among adolescents: do father and mother communication play a different role for sons and daughters?

The purpose of this study was to investigate gender-specific variations in the associations between communication with father and mother, cigarette smoking, alcohol drinking and marijuana use in male and female adolescents. Cross-sectional data were collected from a national sample of 1308 tenth graders who participated in the 2005/06 U.S. HBSC. Outcome variables were self-reported substances used in the past 30 days. Logistic regression analyses controlling for race/ethnicity, family structure and socioeconomic status showed that the association of mother and father communication with adolescent substance use varied by substance and gender. Among sons, father communication was protective against marijuana use and mother communication was protective against smoking. Neither father nor mother communication was protective against substance use by daughters. Research is needed to understand gender-specific differences in correlates of adolescent substance use and the implications for prevention and intervention.

Decreases in adolescent weekly alcohol use in Europe and North America: evidence from 28 countries from 2002 to 2010

BACKGROUND This study examined trends in adolescent weekly alcohol use between 2002 and 2010 in 28 European and North American countries. METHODS Analyses were based on data from 11-, 13- and 15-year-old adolescents who participated in the Health Behaviour in School-Aged Children (HBSC) study in 2002, 2006 and 2010. RESULTS Weekly alcohol use declined in 20 of 28 countries and in all geographic regions, from 12.1 to 6.1% in Anglo-Saxon countries, 11.4 to 7.8% in Western Europe, 9.3 to 4.1% in Northern Europe and 16.3 to 9.9% in Southern Europe. Even in Eastern Europe, where a stable trend was observed between 2002 and 2006, weekly alcohol use declined between 2006 and 2010 from 12.3 to 10.1%. The decline was evident in all gender and age subgroups. CONCLUSIONS These consistent trends may be attributable to increased awareness of the harmful effects of alcohol for adolescent development and the implementation of associated prevention efforts, or changes in social norms and conditions. Although the declining trend was remarkably similar across countries, prevalence rates still differed considerably across countries.

Longitudinal Relationship Between Drinking with Peers, Descriptive Norms, and Adolescent Alcohol Use

Descriptive norms are consistently found to predict adolescent alcohol use but less is known about the factors that predict descriptive norms. The objective of this study is to test if drinking with peers predicts later alcohol consumption and if this relationship is mediated by a change in the descriptive norms of peer alcohol use. Data are from a nationally representative cohort of high school students surveyed in the 10th and 11th grade (N = 2,162). Structural equation modeling was used to test a mediation model of the relationship between drinking with peers (T1) on later alcohol use (T2) and mediation of the relationship by descriptive norms (T2). Descriptive norms significantly mediated the relationship between drinking with peers and alcohol use for both males and females with a somewhat larger effect for males compared to females. These results support a continued focus on the development and evaluation of interventions to alter descriptive norms of alcohol use.

Ethnic differences in perceptions of body satisfaction and body appearance among U.S. Schoolchildren: a cross-sectional study

BackgroundPerceived body appearance and body satisfaction are potentially related to weight problems and poor health. The purpose of this study was to examine how gender, and ethnic differences in body satisfaction, perceived body appearance and weight status change by age in a representative sample of U.S. adolescents 11–17 years old.MethodsWe used the US Health Behavior in School-Aged Children (HBSC) 2001 survey which assessed perceived body appearance, body satisfaction, self-reported body mass index (BMI) and socio-demographic indicators. The associations between age and perceived appearance, age and body satisfaction, and between z-transformed BMI and body satisfaction were analyzed using separate non-parametric regression models for both genders and the three ethnic groups.ResultsBody satisfaction did not vary significantly by age except for an increase with age in the proportion of Non-Hispanic White girls who perceived themselves as too fat. Although boys did not report being too fat unless their BMI was above the age- and gender-specific median, one third of Non-Hispanic White girls felt too fat at or below the age- and gender-specific median. Compared to other ethnicities, African-American students’ perceived appearance was significantly more positive and they were less likely to perceive themselves overweight at higher BMI scores. However, during adolescence, the positive self-reported perceived appearance of African-American boys dropped substantially while it remained relatively stable in African-American girls.ConclusionsThere were substantial differences in body satisfaction and perceived appearance across the three largest ethnic groups of school-age children in the U.S. Stability across age indicates that these perceptions are most likely established before the age of 10 and underline the importance of primary schools and parents in prevention. Special attention should be directed to the dramatic loss of positive perceived appearance among African-American boys.

Trends in Substance Use among 6th-to 10th-Grade Students from 1998 to 2010: Findings from a National Probability Study

Of the handful of national studies tracking trends in adolescent substance use in the United States, only the Health Behavior in School-Aged Children (HBSC) study collects data from 6th through 10th graders. The purpose of this study was to examine trends from 1998 to 2010 (four time points) in the prevalence of tobacco, alcohol, and marijuana use among 6th through 10th graders. Differences in trends by grade, gender, and race/ethnicity were examined for each substance use behavior, with a primary focus on trends for sixth and seventh graders. Overall, there were significant declines in tobacco, alcohol, and marijuana use from 1998 to 2010. The declines were largest for the younger grades, which suggest promise for future declines among high school students as these cohorts age into high school.