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During adolescence hormonal and neurodevelopmental changes geared to ensure reproduction and achieve independence are very likely mediated by growth of neural processes, remodeling of synaptic connections, increased myelination in prefrontal areas, and maturation of connecting subcortical regions. These processes, greatly accelerated in adolescence, follow an asynchronous pattern in different brain areas. Neuroimaging research using functional and structural magnetic resonance imaging has produced most of the insights regarding brain structural and functional neuropathology in adolescent psychiatric disorders. In schizophrenia, first episodes during adolescence are linked to greater-than-normal losses in gray matter density and white matter integrity, and show a divergence of maturational trajectories from normative neural development, in a progression similar to that of adult-onset schizophrenia. Anxiety and mood disorders in adolescence have been linked to abnormally increased activity in the amygdala and ventral prefrontal cortical areas, although some data suggest that neural abnormalities in the amygdala and anxiety maybe particularly more frequent in adolescents than in adults. Alcohol misuse in adolescence results in reduced integrity in the white matter and reduced gray matter density that, given the high intensity of adolescent synaptic and myelin remodeling, may result in persistent and profound changes in circuits supporting memory, emotional and appetitive control. Interaction of persistent changes due to prenatal exposure with contemporaneous expression of genetic factors and disturbing environmental exposure may be an important factor in the appearance of psychiatric disorders in adolescence. Further progress in understanding adolescent psychopathology will require postmortem research of molecular and cellular determinants in the adolescent brain.
PMCID: PMC3936342  PMID: 23828425
Neuroimaging; development; psychiatry
2.  The Negative Consequences of Other Students’ Drinking: Inventory Development and Assessment of Differences by Student Characteristics and Risk Behaviors 
College students continue to report being disrupted by other students’ alcohol use. Objective: This study was designed to develop measures to document the consequences resulting from other students’ drinking and identify differences in experiencing these consequences by student characteristics and drinking behaviors. Study group: A stratified random sample of undergraduate students (N = 3,908) from ten universities in North Carolina, USA, completed a web-based assessment. Methods: Exploratory factor analysis (EFA) was performed on the random first split-half sample (n = 1,954) to identify factor structure. Confirmatory factor analysis (CFA) was performed on the remaining half sample (n = 1,954) using structural equation modeling. Results: EFA revealed two inventories: interpersonal and community consequences of others’ drinking inventories. CFA on the second split-half sample identified model fits for the two factor structure suggested by EFA. Of 3,908 participants, 78% reported experiencing one or more consequences due to others’ drinking during the past 30 days. Multivariable generalized linear mixed modeling further validated the inventories and resulted in several associations. Male students who reported getting drunk experienced significantly more interpersonal consequences from others’ drinking (p < .001). Minority students, students who lived on campus and students who reported getting drunk experienced significantly more community consequences from others’ drinking (p < .01). Conclusions: These findings demonstrate that 4 out of 5 college students experience consequences from others’ drinking, and consequences vary for different subgroups of students. Although these inventories should be tested further, these findings propose standardized measures that may be useful to assess the consequences of others’ drinking among college students.
PMCID: PMC3684566  PMID: 20306764
College; drinking; risk; measurement; consequences
4.  Dimensions of Health in Young People in Foster Care 
To describe the dimensions of health and illness from the perspective of adolescents in foster care.
Descriptive analyses of dimensions of health were conducted on N=105 adolescents in foster care. Differences among demographic (age, gender, race/ethnicity) and foster care placement (age at first placement, reason(s) for foster care placement, length of time in care, number, and types of placement) variables and the dimensions and subdimensions of health (Child Health and Illness Profile- Adolescent Edition) were determined using T-tests and ANOVA.
Most were placed in long-term foster care ( x̄ =6.46 years; SD=4.86) during adolescence (38%), with multiple placements ( x̄ =3.99; SD=3.8). All domains of health were self-reported to be average to low average, with poorer findings in specific risk and resilience subdomains. There were no significant differences by age or race/ethnicity. Girls had lower satisfaction with health and self esteem and more physical and emotional discomfort. Preplacement adverse experiences were associated with increased risks.
Adolescent self-report of the domains of health for those in foster care was better than expected, based on literature review and qualitative data for the larger study. Potential explanations for this inflation of status and functioning include the need for self-protection in foster care, the familiarity of testing regimes by children in foster care with some social desirability effect, and their paradoxical responses to preplacement problems. Data including qualitative and significant other-reported data may be necessary to gain an accurate portrayal of the health status of adolescents in foster care.
PMCID: PMC3436751  PMID: 19702202
foster care; foster youth; adolescent health
5.  Health care utilization for pain in children and adolescents: a prospective study of laboratory and non-laboratory predictors of care-seeking 
Few studies have focused on identifying predictors of medical consultation for pain in healthy children and adolescents.
This investigation sought to identify parent and child laboratory and non-laboratory predictors of pediatric healthcare utilization for pain problems.
Study group
Participants were 210 healthy children and adolescents (102 girls), aged 8–17 years who took part in a laboratory pain session.
Three months after the laboratory session, participants were contacted by telephone to ascertain whether they had experienced pain and whether they had seen a healthcare professional for pain. Zero-order correlations among sociodemographics, child laboratory pain responses, parent physical/mental health status and medical consultation for pain were conducted to identify relevant correlates of pediatric healthcare utilization; these correlates were subjected to multivariate analyses.
Bivariate analyses indicated that higher anticipated pain and bother for the cold pressor task, as well as poorer parent physical health status, were associated with pediatric medical consultation for pain, but only among girls. Sequential logistic regression analyses controlling for child age indicated that only parent physical health status, not the laboratory indicators, significantly predicted healthcare consultation for pain among girls. No parent or child correlates of care-seeking for pain emerged for boys.
The findings suggest that parents’ perceived physical health plays a role in determining whether medical care is sought for pain complaints in healthy girls. These results suggest that interventions to assist parents in managing their own physical health problems may lead to reductions in medical consultation for girls’ pain.
PMCID: PMC3246362  PMID: 22191197
pediatric health care; parent health status; parent-child relationship; experimental pain; acute pain
6.  Suicidality, depression, and alcohol use among adolescents: A review of empirical findings 
Suicide is a serious health problem as it is currently the third leading cause of death for teenagers between the ages of 15 and 24 years. Depression, which is also a serious problem for adolescents, is the most significant biological and psychological risk factor for teen suicide. Alcohol use remains extremely widespread among today’s teenagers and is related to both suicidality and depression. Suicidality refers to the occurrence of suicidal thoughts or suicidal behavior. The consensus in empirical research is that mental disorders and substance abuse are the most important risk factors in both attempted and completed adolescent suicide. Therefore, it is incumbent upon researchers to identify the factors that can lead to their prevention among today’s youth. This review compiles the existing literature on suicidality, depression, and alcohol use among adolescents spanning over the past 15 years. Both Problem Behavior Theory and Stress-coping Theory can explain the relationships among suicidality, depression and alcohol use. The prevention of suicidality is critical, especially during the early school years, when it is associated with depression and alcohol use. Suicidality, depression and alcohol use are three phenomenon that noticeably increase in adolescence marking this time period as an ideal opportunity for prevention efforts to commence. Future empirical work is needed that will further assess the impact of adolescent depression and alcohol use on suicidality. In sum, this review of empirical research highlights critical results and limitations, as well as indicates a need for continued efforts in preventing suicidality, depression, and alcohol use among adolescents.
PMCID: PMC3134404  PMID: 17458321
Adolescent; depression; suicidality; substance abuse; review; USA
7.  A Review of Familial Correlates of Child and Adolescent Obesity: What has the 21st Century Taught us so Far? 
With the rising prevalence rates of child and adolescent obesity over the last several decades it is important to examine the extant research in order to inform future research.
The aim of this paper is to review and critique research investigating familial correlates of child and adolescent obesity in the last decade.
A literature review was conducted between March 2008 and December 2008. Studies published after 2000 that assessed familial associations with child and adolescent obesity in the parental, family functioning, and sibling domains were included in the review. A total of 81 studies met inclusionary criteria.
The majority of studies focused on the parental domain. Substantial evidence indicates an association between authoritative parenting style and child/adolescent lower BMI, healthy dietary intake and physical activity. Also, research on family meals has consistently shown an association between the frequency of family meals and child/adolescent lower BMI and healthy dietary intake.
To date, there is preliminary evidence that suggests that familial factors are associated with child and adolescent obesity, dietary intake, physical activity and weight control behaviors, but the majority of the evidence is cross-sectional and there are limitations with the research. Recommendations for future research are discussed.
PMCID: PMC2890027  PMID: 20306760
review; child obesity; adolescent obesity; family functioning; parenting; sibling
8.  Young adults' judgments of the costs and benefits of smoking: The predictive efficacy of different outcome weightings in behavioral decision making 
Given the public health burden of smoking and the knowledge that many smokers begin during adolescence and young adulthood, understanding how decisions about smoking behaviors are made is of considerable importance. Most health decision-making models relevant to understanding smoking behavior posit that beliefs about the costs and benefits of smoking are an important influence on decision making. However, these models differ in how other factors (e.g., outcome importance, perceived positivity or negativity of outcome) are weighted in cost-benefit analyses. We examined the relative efficacy of different weightings in cost/benefit formulations to predict young adults' current smoking behavior and intentions to smoke in the future. Smoking and non-smoking participants listed advantages and disadvantages of smoking and then rated the importance and positivity/negativity of each outcome. Number of consequences listed, consequences weighted by importance, by positivity/negativity, and by an importance × positivity/negativity interaction were examined as predictors of both current smoking status and reported intentions to smoke in 5 years. Both importance and positivity/negativity (but not their interaction) predicted current smoking status, whereas importance alone was the strongest predictor of future smoking intentions. This suggests the possibility that different decision-making processes might underlie future behavioral intentions relative to those that guide current behavior.
PMCID: PMC2716137  PMID: 18348419
Smoking; smoking behavior; prevention; United States

Results 1-8 (8)