A prospective study of the effects of optimism on adolescent health risks

CONTEXT: The promotion of optimism has been widely advocated for children and adolescents, but epidemiologic data to support this approach are scant. METHODS: This was a 3-wave longitudinal study of health and social development in younger adolescents from 3 Australian states. The 5634 student participants, initially aged 12 to 14 years, were assessed for optimistic thinking style, emotional problems, substance use, and antisocial behaviors. RESULTS: Cross-sectional associations between optimism and each of the study outcomes were strongly protective but tended to differ according to gender in extent. In prospective analyses of the onset of new cases of each study outcome, protective associations were weaker. Those in the highest optimism quartile had risks for depressive symptoms that were reduced by almost half (odds ratio: 0.54 [95% confidence interval: 0.42-0.70]) compared with those in the lowest category. No effect was seen in prevention of anxiety symptoms after adjustment for other aspects of psychological style. In predicting the onset of heavy substance use and antisocial behavior, high optimism had modest protective effects. CONCLUSIONS: Optimistic thinking style is somewhat protective against adolescent health risks; the clearest effects are seen against depressive symptoms. Promoting optimism along with other aspects of psychological and emotional style has a role in mental health promotion that is likely to be enhanced if an intervention also addresses risk and protective factors in an adolescent's social context

Monitoring and Care of Young People at Incipient Risk of Psychosis

Monitoring and Care of Young People at Incipient Risk of Psychosi

Predicting alcohol misuse among Australian 19-year-olds from adolescent drinking trajectories

BACKGROUND: Alcohol use in adolescence predicts future alcohol misuse. However, the extent to which different patterns of adolescent use present risk remains unclear. OBJECTIVES: This study investigated how adolescent trajectories of alcohol consumption during the school years predict alcohol misuse at age 19 years. METHODS: Data were drawn from 707 students from Victoria, Australia, longitudinally followed for 7 years. Five alcohol use trajectories were identified based on the frequency of alcohol use from Grade 6 (age 12 years) to Grade 11 (age 17 years). At age 19 years, participants completed measures indicating Heavy Episodic Drinking (HED), dependency - Alcohol Use Disorders Identification Test (AUDIT) and social harms. RESULTS: At 19 years of age, 64% of participants reported HED, 42% high AUDIT scores (8+), and 23% social harms. Participants belonging to a steep escalator trajectory during adolescence had twice the odds at 19 years of age of high AUDIT scores and social harms, and three times greater odds of HED than participants whose alcohol use slowly increased. Stable moderate consumption was also associated with an increased risk of HED compared to slowly increasing use. Abstinence predicted a reduced likelihood of all forms of misuse at 19 years of age compared to slowly increased alcohol use. CONCLUSIONS: Trajectories of drinking frequency during adolescence predict alcohol misuse at age 19 years. Although rapid increasing use presents the greatest risk, even slowly increasing drinking predicts increased risk compared to abstinence. The findings indicate that alcohol policies should recommend nonuse and reduced frequency of use during adolescence

Mid-life Social and Health Outcomes Associated with early onset chronic NON-Cancer Pain

Objectives: Little is known about how those with early life experiences of chronic pain fare in middle adulthood. The current study examines the association of adolescent, young adult and adult chronic pain onset with middle-age socio-demographic, physical and mental health and substance use profiles. Methods: The Victorian Adolescent Health Cohort Study (VAHCS) commenced in 1992 as a population-representative sample of 1,943 14-15-year-old adolescents who have been followed across 11 waves into middle adulthood. We analysed data from Wave 11 (2019-2021, n=1,412, age 43 years [mid-life]) to describe the mid-life socio-demographic, physical and mental health and substance use profiles of those who retrospectively reported adolescent (10-24 y), young adult (25-34 y) and adult (35-44 y) onset chronic pain. We also describe associations by sex at birth. Results: Two in five participants (41%) reported experiencing chronic pain by age 43 years. This was higher in females than males (44.6% vs. 36.4%, respectively). Of these, just under half (45%) reported adolescent-onset chronic pain, 30% reported young adult-onset and 25% reported adult-onset chronic pain. Compared to later onset pain, adolescent-onset was associated with a greater risk for financial hardship (particularly in males), past 12-month major illness, generalised anxiety disorder (among males) and more frequent cannabis use in mid-adult life. Discussion: Our findings suggest that chronic pain in midlife commonly starts early, across adolescence and young adulthood, and that many with earlier life histories of chronic pain are not faring well across a range of indicators in middle adult life, particularly those with the onset of chronic pain in adolescence

Interpersonal Violence and Gender Inequality in Adolescents: A Systematic Analysis of Global Burden of Disease Data From 1990 to 2019

Purpose: Interpersonal violence is a leading cause of adolescent deaths and disability. This study investigates sex differences in burden of interpersonal violence for adolescents and explores associations with gender inequality. Method: Using data from the 2019 Global Burden of Disease study, we report numbers, proportions, rates of interpersonal violence deaths and disability adjusted life years (DALYs) for all ages, and rate of change (from 1990 to 2019) in adolescents aged 10–24 years disaggregated by sex and geography. We explored associations with gender inequality using gender inequality index. Results: One in four (24.8%) all-age interpersonal violence deaths are in adolescents. In 2019, the rate of deaths in adolescent males was almost six times higher than females (9.3 vs. 1.6 per 100,000); and since 1990, the rate of decline in DALYs for females was double than that for males (−28.9% vs. −12.7%). By contrast, the burden of sexual violence is disproportionately borne by adolescent females, with over double the rate than males (DALYs: 42.8 vs. 17.5 per 100,000). In countries with greater gender inequality, the male-to-female ratio (deaths and DALYs) was increased among older adolescents, pointing to benefits for males in more gender equal settings. Discussion: Social identities, relationships, and attitudes to violence are established in adolescence, which is an inflection point marking the emergence of disproportionate burdens of interpersonal violence. Our findings affirm that global agendas must be expanded to address interrelated factors driving multiple forms of interpersonal violence experienced by adolescents and reverberating to the next generation

Preconception parental personality disorder and psychosocial outcomes during the perinatal period: a prospective population-based study

Abstract Purpose Birthing individuals with personality disorder in young adulthood before pregnancy may be at increased risk of potentially modifiable adverse outcomes in the perinatal period that impact parental and child health. We aimed to investigate the perinatal psychosocial outcomes of preconception (prior to pregnancy) personality disorder. Methods Prospective analysis of 398 birthing individuals with 609 infants from Victorian Intergenerational Health Cohort Study (VIHCS). Preconception personality disorder was measured using the Standardised Assessment of Personality (SAP) at age 24. A range of parental outcomes were assessed during pregnancy and at one year postpartum (age 28 to 37). Log-binomial generalised estimating equations were used to estimate univariable associations between preconception personality disorder and each perinatal outcome. Results Individuals with preconception personality disorder (compared to those without) were approximately two times more likely to have antenatal anxiety symptoms (risk ratio (RR) 2.08, 95% confidence interval (CI) 1.19–3.65) and reduced social support (antenatal RR 2.01, 95% CI 0.98–4.13; postnatal RR 1.38, 95% CI 0.91–2.10). Weaker associations were also observed for experiencing stressful life events (RR 1.37, 95% CI 0.98–1.90) and, albeit with less certainty, for poorer partner relationship quality (RR 1.44, 95% CI 0.78–2.64) and depressive symptoms (antenatal RR 1.56, 95% CI 0.84–2.91; postnatal RR 1.44, 95% CI 0.73–2.83). Close to null associations were observed for parents’ self-efficacy or perceived parent-infant bond. Conclusion The findings highlight a group who may be vulnerable to multiple adverse perinatal outcomes; those with personality disorder and their families may benefit from additional support both with pregnancy planning and into parenthood

Intervention targets for reducing mortality between mid-adolescence and mid-adulthood: a protocol for a machine-learning facilitated systematic umbrella review

IntroductionA rise in premature mortality—defined here as death during the most productive years of life, between adolescence and middle adulthood (15–60 years)—is contributing to stalling life expectancy in high-income countries. Causes of mortality vary, but often include substance misuse, suicide, unintentional injury and non-communicable disease. The development of evidence-informed policy frameworks to guide new approaches to prevention require knowledge of early targets for intervention, and interactions between higher level drivers. Here, we aim to: (1) identify systematic reviews with or without meta-analyses focused on intervention targets for premature mortality (in which intervention targets are causes of mortality that can, at least hypothetically, be modified to reduce risk); (2) evaluate the review quality and risk of bias; (3) compare and evaluate each review’s, and their relevant primary studies, findings to identify existing evidence gaps.Methods and analysisIn May 2023, we searched electronic databases (MEDLINE, PubMed, Embase, Cochrane Library) for peer-reviewed papers published in the English language in the 12 years from 2012 to 2023 that examined intervention targets for mortality. Screening will narrow these papers to focus on systematic reviews with or without meta-analyses, and their primary papers. Our outcome is death between ages 15 and 60 years; with potential intervention targets measured prior to death. A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) will be used to assess quality and risk of bias within included systematic reviews. Results will be synthesised narratively due to anticipated heterogeneity between reviews and between primary studies contained within included reviews.Ethics and disseminationThis review will synthesise findings from published systematic reviews and meta-analyses, and their primary reviewed studies, meaning ethics committee approval is not required. Our findings will inform cross-cohort consortium development, be published in a peer-reviewed journal, and be presented at national and international conferences.PROSPERO registration numberCRD42022355861

Childhood sexual abuse and maternal social and financial resources, mental health, and parenting outcomes in pregnancy and early parenthood: a multicohort observational study

Childhood sexual abuse and maternal social and financial resources, mental health, and parenting outcomes in pregnancy and early parenthood: a multicohort observational stud

World Health Organization and knowledge translation in maternal, newborn, child and adolescent health and nutrition

The World Health Organization (WHO) has a mandate to promote maternal and child health and welfare through support to governments in the form of technical assistance, standards, epidemiological and statistical services, promoting teaching and training of healthcare professionals and providing direct aid in emergencies. The Strategic and Technical Advisory Group of Experts (STAGE) for maternal, newborn, child and adolescent health and nutrition (MNCAHN) was established in 2020 to advise the Director-General of WHO on issues relating to MNCAHN. STAGE comprises individuals from multiple low-income and middle-income and high-income countries, has representatives from many professional disciplines and with diverse experience and interests.Progress in MNCAHN requires improvements in quality of services, equity of access and the evolution of services as technical guidance, community needs and epidemiology changes. Knowledge translation of WHO guidance and other guidelines is an important part of this. Countries need effective and responsive structures for adaptation and implementation of evidence-based interventions, strategies to improve guideline uptake, education and training and mechanisms to monitor quality and safety. This paper summarises STAGE’s recommendations on how to improve knowledge translation in MNCAHN. They include support for national and regional technical advisory groups and subnational committees that coordinate maternal and child health; support for national plans for MNCAHN and their implementation and monitoring; the production of a small number of consolidated MNCAHN guidelines to promote integrated and holistic care; education and quality improvement strategies to support guidelines uptake; monitoring of gaps in knowledge translation and operational research in MNCAHN

Towards a youth mental health paradigm: a perspective and roadmap

AbstractMost mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of mental ill-health. This perspective addresses interactions between risk and protective factors and brain development as key pillars accounting for the emergence of psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis and interventions are required that reflect the evolution of emerging psychopathology, the importance of novel service models, and knowledge exchange between science and practitioners. Taken together, we propose a transformative early intervention paradigm for research and clinical care that could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders