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We examined substance use onset and associations with pregnancy by age 15 years. Participants were girls ages 15 years or younger (weighted n = 8319) from the 1999-2003 Youth Risk Behavior Surveillance System (YRBS). Multivariable logistic regression examined pregnancy as a function of substance use onset (i.e., age 10 years or younger, 11-12, 13-14, and age 15 years) for alcohol, cigarettes and marijuana, controlling for race/ethnicity and metropolitan location. Of girls pregnant by age 15 years (3% of the sample, weighted n = 243), 16% had smoked marijuana by age 10 years and over 20% had smoked cigarettes and initiated alcohol use by age 10 years. In the multivariable analysis, marijuana use by age 14 years and/or cigarette smoking by age 12 years clearly distinguished girls who became pregnant by age 15 years and is perhaps due to a common underlying risk factor. (Contains 2 tables.)

We utilized an updated nationally representative database to examine associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. We used hospital inpatient billing data from the 2009 United States Nationwide Inpatient Sample, part of the Healthcare Cost and Utilization Project. To determine whether the likelihood that maternal morbidity during complications of labor and delivery differed among age groups, separate logistic regression models were run for each complication. Age was the main independent variable of interest. In analyses that controlled for demographics and clinical confounders, we found that complications with the highest odds among women, 11-18 years of age, compared to 25-29 year old women, included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women who were 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women who were [greater than or equal to]35 years old had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Older women ([greater than or equal to]40 years old) had increased odds for mild preeclampsia, fetal distress, and poor fetal growth. Our findings underscore the need for pregnant women to be aware of the risks associated with extremes of age so that they can watch for signs and symptoms of such complications., Author(s): Patricia A. Cavazos-Rehg[sup.1] , Melissa J. Krauss[sup.1] , Edward L. Spitznagel[sup.2] , Kerry Bommarito[sup.3] , Tessa Madden[sup.4] , Margaret A. Olsen[sup.3] [sup.5] , Harini Subramaniam[sup.3] , Jeffrey F. Peipert[sup.4] [...]

The Teacher's Report Form (TRF) was investigated over 3 years for its practical ability to track outcomes in 89 elementary students with emotional disturbances. The students whose placement changed to less restrictive settings demonstrated significant improvement on consecutive TRF's in academic performance, classroom functioning, and aggressive behaviors. (Contains references.) (Author/CR)

A study investigated variables that differentiated 75 successful and 76 unsuccessful students (ages 6-16) with serious emotional disturbances (SED). Four variables emerged as significant predictors of the unsuccessful outcome group: increasing enrollment age, presence of conduct or opposition disorder, lower verbal IQ, and absence of depressive or anxiety disorder. (CR)

To investigate factors associated with favorable pregnancy attitudes among teenage girls. Participants were sexually active teenage girls aged 15-18 years old (n = 965) who took part in the 2002 or 2006-2010 National Survey of Family Growth (NSFG). Multinomial multivariable logistic regression was used to assess the likelihood of being pleased with a teenage pregnancy. Sixteen percent of sexually active teenage girls (n = 164) would be pleased (11 % a little pleased, 5 % very pleased) if they became pregnant. In a multivariable model, participants who had not yet discussed sexual health topics (i.e., how to say no to sexual intercourse or birth control) or had only discussed birth control with a parent were more likely to be very pleased with a teenage pregnancy than participants who had discussed both topics with a parent. Prior pregnancy, racial/ethnic group status, older age, and having parents with a high school education or less also increased the odds of being pleased with a teenage pregnancy. Being pleased with a teenage pregnancy was correlated with a lack of discussion of sexual health topics with parents, prior pregnancy, and sociodemographic factors (having less educated parents, racial/ethnic group status). Pregnancy prevention efforts can be improved by acknowledging the structural and cultural factors that shape teenage pregnancy attitudes. Keywords Teenage pregnancy * Sexual education * Sexual health * Sexual behaviors--adolescent, Introduction In 2009, US teenage birth rates hit a record low at 39.1 per 1,000 teenage women ages 15-19 [1]. Yet, enthusiasm over the progress made in declining teenage birthrates [...]

Objective: The present study examined the associations between initiation and intensity of substance use and with sexual experience with and without a history of teenage pregnancy. Method: Participants were high school females (weighted n = 3,45l) who participated in the 1999-2003 Youth Risk Behavior Surveillance System, a cross-sectional, nationally representative survey. Multinomial multivariable logistic regression was used to assess the likelihood of being sexually experienced (but never pregnant) and teenage pregnancy (reference group: never had sexual intercourse) as a function of age at substance use initiation (i.e., age 12 or younger, 13-14 years of age, and age 15 or older) and intensity of substance use (i.e., nonuser, experimental/ new or nondaily, nonexperimental/daily user) for alcohol, cigarettes, and marijuana, while controlling for race/ethnicity, metropolitan location, symptoms of depression, and illegal drug availability at school. Results: A major finding of our study is that substance use behaviors across each substance (alcohol, cigarettes, and marijuana) independently contributed to an increased risk in sexual intercourse experience with and without a history of teenage pregnancy (vs. nonsexually experienced females). A dose-response relationship was also observed between an increased likelihood of a teenage pregnancy and marijuana behaviors. Furthermore, the risk for teenage pregnancy was compounded for daily cigarette smokers who initiated use at age 12 or younger. Conclusions: Screening substance use behaviors can help to identify girls who may benefit from pregnancy prevention strategies. Targeting cigarette and marijuana behaviors as early as age 12 or younger may provide an added benefit. Prevention strategies should also consider the role of race above and beyond substance use behaviors. (J. Stud. Alcohol Drugs, 72, 194-198, 2011), CHILDREN BORN TO ADOLESCENT MOTHERS are at high risk for premature birth, low birth weight, cognitive deficits, mental health problems, maltreatment, poverty, and death (Fergusson and Woodward, 1999; Overpeck et [...]

Objective: We examined latent classes of alcohol use among current drinkers ages 60 and older and explored risk factors associated with class. Method: We used a subsample of older current drinkers (≥ 60 years; n = 4,646) from the National Epidemiologic Survey on Alcohol and Related Conditions. Employing alcohol consumption and diagnostic indicators, latent class analysis was used to identify classes. We analyzed the associations between class membership and sociodemographic, psychiatric, health, and mental health variables using multinomial and linear regression. Results: Latent class analysis identified three latent classes. Individuals in the low-risk drinker class (89.17%) displayed low endorsement of heavy episodic use, at-risk consumption, and alcohol abuse/dependence criteria. Individuals in the moderate-risk drinker class (9.65%) were more likely to exceed consumption guidelines, and those in the high-risk drinker class (1.17%) displayed high probabilities of both Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria and risky alcohol consumption items. Female gender, older age, and African-American race were associated with decreased risk of being a moderate-risk drinker. Being the adult child of an alcoholic, being a previous smoker, and being a current smoker were associated with increased risk. Female gender, older age, and college education were associated with decreased odds of being a high-risk drinker. Having major depression, being the child of an alcoholic, and being a current smoker were associated with increased odds of being a high-risk drinker. Individuals classified in the high-risk drinker class had significantly lower self-rated mental and physical health than low-risk drinkers. Conclusions: A subpopulation of older drinkers may exceed consumption guidelines without DSM-defined alcohol-related problems. However, for some older drinkers, risky alcohol use is part of a larger pattern of health risks including current smoking, major depression, and alcohol abuse/dependence history., ALCOHOL MISUSE BY OLDER ADULTS is an important public health concern with significant consequences. It is associated with poor mental health functioning (Blow et al., 2000), increased odds of suicide [...]

Cocaine users routinely engage in high-risk sexual behaviors that place them at an elevated risk of contracting HIV and other blood-borne infections. The purpose of the present study was to compare trading sex for drugs and/or money, having 10 or more sexual partners in I year, and sexually transmitted diseases (STDs) of cocaine-dependent individuals in treatment for their dependence across race and gender and against participants who live in their community. Cocaine-dependent individuals (n = 459) were identified through nine publicly and privately funded inpatient and outpatient chemical dependency treatment centers in the St. Louis area during 2001-2006. Community-based participants (n = 459) were matched to cocaine-dependent participants on age, ethnicity, gender, and zip code of residence. Mean age of the sample was 36 years old, 50% were Caucasians, 50% were African American, and 47% were male. Nearly half of cocaine-dependent participants in treatment had traded sex for drugs and/or money and over one-third had more than 10 sexual partners in 1 year with a risk concentrated among African Americans even after controlling for income and educational attainment. Participants recruited from the community with some exposure to cocaine reported similar rates of high risk sexual behaviors as the cocaine dependent subjects from treatment settings. It is important for clinicians to recognize that once released from treatment, cocaine-dependent individuals may be returning to high-risk environments where sexual risk behaviors are occurring in the context of cocaine use.

Disaster mental health research has historically focused on assessment of psychopathology, using measures of psychiatric symptoms and disorders. The Oakland/Berkeley firestorm provided an opportunity to explore resilience among highly exposed survivors through consideration of psychiatric variables in the context of personality. The Diagnostic Interview Schedule/Disaster Supplement was administered to 62 firestorm survivors at approximately 4, 16, and 39 months and the Temperament and Character Inventory administered at 16 months postdisaster. Few individuals had postdisaster psychopathology (16% with any diagnosis, 5 % with PTSD). There was considerable evidence of distress, however, indicated by an abundance of reported posttraumatic symptoms, functional impairments, and endorsement of emotional upset, all of which decreased substantially over time. Group C (avoidance/numbing) posttraumatic symptoms were relatively uncommon and were specifically associated with elevated Self-Transcendence. Groups B (intrusion) and D (hyperarousal) symptoms were prevalent and were associated with high Harm Avoidance and low Self-Directedness. The generally healthy personality profiles of these firestorm survivors reflected their psychological resilience. Examination of symptoms and distress in the context of psychiatric disorders after this disaster demonstrated that symptomatic distress is not inconsistent with psychological resilience. The choice of research focus and methods can provide very different portraits of outcomes post-disaster.

Reliable and valid assessment of abnormal speech patterns may enable earlier recognition of nonpsychotic disorders through characteristic speech patterns. This study sought to establish interrater reliability using a standardized guide for scoring. A scoring guide defining 27 elements (e.g., inappropriate self-reference, simple loss of goal, circumstantiality) of disordered thought was developed. The seminal work of Andreasen's and Holzman's groups provided 12 elements, and 15 new elements were suggested by clinical literature. Audiotaped interviews with 12 psychiatric inpatients, adults of both sexes and various ages hospitalized for acute management of nonpsychotic psychiatric disorders, provided speech samples for observation of disordered thought by two independent raters. Using the guide's definitions and accompanying examples of elements of disordered thought, reliability in scoring was high (kappa of .85 for agreement on the presence of any abnormal speech element and kappa values from .66 to 1.00 for agreement on the presence of individual elements).

Efforts are made to find whether comorbidity information obtained by cancer registrars during their usual chart abstraction process can provide important prognostic information. The results suggest that comorbidity is an important independent prognostic factor in a hospital-based cancer registry, which would increase the value and use of observational research.

Objectives. We examined the prevalence of psychiatric illness among 3 homeless populations in St. Louis, Mo, in approximately 1980, 1990, and 2000. The 3 studies were conducted with the same systemic research methodology. Methods. We compared selected demographics and lifetime substance abuse and dependence and other mental illness among the 3 populations. Results. Among the homeless populations we studied, the prevalence of mood and substance use disorders dramatically increased, and the number of minorities within these populations has increased. Conclusions. The prevalence of psychiatric illness, including substance abuse and dependence, is not static in the homeless population. Service systems need to be aware of potential prevalence changes and the impact of these changes on service needs.

Labrador retrievers (42 of original 48) were used to assess the effects of lifetime diet restriction on glucose tolerance at ages 9-12 y. Restricted-fed (RF) dogs were fed 75% of the same diet consumed by control-fed (CF) pair-mates. An intravenous glucose tolerance test was done annually (maximal stimulation, nonsteady-state). Diet treatment, age, and interactions were fixed effects. Statistical procedures used included mixed-model, repeated-measures ANOVA; least-squares means; Tukey's multiple comparison; paired t tests; and Spearman rank correlations. Glucose k-value and half-life, and insulin sensitivity (total, and 9, 10, 11 y, and per lean mass) were higher (P < 0.05) in RF than in CF dogs. Late-phase insulin release [area under the curve (AUC) 30-120 min] was less (P < 0.05) in RF than in CR dogs. Early-phase insulin release (AUC 0-5 min), y 12 insulin sensitivity and insulinogenic index did not differ between RF and CF dogs. Insulin peak, [DELTA] and total AUC increased (P < 0.05) with age, whereas the glucose k-value and glucose half-life were not affected by age. Insulin sensitivity was negatively, and insulin AUC 30-120 min, peak and [DELTA] glucose were positively correlated with body weight, body condition score, fat mass, percentage of fat and abdominal fat/total tissue. Higher insulinogenic indices tended (P = 0.053) to be associated with greater median survival and dogs with higher insulin sensitivity were at lower (P 0.05) risk of dying or receiving chronic disease treatment. Time to first osteoarthritis treatment or death was greater with lower basal glucose and higher insulin sensitivity (P < 0.05), but diet restriction explained most of this relationship's variation. Glucose disposal efficiency and insulin response were associated with increased quality and length of life in diet-restricted dogs. KEY WORDS: * diet restriction * glucose tolerance * insulin sensitivity * chronic disease * dogs