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Szivak, TK, Thomas, MM, Pietrzak, RH, Nguyen, DR, Ryan, DM, and Mazure, CM. Obesity Risk Among West Point Graduates Later in Life. J Strength Cond Res XX(X): 000-000, 2020-The purpose of this investigation was to evaluate sex differences in health and fitness outcomes among United States Military Academy (USMA) graduates (class years 1980-2011). Subjects (n = 701 men, 641 women, age: 45.7 ± 9.3 years) were surveyed as a part of a larger investigation on risk and resiliency factors among USMA graduates. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form and calculation of weekly metabolic equivalents (METs). Overweight and obesity status were assessed by body mass index (BMI). Significance for the study was set at p ≤ 0.05. Obesity rates for men (30.1%) were significantly higher than for women (16.6%). Men reported significantly higher (p = 0.01) vigorous METs·wk (1,214.6 ± 1,171.6) than women (1,046.8 ± 1,133.2) despite significantly higher (p = 0.00) BMI values (28.75 ± 4.53 kg·m) than women (25.90 ± 5.48 kg·m). Women were 89% more likely to have ever been on a diet and reported higher (15.2%) Army Body Composition Program enrollment rates than men (6.3%). Obesity rates among men reflect trends seen in the broader military, Veteran, and U.S. adult populations, whereas obesity rates among women were lower. Men may be at a greater risk for obesity later in life despite higher self-reported physical activity; however, lean body mass and self-report bias should be considered. Because lifetime obesity may be influenced by factors other than physical activity, health initiatives should use a comprehensive approach early in the career of military officers.

Diabetes Mellitus is a complex condition characterized with hyperglycemia. Type 1 diabetes mellitus(T1DM) and type 2 diabetes mellitus (T2DM) are the most common forms of diabetes present in youth. The increasing prevalence of youth-onset diabetes is associated with profound personal, socio-ecological, cultural, psychological and economic factors as youth and adolescents during their peak productive years. There is a dearth of evidence on which social determinants of health factors are important barriers or facilitators for transitioning to adult care. The primary objective of the planned scoping review is to assess the literature on the social and psychological factors that influence transitioning of care in youth and young adults with T2DM and T1DM. The second objective is to identify knowledge gaps and areas for future research.

This phenomenological study explored compassion fatigue and resiliency factors in animal shelter workers. Compassion fatigue is a phenomenon in which individuals become traumatized through the process of helping others. The sample included seven current and former animal shelter workers. The researchers conducted semi-structured interviews to examine general experiences with animal shelter work as well as compassion fatigue. The researchers read the transcripts multiple times and coded the data into themes and sub-themes. Four major themes and five sub-themes emerged from the data. These themes were 1) Intrinsic Motivations including (a) Right reason, (b) Affinity with animals and (c) Attachment to animals; 2) Purpose, including (a) Making a difference and (b) Focusing on the positive; 3) Social supports; and 4) Coping Strategies. The study has important practical implications, including the potential benefits of screening job applicants for intrinsic motivations and fostering positive relationships between coworkers and the animals they work with.

Increased suicide in adolescent females calls for further study of potential risk and resiliency factors. Considering the relationship that menstrual cycle plays on mood and increased likelihood of suicidality in adult women, it is likely that a similar relationship is present in adolescents. The current review used PubMed and PsycInfo to assess articles related to menstrual cycle and suicide in adolescents. Limited data was present on the role that menstrual cycle and related disorders such as PMS and PMDD has on the worsening of mood symptoms and suicidal ideation and attempts, with minimal research conducted on adolescents. This review identifies a gap in research regarding premenstrual distress as a potential risk factor for suicidal ideation and attempts in adolescents. The present review suggests future routes for research in this area and the impacts that a better understanding of the complex relationship between menstrual cycle and suicide could provide in order to minimize the impact of menstrual distress on suicidality.

BACKGROUND: Admission to a Neuroscience Intensive Care Unit (Neuro-ICU) is sudden and often traumatic for both patients and their informal caregivers. No prior studies have assessed prospectively risk and resiliency factors for chronic posttraumatic symptoms, as well as the potential interdependence between patients and caregivers symptoms over time. PURPOSE: To analyze the impact of baseline resiliency factors on symptoms of posttraumatic stress (PTS) longitudinally in dyads of patients admitted to the Neuroscience Intensive Care Unit (Neuro-ICU) and their primary family caregivers. METHOD: We recruited dyads (M=108) of patients admitted to the Neuro-ICU (total N = 102) and their family caregivers (total N = 103). Dyads completed self-report assessments of PTS, and resiliency factors (mindfulness and coping) at baseline in the Neuro-ICU. PTS was measured again at 3- and 6-month follow-up. RESULTS: Clinically significant PTS symptoms were high at baseline in both patients (20%) and caregivers (16%), and remained high through 6 months (25% in patients;14% in caregivers). Actor-partner interdependence modeling demonstrated that severity of PTS symptoms was predictive of PTS symptoms at subsequent time points (ps

The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how early life exposures shape lifecycle health. To date, no comprehensive list of these exposures and their interactions has been developed, which limits our ability to predict trajectories of risk and resiliency in humans. To address this gap, we developed a model that uses text-mining, machine learning, and natural language processing approaches to automate search, data extraction, and content analysis from DOHaD-related research articles available in PubMed. Our first model captured 2469 articles, which were subsequently categorised into topics based on word frequencies within the titles and abstracts. A manual screening validated 848 of these as relevant, which were used to develop a revised model that finally captured 2098 articles that largely fell under the most prominently researched domains related to our specific DOHaD focus. The articles were clustered according to latent topic extraction, and 23 experts in the field independently labelled the perceived topics. Consensus analysis on this labelling yielded mostly from fair to substantial agreement, which demonstrates that automated models can be developed to successfully retrieve and classify research literature, as a first step to gather evidence related to DOHaD risk and resilience factors that influence later life human health.

The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how environmental exposures in early life shape lifecycle health. Our understanding and the ability to prevent poor health outcomes and enrich for resiliency remain limited, in part, because exposure–outcome relationships are complex and poorly defined. We, therefore, aimed to determine the major DOHaD risk and resilience factors. A systematic approach with a 3-level screening process was used to conduct our Rapid Evidence Review following the established guidelines. Scientific databases using DOHaD-related keywords were searched to capture articles between January 1, 2009 and April 19, 2019. A final total of 56 systematic reviews/meta-analyses were obtained. Studies were categorized into domains based on primary exposures and outcomes investigated. Primary summary statistics and extracted data from the studies are presented in Graphical Overview for Evidence Reviews diagrams. There was substantial heterogeneity within and between studies. While global trends showed an increase in DOHaD publications over the last decade, the majority of data reported were from high-income countries. Articles were categorized under six exposure domains: Early Life Nutrition, Maternal/Paternal Health, Maternal/Paternal Psychological Exposure, Toxicants/Environment, Social Determinants, and Others. Studies examining social determinants of health and paternal influences were underrepresented. Only 23% of the articles explored resiliency factors. We synthesized major evidence on relationships between early life exposures and developmental and health outcomes, identifying risk and resiliency factors that influence later life health. Our findings provide insight into important trends and gaps in knowledge within many exposures and outcome domains.

The purpose of this study was to identify resiliency factors that led to the academic success of three unaccompanied immigrant students in a Texas high school. We used case study methodology to examine the real life context of a phenomenon with data collected from three student participants in their natural settings using interviews, participant observations at school, and photo-elicitation. The findings indicated that internal and external protective factors attributed to the resiliency and school success of the three students who were unaccompanied immigrant children. This study is essential in understanding how resiliency factors impact the academic success of students who are dealing with the challenges of being unaccompanied immigrant children with limited immediate family support and who are English Language Learners (ELLs).

Resilience outcomes following significant adverse events are related to certain personal attributes, termed resiliency factors. This study aimed to adapt the Prince-Embury resiliency model, developed with children and adolescents, to adult populations. To that end, the Resiliency Questionnaire for Adults (RQA) was developed, consisting of nine characteristics organised around three factors: Sense of Mastery, Sense of Relatedness and Emotional Reactivity. The questionnaire adequacy was tested in adults from both general and health-distressed populations (N = 430) through reliability, confirmatory factor, cross-validation and multiple-group analyses. Criterion validity was assessed via path analysis with latent variables to predict resilience outcomes. The RQA scores were reliable and the three-factor model fitted the data well. The three resiliency factors predicted two-thirds of the variance in resilience. This questionnaire constitutes a reliable and valid assessment of personal factors underlyin...

Mixed orientation relationships (MOREs) refer to persons in a relationship whose sexual orientations do not match. To date, however, most literature on MOREs has focused somewhat narrowly on mixed orientation marriages (MOMs), in which one spouse is heterosexual and the other experiences same-sex attraction and may or may not identify as lesbian, gay, or bisexual. This review focuses on 14 recently published scholarly articles, noting an emerging shift in the literature from MOMs to the more broad and inclusive concept of MOREs. Relationship factors, the influence of religious identity, lesbian and bisexual female partners, intentional MOREs, and clinical practice issues are discussed. Further research on MOREs that looks beyond the traditional viewpoint of MOMs is needed in order to better understand the particular challenges, as well as the unique resiliency factors, seen within these non-traditional relationships.

This paper aims at investigating resiliency factors (sense of mastery, sense of relatedness, and emotional reactivity), and hope as predictors of academic performance, while controlling for gender, tuition fees, and age. Differences in resiliency factors across gender and tuition fees were also explored. Participants were 599 Lebanese adolescents (330 female), ranging from ages 11 to 19. Resiliency factors predicted academic performance over gender, tuition fees, and hope, and played a more important role in the academic performance of middle/late than early adolescence. Gender differences were found in emotional reactivity (marginal) and sense of relatedness, with females scoring higher than males in both cases. Finally, adolescents with low tuition fees scored lower than those with middle tuition fees on emotional reactivity and marginally lower than those with high tuition fees on sense of relatedness. The relevance of these findings to resiliency among adolescents is discussed, along with implications and recommendations for future research and educational practice.

In general cases, particularly in developing countries, the weakness of the national electric grid is due to overloading, infrastructures aging, high temperatures and bad weather. In such systems, the interruptions of electricity supply can take several hours to days. To prevent the power deficit, consumers can use diesel generators that are very noisy and highly polluting. But, as alternative, renewable energy sources and storage devices can be used for load shifting. This can help to improve the grid resiliency and the supply continuity. But, to do this, it is necessary to have efficient methodology of weakness analysis and resiliency factors estimation. In this paper, experimental data are used to define the main parameters of the system performance based on the IEEE Std Std 1366TM-2012 indexes.

Everyday commercial, civil, and defense enterprises are faced with disruptive events that have the potential to degrade or altogether impede business as usual. In an increasingly interconnected and interdependent world, where systems/system-of-systems provide functionality enabling operational capabilities, complexity is commonplace; and the ability to anticipate and therefore manage all potential disruptions becomes untenable. Recognizing this dilemma, organizations are trying to understand and infuse the properties of resiliency in their culture, processes, and assets. Resilience is a widely used term and in general is understood as the ability to operate through some adverse condition. Accordingly, engineered resilience, the notion of designing resilience into a system from the outset, is a frequent subject of analysis and research in the systems engineering and acquisition community. This paper explores the question of what it means to purposefully engineer resilient systems by examining systems that displayed resilience, thus continuing to provide a capability even through disruptions. The examples – an acquisition system and an operational system – are analyzed with respect to various resiliency concepts. This includes applying several resiliency definitions to the example systems and identifying metrics for measuring resilience which introduces the notion of drift, timeliness, and process as important resiliency factors. Finally, observations related to engineering resilient systems are offered.

A proposed evaluation protocol addresses the need for standards of practice in assessing candidates for ministry careers. The protocol is tailored to parish clergy psychological risk and resiliency factors articulated by personnel officers and identified in scholarly literature. It employs readily available psychological tests with demonstrated psychometric qualities. It utilises interview questions to confirm or disconfirm test-generated hypotheses and to probe for evidence of coping with challenging circumstances. The protocol generates data for appraising risk and promoting long-term resilience. Application of the protocol to 120 applicants for clergy careers in the Episcopal Diocese of the Southwest (EDSW) demonstrates that applicants respond to psychological tests in a manner different from general job applicants. Data analysis generates norms for indentifying unusual applicants who may be at risk for troubled careers. Discussion centres on identifying early markers of risk and resiliency in ministry...

This study investigated the relationships among stress, intrapersonal resiliency factors (self-esteem, locus of control, and optimism) and quality of life [QOL] (physical health and mental health) among caregivers of children with high functioning autism spectrum disorders (HFASDs). Participants consisted of 113 caregivers of children with HFASDs (males = 38.1%, females = 61.9%; age range = 27–62; 93.6% Caucasians) and 47 caregivers of typically developing children (males = 29.8%; females = 70.2%; age range = 30–56; 93.3% Caucasians). They completed a set of self-rating surveys on perceived locus of control, self-esteem, optimism, and QOL. Within-group inferential statistical analyses were applied. For the HFASD group analyses, two simultaneous regression analyses were used to study the independent effects of the three intrapersonal variables on the physical health and mental health QOL of the caregivers. Intrapersonal factors predicted self-reported mental health QOL but not physical health QOL in caregivers of children with HFASDs.

The self-help literature promotes the use of positive self-statements (e.g., I'm a lovable person) to boost self-esteem and mood; however, research provides evidence that positive self-statements may be harmful to people with low self-esteem. Prior research has only tested the efficacy of one type of positive self-statement (stable/global), but research on attitude change and self-verification motives suggests that people with low self-esteem may benefit more from using unstable/specific positive self-statements. To test the effect of each type of positive self-statement on self-esteem and mood, a quasi-experiment was conducted in which participants with high and low self-esteem were randomly assigned to either write about a stable/global positive self-statement, unstable specific positive self-statement, or their favorite activity following a laboratory stressor. Results provided evidence that participants with low self-esteem experienced the largest decrease in negative affect if they were assigned to w...

This study explored resiliency factors in middle- and upper-income single mothers, a subset of single parents representing 73% of single mothers in the United States. The study used demographic information and the Connor–Davidson Resilience Scale (CD–RISC) to examine if income, education level, or type of marital status is related to resiliency factors among single mothers. An analysis of variance was conducted to compare group differences among income levels, education levels, and types of marital status with resiliency scores. Results revealed that the middle- and upper-income single mothers were generally resilient. A descriptive analysis of descending means revealed five resiliency factors on the CD–RISC that were most strongly rated, four of which relate to personal competence and tenacity. Implications for clinical practice and recommendations for future research to expand the body of research on single mothers were included in this study.

— Researchers have paid little attention to the effects of a rapidly globalizing world on infants and toddlers, even though some features of globalization may have a significant impact on their development and well-being. For example, fragmentation occurs in many North American and European transnational families when infants are separated from parents and cared for by geographically distant relatives, as is the case when new immigrants temporarily leave their infants in their country of origin or send them back to be cared for by relatives. There is much reason to believe that such separations can have an adverse effect on attachment, the emotional development of children, and the adjustment of parents. Yet Western mental-health models may not accurately capture the full complexity of these new realities, nor adequately address risk and resiliency factors in clinical contexts. This article argues that it is the time to devote attention to the experience of infants and toddlers who exist in transnational environments, as these very young children may well be the most overlooked participants in globalization. This article proposes a model to support an emergent field of research, policy making, and practice.

This descriptive study sought to examine the resiliency factors families developed when faced with the challenges of raising a child manifesting a severe disability. The study compared and contrasted how families managed the additional responsibility and stress of raising a child with special needs. The study aimed to identify the key characteristics present in resilient families allowing them to not just survive but thrive, becoming in the process strengthened and resourceful. The study found that there is a relationship between resilience and level of socio-economic status (SES). The study also found that having the time and the ability to reflect was a key to reconfiguration, which is seen as crucial in the development of resilience. Once afforded this type of time, the families reconstructed their vision of family, of disability and their child. Lastly, the study found that the development of resiliency was enhanced by the development of rhythm in the family. Rhythm is defined in this study as the establishment of consistent rules, rituals and routines.

The primary aim of this study was to identify factors associated with resiliency in poor single-parent families. A cross-sectional survey was used to identify and describe resiliency factors that enable families to maintain healthy family functioning. The 51 families that participated in this study were identified by the nature of the crisis and the developmental phase of the family. A biographical questionnaire and several indexes were completed independently by a parent and a child from each family. The results indicated a significant relationship between the families’ adaptation and intrafamilial support, support from family and friends, family hardiness, a positive approach to problems, and religion. The findings can contribute significantly to future interventions and preventive approaches to foster resiliency in families.

Most studies deal with the way of how the hardships and stress aroused by the deficiency affect the family, the family relations and roles. However, some families having children with disabilities can face their situation due to their personality resources, their environment or with the help of social services. The article presents the results of a research on the coping strategies of parents with disabled children. The sample consists of 400 Rumanian families who brought up a disabled person aged 0 to 23. The primary intention of the research was to provide as much information as possible about the families having disabled children, based on which it can be explored how they fight against the situation of life changed by the deficiency. The other aim of the research was to explore the situation of the families living with deficiency through examining the risk and resiliency factors, and to investigate how those families can find those supportive possibilities in their immediate circumstances, in the supplies provided by the supply-system and in their own personalities which make it possible for them to stay balanced in spite of the problems. This paper is looking for protective factors and solutions, which are helpful for parents in finding successful coping strategies. It also examines risk factors, which usually lead to a lack of balance in the family life and makes coping difficult.

Mona El-Sheikh and her colleagues have assembled an impressive series of studies for this monograph. To date, researchers interested in the consequences of marital conflict on children have focused primarily on the main effects of psychological variables. Although these studies have been invaluable in helping us to better understand risk and resiliency factors associated with children’s exposure to marital conflict, future research will almost certainly be conducted at multiple levels of analysis, spanning genes to behavior (Ciccetti, 2008). The authors’ work examining the conjoint effects of marital conflict and biological vulnerability on children’s externalizing behaviors is therefore a welcome addition to the literature and likely marks a transition to a new generation of research. Among the few authors who have examined biological moderators of outcomes among children exposed to marital conflict, respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system (PNS) functioning, has been the predominant measure used (e.g., El-Sheikh & Whitson, 2006; Katz & Gottman, 1995). In this monograph, El-Sheikh and colleagues extend this work in a number of important ways. First, they include a measure of sympathetic nervous system (SNS) functioning and examine interactions between the SNS and PNS in predicting children’s externalizing behaviors. Second, they provide detailed descriptions of and comparisons among several alternative models of autonomic nervous system (ANS)–behavior relations, grounding their hypotheses firmly in theory. Finally, they conduct the same protocol with three separate samples of children (total N5 577), recognizing that three-way interactions, which are required to test their hypotheses, are often spurious and difficult to replicate. The authors should be applauded for this painstaking research effort. Although their pattern of results is complex, the findings indicate that children’s physiological functioning is clearly related to their externalizing behaviors in the context of marital conflict.

SUMMARY The incarceration of women who are mothers affects not only the women, but their children and families. The children are at high risk developmentally, psychologically, emotionally, and economically. This article identifies concerns and interventions for the children, families, and incarcerated women. Risk factors, as well as resiliency factors, are recognized, framing the intervention work needed to support optimal growth, development, and mental well-being of the children and families of incarcerated mothers

Much of the debate on youth bullying and violence focuses upon interventions with instigators of the violence or on broad-based general prevention strategies that may or may not be geared toward individual school conditions. These strategies frequently take a problem-focused approach that can pathologize behavior and create divisions within schools rather than providing solutions. One of the reasons why this occurs is because it is difficult for educators to gather specific information related to bullying and aggressive behaviors in their school or district. This article provides an overview of a comprehensive assessment tool, the Youth Resiliency: Assessing Developmental Strengths questionnaire, developed by Resiliency Canada, that is being used by educators and other concerned stakeholders to understand the dynamics of resiliency to bullying and other aggressive behavior patterns. The article also provides information for understanding the resiliency factors and strengths related to a range of connected behaviors and attitudes of young people who engage in bullying. It also suggests a strength-based approach that can be used by educators, parents, students, and members of the community to promote the development of resiliency through collaborative strategies that address the needs of youth in their school.

The aim of this study was to identify resiliency factors in families with a mentally ill family member. The study population was composed of 30 families, where questionnaires were independently completed by both a parent and a child. The results indicate that family hardiness was an important resilience factor for both the parents and the children. According to the parents the passive evaluation of a crisis situation, or the use of avoidance strategies, was also helpful for the family to adapt. For the children, the extent to which they found support from within the community and the extent to which they experienced emotional support, self-worth, and community support were linked to their view on family adaptation to stressful situations.

This article focuses on how to construct the Scripto-Trauma Genogram and how to use it with trauma survivors who struggle with intrusive memories. Clients develop Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) after a traumatic event, based upon personal factors, predisposing factors, peridisposing factors, postdisposing factors and resiliency factors. Clients with ASD or PTSD, as well as trauma survivors who do not quite meet all the diagnostic criteria for ASD or PTSD, often report struggling with intrusive memories, which are believed to be brief sensory fragments of the traumatic event and are experienced as intensely as they were during the traumatic event. [Brief Treatment and Crisis Intervention 6:36–51 (2006)]

The purpose of this daylong workshop was to reach consensus about a prevention program to decrease risk and increase resiliency behaviors associated with substance abuse and HIV among rural adolescents in faith-based settings. The process and outcomes of the workshop are described. Workshop participants validated and prioritized risk and resiliency factors associated with substance abuse and HIV infection and used these to decide between potential prevention programs. A substance abuse (All Stars) program and an HIV (Be Proud! Be Responsible!) curriculum were selected and integrated. Consensus was reached that the implementation team should consist of adults and adolescents.

Using a cross-sectional survey research design, the present study aimed to explore and explicate those resiliency factors that enable families to adjust and adapt successfully after the loss of a parent. Thirty-nine families completed questionnaires, including an open-ended question in which they were asked to report the most important factors or strengths that they felt helped their family through the stressful period. Results indicate that intrafamilial support, such as emotional and practical support amongst family members, and family hardiness characteristics, such as the internal strengths and durability of the family unit, contribute to resilience within the family. Individual characteristics, for example positive personality characteristics such as optimism, are equally important. Support from extended family and friends, as well as support obtained from religious and spiritual beliefs and activities, were reported as facilitating successful adjustment to the loss.

As part of a nationally-funded effort to examine female delinquency, focus groups with girls and young women involved in the juvenile justice system were conducted in ten California counties. This article presents data from these focus groups and provides a detailed picture of the gendered perspective of these respondents in terms of the individual and social factors that contribute to risky behavior and delinquency among girls and young women. Family problems, including relationships with parents and communication problems, running away, abuse issues and substance use were factors most often discussed. Gang issues and violence were also identified as problems among a minority of girls and young women. Problems with school and the early onset of sexual behavior are also related to high-risk behaviors.

This paper summarizes the literature on alcohol problems in Alaska Natives, briefly summarizing risk and resiliency factors but focusing on Native and Western healing practices. A story (The Red Shoes) is used to illustrate many of the cultural factors that are influencing the role of alcohol in Alaska Native life. Treatment factors explored include both Alaska Native and Western Approaches. The Western approach focused on is Narrative Therapy, which has not yet been applied to Alaska Native populations. Barriers to service delivery are briefly explored, as are suggested ways to overcome such barriers.

Based on in-depth interviews with 42 parents (25 mothers, 17 fathers) in 26 families who had had a child treated for cancer within the previous 3 years, resiliency factors that helped the family recover were identified. The resiliency factors included internal family rapid mobilization and reorganization; social support from the health care team, extended family, the community, and the workplace; and changes in appraisal to make the situation more comprehensible, manageable, and meaningful.

There is a need to understand resiliency factors which can be used to inform and design interventions to prevent externalizing problems, substance use, and depressive symptoms among American Indian (AI) youth.The present study examined the role of self-efficacy in externalizing problems, alcohol use, and depressive symptoms among AI youth from the North American plains.Participants for this study included 146 (53 boys and 93 girls) adolescents, with an age range of 13-18 (M = 14.5) years of age.High self-efficacy for resisting negative peer influences predicted both lower rates of alcohol use and fewer externalizing behaviors. Furthermore, higher levels of both academic and social self-efficacy predicted fewer depressive symptoms. The hypothesis that academic self-efficacy would predict depressive symptoms was not supported.As expected, the best-fitting path model showed self-efficacy for resisting negative peer influences predicting both alcohol use and externalizing problems, and social self-efficacy (as well as being female) predicting depressive symptoms among AI youth. Therefore, this study supports the importance of self-efficacy beliefs for alcohol use and externalizing problems, as well as depressive symptoms, among AI youth.