RESUMO
OBJECTIVES: To estimate associations between psychiatric disorders and gun carrying among adolescents and to estimate the total number of adolescents in the US who have psychiatric disorders and report carrying guns. STUDY DESIGN: We used cross-sectional data from the National Comorbidity Survey - Adolescent Supplement, a nationally representative sample of adolescents age 13-18 years (N = 10â123; response rate = 75.6%). Psychiatric disorders were assessed using the Composite International Diagnostic Interview. Gun carrying in the 30 days prior to the interview was assessed by self-report. We used multivariable Poisson regression to test for associations. RESULTS: The analytic sample included 10â112 adolescents, 2.4% of whom reported carrying a gun in the prior 30 days. The prevalence of gun carrying was greater among adolescents with conduct disorder (adjusted prevalence ratio [APR] = 1.88, 95% CI 1.38, 2.57), drug use disorders (APR = 1.91, 95% CI 1.05, 3.45), and specific phobias (APR = 1.54, 95% CI 1.07, 2.22) compared with adolescents without these disorders. We estimated that 1.1% (95% CI 0.77, 1.48) of adolescents with a disorder associated with self- or other-directed violence also carry guns. Nationally, that is approximately 272â000 adolescents with both risk factors. CONCLUSIONS: Specific psychiatric disorders are associated with an increased risk of gun carrying among adolescents, but the vast majority of adolescents with psychiatric disorders did not report gun carrying. Targeted efforts to assess access to and use of firearms in mental healthcare and other clinical settings are important, as are efforts to identify population approaches to prevention.
Assuntos
Comportamento do Adolescente , Armas de Fogo , Transtornos Mentais/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações , Estados Unidos/epidemiologiaRESUMO
PURPOSE: The purpose of the study was to examine whether access to an at-scale, group-based parenting education program ("Educación Inicial") had differential effects on parenting behaviors and child cognitive development according to mother's age at the birth of her first child, with a focus on adolescent mothers in rural Mexico. METHODS: This was a secondary analysis of a cluster-randomized controlled trial (n = 728 households, n = 106 communities). We conducted intent-to-treat analyses and examined the interaction between treatment group and mother's age at first birth. The primary outcomes were parenting behaviors (Family Care Indicators) and children's cognitive development (McCarthy Scales of Children's Abilities) at ages 3-5 years. RESULTS: We found that children of mothers who began childbearing in adulthood (20-30 years) scored higher on tests of cognitive development when randomized to weekly parenting support than their counterparts in the comparison group. Whereas, the children of mothers who began childbearing in adolescence (≤16 years) did not have higher scores associated with the parenting program (difference in magnitude of associations: Verbal = -8.19; 95% CI = -15.50 to -.88; p = .03; Memory = -7.22; 95% CI = -14.31 to -.14; p = .05). The higher scores among the children of mothers who began childbearing in adulthood were only significant when Educación Inical was supported by Prospera, the conditional cash transfer program. CONCLUSIONS: Our study results suggest that the Educación Inicial parenting intervention did not adequately address the needs of women who began childbearing in adolescence. One reason may be that adolescent mothers are more socially marginalized and less able to benefit from parenting programs.
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Desenvolvimento Infantil/fisiologia , Mães/educação , Mães/estatística & dados numéricos , Poder Familiar/psicologia , Gravidez na Adolescência , Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Masculino , México , Mães/psicologia , Gravidez , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
AIM: To identify and better understand opportunities for and challenges in attaining the maternal role among women who began childbearing in adolescence in rural Mexico. BACKGROUND: Adolescent mothers often face challenges rising from their socioeconomic status and developmental stage that can strain the process of developing confidence and competence in the maternal role. In Mexico, 19% of births are to women under age 20. Little is known about these mothers' experiences with parenting. DESIGN: Mixed methods. METHODS: Quantitative data collected in 2008 from a cluster-random sample of mothers (n = 1,381) in rural, impoverished areas of three southern states provided objective measures of mothers' socioeconomic position, well-being, and parenting practices. Semi-structured interviews conducted in 2013 with mothers (n = 30) provided insight into perceptions of motherhood and opportunities for and challenges in attaining the maternal role. FINDINGS: Ever-adolescent mothers scored lower than never-adolescent mothers on the total HOME and the parental responsivity and learning materials subscales. They also occupied the most economically disadvantaged positions, showing the lowest levels of education and wealth and the most depressive symptoms compared with never-adolescent mothers. The qualitative analysis supported these challenges and highlighted areas of opportunity: (1) early-adolescent parents faced economic challenges; (2) adolescent childbearing was normative with some exceptions; (3) participants' mothers and mothers-in-law provided social support; and (4) mothers focused on learning to parent and helping their children "get ahead" in life. CONCLUSION: Findings have important implications for identifying how to support young women as they become mothers and continue in this role.
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Mães/psicologia , Adolescente , Adulto , Feminino , Humanos , México , Poder Familiar , Gravidez , Gravidez na Adolescência , População Rural , Classe Social , Adulto JovemRESUMO
We examined effects on child development of a group-based parenting support program (Educación Inicial - EI) when combined with Mexico's conditional cash transfer (CCT) program (Prospera, originally Oportunidades and Progresa). This cluster-randomized trial included 204 communities (n = 1,113 children in final sample), stratified by community indigenous status, and assigned to receive either: (T0) CCT only; (T1) CCT plus availability of EI in the community; or (T2) T1 plus promotion of the EI program by the CCT program. Interviews were conducted with the mother or primary caregiver of each child at baseline (2008, children 0-18 months old), and at follow-up (2012, children 3-5 years old); the intervention began after baseline and continued for all eligible households. Cognitive development was assessed with the Extended Ages and Stages Questionnaire (baseline) and the McCarthy Scales of Children's Development (follow-up); assessors were blinded to treatment. All analyses were intention to treat. There were significant effects on child development when EI received support and promotion from the CCT program (T2 vs. T0: General Cognitive Index, ß = 3.90; 95% CI [0.51, 7.30], Verbal Score, ß = 4.28; 95% CI [0.51, 8.05], and Memory Score, ß = 4.14; 95% CI [0.62, 7.66]), effects equivalent to 0.26-0.29 SD. There were no significant benefits when the programs operated independently (T1 vs. T0). In stratified analyses, EI showed significant effects in indigenous communities only. We found consistent results in regressions controlling for covariates, with some reductions in magnitude of differences. Our findings suggest that group-based, parenting support programs can improve child outcomes within the context of a CCT, but only when the 2 programs are integrated and mutually supportive. (PsycINFO Database Record
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Desenvolvimento Infantil , Educação não Profissionalizante , Poder Familiar , Seguridade Social , Pré-Escolar , Cognição , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , México , Pobreza , Testes Psicológicos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
BACKGROUND/OBJECTIVES: Our objective was to explore the association between weight status and behavioral problems in children before school age. We examined whether the association between weight status and behavioral problems varied by age and sex. SUBJECTS/METHODS: This study used cross-sectional data from a nationally-representative sample of children and their families in Chile (N = 11,207). These children were selected using a cluster-stratified random sampling strategy. Data collection for this study took place in 2012 when the children were 1.5-6 years of age. We used multivariable analyses to examine the association between weight status and behavioral problems (assessed using the Child Behavior Checklist), while controlling for child's sex, indigenous status, birth weight, and months breastfed; primary caregiver's BMI and education level; and household wealth. RESULTS: Approximately 24% of our sample was overweight or obese. Overweight or obese girls showed more behavioral problems than normal weight girls at age 6 (ß = 0.270 SD, 95% CI = 0.047, 0.493, P = 0.018). Among boys age 1 to 5 years, overweight/obesity was associated with a small reduction in internalizing behaviors (ß = -0.09 SD, 95% CI = -0.163, -0.006, P = 0.034). CONCLUSIONS: Our data suggest that the associations between weight status and behavioral problems vary across age and sex.