Obesity and Psychosocial Adjustment During Adolescence

描述（由申请人提供）：肥胖青少年心理社会适应的程度和性质尚不清楚，文献中报道的结果不一。很少有人用统计上合理的分析来研究这种随时间变化的动态序列，以捕捉基于时间的因果影响的方向以及肥胖和适应问题的增长轨迹。相对而言，关于体重状况的动态变化与青春期共同发生的适应问题的发展过程之间的联系的信息较少。为响应NICHD项目公告《基于NICHD早期儿童护理和青少年发展研究（SECCYD）》（PA-06-284）的二次数据分析，我们建议对NICHD SECCYD数据进行二次数据分析，以研究在青春期过渡之前和期间，即从三年级（约9岁）到15岁，体重状况动态变化以及个体和共同发生的社会心理适应领域的时间因果过程。我们运用最先进的技术和新的建模方法——潜在生长曲线模型和潜在差异评分的动态模型来(1)描述体重状况和心理社会适应的个体领域的生长曲线的形状，包括抑郁、宽波段行为问题（即内化和外化问题）和窄波段综合症亚量表（即孤僻、躯体抱怨、焦虑/抑郁、社会问题、思想问题、注意力问题、抑郁和抑郁）。三年级（大约九岁）到十五岁期间的不良行为和攻击性行为；(2)描述体重状况和个体心理社会适应领域（包括抑郁、宽带性和窄带性行为问题）的时间滞后因果影响；(3)研究体重状况动态变化与心理适应多领域并存发展过程的联系；(4)通过比较青少年自身特征（性别、种族、青春期时间、三年级前（约9岁）的肥胖状况和早期行为问题，以及从三年级到15岁的过渡时期体重状况的生长轨迹模式），研究一系列可能的调节因子对肥胖和行为问题之间动态相互关系的影响。家庭（父母支持）和同伴（同伴支持）特征。这项研究的结果将有很大的潜力来推进关于青春期肥胖和心理社会适应之间关系的知识，这可以转化为适当的干预措施，以解决青少年肥胖的流行问题。

DESCRIPTION (provided by applicant): The extent and nature of psychosocial adjustment in obese youth is poorly understood with mixed findings reported in the literature. Scant efforts have been made to examine this dynamic sequence over time with a statistically sound analysis to capture the direction of time-based causal influence as well as growth trajectories of both obesity and adjustment problems. Relatively little information is available about the linkage of dynamic changes of weight status to the developmental course of co-occurring adjustment problems during adolescence. In response to the NICHD program announcement of Secondary Data Analysis Based on NICHD Study of Early Child Care and Youth Development (SECCYD) (PA-06-284), we propose to conduct a secondary data analysis of the NICHD SECCYD data to investigate time-based causal processes of dynamic changes of weight status and individual and co-occurring domains of psychosocial adjustment just prior to and during the pubertal transition, that is, from 3rd grade (about age 9) to age 15. We apply state of the art and the novel modeling approaches of latent growth curve models and dynamic models of latent difference score to (1) describe the shapes of growth curves for weight status and individual domains of psychosocial adjustment including depression, broad-band behavior problems (i.e. internalizing and externalizing problems) and narrow- band syndrome subscales (i.e. withdrawn, somatic complaints, anxious/depressed, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior) during the period from 3rd grade (about age nine) to age fifteen; (2) delineate the time-based cross-lagged causal influences of weight status and individual domains of psychosocial adjustment including depression, broad- and narrow-band behavior problems; (3) examine the linkage of dynamic changes of weight status to the development course of co- occurring multiple domains of psychological adjustment; (4) investigate effects of an array of selected possible moderators on the dynamic interrelations between obesity and behavioral problems by comparing growth and changes related to potentially different group dynamics, including characteristics from adolescents themselves (gender, ethnicity, pubertal timing, obesity status and early behavioral problems prior to 3rd grade (about age nine), and growth trajectory patterns of weight status during the transition period from 3rd grade to age 15), family (parental support) and peers (peer support) characteristics. Findings of this study will have the great potential to advance knowledge on associations between obesity and psychosocial adjustment during adolescence, which can be translated into appropriate interventions to address the epidemic of obesity in adolescents. PUBLIC HEALTH RELEVANCE: Over 15% of U.S. adolescents are considered obese. The proposed study will advance our understanding of the dynamic causal sequence of obesity with psychosocial adjustment during pubertal transition, which will have important implication in public health for improving the physical development and mental well-being of adolescents.