Obesity and Psychosocial Adjustment During Adolescence

描述（由申请人提供）：肥胖青年的心理社会调整的程度和性质知之甚少，文献中报道的结果不一。很少有人努力研究这个动态序列随着时间的推移与统计上的声音分析，以捕捉基于时间的因果影响的方向，以及肥胖和调整问题的增长轨迹。相对较少的信息是有关链接的动态变化的体重状况的发展过程中共同发生的调整问题，在青春期。根据NICHD早期儿童保育和青年发展研究（SECCYD）的二级数据分析，（PA-06-284），我们建议对NICHD SECCYD数据进行二次数据分析，以调查青春期过渡之前和期间体重状态动态变化以及心理社会调整的个体和共同发生领域的基于时间的因果过程，也就是说，从三年级（大约9岁）到15岁。本研究应用最新的潜在成长曲线模型和潜在差异分数动态模型的建模方法，（1）描述了体重状况和心理社会适应的个体领域（包括抑郁、宽带行为问题）的成长曲线的形状（即内化和外化问题）和窄带综合征分量表（即退缩、躯体主诉、焦虑/抑郁、社会问题、思维问题、注意力问题、犯罪行为和攻击行为）（2）描述体重状况和心理社会适应的个体领域（包括抑郁症、宽频带和窄频带行为问题）的基于时间的交叉滞后因果影响;（3）探讨体重状况的动态变化与心理适应多领域共现发展过程的联系;（四）研究一系列选定的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，不同的群体动态，包括青少年自身的特征（性别、种族、青春期时间、肥胖状况和三年级（约9岁）之前的早期行为问题，以及从三年级到15岁过渡期间体重状况的增长轨迹模式）、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，以推进知识之间的关联肥胖和心理社会调整在青春期，这可以转化为适当的干预措施，以解决青少年肥胖的流行。 公共卫生相关性：超过15%的美国青少年被认为肥胖。本研究将进一步了解青春期过渡期肥胖与心理社会适应的动态因果关系，这将对改善青少年的身体发育和心理健康具有重要的公共卫生意义。

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broad-band behavior problems (i.e. internalizing and externalizing problems) and narrow- band syndrome subscales (i.e. withdrawn, somatic complaints, anxious/depressed, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior) during the period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.