Weight Development and Mental Health Symptoms in Adolescent Girls

描述（由申请人提供）：超重与心理健康问题之间的相互关系尚不清楚。然而，了解体重发展的模式，以及为什么有些人特别容易体重过重，可能有助于深入了解美国肥胖流行的因果机制，从而为对抗流行趋势指明途径。它还可用于早期识别高风险个体，并定制最适合其特定风险模式的治疗策略。相反，如果体重对心理健康发展产生不利影响，持续的肥胖流行就会引起人们对可能的心理健康影响的担忧。我们建议考虑体重状况的发展与特定心理健康问题的发展之间的相互关系。情绪或行为失调的青少年容易分别出现情绪心理健康问题（例如情绪障碍）和行为心理健康问题（例如破坏性行为障碍）。我们假设他们也可能特别容易体重增加。相反，超重可能会增加抑郁风险，这表明可能存在相互关系，可能导致心理健康和体重状况恶化的循环模式。因此，心理健康问题可能会增加个体对致胖环境的敏感性，或与易导致体重增加的环境因素（例如贫困、犯罪或其他安全问题）协同作用。我们建议在匹兹堡女孩研究 (PGS) 中检查此类风险，这是一项基于社区的纵向研究，对象为 2451 名目前年龄为 12 至 12 岁的城市女孩，发起该研究的目的是深入了解女孩行为和情感问题的自然史。关注这一具有高超重风险的样本（例如，女性；超过一半的非裔美国人；经常出现家庭贫困；以及家庭住所过多地代表弱势社区），既可以提供病因学见解，也可以突出超重和心理健康结果中最严重的情况。这一点尤其重要，因为社会经济地位较低的个人在健康研究中的代表性往往不足。该项目延续了 McTigue 博士职业发展奖关于环境因素对 PGS 体重发展的作用的持续且富有成果的合作。因此，将丰富的 PGS 心理社会发展数据的见解与体重相关行为、健身和身体成分的见解相结合，有望为美国女性与体重相关的健康风险的发展提供独特而重要的见解。公共卫生相关性：对象叙述 随着美国青少年超重人数持续增加，了解谁最有可能出现与体重相关的健康问题非常重要。这项研究将对超重高风险的青春期女孩进行检查，看看某些潜在的心理健康问题是否会增加青春期女孩的体重增加率，另一方面，超重是否也会加剧心理健康风险。我们将推断对女孩健康可能产生的长期影响，并考虑如何利用这些发现来改善对心理健康或超重风险较高的女孩的识别和治疗。

DESCRIPTION (provided by applicant): The inter-relationship between the development of overweight and mental health problems is not well understood. Yet, understanding patterns of body weight development, and why some individuals are especially vulnerable to the accumulation of excess body weight may offer insight into causal mechanisms for the US obesity epidemic, and thus point towards avenues for combating epidemic trends. It also can be useful for early identification of high-risk individuals, and to tailor treatment strategies to be most appropriate for their specific patterns of risk. Conversely, if body weight adversely influences mental health development, the ongoing obesity epidemic raises concern for possible mental health implications. We propose to consider the inter-relationship between the development of body weight status and the development of specific mental health problems. Youth with emotional or behavioral dysregulation are predisposed to develop emotional mental health problems (e.g., mood disorders) and behavioral mental health problems (e.g., disruptive behavior disorder), respectively. We hypothesize that they may also be particularly vulnerable to weight gain. Conversely, overweight may increase depression risk, suggesting a possible reciprocal relationship that could lead to a cyclic pattern of worsening mental health and body weight status. Mental health concerns may thus increase individual susceptibility to an obesogenic environment, or act in synergy with environmental factors predisposing to weight gain (e.g. poverty, crime or other safety issues). We propose to examine such risk in the Pittsburgh Girls Study (PGS), a longitudinal community-based study of 2451 urban girls, currently aged 12 to 12 years, that was initiated to provide insight into the natural history of behavioral and emotional problems in girls. Focusing on this sample with high overweight risk (e.g., female; over half African American; frequent family poverty; and with home residences over-representing disadvantaged neighbor-hoods), can both provide etiologic insight and may highlight the most severe of both overweight and mental health outcomes. It is particularly important since individuals with lower socioeconomic status are frequently under-represented in health research. The project extends an ongoing and fruitful collaboration from Dr. McTigue's career development award on the role of environmental factors on weight development in the PGS. Combining insight from the rich PGS data on psycho-social development with that on weight-related behaviors, fitness, and body composition thus promises to provide unique and important insight into the development of weight-related health risk i US women. PUBLIC HEALTH RELEVANCE: object Narrative As overweight continues to rise among US adolescents, it is important to understand who has the highest risk of developing health problems related to their weight. This study will examine adolescent girls who are at high risk of overweight, to see whether certain underlying mental health problems may increase the rate of weight gain in adolescent girls, and, on the other hand, whether overweight also worsens mental health risk. We will draw inferences about possible long-term implications for the girls' health, as well as consider ways in which these findings may be used to improve identification and treatment of girls with high mental health or overweight risk.