Weight Development and Mental Health Symptoms in Adolescent Girls

描述（由申请人提供）：超重发展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受到超重积累的影响，可能会让我们深入了解美国肥胖流行的因果机制，从而指出对抗流行趋势的途径。它也可以用于早期识别高风险个体，并定制治疗策略，以最适合他们的具体风险模式。相反，如果体重对心理健康的发展有不利影响，那么持续的肥胖流行引起了人们对可能的心理健康影响的关注。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分别容易出现情绪心理健康问题（如情绪障碍）和行为心理健康问题（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，超重可能会增加患抑郁症的风险，这表明一种可能的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，心理健康问题可能增加个体对致肥环境的易感性，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）中检查这种风险，这是一项对2451名12至12岁的城市女孩进行的纵向社区研究，旨在深入了解女孩行为和情感问题的自然历史。关注高超重风险的样本（例如，女性；超过一半的非裔美国人；经常家庭贫困；以及家庭住宅过度代表弱势社区），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卫生研究中的代表性往往不足。该项目延续了McTigue博士关于环境因素对PGS体重发展的作用的职业发展奖的持续和富有成效的合作。将PGS丰富的社会心理发展数据与体重相关行为、健康和身体组成数据相结合，有望为美国女性体重相关健康风险的发展提供独特而重要的见解。随着美国青少年中超重的人数持续上升，了解谁患与体重相关的健康问题的风险最高是很重要的。这项研究将对超重风险较高的青春期女孩进行调查，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长速度，另一方面，超重是否也会加剧心理健康风险。我们将得出对女孩健康可能产生的长期影响的推论，并考虑如何利用这些发现来改进对具有高心理健康或超重风险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.