Obesity and Psychosocial Adjustment During Adolescence

描述(由申请人提供)：肥胖青年的心理社会适应的程度和性质在文献中报道的结果褒贬不一，知之甚少。几乎没有努力用统计上合理的分析来检验这一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。关于体重状况的动态变化与青春期同时发生的适应问题的发展过程之间的联系，可获得的信息相对较少。针对NICHD的《基于NICHD幼儿保育和青年发展研究(SECCYD)的二次数据分析》(PA-06-284)，我们建议对NICHD的SECCYD数据进行二次数据分析，以研究青春期过渡前和青春期过渡期间体重状况动态变化的基于时间的因果过程以及个体和共生的心理社会适应领域，即，从三年级(约9岁)到15岁。本研究运用最新的潜在生长曲线模型和潜在差异得分动态模型，描述了三年级(约9岁)至15岁期间体重状况的增长曲线形状和心理社会适应的个体领域，包括抑郁、宽频行为问题(即内化和外化问题)和窄带症状子量表(即孤僻、躯体抱怨、焦虑/抑郁、社交问题、思维问题、注意力问题、违法行为和攻击行为)；(2)描述体重状况和心理社会适应的个体领域(包括抑郁、宽频行为问题和窄带行为问题)的时间交叉滞后因果影响：(3)检验体重状况的动态变化与心理适应的多个领域共现的发展过程的联系；(4)通过比较与潜在不同的群体动态相关的成长和变化，包括青少年自身的特征(性别、种族、青春期时机、肥胖状况和三年级(约九岁)之前的早期行为问题，以及从三年级到15岁的体重状况的成长轨迹模式)、家庭(父母支持)和同伴(同伴支持)特征，来考察一系列可能的调节因素对肥胖和行为问题之间动态相互关系的影响。这项研究的结果将极有可能促进人们对肥胖与青春期心理社会适应之间关系的了解，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。 与公共健康相关：超过15%的美国青少年被认为肥胖。这项研究将加深我们对青春期过渡时期肥胖的心理社会调节的动态因果序列的理解，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broad-band behavior problems (i.e. internalizing and externalizing problems) and narrow- band syndrome subscales (i.e. withdrawn, somatic complaints, anxious/depressed, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior) during the period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.