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Risk behaviors in adopted adolescents and subsequent outcomes in young adulthood
February 2004
problem-solving and anger management skills knowledge (p ⫽ .012). Trends were seen for both attitudes against violence and reported violent behaviors, with those attending control programs or fewer than 50% of the VP sessions more likely to report attitudes supporting violence (p ⫽ .065), and intervention subjects reporting fewer violent and aggressive behaviors at immediate posttest (p ⫽ .06). No significant intervention effects were seen for intentions, overall violence knowledge, and self-efficacy. Conclusions: Adapting and implementing a school-based violence prevention program in a community-based setting is both feasible and effective in improving skills, attitudes, and behaviors towards aggression and violence. Making these programs more widely available to community-based agencies and families may provide alternatives or complements to school-based programming and offer needed opportunities for enhancing positive behavior changes among youth. RISK BEHAVIORS IN ADOPTED ADOLESCENTS AND SUBSEQUENT OUTCOMES IN YOUNG ADULTHOOD Cheryl Kodjo, M.D., M.P.H., Emily Fingado, and Peggy Auinger, M.S. University of Rochester, Strong Children’s Research Center, Rochester, NY. Purpose: The rate of childhood adoption, particularly international adoption, has increased over the past two decades. This increase has created a need for research within this population, particularly among adopted adolescents (AA). Little is known about risk behaviors in AA or the outcomes of their risk behaviors as they transition into young adulthood. The purpose of this study was to determine the prevalence of risk behaviors, and long-term outcomes, among AA compared to non-adopted adolescents (NA). Methods: Secondary analysis of the restricted-use National Longitudinal Study of Adolescent Health. Linking Waves 1 (1994 –95) and 3 (2001–2002), the sample consisted of 18,250 NA and 656 AA.Risk behaviors from Wave 1 included trying to lose weight, alcohol use, marijuana use, other drug use, sexual activity, violence, and suicidal attempts. Outcomes from Wave 3 included diagnosed eating disorder, drug/alcohol treatment, sexually transmitted disease, emergency room injury treatment, and treatment for mental illness. SUDAAN was used for all analyses. AA and NA were compared on all variables from Wave 1. Those who reported engaging in specific risk behaviors in Wave 1 were then compared on related outcome variables from Wave 3. Bivariate analyses included ⌾2- and t-testing for categorical and continuous variables, respectively (p ⬍ 0.05). Results: The racial/ethnic breakdown of AA from Wave 1 was: 76% White; 11% Black; 6% Hispanic; 3% Asian/PI; 2% Native American; 1% “Other”. Of AA, 51% were female and 66% were less than 17 years of age. There were no significant differences in household income between AA and NA; nor were there significant differences in self-esteem. However, AA were more likely to report more emotional distress (means: 173 vs. 129, p ⬍ 0.01) and less family connectedness (means: 690 vs. 717, p ⬍ 0.01). Regarding risk behaviors, there were no significant differences between AA and NA to engage in losing weight, alcohol use, marijuana use, other drug use, sexual activity, violence, or suicidal attempts. As for adverse outcomes as young adults, there were no significant differences. Conclusions: Despite significant differences in emotional distress and family connectedness in AA vs. NA, AA were not more likely than NA to engage in risk behaviors. Also, AA were not more likely to have adverse outcomes as young adults. Further research
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needs to be done with larger samples of AA in order to gain a consensus about their risk behaviors and outcomes. GETTING INFORMATION ON 9/11 — DID THE MEDIA HAVE AN IMPACT ON ADOLESCENTS? Michele Calderoni, D.O., Elizabeth Alderman, M.D., Ellen Silver, Ph.D., and Laurie Bauman, Ph.D. Dep. Pediatr., Sect. Adoles. Med., Children’s Hosp. at Montefiore, Albert Einstein Coll. Med., Bronx, NY. Background: The terrorist attacks on the World Trade Center (WTC) on 9/11 was an unprecedented event in US history. Many studies have shown that adolescents who are exposed to a traumatic event through the media, particularly television viewing, may develop acute and chronic mental health disorders. Purpose: (1) At a public high school in Bronx, NY, 20 miles north of the WTC, to determine the types of media used by students to access information regarding the events of 9/11. (2) To determine the association between media exposure, specifically television (TV) viewing, and symptoms and diagnosis of post traumatic stress disorder (PTSD). Methods: As part of a larger study, subjects completed a survey 8 months after 9/11 containing questions to assess what types of media were used to obtain knowledge about the events of 9/11. Additionally, a PTSD diagnostic instrument obtained from the Office of Behavioral and Social Science Research (NIH) was completed. Bivariate analysis included two-tailed Chisquare tests and ANOVA to identify significant associations between media sources and symptoms and diagnosis of PTSD. 1214 students completed the survey: 61% female, 62% Hispanic, 29% African American. Mean age 16 yrs, (⫾1.43). 7.4% met DSM-IV criteria for PTSD. Results: 92% used television, 74% used newspapers, 72% used radio, and 48% used the internet to obtain information about the events of 9/11. 4% reported not using any media sources for their information on 9/11. When testing for associations between individual media sources and PTSD, no significant associations were found. Bivariate analysis was used to determine if rates of PTSD diagnosis were different in 4 groups: those using TV only (8% had PTSD); TV plus other media (7% had PTSD); other media but no TV (19%); and those using no media (13%). We found a trend towards a higher rate of PTSD diagnosis in subjects not using TV as an information source (p ⫽ .06 ANOVA). Of the 17 symptoms included in the diagnostic instrument for PTSD, students in the ‘other media but no TV’ and ‘no media’ groups were found to have higher rates of the following symptoms: somatic complaints such as heart pounding, trouble breathing and sweating (p ⫽ .002); intrusive memories (p ⫽ .03); diminished interest in activities (p ⫽ .002); feeling distant from others (p ⫽ .043); diminished interest in activities (p ⫽ .002) and loved ones (p ⫽ .000); and a sense of foreshortened future (p ⫽ .000). Conclusions: As expected, a large majority of urban adolescents living 20 miles north of the WTC used TV as a source of information on 9/11. However, contrary to expectations, we found higher rates of several PTSD symptoms and a trend toward increased rates of diagnosis of PTSD in the minority of adolescents who did not use TV as an information source on 9/11. These adolescents may have been too distressed to watch TV or so disadvantaged that they had no access to TV. Either situation may have predisposed them to develop PTSD symptoms.
problem-solving and anger management skills knowledge (p ⫽ .012). Trends were seen for both attitudes against violence and reported violent behaviors, with those attending control programs or fewer than 50% of the VP sessions more likely to report attitudes supporting violence (p ⫽ .065), and intervention subjects reporting fewer violent and aggressive behaviors at immediate posttest (p ⫽ .06). No significant intervention effects were seen for intentions, overall violence knowledge, and self-efficacy. Conclusions: Adapting and implementing a school-based violence prevention program in a community-based setting is both feasible and effective in improving skills, attitudes, and behaviors towards aggression and violence. Making these programs more widely available to community-based agencies and families may provide alternatives or complements to school-based programming and offer needed opportunities for enhancing positive behavior changes among youth. RISK BEHAVIORS IN ADOPTED ADOLESCENTS AND SUBSEQUENT OUTCOMES IN YOUNG ADULTHOOD Cheryl Kodjo, M.D., M.P.H., Emily Fingado, and Peggy Auinger, M.S. University of Rochester, Strong Children’s Research Center, Rochester, NY. Purpose: The rate of childhood adoption, particularly international adoption, has increased over the past two decades. This increase has created a need for research within this population, particularly among adopted adolescents (AA). Little is known about risk behaviors in AA or the outcomes of their risk behaviors as they transition into young adulthood. The purpose of this study was to determine the prevalence of risk behaviors, and long-term outcomes, among AA compared to non-adopted adolescents (NA). Methods: Secondary analysis of the restricted-use National Longitudinal Study of Adolescent Health. Linking Waves 1 (1994 –95) and 3 (2001–2002), the sample consisted of 18,250 NA and 656 AA.Risk behaviors from Wave 1 included trying to lose weight, alcohol use, marijuana use, other drug use, sexual activity, violence, and suicidal attempts. Outcomes from Wave 3 included diagnosed eating disorder, drug/alcohol treatment, sexually transmitted disease, emergency room injury treatment, and treatment for mental illness. SUDAAN was used for all analyses. AA and NA were compared on all variables from Wave 1. Those who reported engaging in specific risk behaviors in Wave 1 were then compared on related outcome variables from Wave 3. Bivariate analyses included ⌾2- and t-testing for categorical and continuous variables, respectively (p ⬍ 0.05). Results: The racial/ethnic breakdown of AA from Wave 1 was: 76% White; 11% Black; 6% Hispanic; 3% Asian/PI; 2% Native American; 1% “Other”. Of AA, 51% were female and 66% were less than 17 years of age. There were no significant differences in household income between AA and NA; nor were there significant differences in self-esteem. However, AA were more likely to report more emotional distress (means: 173 vs. 129, p ⬍ 0.01) and less family connectedness (means: 690 vs. 717, p ⬍ 0.01). Regarding risk behaviors, there were no significant differences between AA and NA to engage in losing weight, alcohol use, marijuana use, other drug use, sexual activity, violence, or suicidal attempts. As for adverse outcomes as young adults, there were no significant differences. Conclusions: Despite significant differences in emotional distress and family connectedness in AA vs. NA, AA were not more likely than NA to engage in risk behaviors. Also, AA were not more likely to have adverse outcomes as young adults. Further research
CLINICAL AND RESEARCH POSTER PRESENTATIONS
137
needs to be done with larger samples of AA in order to gain a consensus about their risk behaviors and outcomes. GETTING INFORMATION ON 9/11 — DID THE MEDIA HAVE AN IMPACT ON ADOLESCENTS? Michele Calderoni, D.O., Elizabeth Alderman, M.D., Ellen Silver, Ph.D., and Laurie Bauman, Ph.D. Dep. Pediatr., Sect. Adoles. Med., Children’s Hosp. at Montefiore, Albert Einstein Coll. Med., Bronx, NY. Background: The terrorist attacks on the World Trade Center (WTC) on 9/11 was an unprecedented event in US history. Many studies have shown that adolescents who are exposed to a traumatic event through the media, particularly television viewing, may develop acute and chronic mental health disorders. Purpose: (1) At a public high school in Bronx, NY, 20 miles north of the WTC, to determine the types of media used by students to access information regarding the events of 9/11. (2) To determine the association between media exposure, specifically television (TV) viewing, and symptoms and diagnosis of post traumatic stress disorder (PTSD). Methods: As part of a larger study, subjects completed a survey 8 months after 9/11 containing questions to assess what types of media were used to obtain knowledge about the events of 9/11. Additionally, a PTSD diagnostic instrument obtained from the Office of Behavioral and Social Science Research (NIH) was completed. Bivariate analysis included two-tailed Chisquare tests and ANOVA to identify significant associations between media sources and symptoms and diagnosis of PTSD. 1214 students completed the survey: 61% female, 62% Hispanic, 29% African American. Mean age 16 yrs, (⫾1.43). 7.4% met DSM-IV criteria for PTSD. Results: 92% used television, 74% used newspapers, 72% used radio, and 48% used the internet to obtain information about the events of 9/11. 4% reported not using any media sources for their information on 9/11. When testing for associations between individual media sources and PTSD, no significant associations were found. Bivariate analysis was used to determine if rates of PTSD diagnosis were different in 4 groups: those using TV only (8% had PTSD); TV plus other media (7% had PTSD); other media but no TV (19%); and those using no media (13%). We found a trend towards a higher rate of PTSD diagnosis in subjects not using TV as an information source (p ⫽ .06 ANOVA). Of the 17 symptoms included in the diagnostic instrument for PTSD, students in the ‘other media but no TV’ and ‘no media’ groups were found to have higher rates of the following symptoms: somatic complaints such as heart pounding, trouble breathing and sweating (p ⫽ .002); intrusive memories (p ⫽ .03); diminished interest in activities (p ⫽ .002); feeling distant from others (p ⫽ .043); diminished interest in activities (p ⫽ .002) and loved ones (p ⫽ .000); and a sense of foreshortened future (p ⫽ .000). Conclusions: As expected, a large majority of urban adolescents living 20 miles north of the WTC used TV as a source of information on 9/11. However, contrary to expectations, we found higher rates of several PTSD symptoms and a trend toward increased rates of diagnosis of PTSD in the minority of adolescents who did not use TV as an information source on 9/11. These adolescents may have been too distressed to watch TV or so disadvantaged that they had no access to TV. Either situation may have predisposed them to develop PTSD symptoms.