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Publications — No Comments
13
Jul 22

The Flexible Regulation of Emotional Expression Scale for Youth (FREE-Y): Adaptation and Validation Across a Varied Sample of Children and Adolescents

Flexible self-regulation has been shown to be an adaptive ability. This study adapted and validated the adult Flexible Regulation of Emotional Expression (FREE) Scale for use with youth (FREE-Y) in community and maltreatment samples. The FREE-Y measures the ability to flexibly enhance and suppress emotion expression across an array of hypothetical social scenarios. Participants (N = 654, 8-19 years) were included from three studies. Confirmatory factor analysis (CFA) confirmed a theoretically appropriate higher order factor structure. Using multiple-group CFAs, measurement invariance was achieved across maltreatment status, age, and gender. Reliabilities were adequate and construct validity was demonstrated through associations with measures of emotion regulation, psychopathology, IQ, and executive functioning. Group comparisons indicated lower Suppression and Flexibility scores for maltreated versus comparison participants. Findings suggest that the FREE-Y is a valid measure of expressive regulation ability in youth that can be applied across a range of populations.

CITATION: Haag, A.-C., Cha, C. B., Noll, J. G., Gee, D. G., Shenk, C. E., Schreier, H. M. C., Heim, C., Shalev, I., Rose, E. J., Jorgensen, A., & Bonanno, G. A. (in press). Adaptation and validation of      the Flexible Regulation of Emotional Expression Scale for Youth (FREE-Y). Assessment.

Publications — No Comments
13
Jul 22

Hypothalamic-pituitary-adrenal axis attenuation and obesity risk in sexually abused females

Background: Childhood sexual abuse (CSA) confers elevated risks for obesity in females. Mechanisms that explain this link remain unclear. This study tracked serum basal cortisol levels with body mass index (BMI) from childhood into adulthood to test whether hypothalamic-pituitary-adrenal (HPA) axis attenuation accounts for elevated obesity risks for sexually abused females.

Methods: Data drew from six timepoints of a longitudinal study of the impact of CSA on development. Participants were females aged 6-16 years at time of study enrollment with substantiated CSA and demographically matched non-abused peers. Analyses included only participants who did not have obesity at study enrollment. Main outcomes were BMI growth trajectories across ages 6-27 (n = 150; 66 abused, 84 comparisons) and early adulthood obesity status (ages 20-27; n = 133; 62 abused, 71 comparison). HPA axis functioning indicators were intercept and linear slope parameters extracted from multilevel growth trajectories of serum basal cortisol levels across development. Racial-ethnic minority status, parity, steroid medication use, depression history and disordered eating history were covaried.

Results: While controlling for covariates, multilevel modeling indicated that high initial serum basal cortisol levels in childhood and attenuated cortisol growth rate over time (i.e., HPA axis attenuation) were associated with accelerated BMI accumulation (p < .01). Attenuated cortisol growth rate mediated the effect of CSA on accelerated BMI accumulation and on elevated adulthood obesity rates (p < .05).

Conclusion: This work establishes a mechanistic association between HPA axis attenuation and obesity, suggesting that trauma treatments for abuse survivors should include interventions that reduce health consequences associated with dysregulated stress physiology.

CITATION: Li, J. C., Hall, M. A., Shalev, I., Schreier, H. M. C., Zarzar, T. G., Marcovici, I., Putnam, F. W., & Noll, J. G. (2021). Hypothalamic-pituitary-adrenal axis attenuation and obesity risk in sexually abused females. Psychoneuroendocrinology, 129, 105254.

Publications — No Comments
13
Jul 22

The intergenerational interplay of adversity on salivary inflammation in young children and caregivers

Systemic inflammation links exposure to early childhood adversity to later disease. The associations among adversity and disease risk might in part operate through poor oral hygiene and subsequent periodontal inflammation, which can be measured in saliva. Few studies, however, have examined the association between adversity and salivary inflammation in young children. Further, there is a dearth of literature investigating adverse experiences and salivary inflammation in children and caregivers together, limiting our understanding of the intergenerational, dual effects of adversity on inflammation for both members of the caregiver-child dyad. This study tested child and caregiver adversity and their associations with an inflammatory composite (i.e., IL-6, IL-1β, IL-8, TNF-α) and CRP in 93 preschool-age children and their caregivers. Caregivers reported on their child’s experiences of adversity, as well as on their own adverse experiences, using a comprehensive questionnaire synthesized from previous checklists for complete coverage of possible adverse events. Results showed that caregivers’ salivary inflammatory markers (i.e., IL-6, IL-1β, IL-8, TNF-α, and CRP) were not significantly correlated with the same five inflammatory markers in children’s saliva. Among children, adversity was associated with significantly higher levels of the inflammatory composite, though not CRP. This association was amplified among children whose caregivers also experienced more adversity during adulthood. Among caregivers, childhood adversity and adulthood adversity were each independently associated with significantly higher levels of the inflammatory composite and CRP. The association between caregivers’ own childhood adversity and inflammation was amplified among caregivers whose children also experienced more adversity during their childhoods. These findings provide preliminary evidence for the possible dual role of young children’s and caregivers’ adverse experiences in contributing to salivary inflammation for both members of the dyad, suggesting possible implications for systemic inflammation and future disease.

CITATION: Huffhines, L., Jackson, Y., McGuire, A. B. & Schreier, H. M. C. (2021). The intergenerational interplay of adversity on salivary inflammation in young children and caregivers. Psychoneuroendocrinology, 128, 105222.

Publications — No Comments
13
Jul 22

Childhood physical neglect is associated with exaggerated systemic and intracellular inflammatory responses to repeated psychosocial stress in adulthood

Experiences of child maltreatment are associated with a host of adverse mental and physical health outcomes in adulthood. Altered reactivity to psychosocial stress exposure may partially explain known associations between early experiences of maltreatment and later life health. The present study focuses on examining whether experiences of child maltreatment are associated with physiological reactions to initial and repeated psychosocial stress in adulthood. To this end, 44 healthy adults (52% male, aged 18-65) completed the Childhood Trauma Questionnaire to provide information about exposure to child maltreatment and completed the Trier Social Stress Test (TSST) on 2 consecutive days. Peripheral blood was collected prior to as well as 30 and 120 min following the TSST on each day. Plasma Interleukin-6 (IL-6) and gene expression of IL-6, IL-1β, nuclear factor-kB (NF-kB), and inhibitor of kB (IkB) were measured from each blood sample. Total CTQ scores were unrelated to plasma IL-6 and gene expression (ps > .10) but a history of childhood physical neglect was associated with increased interleukin-1β (β =.35; p =.02; R2 =.19) and nuclear factor-kB (β =.30; p =.046; R2 =.13) expression following initial stress. Following repeated exposure to the TSST, childhood physical neglect was associated with increased plasma IL-6 reactivity (β =.34; p =.02; R2 =.16) and increased expression of nuclear factor-kB (β =.31; p =.04; R2 =.08). Finally, childhood physical neglect was associated with decreased habituation following repeated exposure to the TSST. Other CTQ subscales were not related to plasma IL-6 and gene expression when considered individually. Results from this study are suggestive of a unique effect of childhood physical neglect on the physiological stress response following initial and repeated exposure to a common psychosocial stressor. This provides important directions for future research because the effect of childhood physical neglect on long-term neglect are not well understood and in need of further investigation.

CITATION: Schreier, H. M. C., Kuras, Y. I., McInnis, C. M., Thoma, M. V., Gianferante, D., Hanlin, L., Chen, X., Wang, D., Goldblatt, D. & Rohleder, N. (2020). Childhood physical neglect is associated with exaggerated systemic and intracellular inflammatory responses to repeated psychosocial stress in adulthood. Frontiers Psychiatry, 11, 504.

Publications — No Comments
13
Jul 22

Neuroendocrine coordination and youth behavior problems: A review of studies assessing sympathetic nervous system and hypothalamic-pituitary-adrenal axis activity using salivary alpha amylase and salivary cortisol

Externalizing and internalizing behavior problems can have deleterious psychosocial consequences for youth. Both sympathetic nervous system (SNS) and hypothalamic-pituitary adrenal (HPA) axis activity and reactivity may contribute to behavior problems but have largely been studied separately, with inconsistent findings. Because the SNS and HPA axis interact to carry out physiological processes (e.g., responding to stressors), considering SNS and HPA axis activity jointly may elucidate disparate findings. This review discusses studies that simultaneously assessed SNS and HPA axis (re)activity and youth behavior problems using measures of salivary alpha amylase (sAA) and salivary cortisol. Multiple patterns of SNS and HPA axis coordination were associated with problem behaviors, especially when considering individual differences and youth’s psychosocial context. Importantly, many study findings may be artifacts of widespread methodological differences. The reviewed studies lay the foundation for future research on neuroendocrine coordination as a contributing factor to youth problem behaviors and some recommendations for future research are discussed.

CITATION: Jones, E. J., Rohleder, N., & Schreier, H. M. C. (2020). Neuroendocrine coordination and youth behavior problems: A review of studies assessing sympathetic nervous system and hypothalamic-pituitary-adrenal axis activity using salivary alpha amylase and salivary cortisol. Hormones & Behavior, 122.

Adolescents / Family Influences / Publications — No Comments
03
Oct 18

Chronic Family Stress and Adolescent Health: The Moderating Role of Emotion Regulation

Objective: The aim of the study was to assess whether the association between chronic family stress and physiological measures is moderated by emotion regulation strategies in an adolescent sample.

Methods: Chronic family stress was assessed via a semistructured interview and emotion regulation strategies (cognitive reappraisal and suppression) via questionnaire among 261 adolescents (14.57 (1.07) years). Several metabolic (waist-hip ratio, systolic and diastolic blood pressure) and inflammatory markers (basal and stimulated proinflammatory cytokine production in response to bacterial challenge) as well as glucocorticoid sensitivity were assessed.

Results: There were no main effects of chronic family stress, cognitive reappraisal, or suppression on physiological measures (all p’s > .10). Emotion regulation moderated the association between chronic family stress and physiological measures. As chronic family stress increased, adolescents higher in cognitive reappraisal had smaller waist-hip ratios (B = −.003, SE = .001, p = .015) and lower systolic blood pressure (B = −.303, SE = .143, p = .035), although no moderation was found with respect to inflammatory markers and glucocor- ticoid sensitivity (all p’s > .30). In addition, as chronic family stress increased, adolescents higher in suppression showed evidence of higher stimulated proinflammatory cytokine production (B = .046, SE = .020, p = .021) and lower glucocorticoid sensitivity (B = .051, SE = .021, p = .015), although basal inflammation and metabolic measures were not moderated by suppression (all p’s > .50).

Conclusions: This study suggests that the types of emotion regulation strategies used by adolescents may affect the extent to which chronic family stress affects important metabolic and immune processes.

CITATION: Jones, E. J., Lam, P.H., Hoffer, L.C., Chen, E., & Schreier, H.M.C. (2018). Chronic stress and adolescent health: the moderating role of emotion regulation. Psychosomatic Medicine, 80(8), 764-773.

Adolescents / Inflammation / Publications — No Comments
27
Aug 16

Low-Grade Inflammation and Ambulatory Cortisol in Adolescents: Interaction Between Interviewer-Rated Versus Self-Rated Acute Stress and Chronic Stress

Objective: To determine whether the association between self-rated or interviewer-rated recent acute stress exposures and low-grade inflammation and daily cortisol production in adolescents is moderated by chronic stress ratings. Methods: Acute and chronic stress exposures were assessed in 261 adolescents aged 13 to 16 years using a semistructured life stress interview. The negative impact of acute stressors was independently rated by both adolescents (self-rated) and interviewers (interviewer-rated). Markers of inflammation (interleukin (IL)-6, IL-1ra, C-reactive protein) were measured from peripheral blood samples obtained via antecubital venipuncture. Participants collected 4 saliva samples at home on each of 6 consecutive days for the analysis of diurnal salivary cortisol profiles. Results: There were no main effects of acute stressors (self- and interviewer-rated) and chronic family or peer stress on adolescent inflammation markers and cortisol (p values > .10). However, the interaction between interviewer-rated acute stress and chronic family stress was significantly associated with adolescent inflammation markers (IL-6, IL-1ra). Specifically, as chronic family stress increased, the association between acute stressor impact (interviewer-rated) and inflammation markers became more positive (IL-6 (B = .054, SE = .023, p = .022); IL-1ra (B = .030, SE = .014, p = .034)). Interactions between self-rated acute stress and chronic family stress were not associated with any biological measures (p values > .10). Interactions between acute stressor impact (both self- and interviewer-rated) and chronic peer stress were also not significantly associated with any biological measures (p values > .05). Conclusions: Among adolescents, interviewer-based ratings of acute stressor impact may allow for better prediction of health-relevant inflammation markers than adolescents’ own ratings.

CITATION: Schreier, H. M. C. & Chen, E. (2016). Low-Grade Inflammation and Ambulatory Cortisol in Adolescents: Interaction Between Interviewer-Rated Versus Self-Rated Acute Stress and Chronic Stress. Psychosomatic Medicine.

Chronic Illnesses / Publications / Trauma — No Comments
11
Apr 16

Child maltreatment and pediatric asthma: A review of the literature

Background: Child maltreatment is a common problem with known adverse consequences, yet its contributions to the development and course of pediatric asthma are only poorly understood. Main: This review first describes possible pathways connecting child maltreatment to pediatric asthma, including aspects of the physical home environment, health behaviors and disease management, and psychological consequences of child maltreatment. We subsequently review existing studies, which generally report an association between maltreatment experiences and asthma outcomes in childhood. However, this literature is in its early stages; there are only a handful studies, most of them rely on self-reports of both child maltreatment and asthma history, and none have investigated the physiological underpinnings of this association. Taken together, however, the studies are suggestive of child maltreatment playing a role in pediatric asthma incidence and expression that should be explored further. Conclusion: Existing data are sparse and do not allow for specific conclusions. However, the data are suggestive of child maltreatment influencing asthma risk and morbidity long before the adult years. Future research should focus on understanding how child maltreatment contributes to asthma disease risk and progression in this highly vulnerable population.
CITATION: Schreier, H. M. C., Chen, E. & Miller, G. E. (2016). Child maltreatment and pediatric asthma: a review of the literature. Asthma Research and Practice, 2(7).
Adolescents / Chronic Illnesses / Publications — No Comments
15
Sep 15

Prospective associations between coping and health among youth with asthma and healthy youth

The present study evaluated whether primary and secondary coping would predict longitudinal asthma-related clinical outcomes, such as peak expiratory flow rate (PEFR) and self-reported school absenteeism, rescue inhaler use, and asthma-related physician contacts, in youth with asthma. The 62 youth (68% males) had an average age of 12.6 +/- 2.73 years and were primarily of European origin. Coping and asthma outcomes were obtained by youth self-report at baseline and over a 12-month follow-up period. Greater secondary coping at baseline was related to greater increases in PEFR and a greater likelihood of physician contact over the following year. Greater primary coping at baseline was related to greater likelihood of rescue inhaler use, school absenteeism, and physician contact over the following year. In contrast, asthma measures at baseline did not predict changes in coping over the following year. These patterns suggest that youth who engage in secondary coping accept and adapt to their asthma in ways that improve pulmonary function over time. Youth who engage in primary coping may be more likely to communicate asthma problems to others, and such communication perhaps leads to increases in behaviors meant to address these problems.

CITATION: Schreier, H. M. C. & Chen, E. (2008). Prospective associations between coping and health among youth with asthma and healthy youth. Journal for Consulting and Clinical Psychology, 76(5), 790-798.

Adolescents / Chronic Illnesses / Family Influences / Inflammation / Publications — No Comments
15
Sep 15

Chronic traffic-related air pollution and stress interact to predict biologic and clinical outcomes in asthma

Background: Previous research has documented effects of both physical and social environmental exposures on childhood asthma. However, few studies have considered how these two environments might interact to affect asthma. Objective: This study aimed to test interactions between chronic exposure to traffic-related air pollution and chronic family stress in predicting biologic and clinical outcomes in children with asthma. Method: Children with asthma (n = 73, 9-18 years of age) were interviewed about life stress, and asthma-relevant inflammatory markers [cytokine production, immunoglobulin E (IgE), eosinophil counts] were measured. Parents reported on children’s symptoms. Children completed daily diaries of symptoms and peak expiratory flow rate (PEFR) measures at baseline and 6 months later. Exposure to traffic-related air pollution was assessed using a land use regression model for nitrogen dioxide concentrations. Results: NO(2) by stress interactions were found for interleukin-5 (beta for interaction term = -0.31, p = 0.02), IgE (interaction beta = -0.29, p = 0.02), and eosinophil counts (interaction beta = -0.24, p = 0.04). These interactions showed that higher chronic stress was associated with heightened inflammatory profiles as pollution levels decreased. Longitudinally, NO(2) by stress interactions emerged for daily diary symptoms (interaction beta = -0.28, p = 0.02), parent-reported symptoms (interaction beta = -0.25, p = 0.07), and PEFR (interaction beta = 0.30, p = 0.03). These interactions indicated that higher chronic stress was associated with increases over time in symptoms and decreases over time in PEFR as pollution levels decreased. Conclusions: The physical and social environments interacted in predicting both biologic and clinical outcomes in children with asthma, suggesting that when pollution exposure is more modest, vulnerability to asthma exacerbations may be heightened in children with higher chronic stress.

CITATION: Chen, E., Schreier, H. M. C., Strunk, R. C., & Brauer, M. (2008). Chronic traffic-related air pollution and stress interact to predict biologic and clinical outcomes in asthma. Environmental Health Perspectives, 116(7), 970-975.

Adolescents / Chronic Illnesses / Family Influences / Inflammation / Publications — No Comments
15
Sep 15

Longitudinal relationships between family routines and biological profiles among youth with asthma

Objective: To investigate whether longitudinal trajectories of inflammatory markers of asthma can be predicted by levels of family routines in youth with asthma. Design: Family routines were assessed through parent questionnaires and peripheral blood samples obtained from youth every 6 months throughout the 18-month study period. Longitudinal relationships were evaluated using hierarchical linear modeling. Main Outcome Measures: Mitogen-stimulated production of cytokines implicated in asthma, specifically IL-4, IL-5, and IL-13. Results: Youth with more family routines in their home environment showed decreases in IL-13 (but not IL-4 or IL-5) over the course of the study period. In turn, within-person analyses indicated that at times when stimulated production of IL-13 was high, asthma symptoms were also high, pointing to the clinical relevance of changes in IL-13 over time. A variety of child and parent psychosocial as well as child behavioral characteristics could not explain these effects. However, medication use eliminated the relationship between family routines and stimulated production of IL-13. Conclusion: Our study suggests that family routines predict asthma outcomes at the biological level, possibly through influencing medication use. Considering daily family behaviors when treating asthma may help improve both biological and clinical profiles in youth with asthma.

CITATION: Schreier, H. M. C. & Chen, E. (2010). Longitudinal relationships between family routines and biological profiles among youth with asthma. Health Psychology, 29(1), 82-90.

Adolescents / Chronic Illnesses / Publications — No Comments
15
Sep 15

Clinical potentials for measuring stress in youth with asthma

It is well established that the course of asthma can be affected by the psychological stress an individual experiences. This article reviews literature assessing the effects of psychological stress on asthma outcomes and discusses the benefits and disadvantages of different measures for assessing stress, including subjective questionnaires, event checklists, and interview-based approaches. We discuss the importance of taking into account the timing and chronicity of stress, as well as individuals’ subjective appraisals of stress. We suggest that, although questionnaire and checklist approaches are easier to administer, interview-based stress assessments are preferable, where feasible, because they generate richer and more in-depth information regarding the stressors that people experience. In addition, this kind of information seems to be more robustly linked to pediatric asthma outcomes of interest.

CITATION: Schreier, H. M. C., Miller, G. E., & Chen, E. (2011). Clinical potentials for measuring stress in youth with asthma. Immunology and Allergy Clinics of North America, 31(1), 41-54.

Adolescents / Chronic Illnesses / Publications / Socioeconomic Status — No Comments
15
Sep 15

Resilience in low socioeconomic status children with asthma: adaptations to stress

Background: Low socioeconomic status (SES) is a strong predictor of many health problems, including asthma impairment; however, little is understood about why some patients defy this trend by exhibiting good asthma control despite living in adverse environments. Objective: This study sought to test whether a psychological characteristic, the shift-and-persist strategy (dealing with stressors by reframing them more positively while at the same time persisting in optimistic thoughts about the future), protects low-SES children with asthma. Methods: One hundred twenty-one children aged 9 to 18 years with a physician’s diagnosis of asthma were recruited from medical practices and community advertisements (mean age, 12.6 years; 67% male; 61% white). Shift-and-persist scores and asthma inflammation (eosinophil counts and stimulated IL-4 cytokine production) were assessed at baseline, and asthma impairment (daily diary measures of rescue inhaler use and school absences) and daily peak flow were monitored at baseline and at a 6-month follow-up. Results: Children who came from low-SES backgrounds but who engaged in shift-and-persist strategies displayed less asthma inflammation at baseline (β = 0.19, P < .05), as well as less asthma impairment (reduced rescue inhaler use and fewer school absences; β = 0.32, P < .01) prospectively at the 6-month follow-up period. In contrast, shift-and-persist strategies were not beneficial among high-SES children with asthma. Conclusion: An approach that focuses on the psychological qualities that low-SES children develop to adapt to stressors might represent a practical and effective starting point for reducing health disparities. Moreover, the approaches that are effective in low-SES communities might be different from those that are optimal in a high-SES context.

CITATION: Chen, E., Strunk, R. C., Threthewey, A., Schreier, H. M. C., Maharaj, N., & Miller, G. E. (2011). Resilience in low socioeconomic status children with asthma: adaptations to stress. Journal of Asthma and Clinical Immunology, 128(5), 970-976.

Adolescents / Family Influences / Inflammation / Publications / Socioeconomic Status — 1 Comment
09
Sep 15

Family chaos and adolescent inflammatory profiles: the moderating role of socioeconomic status

Objective: To test whether family chaos influences adolescents’ inflammatory profiles and whether adolescents from low socio- economic status (SES) environments are at higher risk for experiencing adverse inflammatory profiles from living in chaotic family environments. Methods: A total of 244 families with an adolescent aged 13 to 16 years participated. Parents completed measures of family SES and family chaos. Both systemic inflammation and stimulated proinflammatory cytokine production in response to bacterial challenge were assessed in adolescents. Results: Our results suggest that SES moderates the detrimental effect of family chaos on systemic inflammation and interleukin-6 (B = -0.010, standard error [SE] = 0.004, p = .026), but not C-reactive protein (B = 0.009, SE = 0.006, p = .11), and on stimulated proinflammatory cytokine production (B = -0.098, SE = 0.044, p = .026) in adolescents, such that a chaotic family environment is positively associated with greater systemic inflammation and greater stimulated proinflammatory cytokine production in adolescents as family SES declines. Conclusions: These findings indicate that living in chaotic family environments places youth who may be vulnerable based on socioeconomic factors at a potentially higher risk for inflammation-related diseases. Key words: inflammation, family chaos, adolescents, socioeconomic status.

CITATION: Schreier, H. M. C., Roy, L. B., Frimer, L., & Chen, E. (2014). Family chaos and adolescent inflammatory profiles: the moderating role of socioeconomic status. Psychosomatic Medicine, 76(6), 460-467.

Chronic Illnesses / Publications / Socioeconomic Status — No Comments
09
Sep 15

Socioeconomic status and the health of youth: A multi-level, multi-domain approach to conceptualizing pathways

Previous research has clearly established associations between low socioeconomic status (SES) and poor youth physical health outcomes. This article provides an overview of the main pathways through which low SES environments come to influence youth health. We focus on 2 prevalent chronic health problems in youth today, asthma and obesity. We review and propose a model that encompasses (a) multiple levels of influence, including the neighborhood, family and person level; (b) both social and physical domains in the environment; and finally (c) dynamic relationships between these factors. A synthesis of existing research and our proposed model draw attention to the notion of adverse physical and social exposures in youth’s neighborhood environments altering family characteristics and youth psychosocial and behavioral profiles, thereby increasing youth’s risk for health problems. We also note the importance of acknowledging reciprocal influences across levels and domains (e.g., between family and child) that create self-perpetuating patterns of influence that further accentuate the impact of these factors on youth health. Finally, we document that factors across levels can interact (e.g., environmental pollution levels with child stress) to create unique, synergistic effects on youth health. Our model stresses the importance of evaluating influences on youth’s physical health not in isolation but in the context of the broader social and physical environments in which youth live. Understanding the complex relationships between the factors that link low SES to youth’s long-term health trajectories is necessary for the creation and implementation of successful interventions and policies to ultimately reduce health disparities.

CITATION: Schreier, H. M. C. & Chen, E. (2013). Socioeconomic status and the health of youth: A multi-level, multi-domain approach to conceptualizing pathways. Psychological Bulletin, 139(3), 606-654.

Adolescents / Inflammation / Intervention / Publications / Volunteering — No Comments
08
Sep 15

Effect of volunteering on cardiovascular risk in adolescents

Importance The idea that individuals who help others incur health benefits themselves suggests a novel approach to improving health while simultaneously promoting greater civic orientation in our society. The present study is the first experimental trial, to our knowledge, of whether regular volunteering can reduce cardiovascular risk factors in adolescents. Objective To test a novel intervention that assigned adolescents to volunteer with elementary school–aged children as a means of improving adolescents’ cardiovascular risk profiles. Design Randomized controlled trial, with measurements taken at baseline and 4 months later (postintervention). Setting Urban public high school in western Canada. Participants One hundred six 10th-grade high school students who were fluent in English and free of chronic illnesses. Intervention Weekly volunteering with elementary school–aged children for 2 months vs wait-list control group. Main Outcome Measures Cardiovascular risk markers of C-reactive protein level, interleukin 6 level, total cholesterol level, and body mass index. Results No statistically significant group differences were found at baseline. Postintervention, adolescents in the intervention group showed significantly lower interleukin 6 levels (log10 mean difference, 0.13; 95% CI, 0.004 to 0.251), cholesterol levels (log10 mean difference, 0.03; 95% CI, 0.003 to 0.059), and body mass index (mean difference, 0.39; 95% CI, 0.07 to 0.71) compared with adolescents in the control group. Effects for C-reactive protein level were marginal (log10 mean difference, 0.13; 95% CI, −0.011 to 0.275). Preliminary analyses within the intervention group suggest that those who increased the most in empathy and altruistic behaviors, and who decreased the most in negative mood, also showed the greatest decreases in cardiovascular risk over time. Conclusions and Relevance Adolescents who volunteer to help others also benefit themselves, suggesting a novel way to improve health.

CITATION: Schreier, H. M. C., Schonert-Reichl, K. A., & Chen, E. (2013). Effect of volunteering on cardiovascular risk in adolescents. JAMA – Pediatrics, 167(4), 327-332.

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