Adolescents | Schreier Lab

Is sexual abuse a unique predictor of sexual risk behaviors, pregnancy, and motherhood in adolescence?

This study tested sexual abuse as a unique predictor of subsequent adolescent sexual behaviors, pregnancy, and motherhood when in company with other types of maltreatment (physical abuse, neglect) and alternative behavioral, family, and contextual risk factors in a prospective, longitudinal study of maltreated (n = 275) and comparison (n = 239) nulliparous females aged 14-19 years old assessed annually through 19 years old. Hierarchical regression was used to disentangle risk factors that account for the associations of maltreatment type on risky sexual behaviors at 19 years old, adolescent pregnancy, and adolescent motherhood. Findings indicate that sexual and physical abuse remain significant predictors of risky sexual behaviors, and that sexual abuse remains a significant predictor of adolescent motherhood when alternative explanatory variables are controlled.

CITATION: Noll, J. G., Guastaferro, K., Beal, S. J., Schreier, H. M. C., Barnes, J., Reader, J.M., & Font, S. A. (2019). Is sexual abuse a unique predictor of sexual risk behaviors, pregnancy, and motherhood in adolescence? Journal of Research on Adolescence, 29(4), 967-983.

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 semi-structured 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 pro-inflammatory 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 glucocorticoid sensitivity (all p’s > .30). In addition, as chronic family stress increased, adolescents higher in suppression showed evidence of higher stimulated pro-inflammatory 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.

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 / 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 / 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 / Socioeconomic Status — No Comments
15
Sep 15

Socioeconomic status in one’s childhood predicts offspring cardiovascular risk

Objective: To test whether effects of socioeconomic environments can persist across generations, we examined whether parents’ childhood socioeconomic status (SES) could predict blood pressure (BP) trajectories in their youth across a 12-month study period and C-reactive protein (CRP) levels at one year follow-up. Methods: BP was assessed in 88 healthy youth (M age = 13 ± 2.4) at three study visits, each 6 months apart. CRP was also assessed in youth at baseline and one year follow-up. Parents reported on current and their own childhood SES (education and crowding). Results: If parents’ childhood SES was lower, their children displayed increasing SBP and CRP over the 12-month period, or conversely, the higher parents’ childhood SES, the greater the decrease in SBP and CRP in their youth over time. These effects persisted even after controlling for current SES. A number of other factors, including child health behaviors, parent psychosocial characteristics, general family functioning, and parent physiology could not explain these effects. Conclusion: Our study suggests that the SES environment parents grow up in may influence physical health across generations, here, SBP and CRP in their children, and hence that intergenerational histories are important to consider in predicting cardiovascular health in youth.

CITATION: Schreier, H. M. C. & Chen, E. (2010). Socioeconomic status in one’s childhood predicts offspring cardiovascular risk. Brain, Behavior, & Immunity, 24, 1324-1331.

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 / 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.

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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