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      Sex, drugs, risk and resilience: analysis of data from the Canadian Health Behaviour in School-aged Children (HBSC) study

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          Abstract

          Background

          Risk-taking behaviour among adolescents, particularly those experiencing childhood adversities, can predispose to injury, unwanted pregnancy, long-term morbidity and death. Resilience, i.e. adapting to threats and thriving, has rarely been examined as a protective factor for adolescent risk-taking. We studied whether the malleable traits of empathy, confidence, self-control and optimism, all markers of resilience, align with decreased risk-taking despite adversity, among 11–15 year olds.

          Methods

          From responses of 22 643 Canadian youth to the Health Behaviour in School-aged Children (2014) survey we validated a five-item resilience scale. Using regression analyses, this scale and a single measure of self-control were considered as potential protective factors for a composite measure of risk-taking behaviour and of initiation of sexual activity before age 14.

          Results

          There was a dose-dependent association between greater resilience and diminished risk-taking for boys and, even more so, among girls. This relationship remained significant after controlling for family and social support, implying that greater resilience may override the detrimental impact of childhood adversity on risk-taking. The least resilient youth were most likely to report early sexual activity, although this relationship was not linear. Generally, the impact of self-control on risk-taking was not statistically significant, perhaps because of shortcomings of the self-control indicator.

          Conclusion

          Brief screening protocols can identify assets that protect against risk-taking behaviours among adolescents. The malleable nature of these traits offers primary care providers and public health personnel a novel and effective route to decreasing adolescent risk-taking and fostering future health.

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          Most cited references20

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          Behavioral and neural correlates of delay of gratification 40 years later.

          We examined the neural basis of self-regulation in individuals from a cohort of preschoolers who performed the delay-of-gratification task 4 decades ago. Nearly 60 individuals, now in their mid-forties, were tested on "hot" and "cool" versions of a go/nogo task to assess whether delay of gratification in childhood predicts impulse control abilities and sensitivity to alluring cues (happy faces). Individuals who were less able to delay gratification in preschool and consistently showed low self-control abilities in their twenties and thirties performed more poorly than did high delayers when having to suppress a response to a happy face but not to a neutral or fearful face. This finding suggests that sensitivity to environmental hot cues plays a significant role in individuals' ability to suppress actions toward such stimuli. A subset of these participants (n = 26) underwent functional imaging for the first time to test for biased recruitment of frontostriatal circuitry when required to suppress responses to alluring cues. Whereas the prefrontal cortex differentiated between nogo and go trials to a greater extent in high delayers, the ventral striatum showed exaggerated recruitment in low delayers. Thus, resistance to temptation as measured originally by the delay-of-gratification task is a relatively stable individual difference that predicts reliable biases in frontostriatal circuitries that integrate motivational and control processes.
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            Perceived socioeconomic status: a new type of identity that influences adolescents' self-rated health.

            The cognitive, social, and biological transitions of adolescence suggest that subjective perceptions of social position based on the socioeconomic hierarchy may undergo important changes during this period; yet how such perceptions develop is poorly understood, and no studies have assessed whether changes in such perceptions influence adolescents' health. This study describes adolescents' subjective perceptions of familial socioeconomic status (SSS), how SSS changes over time, and how age, race, and objective socioeconomic status (SES) indicators influence SSS. In addition, the study determines whether SSS independently influences adolescents' self-rated health, an important predictor of morbidity and health service use. A total of 1179 non-Hispanic black and white baseline 7-12th graders from a Midwestern public school district completed a validated, teen-specific measure of SSS annually for 4 consecutive years. A parent provided information on SES. Markov modeling assessed transitions in SSS over time. SSS declined with age (p = .001) and stabilized among older teens. In addition to age, SES and race, but not gender, were significant correlates of SSS, but the relationships between these factors were complex. In cross-sectional and longitudinal analyses, black teens from families with low parent education had higher SSS than white teens from similarly educated families, whereas white teens from highly educated families had higher SSS than black teens from highly educated families. Lower SSS and changes in SSS predicted poor self-rated health even when adjusting for race and objective SES measures. Subjective evaluations of socioeconomic status predict adolescents' global health ratings even when adjusting for the sociodemographic factors that shape them.
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              Leveraging the biology of adversity to address the roots of disparities in health and development.

              Extensive evidence that personal experiences and environmental exposures are embedded biologically (for better or for worse) and the cumulative knowledge of more than four decades of intervention research provide a promising opportunity to mobilize evolving scientific insights to catalyze a new era of more effective early childhood policy and practice. Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers.
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                Author and article information

                Journal
                Eur J Public Health
                Eur J Public Health
                eurpub
                The European Journal of Public Health
                Oxford University Press
                1101-1262
                1464-360X
                February 2019
                04 September 2018
                04 September 2018
                : 29
                : 1
                : 38-43
                Affiliations
                [1 ]Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
                [2 ]Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada
                [3 ]Department of Religious Studies, Queen's University, Kingston, Ontario, Canada
                Author notes
                Correspondence: Susan P. Phillips, Department of Family Medicine, Queen’s University, 220 Bagot St., Kingston, ON K7L 5E9, Canada, Tel: +1 613 533 9303, Fax: +1 613 549 5403, e-mail: phillip@ 123456queensu.ca
                Article
                cky169
                10.1093/eurpub/cky169
                6345143
                30188987
                35fac108-6f33-40ee-b465-665dd9f98def
                © The Author(s) 2018. Published by Oxford University Press on behalf of the European Public Health Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Pages: 6
                Categories
                Child and Adolescent Health

                Public health
                Public health

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