Biomedical subjects

David J Klein

Publications and source records attributed to David J Klein.

30 records · Page 2Linked to original sources

PubMed2004

Antecedents and outcomes of marijuana use initiation during adolescence.

BACKGROUND: This study identified similarities and differences in risk factors for marijuana use initiation from grades 7 to 8, grades 8 to 9, and grades 9 to 10, and examined differences between earlier initiates, later initiates, and nonusers on various problem behaviors at grade 10. METHOD: Longitudinal data were used to examine predictors and outcomes associated with marijuana initiation from grade 7 (N = 1,955) to grade 10 (N = 909). Participants completed yearly surveys to assess problem behaviors, social influences, and marijuana-related attitudes and behavior. RESULTS: Earlier initiates were more likely than later initiates to exhibit problem-related marijuana use, hard drug use, polydrug use, poor grades, and low academic intentions at grade 10. Across ages, initiation was predicted by smoking, frequency of marijuana offers, and poor grades. Results provided some evidence for a shift from familial to peer influence on marijuana initiation with increasing age. Marijuana-related beliefs were relatively weak predictors of initiation at all ages after controlling for pro-marijuana social influences and engagement in other types of substance use and delinquent behavior. CONCLUSIONS: Results emphasize the importance of early intervention and identify a wide range of potentially modifiable risk factors that may be targeted.

Adolescent↗

PubMed2004

Developmental trajectories of cigarette smoking and their correlates from early adolescence to young adulthood.

Smoking initiation typically occurs in adolescence and increases over time into emerging adulthood. Thus adolescence and emerging adulthood compose a critical time period for prevention and intervention efforts. To inform these efforts, this study used latent growth mixture modeling to identify 6 smoking trajectories from ages 13 to 23 among 5,914 individuals: nonsmokers (28%), stable highs (6%), early increasers (10%), late increasers (10%), decreasers (6%), and triers (40%). By age 23, the trajectories merged into 2 distinct groups of low- and high-frequency and their standing on age 23 outcomes reflected this grouping. Consideration of these results can help researchers identify at-risk individuals before their smoking becomes too problematic, providing an opportunity for intervention and possible prevention of nicotine dependence.

Adolescent↗

PubMed2004

Social control of health behaviors: a comparison of young, middle-aged, and older adults.

Social control can positively influence health behaviors, but changes in social networks over time may cause older adults to experience less health-related social control. The size and composition of social control networks, and receipt of health-related social control, were examined in a probability sample of 509 household residents (aged 25-80 years) in Los Angeles County who completed a telephone survey. Compared with younger and middle-aged adults, older adults identified fewer people who attempted to influence their health behaviors and fewer health behaviors that others urged them to change. Older adults also reported less frequent social control attempts aimed at modifying their health behaviors, even after health status, health habits, and social network characteristics were controlled for. Possible explanations for these age-related differences are discussed.

Adult↗

PubMed2004

A national longitudinal study of the psychological consequences of the September 11, 2001 terrorist attacks: reactions, impairment, and help-seeking.

This article examines the evolution of psychological and behavioral reactions following the September 2001 terrorist attacks in a nationally representative sample, and describes where people turned for support, information, and counseling. From November 9 to November 28, 2001, we resurveyed 395 (71%) of the original 560 adults 19 years or older within the United States who participated in our national random-digit-dialing telephone survey conducted on September 14 to September 16, 2001, about their terrorism-related psychological distress and behavior. Sixteen percent of adults had persistent distress, reporting one or more substantial distress symptoms in both September and November. Adults with persistent distress reported accomplishing less at work (65%); avoiding public gathering places (24%); and using alcohol, medications, or other drugs to relax, sleep, or feel better because of worries about terrorism (38%). Seventy-five percent talked with family and friends; however, 43% reported sometimes feeling unable to share their terrorism-related thoughts and feelings with others because it made others uncomfortable. Few reported receiving counseling or information about psychological distress from general medical providers (11%). These findings suggest that a significant number of adults across the country were continuing to experience terrorism-related distress and disruption of their daily lives approximately 2 months after September 11; many turned to family and friends for support, but at times many felt uncomfortable doing so, and few used clinicians as a source of information or support. Clinicians and policymakers should consider how the healthcare system and other community organizations might provide a coordinated community-wide response for individuals needing information and counseling following terrorist events.

Adaptation, Psychological↗

PubMed2004

From adolescence to young adulthood: racial/ethnic disparities in smoking.

OBJECTIVES: We used data gathered from 6259 youths between the ages of 13 and 23 years to compare trends in smoking among 4 racial/ethnic groups. METHODS: We weighted trend data to represent baseline respondent characteristics and evaluated these data with linear contrasts derived from multiple regression analyses. RESULTS: Although African Americans exhibited higher initiation rates than Whites, they exhibited consistently lower rates of regular smoking than both Whites and Hispanics. This seeming anomaly was explained by African Americans' lower rates of transition to regular smoking and greater tendency to quit. Racial/ethnic disparities were accounted for by differences in pro-smoking influences. CONCLUSIONS: Reducing racial/ethnic disparities in smoking may require reducing differences in the psychosocial factors that encourage smoking.

Adolescent↗

PubMed2004

Obesity and the development of insulin resistance and impaired fasting glucose in black and white adolescent girls: a longitudinal study.

OBJECTIVE: Age at onset of type 2 diabetes has decreased during the past 20 years, especially in black women. Studies of factors associated with insulin resistance and hyperglycemia in preadolescent and adolescent populations are essential to understanding diabetes development. RESEARCH DESIGN AND METHODS: The National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study (NGHS) is a 10-year cohort study of the development of obesity in black and white girls. Two NGHS centers examined the associations of obesity, puberty, and race with fasting insulin, glucose, and homeostasis model assessment of insulin resistance (HOMA-IR; a calculated index of insulin resistance) measures at 9-10 years of age (baseline) and 10 years later. RESULTS: Black girls had greater baseline and year-10 BMI than white girls, with a greater 10-year incidence of obesity. BMI-insulin correlations were positive in both black and white girls at both visits, but insulin remained higher in black girls after controlling for BMI. In black girls, insulin and HOMA-IR were higher in the prepubertal period (before the emergence of racial differences in BMI), increased more during puberty, and decreased less with its completion. Baseline BMI predicted year-10 glucose and the development of impaired fasting glucose (IFG) in black girls. In white girls, the rate of BMI increase during follow-up predicted these outcomes. The 10-year incidence of diabetes in black girls was 1.4%. CONCLUSIONS: Black-white differences in insulin resistance are not just a consequence of obesity, but precede the pubertal divergence in BMI. The development of IFG appears to be a function of the rate of increase of BMI in white girls and early obesity in black girls.

Adolescent↗

PubMed2003

Explaining racial/ethnic differences in smoking during the transition to adulthood.

Using data from a longitudinal panel of nearly 3000 adolescents to predict current smoking among young adults, we test whether adding variables that tap prior social bonds and influences to the model eliminates race/ethnicity as a significant predictor of current smoking. At age 23, African Americans and Asians exhibited substantially lower rates of current smoking than Whites and Hispanics. Controlling for social influences during high school, particularly exposure to siblings and friends who smoked plus parental disapproval of smoking, accounted for these differences. Social bonding variables, in contrast, had a limited mediating effect. Interventions aimed at decreasing adolescent vulnerability to prosmoking influences, reducing overall levels of peer cigarette use, and helping parents better convey their disapproval of smoking should help curb young adult smoking and diminish racial/ethnic differences in tobacco use.

Adolescent↗

PubMed2003

Predictors of the transition to regular smoking during adolescence and young adulthood.

PURPOSE: To identify predictors of the transition from experimentation to regular smoking in middle adolescence, late adolescence, and young adulthood. METHODS: California and Oregon students completed self-report surveys assessing the following potential predictors of the transition to regular smoking from grades 8 to 10 (n = 2,496), grades 10 to 12 (n = 2,149), and grade 12 to age 23 years (n = 1,534): demographic characteristics; smoking-related attitudes, behaviors and environment; other problem behaviors; academic orientation; parental bonding; and mental health. Huberized regression techniques, which adjust for weighting and clustering of observations, were used to determine the independent associations of the predictor variables on subsequent smoking status. RESULTS: Risk factors for the transition to regular smoking during middle adolescence included being white, prosmoking attitudes, friend smoking, weak academic orientation, and less parental support. During late adolescence, being African-American was protective, whereas risk factors included prosmoking attitudes, drinking, non-intact nuclear family, and less parental support. Risk factors in young adulthood included younger age and prosmoking attitudes. CONCLUSIONS: Results point to several smoking-related attitudes, social influences, and behaviors that prevention efforts may target to curb the escalation of smoking.

Adolescent↗

PubMed2003

Ten-year prospective study of public health problems associated with early drinking.

OBJECTIVE: To compare early nondrinkers, experimenters, and drinkers on the prevalence of problem behaviors at grades 7 and 12 and at age 23 (N = 6338, 4265, and 3369, respectively). METHODS: Results are based on longitudinal self-report data from individuals who were originally recruited from 30 California and Oregon schools at grade 7 (1985) and assessed again at grade 12 (1990) and at age 23 (1995). Logistic regression was used to develop weighted estimates of the prevalence of academic difficulties, employment problems, substance use, and delinquent and violent behaviors within the 3 drinking status groups at grades 7, 12, and/or at age 23. Huber variance estimates, which adjust for weighting and clustering of observations, were used to assess the statistical significance of differences across groups. RESULTS: Early drinkers and experimenters were more likely than nondrinkers to report academic problems, substance use, and delinquent behavior in both middle school and high school. By young adulthood, early alcohol use was associated with employment problems, other substance abuse, and criminal and violent behavior. CONCLUSIONS: Early drinkers do not necessarily mature out of a problematic lifestyle as young adults. Interventions for these high-risk youth should start early and address their other public health problems, particularly their tendency to smoke and use other illicit drugs.

Adolescent↗

PubMed2003

Social context and adolescent health behavior: does school-level smoking prevalence affect students' subsequent smoking behavior?

This paper examines the links between individual adolescent smoking behavior and actual and perceived smoking behavior in the individual's school cohort. We hypothesized that students enrolled in schools with higher smoking prevalence among students in their grade are more likely to smoke subsequently. We also expected perceived school-level prevalence of smoking to have a greater impact than actual prevalence because the former is a more direct measure of perceived norms. Adjusting for demographics, actual school-level prevalence at baseline (grade 7) was strongly associated with smoking frequency one year later. However, the association disappeared after adjusting for individual smoking frequency at baseline. School-level prevalence did not moderate the association between individual's baseline and subsequent smoking frequency. Perceived prevalence of smoking among grade 8 students and two measures tapping the behavior of smaller peer groups--cigarette offers and exposure to friends and other peers who smoke--were associated with increased risk of smoking.

Adolescent↗

PubMed2002

Smoking cessation during the transition from adolescence to young adulthood.

The psychosocial and behavioral determinants of smoking cessation from late adolescence to early adulthood were investigated in a sample of 711 individuals followed from 1990 (grade 12) to 1995. Analyses stratified by sex indicated that female smokers were more likely to quit 5 years later if they had fewer friends who smoked, less parental approval of their smoking, weaker intentions to continue smoking, higher smoking resistance self-efficacy and better grades at grade 12. Several of these associations could be accounted for by smoking quantity. Similar analyses for male smokers indicated that those who eventually quit were more likely to have fewer cigarette offers, weaker intentions to smoke, better grades and an intact nuclear family at grade 12. The associations for males could not be explained by smoking quantity. Interaction analyses showed few significant sex differences in the predictors of smoking cessation. Results suggest that cessation programs should continue to target parental and peer influences, as well as skills at resisting social influences to smoke, through late adolescence, but do not indicate that such programs need to be adapted to the special needs of male and female smokers.

Adolescent↗

PubMedDate not supplied

Cigarette smoking from adolescence to young adulthood: women's developmental trajectories and associates outcomes.

OBJECTIVES: This study aimed to compare 1,442 women with distinct developmental trajectories of smoking from ages 13-23 on important young adult outcomes at age 29 (e.g., education, income, mental and physical health, arrest history, drug and alcohol abuse), as well as early transitions to sexual intercourse, parenthood, and marriage. METHODS: Women were classified as Abstainers or into 1 of 5 trajectory classes for which they had the highest probability of membership: Stable Highs, Early Increasers, Late Increasers, Triers, and Decreasers. Regression analysis was used to model outcomes as a function of trajectory class membership. RESULTS: Abstainers and Triers generally had more favorable outcomes than Stable Highs and Early Increasers. Decreasers were more likely to graduate from college than Stable Highs and Early Increasers and had a lower arrest rate than Stable Highs. Women who increased their smoking from initial low levels (Late Increasers) generally had poorer young adult outcomes compared to Triers and Abstainers, but lower risk for early sex and early parenthood compared to Stable Highs and Early Increasers. CONCLUSIONS: Women with certain patterns of smoking from age 13-23 are at heightened risk for early transitions to sexual activity and parenthood, as well as health, behavioral, and socioeconomic problems during young adulthood.

Adolescent↗