Journal of Adolescent Health最新文献

{"title":"Sleep as a Protective Factor: Multiple Forms of Discrimination and Substance Use Intention Among Racially and Ethnically Minoritized United States Youth","authors":"Yijie Wang Ph.D. ,&nbsp;Zhenqiang Zhao Ph.D. ,&nbsp;Meng-Run Zhang Ph.D. ,&nbsp;Youchuan Zhang Ph.D. ,&nbsp;Jinjin Yan Ph.D. ,&nbsp;Elizabeth Jelsma Ph.D. ,&nbsp;Heining Cham Ph.D. ,&nbsp;Margarita Alegría Ph.D. ,&nbsp;Tiffany Yip Ph.D.","doi":"10.1016/j.jadohealth.2024.12.004","DOIUrl":"10.1016/j.jadohealth.2024.12.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Research has rarely examined biobehavioral factors in mitigating substance use (SU) risks associated with discrimination among racially and ethnically minoritized youth. This study investigated sleep duration as a potential moderator of the association between multiple forms of discrimination based on race and ethnicity, sexual orientation, and weight (i.e., multiple discrimination) and subsequent SU intention in this population.</div></div><div><h3>Methods</h3><div>Data were drawn from a national, longitudinal sample of racially and ethnically minoritized early adolescents (N = 3,495, <em>M</em>_age = 11.52 years) participating in the Adolescent Brain Cognitive Development Study. Multiple discrimination was assessed through aggregated youth reports at 1-year follow-up (Y1) and 2-year follow-up (Y2). Sleep duration was assessed at Y2 via self-reports in the full sample and actigraphy over 3 weeks in a subsample (N = 1,404). Youth reported SU intention at Y2 and 3-year follow-up (Y3). Relevant sociodemographic and psychosocial covariates were included.</div></div><div><h3>Results</h3><div>Path analyses showed that more exposure to multiple discrimination was associated with greater subsequent SU intention, controlling for prior SU intention levels. However, this association was only significant among adolescents with shorter sleep duration on weekdays, not among those who slept longer (above 9.6 hours based on self-reports or 7.5 hours based on actigraphy) on weekdays. Actigraphy sleep duration mean and variability also exhibited nuanced linkages with subsequent SU intention.</div></div><div><h3>Discussion</h3><div>Findings highlighted sleep duration as a promising lever of change for preventative interventions aiming to curb SU among racially and ethnically minoritized youth in early development.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 4","pages":"Pages 718-726"},"PeriodicalIF":5.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Traumatic Brain Injury: Lessons Learned During the First Five Years.","authors":"Brason Lee","doi":"10.1016/j.jadohealth.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.017","url":null,"abstract":"","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Misuse and Suicide-Related Outcomes Among Adolescents and Young Adults: A Systematic Review.","authors":"Jessica Duncan Cance, Sara Hairgrove, Lissette M Saavedra, Erin E Bonar, Maureen A Walton, Sheila V Patel, Amy M Yule, Cheryl King, Laura J Chavez, Natasha Slesnick, Claudia-Santi F Fernandes","doi":"10.1016/j.jadohealth.2024.10.026","DOIUrl":"10.1016/j.jadohealth.2024.10.026","url":null,"abstract":"<p><p>The purpose of this systematic review is to assess evidence for an association between opioid misuse and suicide-related outcomes among youth and young adults (aged 12-30 years). A Boolean search strategy of eligible publications from January 1990 to June 2024 identified 2,696 independent citations. An additional 10 were identified through reference screening. A total of 55 publications met the inclusion criteria. Twelve studies used administrative data and 43 were based on observational data. Risk of bias was assessed qualitatively by domain. Nearly all (98%) studies using observational data found an association between opioid misuse and at least one suicide-related outcome (e.g., suicidal ideation, suicide plan, suicide attempt). Administrative data studies had higher risk of bias compared with observational studies, typically due to higher confounding bias. Reporting bias was moderate to high across all studies in the review. Our review provides clear evidence of the association between opioid misuse and suicide-related outcomes among youth and young adults. However, we highlight a need for longitudinal research on the directionality of the association and potential mechanisms.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent Mental Health and School Belonging in KwaZulu-Natal, South Africa: Impact of the COVID-19 Pandemic and Subsequent Government Lockdowns","authors":"Roisin E. Drysdale Ph.D. ,&nbsp;Sanele Mvelase ,&nbsp;Jeremy Kane Ph.D. ,&nbsp;Rachel S. Gruver M.P.H. ,&nbsp;Chris Desmond Ph.D. ,&nbsp;Leslie L. Davidson M.D., M.Sc.","doi":"10.1016/j.jadohealth.2024.11.240","DOIUrl":"10.1016/j.jadohealth.2024.11.240","url":null,"abstract":"<div><h3>Purpose</h3><div>We hypothesized that extended exposure to the COVID-19 pandemic and government lockdown was associated with increased depression and anxiety symptoms among South African adolescents and a sense of school belonging mediated these relationships. We also hypothesized that poor mental health or school belonging impacted alcohol consumption.</div></div><div><h3>Methods</h3><div>Embedded in the Asenze Cohort Study, data were collected from adolescents between 2019 and 2021. The Patient Health Questionnaire, General Anxiety Disorder questionnaire and Psychological Sense of School Membership scale were used to measure depression, anxiety, and school belonging, respectively. Alcohol consumption was a cumulative score of the total number of days alcohol was consumed in the previous 30 days. Lockdown exposure was the number of months participants were exposed to lockdown conditions. Structural equation modeling was used to assess the relationship between the outcome variables.</div></div><div><h3>Results</h3><div>Among 866 adolescents included in the analysis, approximately 20% met the symptom criteria for moderate or severe depression or anxiety. The mean school belonging score was high (23; SD = 5.79) and alcohol consumption low. Lockdown exposure was not directly or indirectly associated with depression or anxiety symptoms. A greater sense of school belonging reduced both depression and anxiety symptoms.</div></div><div><h3>Discussion</h3><div>This study contradicts previous studies and suggests that lockdown was not associated with poor mental health in this cohort of adolescents. School belonging was high despite school closures and associated with lower depression and anxiety. Research around school belonging and how it can be promoted to better support isolated students is recommended.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 4","pages":"Pages 638-646"},"PeriodicalIF":5.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health and Care Utilization Among Sexual and Gender Minority Youth by Race and Ethnicity","authors":"Hyemin Lee Ph.D., M.P.H. ,&nbsp;Jessica R. Abramson ,&nbsp;Arushee Bhoja ,&nbsp;Ryan J. Watson Ph.D. ,&nbsp;Ethan H. Mereish Ph.D.","doi":"10.1016/j.jadohealth.2024.11.244","DOIUrl":"10.1016/j.jadohealth.2024.11.244","url":null,"abstract":"<div><h3>Purpose</h3><div>Existing literature has provided limited and inconsistent findings regarding disparities in mental health and mental health care utilization among racial and ethnic subgroups of sexual and gender minority adolescents (SGMA). This study aimed to investigate racial and ethnic disparities in mental health and care utilization among SGMA.</div></div><div><h3>Methods</h3><div>Data from a large national sample of SGMA who participated in the 2022 <em>Lesbian, Gay, Bisexual, Transgender and Queer National Teen Survey</em> (N = 9,691) were analyzed. Symptoms of depression and anxiety were assessed using the patient health questionnaire-4. Mental health care utilization was classified as follow: (1) received; (2) wished for but not received (indicating unmet mental health care needs); and (3) neither wished for nor received.</div></div><div><h3>Results</h3><div>Compared to White SGMA, Black/African American SGMA were less likely to report anxiety symptoms (adjusted prevalence ratio = 0.89, 95% confidence intervals [CIs] = 0.82–0.97). No significant racial and ethnic differences in depression symptoms were observed among SGMA. Regarding mental health care utilization, Asian or Asian American (adjusted relative risk ratio [ARRR] = 2.07, 95% CIs = 1.62–2.64), Black/African American (ARRR = 1.80, 95% CIs = 1.41–2.28), and Hispanic/Latino SGMA (ARRR = 1.32, 95% CIs = 1.16–1.51) were more likely to report unmet mental health care needs than White SGMA.</div></div><div><h3>Discussion</h3><div>Despite the lack of major and consistent racial and ethnic differences in anxiety and depression symptoms documented in our sample, Asian or Asian American, Black/African American, and Hispanic/Latino SGMA were more likely to report unmet mental health care needs than their White counterparts. This finding highlights the need to address barriers to mental health care for racially and ethnically minoritized SGMA.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 4","pages":"Pages 592-598"},"PeriodicalIF":5.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide Risk and Social Connectedness in Cisgender and Transgender Lesbian, Gay, Bisexual, and Queer/Questioning Youth in the Emergency Department","authors":"August X. Wei ,&nbsp;Annabelle M. Mournet M.S. ,&nbsp;Patrick C. Ryan ,&nbsp;Donna A. Ruch Ph.D. ,&nbsp;Maryland Pao M.D. ,&nbsp;Lisa M. Horowitz M.P.H., Ph.D ,&nbsp;Jeffrey A. Bridge Ph.D.","doi":"10.1016/j.jadohealth.2024.11.241","DOIUrl":"10.1016/j.jadohealth.2024.11.241","url":null,"abstract":"<div><h3>Purpose</h3><div>Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are at high suicide risk. Family/peer connectedness may be protective factors; few studies assess social connectedness within cisgender lesbian, gay, bisexual, and queer (cis-LGBQ) and transgender and gender-diverse (TGD) samples. This study aims to identify associations between family/peer connectedness and suicidal thoughts/behaviors (STBs) among cisgender-LGBQ and TGD youth to better inform suicide prevention strategies.</div></div><div><h3>Methods</h3><div>This study utilized data from LGBTQ youth aged 12–17 in the Emergency Department Screen for Teens at Risk for Suicide study. Youth completed measures for STBs (Ask Suicide-Screening Questions and Columbia Suicide Severity Rating Scale) and family/peer connectedness (“low,” “moderate,” and “high”). Logistic regression analyses examined associations between family/peer connectedness and STBs in cis-LGBQ and TGD youth.</div></div><div><h3>Results</h3><div>53.2% (607/1,140) of cis-LGBQ and 69.7% (99/142) of TGD youth self-reported STBs. For cis-LGBQ youth, the odds of reporting STBs increased when comparing low/moderate versus high family connectedness (<em>p</em> &lt; .001, adjOR = 9.8[6.8–14.2]; <em>p</em> &lt; .001, adjOR = 3.5[2.7–4.7]) and low versus moderate (<em>p</em> &lt; .001, adjOR = 2.8[1.9–4.0]). Regarding cis-LGBQ peer connectedness, the odds of reporting STBs increased when comparing low/moderate versus high (<em>p</em> &lt; .01, adjOR = 1.8[1.2–2.7]; <em>p</em> &lt; .05, adjOR = 1.5[1.1–2.1]), not low versus moderate (<em>p</em> = .4). For TGD youth, the odds of reporting STBs significantly increased when comparing low/moderate versus high family connectedness (<em>p</em> &lt; .001, adjOR = 9.8[3.7–28.2]; <em>p</em> &lt; .001, adjOR = 7.7[2.8–22.8]), not when comparing low versus moderate (<em>p</em> = .7). Peer connectedness levels had no significant associations with TGD youths' STB rates (<em>p</em> = .2, <em>p</em> = .3, <em>p</em> = .8).</div></div><div><h3>Discussion</h3><div>LGBTQ, especially TGD youth, are at elevated suicide risk. High levels of family connectedness may especially help mitigate suicide risk in TGD youth. Future research should replicate findings in larger TGD samples and adapt LGBTQ-specific, family-based emergency department interventions.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 4","pages":"Pages 599-605"},"PeriodicalIF":5.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Oppression-Based Stressors, Social Support, Suicide Ideation, and Nonsuicidal Self-Injury Ideation Among Sexual and Gender Minority Adolescents","authors":"Ethan H. Mereish Ph.D. ,&nbsp;Hyemin Lee Ph.D. ,&nbsp;Arushee Bhoja ,&nbsp;Jessica R. Abramson ,&nbsp;Jessica R. Peters Ph.D. ,&nbsp;Shirley Yen Ph.D.","doi":"10.1016/j.jadohealth.2024.12.008","DOIUrl":"10.1016/j.jadohealth.2024.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Sexual and gender minority adolescents (SGMA) are at heighted risk for suicide ideation (SI) and nonsuicidal self-injury ideation (NSSII) compared to their heterosexual and cisgender counterparts. Oppression-based stressors are posited to explain these disparities. However, there is limited research examining protective factors that mitigate the impact of oppression-based stressors. We conducted a 28-day daily diary study to test the moderating effects of daily general and SGM-affirmative social support on the associations between oppression-based stressors and SI and NSSII among SGMA.</div></div><div><h3>Methods</h3><div>Participants were 92 SGMA, ages 12–19 years (M = 16.28; standard deviation = 1.77; 52% cisgender; 61% White, non-Hispanic/Latine). Participants completed one daily survey per day over a 28-day monitoring period and demonstrated high compliance.</div></div><div><h3>Results</h3><div>On days SGMA experienced greater oppression-based stressors than their average, they had a greater likelihood of reporting same-day SI and NSSII. On days SGMA had greater SGM-affirmative social supports than their average, they had a lower likelihood of endorsing samde-day SI but not NSSII. General social supports were not associated with a lower likelihood of endorsing SI or NSSII. The interactions between all social supports and oppression-based stressors were not significant for SI or NSSII.</div></div><div><h3>Discussion</h3><div>The novel results underscore the harm oppression-based stressors inflict on SGMA's mental health, and highlight the unique importance of SGM-affirmative support in reducing risk for daily SI. Suicide interventions for this population may need to target SGM-affirmative social supports and exposure to or impact of oppression-based stressors.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 4","pages":"Pages 613-621"},"PeriodicalIF":5.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Associations Between Prosocial Behavior, Internalizing Symptoms, and Suicide Risk During the Transition to Adulthood","authors":"Laura M. Padilla-Walker Ph.D.,&nbsp;Katey Workman M.S.,&nbsp;Corinne Archibald M.S.","doi":"10.1016/j.jadohealth.2024.12.006","DOIUrl":"10.1016/j.jadohealth.2024.12.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Rates of internalizing symptoms and suicide risk are increasing among emerging adult populations. The current study highlighted resiliency factors, including prosocial behavior and self-esteem, and their longitudinal associations with depressive symptoms, anxiety symptoms, and suicidal risk.</div></div><div><h3>Methods</h3><div>Participants included 472 emerging adults at 2 time points (Time 1 <em>M</em> age = 18.37, 52% women; Time 2 <em>M</em> age = 23.31).</div></div><div><h3>Results</h3><div>Results from path analyses suggested that prosocial behavior toward family members at Time 1 was associated with lower levels of depressive symptoms and suicidal risk at Time 2 via emerging adults’ self-esteem.</div></div><div><h3>Discussion</h3><div>Findings highlight the importance of family relationships during the transition to adulthood in protecting against internalizing symptoms and suicide risk.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 4","pages":"Pages 632-637"},"PeriodicalIF":5.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Multicomponent Intervention to Improve Menstrual Health and Hygiene and School Attendance Among Adolescent Girls in the Gambia (MEGAMBO Trial).","authors":"Vishna Shah, Wolf Schmidt, Bakary Sonko, Edrisa Sinjanka, Francois Mendy, Julie Hennegan, Penelope Phillips-Howard, Belen Torondel","doi":"10.1016/j.jadohealth.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2024.12.018","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence on the effect of menstrual health and hygiene (MHH) interventions on education is scarce. This trial assessed the effect of a multicomponent intervention on school attendance, urogenital health, and other wellbeing outcomes among schoolgirls in rural Gambia.</p><p><strong>Methods: </strong>A cluster-randomised controlled trial was conducted between July 2019 and December 2020 in 50 villages across 2 regions of The Gambia, selecting one school per village. Using restricted randomisation, half of the villages received a 3-month NGO-led intervention, which included Peer education camps, Mother's outreach sessions, Community meetings and improving school water, sanitation, and hygiene (WASH). The other 25 villages received no intervention. The primary outcome was self-reported schoolgirls' absenteeism of at least one-day due to last period. Secondary outcomes included: urinary tract infections measured with symptoms and biochemical markers, reproductive tract infections symptoms, menstruation-related wellbeing, social support and knowledge, attitudes, and practices toward menstruation. All menstruating schoolgirls 13 years and older were eligible for outcome assessment. We analyzed data on an intention-to-treat basis.</p><p><strong>Results: </strong>Outcome assessment included 3556 schoolgirls (1832 [51.5%] in the intervention group and 1724 [48.5%] in the control group). Self-reported school absenteeism was only slightly lower in the intervention arm than the control arm (15.6% vs. 17.1%, risk difference = -1.4%, 95% CI = -4.6%-1.9%). The intervention had no effect on urogenital health but had broad positive effects on menstrual knowledge, attitudes, wellbeing, and social support.</p><p><strong>Discussion: </strong>The multicomponent MHH intervention had no effect on absence due to last period, but achieved improvements in MHH knowledge, experiences, and needs.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Preadmission Energy Balance on Short-Term Medical Outcomes: Findings From the Study of Refeeding to Optimize Inpatient Gains","authors":"Amanda E. Downey M.D. ,&nbsp;Cynthia J. Kapphahn M.D., M.P.H. ,&nbsp;Sasha Gorrell Ph.D. ,&nbsp;Siena S. Vendlinski ,&nbsp;Jing Cheng M.D., Ph.D. ,&nbsp;Daniel Le Grange Ph.D. ,&nbsp;Erin C. Accurso Ph.D. ,&nbsp;Sara M. Buckelew M.D., M.P.H. ,&nbsp;Anna Kreiter Psy.D. ,&nbsp;Brooke Marsal R.D. ,&nbsp;Paige Wright M.S., R.D. ,&nbsp;Neville H. Golden M.D. ,&nbsp;Andrea K. Garber Ph.D., R.D.","doi":"10.1016/j.jadohealth.2024.11.245","DOIUrl":"10.1016/j.jadohealth.2024.11.245","url":null,"abstract":"<div><h3>Purpose</h3><div>Caloric restriction and excessive exercise create an energy imbalance with medical sequelae in restrictive eating disorders. We examined the effect of acute and chronic energy imbalance on admission illness severity and refeeding outcomes in adolescents and young adults with anorexia nervosa (AN) and atypical AN.</div></div><div><h3>Methods</h3><div>Secondary data analysis from the Study of Refeeding to Optimize Inpatient Gains, a multicenter randomized trial comparing higher- versus lower-calorie refeeding in 120 youth with AN or atypical AN hospitalized with medical instability. Vital signs were measured daily. Acute energy balance was calculated as caloric output (exercise recall plus estimated resting energy expenditure) subtracted from caloric input (dietary recall) before admission. Chronic energy imbalance variables included magnitude, rate, and duration of weight loss before admission. Regression analyses examined associations among energy balance, illness severity, and refeeding outcomes; dominance analyses examined the relative importance of energy balance.</div></div><div><h3>Results</h3><div>Among 82 participants (91% female), admission mean (SD) age was 16.5 (2.5) years, %median body mass index was 85 (10) and acute energy balance was −898 (678) kilocalories. Those with more negative acute energy balance before admission required more days (−0.18, [95% CI, −0.35, −0.02] <em>p</em> = .03) and kilocalories to restore medical stability (−431.10, [95% CI, −857.06, −5.13] <em>p</em> = .047). Acute energy balance was a more important predictor than weight suppression in determining these outcomes.</div></div><div><h3>Discussion</h3><div>More acute negative energy balance was associated with a need for more intensive refeeding, which supports the inclusion of preadmission dietary recall and exercise assessments, alongside weight history, to inform individualized refeeding protocols.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 4","pages":"Pages 702-709"},"PeriodicalIF":5.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}