Citation

Ranney ML, Bromberg J, Hozey A, Casper TC, Mello MJ, Spirito A, Chun TH, Linakis JG. Acad. Pediatr. 2018; 18(6): 650-654.

Affiliation

Department of Emergency Medicine, Warren Alpert Medical School of Brown University; 593 Eddy St, Claverick 2, Providence, RI, 02903; Injury Prevention Center, Rhode Island Hospital; 593 Eddy St, Claverick 2, Providence, RI, 02903.

Copyright

(Copyright © 2018, Academic Pediatric Association, Publisher Elsevier Publishing)

DOI

10.1016/j.acap.2018.02.016

PMID

29505897

Abstract

OBJECTIVE: Problem behaviors such as substance use and peer aggression frequently co-exist, and are common among youth seen in emergency departments (EDs). EDs are increasingly urged to screen for both psychological distress and problem behaviors. To inform screening and intervention efforts, we aimed to identify classes of problematic substance use and peer aggression in a sample of adolescents from 16 pediatric EDs, and to examine the relative prevalence of psychological distress in identified classes.

METHODS: We completed a cross-sectional survey of youth (n = 5001) presenting for any reason to 16 pediatric EDs across the United States, using validated measures of demographics, alcohol and substance use, and peer aggression. We used standard latent class analysis (LCA) techniques to create behavioral risk classes of adolescents, based on violence and substance use variables; then conducted logistic regression to examine the relationship between psychological distress and latent classes.

RESULTS: Three classes of problem behaviors were identified: low-risk (few problem behaviors, 91.2% of sample), medium risk (high cigarette smoking; moderate violence, alcohol, substance use, 5.2%), and high risk (high levels of all problem behaviors, 3.5%). A significant directional association (p <.001) between worse psychological distress and higher risk behavior classes was noted, even after adjusting for demographics.

CONCLUSIONS: Youth seen in the ED for any reason, who report higher levels of past-year substance use and peer aggression, are significantly more likely to report negative mood symptoms. Targeted screening and interventions for this population may be indicated.

Copyright © 2018. Published by Elsevier Inc.

Language: en

Keywords

Adolescent; emergency department; latent class analysis; substance use; violence