Featured Research in Adolescent Health

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Collection Editor
1. Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA
2. Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
Interests: child and adolescent health; prevention of obesity and cardiovascular disease; social and behavioral determinants of health

Topical Collection Information

Dear Colleagues,

I am delighted to announce this Topical Collection of Adolescents that will feature papers authored and invited by our Editorial Board Members. In addition, we also invite original research that focuses on topics relevant to adolescent health and development for consideration for publication in this Topical Collection. Manuscripts that address the topics listed below will be considered for publication in this Topical Collection.

  • Adolescent health and wellbeing;
  • Adolescent development;
  • Adolescent psychology; 
  • Adolescent gynecology;
  • Adolescent oncology;
  • Adolescent psychiatry;
  • Adolescent substance abuse; 
  • School health and wellbeing;
  • Bullying, cyberbullying, teen dating violence;
  • Youth deviance;
  • Youth crime;
  • School health promotion policies and practices.  

Prof. Dr. Laura L. Hayman
Collection Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Adolescents is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (12 papers)

2023

Jump to: 2022

12 pages, 270 KiB  
Article
Witnessing Sexual Harassment and Associated Substance Use and Poor Mental Health Outcomes among Adolescent Girls in the US
by Elizabeth Reed, Marissa Salazar, Alma I. Behar, Niloufar Agah, Alice L. Wong, Jay G. Silverman, Melanie L. A. Rusch and Anita Raj
Adolescents 2023, 3(3), 478-489; https://doi.org/10.3390/adolescents3030034 - 2 Aug 2023
Viewed by 1864
Abstract
Direct experiences of sexual harassment have been found to be associated with substance use and poor mental health among girls. Indirect experiences, such as witnessing the sexual harassment of others, may be indicative of a climate supportive of sexual harassment against girls and [...] Read more.
Direct experiences of sexual harassment have been found to be associated with substance use and poor mental health among girls. Indirect experiences, such as witnessing the sexual harassment of others, may be indicative of a climate supportive of sexual harassment against girls and elicit similar adverse outcomes. The current study sought to assess reports of witnessing sexual harassment and associations with substance use and mental heath outcomes among adolescent girls. The data were from questionnaires among girls (n = 152) ages 15–19 recruited from a health clinic serving a low-resource community in San Diego County. Using crude and adjusted regression models, we assessed witnessing the sexual harassment of girls (past year) as well as the frequency of witnessing such acts in relation to substance use, anxiety, depression, and suicidal ideation. The adjusted models included demographics and direct experiences of sexual harassment (past 6 months) as covariates. The participants had an average age of 17, and 76% were Latina. The majority (70%) reported witnessing sexual harassment (past year); 65% reported directly experiencing sexual harassment (past 6 months). Among those reporting witnessing, most witnessed sexual harassment at school (69%), at a party (45%), in their neighborhood (34%), or on public transport (33%). In adjusted logistic regression models, witnessing sexual harassment was significantly associated with past 30-day alcohol use, ever using drugs, feeling depressed (past 30 days), feeling anxious (past 30 days), and past-year suicidal ideation (ORs range 2.9–18.2). The findings suggest that, in addition to direct experiences of sexual harassment, indirect experiences of witnessing the sexual harassment of others may also be associated with negative outcomes regarding girls’ health and well-being. Full article
12 pages, 499 KiB  
Article
Mental Health Screening for Korean Ukrainian Refugee Minors in the Republic of Korea: A Cross Sectional Pilot Study
by Sejeong Park, Jenny Seongryung Lee, Hye-Jung Kim, Hojung Lee, Myungjoo Lee, Soo-Yeon Kim and Han Choi
Adolescents 2023, 3(1), 141-152; https://doi.org/10.3390/adolescents3010011 - 21 Feb 2023
Cited by 1 | Viewed by 2565
Abstract
Since February 2022, the Ukrainian refugee crisis has been highlighting mental health problems associated with trauma and distress. This study aimed to evaluate the mental health status of twenty-seven refugee minors (10 to 18 years old) who fled Ukraine and temporarily settled in [...] Read more.
Since February 2022, the Ukrainian refugee crisis has been highlighting mental health problems associated with trauma and distress. This study aimed to evaluate the mental health status of twenty-seven refugee minors (10 to 18 years old) who fled Ukraine and temporarily settled in the Republic of Korea (ROK). This cross-sectional survey study aimed to evaluate the mental health status of ethnic Korean Ukrainian refugee minors. The Child and Adolescent Trauma ScreenYouth Report (CATS), generalized anxiety disorder seven-item scale (GAD-7), and subjective unit of distress scale (SUDs) were used for assessment. A preliminary analysis indicated that 77% Ukrainian refugee minors were exposed to and experienced war-related trauma. They are at a relatively low risk of trauma symptoms, anxiety, and distress due to stable family and visa status and a comparably better environment in the ROK. Meanwhile, refugee teenagers showed higher rates of psychological distress compared with refugee children. This finding suggests that an early psychological interventions in a host country may be beneficial to prevent mental health issues in refugee minors. Full article
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10 pages, 285 KiB  
Article
Associations between Mental Health and COVID-19 Status among 18- and 19-Year-Old Adolescents: A Multi-Country Study
by Morenike Oluwatoyin Folayan, Roberto Ariel Abeldaño Zuñiga, Mir Faeq Ali Quadri, Joanne Lusher, Balgis Gaffar, Passent Ellakany, Annie L. Nguyen and Maha El Tantawi
Adolescents 2023, 3(1), 131-140; https://doi.org/10.3390/adolescents3010010 - 16 Feb 2023
Cited by 2 | Viewed by 2215
Abstract
The aim of this study was to describe the mental health status of 18- and 19-year-old adolescents who were infected or affected by COVID-19 during the first wave of the COVID-19 pandemic. This was a secondary analysis of a dataset collected from 152 [...] Read more.
The aim of this study was to describe the mental health status of 18- and 19-year-old adolescents who were infected or affected by COVID-19 during the first wave of the COVID-19 pandemic. This was a secondary analysis of a dataset collected from 152 countries between July and December 2020. Dependent variables were anxiety, depression, and post-traumatic stress symptoms. The independent variable was COVID-19 status (tested positive for COVID-19, had COVID-19 symptoms but did not test, had a close friend who tested positive for COVID-19, knew someone who died from COVID-19). Three multivariable logistic regression analyses were conducted to determine the associations between the dependent and independent variables while adjusting for confounding variables (sex—male, female, and country income level). Data of 547 participants were extracted, and 98 (17.9%) had experienced depression, 130 (23.8%) had experienced anxiety, and 219 (40.0%) had experienced post-traumatic stress symptoms. Knowing someone who died from COVID-19 was associated with significantly lower odds of having post-traumatic stress symptoms (AOR: 0.608). Having COVID-19 symptoms but not getting tested was associated with significantly higher odds of having anxiety symptoms (AOR: 2.473). Results indicate diverse mental health responses among adolescents aged 18–19-years old as a sequela of COVID-19. This needs to be studied further. Full article

2022

Jump to: 2023

10 pages, 265 KiB  
Article
Multi-Level Protective and Risk Factors Longitudinally Associated with Dating Violence Perpetration among Non-Urban Mexican-American Adolescents
by Sabrina C. Boyce, Julianna Deardorff, Linda McGlone and Alexandra M. Minnis
Adolescents 2023, 3(1), 72-81; https://doi.org/10.3390/adolescents3010005 - 30 Dec 2022
Cited by 2 | Viewed by 2306
Abstract
To assess the longitudinal relationship between individual and interpersonal risk and protective factors and dating violence perpetration among non-urban Mexican-American youth. With data from a 24-month prospective cohort study (2015–2019; baseline recruitment spanned from 2015–2017; four follow-up interviews every 6 months) of Mexican-American [...] Read more.
To assess the longitudinal relationship between individual and interpersonal risk and protective factors and dating violence perpetration among non-urban Mexican-American youth. With data from a 24-month prospective cohort study (2015–2019; baseline recruitment spanned from 2015–2017; four follow-up interviews every 6 months) of Mexican-American youth (8th grade at baseline) living in an agricultural region (Salinas, California), we utilized multivariable modified Poisson general estimating equations stratified by gender (n = 489) to assess the relationships of religiosity, non-violent problem-solving skills, school connectedness, family cohesion, and bullying victimization with dating violence perpetration. Among girls, but not boys, non-violent problem-solving skills [adjusted relative risk (ARR): 0.7; 95% confidence interval (CI): 0.56–0.99] and family cohesion (ARR: 0.7; 95% CI: 0.48–0.97) were negatively associated with dating violence perpetration, and frequency of bullying victimization was positively associated (ARR: 1.9; 95% CI: 1.37–2.59). Non-urban Mexican-American female youth may benefit from multi-level dating violence prevention that strengthens family cohesion by building upon the Mexican-American cultural value of familismo and addresses common risk factors for bullying and dating violence perpetration. Additionally, results affirm etiological differences between girls’ and boys’ dating violence perpetration and the need for improved measurement. Full article
19 pages, 565 KiB  
Article
Interconnections between Emotion Recognition, Self-Processes and Psychological Well-Being in Adolescents
by Meghan L. Maynard, Shanel Quenneville, Kristina Hinves, Victoria Talwar and Sandra L. Bosacki
Adolescents 2023, 3(1), 41-59; https://doi.org/10.3390/adolescents3010003 - 23 Dec 2022
Viewed by 4206
Abstract
Background: Adolescence is a critical developmental period for mentalization and emotion regulation skills. Studies show that during this time, adolescents may experience greater vulnerability to challenges of mental and emotional well-being. Studies also show that self-skills, such as mentalization, self-compassion, and self-control are [...] Read more.
Background: Adolescence is a critical developmental period for mentalization and emotion regulation skills. Studies show that during this time, adolescents may experience greater vulnerability to challenges of mental and emotional well-being. Studies also show that self-skills, such as mentalization, self-compassion, and self-control are independently associated with feelings of global self-worth or psychological well-being. To date, no known studies have explored interconnected relations among these self-skills, despite significant overlaps in the social-biological development of these skills. Aims: To investigate interconnected relations among psychological well-being, mentalization, self-compassion and self-control. Gender differences in these relations are explored. Method: As part of a larger, longitudinal study of adolescent well-being, this cross-sectional study drew on a variety of self-report measures, investigating relations among adolescents’ self-reports of psychological well-being, emotion recognition, self-control, and self-compassion. Participants consisted of 88 girls and 57 boys, mean age 13.38. Results: Main results showed associations among emotion recognition, self-control and self-compassion and feelings of global self-worth. Specifically, results showed that understanding negative emotions in others relates to lower levels of self-compassion and feelings of self-worth. Further, adolescents who report low levels of self-control reported uncompassionate self-responding and lower levels of self-worth. Gender differences and implications for further research and adolescent social-emotional interventions are discussed. Full article
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9 pages, 229 KiB  
Brief Report
Levels and Pattern of Alcohol Consumption among Adolescents in Bolivia: A National Cross-Sectional Survey in 2018
by Esther Luwedde and Karl Peltzer
Adolescents 2023, 3(1), 1-9; https://doi.org/10.3390/adolescents3010001 - 21 Dec 2022
Cited by 1 | Viewed by 2037
Abstract
The purpose of this investigation was to assess the prevalence and associated factors of four alcohol use indicators among male and female school adolescents in Bolivia. In total, 7931 participants (M = 15.5 years, SD = 1.6) responded to a questionnaire in a [...] Read more.
The purpose of this investigation was to assess the prevalence and associated factors of four alcohol use indicators among male and female school adolescents in Bolivia. In total, 7931 participants (M = 15.5 years, SD = 1.6) responded to a questionnaire in a cross-sectional nationally representative school survey in Bolivia in 2018. The proportion of current alcohol use was 26.4%, heavy alcohol use 11.1%, ever having been drunk 24.1%, and trouble resulting from alcohol use 21.4%. Among boys, older age, current cannabis use, multiple sexual partners, being in a physical fight, school truancy, soft drink intake, injury and psychological distress increased the risk of current alcohol use and/or heavy drinking. Among girls, older age, multiple sexual partners, fast food intake, being in a physical fight, school truancy, sedentary behaviour and psychological distress increased the risk of current alcohol use and/or heavy drinking. Older age, multiple sexual partners, current cannabis use, low parental support and school truancy were associated with trouble from alcohol use and history of intoxication in both sexes. Among boys, ever having used amphetamines, fast food intake, injury, peer support, and being in a physical fight were associated with ever having been drunk; and among girls, sedentary behaviour and psychological distress increased the odds of ever having been drunk. The study found that more than one in ten adolescents engage in heavy alcohol use, and several sex specific factors are identified for four alcohol use indicators. Full article
15 pages, 300 KiB  
Article
Children’s and Adolescents’ Pet Attachment, Empathy, and Compassionate Responding to Self and Others
by Sandra Bosacki, Christine Yvette Tardif-Williams and Renata P. S. Roma
Adolescents 2022, 2(4), 493-507; https://doi.org/10.3390/adolescents2040039 - 29 Nov 2022
Cited by 3 | Viewed by 6113
Abstract
The research shows that children’s and adolescents’ attachments with pets play an important role in their social and emotional lives. However, little research exists on how children and adolescents show compassion toward themselves and others and how this caring ability relates to their [...] Read more.
The research shows that children’s and adolescents’ attachments with pets play an important role in their social and emotional lives. However, little research exists on how children and adolescents show compassion toward themselves and others and how this caring ability relates to their attachment with pets. This study explored the relations among children’s and adolescents’ compassion, empathy, and attachment to their pets. Sixty-one Canadian youths aged 7–15.9 years (M = 11.35) participated in this study (n = 38 g, 23 b) and completed self-report questionnaires including the Lexington Attachment to Pets scale, subscale of Dispositional Positive Emotions, Self-compassion scale for children, and Bryant’s Index of Empathy for Children and Adolescents (IECA). The results showed older adolescents were more likely than younger children to score high on cognitive and emotional dimensions of empathy and be less likely to feel alone and isolated. High levels of emotional pet attachment related to high levels of the ability to feel sad when witnessing others in distress and high levels of mindful, compassionate, and self-responding feelings of compassion for others. The results also showed that those participants who experienced intensified emotional attachment toward their pets (either current or in the past), were less likely to judge themselves in negative ways. Overall, our findings suggest that children’s emotional attachments with pets relate to their ability to respond to themselves and others in kind and compassionate ways and not necessarily their ability to understand another person’s emotions. Full article
7 pages, 221 KiB  
Article
Lifestyle Practices and Mental Health in Adolescents: Explorative Analysis from Malaysian Health and Morbidity Survey 2017
by Irma Liyana Mushaddik, Karniza Khalid, Amalina Anuar, Siti Zulaiha Che Hat and Ruzita Jamaluddin
Adolescents 2022, 2(4), 459-465; https://doi.org/10.3390/adolescents2040036 - 31 Oct 2022
Cited by 2 | Viewed by 3019
Abstract
Many significant psychosocial problems may go undetected and untreated in adolescents. We aim to determine the prevalence of high-risk behaviors among Malaysian adolescents. Retrospective data analysis was performed using data from the National Health and Morbidity Survey (NHMS) 2017 report. The dataset included [...] Read more.
Many significant psychosocial problems may go undetected and untreated in adolescents. We aim to determine the prevalence of high-risk behaviors among Malaysian adolescents. Retrospective data analysis was performed using data from the National Health and Morbidity Survey (NHMS) 2017 report. The dataset included 27,497 responses from adolescents aged 13 to 17 years old from five established topographic zones: northern peninsular, east coast peninsular, southern peninsular, central, and east Malaysia. The strength of associations between selected high-risk behaviors and different topographical zones were performed using logistic regression analysis. Adolescents from the northern peninsular reported the highest prevalence of suicidal attempt (27.1%) and active drug user (30.1%). The same region reported the highest prevalence of those who ever had sexual intercourse (SI) (27.2%), with 32.5% who had their first SI before 14 years old, while east Malaysia reported the highest prevalence of current smokers (26.1%) and current alcohol consumers (30.6%). Overall poor lifestyle choices were evident in the northern peninsular region. Hence, specific districts breakdown may enable targeted interventional lifestyle strategies for adolescents at risk. Full article
11 pages, 274 KiB  
Article
Keep It Brief and Targeted: Driving Performance Feedback Report Features to Use with Novice Drivers
by Chelsea M. Ward McIntosh, Elizabeth A. Walshe, Shukai Cheng, Flaura K. Winston and Ellen Peters
Adolescents 2022, 2(4), 448-458; https://doi.org/10.3390/adolescents2040035 - 22 Oct 2022
Viewed by 1968
Abstract
Driving evaluations aim to ensure adequate skills; however, feedback beyond pass/fail is needed for improvement. Therefore, the goal of this study was to inform driving feedback report design to ensure ease of use and understandability while motivating improvements. Participants ages 18–25 years (n [...] Read more.
Driving evaluations aim to ensure adequate skills; however, feedback beyond pass/fail is needed for improvement. Therefore, the goal of this study was to inform driving feedback report design to ensure ease of use and understandability while motivating improvements. Participants ages 18–25 years (n = 521) were recruited from CloudResearch Prime Panels to rate one of nine report design conditions with various combinations of five key features: performance summary presence, action plan (AP) length, AP order, AP grading system, and peer comparison presence; they then completed questionnaires. Participants were more motivated to improve when a summary was present (p = 0.02); they rated reports easier to use if they had a long AP (p = 0.01), a short AP paired with a summary (p = 0.007), or an AP with a number grade (p = 0.016); and they rated reports easier to understand if they had a short AP (p = 0.002) or an AP ordered by worst-to-best performance (p = 0.05). These results suggest that feedback reports designed with a performance summary and short, targeted action plan starting with the biggest area for improvement are likely to motivate action to improve driving skills while being easy to use and understand. Future research should evaluate the effect of such a redesigned report on driving outcomes among young drivers. Full article
15 pages, 305 KiB  
Article
Predicting Antisocial Personality Features among Justice-Involved Males and Females: The Effects of Violence Exposure in Childhood and Adolescence
by Zoe R. Feingold, Emily C. Weinberger and John K. Samuels
Adolescents 2022, 2(4), 424-438; https://doi.org/10.3390/adolescents2040033 - 27 Sep 2022
Cited by 1 | Viewed by 3606
Abstract
The high rate of antisocial personality disorder (ASPD) among individuals involved in the justice system represents a significant public health concern, as individuals with ASPD are more likely to reoffend after incarceration and to engage in longer-term offending behavior patterns over the lifespan. [...] Read more.
The high rate of antisocial personality disorder (ASPD) among individuals involved in the justice system represents a significant public health concern, as individuals with ASPD are more likely to reoffend after incarceration and to engage in longer-term offending behavior patterns over the lifespan. Research suggests that traumatic event exposure in childhood and adolescence may be one factor that contributes to the heightened risk for ASPD in adulthood, though findings are mixed depending on the operationalization of trauma exposure and demographics of study samples. The present study examined the impact of early and varied exposure to violence on the development of ASPD features in young adulthood. In addition, given evidence for gender differences in how youth respond to trauma, as well as disparate prevalence rates of ASPD among males and females, a secondary aim was to assess the impact of gender on the relationship between early trauma and antisocial personality outcomes. The study sample consisted of 1354 adolescents (86% male) who participated in a longitudinal research study of serious juvenile offenders. A series of linear regression analyses revealed that the magnitude of violence exposure participants endorsed at baseline significantly predicted antisocial personality features at six-year follow-up. Participants’ gender was not found to moderate the relationship between violence exposure and antisocial outcomes. Results suggest that targeting maladaptive cognitions and behaviors resulting from chronic exposure to early trauma may be a crucial component of treatment for justice-involved individuals exhibiting ASPD features. Full article
15 pages, 306 KiB  
Article
Public Understanding of Adolescents’ Risks on Facebook in Taiwan
by Yue Tan
Adolescents 2022, 2(2), 296-310; https://doi.org/10.3390/adolescents2020023 - 10 Jun 2022
Cited by 2 | Viewed by 2576
Abstract
An increasing number of parents and scholars have begun expecting schools and the government to share the responsibility of reducing the potential negative effects of SNS use among adolescents. This study examines how the public understands the risks that adolescents face, as well [...] Read more.
An increasing number of parents and scholars have begun expecting schools and the government to share the responsibility of reducing the potential negative effects of SNS use among adolescents. This study examines how the public understands the risks that adolescents face, as well as the causes and solutions, and how news media influence not only the public’s risk perceptions but also their policy preference for public interventions. Drawing on framing and attribution theories, this study used two datasets. First, the content analysis data explore Taiwanese news media’s coverage of youths’ online behaviors and how the media has framed the question “Who is responsible for adolescents’ risky and opportunity behaviors?” Second, the public opinion survey data addresses the influence of news consumption on the public perception of the risks facing adolescent Facebook users, the public’s attribution of related responsibilities to various stakeholders, and the public’s evaluation of parental mediation and government regulations. Full article
10 pages, 255 KiB  
Article
Cognitive Dysfunction among U.S. High School Students and Its Association with Time Spent on Digital Devices: A Population-Based Study
by Saral Desai, Travis Satnarine, Puneet Singla, Ayushi Mistry, Salika Gadiwala, Sejal Patel, Bibhuti Das, Prerna Sharma, Muna Telsem, Robert Stuart, Meher Chahal, Abdul Akim Bakarr, Ya-Ching Hsieh, Rana Prathap Mercy Pathrose, Urvish Patel, Tapan Parikh and Saurabhkumar Patel
Adolescents 2022, 2(2), 286-295; https://doi.org/10.3390/adolescents2020022 - 31 May 2022
Viewed by 4615
Abstract
Introduction: Cognitive dysfunction is a hallmark feature of many psychiatric disorders. We aimed to study the prevalence and predictors of cognitive dysfunction (CD) among U.S. high school students and its association with time spent on digital devices. Methods: We performed a cross-sectional survey [...] Read more.
Introduction: Cognitive dysfunction is a hallmark feature of many psychiatric disorders. We aimed to study the prevalence and predictors of cognitive dysfunction (CD) among U.S. high school students and its association with time spent on digital devices. Methods: We performed a cross-sectional survey study using YRBSS 2019 data of U.S. high school students in grades 9–12. Cognitive dysfunction was defined by difficulties with remembering, concentrating, and making decisions due to emotional, physical, or mental problems. Digital screen time was described by daily time spent on TV, computers, tablets, and phone. We performed univariate and multivariable survey logistic regression analysis to identify the prevalence of cognitive dysfunction and its association with time spent on digital devices. Results: Out of 10,317 total participants, 3914 (37.9%) reported CD. The prevalence of CD was higher in females compared to males (46.0% vs. 29.9%). Compared to participants with no CD, participants with CD reported substance abuse, such as alcohol (35.8% vs. 26.6%), marijuana (28.3% vs. 17.6%), cigarette (8.1% vs. 4.7%), and illicit drugs (18.9% vs. 9.0%) and they reported a higher prevalence (p < 0.0001 for all substances). Participants who felt sad and hopeless (62.8 vs. 22.1%) reported a high prevalence of CD, whereas participants with adequate sleep reported low prevalence (15.7% vs. 25.6%). In a regression, daily video game/internet use for non-work-related activities for 4 h (aOR:1.27; p = 0.03) and ≥5 h (aOR:1.70; p < 0.0001) demonstrated higher odds of CD, compared to participants with no daily use. Female sex, substance use, and depressed mood were additional predictors of CD. Conclusion: The prevalence of CD is high in U.S. high-school students. Female sex, substance abuse, depressed mood, and excessive VG/PC use is associated with high odds of cognitive dysfunction. Further research is needed to explore the complex relationship between screen time and cognitive dysfunction. Full article
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