Defining adolescence: priorities from a global health perspective

Kinghorn, Anthony; Shanaube, Kwame; Toska, Elona; Cluver, Lucie; Bekker, Linda‐Gail

doi:10.1016/s2352-4642(18)30096-8

Cited by 37 publications

(33 citation statements)

References 4 publications

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“…This age range is consistent with recent scientific advances that suggest adolescence in human development may last nearly fifteen years(71) …”

supporting

confidence: 91%

Revisiting the Neural Architecture of Adolescent Decision-Making: Univariate and Multivariate Evidence for System-Based Models

Moreira¹,

Leal²,

Waizman³

et al. 2020

Preprint

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System-based theories are a popular approach to explaining the psychology of human decision making. Such theories posit that decision-making is governed by interactions between different psychological processes that arbitrate amongst each other for control over behavior. To date, system-based theories have received inconsistent support at the neural level, leading some to question their veracity. Here we examine the possibility that prior attempts to evaluate system-based theories have been limited by their reliance on predicting brain activity from behavior, and seek to advance evaluations of system-based models through modeling approaches that predict behavior from brain activity. Using within-subject decision-level modeling of fMRI data from a risk-taking task in a sample of over 2000 decisions across 51 adolescents—a population in which decision-making processes are particularly dynamic and consequential—we find support for system-based theories of decision-making. In particular, neural activity in lateral prefrontal cortex and a multivariate pattern of cognitive control both predicted a reduced likelihood of making a risky decision, whereas increased activity in the ventral striatum—a region typically associated with valuation processes—predicted a greater likelihood of engaging in risk-taking. These results comprise the first formalized within-subjects neuroimaging test of system-based theories, garnering support for the notion that competing systems drive decision behaviors.Significance StatementDecision making is central to adaptive behavior. While dominant psychological theories of decision-making behavior have found empirical support, their neuroscientific implementations have received inconsistent support. This may in part be due to statistical approaches employed by prior neuroimaging studies of system-based theories. Here we use brain modeling—an approach that predicts behavior from brain activity—of univariate and multivariate neural activity metrics to better understand how neural components of psychological systems guide decision behavior. We found broad support for system-based theories such that that neural systems involved in cognitive control predicted a reduced likelihood to make risky decisions, whereas value-based systems predicted greater risk-taking propensity.

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“…This age range is consistent with recent scientific advances that suggest adolescence in human development may last nearly fifteen years(71) …”

supporting

confidence: 91%

Revisiting the Neural Architecture of Adolescent Decision-Making: Univariate and Multivariate Evidence for System-Based Models

Moreira¹,

Leal²,

Waizman³

et al. 2020

Preprint

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“…Including out-of-school adolescents in our analysis would probably have influenced our findings but was not possible because of lack of data in this largely understudied population 24 . We call for this gap in surveillance of physical activity to be urgently addressed to enable countries to respond and meet the call for reporting of disaggregated health statistics 25 …”

Section: Discussionmentioning

confidence: 99%

Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants

Guthold¹,

Stevens

Riley³

et al. 2020

The Lancet Child & Adolescent Health

2,262

1,598

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SummaryBackgroundPhysical activity has many health benefits for young people. In 2018, WHO launched More Active People for a Healthier World, a new global action on physical activity, including new targets of a 15% relative reduction of global prevalence of insufficient physical activity by 2030 among adolescents and adults. We describe current prevalence and trends of insufficient physical activity among school-going adolescents aged 11–17 years by country, region, and globally.MethodsWe did a pooled analysis of cross-sectional survey data that were collected through random sampling with a sample size of at least 100 individuals, were representative of a national or defined subnational population, and reported prevalence of of insufficient physical activity by sex in adolescents. Prevalence had to be reported for at least three of the years of age within the 10–19-year age range. We estimated the prevalence of insufficient physical activity in school-going adolescents aged 11–17 years (combined and by sex) for individual countries, for four World Bank income groups, nine regions, and globally for the years 2001–16. To derive a standard definition of insufficient physical activity and to adjust for urban-only survey coverage, we used regression models. We estimated time trends using multilevel mixed-effects modelling.FindingsWe used data from 298 school-based surveys from 146 countries, territories, and areas including 1·6 million students aged 11–17 years. Globally, in 2016, 81·0% (95% uncertainty interval 77·8–87·7) of students aged 11–17 years were insufficiently physically active (77·6% [76·1–80·4] of boys and 84·7% [83·0–88·2] of girls). Although prevalence of insufficient physical activity significantly decreased between 2001 and 2016 for boys (from 80·1% [78·3–81·6] in 2001), there was no significant change for girls (from 85·1% [83·1–88·0] in 2001). There was no clear pattern according to country income group: insufficient activity prevalence in 2016 was 84·9% (82·6–88·2) in low-income countries, 79·3% (77·2–87·5) in lower–middle-income countries, 83·9% (79·5–89·2) in upper–middle-income countries, and 79·4% (74·0–86·2) in high-income countries. The region with the highest prevalence of insufficient activity in 2016 was high-income Asia Pacific for both boys (89·0%, 62·8–92·2) and girls (95·6%, 73·7–97·9). The regions with the lowest prevalence were high-income western countries for boys (72·1%, 71·1–73·6), and south Asia for girls (77·5%, 72·8–89·3). In 2016, 27 countries had a prevalence of insufficient activity of 90% or more for girls, whereas this was the case for two countries for boys.InterpretationThe majority of adolescents do not meet current physical activity guidelines. Urgent scaling up of implementation of known effective policies and programmes is needed to increase activity in adolescents. Investment and leadership at all levels to intervene on the multiple causes and inequities that might perpetuate the low participation in physical activity and sex differences, as well as engagement of yo...

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“…Even where ethical procedures allow for recruitment, specific resources are often needed to support adolescent engagement, including specially trained researchers and acceptable measurement tools or interventions. Disaggregating data by 5-year age bands may be a strong first step to making this possible (Kinghorn et al, 2018) so that data on 10-19 year-olds could be collated as needed.…”

Section: Implications Of These Findingsmentioning

confidence: 99%

Adolescent mothers affected by HIV and their children: A scoping review of evidence and experiences from sub-Saharan Africa

Toska

Laurenzi

Roberts

et al. 2020

Global Public Health

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While adolescents have received increasing attention in the global HIV response and international strategies and commitments, adolescent mothers and their children remain largely overlooked in research, funding and, programming for health-related outcomes. We conducted an extensive scoping review of current evidence on the experiences of adolescent mothers affected by HIV and their children in this region. We included published literature and conference abstracts, complemented by consultations with key stakeholders, and a review of documents through grey literature searching. First, we summarise the experiences of adolescent mothers and their children related to HIV and key health and development indicators. The syndemic of early motherhood and HIV in sub-Saharan Africa increases the vulnerability of adolescent mothers and their children. We then highlight lessons from a series of promising programmes focused on supporting adolescent mothers through novel approaches. In sub-Saharan Africa, supporting adolescent mothers living in high HIV-risk communities is critical not only to eliminate HIV/AIDS, but also to attain the Sustainable Development Goals. While research on and programming for adolescent mothers and their children is growing, the complex needs for this vulnerable group remain unmet. We conclude with evidence gaps and programming priorities for adolescent mothers affected by HIV and their children.

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Defining adolescence: priorities from a global health perspective

Cited by 37 publications

References 4 publications

Revisiting the Neural Architecture of Adolescent Decision-Making: Univariate and Multivariate Evidence for System-Based Models

Revisiting the Neural Architecture of Adolescent Decision-Making: Univariate and Multivariate Evidence for System-Based Models

Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants

Adolescent mothers affected by HIV and their children: A scoping review of evidence and experiences from sub-Saharan Africa

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