Bio

Honors & Awards


  • Fellow, Society of Behavioral Medicine (Since 1992)

Professional Education


  • PhD, Stanford University, Counseling Psychology (1982)

Community and International Work


  • Family-based nutrition intervention for Latino children

    Topic

    obesity prevention

    Partnering Organization(s)

    NHLBI

    Populations Served

    low income Hispanic families

    Location

    Bay Area

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

Research & Scholarship

Current Research and Scholarly Interests


Drug addictions are viewed as chronic, relapsing disorders that may require extended therapy and follow-up. However, very few smoking cessation trials have examined the utility of extended therapy models. In a recently completed trial we attempted to boost long-term abstinence rates by extending the course of therapy. 362 adult smokers received 11 weeks of therapy that combined nicotine replacement, bupropion and behavioral therapy followed by an additional 14 weeks of therapy with bupropion or matching placebo. 52% were abstinent at 11 weeks. This result is almost double the mean treatment response (27%) typically observed for nicotine patch therapy. The overall abstinence rate at 25 weeks was about 40%, nearly twice the 24-week follow-up response observed in nicotine patch studies (21%). Abstinence percentages at week 52 (30%+) also represent a better-than-average treatment response.

We are now conducting a randomized clinical trial to examine the efficacy of a selegiline transdermal system in promoting cigarette smoking cessation.This is the first trial to examine this medication, developed as a treatment for Parkinson’s disease, as a possible therapy for nicotine dependence. We are interested in selegiline as a smoking cessation therapy because this medication potentiates dopamine through inhibition of MAO-B. Our interest in this medication derives from evidence suggesting that (1) the positive reinforcing effects of addictive drugs play an important role in maintaining drug use; (2) facilitation of dopaminergic neurotransmission in the mesocorticolimbic dopamine system appears to be critical for the acute reinforcing actions of stimulant drugs including nicotine and (3) the craving which produces relapse reflects memory of dopamine- mediated positive reinforcement. The choice of selegiline is based on the rationale that a medication that can potentiate dopamine may thus help to alleviate craving to take a drug for its positive reinforcing effects.

Finally, we are exploring genetic factors that may influence response to treatment. In each of the studies described above smokers are genotyped for polymorphisms at loci hypothesized to affect nicotine dependence and/or treatment efficacy to determine if polymorphisms at these loci affect relapse rate in smokers.

Clinical Trials


  • Extended Cessation Treatment for Teen Smokers (Nicoteens) Not Recruiting

    This study is designed to test the efficacy of an extended smoking cessation program for teen smokers. The investigators hypothesize that teen smokers randomized to extended treatment will have a higher abstinence rate at 52 week follow-up than teen smokers receiving only open label treatment.

    Stanford is currently not accepting patients for this trial. For more information, please contact Joel Killen, (650) 725 - 9443.

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  • Behavioral Maintenance Treatment for Smoking Cessation Not Recruiting

    Our primary goal is to examine the effectiveness of a multi-factor maintenance treatment strategy in promoting longer-term smoking abstinence. The investigators will also conduct secondary analyses of mediators and moderators of treatment response.

    Stanford is currently not accepting patients for this trial. For more information, please contact Joel Killen, (650) 725 - 9443.

    View full details

  • Selegiline Patch for Treatment of Nicotine Dependence Not Recruiting

    Relapse to smoking is a common problem affecting smokers who seek treatment. The purpose of this study is examine whether selegiline, given in the form of a skin patch, is effective in stopping smoking.

    Stanford is currently not accepting patients for this trial. For more information, please contact Joel Killen, (650) 725 - 9443.

    View full details

  • Extended Treatment for Smoking Cessation Recruiting

    Adult smokers (21-65) and adolescent smokers (18 - 21) years of age residing in Alameda and Santa Clara counties will serve as the target population for this study. A total of 400 smokers meeting eligibility criteria will be randomized. Treatment will include both open label and extended treatment phases. Randomization. Participants will be randomized to extended therapy or control conditions at baseline (prior to open label treatment) and the analysis will be intention-to-treat (ITT) to avoid the threat of selection bias. Primary hypothesis. Smokers randomized to receive CBT during extended treatment will have a higher prolonged abstinence rate (PA) at 52 week and 104 week follow-up than participants in the Supportive therapy Control treatment.

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  • Environmental Strategies & Behavior Change to Reduce Overeating in Obese Children Not Recruiting

    There is a need for effective weight control methods for obese children. Environmental strategies such as reducing the size of dishware and serving utensils, storing food out of view and reducing food consumption while watching television may reduce food intake without requiring conscious, cognitive self-control. The investigators propose to test these methods when added to a current state-of-the-art behavioral program.

    Stanford is currently not accepting patients for this trial. For more information, please contact Donna Matheson, PhD, 650-498-4765.

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Teaching

2013-14 Courses


Publications

Journal Articles


  • Predicting Successful 24-Hr Quit Attempt in a Smoking Cessation Intervention NICOTINE & TOBACCO RESEARCH Bailey, S. R., Bryson, S. W., Killen, J. D. 2011; 13 (11): 1092-1097

    Abstract

    The factors that influence the initial phase of quitting smoking have been understudied. Although maintenance of change is the ultimate test of the efficacy of treatment, maintenance is a nonissue for those who fail to manage even brief periods of abstinence. We examined factors associated with smokers' ability to achieve a targeted 24-hr quit during a smoking cessation program. As a comparison, we also examine whether predictors of an initial quit are different from factors that predict smoking abstinence at 52-week follow-up.Using baseline data from a randomized clinical trial to examine the efficacy of selegiline for cigarette smoking cessation (n = 280), we conducted univariate analyses (analysis of variance or chi-square) to determine statistically significant predictors of a successful quit attempt (SQA) versus unsuccessful quit attempt. Multiple logistic regression was performed with significant predictors from the univariate analyses to determine main effects and interactions in a multivariate model. The same factors and analyses were used to examine predictors of 52-week point prevalence abstinence.Lower nicotine dependence (modified Fagerström Tolerance Questionnaire [mFTQ]), higher Behavioral Inhibition System score, and lower baseline heart rate were predictive of SQA in both the univariate and the multivariate models. Gender was the only predictor of 52-week smoking abstinence.Predictors of initial induction of change were not predictors of abstinence at the 1-year follow-up, suggesting that different factors mediate the different subprocesses of behavior change. Knowledge of these pretreatment factors that moderate a SQA could help clinicians target smokers who need more intensive therapy during the initial induction of cessation.

    View details for DOI 10.1093/ntr/ntr151

    View details for Web of Science ID 000296352300011

    View details for PubMedID 21832272

  • Markers in the 15q24 Nicotinic Receptor Subunit Gene Cluster (CHRNA5-A3-B4) Predict Severity of Nicotine Addiction and Response to Smoking Cessation Therapy AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS Sarginson, J. E., Killen, J. D., Lazzeroni, L. C., Fortmann, S. P., Ryan, H. S., Schatzberg, A. F., Murphy, G. M. 2011; 156B (3): 275-284

    Abstract

    Stopping smoking is difficult even with treatment. Many patients prescribed pharmacologic treatments for smoking cessation experience side effects or lack of efficacy. We performed a pharmacogenetic study of the efficacy and tolerability of bupropion and transdermal nicotine (TN), two treatments for smoking cessation. Samples were drawn from two studies. In the first study (Maintenance 1, MT1), 301 smokers received bupropion plus TN for 11 weeks, followed by 14 weeks of placebo or bupropion. In the second study (MT2), 276 smokers received bupropion and TN for 8 weeks. We focused on eight SNPs in the 15q24 region, which contains the genes for the nicotinic cholinergic receptor subunits CHRNA5, CHRNA3, and CHRNB4, and has previously been implicated in nicotine addiction and smoking cessation. Analyses of baseline smoking quantity (SQ) identified an association between SQ and both the functional CHRNA5 SNP rs16969968 (D398N) and the CHRNA3 SNP rs1051730 (Y215Y) in a combined cohort containing MT1 and MT2. An association between SQ and ethnicity was also identified in the combined cohort. Pharmacogenetic analysis showed a significant association between rs8192475 (R37H) in CHRNA3 and both higher craving after quitting and increased withdrawal symptoms over time in MT2. Two markers for point prevalence abstinence, CHRNA5 SNP rs680244 and CHRNB4 SNP rs12914008, were also identified in MT2, with the strongest findings at week 52. These results provide further support for the role of the CHRNA5/A3/B4 subunits in determining number of cigarettes smoked and response to smoking cessation therapy.

    View details for DOI 10.1002/ajmg.b.31155

    View details for Web of Science ID 000288332600003

    View details for PubMedID 21268243

  • A Randomized Controlled Trial of Culturally Tailored Dance and Reducing Screen Time to Prevent Weight Gain in Low- Income African American Girls ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Robinson, T. N., Matheson, D. M., Kraemer, H. C., Wilson, D. M., Obarzanek, E., Thompson, N. S., Alhassan, S., Spencer, T. R., Haydel, K. F., Fujimoto, M., Varady, A., Killen, J. D. 2010; 164 (11): 995-1004

    Abstract

    To test a 2-year community- and family-based obesity prevention program for low-income African American girls: Stanford GEMS (Girls' health Enrichment Multi-site Studies).Randomized controlled trial with follow-up measures scheduled at 6, 12, 18, and 24 months.Low-income areas of Oakland, California.African American girls aged 8 to 10 years (N=261) and their parents or guardians.Families were randomized to one of two 2-year, culturally tailored interventions: (1) after-school hip-hop, African, and step dance classes and a home/family-based intervention to reduce screen media use or (2) information-based health education.Changes in body mass index (BMI).Changes in BMI did not differ between groups (adjusted mean difference [95% confidence interval] = 0.04 [-0.18 to 0.27] per year). Among secondary outcomes, fasting total cholesterol level (adjusted mean difference, -3.49 [95% confidence interval, -5.28 to -1.70] mg/dL per year), low-density lipoprotein cholesterol level (-3.02 [-4.74 to -1.31] mg/dL per year), incidence of hyperinsulinemia (relative risk, 0.35 [0.13 to 0.93]), and depressive symptoms (-0.21 [-0.42 to -0.001] per year) decreased more among girls in the dance and screen time reduction intervention. In exploratory moderator analysis, the dance and screen time reduction intervention slowed BMI gain more than health education among girls who watched more television at baseline (P = .02) and/or those whose parents or guardians were unmarried (P = .01).A culturally tailored after-school dance and screen time reduction intervention for low-income, preadolescent African American girls did not significantly reduce BMI gain compared with health education but did produce potentially clinically important reductions in lipid levels, hyperinsulinemia, and depressive symptoms. There was also evidence for greater effectiveness in high-risk subgroups of girls.

    View details for Web of Science ID 000283735700006

    View details for PubMedID 21041592

  • Failure to improve cigarette smoking abstinence with transdermal selegiline plus cognitive behavior therapy ADDICTION Killen, J. D., Fortmann, S. P., Murphy, G. M., Hayward, C., Fong, D., Lowenthal, K., Bryson, S. W., Killen, D. T., Schatzberg, A. F. 2010; 105 (9): 1660-1668

    Abstract

    To examine the effectiveness of transdermal selegiline for producing cigarette smoking abstinence.Adult smokers were randomly assigned to receive selegiline transdermal system (STS) or placebo given for 8 weeks. All participants received cognitive behavior therapy (CBT). Follow-ups were conducted at 25 and 52 weeks.Community smoking cessation clinic.243 adult smokers (> or =18 years of age; > or =10 cigarettes/day).Expired-air carbon monoxide confirmed 7-day point prevalence abstinence.STS was not superior to placebo. More women than men were abstinent at 52 week follow-up (28% vs 16%, P < 0.05). Behavioral activation (BAS) moderated treatment response (P = 0.01). The survival rate through week 52 for those with high 'drive' scores on the BAS was 47% if assigned to selegiline and 34% if assigned to placebo. The survival rate for those with low 'drive scores' on the BAS was 35% if assigned to selegiline compared to 53% if assigned to placebo.Transdermal selegiline does not appear generally effective in aiding smoking cessation though there may be a selective effect in those smokers with low 'behavioral activation'.

    View details for DOI 10.1111/j.1360-0443.2010.03020.x

    View details for Web of Science ID 000280668200027

    View details for PubMedID 20707784

  • Perceived drug assignment and treatment outcome in smokers given nicotine patch therapy JOURNAL OF SUBSTANCE ABUSE TREATMENT Bailey, S. R., Fong, D. M., Bryson, S. W., Fortmann, S. P., Killen, J. D. 2010; 39 (2): 150-156

    Abstract

    This study assessed the relationship between treatment outcome and perceived drug assignment in smokers (nicotine patch [NP] or placebo) using abstinence and relapse status. Smokers (N = 424) were randomly assigned to receive either NP or placebo as part of a study that examined the effects of combining NP with self-help programs. Beliefs about drug assignment, assessed at the 12-month follow-up, were obtained from 384 participants. Beliefs were related to abstinence at the 2-month, p < .05, and 6-month follow-ups, p < .05, for the NP group, but not the placebo. Beliefs were not related to abstinence at 12 months for either group. Survival analysis assessing relapse revealed that beliefs were related to relapse status, regardless of actual group assignment. Our results suggest that there is a relationship between perceived drug assignment and treatment outcome. Future studies using multiple treatment outcome measures and assessments of beliefs over time are warranted.

    View details for DOI 10.1016/j.jsat.2010.05.013

    View details for Web of Science ID 000280623600008

    View details for PubMedID 20598833

  • Using Treatment Process Data to Predict Maintained Smoking Abstinence AMERICAN JOURNAL OF HEALTH BEHAVIOR Bailey, S. R., Hammer, S. A., Bryson, S. W., Schatzberg, A. F., Killen, J. D. 2010; 34 (6): 801-810

    Abstract

    To identify distinct subgroups of treatment responders and nonresponders to aid in the development of tailored smoking-cessation interventions for long-term maintenance using signal detection analysis (SDA).The secondary analyses (n = 301) are based on data obtained in our randomized clinical trial designed to assess the efficacy of extended cognitive behavior therapy for cigarette smoking cessation. Model 1 included only pretreatment factors, demographic characteristics, and treatment assignment. Model 2 included all Model 1 variables, as well as clinical data measured during treatment.SDA was successfully able to identify smokers with varying probabilities of maintaining abstinence from end-of-treatment to 52-week follow-up; however, the inclusion of clinical data obtained over the course of treatment in Model 2 yielded very different partitioning parameters.The findings from this study may enable researchers to target underlying factors that may interact to promote maintenance of long-term smoking behavior change.

    View details for Web of Science ID 000291935900014

    View details for PubMedID 20604703

  • Withdrawal symptoms over time among adolescents in a smoking cessation intervention: Do symptoms vary by level of nicotine dependence? ADDICTIVE BEHAVIORS Bailey, S. R., Harrison, C. T., Jeffery, C. J., Ammerman, S., Bryson, S. W., Killen, D. T., Robinson, T. N., Schatzberg, A. F., Killen, J. D. 2009; 34 (12): 1017-1022

    Abstract

    Nicotine dependence may be expressed differently in teens than in adults. Thus, it may not be sufficient to build diagnostic and cessation treatment strategies for teens based on adult-derived clinical and research data. This is the first study to prospectively examine the development of withdrawal symptoms by level of nicotine dependence among adolescent smokers. Forty-seven adolescent smokers completed nicotine withdrawal symptoms measures during 10 weeks of cessation treatment. Nicotine dependence was assessed at baseline using the mFTQ. Change in withdrawal symptoms over time by level of nicotine dependence was examined via mixed model ANOVA. Nicotine withdrawal in daily adolescent smokers was strongly and prospectively associated with the level of nicotine dependence. Craving was rated as the most problematic symptom at the baseline assessment. The results of this study may help guide the development of future research on diagnostic and cessation treatment strategies for teens.

    View details for DOI 10.1016/j.addbeh.2009.06.014

    View details for Web of Science ID 000270472500005

    View details for PubMedID 19647373

  • Extended cognitive behavior therapy for cigarette smoking cessation ADDICTION Killen, J. D., Fortmann, S. P., Schatzberg, A. F., Arredondo, C., Murphy, G., Hayward, C., Celio, M., Cromp, D., Fong, D., Pandurangi, M. 2008; 103 (8): 1381-1390

    Abstract

    PRIMARY AIM: Examine the effectiveness of extended cognitive behavior therapy (CBT) in promoting longer-term smoking abstinence.Open-label treatment phase followed by extended treatment phase. Randomization conducted prior to entry into open-label treatment phase; analysis based on intention-to-treat to avoid threat of selection bias.Community smoking cessation clinic.A total of 304 adult smokers (> or = 18 years of age; > or = 10 cigarettes/day).Open-label (8 weeks): all participants received bupropion SR, nicotine patch, CBT. Extended treatment (12 weeks): participants received either CBT + voicemail monitoring and telephone counseling or telephone-based general support.Seven-day point prevalence abstinence, expired-air carbon monoxide.At week 20 follow-up, CBT produced a higher 7-day point prevalence abstinence rate: 45% versus 29%, P = 0.006; at 52 weeks the difference in abstinence rates (31% versus 27%) was not significant. History of depression was a moderator of treatment. Those with a positive history had a better treatment response at 20 weeks when assigned to the less intensive telephone support therapy (P < 0.05).The superiority of CBT to 20 weeks suggests that continued emphasis on the development of cognitive and behavioral strategies for maintaining non-smoking during an extended treatment phase may help smokers to maintain abstinence in the longer term. At present, the minimum duration of therapy is unknown.

    View details for DOI 10.1111/j.1360-0443.2008.02273.x

    View details for Web of Science ID 000257692800021

    View details for PubMedID 18855829

  • Extended Cognitive Behavior Therapy for Cigarette Smoking Cessation Addiction Killen JD, Fortmann SP, Schatzberg AF, Arredondo C, Murphy G, Hayward C, Celio M, Cromp D, Fong D, Pandurangi M 2008; 103: 1381-1390
  • Randomized clinical trial of the efficacy of Bupropion combined with nicotine patch in the treatment of adolescent smokers JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Robinson, T. N., Ammerman, S., Hayward, C., Rogers, J., Stone, C., Samuels, D., Levin, S. K., Green, S., Schatzberg, A. F. 2004; 72 (4): 729-735

    Abstract

    Adolescent smokers (N = 211) were randomized to 1 of 2 groups: (a) nicotine patch plus bupropion SR (sustained release; 150 mg per day) or (b) nicotine patch plus placebo. Group skills training sessions were conducted each week by research staff. Abstinence rates at Weeks 10 and 26 were as follows: (a) patch plus bupropion, 23% and 8%, (b) patch plus placebo, 28% and 7%. Despite the lack of a treatment effect, a large majority of adolescents in both treatment groups reduced their consumption to a few cigarettes per day or less and maintained this reduction over time. Similarly, an examination of survival curves revealed that by the end of treatment many had managed to avoid a return to daily smoking. These findings are encouraging and suggest new avenues for research. For example, treatments of the kind examined in this report, augmented by extended maintenance therapies, may yield higher long-term success rates.

    View details for DOI 10.1037/0022-006X.72.4.729

    View details for Web of Science ID 000222924600020

    View details for PubMedID 15301658

  • Efficacy and Tolerability of Pharmacotherapies to Aid Smoking Cessation in Adolescents PEDIATRIC DRUGS Bailey, S. R., Crew, E. E., Riske, E. C., Ammerman, S., Robinson, T. N., Killen, J. D. 2012; 14 (2): 91-108

    Abstract

    Adolescent smoking remains a public health problem. Despite concerns regarding adolescent nicotine dependence, few well-designed smoking cessation studies have been conducted with teen smokers. This is particularly true regarding pharmacologic treatments for nicotine dependence. Currently, pharmacologic aids are not recommended for treating adolescent nicotine dependence, as efficacy has not been shown in this population. This review includes studies that have examined the efficacy of pharmacotherapy for smoking abstinence and/or reduction in cigarette consumption among adolescent smokers who want to quit smoking, laboratory-based adolescent studies that have examined the efficacy of these medications in reducing cravings and/or withdrawal symptoms, and/or studies that have assessed the tolerability of medications for smoking cessation in adolescent smokers. It provides information on the pharmacologic action of each medication, the efficacy of each medication for adolescent smoking cessation, the tolerability of each medication based on reported adverse events, and compliance with the medication protocols. Thirteen relevant articles were identified and included in the review. Nicotine patch (NP), nicotine gum, nicotine nasal spray, bupropion, and varenicline have been studied in adolescent smokers. The adverse events reported in the studies on pharmacology for adolescent smoking suggest that the side effect profiles for nicotine replacement therapy, bupropion, and varenicline are similar to those reported in adult studies. There is some evidence of efficacy of NP and bupropion at the end of treatment (efficacy of varenicline has not been assessed), but none of the medications included in this review were efficacious in promoting long-term smoking cessation among adolescent smokers. It is noted that many of the study protocols did not follow the recommended dose or length of pharmacotherapy for adults, rendering it difficult to determine the true efficacy of medication for adolescent smoking cessation. Future efficacy studies are warranted before recommending pharmacotherapy for adolescent smoking cessation.

    View details for Web of Science ID 000301274700003

    View details for PubMedID 22248234

  • Assessing teen smoking patterns: The weekend phenomenon DRUG AND ALCOHOL DEPENDENCE Bailey, S. R., Jeffery, C. J., Hammer, S. A., Bryson, S. W., Killen, D. T., Ammerman, S., Robinson, T. N., Killen, J. D. 2012; 120 (1-3): 242-245

    Abstract

    Adolescent cigarette smokers may have more daily variability in their smoking patterns than adults. A better understanding of teen smoking patterns can inform the development of more effective adolescent smoking cessation interventions.Teen smokers seeking cessation treatment (N=366) reported the number of cigarettes smoked on each day of a typical week. A paired t-test was used to examine differences between weekday (Sunday-Thursday) and weekend (Friday-Saturday) smoking. Main effects and interactions for race/ethnicity and gender were assessed using a 2-way ANOVA for the following variables: typical weekly smoking, average weekday smoking, average weekend smoking, and difference between weekday and weekend smoking. Scheffé post hoc tests were used to analyze any statistically significant differences.There was significantly more weekend smoking compared to weekday smoking, p<0.001. The difference in weekday versus weekend smoking levels was larger for females than for males, p<0.05. Hispanics reported less typical weekly smoking, p<0.001, less weekday smoking, p<0.001, and less weekend day smoking, p<0.01, compared to Caucasians and multi-racial teens. There was no difference in weekend day versus weekday smoking by race/ethnic background.Using a more detailed assessment of smoking quantity captures patterns of adolescent smoking that may lead to more effective smoking cessation interventions.

    View details for DOI 10.1016/j.drugalcdep.2011.07.014

    View details for Web of Science ID 000299499800037

    View details for PubMedID 21885211

  • Stanford GEMS phase 2 obesity prevention trial for low-income African-American girls: Design and sample baseline characteristics CONTEMPORARY CLINICAL TRIALS Robinson, T. N., Kraemer, H. C., Matheson, D. M., Obarzanek, E., Wilson, D. M., Haskell, W. L., Pruitt, L. A., Thompson, N. S., Haydel, K. F., Fujimoto, M., Varady, A., McCarthy, S., Watanabe, C., Killen, J. D. 2008; 29 (1): 56-69

    Abstract

    African-American girls and women are at high risk of obesity and its associated morbidities. Few studies have tested obesity prevention strategies specifically designed for African-American girls. This report describes the design and baseline findings of the Stanford GEMS (Girls health Enrichment Multi-site Studies) trial to test the effect of a two-year community- and family-based intervention to reduce weight gain in low-income, pre-adolescent African-American girls.Randomized controlled trial with measurements scheduled in girls' homes at baseline, 6, 12, 18 and 24 month post-randomization.Low-income areas of Oakland, CA.Eight, nine and ten year old African-American girls and their parents/caregivers.Girls are randomized to a culturally-tailored after-school dance program and a home/family-based intervention to reduce screen media use versus an information-based community health education Active-Placebo Comparison intervention. Interventions last for 2 years for each participant.Change in body mass index over the two-year study.Recruitment and enrollment successfully produced a predominately low-socioeconomic status sample. Two-hundred sixty one (261) families were randomized. One girl per family is randomly chosen for the analysis sample. Randomization produced comparable experimental groups with only a few statistically significant differences. The sample had a mean body mass index (BMI) at the 74 th percentile on the 2000 CDC BMI reference, and one-third of the analysis sample had a BMI at the 95th percentile or above. Average fasting total cholesterol and LDL cholesterol were above NCEP thresholds for borderline high classifications. Girls averaged low levels of moderate to vigorous physical activity, more than 3 h per day of screen media use, and diets high in energy from fat.The Stanford GEMS trial is testing the benefits of culturally-tailored after-school dance and screen-time reduction interventions for obesity prevention in low-income, pre-adolescent African-American girls.

    View details for DOI 10.1016/j.cct.2007.04.007

    View details for Web of Science ID 000252584100007

    View details for PubMedID 17600772

  • The developmental psychopathology of social anxiety in adolescents DEPRESSION AND ANXIETY Hayward, C., Wilson, K. A., Lagle, K., Kraemer, H. C., Killen, J. D., Taylor, C. B. 2008; 25 (3): 200-206

    Abstract

    To evaluate a developmental psychopathology approach for understanding adolescent social anxiety, parent-reported predictors of social anxiety were examined in a nonclinical sample of adolescents. Structured diagnostic interviews were obtained from biological parents of 770 participants. Potential risk factors assessed included child characteristics: negative affect, shyness, separation anxiety disorder, and childhood chronic illness, as well as parent characteristics: major depression, panic disorder, and agoraphobia. Adolescent social anxiety was measured multiple times during high school. Findings indicate stability in social anxiety symptoms across time. Parent-reported, childhood negative affect, shyness, and chronic illness as well as parental panic disorder or agoraphobia were associated with adolescent social anxiety. Interactions were observed between parent-reported childhood shyness and gender and between parent-reported childhood shyness and parent-reported childhood chronic illness in the prediction of social anxiety. Parent-reported childhood shyness was a stronger predictor of adolescent social anxiety in females compared to males. The combined effect of subjects being positive for both parent-reported childhood shyness and parent-reported childhood chronic illness was greater than would be expected based on additive effects. This study provides support for a multifactorial and developmentally informed understanding of adolescent social anxiety.

    View details for DOI 10.1002/da.20289

    View details for Web of Science ID 000254588400004

    View details for PubMedID 17348001

  • Do Mexican-American mothers' food-related parenting practices influence their children's weight and dietary intake? JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Matheson, D. M., Robinson, T. N., Varady, A., Killen, J. D. 2006; 106 (11): 1861-1865

    Abstract

    Food-related parenting attitudes are thought to influence children's dietary intake and weight. The objective of this study was to examine the associations between mothers' reports of food-related parenting and children's dietary intake and body mass index (BMI). A sample of 108 Mexican-American fifth-grade children and their mothers were surveyed. Children's height, weight, and three 24-hour dietary recalls were collected. Mothers reported household food insecurity status and food-related parenting attitudes. Correlational analyses were calculated among dietary intake variables, children's BMI percentiles, and food-parenting behaviors. Mothers' pressure on their children to eat was inversely correlated with children's BMI. In food-insecure families, attitudes toward making healthful foods available were inversely associated with children's daily energy intake and BMI. In contrast, in food-secure families, attitudes about making healthful foods available were positively associated with children's fruit intake and percentage energy from fat, and parental modeling of healthful food behaviors was inversely associated with the energy density. In our sample of Mexican-American families, mothers' food-related parenting was associated with their children's weight and dietary intake. These associations differed in food-secure and food-insecure households. Overall, pressure to eat was highly associated with children's weight, but the temporal nature of these relationships cannot be discerned.

    View details for DOI 10.1016/j.jada.2006.08.004

    View details for Web of Science ID 000241715300023

    View details for PubMedID 17081838

  • Extended treatment with bupropion SR for cigarette smoking cessation JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Fortmann, S. P., Murphy, G. M., Hayward, C., Arredondo, C., Cromp, D., Celio, M., Abe, L., Wang, Y., Schatzberg, A. F. 2006; 74 (2): 286-294

    Abstract

    The authors present results of a randomized clinical trial of the efficacy of extended treatment with bupropion SR in producing longer term cigarette smoking cessation. Adult smokers (N = 362) received open-label treatment (11 weeks) that combined relapse prevention training, bupropion SR, and nicotine patch followed by extended treatment (14 weeks) with bupropion SR or matching placebo. Abstinence percentages were relatively high (week 11: 52%; week 25: bupropion, 42%; placebo, 38%; week 52: bupropion, 33%; placebo, 34%), but bupropion SR did not surpass placebo. Gender and baseline craving level were identified as significant, independent moderators of treatment response. Men were more likely to abstain than women (week 11: 59% vs. 43%, p = .001; week 25: 48% vs. 31%, p = .001; week 52: 39% vs. 27%, p = .01). Because most smokers suffer relapse with any current cessation treatment, the comparatively high abstinence percentages achieved in this trial are of interest.

    View details for DOI 10.1037/0022-006X.74.2.286

    View details for Web of Science ID 000237667500009

    View details for PubMedID 16649873

  • Major depression among adolescent smokers undergoing treatment for nicotine dependence ADDICTIVE BEHAVIORS Killen, J. D., Robinson, T. N., Ammerman, S., Hayward, C., Rogers, J., Samuels, D., Schatzberg, A. F. 2004; 29 (8): 1517-1526

    Abstract

    This is the first study to examine the prevalence and effects of major depression (MDD) in a sample of adolescent smokers (N = 211) undergoing treatment for nicotine dependence. We assessed MDD at baseline and end of treatment with the mood disorders portion of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Eleven percent of participants reported a history of MDD (6% of males and 21% of females). Study variables did not distinguish those with and without a history of MDD. End of treatment abstinence rates and relapse rates were similar in both groups. Two participants (1%), both female, experienced onset of MDD during the treatment. The findings provide further evidence that MDD is a comparatively common disorder among children and adolescents and that clinicians should monitor and be prepared to respond to depression that may emerge during the treatment of nicotine-dependent adolescents.

    View details for DOI 10.1016/j.addbeh.2004.02.029

    View details for Web of Science ID 000224464000002

    View details for PubMedID 15451121

  • Children's food consumption during television viewing AMERICAN JOURNAL OF CLINICAL NUTRITION Matheson, D. M., Killen, J. D., Wang, Y., Varady, A., Robinson, T. N. 2004; 79 (6): 1088-1094

    Abstract

    Television viewing is associated with childhood obesity. Eating during viewing and eating highly advertised foods are 2 of the hypothesized mechanisms through which television is thought to affect children's weight.Our objectives were to describe the amounts and types of foods that children consume while watching television, compare those types with the types consumed at other times of the day, and examine the associations between children's body mass index (BMI) and the amounts and types of foods consumed during television viewing.Data were collected from 2 samples. The first sample consisted of ethnically diverse third-grade children, and the second consisted predominantly of Latino fifth-grade children. Three nonconsecutive 24-h dietary recalls were collected from each child. For each eating episode reported, children were asked whether they had been watching television. Height and weight were measured by using standard methods and were used to calculate BMI.On weekdays and weekend days, 17-18% and approximately 26% of total daily energy, respectively, were consumed during television viewing in the 2 samples. Although the fat content of the foods consumed during television viewing did not differ significantly from that of the foods consumed with the television off, less soda, fast food, fruit, and vegetables were consumed with the television on. The amount of food consumed during television viewing was not associated with children's BMI, but in the third-grade sample, the fat content of foods consumed during television viewing was associated with BMI.A significant proportion of children's daily energy intake is consumed during television viewing, and the consumption of high-fat foods on weekends may be associated with BMI in younger children.

    View details for Web of Science ID 000221553500021

    View details for PubMedID 15159240

  • Parent-reported predictors of adolescent panic attacks JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Hayward, C., Wilson, K. A., Lagle, K., Killen, J. D., Taylor, C. B. 2004; 43 (5): 613-620

    Abstract

    To identify parent-reported risk factors for adolescent panic attacks.Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder [SAD], childhood chronic illness, and childhood loss) as well as characteristics of the parent (parental panic disorder or agoraphobia [PDA], parental major depression, and parental chronic illness).Bivariate predictors of adolescent panic attacks included parent history of PDA, parent history of chronic illness, child negative affect, and child SAD. Using signal detection methods, three subgroups of participants at risk for panic attacks were identified. Fifty-eight percent of adolescents with panic attacks belonged to one of these high-risk groups. Adolescents with a positive parental history of PDA were at highest risk: 24% of this group experienced panic attacks. Among those without a positive parental history of PDA, those with high childhood negative affect or history of SAD were at increased risk for panic attacks (14% and 20%, respectively).The use of parent-reported data provides cross-validation for previously identified risk factors of adolescent panic attacks. Signal detection results suggest there are multiple paths (equifinality) to the development of adolescent panic attacks.

    View details for Web of Science ID 000221014800015

    View details for PubMedID 15100568

  • Effects of an advocacy intervention to reduce smoking among teenagers ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Winkleby, M. A., Feighery, E., Dunn, M., Kole, S., Ahn, D., Killen, J. D. 2004; 158 (3): 269-275

    Abstract

    To test whether high school students' participation in advocacy activities related to the advertising, availability, and use of tobacco in their communities would prevent or reduce their own tobacco use.Ten continuation high schools in northern California, randomly assigned to a semester-long program in which students either carried out advocacy activities to counter environmental-level smoking influences in their communities (treatment) or learned about drug and alcohol abuse prevention (control).Eleventh and 12th grade high school students; 5 (advocacy) treatment and 5 control schools over 4 semesters from 2000 through 2002.Self-reported smoking defined as nonsmokers (those who had never smoked tobacco or those who were former smokers), light smokers (those who smoked <1 pack per week), or regular smokers (those who smoked >or=1 pack per week), and confirmed by carbon monoxide level readings. The following 3 constructs related to social cognitive theory- perceived incentive value, perceived self-efficacy, and outcome expectancies-were assessed.There was a significant net change from baseline to the end of the semester (after the intervention) between treatment and control schools for students who were regular smokers, but not for students who were nonsmokers or light smokers. Regular smoking decreased 3.8% in treatment schools and increased 1.5% in control schools (P<.001). Regular smoking continued to decrease at 6 months after the intervention in treatment schools, with a total change in prevalence from 25.1% to 20.3%. Involvement in community-advocacy activities and the 3 social constructs-perceived incentive value, perceived self-efficacy, and outcome expectancies-also showed significant net changes between treatment and control schools (all P values <.01).Student engagement in community-advocacy activities that addressed environmental influences of cigarette smoking resulted in significant decreases in regular smoking.

    View details for Web of Science ID 000189270300014

    View details for PubMedID 14993087

  • Associations among familism, language preference, and education in Mexican-American mothers and their children JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS Romero, A. J., Robinson, T. N., Haydel, K. F., Mendoza, F., Killen, J. D. 2004; 25 (1): 34-40

    Abstract

    Latino families who express a higher degree of familism are characterized by positive interpersonal familial relationships, high family unity, social support, interdependence in the completion of daily activities, and close proximity with extended family members. Retention of cultural values, such as familism, may be linked to positive health outcomes; however, little is known about how families retain culture of origin values in the face of acculturation pressures. The current study explores acculturation influences as indexed by language preference and household education on maternal and child familism. Mothers and children of Mexican descent (fourth grade students) (n = 219) completed measures of demographics, household education, language preference, and familism. Three hypotheses were examined. First, we predicted that lower household education would be correlated with higher familism scores. However, contrary to our prediction, a higher familism score was significantly associated with a higher level of household education (p <.05). Second, we predicted that higher child familism would be associated with the preference for speaking Spanish. Children who preferred to use both English and Spanish (p <.01) or English alone (p <.05) had higher familism scores than those who preferred Spanish. Third, we predicted that lower child familism scores would be associated with greater differences in mother and child language preferences. There were no significant differences in child familism based on differences between parent and child language. Protective influences of cultural maintenance deserve further attention in longitudinal studies and in relation to the physical and mental health of youth.

    View details for Web of Science ID 000189076300005

    View details for PubMedID 14767354

  • Are adolescents harmed when asked risky weight control behavior and attitude questions? Implications for consent procedures INTERNATIONAL JOURNAL OF EATING DISORDERS Celio, A. A., Bryson, S., Killen, J. D., Taylor, C. B. 2003; 34 (2): 251-254

    Abstract

    This study explores whether asking minors about risky weight control behaviors and attitudes increases the frequency of those behaviors and attitudes.Participants were 115 sixth-grade girls who responded to questions on risky weight control behaviors and attitudes at baseline and at 12-month follow-up. An additional 107 girls, who had not been part of the baseline, provided data only at follow-up. The two groups were compared on risky weight control behaviors and attitudes at follow-up using chi-square analyses, Mann-Whitney U tests, Cohen's effect sizes, and odds ratios.No evidence of a negative effect in the twice-assessed group was found. All rates decreased from baseline to follow-up.There is only minimal risk and perhaps even some benefit of asking questions about risky weight control behaviors and attitudes. Implications for determining appropriate consent procedures are discussed.

    View details for DOI 10.1002/eat.10188

    View details for Web of Science ID 000184510900009

    View details for PubMedID 12898562

  • The relationship between agoraphobia symptoms and panic disorder in a non-clinical sample of adolescents PSYCHOLOGICAL MEDICINE Hayward, C., Killen, J. D., Taylor, C. B. 2003; 33 (4): 733-738

    Abstract

    The purpose of this study was to evaluate the clinical correlates of agoraphobic fear and avoidance and panic disorder in a non-clinical sample of adolescents.In a sample of 2365 high school students, combined data from a questionnaire and a structured clinical interview were used to classify subjects with agoraphobic fear and avoidance. Panic symptoms, major depression, childhood separation anxiety disorder, anxiety sensitivity and negative affectivity were also assessed.Fifteen subjects met study criteria for agoraphobic fear and avoidance in the past year. Only three (20%) of those with agoraphobia symptoms reported histories of panic attacks and there was no overlap between those with agoraphobic fear and avoidance and the 12 subjects who met DSM-III-R criteria for panic disorder. However, subjects with agoraphobia symptoms and those with panic disorder reported similar levels of anxiety sensitivity and negative affectivity. Childhood separation anxiety disorder was more common among those with agoraphobic fear and avoidance compared to those without.Agoraphobic avoidance is rare in non-clinical samples of adolescents and usually not associated with panic attacks. However, adolescents with agoraphobia symptoms and those with panic disorder have similar clinical correlates consistent with a panic/agoraphobia spectrum model.

    View details for DOI 10.1017/S0033291702006955

    View details for Web of Science ID 000183495600017

    View details for PubMedID 12785475

  • Onset of major depression during treatment for nicotine dependence ADDICTIVE BEHAVIORS Killen, J. D., Fortmann, S. P., Schatzberg, A., Hayward, C., Varady, A. 2003; 28 (3): 461-470

    Abstract

    We monitored the emergence of major depression (MDD) during treatment for nicotine dependence among 224 smokers. MDD was assessed on three occasions during the course of treatment with the mood disorders portion of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID), fourth edition (DSM-IV). Out of 224 participants, 20% had suffered a past episode of MDD, 18% of males and 22% of females. Four percent (n=10) experienced onset of MDD during the course of the study, four males and six females. Only 2 of the 10 cases managed to achieve abstinence at end of treatment. Those who reported large increases in depression symptoms between baseline and end of treatment (Week 10) were less likely to be abstinent at 26-week follow-up. The evidence indicates that those who treat nicotine dependence must be prepared to monitor and respond to the emergence of depression associated with treatment.

    View details for DOI 10.1016/S0306-4603(01)00266-0

    View details for Web of Science ID 000181706200005

    View details for PubMedID 12628619

  • Risk factors for the onset of eating disorders in adolescent girls: Results of the McKnight longitudinal risk factor study AMERICAN JOURNAL OF PSYCHIATRY Taylor, C. B., Bryson, S. W., Altman, T. M., Abascal, L., Celio, A., Cunning, D., Killen, J. D., Shisslak, C. M., Crago, M., Ranger-Moore, J., Cook, P., Ruble, A., Olmsted, M. E., Kraemer, H. C., Smolak, L. 2003; 160 (2): 248-254

    Abstract

    This study examined the importance of potential risk factors for eating disorder onset in a large multiethnic sample followed for up to 3 years, with assessment instruments validated for the target population and a structured clinical interview used to make diagnoses.Participants were 1,103 girls initially assessed in grades 6-9 in school districts in Arizona and California. Each year, students completed the McKnight Risk Factor Survey, had body height and weight measured, and underwent a structured clinical interview. The McKnight Risk Factor Survey, a self-report instrument developed for this age group, includes questions related to risk factors for eating disorders.During follow-up, 32 girls (2.9%) developed a partial- or full-syndrome eating disorder. At the Arizona site, there was a significant interaction between Hispanics and higher scores on a factor measuring thin body preoccupation and social pressure in predicting onset of eating disorders. An increase in negative life events also predicted onset of eating disorders in this sample. At the California site, only thin body preoccupation and social pressure predicted onset of eating disorders. A four-item screen derived from thin body preoccupation and social pressure had a sensitivity of 0.72, a specificity of 0.80, and an efficiency of 0.79.Thin body preoccupation and social pressure are important risk factors for the development of eating disorders in adolescents. Some Hispanic groups are at risk of developing eating disorders. Efforts to reduce peer, cultural, and other sources of thin body preoccupation may be necessary to prevent eating disorders.

    View details for Web of Science ID 000180788300008

    View details for PubMedID 12562570

  • Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study. Ethnicity & disease Robinson, T. N., Killen, J. D., Kraemer, H. C., Wilson, D. M., Matheson, D. M., Haskell, W. L., Pruitt, L. A., Powell, T. M., Owens, A. S., Thompson, N. S., Flint-Moore, N. M., Davis, G. J., Emig, K. A., Brown, R. T., Rochon, J., Green, S., Varady, A. 2003; 13 (1): S65-77

    Abstract

    To test the feasibility, acceptability, and potential efficacy of after-school dance classes and a family-based intervention to reduce television viewing, thereby reducing weight gain, among African-American girls.Twelve-week, 2-arm parallel group, randomized controlled trial.Low-income neighborhoods.Sixty-one 8-10-year-old African-American girls and their parents/guardians.The treatment intervention consisted of after-school dance classes at 3 community centers, and a 5-lesson intervention, delivered in participants' homes, and designed to reduce television, videotape, and video game use. The active control intervention consisted of disseminating newsletters and delivering health education lectures.Implementation and process measures, body mass index, waist circumference, physical activity measured by accelerometry, self-reported media use, and meals eaten with TV.Recruitment and retention goals were exceeded. High rates of participation were achieved for assessments and intervention activities, except where transportation was lacking. All interventions received high satisfaction ratings. At follow up, girls in the treatment group, as compared to the control group, exhibited trends toward lower body mass index (adjusted difference = -.32 kg/m2, 95% confidence interval [CI] -.77, .12; Cohen's d = .38 standard deviation units) and waist circumference (adjusted difference = -.63 cm, 95% CI -1.92, .67; d = .25); increased after-school physical activity (adjusted difference = 55.1 counts/minute, 95% CI -115.6, 225.8; d = .21); and reduced television, videotape, and video game use (adjusted difference = -4.96 hours/week, 95% CI -11.41, 1.49; d = .40). The treatment group reported significantly reduced household television viewing (d = .73, P = .007) and fewer dinners eaten while watching TV (adjusted difference = -1.60 meals/week, 95% CI -2.99, -.21; d = .59; P = .03). Treatment group girls also reported less concern about weight (d = .60; P = .03), and a trend toward improved school grades (d = .51; P = .07).This study confirmed the feasibility, acceptability, and potential efficacy of using dance classes and a family-based intervention to reduce television viewing, thereby reducing weight gain, in African-American girls.

    View details for PubMedID 12713212

  • Do men outperform women in smoking cessation trials? Maybe, but not by much EXPERIMENTAL AND CLINICAL PSYCHOPHARMACOLOGY Killen, J. D., Fortmann, S. P., Varady, A., Kraemer, H. C. 2002; 10 (3): 295-301

    Abstract

    Using data from 4 smoking cessation trials conducted from 1988 to 2000, the authors investigated whether men are more successful than women in quitting smoking. Odds ratios indicated that the abstinence rates were not significantly different for men and women. Thus, there may be little value to diverting research funds from efforts to develop more effective treatments for both men and women to efforts to explain a very small gender effect associated with existing treatments. However, it may be appropriate to make gender comparisons for new therapies for nicotine dependence. The authors recommend against analyses of gender differences in studies that do not account for gender in their research designs.

    View details for DOI 10.1037//1064-1297.10.3.295

    View details for Web of Science ID 000177711900014

    View details for PubMedID 12233990

  • Household food security and nutritional status of Hispanic children in the fifth grade AMERICAN JOURNAL OF CLINICAL NUTRITION Matheson, D. M., Varady, J., Varady, A., Killen, J. D. 2002; 76 (1): 210-217

    Abstract

    Food insecurity is a critical variable for understanding the nutritional status of low-income populations. However, limited research is available on the relation between household food insecurity and children's nutritional status.Our objective was to examine the relations among household food insecurity, household food supplies, and school-age children's dietary intakes and body mass indexes (BMIs).A sample of 124 predominantly Hispanic, fifth-grade children and their mothers were surveyed as part of a school-based obesity-prevention program. Data on the children's weights and heights were collected and three 24-h dietary recalls were conducted. The mothers provided reports of household food insecurity and household food supplies.Food insecurity was negatively associated with the children's BMIs and household food supplies but not with the children's food intakes. However, a secondary analysis showed that as payday approached, children from the most food-insecure households had significant decreases in energy intakes and meat consumption.This is one of the first studies to report a significant association between food insecurity and children's nutritional status. The ages and sex-adjusted BMIs of the food-insecure children were lower than those of the food-secure children but were still within the normal range. The lower BMIs in the food-insecure children may have been due to short-term, yet periodic food restrictions that resulted as household food supplies diminished before payday. Future research is needed to assess the physiologic and psychological effects of periodic food restriction on children's health.

    View details for Web of Science ID 000176378500025

    View details for PubMedID 12081837

  • Men gain additional psychological benefits by adding exercise to a weight-loss program OBESITY RESEARCH Kiernan, M., King, A. C., Stefanick, M. L., Killen, J. D. 2001; 9 (12): 770-777

    Abstract

    Adding exercise to a comprehensive weight-loss program might not only attenuate any psychological distress associated with weight-loss attempts but also may provide psychological benefits. This study examined whether a diet-plus-exercise weight-loss program improved psychological outcomes more than a diet-only weight-loss program or an assessment-only control group.This study was part of a larger 1-year randomized weight-loss trial examining the effects of diet and exercise on cardiovascular disease risk factors in 264 overweight adults. Psychological measures specific to weight control (e.g., cognitive restraint, disinhibition, hunger, and body dissatisfaction) as well as traditional measures of psychological distress (e.g., symptoms of depression, anxiety, and stress) were obtained at baseline and 1 year.Men and women in either weight-loss program reported greater restraint, less disinhibition, and less hunger at 1 year than those in no program. Men in the diet-plus-exercise program experienced additional increases in restraint and decreases in hunger than did men in the diet-only program. Women in the diet-plus-exercise program did not experience additional psychological benefits specific to weight control than those in the diet-only program, despite increases in aerobic capacity.The pattern seen for overweight men in the diet-plus-exercise program at 1 year-greater restraint, less disinhibition, and less hunger-is similar to the pattern seen in successful weight maintainers. These results underscore the need for innovative strategies that will enhance and sustain the pattern of psychological benefits specific to weight control associated with successful weight loss, especially for overweight women.

    View details for Web of Science ID 000172892000006

    View details for PubMedID 11743061

  • Generalizability of findings from a chewing tobacco cessation clinical trial. Nicotine & tobacco research Howard-Pitney, B., Fortmann, S. P., Killen, J. D. 2001; 3 (4): 347-352

    Abstract

    This study examined selection bias by comparing characteristics of a general population sample of tobacco chewers, participants in a chewing tobacco cessation trial, and non-participants in the trial. A population-based sample of chewers (n = 155) was surveyed by telephone to assess demographics, tobacco-use patterns, and quitting history. Six months later, chewers from this same population were recruited for a cessation trial (n = 401 participants and 68 non-participants). Trial participants differed little from general population chewers on demographics, but they used more chew and were more dependent on nicotine. They were more likely to have tried to quit, received advice to quit and experienced tobacco-related health problems. Trial non-participants were virtually identical to participants on demographic and tobacco use measures. The findings suggest that clinically tested treatments are generalizable beyond the research setting, because trial participants are demographically representative of the general population of chewing tobacco users, are not biased toward light users, and are representative of those chewers most likely to seek out community-based cessation services outside the trial context.

    View details for PubMedID 11694202

  • Are perceived neighborhood hazards a barrier to physical activity in children? ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Romero, A. J., Robinson, T. N., Kraemer, H. C., Erickson, S. J., Haydel, K. F., Mendoza, F., Killen, J. D. 2001; 155 (10): 1143-1148

    Abstract

    We hypothesized that children's perceptions of more neighborhood hazards would be associated with less physical activity, less aerobic fitness, and a higher body mass index.To examine the association between a hazardous neighborhood context and physical activity in children.Fourth-grade students (n = 796) of diverse ethnic and economic backgrounds completed measures of neighborhood hazards, self-reported physical activity, physical fitness, height, and weight. Parents (n = 518) completed telephone interviews and provided data on their education level and occupation.As expected, children from families of lower socioeconomic status perceived significantly more neighborhood hazards. Contrary to our hypothesis, the perception of more hazards was significantly associated with more reported physical activity. This finding was not explained by school heterogeneity, alteration of the hazards measure, or differences in socioeconomic status.To further examine the relationship between neighborhood hazards and physical activity, we suggest that future studies include assessments of sedentary behavior, parental fear of violence, parental regulation of children's leisure activities, and cost and quality of available play areas and organized sports.

    View details for Web of Science ID 000171320800010

    View details for PubMedID 11576010

  • Do adolescent smokers experience withdrawal effects when deprived of nicotine? EXPERIMENTAL AND CLINICAL PSYCHOPHARMACOLOGY Killen, J. D., Ammerman, S., Rojas, N., Varady, J., Haydel, F., Robinson, T. N. 2001; 9 (2): 176-182

    Abstract

    This is the first controlled prospective study of the effects of nicotine deprivation in adolescent smokers. Heart rate and subjective withdrawal symptoms were measured over an 8-hr period while participants smoked normally. Seven days later, participants were randomized to wear a 15-mg (16-hr) nicotine patch or a placebo patch for 8 hr, and they refrained from smoking during the session. Those wearing the placebo experienced a decrease in heart rate across sessions and an increase in subjective measures of nicotine withdrawal. Those wearing the active patch also reported significant increases for some subjective symptoms. Expectancy effects were also observed. The findings indicate that adolescent smokers experience subjective and objective changes when deprived of nicotine. As in previous research with adults, expectancies concerning the effects of nicotine replacement also influenced perceptions of withdrawal.

    View details for Web of Science ID 000170981800009

    View details for PubMedID 11518093

  • Overweight concerns and body dissatisfaction among third-grade children: The impacts of ethnicity and socioeconomic status JOURNAL OF PEDIATRICS Robinson, T. N., Chang, J. Y., Haydel, K. F., Killen, J. D. 2001; 138 (2): 181-187

    Abstract

    To examine the prevalence of overweight concerns and body dissatisfaction among third-grade girls and boys and the influences of ethnicity and socioeconomic status (SES).Nine hundred sixty-nine children (mean age, 8.5 years) attending 13 northern California public elementary schools completed assessments of overweight concerns, body dissatisfaction, and desired shape, height, and weight.The sample was 44% white, 21% Latino, 19% non-Filipino Asian American, 8% Filipino, and 5% African American. Twenty-six percent of boys and 35% of girls reported wanting to lose weight, and 17% of boys and 24% of girls reported dieting to lose weight. Among girls, Latinas and African Americans reported significantly more overweight concerns than Asian Americans and Filipinas, and Latinas reported significantly more overweight concerns than whites. White and Latina girls also reported greater body dissatisfaction than Asian American girls. Some differences persisted even after controlling for actual body fatness. Higher SES African American girls reported significantly more overweight concerns than lower SES African American girls, but higher SES white girls reported less overweight concerns than lower SES white girls.Overweight concerns and body dissatisfaction are highly prevalent among third-grade girls and boys, across ethnicity and SES. Young Latina and African American girls manifest equivalent or higher levels of disordered eating attitudes and behaviors as white and Asian American girls.

    View details for Web of Science ID 000166905800008

    View details for PubMedID 11174614

  • Nicotine patch and paroxetine for smoking cessation JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Fortmann, S. P., Schatzberg, A. F., Hayward, C., Sussman, L., Rothman, M., Strausberg, L., Varady, A. 2000; 68 (5): 883-889

    Abstract

    Smokers (N = 224) were randomized to 1 of 3 groups: (a) transdermal system (TNS) + placebo; (b) TNS + paroxetine (20 mg); (c) TNS + paroxetine (40 mg). Assignment to treatment was double-blind. Nicotine patch (TNS) treatment was provided for 8 weeks; paroxetine or placebo was provided for 9 weeks. Abstinence rates at Weeks 4, 10, and 26 were as follows: (a) TNS + placebo: 45%, 36%, and 25%; (b) TNS + paroxetine (20 mg): 48%, 33%, and 21%; (c) TNS + paroxetine (40 mg): 57%, 39%, and 27%. The differences were not statistically significant. The combined treatment was more effective in reducing both craving and depression symptoms associated with smoking cessation. A subgroup analysis comparing compliant participants was also conducted. Abstinence rates at Weeks 4, 10, and 26 were as follows: (a) TNS + placebo: 46%, 35%, and 24%; (b) TNS + paroxetine (20 mg): 64%, 43%, and 33%; (c) TNS + paroxetine (40 mg): 74%, 51%, and 38%. The differences between paroxetine groups and placebo at Week 4 were statistically significant. Although paroxetine may add value to the current standard of care in excess of potential risk, more conclusive evidence is needed.

    View details for Web of Science ID 000090108300014

    View details for PubMedID 11068974

  • Body-image and eating disturbances predict onset of depression among female adolescents: A longitudinal study JOURNAL OF ABNORMAL PSYCHOLOGY Stice, E., Hayward, C., Cameron, R. P., Killen, J. D., Taylor, C. B. 2000; 109 (3): 438-444

    Abstract

    This study examined data from a 4-year school-based longitudinal study (n = 1,124), to test whether the increase in major depression that occurs among girls during adolescence may be partially explained by the body-image and eating disturbances that emerge after puberty. Elevated body dissatisfaction, dietary restraint, and bulimic symptoms at study entry predicted onset of subsequent depression among initially nondepressed youth in bivariate analyses controlling for initial depressive symptoms. Although the unique effect for body dissatisfaction was not significant in the multivariate model, this set of risk factors was able to fairly accurately foretell which girls would go on to develop major depression. Results were consistent with the assertion that the body-image- and eating-related risk factors that emerge after puberty might contribute to the elevated rates of depression for adolescent girls.

    View details for Web of Science ID 000089411800009

    View details for PubMedID 11016113

  • Predictors of panic attacks in adolescents JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Hayward, C., Killen, J. D., Kraemer, H. C., Taylor, C. B. 2000; 39 (2): 207-214

    Abstract

    To identify risk factors for onset of panic attacks in adolescents, a prospective cohort design was used to evaluate the following risk factors: negative affectivity, female sex, anxiety sensitivity, and childhood separation anxiety disorder. These risk factors were also evaluated for predicting onset of major depression to test their specificity.The sample consisted of 2,365 high school students assessed over a 4-year period. Assessments included self-report questionnaires and structured clinical interviews. Cox proportional hazards models were used to evaluate risk.Consistent with previous studies, prior major depression predicted onset of panic attacks and a history of panic attacks predicted onset of major depression. After adjusting for the effects of prior major depression, negative affectivity and anxiety sensitivity, but not female sex or childhood separation anxiety disorder, predicted onset of 4-symptom panic attacks. However, female sex and negative affectivity but not anxiety sensitivity or childhood separation anxiety disorder predicted onset of major depression after adjustment for the effects of prior panic attacks.Negative affectivity appears to be a nonspecific risk factor for panic attacks and major depression, whereas anxiety sensitivity appears to be a specific factor that increases the risk for 4-symptom panic attacks in adolescents.

    View details for Web of Science ID 000085031900021

    View details for PubMedID 10673832

  • Does the camera add 10 pounds? Media use, perceived importance of appearance, and weight concerns among teenage girls JOURNAL OF ADOLESCENT HEALTH Borzekowski, D. L., Robinson, T. N., Killen, J. D. 2000; 26 (1): 36-41

    Abstract

    To examine the relationship between use of electronic media and perceived importance of appearance and weight concerns among adolescent girls.Physical measures and self-report surveys were obtained from 837 ninth-grade girls attending pubs lic high schools in San Jose, California (mean age = 14.9 +/- 0.47 years; 36% Latino, 24% White, 22% Asian, 8% Black, 10% other). Correlational and multiple regression analyses were performed with ethnicity, body mass index (BMI), perceived importance of appearance, weight concerns, and media use (based on self-reported average weekly use of television, videotapes, video and computer games, and music videos).Total media use was not significantly related to perceived importance of appearance or weight concerns. When media use was separated into distinct media genres, only hours of watching music videos was related to perceived importance of appearance and weight concerns (r = 0.12, p < .001, and r = .08, p < .05, respectively). In multivariate analyses, after controlling for BMI and ethnicity, no media use variables were significantly associated with either perceived importance of appearance or weight concerns.Frequent music video use may be a risk factor for increased perceived importance of appearance and increased weight concerns among adolescent girls.

    View details for Web of Science ID 000084662700007

    View details for PubMedID 10638716

  • Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Stice, E., Cameron, R. P., Killen, J. D., Hayward, C., Taylor, C. B. 1999; 67 (6): 967-974

    Abstract

    This study examined the prospective relations of naturalistic weight-reduction efforts to growth in relative weight and onset of obesity with data from a community study of female adolescents (N = 692). Initial self-labeled dieting, appetite suppressant/laxative use, incidental exercise, vomiting for weight-control purposes, and binge eating predicted elevated growth in relative weight over the 4-year period. Dietary restraint, self-labeled dieting, exercise for weight-control purposes, and appetite suppressant/laxative use predicted an increased risk for obesity onset. Data imply that the weight-reduction efforts reported by adolescents are more likely to result in weight gain than in weight loss and suggest the need to educate youth on more effective weight-control strategies.

    View details for Web of Science ID 000083979000015

    View details for PubMedID 10596518

  • Do heavy smokers benefit from higher dose nicotine patch therapy? EXPERIMENTAL AND CLINICAL PSYCHOPHARMACOLOGY Killen, J. D., Fortmann, S. P., Davis, L., Strausberg, L., Varady, A. 1999; 7 (3): 226-233

    Abstract

    Heavy smokers (N = 408, smoking more than 25 cigarettes/day) were randomized to receive high-dose (25 mg) or standard-dose (15 mg) nicotine patch therapy delivered during the daytime only (16 hr) for a period of 6 weeks. Treatment effects of each dose were similar. The percentages of participants not smoking at 2-, 6-, and 12-month follow-ups were 26 versus 20, 14 versus 16, and 14 versus 14 for the 15-mg and 25-mg doses, respectively. The higher dose was well tolerated, and adverse event profiles for both treatment doses were very similar. Stepwise Cox proportional hazards analyses indicated that initial postrandomization craving and baseline scores on the Center for Epidemiological Studies Depression Instrument predicted time-to-relapse during treatment; only initial craving predicted relapse over the entire study interval (12 months). The results of this trial do not support the routine use of higher dose nicotine patch therapy in the treatment of nicotine dependence.

    View details for Web of Science ID 000082154900005

    View details for PubMedID 10472510

  • Development and evaluation of the McKnight Risk Factor Survey for assessing potential risk and protective factors for disordered eating in preadolescent and adolescent girls INTERNATIONAL JOURNAL OF EATING DISORDERS Shisslak, C. M., Renger, R., Sharpe, T., Crago, M., McKnight, K. M., Gray, N., Bryson, S., Estes, L. S., Parnaby, O. G., Killen, J., Taylor, C. B. 1999; 25 (2): 195-214

    Abstract

    To describe the development, test-retest reliability, internal consistency, and convergent validity of the McKnight Risk Factor Survey-III (MRFS-III). The MRFS-III was designed to assess a number of potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls.Several versions of the MRFS were pilot tested before the MRFS-III was administered to a sample of 651 4th through 12th- grade girls to establish its psychometric properties.Most of the test-retest reliability coefficients of individual items on the MRFS-III were r > .40. Alpha coefficients for each risk and protective factor domain on the MRFS-III were also computed. The majority of these coefficients were r > .60. High convergent validity coefficients were obtained for specific items on the MRFS-III and measures of self-esteem (Rosenberg Self-Esteem Scale) and weight concerns (Weight Concerns Scale).The test-retest reliability, internal consistency, and convergent validity of the MRFS-III suggest that it is a useful new instrument to assess potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls.

    View details for Web of Science ID 000078638900009

    View details for PubMedID 10065397

  • Television and music video exposure and risk of adolescent alcohol use PEDIATRICS Robinson, T. N., Chen, H. L., Killen, J. D. 1998; 102 (5)

    Abstract

    Alcohol use is frequently portrayed in television programming and advertising. Exposure to media portrayals of alcohol use may lead to increased drinking. To address this issue, we examined prospectively the associations between media exposure and alcohol use in adolescents.Prospective cohort study. Setting. Six public high schools in San Jose, California. Participants. Ninth-grade students (N = 1533; mean age = 14.6 years).Students reported hours of television, music video, and videotape viewing; computer and video game use; and lifetime and past 30 days' alcohol use at baseline and 18 months later. Associations between baseline media exposure and subsequent alcohol use were examined with multiple logistic regression.During the 18-month follow-up, 36.2% of baseline nondrinkers began drinking and 50.7% of baseline drinkers continued to drink. Onset of drinking was significantly associated with baseline hours of television viewing (odds ratio [OR] = 1.09; 95% confidence interval [95% CI] = 1.01-1.18), music video viewing (OR = 1.31; 95% CI = 1. 17-1.47), and videotape viewing (OR = 0.89; 95% CI = 0.79-0.99), controlling for age, sex, ethnicity, and other media use. Computer and video game use was not significantly associated with the subsequent onset of drinking. Among baseline drinkers, there were no significant associations between baseline media use and maintenance of drinking.Increased television and music video viewing are risk factors for the onset of alcohol use in adolescents. Attempts to prevent adolescent alcohol use should address the adverse influences of alcohol use in the media.

    View details for Web of Science ID 000076774600006

    View details for PubMedID 9794984

  • Age of onset for binge eating and purging during late adolescence: A 4-year survival analysis JOURNAL OF ABNORMAL PSYCHOLOGY Stice, E., Killen, J. D., Hayward, C., Taylor, C. B. 1998; 107 (4): 671-675

    Abstract

    This prospective study examined age of onset for binge eating and purging among girls during late adolescence and tested whether dieting and negative affectivity predicted these outcomes. Of initially asymptomatic adolescents, 5% reported onset of objective binge eating, 4% reported onset of subjective binge eating, and 4% reported onset of purging. Peak risk for onset of binge eating occurred at age 16, whereas peak risk for onset of purging occurred at age 18. Adolescents more often reported onset of a single symptom rather than multiple symptoms, and symptoms were episodic. Dieting and negative affectivity predicted onset of binge eating and purging. Findings suggest that late adolescence is a high-risk period for onset of bulimic behaviors and identify modifiable risk factors for these outcomes.

    View details for Web of Science ID 000076987000013

    View details for PubMedID 9830254

  • Support for the continuity hypothesis of bulimic pathology JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Stice, E., Killen, J. D., Hayward, C., Taylor, C. B. 1998; 66 (5): 784-790

    Abstract

    There has been debate as to whether bulimia represents the endpoint of an eating disorder continuum (the continuity hypothesis) or is categorically different from subthreshold bulimia or an absence of eating disorders (the discontinuity hypothesis). The present study tested whether differences among bulimic, subthreshold bulimic, and control women on weight-concern and psychopathology variables better accord with the continuity or discontinuity hypothesis. These 3 groups were compared on body mass, thin-ideal internalization, body dissatisfaction, dietary restraint, depressive symptoms, anxiety symptoms, and temperamental emotionality. Discriminant function analysis and follow-up pairwise contrasts indicated that the continuity hypothesis was supported for measures of both weight concern and psychopathology. Research and treatment implications of the continuity perspective are discussed.

    View details for Web of Science ID 000076550300008

    View details for PubMedID 9803697

  • Psychosocial factors associated with youth involvement in community activities promoting heart health HEALTH EDUCATION & BEHAVIOR Altman, D. G., Feighery, E., Robinson, T. N., Haydel, K. F., Strausberg, L., Lorig, K., Killen, J. D. 1998; 25 (4): 489-500

    Abstract

    This study examined factors that influence youth participation in heart disease prevention activities among 2,609 ninth graders in six inner-city public high schools. Constructs derived from social cognitive, empowerment, and community development theories informed the conceptual framework employed. Study participants were diverse with respect to gender, ethnicity, parent education, acculturation, and academic achievement. Perceived incentive value, self-efficacy, outcome expectancies, sense of community, and perceived policy control were all significantly associated with participation in community activities promoting heart health. In multivariate analyses, perceived incentive value, defined as the extent to which participants valued a heart-healthy environment, was most strongly associated with community participation, accounting for 11.9% of the total variance. These findings have implications for designing school curricula and after-school and community programs targeting adolescents' involvement in health advocacy activities.

    View details for Web of Science ID 000074933300007

    View details for PubMedID 9690106

  • Nicotine dependence among adolescent smokers ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Rojas, N. L., Killen, J. D., Haydel, K. F., Robinson, T. N. 1998; 152 (2): 151-156

    Abstract

    To assess nicotine dependence among adolescents to determine whether quitting smoking is associated with the emergence of nicotine withdrawal symptoms and craving, and to identify the factors associated with these symptoms.Cross-sectional survey.We studied 2197 10th-grade students in 6 San Jose, Calif, high schools.Smoking status; history of quitting smoking; Modified Fagerstrom Tolerance Questionnaire (mFTQ) scores; subjective nicotine withdrawal symptoms from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; Center for Epidemiologic Studies Depression Scale (CES-D); and saliva cotinine levels.Of the 485 participants who reported having smoked during the past 30 days, 249 reported previous attempts to quit smoking. Among the participants who had attempted to quit, the self-reported frequencies of subjective withdrawal symptoms were a strong need to smoke (45.4%), nervous and tense (31.8%), restless (29.4%), irritable (28.7%), hungry (25.3%), unable to concentrate (21.7%), miserable and sad (15.3%), and trouble sleeping (12.8%). The total number of withdrawal symptoms was correlated with the mFTQ score (Spearman r = 0.51; P < .001). In a stepwise linear regression analysis, the mFTQ score and the CES-D score accounted for approximately 35% of the variance in total number of withdrawal symptoms (R2 = 0.35; P < .001). Males smoked significantly more and had significantly higher mFTQ scores than did females, while female smokers had significantly higher CES-D scores than did their male counterparts.Considerable levels of nicotine dependence were present among adolescent smokers. Use of mFTQ scores; withdrawal symptoms including nicotine craving; CES-D scores; and saliva cotinine levels may be helpful in designing cessation programs targeted to nicotine-dependent adolescents.

    View details for Web of Science ID 000071997500007

    View details for PubMedID 9491041

  • Attachment style and weight concerns in preadolescent and adolescent girls INTERNATIONAL JOURNAL OF EATING DISORDERS Sharpe, T. M., Killen, J. D., Bryson, S. W., Shisslak, C. M., Estes, L. S., Gray, N., Crago, M., Taylor, C. B. 1998; 23 (1): 39-44

    Abstract

    The purpose of this study was to assess the association between attachment style and weight concerns, a major risk factor for eating disorders, in preadolescent and adolescent girls.Three hundred and five female elementary and middle school students completed measures of attachment style and weight concerns.Insecurely attached subjects reported higher weight concerns than did securely attached subjects. A greater proportion of insecurely attached subjects obtained "at risk" weight concerns scores than securely attached subjects.The findings suggest that attachment style may play an important role in the development of weight concerns, which, in turn, have been shown to be associated with the onset of eating disorders.

    View details for Web of Science ID 000071004600005

    View details for PubMedID 9429917

  • Characteristics of successful and unsuccessful dieters: An application of signal detection methodology ANNALS OF BEHAVIORAL MEDICINE Kiernan, M., King, A. C., Kraemer, H. C., Stefanick, M. L., Killen, J. D. 1998; 20 (1): 1-6

    Abstract

    Signal detection methods were used to identify predictors of successful weight loss in 177 mildly to moderately overweight women and men assigned to one of two weight-loss programs. Predictors included initial demographic, physiological, behavioral, and psychosocial characteristics, and program type (e.g. diet-only and diet-plus-exercise). Successful weight loss was defined as a loss of at least two units of body mass index at one year. Four subgroups were identified. Participants in the diet-plus-exercise program who were initially more satisfied with their bodies and did not have a history of repeated weight loss were most likely to succeed (63% succeeded). In contrast, participants assigned to the diet-plus-exercise program who were either extremely dissatisfied with their bodies or who had a history of repeated weight loss were at similar risk for failure as participants in the diet-only program (only 26% to 35% succeeded). The results underscore the potential utility of exploring these subgroups further to inform the development of new treatment strategies to increase the likelihood of success.

    View details for Web of Science ID 000075741800001

    View details for PubMedID 9755345

  • Prospective study of risk factors for the initiation of cigarette smoking JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Robinson, T. N., Haydel, K. F., Hayward, C., Wilson, D. M., Hammer, L. D., Litt, I. F., Taylor, C. B. 1997; 65 (6): 1011-1016

    Abstract

    Risk factors for the initiation of cigarette smoking were examined in 2 consecutive cohorts of teenagers (N = 1,901). Students in Cohort 1 were followed over 4 years from 9th to 12th grade; those in Cohort 2 were followed over 3 years from 9th to 11th grade. Among girls with no history of smoking at baseline, those with more friends who smoked at baseline (p < .001) and those with higher sociability scores (p < .05) were significantly more likely to have tried smoking over the study interval. Among boys with no history of smoking at baseline, those with more friends who smoked at baseline (p < .05) and those with higher depression symptoms scores (p < .01) were significantly more likely to have tried smoking over the study interval. The data suggest that future research is needed to examine potential gender differences that may have implications for the next generation of smoking-prevention programs.

    View details for Web of Science ID A1997YJ46300011

    View details for PubMedID 9420362

  • Nicotine patch and self-help video for cigarette smoking cessation JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Fortmann, S. P., Davis, L., Varady, A. 1997; 65 (4): 663-672

    Abstract

    A total of 424 smokers were randomized in a 2 x 2 factorial experiment. A pharmacologic factor contained 2 levels: transdermal nicotine path (TNP; 21 mg) and placebo. A self-help behavioral treatment factor contained 2 levels: video-enhanced self-help treatment manual and self-help treatment manual only. At 2 months, TNP produced a higher level of abstinence (36%) than placebo (20%), p < .001. No other comparison was significant. In secondary analyses, (at 2 months) and compliance with patch treatment regimen (at 2, 6, and 12 months) were associated with less relapse. Although nicotine replacement therapy has improved our ability to produce smoking cessation, the production of sustained, longer term abstinence remains an elusive goal.

    View details for Web of Science ID A1997XM67400016

    View details for PubMedID 9256568

  • Craving is associated with smoking relapse: Findings from three prospective studies EXPERIMENTAL AND CLINICAL PSYCHOPHARMACOLOGY Killen, J. D., Fortmann, S. P. 1997; 5 (2): 137-142

    Abstract

    In a combined sample of more than 2600 smokers, immediate postcessation craving is shown to be prospectively associated with smokers' ability to maintain abstinence. Relapse is strikingly rapid among those reporting high levels of craving following cessation. More than 32% of those with high craving scores relapsed within 1 week of cessation. In contrast, fewer than 15% of those with low craving relapsed in the first week (p < .001). Our findings provide a warrant for an increased research effort designed to provide a better understanding of the factors that control following smoking cessation and the processes by which craving influences smoking relapse.

    View details for Web of Science ID A1997WY83800007

    View details for PubMedID 9234050

  • Do cigarette warning labels reduce smoking? Paradoxical effects among adolescents ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Robinson, T. N., Killen, J. D. 1997; 151 (3): 267-272

    Abstract

    To examine the association between adolescents knowledge of cigarette warning labels and actual smoking behavior.Cohort analytic study.Four public high schools in northern California.Seventeen hundred forty-seven ninth graders (mean age, 14.9 years). Students from 2 of the schools (n = 803) were observed for approximately 3 months.Self-reported knowledge of warning labels was assessed at baseline. Self-reports of smoking behavior were completed at baseline and at follow-up.Greater knowledge of cigarette package warning labels was significantly associated with higher levels of smoking. Knowledge of warning labels on magazine and billboard advertisements did not differ significantly by level of smoking. In the longitudinal sample, greater knowledge of cigarette package warning labels was significantly associated with a subsequent increase in smoking, controlling for the baseline level of smoking, sex, ethnicity, and knowledge of warning labels on cigarette advertisements (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.02-1.46). Knowledge of warning labels on cigarette advertisements was not associated with a significant change in smoking behavior (OR, 1.06; 95% CI, 0.82-1.35).Sizable proportions of adolescent smokers are not seeing, reading, or remembering cigarette warning labels. In addition, knowledge of warning labels on cigarette packages and advertisements is not associated with reduced smoking. The current warning labels are ineffective among adolescents.

    View details for Web of Science ID A1997WN48600009

    View details for PubMedID 9080935

  • Psychiatric risk associated with early puberty in adolescent girls JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Hayward, C., Killen, J. D., Wilson, D. M., Hammer, L. D., Litt, I. F., Kraemer, H. C., Haydel, F., Varady, A., Taylor, C. B. 1997; 36 (2): 255-262

    Abstract

    This study prospectively evaluated the relationship between early puberty and the onset of internalizing symptoms and disorders in adolescent girls.The sample was drawn from 1,463 sixth-, seventh-, and eighth-grade girls who participated in a longitudinal school-based study of growth and development. Pubertal stage was determined by self-assessment of Tanner stage. Psychiatric assessments included self-report instruments and structured diagnostic interviews. Survival methods were utilized for data analysis.Girls with onset of internalizing symptoms were on average 5 months earlier in pubertal development than those who were asymptomatic (p < .001). In addition, girls with earlier maturation (earliest quartile) were more likely to develop internalizing symptoms than were nonearly matures (hazard ratio = 1.8, confidence interval = 1.2, 2.7). In a subsample of girls followed into high school, early-maturing girls were at marginally higher risk (p < .10) for developing internalizing disorders by the study's end. The highest risk for internalizing disorders was for those girls with both early puberty and prior internalizing symptoms (odds ratio = 3.3).Early puberty increases the risk of internalizing symptoms and perhaps internalizing disorders in adolescent girls.

    View details for Web of Science ID A1997WD92900017

    View details for PubMedID 9031579

  • Ethnicity and body dissatisfaction: Are Hispanic and Asian girls at increased risk for eating disorders? JOURNAL OF ADOLESCENT HEALTH Robinson, T. N., Killen, J. D., Litt, I. F., Hammer, L. D., Wilson, D. M., Haydel, K. F., Hayward, C., Taylor, C. B. 1996; 19 (6): 384-393

    Abstract

    To compare prevalences and correlates of body dissatisfaction among white, Hispanic, and Asian girls.A total of 939 6th and 7th grade girls (mean age 12.4 years) attending four middle schools in northern California completed self-administered assessments of age, ethnicity, desired body shape, parent education levels, mother's and father's body shapes, pubertal stage, and body dissatisfaction. Body dissatisfaction was assessed with the Body Dissatisfaction scale of the Eating Disorder Inventory. Height, weight, triceps skinfold thickness, and waist and hip circumferences were measured by trained examiners.Hispanic girls reported significantly greater body dissatisfaction than white girls, with Asian girls in-between. After adjustment for body mass index (weight/height), normal and overweight white, Hispanic, and Asian girls reported similar levels of body dissatisfaction. However, among the leanest 25% of girls, Hispanics and Asians reported significantly more body dissatisfaction than white girls. Body mass index was the strongest independent predictor of increased body dissatisfaction in all three ethnic groups. Shorter height among white girls and taller height among Asian girls also made significant independent contributions. Parent education level, a measure of socioeconomic status, was not significantly associated with body dissatisfaction.Body dissatisfaction is not limited to white girls in middle and upper socioeconomic strata. These findings suggest Hispanic and Asian girls may be at greater risk for adopting eating disorder behaviors than previously recognized.

    View details for Web of Science ID A1996VY33400005

    View details for PubMedID 8969369

  • Weight concerns influence the development of eating disorders: A 4-year prospective study JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Taylor, C. B., Hayward, C., Haydel, K. F., Wilson, D. M., Hammer, L., Kraemer, H., BLAIRGREINER, A., Strachowski, D. 1996; 64 (5): 936-940

    Abstract

    The authors examined factors prospectively associated with age of onset of partial syndrome eating disorders over a 4-year interval in a community sample (N = 877) of high school-age adolescent girls. Four percent developed a partial syndrome eating disorder over the interval. A measure of weight concerns was significantly associated with onset in a multivariate Cox proportional hazard analysis (p < .001). Girls scoring in the highest quartile on the measure of weight concerns had the highest incidence (10%) of partial syndrome onset, whereas none of the girls in the lowest quartile developed eating disorder symptoms. This finding is consistent with both theoretical and clinical perspectives and may represent a useful step toward the establishment of a rational basis for the choice of a prevention intervention target.

    View details for Web of Science ID A1996VM70000015

    View details for PubMedID 8916622

  • Interactive effects of depression symptoms, nicotine dependence, and weight change on late smoking relapse JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Fortmann, S. P., Kraemer, H. C., Varady, A. N., Davis, L., Newman, B. 1996; 64 (5): 1060-1067

    Abstract

    Signal detection methods were used to develop an algorithm useful in distinguishing those at risk for late relapse from those likely to maintain abstinence. Four subgroups with 24-month survival (nonrelapse) rates ranging from 79% to 33% were identified. Among participants whose depression symptoms decreased from baseline to the end of treatment, lower levels of nicotine dependence were associated with less relapse at the 24-month follow-up (odds ratio = 2.77; 95% confidence interval: 1.36-5.62). Among participants whose depression symptoms increased from baseline to the end of treatment, greater weight gain was associated with less relapse at follow-up (odds ratio = 2.90; 95% confidence interval: 1.41-5.96). This study suggested that it may become possible to use both baseline and treatment information to "titrate" interventions.

    View details for Web of Science ID A1996VM70000029

    View details for PubMedID 8916636

  • Predicting onset of drinking in a community sample of adolescents: The role of expectancy and temperament ADDICTIVE BEHAVIORS Killen, J. D., Hayward, C., Wilson, D. M., Haydel, K. F., Robinson, T. N., Taylor, C. B., Hammer, L. D., Varady, A. 1996; 21 (4): 473-480

    Abstract

    We report results of a prospective examination of the influence of outcome expectancy variables and inherited temperaments on the onset of drinking over a 12-month period in a sample of 1,164 high school students. While univariate prospective analysis indicated that drinkers and nondrinkers were different both on measures of outcome expectancy and temperament, multivariate analysis supported, most strongly, a social learning account of the processes influencing the onset and maintenance of drinking behavior in this sample. The multivariate analysis revealed that only expectancies for enhanced social behavior were consistently associated with the onset of drinking from baseline to 12-month follow-up (p < .001). Among all nondrinkers at baseline, those entertaining higher expectancies about the positive effects of alcohol on social interaction were more likely to begin drinking between baseline and follow-up. At present, few, if any, alcohol abuse prevention studies with adolescents have explicitly attempted to alter alcohol expectancies or to establish a link between expectancy and behavior change. Our results suggest that it may be useful to do so.

    View details for Web of Science ID A1996UR66600005

    View details for PubMedID 8830905

  • SCHOOL REFUSAL IN YOUNG ADOLESCENT GIRLS WITH NONCLINICAL PANIC ATTACKS JOURNAL OF ANXIETY DISORDERS Hayward, C., Taylor, C. B., BLAIRGREINER, A., Strachowski, D., Killen, J. D., Wilson, D. M., Hammer, L. D. 1995; 9 (4): 329-338
  • NICOTINE GUM AND SELF-HELP BEHAVIORAL TREATMENT FOR SMOKING RELAPSE PREVENTION - RESULTS FROM A TRIAL USING POPULATION-BASED RECRUITMENT JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Fortmann, S. P., Killen, J. D. 1995; 63 (3): 460-468

    Abstract

    Smokers aged 18 to 65 years (N = 1,044) who were able to quit for 24 hr were randomized using a 2 x 2 factorial design to compare nicotine gum to no gum use and self-help materials to no use of materials. All participants were offered a $100 incentive to quit and stay quit for 6 months. Six-month abstinence was 27% in the gum groups, compared with 19% in the no-gum group (p = .002). Compared with the no-gum group, relapse occurred at a significantly lower rate in the gum group for the entire 12 months of follow-up (odds of relapse in the gum group was 0.72, 95% confidence interval, 0.62 to 0.83). There was no significant main effect for the self-help materials, no interaction between gum and materials, and no evidence that the effectiveness of gum differed between the sexes or between heavy and light smokers. Nicotine gum is an effective adjunct to minimal-contact smoking cessation materials plus monetary incentive in a population-based sample of smokers.

    View details for Web of Science ID A1995RA10700017

    View details for PubMedID 7608359

  • PURSUIT OF THINNESS AND ONSET OF EATING DISORDER SYMPTOMS IN A COMMUNITY SAMPLE OF ADOLESCENT GIRLS - A 3-YEAR PROSPECTIVE ANALYSIS INTERNATIONAL JOURNAL OF EATING DISORDERS Killen, J. D., Taylor, C. B., Hayward, C., Wilson, D. M., Haydel, K. F., Hammer, L. D., SIMMONDS, B., Robinson, T. N., Litt, I., Varady, A., Kraemer, H. 1994; 16 (3): 227-238

    Abstract

    Community-based prospective studies are needed to shed light on mechanisms that may influence development of eating disorders and identify variables that could serve as potential targets for prevention efforts. In this paper we examine level of weight preoccupation and other variables prospectively associated with age of onset of eating disorder symptoms over a 3-year interval in a community sample (N = 939) of young adolescent girls. 3.6% (32/887) experienced onset of symptoms over the interval. Only one factor, a measure of Weight Concerns, was significantly associated with onset (p < .001). Girls scoring in the highest quartile on the measure of Weight Concerns had the shortest survival time (12% incidence by age 14.5) and those scoring in the lowest quartile had the highest survival time (2% incidence by age 14.5; p < .001). This finding is consistent with both theoretical and clinical perspectives and represents one of the first prospective demonstrations of a linkage between weight and body shape concerns and later onset of eating disorder symptoms. An understanding of the independent variables that predispose girls to development of symptoms is a useful step towards the establishment of a rational basis for the choice of a prevention intervention target.

    View details for Web of Science ID A1994PN81000002

  • TIMING AND RATE OF SEXUAL-MATURATION AND THE ONSET OF CIGARETTE AND ALCOHOL-USE AMONG TEENAGE GIRLS ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Wilson, D. M., Killen, J. D., Hayward, C., Robinson, T. N., Hammer, L. D., Kraemer, H. C., Varady, A., Taylor, C. B. 1994; 148 (8): 789-795

    Abstract

    To test the hypothesis that the patterns of pubertal progression, early vs late puberty and fast vs slow, are associated with the age at which girls start to drink alcohol and smoke cigarettes.The study included 1463 female students, 10.7 to 18.2 years of age, who were assessed five times during the 2.7-year study. Data regarding pubertal stage, alcohol use, and cigarette use were obtained at each assessment. These data were used to calculate two indexes of pubertal development, the age at which the midpoint of puberty was achieved and the rate of progression through puberty, and the ages when each subject first drank, first drank moderate amounts of alcohol, and first smoked.Girls with earlier puberty (midpoint < 12.2 years) first reported drinking any alcohol at a median age of 12.5 years, 0.7 years younger than girls whose puberty was later. Similarly, girls with earlier puberty reported drinking moderate amounts of alcohol at a median age of 13.7 years, 0.9 years younger than girls with later puberty. Girls with earlier puberty further reported first smoking cigarettes at a median age of 12.8 years, 0.6 years younger than girls with later puberty. The rate of pubertal progression was significantly associated only with the age when girls first drank moderate amounts of alcohol.Earlier puberty is associated with a younger age of onset for both drinking and smoking among adolescent girls.

    View details for Web of Science ID A1994PB26400003

    View details for PubMedID 8044254

  • WHO SHALL QUIT - COMPARISON OF VOLUNTEER AND POPULATION-BASED RECRUITMENT IN 2 MINIMAL-CONTACT SMOKING CESSATION STUDIES AMERICAN JOURNAL OF EPIDEMIOLOGY Fortmann, S. P., Killen, J. D. 1994; 140 (1): 39-51

    Abstract

    To better understand the generalizability of experimental smoking studies, the authors compare volunteer and population-based recruitment in two randomized clinical trials of smoking cessation methods, one that used a volunteer sample and one that used a random, population-based sample. Participants are compared with nonparticipants within each study, to the participants in the other study, and to the general population. Smokers aged 18-65 years without contraindications to using nicotine polacrilex who were able to quit unassisted were eligible for the two studies. In the first study (1984-1989), advertising recruited 3,758 eligible smokers (75% of all inquiries) who were willing to give a baseline telephone interview. Of these 3,758 eligible smokers, 2,592 attempted to quit and 1,226 succeeded for 48 hours and were randomized. In the second study (1988-1993), 7,135 smokers were identified through a random household telephone survey, and of these 7,135 smokers, 5,124 (72%) agreed to the telephone interview, 2,209 made a quit attempt, and 1,170 succeeded for 24 hours and entered the study. Compared with nonparticipants who provided an interview, subjects in both studies were more likely to be male, married, and employed, and were older and better educated. Compared with population-based recruitment, volunteer recruitment produced subjects who were less likely to be male and married, and were older, more educated, only slightly less representative of all ethnic subgroups, and heavier, more addicted smokers. Women were less likely than men to quit in the first 24-48 hours. The authors conclude that volunteer recruitment to smoking cessation studies appears to produce a reasonable sample of smokers, especially of heavy smokers, and that, compared with men, women may have more difficulty with the initial stages of smoking cessation.

    View details for Web of Science ID A1994NT91000005

    View details for PubMedID 8017402

  • FACTORS ASSOCIATED WITH EATING DISORDER SYMPTOMS IN A COMMUNITY SAMPLE OF 6TH AND 7TH GRADE GIRLS INTERNATIONAL JOURNAL OF EATING DISORDERS Killen, J. D., Hayward, C., Wilson, D. M., Taylor, C. B., Hammer, L. D., Litt, I., SIMMONDS, B., Haydel, F. 1994; 15 (4): 357-367

    Abstract

    Nine hundred thirty-nine 6th and 7th grade girls participated in the baseline phase of a prospective study designed to examine a set of potential risk factors for the development of eating disorders. Of the 939,839 girls (89%) completed the bulimia nervosa section of the Structured Clinical Interview for DSM-III-R disorders. One girl received the diagnosis of bulimia nervosa, another 35 were classified as a symptomatic group. Using analysis of covariance (ANCOVA), controlling for age and stage of sexual maturation, symptomatic and asymptomatic groups were compared on the following measures: Eating Disorders Inventory (EDI), BMI, triceps skinfold thickness, waist-to-hip ratio, depression symptoms (CES-D and DSRS), Restraint Scale, and a measure of family adaptability and cohesion (FACES). Symptomatic girls were more developmentally mature, significantly heavier, reported greater fear of weight gain, experienced greater dysphoria, indicated increased body dissatisfaction, and reported greater feelings of inadequacy and personal worthlessness. Their status on these dimensions may indicate potential vulnerability to eating disorders and, ultimately, suggest the choice of targets for intervention. Our future goal is to conduct the prospective analyses needed to confirm the hypothesized linkages.

    View details for Web of Science ID A1994NG59800005

    View details for PubMedID 8032350

  • ROLE OF NICOTINE DEPENDENCE IN SMOKING RELAPSE - RESULTS FROM A PROSPECTIVE-STUDY USING POPULATION-BASED RECRUITMENT METHODOLOGY INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE Killen, J. D., Fortmann, S. P. 1994; 1 (4): 320-334

    Abstract

    Results of a prospective examination of factors influencing smoking relapse are reported for a sample of smokers (N = 522) obtained through population-based recruitment. All subjects were given a modified Fagerstrom Tolerance Questionnaire (modified FTQ), which is a 5-item self-report instrument characterizing smokers according to their degree of nicotine dependence. At 30 days post-cessation, those placing in the lowest quartile of the modified FTQ at baseline had the highest survival rate (79%) and those placing in the highest quartile at baseline had the lowest survival (non-relapse) rate (43%). The difference in survival among the groups was statistically significant (p < .001). At 12 months, those placing in the lowest quartile of baseline cigarette consumption had the highest survival rate (34%) and those placing in the highest quartile had the lowest survival rate (14%; p < .001). It seems increasingly clear that level of dependence, even as indexed by comparatively crude self-report measures such as amount smoked is associated with the rate and pattern of smoking relapse.

    View details for Web of Science ID A1994QG47600003

    View details for PubMedID 16250793

  • THE FAVORITE CIGARETTE OF THE DAY JOURNAL OF BEHAVIORAL MEDICINE Jarvik, M., Killen, J. D., Varady, A., Fortmann, S. P. 1993; 16 (4): 413-422

    Abstract

    The choice of a favorite cigarette smoked during a given day varies considerably. Preferences are related to nicotine dependence and the lifestyles of smokers. In a sample of 5124 smokers, the "after-dinner cigarette" was chosen as the cigarette which they would miss most, while the next largest proportion of smokers (33%) said that they would miss the "first cigarette of the morning" most. The latter group scored highest on tests of nicotine dependence. In contrast, infrequent smokers ("chippers") chose the after-dinner cigarette.

    View details for Web of Science ID A1993LV62800006

    View details for PubMedID 8411146

  • AN ATTEMPT TO MODIFY UNHEALTHFUL EATING ATTITUDES AND WEIGHT REGULATION PRACTICES OF YOUNG ADOLESCENT GIRLS INTERNATIONAL JOURNAL OF EATING DISORDERS Killen, J. D., Taylor, C. B., Hammer, L. D., Litt, I., Wilson, D. M., Rich, T., Hayward, C., SIMMONDS, B., Kraemer, H., Varady, A. 1993; 13 (4): 369-384

    Abstract

    This is the first long-term, controlled study evaluating the effectiveness of a prevention curriculum designed to modify the eating attitudes and unhealthful weight regulation practices of young adolescent girls. Nine hundred sixty-seven sixth and seventh-grade girls were randomized to experimental healthy weight regulation curriculum or no-treatment control classes. A prevention intervention was developed around three principal components: (1) Instruction on the harmful effects of unhealthful weight regulation; (2) promotion of healthful weight regulation through the practice of sound nutrition and dietary principles and regular aerobic physical activity; (3) development of coping skills for resisting the diverse sociocultural influences that appear linked to the current popular obsessions with thinness and dieting. The intervention failed to achieve the hoped-for impact. We did observe a significant increase in knowledge among girls receiving the intervention and among high-risk students only, there was a small albeit statistically significant effect on body mass index. These findings question the wisdom of providing a curriculum directed at all young adolescents, most of whom are not at risk to develop an eating disorder. Rather than targeting the entire population, a healthy weight curriculum designed to modify the eating attitudes and unhealthful weight regulation practices of young adolescent girls might better focus on "at risk" students.

    View details for Web of Science ID A1993KZ50300004

    View details for PubMedID 8490639

  • DOES TELEVISION VIEWING INCREASE OBESITY AND REDUCE PHYSICAL-ACTIVITY - CROSS-SECTIONAL AND LONGITUDINAL ANALYSES AMONG ADOLESCENT GIRLS PEDIATRICS Robinson, T. N., Hammer, L. D., Killen, J. D., Kraemer, H. C., Wilson, D. M., Hayward, C., Taylor, C. B. 1993; 91 (2): 273-280

    Abstract

    To examine the relationships between hours of television viewing and adiposity and physical activity among female adolescents, a cohort study with follow-up assessments 7, 14, and 24 months after baseline was conducted. All sixth- and seventh-grade girls (N = 971) attending four northern California middle schools were eligible to participate. Six hundred seventy-one students had sufficient data for baseline cross-sectional analyses, and 279 students in a no-intervention cohort had sufficient data for longitudinal analyses. The baseline sample had a mean age of 12.4 years and was 43% white, 22% Asian, 21% Latino, 6% Pacific Islander, 4% black, 2% American Indian, and 2% other. Hours of after-school television viewing, level of physical activity, and stage of sexual maturation were assessed with self-report instruments. Height, weight, and triceps skinfold thickness were measured and body mass index (ratio of weight [in kilograms] to height [in meters] squared) and triceps skinfold thickness were adjusted by level of sexual maturity for the analyses. Baseline hours of after-school television viewing was not significantly associated with either baseline or longitudinal change in body mass index or triceps skinfold thickness. Baseline hours of after-school television viewing was weakly negatively associated with level of physical activity in cross-sectional analyses but not significantly associated with change in level of physical activity over time. All results were essentially unchanged when adjusted for age, race, parent education, and parent fatness. Among adolescent girls, television viewing time appears to have only weak, if any, meaningful associations with adiposity, physical activity, or change in either over time.

    View details for Web of Science ID A1993KK57800001

    View details for PubMedID 8424000

  • INSULIN-LIKE GROWTH-FACTOR BINDING PROTEIN-3 IN NORMAL PUBERTAL GIRLS ACTA ENDOCRINOLOGICA Wilson, D. M., STENE, M. A., Killen, J. D., Hammer, L. D., Litt, I. F., Hayward, C., Taylor, C. B. 1992; 126 (5): 381-386

    Abstract

    IGFBP-3 concentrations rise in the second decade of life. To test the hypothesis that the stage of pubertal development, independent of chronological age, was associated with these increases we measured serum IGFBP-3 concentrations by radioimmunoassay in 324 sixth and seventh grade girls (12.3 +/- 0.7 years) at the beginning of a multisite school-based health curriculum. The mean (+/- SD) serum IGFBP-3 among the 242 girls with complete data was 4.0 +/- 0.7 mg/l. Pubertal stage was significantly associated with IGFBP-3 (p less than 0.0001, ANOVA). Mean concentrations rose from 3.5 +/- 0.7 mg/l among those with the earliest pubertal stages to 4.2 +/- 0.7 mg/l among the mature girls. IGF-I and IGFBP-3 concentrations were significantly correlated (Spearman's r = 0.43, p less than 0.0001). After controlling for the association between pubertal development and IGFBP-3 concentrations, only the waist/hip ratio, among the various measures of body composition, was significantly associated with IGFBP-3 concentration (Spearman's r = -0.23, p = 0.0002). Likewise, none of the measures of nutrition: intake of total calories, protein, fat and carbohydrate; serum iron; red cell mean corpuscular volume; or cholesterol; were significantly associated with IGFBP-3 concentrations. There was, however, a small, but significant association between IGFBP-3 concentrations and both serum transferrin and blood hemoglobin concentrations. Pubertal stage has a significant impact on IGFBP-3 concentrations and those attempting to utilize IGFBP-3 concentrations during adolescence should be cognizant of the subject's pubertal stage.

    View details for Web of Science ID A1992HZ93000001

    View details for PubMedID 1377853

  • IS PUBERTY A RISK FACTOR FOR EATING DISORDERS AMERICAN JOURNAL OF DISEASES OF CHILDREN Killen, J. D., Hayward, C., Litt, I., Hammer, L. D., Wilson, D. M., Miner, B., Taylor, B., Varady, A., Shisslak, C. 1992; 146 (3): 323-325

    Abstract

    To examine the association between stage of sexual maturation and eating disorder symptoms in a community-based sample of adolescent girls.All sixth- and seventh-grade girls (N = 971) enrolled in four northern California middle schools. MAIN VARIABLES EXAMINED: Pubertal development measured using self-reported Tanner stage and body mass index (kg/m2). The section of the Structured Clinical Interview for DSM-III-R Disorders (SCID) discussing bulimia nervosa was used to evaluate symptoms of bulimia nervosa.Girls manifesting eating disorder symptoms, while not significantly older than their peers without such symptoms, were more developmentally advanced as determined with Tanner self-staging. The odds ratio for the association between sexual maturity and symptoms was 1.8 (95% confidence interval, 1.2 to 2.8); ie, at each age, an increase in sexual maturity of a single point was associated with a 1.8-fold increase in the odds of presenting symptoms. The odds ratio for the association between body mass index (adjusted for sexual maturity) and symptoms was 1.02 (95% confidence interval, 1.0 to 1.05). There was no independent effect of age or of the interaction between age and the sexual maturity index.These results suggest that (1) puberty may be a risk factor for the development of eating disorders, and (2) prevention efforts might best be directed at prepubertal and peripubertal adolescents.

    View details for Web of Science ID A1992HG92400016

    View details for PubMedID 1543180

  • INSULIN-LIKE GROWTH FACTOR-I AS A REFLECTION OF BODY-COMPOSITION, NUTRITION, AND PUBERTY IN 6TH AND 7TH GRADE GIRLS JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM Wilson, D. M., Killen, J. D., Hammer, L. D., Litt, I. F., VOSTI, C., Miner, B., Hayward, C., Taylor, C. B. 1991; 73 (4): 907-912

    Abstract

    Large variations in nutritional intake have profound effects on the GH-insulin-like growth factor-I (IGF-I) axis in children and adults, but the effect of normal variations in nutrition on IGF-I concentrations is largely unstudied, particularly during puberty. We measured serum IGF-I concentrations in 325 sixth and seventh grade girls (12.4 +/- 0.7 yr) at the beginning of a multisite school-based health curriculum. The mean serum IGF-I level among the 243 girls with complete data was 573 +/- 244 micrograms/L. Pubertal stage was significantly associated with IGF-I (P less than 0.0001, by analysis of variance). Mean concentrations rose from 427 +/- 198 micrograms/L among those at the earliest pubertal stages to 639 +/- 219 micrograms/L among the mature girls. After adjusting for the association with the stage of pubertal development, serum IGF-I was not significantly associated with measures of body composition (body mass index, triceps skin fold thickness, waist/hip ratio, height, and weight). Additionally, IGF-I concentrations were not associated with nutritional intake (total calories, total protein, total fat, and total carbohydrate) or such measures of nutrition as serum iron, hemoglobin, red cell mean corpuscular volume, white cell count, and cholesterol. IGF-I concentrations, however, were significantly correlated with transferrin concentrations, another possible index of nutritional status (r = 0.29; P less than 0.0001). IGF-I is not a clinically useful index of nutritional status among normal pubertal girls.

    View details for Web of Science ID A1991GF68400035

    View details for PubMedID 1890162

  • IMPACT OF PUBERTAL DEVELOPMENT ON BODY-FAT DISTRIBUTION AMONG WHITE, HISPANIC, AND ASIAN FEMALE ADOLESCENTS JOURNAL OF PEDIATRICS Hammer, L. D., Wilson, D. M., Litt, I. F., Killen, J. D., Hayward, C., Miner, B., VOSTI, C., Taylor, C. B. 1991; 118 (6): 975-980

    Abstract

    Variation in the waist/hip ratio (WHR) may be related to changes in hormonal secretion associated with pubertal maturation. We therefore studied the effects of race, pubertal development, and body fatness on WHR during adolescence in a multiethnic population. A total of 688 white, Asian, and Hispanic female adolescents (mean (+/- SD) 12.4 +/- 0.7 years), participating in the evaluation of a multisite school-based health education program, were included in these analyses. Self-assessed stage of puberty and measurements of height, weight, waist circumference, and hip circumference were obtained from each participant. The WHR and age-adjusted body mass index were calculated. Analysis of covariance demonstrated that puberty significantly affects hip circumference and WHR but not waist circumference among female adolescents. Age and fatness, as reflected by age-adjusted body mass index, contributed significantly to both circumferences and to the WHR. There was a significant effect of ethnicity on hip circumference but not on waist circumference or the WHR. These results confirm that pubertal stage exerts a significant effect on the hip circumference and WHR in female adolescents, even after the effects of fatness and age are controlled. Studies of body fat distribution during late childhood and adolescence should include assessments of pubertal maturation.

    View details for Web of Science ID A1991FQ10800029

    View details for PubMedID 2040937

  • PROSPECTIVE-STUDY OF FACTORS INFLUENCING THE DEVELOPMENT OF CRAVING ASSOCIATED WITH SMOKING CESSATION PSYCHOPHARMACOLOGY Killen, J. D., Fortmann, S. P., Newman, B., Varady, A. 1991; 105 (2): 191-196

    Abstract

    There have been few prospective studies of craving following smoking cessation. This paper presents findings from a prospective examination of factors associated with craving over an 8-week treatment period. Two findings merit attention: (1) dependence, as measured by the Dependence Index (DI), was associated with craving at 48 h, 4 and 8 weeks post-cessation. The magnitude of the association between the DI and short-term craving was, at the least, comparable to that previously reported among several biochemical measures of smoke intake; (2) a measure of craving obtained 48 h after smoking cessation was associated with treatment outcome. Forty-three per cent of participants with low initial craving scores were abstinent at a 2-month follow-up compared to only 26% of those with high craving scores. The DI was also associated with participants' status at follow-up. This result is interesting because evidence that craving or other abstinence effects are prospectively associated with outcome has been lacking.

    View details for Web of Science ID A1991GG35300009

    View details for PubMedID 1796127

  • PSYCHOSOCIAL PREDICTORS OF PHYSICAL-ACTIVITY IN ADOLESCENTS PREVENTIVE MEDICINE Reynolds, K. D., Killen, J. D., Bryson, S. W., Maron, D. J., Taylor, C. B., MACCOBY, N., Farquhar, J. W. 1990; 19 (5): 541-551

    Abstract

    Regular physical activity consistently demonstrates an inverse relationship with coronary heart disease and has positive effects on quality of life and other psychological variables. Despite the benefits of exercise, many youth and adults maintain a sedentary lifestyle. Interventions are needed, particularly with youth, to increase levels of physical activity. A better understanding of the psychosocial predictors of physical activity will aid in structuring these interventions. Longitudinal data from a cohort of 743 10th-grade students from the control condition of the Stanford Adolescent Heart Health Program were analyzed. Regression analysis indicated that psychosocial variables were significantly related to physical activity after controlling for baseline levels of physical activity and BMI. Associations with physical activity were found for intention to exercise, self-efficacy, stress, and direct social influence. The designers of future interventions should consider including program components that target these variables.

    View details for Web of Science ID A1990DX46600005

    View details for PubMedID 2235921

  • SMOKING CESSATION AFTER ACUTE MYOCARDIAL-INFARCTION - EFFECTS OF A NURSE-MANAGED INTERVENTION ANNALS OF INTERNAL MEDICINE Taylor, C. B., HOUSTONMILLER, N., Killen, J. D., DeBusk, R. F. 1990; 113 (2): 118-123

    Abstract

    To determine the effect of a nurse-managed intervention for smoking cessation in patients who have had a myocardial infarction.Randomized, with a 6-month treatment period and a 6-month follow-up.Kaiser Foundation hospitals in Redwood City, Santa Clara, Hayward, and San Jose, California.Sequential sample of 173 patients, 70 years of age or younger, who were smoking before hospitalization for acute myocardial infarction. Eighty-six patients were randomly assigned to the intervention and 87 to usual care; 130 patients (75%) completed the study and were available for follow-up.Nurse-managed and focused on preventing relapse to smoking, the intervention was initiated in the hospital and maintained thereafter primarily through telephone contact. Patients were given an 18-page manual that emphasized how to identify and cope with high-risk situations for smoking relapse.One year after myocardial infarction, the smoking cessation rate, verified biochemically, was 71% in the intervention group compared with 45% in the usual care group, a 26% difference (95% CI, 9.5% to 42.6%). Assuming that all surviving patients lost to follow-up were smoking, the 12-month smoking cessation rate was 61% in the intervention group compared with 32% in the usual care group, a 29% difference (95% CI, 14.5% to 43.5%). Patients who either resumed smoking within 3 weeks after infarction or expressed little intention of stopping in the hospital were unlikely to have stopped by 12 months.A nurse-managed smoking cessation intervention largely conducted by telephone, initiated in the hospital, and focused on relapse prevention can significantly reduce smoking rates at 12 months in patients who have had a myocardial infarction.

    View details for Web of Science ID A1990DN08300006

    View details for PubMedID 2360750

  • EVALUATION OF A TREATMENT APPROACH COMBINING NICOTINE GUM WITH SELF-GUIDED BEHAVIORAL TREATMENTS FOR SMOKING RELAPSE PREVENTION JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY Killen, J. D., Fortmann, S. P., Newman, B., Varady, A. 1990; 58 (1): 85-92

    Abstract

    1,218 smokers able to quit smoking for 48 hr were randomly assigned to one of 12 cells in a 4 x 3 fully crossed factorial experiment. A pharmacologic factor contained four levels: nicotine polacrilex (gum) delivered ad lib or on a fixed regimen, placebo gum, and no gum. A self-guided behavioral treatment factor contained three levels: self-selected relapse prevention modules, randomly administered modules, and no modules. Those receiving nicotine gum were more likely to be abstinent at the 2- and 6-month follow-ups. The fixed regimen accounted for most of the effect for gum. There was no effect for the relapse prevention module factor. Men and women showed a differential treatment response. Men who received nicotine gum were more likely to be abstinent at each follow-up (2, 6, and 12 months). No treatment was significantly better among women. We conclude that research on different gum chewing regimens is warranted and that further examination of possible gender differences in response to replacement therapy is needed.

    View details for Web of Science ID A1990CR17600011

    View details for PubMedID 2319049

  • SOCIAL INFLUENCES APPROACH TO SMOKING PREVENTION - THE EFFECTS OF VIDEOTAPE DELIVERY WITH AND WITHOUT SAME-AGE PEER LEADER PARTICIPATION ADDICTIVE BEHAVIORS Telch, M. J., Miller, L. M., Killen, J. D., Cooke, S., MACCOBY, N. 1990; 15 (1): 21-28

    Abstract

    This study tested the hypothesis that cigarette smoking adoption among adolescents could be suppressed by providing school-based videotape instruction for resisting social influences to smoke. The utilization of same-age peer leaders was also varied to test whether their participation in the classroom would enhance program effects. Seventh grade students (N = 540) from one junior high school in Southern California were randomly assigned by classrooms (N = 15) to: (a) videotape instruction, (b) videotape instruction plus peer leader involvement, or (c) survey-only. Seventh grade students (N = 234) in a second junior high school served as a measurement-only control. Assessments were conducted at the beginning and end of the academic year. Results revealed a marked suppression in the onset of both experimental and regular smoking among those students exposed to the pressure resistance training with peer leader involvement. Pressure resistance training without peer leader involvement produced a more variable and less powerful effect on students' smoking behavior. Data collected on students' use of alcohol and marijuana revealed a generalized suppression effect, albeit weaker than for tobacco, among those students exposed to the social resistance training with peer leader involvement. Results provide further encouraging support for the use of peer-led pressure resistance training in preventing adolescent drug use.

    View details for Web of Science ID A1990CL86900003

    View details for PubMedID 2316409

  • WEIGHT CHANGE AMONG PARTICIPANTS IN A LARGE SAMPLE MINIMAL CONTACT SMOKING RELAPSE PREVENTION TRIAL ADDICTIVE BEHAVIORS Killen, J. D., Fortmann, S. P., Newman, B. 1990; 15 (4): 323-332

    Abstract

    Weight at baseline and posttreatment was measured for 1096 participants in a smoking relapse prevention trial: 42.1% maintained their weight, 42.5% gained more than 1 kg and 15.4% lost more than 1 kg during the eight-week treatment program. Abstainers (n = 383) gained more than four times the weight gained by relapsers (n = 713) (Abstainers: 1.6 kg, Relapsers: 0.4 kg, p less than .0001). In order to examine the anorexic properties of nicotine gum. Abstainers were classified into nicotine gum user and non-user categories. Users gained significantly less weight than non-users although the difference was small (Users: 1.1 kg, Non-users: 1.8 kg, p less than .004). A dose-response relationship was observed between number of cigarettes smoked per day at baseline and weight gain. Higher cigarette consumption was associated with increased weight gain in both gum user (p less than .004), and non-user groups (p less than .02). There was no significant difference in weight gain between Abstainers who later relapsed at 6 months and those who maintained abstinence (p less than .29). Although the impact of nicotine gum on weight gain was small, this apparent property of the substance may be useful in encouraging cessation among smokers who perceive weight gain as a potential stumbling block to success.

    View details for Web of Science ID A1990DV56900003

    View details for PubMedID 2248106

  • PANIC ATTACKS IN YOUNG ADOLESCENTS AMERICAN JOURNAL OF PSYCHIATRY Hayward, C., Killen, J. D., Taylor, C. B. 1989; 146 (8): 1061-1062

    Abstract

    The lifetime prevalence of interview-determined four-symptom panic attacks in 95 ninth graders was 11.6%. Those with panic attacks were significantly more depressed, were significantly more likely to have separated or divorced parents, and tended to be more likely to have tried cigarette smoking.

    View details for Web of Science ID A1989AH11900022

    View details for PubMedID 2787606

  • THE STANFORD ADOLESCENT HEART HEALTH-PROGRAM HEALTH EDUCATION QUARTERLY Killen, J. D., Robinson, T. N., Telch, M. J., Saylor, K. E., Maron, D. J., Rich, T., Bryson, S. 1989; 16 (2): 263-283

    Abstract

    This study was designed to create, implement, and test a school-based multiple risk factor reduction program for high school students. All tenth graders in four senior high schools (N = 1447) from two school districts participated in the study. Within each district, one school was assigned at random to receive a special 20-session CVD risk reduction intervention and one school served as a control. The schools were matched for size and distribution of racial groups before randomization. At a two-month follow-up, knowledge gains were significantly greater for students in the treatment group on each of the risk factor domains tested: nutrition/diet (p less than 0.0001), physical activity (p less than 0.0001), and cigarette smoking (p less than 0.0001). Compared to controls, a higher proportion of those in the treatment group who were not exercising regularly at baseline, reported regular exercise at follow-up (p less than 0.0003). Almost twice as many baseline experimental smokers in the treatment group reported quitting at follow-up while only 5.6% of baseline experimental smokers in the treatment group graduated to regular smoking compared to 10.3% in the control group (p = 0.009). Students in the treatment group were more likely to report that they would choose heart healthy snack items (p less than 0.0001). Beneficial treatment effects were observed for resting heart rate (p less than 0.0001), BMI (p = 0.05), triceps skinfold thickness (p = 0.003), and subscapular skinfold thickness (p = 0.01). The results suggest that it is feasible to provide CVD risk reduction training to a large segment of the population through school-based primary prevention approaches.

    View details for Web of Science ID A1989U744100011

    View details for PubMedID 2732068

  • CARDIOVASCULAR-DISEASE RISK REDUCTION FOR 10TH GRADERS - A MULTIPLE-FACTOR SCHOOL-BASED APPROACH JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Killen, J. D., Telch, M. J., Robinson, T. N., MACCOBY, N., Taylor, C. B., Farquhar, J. W. 1988; 260 (12): 1728-1733

    Abstract

    All tenth graders in four senior high schools (N = 1447) from two school districts participated in a cardiovascular disease risk-reduction trial. Within each district, one school was assigned at random to receive a special 20-session risk-reduction intervention and one school served as a control. At a two-month follow-up, risk factor knowledge scores were significantly greater for students in the treatment group. Compared with controls, a higher proportion of those in the treatment group who were not exercising regularly at baseline reported regular exercise at follow-up. Almost twice as many baseline experimental smokers in the treatment group reported quitting at follow-up, while only 5.6% of baseline experimental smokers in the treatment group graduated to regular smoking compared with 10.3% in the control group. Students in the treatment group were more likely to report that they would choose "heart-healthy" snack items. Beneficial treatment effects were observed for resting heart rate, body mass index, triceps skin fold thickness, and subscapular skin fold thickness. The results suggest that it is feasible to provide cardiovascular disease risk-reduction training to a large segment of the population through school-based primary prevention approaches.

    View details for Web of Science ID A1988Q100100023

    View details for PubMedID 3411756

  • ARE HEAVY SMOKERS DIFFERENT FROM LIGHT SMOKERS - A COMPARISON AFTER 48 HOURS WITHOUT CIGARETTES JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Killen, J. D., Fortmann, S. P., Telch, M. J., Newman, B. 1988; 260 (11): 1581-1585

    Abstract

    Correlates of heavy smoking (greater than or equal to 25 cigarettes per day) were examined in a group of 380 smokers participating in a minimal-contact smoking relapse prevention trial. The results indicate that heavy smokers are more dependent on cigarettes. Compared with smokers consuming 15 or fewer cigarettes per day, heavy smokers reported greater difficulty quitting, were more troubled by withdrawal symptoms, experienced stronger urges and cravings, and had higher scores on a modified version of the Fagerstrom tolerance questionnaire. Heavy smokers weighed more and were more obese as measured by body mass index. Eighty percent of heavy smokers were classified correctly using discriminant function analysis with two dependence-related measures entering as the most important discriminator variables. Logistic regression analyses yielded similar results. The findings underscore the importance of addressing potential physical dependence factors when developing smoking-cessation treatments for heavy smokers.

    View details for Web of Science ID A1988P965000027

    View details for PubMedID 3411738

  • MINIMAL CONTACT TREATMENT FOR SMOKING CESSATION - A PLACEBO CONTROLLED TRIAL OF NICOTINE POLACRILEX AND SELF-DIRECTED RELAPSE PREVENTION - INITIAL RESULTS OF THE STANFORD STOP SMOKING PROJECT JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Fortmann, S. P., Killen, J. D., Telch, M. J., Newman, B. 1988; 260 (11): 1575-1580

    Abstract

    To determine the effectiveness of nicotine polacrilex combined with self-administered relapse prevention materials in maintaining smoking cessation, we conducted a randomized, double-blind, placebo controlled trial. Volunteers aged 18 to 65 years responding to media announcements were required to quit smoking for 48 hours without assistance. Of 1844 potential participants, 136 were medically excluded, 535 declined to make a quit attempt, and 573 were unable to quit, leaving 600 participants (35%) who were randomized. Eight self-help relapse prevention modules were mailed weekly. Gum was used either ad lib for smoking urges or on a fixed, hourly schedule (12 pieces per day). Only 15% of the subjects in each gum group stopped using the gum altogether because of side effects, but only 20% of the ad lib groups and 40% of the fixed-dosage group used at least eight pieces of gum per day during the first week. The abstinence rates (for at least seven days) at the six-month follow-up were 31% in both active gum groups and 22% in the placebo and no gum groups. Relapse rates in the two active gum groups were about half those in the placebo and no gum groups. Nicotine polacrilex may be a useful adjunct to minimal contact smoking cessation formats, which have broad appeal. Also, minimal contact relapse prevention programs may assist physicians in helping patients to maintain smoking cessation using nicotine polacrilex.

    View details for Web of Science ID A1988P965000026

    View details for PubMedID 3045351

  • PROMOTING DIETARY CHANGE IN ADOLESCENTS - A SCHOOL-BASED APPROACH FOR MODIFYING AND MAINTAINING HEALTHFUL BEHAVIOR AMERICAN JOURNAL OF PREVENTIVE MEDICINE King, A. C., Saylor, K. E., Foster, S., Killen, J. D., Telch, M. J., Farquhar, J. W., Flora, J. A. 1988; 4 (2): 68-74

    Abstract

    We examined the immediate and long-term effects of a school-based, behaviorally focused dietary change program for tenth-graders. Our behavioral change objectives included increased consumption of complex carbohydrates and decreased intake of saturated fats, sugar, and salt, particularly in the form of snack foods. We randomly assigned tenth-grade classes in two northern California high schools to either a five-session dietary change program or an assessment-only control group. We collected pre- and postprogram self-report data on 218 students in areas of dietary knowledge, behavior, attitudes, food availability in the home, and intentions and self-efficacy concerning eating in specific ways. We also observed school snack choices both directly and indirectly. Our results indicated significant changes in reported behavior, knowledge, and food availability at home, as well as changes in snack choices at school. We found these changes to be durable at one-year follow-up. Our findings suggest ways in which school-based programs focused on behavioral and environmental changes may be effective in promoting dietary changes at school and at home.

    View details for Web of Science ID A1988N201600002

    View details for PubMedID 3395493

  • DEPRESSIVE SYMPTOMS AND SUBSTANCE USE AMONG ADOLESCENT BINGE EATERS AND PURGERS - A DEFINED POPULATION STUDY AMERICAN JOURNAL OF PUBLIC HEALTH Killen, J. D., Taylor, C. B., Telch, M. J., Robinson, T. N., Maron, D. J., Saylor, K. E. 1987; 77 (12): 1539-1541

    Abstract

    We surveyed 646 tenth grade females in Northern California to assess the prevalence of binge eating and purging behaviors. Of these, 10.3 per cent met study criteria for bulimia and an additional 10.4 per cent reported purging behaviors for weight control. Bulimics and purgers were heavier, had greater triceps and subscapular skinfold thicknesses, and reported higher rates of drunkenness, marijuana use, cigarette use, and greater levels of depressive symptomatology.

    View details for Web of Science ID A1987K958400013

    View details for PubMedID 3674255

  • PERSPECTIVES ON ADOLESCENT SUBSTANCE USE - A DEFINED POPULATION STUDY JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Robinson, T. N., Killen, J. D., Taylor, C. B., Telch, M. J., Bryson, S. W., Saylor, K. E., Maron, D. J., MACCOBY, N., Farquhar, J. W. 1987; 258 (15): 2072-2076

    Abstract

    We asked 1447 tenth graders to complete a survey on physical activity, nutrition, stress, and substance use and to undergo basic physical assessments. In a multiple regression analysis, increased level of substance use by both boys and girls was most strongly predicted by friends' marijuana use. For boys, this was followed by perceived safety of cigarette smoking; poor school performance; parents' education; and use of diet pills, laxatives, or diuretics for weight control, accounting for 44% of the overall variation in substance use. For girls, friends' marijuana use was followed by poor school performance; self-induced vomiting for weight control; perceived safety of cigarette smoking; use of diet pills, laxatives, or diuretics for weight control; parents' education; perceived adult attitudes about cigarettes; and nonuse of seat belts, accounting for 53% of the overall variance. Separate multiple regression analyses for each substance produced similar results. The homogeneity of the study population precluded ethnic comparisons. These findings suggest that for many purposes substance use may be considered a single behavior regardless of the specific substance(s) used and that substance use may exist as part of a syndrome of adolescent problem behaviors. In addition, the potent influence of perceived social environment suggests that a social influence resistance model may represent the most successful preventive strategy.

    View details for Web of Science ID A1987K353200022

    View details for PubMedID 3656622

  • EVIDENCE FOR AN ALCOHOL STRESS LINK AMONG NORMAL WEIGHT ADOLESCENTS REPORTING PURGING BEHAVIOR INTERNATIONAL JOURNAL OF EATING DISORDERS Killen, J. D., Taylor, C. B., Telch, M. J., Saylor, K. E., Maron, D. J., Robinson, T. N. 1987; 6 (3): 349-356
  • CORRELATES OF SEAT-BELT USE BY ADOLESCENTS - IMPLICATIONS FOR HEALTH PROMOTION PREVENTIVE MEDICINE Maron, D. J., Telch, M. J., Killen, J. D., Vranizan, K. M., Saylor, K. E., Robinson, T. N. 1986; 15 (6): 614-623

    Abstract

    This study examined the psychosocial and behavioral correlates of seat-belt use among 1,728 10th-graders in four Northern California high schools. Parent and friend seat-belt use patterns were most highly correlated with student seat-belt use (r = 0.66 and r = 0.61, respectively) and together accounted for 46% of the variation in use. These relationships held across differences in sex, ethnicity, and socioeconomic status. Failure to wear seat belts was associated with a higher use of alcohol, cigarettes, marijuana, and cocaine; more tolerance toward speeding and drinking while driving; less exercise; and more preference for fat in the diet. Our findings attest to the power of parent and peer influences in shaping seat-belt use by adolescents and suggest that not wearing seat belts can be conceptualized as one facet of a pattern of general risk-taking behavior. These findings suggest several possible educational interventions to increase seat-belt use by adolescents.

    View details for Web of Science ID A1986E957000006

    View details for PubMedID 3797393

  • SELF-INDUCED VOMITING AND LAXATIVE AND DIURETIC USE AMONG TEENAGERS - PRECURSORS OF THE BINGE-PURGE SYNDROME JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Killen, J. D., Taylor, C. B., Telch, M. J., Saylor, K. E., Maron, D. J., Robinson, T. N. 1986; 255 (11): 1447-1449

    Abstract

    Bulimia (binge-purge syndrome) is a recently described but apparently common eating disorder. Purging behaviors associated with bulimia can cause serious medical complications. Prevalence data on purging behaviors are lacking for younger adolescents. A survey was conducted with 1,728 tenth-grade students to assess their attitudes about eating, dieting, weight control, and frequency of purging. Height, weight, and skin-fold thicknesses were also measured. Thirteen percent reported purging behavior. Female purgers outnumbered male purgers 2 to 1. Male purgers were significantly heavier than male nonpurgers and had significantly greater skin-fold thicknesses and weight/height2 ratios. Both male and female purgers felt guiltier after eating large amounts of food, counted calories more often, dieted more frequently, and exercised less than nonpurgers. Our findings suggest that an alarming number of young adolescents may employ unhealthy weight regulation strategies. Physicians who see adolescents should look for the presence of the attitudes and behaviors that characterize bulimia; this will enhance the likelihood of detection of the disorder and prevention of its complications.

    View details for Web of Science ID A1986A425900019

    View details for PubMedID 3456453

  • EFFICACY OF SELF-HELP BEHAVIOR-MODIFICATION MATERIALS IN SMOKING CESSATION AMERICAN JOURNAL OF PREVENTIVE MEDICINE Sallis, J. F., Hill, R. D., Killen, J. D., Telch, M. J., Flora, J. A., Girard, J., Taylor, C. B. 1986; 2 (6): 342-344

    Abstract

    We evaluated the efficacy of the Stanford Quit Kit, an eight-page self-administered smoking cessation program. Subjects were randomly assigned to receive the Quit Kit (n = 142) or a delayed intervention (n = 65). Confirmed abstinence (p less than .05) and reduced smoking among continuing smokers (p less than .002) were greater in the Quit Kit group than in the control group at the two-month follow-up. At the six-month follow-up 10.6 percent of the Quit Kit subjects were confirmed as abstinent. From these results we conclude that well-designed, self-administered behavior change materials can assist chronic smokers in quitting.

    View details for Web of Science ID A1986F352900006

    View details for PubMedID 3453200

  • NICOTINE GUM AND SELF-REGULATION TRAINING IN SMOKING RELAPSE PREVENTION BEHAVIOR THERAPY Killen, J. D., MACCOBY, N., Taylor, C. B. 1984; 15 (3): 234-248
  • HIGH-SCHOOL SMOKING PREVENTION - THE RELATIVE EFFICACY OF VARIED TREATMENTS AND INSTRUCTORS ADOLESCENCE Perry, C. L., Telch, M. J., Killen, J., Burke, A., MACCOBY, N. 1983; 18 (71): 561-566

    View details for Web of Science ID A1983RL06800010

    View details for PubMedID 6650269

  • Adolescent perceptions of family health behavior: a tenth grade educational activity to increase family awareness of a community cardiovascular risk reduction program. journal of school health Nader, P. R., Perry, C., MACCOBY, N., Solomon, D., Killen, J., Telch, M., Alexander, J. K. 1982; 52 (8): 372-377

    View details for PubMedID 6922315

  • ADOLESCENT PERCEPTIONS OF FAMILY HEALTH BEHAVIOR - A 10TH GRADE EDUCATIONAL ACTIVITY TO INCREASE FAMILY AWARENESS OF A COMMUNITY CARDIOVASCULAR RISK REDUCTION PROGRAM JOURNAL OF SCHOOL HEALTH Nader, P. R., Perry, C., MACCOBY, N., Solomon, D., Killen, J., Telch, M., Alexander, J. K. 1982; 52 (6): 372-377
  • LONG-TERM FOLLOW-UP OF A PILOT PROJECT ON SMOKING PREVENTION WITH ADOLESCENTS JOURNAL OF BEHAVIORAL MEDICINE Telch, M. J., Killen, J. D., McAlister, A. L., Perry, C. L., MACCOBY, N. 1982; 5 (1): 1-8

    Abstract

    Seventh graders (N = 353) in one junior high school received an experimental smoking prevention program aimed at teaching students to resist the social pressures to smoke cigarettes. Seventh graders (N = 217) in another school served as controls. Teams of high-school students trained in basic behavior change skills led seven classroom sessions of instruction in counter-arguing during the school year. Significant differences were found between groups in reported smoking at a 9-month posttest. Results were maintained at 21- and 33-month follow-ups.

    View details for Web of Science ID A1982PK77300001

    View details for PubMedID 7120372

Conference Proceedings


  • Stanford GEMS (Girls health enrichment multisite studies): Long-term efficacy of after-school dance and screen time reduction in low-income African-American girls Robinson, T. N., Matheson, D. M., Kraemer, H. C., Obarzanek, E., Wilson, D. M., Haskell, W. L., Pruitt, L. A., Thompson, N. S., Haydel, K. F., Fujimoto, M., Varady, A., Killen, J. D. LIPPINCOTT WILLIAMS & WILKINS. 2007: 843-843
  • Are overweight children unhappy? Body mass index, depressive symptoms, and overweight concerns in elementary school children Erickson, S. J., Robinson, T. N., Haydel, K. F., Killen, J. D. AMER MEDICAL ASSOC. 2000: 931-935

    Abstract

    It is commonly believed that overweight children are unhappy with their weight. However, population-based data addressing this association are lacking.To evaluate the association between obesity and depressive symptoms in a diverse, school-based sample of preadolescent children, and to examine whether overweight concerns play a role in this association.Third-grade students (N = 868, mean age, 8.4 years) attending 13 public elementary schools in Northern California were measured for weight and height, and were asked to complete self-report assessments of depressive symptoms and overweight concerns.A modest association between depressive symptoms and body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) was found for girls (r = 0.14, P<.01), but not for boys (r = 0.01, P<.78). Among girls, depressive symptoms were strongly associated with overweight concerns (r = 0.32, P<.001). After controlling for level of overweight concerns, BMI was no longer significantly associated with depressive symptoms among girls. In contrast, after controlling for BMI, overweight concerns remained significantly associated with depressive symptoms.This study provides cross-sectional evidence for a relationship between depressive symptoms and BMI in preadolescent girls, but not in preadolescent boys. This relationship seems to be explained by an excess of overweight concerns. Assessing overweight concerns may be a useful method to identify those overweight girls who are at highest risk for associated depressive symptoms.

    View details for Web of Science ID 000089222200012

    View details for PubMedID 10980798

  • Quitting chew: Results from a randomized trial using nicotine patches Howard-Pitney, B., Killen, J. D., Fortmann, S. P. AMER PSYCHOLOGICAL ASSOC. 1999: 362-371

    Abstract

    The authors examined the efficacy of transdermal nicotine replacement for cessation in 410 adult nonsmoking chewing tobacco users. Participants were randomly assigned to 6 weeks of 15-mg nicotine patch plus behavioral treatment or placebo patch plus behavioral treatment. All participants received the same behavioral treatment of 2 pharmacy visits, 2 support calls, and self-help materials. At 6 months after treatment, biochemically confirmed point-prevalence rates (no chewing in the last 7 days) in the active (38%) and placebo (34%) groups were high and not significantly different. The difference in relapse (no chewing for 7 consecutive days) between the active patch group (33%) and placebo group (48%) was significant at 6 months (p = .003). Nicotine dependence and age predicted nonrelapse at 6 months. The results suggest that nicotine replacement may improve chewers' chances of abstinence.

    View details for Web of Science ID 000084175500007

    View details for PubMedID 10609971

  • PUBERTAL STAGE AND PANIC ATTACK HISTORY IN 6TH-GRADE AND 7TH-GRADE GIRLS Hayward, C., Killen, J. D., Hammer, L. D., Litt, I. F., Wilson, D. M., SIMMONDS, B., Taylor, C. B. AMER PSYCHIATRIC ASSOCIATION. 1992: 1239-1243

    Abstract

    Although the incidence of first panic attacks appears to peak during adolescence, little is known about which features of adolescence contribute to the risk of a first panic episode. The purpose of this study was to compare the relative importance of age and pubertal stage in explaining the occurrence of panic attacks in adolescents.From a school-based sample of sixth- and seventh-grade girls, 754 subjects completed both a structured clinical interview determining history of one or more panic episodes and a self-assessment of Tanner stages of pubertal development. A multiple logistic regression analysis was performed with panic attack history as the dependent variable and pubertal stage, age, and their interaction as the independent variables.A history of one or more four-symptom panic attacks was found in 5.3% of the girls (N = 40). After age was controlled for, pubertal stage was significantly related to panic attack history. At each age, higher rates of panic attacks were found in the more physically mature girls.Pubertal stage, after adjustment for the effects of age, appears to predict panic attack occurrence in young adolescent girls. Understanding the link between puberty and panic may offer clues regarding the onset and etiology of panic attacks.

    View details for Web of Science ID A1992JK72200019

    View details for PubMedID 1503139

  • EFFECTS OF PUBERTAL DEVELOPMENT ON WAIST-HIP RATIO (WHR) Wilson, D. M., Hammer, L. D., Litt, I. F., Killen, J. D., Taylor, C. B., Hayward, C., Miner, B., VOSTI, C. NATURE PUBLISHING GROUP. 1990: A8-A8
  • EFFECTS OF PUBERTAL DEVELOPMENT ON WAIST-HIP RATIO (WHR) Hammer, L. D., Wilson, D. M., Litt, I. F., Killen, J. D., Taylor, C. B., Hayward, C., Miner, B., VOSTI, C. SLACK INC. 1990: A163-A163

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