Philip Baiden

Depression is highly prevalent among cancer survivors and contributes to poorer quality of life, reduced treatment adherence, and increased morbidity. Functional limitations, loneliness, and inadequate social and emotional support are important psychosocial factors associated with self-reported lifetime diagnosis of major depressive disorder among cancer survivors. Using a cross-sectional study design, this study examined the independent associations of functional limitations, loneliness, and social/emotional support with a self-reported lifetime diagnosis of major depressive disorder among a large sample of U.S. cancer survivors. Data were drawn from the 2023 and 2024 Behavioral Risk Factor Surveillance System. The analytic sample included 70,620 adult cancer survivors (56.3% female) with depression as the outcome variable. Functional limitations, loneliness, and social/emotional support were primary explanatory variables. Multivariable logistic regression models estimated adjusted odds ratios (AORs) and 95% confidence intervals (CIs), controlling for demographic, socioeconomic, and health-related covariates. Overall, 21.8% of cancer survivors reported depression. In the fully adjusted models, loneliness (AOR = 2.72, 95% CI: 2.44–3.03), functional limitations (AOR = 2.05, 95% CI: 1.81–2.31), and lack of social/emotional support (AOR = 1.43, 95% CI: 1.27–1.62) were independently associated with higher odds of depression. Female sex, low income, cost-related forgone medical care, poor self-rated health, obesity, and current/former smoking were also significantly negatively associated with depression, while physical activity was protective. We found that functional limitations, loneliness, and inadequate social support are robust and independent associated factors of depression among cancer survivors. Screening and interventions targeting these psychosocial factors may improve mental health outcomes and enhance overall survivorship care.

Background: Although prior research has linked perceived racial discrimination (PRD) to adverse outcomes among adolescents, fewer studies have comprehensively examined its associations with mental health, substance use, and victimization outcomes within a single nationally representative sample. The objective of this study is to examine the associations between school-based interpersonal PRD and a broad range of mental health, substance use, and victimization outcomes among racial/ethnic minority adolescents in the United States. Methods: Data for this study were obtained from the 2023 Youth Risk Behavior Survey. The analytic sample included 9,885 racial/ethnic minority adolescents aged 14–18 (50.7% male). The associations between school-based interpersonal PRD and twenty-two outcomes spanning mental health ( n = 6), current substance use ( n = 6), and victimization and violence-related experiences ( n = 10) were examined using binary logistic regression. Results: We found that 16.7% of adolescents reported sometimes experiencing school-based interpersonal PRD and 6.9% experienced PRD most of the time or always. In the multivariable logistic regression models, adolescents who experienced school-based interpersonal PRD most of the time or always had higher odds of poor mental health, sadness or hopelessness, suicidal ideation, suicide planning, and suicide attempts (adjusted odds ratios [AORs] = 3.39–5.19) compared to adolescents who never experienced PRD. The strongest associations were observed for victimization outcomes, including school bullying (AOR = 9.68), being threatened or injured on school property (AOR = 8.44), and physical dating violence (AOR = 7.68). Conclusions: School-based interpersonal PRD was associated with mental health problems, substance use, and victimization among racial/ethnic minority adolescents. These findings highlight the broad health correlates of school-based interpersonal PRD and emphasize the need for multilevel prevention and intervention strategies that strengthen individual coping while addressing the broader social and structural inequities that contribute to discriminatory experiences.

Adolescent gun carrying is a critical U.S. public health issue, yet little is known about how multiple violence exposures contribute to this risk. Guided by the Cumulative Risk and Protective Model, this study examined the direct effects of seven violence and threat exposures on gun carrying, alongside the promotive and protective roles of parental monitoring. Using a nationally representative sample from the 2023 Youth Risk Behavior Survey, complementary log-log regression models were employed, controlling for adverse childhood experiences, mental health, and demographics factors. Of the 20,103 adolescent examined, 4% reported gun carrying the past year. Results indicated that school threats, physical fights, neighborhood violence, sexual abuse, and racial discrimination significantly increased the odds of gun carrying. Conversely, school bullying was associated with reduced odds of gun carrying, whereas cyberbullying showed no significant association with gun carrying. Parental monitoring emerged as a strong promotive factor, reducing the odds of gun carrying by 38%; however, it did not buffer the risks posed by violence exposures. The findings of this study suggest that while parental monitoring is a vital protective asset, it may be insufficient to mitigate the influence of multiple violence exposures, necessitating multi-level strategies across school, community, and family contexts.

Adolescent suicide remains a major public health concern in the United States. Racial/ethnic minority adolescents often experience psychosocial stressors such as discrimination, which may contribute to suicidal thoughts and behaviors (STBs). This study examined the association between perceived racial discrimination (PRD) and STBs among U.S. racial/ethnic minority adolescents and assessed whether persistent sadness/hopelessness and vaping mediate this association after adjusting for demographic characteristics. Data were drawn from the 2023 Youth Risk Behavior Survey. The analytic sample included 8,054 racial/ethnic minority adolescents aged 14–18 years (50.8% male). Multivariable logistic regression models were used to examine associations between PRD and suicidal ideation, suicide planning, and suicide attempts. Mediation analyses assessed whether persistent sadness/hopelessness and vaping explained these associations while controlling for demographic characteristics. Approximately 43% of racial/ethnic minority adolescents reported experiencing PRD. Adolescents reporting PRD had higher odds of suicidal ideation (AOR = 1.44, 95% CI = 1.20–1.73), suicide planning (AOR = 1.26, 95% CI = 1.02–1.57), and suicide attempts (AOR = 1.49, 95% CI = 1.16–1.93). Persistent sadness/hopelessness significantly mediated these associations, accounting for 47.2% of the total effect for suicidal ideation, 44.0% for suicide planning, and 42.3% for suicide attempts. Vaping mediated a smaller proportion of the associations, explaining 18.1%, 17.1%, and 19.0% of the effects for suicidal ideation, suicide planning, and suicide attempts, respectively. Racial discrimination, rather than racial/ethnic identity itself, was associated with increased suicide risk among racial/ethnic minority adolescents. This association is largely explained by feelings of sadness or hopelessness. These findings underscore the importance of addressing racial discrimination and its psychological and behavioral consequences in efforts to reduce suicide risk among racial/ethnic minority adolescents.