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PublicationAfterword to the Issue “Adolescents in the Digital Age: Effects on Health and Development”(2016-01-01) Romer, Daniel; Rich, MichaelThe articles in this thematic issue suggest both opportunities and hazards for the health and development of adolescents in the digital age. We place these concerns in the context of improving health for young people in the US and elsewhere, and suggest that based on evidence uncovered to date, increasing digital connection may be having no less favorable than adverse effect on adolescents. PublicationReanalysis of the effects of “13 Reasons Why”: Response to Bridge et al.(2020-11-18) Romer, Daniel PublicationEmotional Graphic Cigarette Warning Labels Reduce the Electrophysiological Brain Response to Smoking Cues(2015-03-01) Wang, An-Li; Romer, Daniel; Turetsky, Bruce I; Gur, Ruben; Langleben, Daniel D; Elman, IgorThere is an ongoing public debate about the new graphic warning labels (GWLs) that the Food and Drug Administration (FDA) proposes to place on cigarette packs. Tobacco companies argued that the strongly emotional images FDA proposed to include in the GWLs encroached on their constitutional rights. The court ruled that FDA did not provide sufficient scientific evidence of compelling public interest in such encroachment. This study's objectives were to examine the effects of the GWLs on the electrophysiological and behavioral correlates of smoking addiction and to determine whether labels rated higher on the emotional reaction (ER) scale are associated with greater effects. We studied 25 non-treatment-seeking smokers. Event-related potentials (ERPs) were recorded while participants viewed a random sequence of paired images, in which visual smoking (Cues) or non-smoking (non-Cues) images were preceded by GWLs or neutral images. Participants reported their cigarette craving after viewing each pair. Dependent variables were magnitude of P300 ERPs and self-reported cigarette craving in response to Cues. We found that subjective craving response to Cues was significantly reduced by preceding GWLs, whereas the P300 amplitude response to Cues was reduced only by preceding GWLs rated high on the ER scale. In conclusion, our study provides experimental neuroscience evidence that weighs in on the ongoing public and legal debate about how to balance the constitutional and public health aspects of the FDA-proposed GWLs. The high toll of smoking-related illness and death adds urgency to the debate and prompts consideration of our findings while longitudinal studies of GWLs are underway. PublicationThe Role of Parents in Problematic Internet Use Among US Adolescents(2016-01-01) Bleakley, Amy; Ellithorpe, Morgan; Romer, DanielThe internet has transformed the way youth communicate, learn, and network, with implications for their broader social, psychological, and physical health and well-being. With the technological capability of accessing the internet from anywhere, at any time, paired with the enormous variety of internet activities in which youth engage—from social networking to chatting to streaming videos to playing games to watching television content—instances of problematic internet behavior have emerged. We conducted an online national survey of 629 US adolescents ages 12–17 years old and a matching survey of one of their parents. We investigated the relationship between problematic internet behavior and parental monitoring, parental mediation of internet use, and parental estimates of their adolescent’s time spent using computers. Analyses showed that problematic internet use was associated with less parental monitoring and parental mediation and poorer parental relationships. Adolescents that spent a lot of time on the computer were also more likely to engage in problematic internet use. Although we cannot determine the direction of the relationships, results support the important role of parents in adolescents’ problematic internet use. PublicationReanalysis of the Bridge et al. study of suicide following release of 13 Reasons Why(2020-01-16) Romer, DanielBridge et al. recently presented a time series analysis of suicide rates in the US following the release of the 2017 Netflix series “13 Reasons Why.” Their analysis found a powerful effect of the show on boys ages 10–17 for nine months after the show was released in April 2017. I questioned this finding on two grounds. First, contagion would be expected to be stronger for girls than boys for this story, and second their analysis did not take into account strong secular trends in suicide, especially in boys from 2016 to 2017. I reanalyzed their data using a simple auto-regression model that tested for changes in rates after removing auto-correlation and national trends in suicide. I found that the increase for boys observed by Bridge et al. in April was no greater than the increase observed during the prior month before the show was released. There were also no effects in later months of that year. For girls, I found a small but nonsignificant increase in suicide in April that was unique to that month, potentially consistent with a combined protective and harmful effect of the show. In total, I conclude that it is difficult to attribute harmful effects of the show using aggregate rates of monthly suicide rates. More fine-grained analyses at the weekly level may be more valid but only after controlling for secular changes in suicide that have been particularly strong since 2008 in the US. PublicationMultiple Method Contraception Use Among African American Adolescents in Four US Cities(2011-06-01) Hennessy, Michael; Brown, Jennifer L; Sales, Jessica M; DiClemente, Ralph J; Salazar, Laura F; Vanable, Peter A; Romer, Daniel; Carey, Michael P; Valois, Robert F; Brown, Larry K; Stanton, BonitaWe report on African American adolescents' (N = 850; M age = 15.4) contraceptive practices and type of contraception utilized during their last sexual encounter. Respondents completed measures of demographics, contraceptive use, sexual partner type, and ability to select “safe” sexual partners. 40% endorsed use of dual or multiple contraceptive methods; a total of 35 different contraceptive combinations were reported. Perceived ability to select “safe” partners was associated with not using contraception (OR = 1.25), using less effective contraceptive methods (OR = 1.23), or hormonal birth control (OR = 1.50). Female gender predicted hormonal birth control use (OR = 2.33), use of less effective contraceptive methods (e.g., withdrawal; OR = 2.47), and using no contraception (OR = 2.37). Respondents' age and partner type did not predict contraception use. Adolescents used contraceptive methods with limited ability to prevent both unintended pregnancies and STD/HIV. Adolescents who believed their partners posed low risk were more likely to use contraceptive practices other than condoms or no contraception. Reproductive health practitioners are encouraged to help youth negotiate contraceptive use with partners, regardless of the partner's perceived riskiness. PublicationGraphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial(2015-01-01) Evans, Abigail T; Strasser, Andrew A; Peters, Ellen; Emery, Lydia F; Romer, Daniel; Sheerin, Kaitlin MObjective Observational research suggests that placing graphic images on cigarette warning labels can reduce smoking rates, but field studies lack experimental control. Our primary objective was to determine the psychological processes set in motion by naturalistic exposure to graphic vs. text-only warnings in a randomized clinical trial involving exposure to modified cigarette packs over a 4-week period. Theories of graphic-warning impact were tested by examining affect toward smoking, credibility of warning information, risk perceptions, quit intentions, warning label memory, and smoking risk knowledge. Methods Adults who smoked between 5 and 40 cigarettes daily (N = 293; mean age = 33.7), did not have a contra-indicated medical condition, and did not intend to quit were recruited from Philadelphia, PA and Columbus, OH. Smokers were randomly assigned to receive their own brand of cigarettes for four weeks in one of three warning conditions: text only, graphic images plus text, or graphic images with elaborated text. Results Data from 244 participants who completed the trial were analyzed in structural-equation models. The presence of graphic images (compared to text-only) caused more negative affect toward smoking, a process that indirectly influenced risk perceptions and quit intentions (e.g., image->negative affect->risk perception->quit intention). Negative affect from graphic images also enhanced warning credibility including through increased scrutiny of the warnings, a process that also indirectly affected risk perceptions and quit intentions (e.g., image->negative affect->risk scrutiny->warning credibility->risk perception->quit intention). Unexpectedly, elaborated text reduced warning credibility. Finally, graphic warnings increased warning-information recall and indirectly increased smoking-risk knowledge at the end of the trial and one month later. Conclusions In the first naturalistic clinical trial conducted, graphic warning labels are more effective than text-only warnings in encouraging smokers to consider quitting and in educating them about smoking’s risks. Negative affective reactions to smoking, thinking about risks, and perceptions of credibility are mediators of their impact. PublicationBeyond Stereotypes of Adolescent Risk Taking: Placing the Adolescent Brain in Developmental Context(2017-10-01) Romer, Daniel; Reyna, Valerie F; Satterthwaite, Theodore DRecent neuroscience models of adolescent brain development attribute the morbidity and mortality of this period to structural and functional imbalances between more fully developed limbic regions that subserve reward and emotion as opposed to those that enable cognitive control. We challenge this interpretation of adolescent development by distinguishing risk-taking that peaks during adolescence (sensation seeking and impulsive action) from risk taking that declines monotonically from childhood to adulthood (impulsive choice and other decisions under known risk). Sensation seeking is primarily motivated by exploration of the environment under ambiguous risk contexts, while impulsive action, which is likely to be maladaptive, is more characteristic of a subset of youth with weak control over limbic motivation. Risk taking that declines monotonically from childhood to adulthood occurs primarily under conditions of known risks and reflects increases in executive function as well as aversion to risk based on increases in gist-based reasoning. We propose an alternative Lifespan Wisdom Model that highlights the importance of experience gained through exploration during adolescence. We propose, therefore, that brain models that recognize the adaptive roles that cognition and experience play during adolescence provide a more complete and helpful picture of this period of development. PublicationIdentifying Best Practices in Civic Education: Lessons From the Student Voices Program(2007-11-01) Feldman, Lauren; Romer, Daniel; Pasek, Josh; Jamieson, Kathleen HallSchool‐based civic education is increasingly recognized as an effective means for increasing political awareness and participation in American youth. This study examines the Student Voices curriculum, implemented in 22 Philadelphia high schools, to assess program activities that mediate gains in outcomes linked to future political participation (following of politics, political knowledge, and political efficacy). The results indicate that class deliberative discussions, community projects, and informational use of the Internet produce favorable outcomes that build over the course of two semesters. Effects were comparable for both white and nonwhite students. PublicationIntroduction to the Issue “Adolescents in the Digital Age: Effects on Health and Development”(2016-01-01) Romer, DanielThis thematic issue brings together papers by researchers who are studying the ways that today’s adolescents interact with their peers, families, and the larger media environment in the digital age. The contributors highlight both the challenges and the opportunities that this new age presents for the healthy development of young people.