Implications for future research and applications to families will be discussed. Background: Adult obesity is associated with poorer cognitive function and physical coordination in childhood. Hypothesis: Hearing impairment in childhood as a marker of childhood function is associated with adult obesity, and is a better marker for neurological function as it is less subject to social confounding and unlikely to influence exercise. Methods: Among 3288 male and 3527 female members of a longitudinal cohort born in Great Britain in 1970 associations with adult obesity for hearing impairment were assessed. BMI was measured at age 10 years and self-reported at age 34 years. Audiometry was conducted at age 10 years. The dependent variable in logistic regression was minor impairment with bilateral loss as a marker of systemic effects. Adjustment for potential confounding factors included social class, both parents living in the household, maternal education and pubertal development at age 10 years. Results: Among females, the adjusted odds ratios (95% CI) for associations observed with hearing impairment at age 10 years were 2.33 (1.36-3.98 ) for overweight/obesity; and at age 34 years they were 1.71 (1.00-2.92) for overweight and 2.73 (1.58-4.71 ) for obesity. Childhood BMI did not explain the association of childhood hearing impairment with adult BMI. There were no consistent associations among males for hearing impairment and BMI. Conclusion: The association between bilateral hearing impairment in childhood and subsequent adult-onset obesity might be due to early exposures such as psychosocial stress with chronic activation of glucocorticoid receptors, which may damage hearing through detrimental effects on the central nervous system (i.e. via interactions with estrogen receptors in the cochlea) and also result in obesity. Parenting involvement is important in children's management of T1D with the quality of involvement being a key factor. For example, negative or critical parenting has been associated with poorer adherence to T1D regimens and worse metabolic control. However, there is little research that has examined the psychosocial impact of non-supportive parenting on youth with T1D. Therefore, the current study examined the relationship of non-supportive parent behaviors and child self-efficacy, hypothesizing child depressive symptoms as a mediator. Baseline data from an RCT to promote adherence in preadolescents with T1D were used. For the current study, youth self-report was used; including measures of non-supportive parental behavior (Diabetes Family Behavior Checklist), depressive symptoms (Child Depression Inventory; CDI) and self-efficacy for diabetes care (Self-Efficacy for Diabetes Scale). Participants were 86 youth 8 to 11 years old. A mediation model was tested (Holmbeck, 2001) controlling for child age, insulin regimen, and ethnicity. None of the demographic variables were significant in the models. More nonsupportive parental behavior was associated with higher levels of depressive symptoms (F(1,77)=8.058, p< .01). Higher CDI scores were associated with lower self-efficacy (F(1,83)=15.316, p<.0001). With all variables entered into the regression equation (F(2,69)=7.201, p=.001), the association between non-supportive parental behavior and child self efficacy was no longer significant and was fully mediated by child depressive symptoms, as tested by Sobel's equation (z= -2.06). In sum, non-supportive parental behaviors appear to be related to increased child depressive symptoms, which in turn are related to lower self-efficacy for diabetes management. Clinical implications of these findings include encouraging positive parental involvement in children's diabetes management and decreasing negative or critical involvement, as well as assessing and treating depression in youth with T1D in order to improve diabetes self-efficacy and self care. Background: A negative social gradient in overweight among adolescents has been shown in developed countries but few studies have examined whether weight gain and the development of overweight differs among adolescents from different socioeconomic groups in a longitudinal study. Objective: To identify the possible association between parental socioeconomic position, weight change and the risk of developing overweight among adolescents between the ages 15 to 21. Design: Prospective cohort study conducted in Denmark with baseline examination in 1996 and follow-up questionnaire in 2003. A sample of 1,656 adolescents participated in both baseline and follow-up. Of these 1,402 had a body mass index (BMI=weight/ height2kg/m2) below 25 at baseline when adjusted for age and gender according to guidelines from International Obesity Taskforce, and were at risk of developing overweight during the study period. The main outcome measures were change in BMI and development of overweight (from BMI<25 to BMI>=25). Results: Average BMI increased from 21.3 to 22.7 for girls and from 20.6 to 23.6 for boys from age 15 to 21. An inverse social gradient in overweight was seen for girls at baseline and follow-up and for boys at follow-up. In the full population there was a tendency to a social gradient in the overall increase in BMI for girls, but not for boys. A total of 13.4 percent developed overweight during the follow-up period. Girls of lower socioeconomic position had a higher risk of developing overweight (OR's between 4.72; CI 1.31 to 17.04 and 2.03; CI 1.10-3.74) when compared to girls of high socioeconomic position. The risk of developing overweight or obesity during the follow-up period was not associated with parental socioeconomic position for boys. Conclusions: The levels of overweight and obesity among adolescents are high and continue to rise. Results from this study suggest that the social gradient in overweight becomes steeper for girls and emerge for boys in late adolescence (age span 15 to 21 years). Late adolescence seems to be an important window of opportunity in reducing the social inequality in overweight among Danish adolescents. Introduction: Adolescent sleep deprivation is an international health crisis affecting learning, high risk behaviors, and mood. Adolescent sleep is impacted by numerous factors; the family sleep environment being one of the most important and most amenable to change. There are currently no valid, reliable measures of family sleep environments. This research developed and validated the Howard Family Sleep Questionnaire (HFSQ) . We demonstrated that a) the HFSQ can predict sleep disorders b) gender interacts with family factors to predict the quality, duration and timing of sleep (still analyzing) and c) cultural impacts on the relationship between sleep and family factors (still analyzing). Methods: The HFSQ, the Pittsburg Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Epworth-Billings Sleepiness scale (EBSS), and questionnaires assessing sleep behaviors were collected from 50 adolescents in various parts of Maryland. An additional 50 adolescents in Karachi, Pakistan were given the test packet. Results: In the Maryland sample, individuals identified with excessive daytime sleepiness (EDS) either by the ESS or the EBSS scored significantly higher on the HFSQ (ESS t (34) = -2.509, p = 0.017; EBSS t (34) = -2.028, p = .05). The HSFQ was significantly correlated with the PSQI total score (r = .376, p = .05) and the PSQI sleep disturbance index (r = .444, p = .001), while the ESS and EBSS scores were not significantly correlated with the HFSQ. Similar analyses on the Pakistan sample is about to begin. Conclusion: These results suggest that the family sleep environment can significantly predict excessive daytime sleepiness in adolescents. Additionally, the HFSQ gains construct validity by its significant relationship to the PSQI total score (i.e., poor sleepers) and PSQI sleep disturbance index. Hopefully, the HFSQ will be translated and validated in numerous cultures since there is a need for large scale international collaboration on this all important health topic. The objective of this study was to examine the effects of parental conflict on the health-related quality of life in a sample of Spanish children between 8 and 12 years. Participants were 1111 children with a mean age of 10,13 years (SD=1,29), 50,3% boys and 49,7% girls. The level of parental conflict was assessed by a fivepoint scale, in which children estimated the current relationship between his/her parents as very good, good, fair, poor, very poor. Quality of life was evaluated using the Child Health and Illness Profile-Child Edition that examines the children perceived health in five dimensions: satisfaction (with self and health), comfort (emotional and physical symptoms and limitations), resilience (positive activities that promote health), risk avoidance (risky behaviors that influence future health) and achievement (social expectations in school and with peers). Results show a positive and significant relation in all dimensions, indicating that the more conflictive is the relationship between parents, the worse the quality of life (satisfaction: F=26.52, p=.00; comfort: F=8.44, Parents of children with chronic illness typically report higher stress relative to those of healthy children; however, general parenting stress measures may not capture their unique challenges. The Pediatric Inventory for Parents (PIP) was developed to assess parents' stress in caring for a child with an illness. However, the extant psychometric data for the PIP is limited and has not been adequately examined within a large sample of parents of children and adolescents. The current study more thoroughly explores the psychometric properties of the PIP in Type 1 diabetes (T1D). Participants included 430 primary caregivers of children and adolescents with T1D who had participated in various research studies at a mid-atlantic children's hospital. Child ages ranged from 2.16-17.06 years (SD=3.49); illness duration ranged from .30-13.64 years (SD=2.76). All participants completed the PIP, which provides total frequency and difficulty scores and four domain scores (Communication, Emotional Functioning, Medical Care, Role Function). A substantial subsample completed self-report measures of theoretically associated constructs, including parent anxiety, depression, and family allocation of diabetes management responsibility. The internal consistency estimates for the total score (α = .97), and Frequency (α = .93) and Difficulty domains (α = .95), were very good. For the four domains, internal consistency ranged from adequate to good (α = .74-.90). The overall validity of the PIP was promising, as Frequency and Difficulty scores were significantly correlated with parental anxiety (r=.34-.53, p<.01) and depression (r=.29-.45, p<.01) scores across all domains. Greater parental responsibility for diabetes care was positively correlated with lower medical care stress (r= -.19, p<.05) . These data support the PIP as a valid and reliable measurement of pediatric parenting stress for primary caregivers of children and adolescents with T1D, indicating its utility in quantifying parenting stress in clinical and research endeavors with families of children with T1D and other chronic illnesses. , p=.00; resilience: F=30.45, p=.00; achievement: F =16.39, p=.00; risk avoidance: F=13.77, p=.00). Post hoc comparisons showed that significant differences were found between children who perceived the relationship between parents very good and those that considered it as good, fair, poor and very poor. However, there were no significant differences between the other groups. The results highlight the importance of the child's perception of a good family atmosphere and the absence of parental conflict for optimal health-related quality of life. Background: Studies have shown that children and adolescents who somatize are at high risk for presenting with underlying psychosocial problems. Objective: To investigate the relationship between somatization symptoms and psychosocial problems in children and adolescents receiving treatment in a pediatric Emergency Department (ED). Method: Three-hundred and fiftyeight patients (48.6% male, 51.4% female) were recruited from the ED at Childrens Hospital Los Angeles. Patients ranged from 8 to 18 years of age (M=12.8, SD=2.9). Investigators conducted an anonymous, cross-sectional, multi-informant (child and caregiver) study. Pearson's product moment correlation coefficient was used to analyze relationships between somatization (pain/weakness, gastrointestinal, and pseudoneurological symptoms) and psychosocial problems (attention, internalizing, externalizing, and total psychosocial problems). Results: Pain/weakness symptoms were significantly correlated with attention (r=.292, p<.01), externalizing (r=.242, p<.001), internalizing (r=.383, p<.001), and total psychosocial problems (r=.452, p<.001). Gastrointestinal symptoms also had a significant positive correlation with attention (r=.304, p<.001), externalizing (r=.242, p<.001), internalizing (r =.383, p<.001), and total psychosocial problems (r =.452, p<.001). Pesudoneurological symptoms also had a positive significant relationship with attention (r=.357, p<.001), externalizing (r=.211, p<.001), internalizing (r=.408, p<.001), and total psychosocial problems (r=.455, p<.001). Conclusion: All measures of somatization were associated with psychosocial problems. This demonstrates the importance of screening children and adolescents for somatization symptoms. The pediatric ED can be a useful setting to screen for somatization in order to identify children and adolescent who need referral for mental health assessment and treatment. Objective: To assess parental attributions of internal locus of control of adolescent obesity as a predictor of Expressed Emotion (EE), specifically Criticism, in parents of obese adolescents. Background: EE is a measure of family attitudes and feelings towards a symptomatic family member. One theory regarding EE, particularly the criticism facet, is that it stems from attributions of internal control to the afflicted family member. Significant correlations between EE and misattributions have been found in a number of disorders including schizophrenia, anxiety disorders and learning disabilities suggesting that correcting misattributions may in turn modify levels of EE, a positive predictor of relapse rates and a negative predictor of treatment compliance. Methods: Thirty four parent-adolescent dyads participating in a treatment study targeting adolescent overweight and obesity at Mount Sinai School of Medicine and at the University of Chicago participated in this study. Parents completed the Family Questionnaire to assess EE, and the Multidimensional Health Locus of Control Scale to assess attributions of their child's obesity. Data were collected at baseline assessment. Results: Linear regression analyses with parental BMI as a covariate indicated that parental internal locus of control regarding adolescent obesity was significant (beta=−.417, p=.039) as a unique negative predictor of the criticism factor of EE. Discussion: Contrary to our hypothesis, increased attributions of obesity to a locus of control internal to the child were associated with reduced parental criticism. Though contradictory to literature on attributions and EE in other disorders and conditions, our findings are consistent with data on parental obesity indicating that overweight parents tend to be less alarmed regarding their overweight child. Notably, the majority (92.6%) of parents in our sample were overweight or obese. Given the concordance of overweight or obese status between parents and offspring in our are domains of particular vulnerability. There have also been several reports of lower visual-motor drawing ability among children with complex congenital heart disease. Multiple medical and surgical variables have been recognized as impacting neurodevelopmental outcome for these children. Very few studies have specifically examined neurodevelopmental outcome for children with ventricular septal defects (VSDs), which are among the most common congenital heart problems with a rate of approximately one out of 500 births. This population is generally expected to have excellent medical outcome and typical development. As part of a larger study examining mid-term neurodevelopmental outcome for children VSDs surgically repaired in infancy, visualmotor ability was assessed among 31 children ages 3 to 16 years with a commonly used graphomotor drawing task. Whereas many areas of cognitive functioning, including full-scale IQ (M=95.6, SD=15.3, p=.12) were comparable to the general population (M= 100, SD=15), visual-motor ability was an area of weakness (M= 87.9, SD=14.2, p<.001) . Additional results showed that household income and the presence of a comorbid medical condition were significant predictors of visual-motor ability. Specifically, lower income was associated with lower visual-motor scores (p=.007). The presence of a comorbid medical condition was also associated with lower visual-motor ability (p=.019). Twenty-two additional patient and surgical factors were also examined, with no other variables statistically related to visual-motor ability. This study shows that the weaknesses in visual-motor ability observed among children with more complex, cyanotic congenital heart disease are also found among children with repaired VSD. Furthermore, surgical factors do not appear to affect visualmotor ability among children with VSD. This research aimed to investigate aspects of body image, stress and what coping strategies are used by adolescents in a stressful situation that involves body discomfort. A sample of 166 girls and 47 boys, aged 15-18 years, was recruited from public high schools in Ribeirão Preto, state of São Paulo, Brazil. The main outcome measures used were Figure Rating Scale, Lipp Stress Symptoms Inventory and The Ways of Coping Questionnaire. Descriptive analyses were performed. Correlational analyses tested the associations of body image, stress and coping with sex and BMI. Logistic regression analyses were conducted for each of the 8 coping strategies. The confidence intervals used were 95%. The results revealed that both boys and girls were dissatisfied with their body size and the majority overestimated it. The exception was the overweight adolescents that had significantly negative body distortion. Girls showed more body distortion than boys. The correlation between body dissatisfaction and body distortion was negative and moderate (r=− .65). A large proportion (55,86%) of adolescents are found to have significant stress symptoms. A greater proportion of females (61,40%) than males (36,20%) are found to have stress. Adolescents with stress had more probability using confrontive coping (OR=3, 14) , distancing (OR=2,09), seeking social support (OR=3,33), self-controlling (OR=2,06), accepting responsibility (OR=4,40) and escape-avoidance (OR=3,17) in a situation that involves body discomfort. Girls significantly employed more self-controlling than boys. In conclusion, negative body image perception and stress were observed in the present sample. Adolescents with stress used more coping strategies. University of Tsukuba, Tsukuba, Japan and 2 Ibaraki University, Japan.