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ObjectiveTo determine the associations between Adverse Childhood Experiences (ACEs), adolescent screen time, and physical activity during the early COVID-19 pandemic.MethodsData (2016-2020) from the Adolescent Brain Cognitive Development (ABCD) study were analyzed. Linear regression analyses estimated associations between ACE score and screen time and physical activity in May 2020, adjusting for potential confounders.ResultsOf the 6749 adolescent respondents primarily aged 12-13, 81.6% reported a history of one ACE or more. In adjusted models, a higher ACE score was significantly associated with greater hours per day of screen time, with youth with ≥4 ACEs associated with 2.3 more hours of screen time per day compared to youth with 0 ACEs. In addition, the adjusted models found that a higher ACE score was associated with lower physical activity; youth with ≥4 ACEs averaged 0.8 fewer hours per week of physical activity and 0.5 fewer days per week of 60 minutes of physical activity compared to youth with 0 ACEs. Gender and race were also significantly associated with changes in screen time and physical activity.ConclusionsACEs are associated with higher adolescent sedentary behaviors, particularly greater screen time, during the early COVID-19 pandemic (May 2020). Clinicians caring for youth exposed to trauma in the postpandemic environment should explore screen time and physical activity behaviors.

Objective: To determine the prevalence and sociodemographic correlates of cyberbullying victimization and perpetration among a racially, ethnically and socioeconomically diverse population-based sample of 11–12-year-old early adolescents. Methods: We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2; N = 9429). Multiple logistic regression analyses were used to estimate associations between sociodemographic factors (sex, race/ethnicity, sexual orientation, country of birth, household income, parental education) and adolescent-reported cyberbullying victimization and perpetration. Results: In the overall sample, lifetime prevalence of cyberbullying victimization was 9.6%, with 65.8% occurring in the past 12 months, while lifetime prevalence of cyberbullying perpetration was 1.1%, with 59.8% occurring in the past 12 months. Boys reported higher odds of cyberbullying perpetration (AOR 1.71, 95% CI 1.01–2.92) but lower odds of cyberbullying victimization (AOR 0.80, 95% CI 0.68–0.94) than girls. Sexual minorities reported 2.83 higher odds of cyberbullying victimization (95% CI 1.69–4.75) than nonsexual minorities. Lower household income was associated with 1.64 (95% CI 1.34–2.00) higher odds of cyberbullying victimization than higher household income, however household income was not associated with cyberbullying perpetration. Total screen time, particularly on the internet and social media, was associated with both cyberbullying victimization and perpetration. Conclusions: Nearly one in 10 early adolescents reported cyberbullying victimization. Pediatricians, parents, teachers, and online platforms can provide education to support victims and prevent perpetration for early adolescents at the highest risk of cyberbullying.

This study aimed to describe the prevalence and sociodemographic characteristics of U.S. adolescents who engage in frequent muscle-building exercise. Data from the 2019 National Youth Risk Behavior Survey (N = 8474) were analyzed. Frequent muscle-building exercise in the past week (≥ 5 days and 7 days) were assessed. Multivariable logistic analyses were conducted separately by sex to obtain adjusted odds ratios and 95% confidence intervals for the association between key sociodemographic characteristics and muscle-building exercise. Nearly one in five (17.9%) boys, compared to 7.7% of girls, reported seven days of muscle-building exercise in the past week. Patterns of sociodemographic characteristics were associated with seven days of muscle-building exercise in the past week, including weight gain attempts among boys and Hispanic/Latina identity among girls. High engagement in muscle-building exercise is common among adolescents, particularly boys, and varied by sociodemographic characteristics, indicating a need for research to further describe engagement in muscle-building exercise among adolescents.

This study examined relationship status (e.g., single versus not single) and number of sexual partners in relation to muscularity- and disordered eating-related attitudes and behaviors among 1090 cisgender gay men enrolled in The PRIDE Study in 2018. Participants completed measures assessing muscle dysmorphia (MD) symptoms, disordered eating attitudes and behaviors, and appearance- and performance-enhancing drug or supplement (APEDS) use. In linear regression models adjusting for theoretically relevant covariates, neither relationship status nor number of past-month sexual partners was associated with disordered eating attitudes. In terms of MD symptoms, single (versus not single) relationship status was associated with greater appearance intolerance, and a greater number of sexual partners was associated with greater drive for size and functional impairment. In adjusted logistic regression models, a greater number of past-month sexual partners was associated with use of anabolic-androgenic steroids, synthetic performance-enhancing substances, protein supplements, and creatine supplements, as well as greater likelihood of engaging in compelled/driven exercise. Across all associations, effect sizes were generally small. Overall, results support that inquiring about sexual partners may have utility in evaluating risk for muscularity-oriented attitudes and behaviors among cisgender gay men. Future work will need to replicate these findings, particularly in more diverse samples.

Objectification theory and the tripartite influence model provide useful frameworks for understanding the body image experiences of men and women. However, there is little systematic investigation of how sexual orientation moderates the links between these constructs and body image satisfaction. It has been hypothesized, for example, that the associations of surveillance (i.e., monitoring of one's appearance due to objectification by others) would be strongest for groups targeted by the male gaze (e.g., gay men, lesbian women, and bisexual men and women). Here we proposed an integrated sociocultural model and examined these pathways in multigroup structural equation models in a national sample of heterosexual, bisexual, and lesbian women (ns = 5395; 598; 213, respectively), and heterosexual, bisexual, and gay men (4869; 194; and 194, respectively) aged 18-65 years. Sexual orientation moderated some of these pathways. The most consistent pattern was that appearance pressures were internalized to a greater extent among bisexual participants. The pathways to poorer body image were generally similar among heterosexual and gay/lesbian men and women. These findings highlight the importance of examining sexual orientation-specific influences on body image across diverse groups, as well as the commonalities in the experiences of men and women across sexual orientations.

Despite high levels of body dissatisfaction and an increasing drive for muscularity among Brazilian women, most of the existing literature on muscle dysmorphia focuses on men and has mainly been conducted in Western and English-speaking regions. As a result, one of the most widely used assessment tools for symptoms of the disorder, the Muscle Dysmorphic Disorder Inventory (MDDI), has not yet been evaluated in Brazilian women-an at-risk population. In the present study, we perform a psychometric evaluation of the Brazilian Portuguese translation of the MDDI in a sample of 515 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach, which supported the original three-factor structure of the measure. Additionally, we found good internal consistency, convergent validity, and test-retest reliability of the measure. Collectively, these results support the use of the measure in Brazilian women and provide a foundation to expand the literature in this population.

The prevalence of eating disorders (EDs) in young children remains relatively unknown. Here, we aimed to assess the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), binge ED (BED), and their subclinical derivatives, among 10- to 11-year-old children in the United States.Cross-sectional data from the year 1 sample of the nationwide Adolescent Cognitive Brain Development study were extracted, and unadjusted prevalence of EDs was reported, as per DSM-5 criteria.Among 10- to 11-year-old children in the United States, no cases of AN were reported. The prevalence of BN was negligible, whereas the prevalence of BED was 1.1%. The prevalence of subclinical AN, BN, and BED was 6%, 0.2%, and 0.5%, respectively.BED is the most prevalent ED subtype among preadolescent children in the United States, although subclinical markers for all ED subtypes are evident in this age range.

Purpose The current study investigates the association between maternal adverse childhood experiences (ACEs) and having an unwanted (i.e., a pregnancy that was undesired) or mistimed pregnancy (i.e., a pregnancy that occurred sooner than wanted). Methods Data are from the 2018 North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS) (N = 1897). Multinomial logistic regression analyses are used to assess the association between levels of ACE exposure and having an unwanted or mistimed pregnancy relative to an intended pregnancy. Results Findings demonstrated that women with three ACEs (Relative Risk Ratio [RRR] = 2.157, 95% confidence interval [CI], 1.121–4.151) and four or more ACEs (RRR = 1.836, 95% CI, 1.181–2.854) had approximately twice the relative risk of having an unwanted pregnancy (vs. an intended pregnancy) compared to women with 0 ACEs. There was no association between ACEs and reporting a mistimed pregnancy. Conclusions These findings add to a burgeoning literature detailing how accumulating ACEs can create challenges for family planning by increasing the likelihood of having an unintended pregnancy. Study results suggest the need to devote greater resources to the prevention of ACEs and unintended pregnancies.

Purpose Young adults have the highest cumulative incidence of COVID-19 infection in the country. Using March 2021 Household Pulse Survey data, an ongoing, cross-sectional nationally representative survey, we examined U.S. young adult intention to accept COVID-19 vaccines. Methods Young adult (ages 18–25 years) Household Pulse Survey participants were queried on intention to receive a COVID-19 vaccine and related perspectives (N = 5,082). Results Most unvaccinated respondents (76%) indicated an intention to become vaccinated. The most frequently cited reasons for potentially rejecting vaccination included desire to wait and see if the vaccine is safe (56%); concerns over side effects (53%); and believing others are in greater need of the vaccine (44%). Conclusions With 24% of young adults hesitant to accept a COVID-19 vaccine, public health interventions should target reasons for hesitancy, address concerns about safety and side effects, and underscore the importance of vaccinations for this population.

Introduction The optimum physical activity dose to achieve during young adulthood to prevent hypertension using the 2017 American College of Cardiology/American Heart Association guidelines remains undefined. This study aims to determine the association between level and change in physical activity through the adult life course and the onset of hypertension using these 2017 definitions. Methods In 2020, prospective community-based cohort data of 5,115 Coronary Artery Risk Development in Young Adults study participants were analyzed. The cohort included Black and White men and women aged 18–30 years at baseline (1985–1986) at 4 urban sites, collected through 30 years of follow-up (2015–2016). Individualized physical activity trajectories were developed for each participant using linear mixed models. Results Black women reported the lowest physical activity levels from young adulthood through middle age. Lower physical activity score (per 100 units) at age 18 years was associated with 4% (95% CI=1%, 7%, p=0.002) higher odds of hypertension incidence. Each additional 1-unit reduction per year in physical activity score was associated with 2% (95% CI=1%, 3%, p=0.001) higher annual odds of hypertension incidence. Meeting approximately the current minimum physical activity guideline levels at age 18 years and through follow-up was not protective of hypertension incidence; however, meeting approximately twice the current minimum physical activity guideline level at age 18 years and through follow-up was protective of hypertension incidence. Conclusions Moderate physical activity levels may need to exceed current minimum guidelines to prevent hypertension onset using 2017 American College of Cardiology/American Heart Association definitions.

Muscularity dissatisfaction is documented to be a pervasive phenomenon among men. While previous studies have examined theoretically relevant predictors of muscularity dissatisfaction, such as adherence to traditional masculine norms, to the best of our knowledge we are not aware of empirical research that has assessed how perceived discrepancies in one's level of masculinity may also be associated with these concerns. Therefore, the objective of this study was to determine whether perceived deficits in masculinity bear predictive utility over and above adherence to traditional masculine norms in the context of muscularity dissatisfaction. An online survey that included measures assessing the aforementioned constructs was completed by 390 university and community adult men. A hierarchical regression analysis showed that while adherence to masculine norms was associated with increased muscularity dissatisfaction, masculine role discrepancy (and attendant stress) were particularly strong predictors of muscularity dissatisfaction. Our findings make a novel contribution to the male body image literature by demonstrating the relative importance of perceived discrepancies in masculinity, and related stress, in the context of muscularity dissatisfaction. Pending replication in relevant clinical samples using prospective designs, this study provides preliminary evidence that masculine role discrepancies may be promising targets to help allay muscularity concerns among men.

Purpose The aim of the study was to determine the association between food insecurity, mental health, and sleep outcomes among young adults. Young adulthood represents an important developmental period when educational and economic transitions may increase the risk for food insecurity; however, little is known about associations between food insecurity and health outcomes in this period. Methods Cross-sectional nationally representative data of U.S. young adults aged 24–32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2018. Multiple logistic regression analysis was conducted with food insecurity as the independent variable and self-reported mental health (depression, anxiety, and suicidality) and sleep (trouble falling and staying asleep) outcomes as the dependent variables. Results Of the 14,786 young adults in the sample, 11% were food insecure. Food-insecure young adults had greater odds of mental health problems including a depression diagnosis (1.67, 95% confidence interval [CI] 1.39–2.01), anxiety or panic disorder diagnosis (1.47, 95% CI 1.16–1.87), and suicidal ideation in the past 12 months (2.76, 95% CI 2.14–3.55). Food insecurity was also associated with poorer sleep outcomes including trouble falling (adjusted odds ratio 1.78, 95% CI 1.52–2.08) and staying (adjusted odds ratio 1.67, 95% CI 1.42–1.97) asleep. Conclusions Food insecurity is associated with poorer mental and sleep health in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should test interventions to simultaneously combat food insecurity and mental health problems in young adulthood.

Adverse childhood experiences (ACEs) negatively impact health over the life-course. Yet, compared to the robust literature on the consequences for ACEs for health, substantially fewer studies assess the implications of exposure to ACEs for health insurance status and health care utilization in adulthood.To assess the association between accumulating ACEs and (1) an individual's health insurance status, and (2) usual source of care, as well as examine the mediating role of adult socioeconomic status.Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 8,757). Multinomial logistic regression is used to assess the relationship between ACEs and health insurance status and the usual source of care.Net of control and mediating variables, accumulating exposure to ACEs -particularly four or more ACEs- is associated with a higher likelihood of being uninsured and utilizing the emergency room as the usual source of care. Adult socioeconomic status including educational attainment, household income, employment status, and being uninsured-in the case of usual source of care-substantially mediates these associations.ACEs carry negative repercussions for health insurance and patterns of healthcare utilization that spans into adulthood, and this is largely driven by poor adult socioeconomic status.

Summary Background We constructed measures of an individual's gendered behaviour and their gendered environment to investigate the salience of gender norms during adolescence for social mobility during the next decade of life. Methods In this nationally representative observational study, we collected individual-level data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), which enrolled a cohort of nationally representative school students aged 11–19 years from across the USA and followed them up for 14 years (ie, to age 25–33 years). We characterised gendered behaviour for adolescents in a performative sense via self-reports of behaviours and beliefs. We aggregated this individual-level measure to create a proxy measure of an individual's social context by taking averages for an individual's peers of the same sex and school year. Findings Between Jan 5, 1994, and Dec 26, 1995, Add Health collected data on a cohort of 20 745 students. 14 540 respondents were followed-up 14 years later between April 3, 2007, and Feb 1, 2009, of whom 7722 (53·1%) were female. More masculine male respondents were downwardly mobile; they were enrolled in school for fewer years and were more likely to have lower status jobs than their less masculine same-sex school peers. More masculine male respondents were also more likely to have jobs in occupational categories with larger proportions of males than their same-sex school peers. Gendered behaviour was not predictive of future educational and occupational attainment for female respondents. Male adolescents in school years with more masculine same-sex peers than male adolescents in other school years also tended to have lower educational and occupational attainment than their male peers. Educational and occupational attainment in early midlife for female respondents was not affected by their gendered environment. Interpretation Gender, when measured as a set of gender-distinct behaviours in adolescence, was associated with differential patterns of social mobility from adolescence to young adulthood. Moreover, variation in an individual's local gender norms has implications for subsequent socioeconomic attainment, especially for male adolescents. These findings have potential implications for observed health disparities. Funding Bill & Melinda Gates Foundation.

Despite global commitments to achieving gender equality and improving health and wellbeing for all, quantitative data and methods to precisely estimate the effect of gender norms on health inequities are underdeveloped. Nonetheless, existing global, national, and subnational data provide some key opportunities for testing associations between gender norms and health. Using innovative approaches to analysing proxies for gender norms, we generated evidence that gender norms impact the health of women and men across life stages, health sectors, and world regions. Six case studies showed that: (1) gender norms are complex and can intersect with other social factors to impact health over the life course; (2) early gender-normative influences by parents and peers can have multiple and differing health consequences for girls and boys; (3) non-conformity with, and transgression of, gender norms can be harmful to health, particularly when they trigger negative sanctions; and (4) the impact of gender norms on health can be context-specific, demanding care when designing effective gender-transformative health policies and programmes. Limitations of survey-based data are described that resulted in missed opportunities for investigating certain populations and domains. Recommendations for optimising and advancing research on the health impacts of gender norms are made.

INTRODUCTION: During the COVID-19 pandemic, the rates of food insecurity and mental illness have been projected to increase in the U.S. owing to significant social and economic disruption. This study aims to estimate the prevalence of food insufficiency (often the most extreme form of food insecurity), the correlates of food insufficiency, and the associations between food insufficiency and symptoms of poor mental health in the U.S. during the COVID-19 pandemic. METHODS: Cross-sectional data from 63,674 participants of the U.S. Census Household Pulse Survey were collected and analyzed in 2020. Multiple Poisson regression models were used to estimate associations with food insufficiency. RESULTS: Food insufficiency rose from 8.1% to 10.0% from March to June 2020. Factors associated with food insufficiency included lower age, Black/African American or Latinx race/ethnicity, being unmarried, larger household size, recent employment loss, income below the federal poverty line, and lower education (all p

This study aimed to evaluate adolescents' moderate-to-vigorous intensity physical activity (MVPA) during the COVID-19 pandemic with regards to sociodemographic characteristics and determine mental health and resiliency factors associated with MVPA among a diverse national sample of adolescents ages 10-14 years. Data were collected during the pandemic in May 2020 from the Adolescent Brain Cognitive Development Study (ABCD, N = 5,153), a national prospective cohort study in the U.S. MVPA was quantified as the product of reported duration and frequency (hours per week), which was further summarized as the proportion meeting age-appropriate 2018 Physical Activity Guidelines for Americans. A similar estimate was generated using MVPA data collected prior to the pandemic. Mental health and resiliency measures were collected during the pandemic. Regression models examined associations between mental health or resiliency measures and MVPA during the pandemic. Median MVPA was 2 h per week (IQR 0, 6). Overall, the percentage of the cohort meeting MVPA guidelines decreased from 16.1% (pre-pandemic) to 8.9% (during the pandemic). Racial/ethnic minority adolescents and adolescents from lower socioeconomic backgrounds were significantly less likely to meet MVPA guidelines during the pandemic. Poorer mental health, COVID-related worry, and stress were associated with lower MVPA, while more social support and coping behaviors were associated with higher MVPA during the pandemic. In this large, national sample of adolescents, the proportion of those meeting MVPA Guidelines was lower during the COVID-19 pandemic, with significant disparities by race/ethnicity and socioeconomic status. Interventions to promote social support and coping behaviors may improve MVPA levels among adolescents during the pandemic.

Appearance and performance-enhancing drugs and supplements (APEDS) are used to enhance muscle growth, athletic performance, and physical appearance. The aim of this study was to examine the lifetime use of APEDS and associations with eating disorder and muscle dysmorphia symptoms among cisgender sexual minority people.Participants were cisgender sexual minority people (1090 gay men, 100 bisexual plus men, 564 lesbian women, and 507 bisexual plus women) recruited from The PRIDE Study in 2018 who reported lifetime APEDS use and completed the Eating Disorder Examination-Questionnaire (EDE-Q) and the Muscle Dysmorphic Disorder Inventory (MDDI). Regression analyses stratified by gender and sexual orientation examined associations of any APEDS use with EDE-Q and MDDI scores.Lifetime APEDS use was common across the four groups of cisgender sexual minority people (44% of gay men, 42% of bisexual plus men, 29% of lesbian women, and 30% of bisexual plus women). Protein supplements and creatine supplements were the most commonly used APEDS. Any APEDS use was associated with higher EDE-Q scores on one or more subscales in all sexual minority groups. Further, any APEDS use was associated with higher MDDI Total Scores in all groups; any APEDS use was associated with all MDDI subscale scores in cisgender gay men only.APEDS use is common and associated with eating disorder and muscle dysmorphia symptoms in sexual minority men and women, thus highlighting the importance of assessing for these behaviors and symptoms among these populations in clinical settings.

Rationale. Prior research has found adverse childhood experiences (ACEs) to be a risk factor for disability in adulthood. Moreover, accumulating evidence highlights that both ACEs and disability during pregnancy are a risk factor for both maternal and infant wellbeing. Yet, no previous work has assessed whether ACEs increase the risk of maternal disability. Objective The current study assesses the link between maternal ACE exposure and disability. Methods Data are from the North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS), 2019 (N = 1775). Logistic regression was used to assess the relationship between accumulating ACEs and maternal disability. Results Mothers with exposure to a greater number of ACE—notably, 4 or more ACEs— had elevated rates of several disabilities including difficulty communicating, difficulty remembering, difficulty seeing, and difficulty walking. Conclusions Understanding the long-term health repercussions of ACEs for pregnant women and mothers is important to help inform the design and implementation of health care interventions. This study can be used to better understand the prevalence of disabilities among mothers and corroborate early life experiences as an important risk factor for disability.

The recognition of eating disorders (EDs) in males represents an ongoing challenge for physicians. This challenge is particularly complex in the case of EDs that are oriented toward muscularity, as opposed to thinness, which current diagnostic criteria do not accommodate. Nevertheless, EDs in males, and muscularity-oriented disordered eating (MODE) in particular, are increasingly prevalent and are likely to be encountered in clinical practice. We report the case of a 16-year-old male who presented with medical instability, requiring hospitalization, in the context of MODE. Importantly, this patient did not meet formal diagnostic criteria for a specific ED, and behavioral symptoms were deemed goal oriented in the context of high school wrestling pursuits. This case highlights the challenges of identifying MODE and the medical risks associated therein. Pediatricians are encouraged to screen for MODE in adolescent males reporting body image concerns.

Applying a symbolic interactionist and minority stress framework, we examine how self-perceived gender expression and everyday discrimination contributes to gender disparities in mental health using a sample of 5896 cisgender women and 4433 cisgender men from Wave 1 (ages 11–18) and Wave 5 (ages 33–43) of the National Longitudinal Study of Adolescent to Adult Health (Add Health). We estimate Poisson regression to assess counts of depressive symptoms, and logistic regression to assess odds of suicidality, as a function of self-perceived gender expression, experiences of discrimination, and other established correlates of poor mental health outcomes. We then utilize generalized structural equation models to test whether self-perceived gender expression mediates the relationship between discrimination and mental health. Results suggest women report more variation in their perceived gender expression than men. Higher levels of perceived gender expression nonconformity are associated with depressive symptoms for men and women, even when accounting for experiences of discrimination. In addition, elevated discrimination is associated with increased depressive symptoms and higher odds of suicidality. Mediation analyses suggest that discrimination works directly and indirectly through self-perceived gender expression to shape mental health outcomes. This study contributes to a more nuanced understanding of the association between gender and mental health.

Historically, male presentations of eating disorders (EDs) have been perceived as rare and atypical - a perception that has resulted in the systematic underrepresentation of males in ED research. This underrepresentation has profoundly impacted clinical practice with male patients, in which i) stigmatization and treatment non-engagement are more likely, ii) a distinct array of medical complexities are faced, and iii) symptom presentations differ markedly from female presentations. Further, the marginalization of males from ED research has hindered the assessment and clinical management of these presentations. This critical review provides an overview of the history of male EDs and synthesizes current evidence relating to the unique characteristics of male presentations across the diagnostic spectrum of disordered eating. Further, the emerging body of evidence relating to muscularity-oriented eating is synthesized in relation to the existing nosological framework of EDs. The impact of marginalizing male ED patients is discussed, in light of findings from epidemiological studies suggesting that clinicians will be increasingly likely to see males with ED in their practices. It is suggested that changes to current conceptualizations of ED pathology that better accommodation male ED presentations are needed.

Background Research has documented an association between anabolic-androgenic steroid (AAS) use and criminal offending. Still, whether legal performance-enhancing substance (e.g., creatine; PES) use is similarly associated with criminal offending is unknown. The aim of the present study was to determine the prospective associations between legal PES use and AAS use and criminal offending among U.S. adults. Methods Data from three waves over 15 years of the National Longitudinal Study of Adolescent to Adult Health, a prospective cohort study, were analyzed. Legal PES use and AAS use were assessed at Wave III (ages 18−26) and criminal offending was assessed at Wave IV (ages 24−32; N = 10,861) and Wave V (ages 33–43; N = 9,451). Criminal offending was measured using a summed score of six items (range 0–6). Multiple negative binominal regressions were conducted, transformed to incident rate ratios (IRR), adjusting for biological sex, age, race/ethnicity, household income, body mass index, depression, smoking, alcohol, and prior victimization and offending. Main Findings Among the sample (51.3 % male; 68.8 % White), legal PES use (Wave IV: IRR 1.46, 95 % confidence interval [CI] 1.15−1.85; Wave V: IRR 1.52, 95 % CI 1.02−2.27) and AAS use (Wave IV: IRR 1.73, 95 % CI 1.09−2.76; Wave V: IRR 2.36, 95 % CI 1.33−4.19) were prospectively associated with criminal offending during young and middle adulthood, while adjusting for demographic and behavioral factors. Conclusions These results confirm and expand upon prior research by describing the prospective associations between both legal PES use and AAS use and criminal offending among a nationally representative sample of U.S. adults.