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With a novel multilingual approach, this cross-cultural meta-analysis study investigated the associations between personality traits and Internet addiction. Articles were identified and retrieved by searching through general and language-specific databases, and thereafter reviewed for inclusion based on the selection criteria. Random effects models with the Hartung-Knapp-Sidik-Jonkman method were used to examine the associations of Internet addiction with seven personality traits: Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism, Psychoticism, and Lie (OCEAN-PL). Forest plots with summary statistics were produced to inspect the between-study heterogeneity. Subgroup analysis was performed to further determine the contributions of moderators (geographic region, population subgroup, scales for assessing personality traits and Internet addiction, and language of publication) to the observed between-study heterogeneity. Funnel plots and Egger's test were used to detect possible small-study effects. A sample of 34,438 participants from 37 studies (24 from Asia) were included for data analysis. The major languages of publications of the selected articles were English and Asian languages. According to the pooled results, Internet addiction was associated positively with Neuroticism and Psychoticism, but negatively with Conscientiousness, Extraversion, Agreeableness, and Lie. Geographic region and language of publication significantly moderated the associations of Internet addiction with Agreeableness and Neuroticism, and Openness and Extraversion, respectively. No significant small-study effect was present for all OCEAN-PL personality traits, except Neuroticism. In conclusion, the Internet addiction group is relatively more neurotic and psychotic, and less conscientious, extraverted, agreeable, and untruthful than the nonaddiction group. A multilingual approach is useful for improving the search strategies for systematic reviews, cross-cultural meta-analyses in particular.

This study aims to provide a systematic review of the applications of machine learning methods in addiction research. In this study, multiple searches on MEDLINE, Embase and the Cochrane Database of Systematic Reviews were performed. 23 full-text articles were assessed and 17 articles met the inclusion criteria for the final review. The selected studies covered mainly substance addiction (N = 14, 82.4%), including smoking (N = 4), alcohol drinking (N = 3), as well as uses of cocaine (N = 4), opioids (N = 1), and multiple substances (N = 2). Other studies were non-substance addiction (N = 3, 17.6%), including gambling (N = 2) and internet gaming (N = 1). There were eight cross-sectional, seven cohort, one non-randomized controlled, and one crossover trial studies. Majority of the studies employed supervised learning (N = 13), and others employed unsupervised learning (N = 2) and reinforcement learning (N = 2). Among the supervised learning studies, five studies used ensemble learning methods or multiple algorithm comparisons, six used regression, and two used classification. The two included reinforcement learning studies used the direct methods. These results suggest that machine learning methods, particularly supervised learning are increasingly used in addiction psychiatry for informing medical decisions.

This study investigated the measurement equivalence of the Internet Addiction Test-Revised (IAT-R) among university students. In the Asian College Health Assessment (ACHA), 200 Japanese and 348 Filipino university students completed a survey in 2016-2017 school year. Multiple-group confirmatory factor analysis was performed to examine the three hierarchical levels (configural, metric, and scalar) of measurement invariance. A first-order three-factor model with three domains, namely "Excessive Use, Lack of Control, and Neglect Work," "Anticipation and Salient," and "Neglect Social Life," emerged. The fit indices were 0.958 for comparative fit index (CFI) and 0.025 (0.017-0.034) for root mean square error of approximation (RMSEA) (confidence interval [90% CI]) in Japanese sample; and 0.962 for CFI and 0.068 (0.053-0.088) for RMSEA (90% CI) in Filipino sample. All three levels of measurement invariance between the two samples were established, with ΔCFI and ΔRMSEA not exceeding -0.01 and 0.015, respectively, for each increasing stringent level. The results indicated the measurement equivalence of IAT-R for assessing Internet addiction risks across cultural groups.

This study developed and investigated the differential item functioning (DIF) of the Internet Addiction Test-Revised (IAT-R) with an item response theory approach. In the Asian College Health Assessment (ACHA), 1,072 university students completed a survey in 2016-2017 school year. Confirmatory factor analysis models with robust maximum likelihood and diagonal weighted least square estimation methods were used to evaluate the construct validity of the 20-item IAT-R. Graded response model was used to produce categorical characteristic curves (CCCs), test characteristic curves (TCCs), item information function (IIF) curves, and test information function (TIF) curves for detecting DIF of the polytomous responses. Furthermore, DIF between genders was examined by ordinal logistic regression and Monte Carlo simulations. A first-order three-factor model was the most parsimonious model with normed fit index (NFI) of 0.915, non-normed fit index (NNFI) of 0.927, comparative fit index (CFI) of 0.937, and root mean square error of approximation (RMSEA) of 0.050. The emerged factors included Excessive Use and Neglect Work, Anticipation and Lack of Control, as well as Neglect Social Life and Salience. CCCs, TCCs, IIFs, and TIFs showed that all items were sensitive at moderate-to-high trait values. No nonuniform scale-level DIF relating to gender was determined. Under no DIF, the thresholds for proportional beta change exhibited a fairly steady trend (below 0.10) across items. In conclusion, IAT-R is a valid measurement scale of Internet addiction with measurement equivalence between genders being established.

Objective This study examined the mediating role of internet addiction in the association between psychological resilience and depressive symptoms. Methods 837 Korean university students completed a survey with items of demographic information, Connor-Davidson Resilience Scale (CD-RISC), Internet Addiction Test (IAT), and Patient Health Questionnaire (PHQ-9) in 2015. The complex associations among psychological resilience, internet addiction, and depressive symptoms were delineated using structural equation models. Results In the most parsimonious model, the total effect and indirect effect of resilience on depressive symptoms via internet addiction, were statistically significant. The goodness of fit of the measurement model was satisfactory with fit indices, normed fit index (NFI) of 0.990, non-normed fit index (NNFI) of 0.997, comparative fit index (CFI) of 0.998, root mean square error (RMSEA) of 0.018 (90%CI=0.001–0.034); and Akaike Information Criterion (AIC) of -21.049. Conclusion The association between psychological resilience and depressive symptoms was mediated by internet addiction in Korean university students. Enhancement of resilience programs could help prevent internet addiction and reduce the related depression risks.

Few population-based studies have used an econometric approach to understand the association between two cancer risk factors, obesity and stress. This study investigated sociodemographic differences in the association between obesity and stress among Korean adults (6,546 men and 8,473 women). Data were drawn from the Korean National Health and Nutrition Examination Survey for 2008, 2009, and 2010. Ordered logistic regression models and propensity score matching methods were used to examine the associations between obesity and stress, stratified by gender and age groups. In women, the stress level of the obese group was found to be 27.6% higher than the nonobese group in the ordered logistic regression; the obesity effect on stress was statistically significant in the propensity score-matched analysis. Corresponding evidence for the effect of obesity on stress was lacking among men. Participants who were young, well-educated, and working were more likely to report stress. In Korea, obesity causes stress in women but not in men. Young women are susceptible to a disproportionate level of stress. More cancer prevention programs targeting young and obese women are encouraged in developed Asian countries.

Internet addiction has become a serious behavioral health problem in Asia. However, there are no up-to-date country comparisons. The Asian Adolescent Risk Behavior Survey (AARBS) screens and compares the prevalence of Internet behaviors and addiction in adolescents in six Asian countries. A total of 5,366 adolescents aged 12-18 years were recruited from six Asian countries: China, Hong Kong, Japan, South Korea, Malaysia, and the Philippines. Participants completed a structured questionnaire on their Internet use in the 2012-2013 school year. Internet addiction was assessed using the Internet Addiction Test (IAT) and the Revised Chen Internet Addiction Scale (CIAS-R). The variations in Internet behaviors and addiction across countries were examined. The overall prevalence of smartphone ownership is 62%, ranging from 41% in China to 84% in South Korea. Moreover, participation in online gaming ranges from 11% in China to 39% in Japan. Hong Kong has the highest number of adolescents reporting daily or above Internet use (68%). Internet addiction is highest in the Philippines, according to both the IAT (5%) and the CIAS-R (21%). Internet addictive behavior is common among adolescents in Asian countries. Problematic Internet use is prevalent and characterized by risky cyberbehaviors.

Smoking raises the risk of cardiovascular diseases in active and passive smokers throughout life. Taking a life-course approach, we reviewed current literature on the familial and lifestyle factors of smoking initiation and cessation. Single-parent and parental smoking are risk factors of smoking in young people, while smoking cessation of parents and family support predict quitting in both young and adult smokers. Results on the familial influences on relapses are limited and mixed in adolescents and adults. Regarding behavioral factors, poor eating habits and alcohol drinking would increase, and a high physical activity level would decrease, the likelihood of smoking in both adolescents and adults. Nutritional status of children improves with parental smoking cessation. In addition, disordered eating may hinder smoking cessation in women. Familial and behavioral factors interplay in their associations with smoking initiation and cessation in the life-course, which warranted further investigations for formulating better smoking prevention and cessation programs.

Overdosing is an accessible method adopted by people attempting suicide in city settings.This study aimed to compare the trends and characteristics of people attempting suicide by drug overdose and by other methods in Singapore.This study examined the medical records of 628 patients who were admitted to a university hospital in Singapore, between January 2004 and December 2006. Patients were classified as overdose and non-overdose persons attempting suicide for comparisons of demographic and suicidal characteristics. Logistic regression was used to determine the odds ratios of various factors associated with self-perceived lethality of the suicide attempt. Patterns of monthly and weekly variations in the frequencies of suicide attempts were also analyzed.The percentages of Chinese people was higher in the non-overdose group (71.5% vs. 62.9%), while the percentages of Malay and Indian people were higher in the overdose group (31.6% vs. 18.5%). The female gender (OR=0.36, p=0.04) and admission of suicide intention (OR=7.11, p0.001) were significantly associated with higher perceived lethality of the suicide method in the non-overdose group. Suicide attempts occurred more frequently between May and November, and on Tuesdays.Gender and ethnic differences between overdose and non-overdose people attempting suicide were found. Temporal variations of suicidal cases were also noted.

Depressive disorder is treatable but costly, thus influencing quality of life of people.Determine direct and indirect costs incurred by depressive disorder in Singapore.A 1-year prospective naturalistic study was conducted in a university mood disorder center between 2007 and 2008. Patients with primary International Classification of Disease-10 diagnosis of depressive disorder were recruited. Disease costs between mild, moderate and severe depression, and cost predictors were analyzed and determined.Forty nine patients completed the study. Mean annual total costs per patient were US$7638. Indirect costs (81%) dominated the total costs. Approximately 50% of indirect costs were associated with loss of productivity and unemployment. Higher education level, higher mean Hamilton Rating Scale for Depression score and number of suicide attempts were independent variables associated with increased direct costs while mean Hamilton Rating Scale for Depression scale score was an independent variable for indirect costs.Medical cost saving strategies should focus on indirect costs.

Objective This study examined the psychometric properties of the Young’s Internet Addiction Test (IAT) in 844 Hong Kong Chinese adolescents (37.7% boys) with mean age of 15.9 (standard deviation ¼ 3.5) years. Methods Demographic items, Internet use habits, IAT, and the Revised Chen Internet Addiction Scale (CIAS-R) were administered. 3 percent of the participants were classified as addicted and 31.6% as occasional problematic Internet users. Confirmatory factor analysis results indicated that the 18-item second-order three-factor model has the best fit with our data (Satorra–Bentler scaled w 2 ¼ 160.56, df ¼ 132, p < .05, normed fit index ¼ 0.95, non-normed fit index ¼ 0.99, comparative fit index ¼ 0.99, root mean square error of approximation ¼ 0.02). Results IAT demonstrated strong internal consistency (Cronbach’s a ¼ .93). Satisfactory concurrent and convergent validity of IAT were found moderately correlated with CIAS-R (r ¼ .46) and the average online time per day (r ¼ .40 for weekdays; r ¼ .37 for weekends). Conclusion IAT has evidence of being a valid and reliable scale for screening Internet addiction in Chinese adolescents.

This study investigates the associations between percentage body fat (%BF) and anthropometric parameters in adolescents of mixed weight status. Anthropometric parameters including height, weight, and waist circumference (WC), and %BF were assessed in 903 Hong Kong Chinese students (mean age 14.7 years). The calculated body mass index (BMI) and waist-to-stature ratio (WSR) were used to classify students into different weight status groups and central obesity groups, respectively. The %BF/BMI and %BF/WC relationships were examined by partial correlation coefficients and linear regression models. The %BF correlated significantly with BMI, except in underweight boys. BMI predicted %BF better (adjusted R (2): 0.40 in boys; 0.85 in girls) than WC (adjusted R (2): 0.34 in boys; 0.63 in girls) or WSR (adjusted R (2): 0.33 in boys; 0.60 in girls). In general, BMI predicts %BF better than WC or WSR in Hong Kong adolescents, but these relationships are sex and weight status specific.

This study compared the nutritional status before pregnancy, as well as dietary profiles and biomarkers during first trimester, between never-smokers and antenatal quitters among Japanese women. One hundred fifty pregnant women (79 never-smokers and 71 antenatal quitters) from two obstetrics and gynecology clinics were recruited in Japan. Subjects' prepregnancy nutritional status was indicated by their body mass index (BMI). In the first trimester, their dietary profiles were assessed by the Brief Diet-History Questionnaire (BDHQ) and pregnancy outcomes were screened by biomarker tests. Generalized linear regression was used to examine the differences of energy-adjusted dietary intakes and biomarker results between the two smoking groups, with adjustment of maternal age, BMI, gestation week, and parity. The results showed that antenatal quitters were more likely to have a prepregnancy underweight status than never-smokers. During the first trimester, antenatal quitters had significantly higher intakes of unsaturated fatty acids and antioxidants (vegetable lipids and isoflavone), and lower intakes of total cholesterol than never-smokers. Moreover, antenatal quitters had a significantly higher level of serum homocysteine (6.36 nmol/mL vs 4.88 nmol/mL) than never-smokers. In conclusion, antenatal quitters are more likely to have a poor nutritional status before pregnancy than never-smokers. Quitting smoking before pregnancy and having a good nutritional profile during the trimester may not sufficiently reverse the adverse effects of former smoking behaviors on pregnancy outcomes.

BACKGROUND: Sleep problems may have different influences on students' academic performance. We investigated the prevalence of sleep patterns, naps, and sleep disorders, and their associations with academic performance in Hong Kong adolescents. METHODS: In 2007-2008, 22,678 students aged 12-18 (41.6% boys) completed a questionnaire on sociodemographic characteristics, sleep patterns and problems, and lifestyle factors including exercise, smoking, alcohol drinking, and academic performance. RESULTS: The prevalence of having >8 hours of sleep was higher on holiday nights (86.4%) than on school-day nights (27.4%). Sleeping after midnight was more common before holidays (49.3%) than before school days (19.9%). Symptoms of insomnia and obstructive sleep apnea (OSA) were reported by 21.5% and 34.4% of students. Having >2 hours of weekend sleep delay was associated with poor academic performance with an odds ratio (OR) (95% confidence interval) of 1.46 (1.29-1.65). However, having 1-2 hours and >2 hours of weekend wake-up delay were both associated with less likelihood of poor academic performance with ORs of 0.64 (0.56-0.73) and 0.69 (0.59-0.80). Other factors associated with poor academic performance included >2 hours of sleep debt, OR of 1.17 (1.03-1.33); having any insomnia symptoms in the past 30 days, OR of 1.27 (1.17-1.37); and having any OSA symptoms at least weekly, OR of 1.23 (1.14-1.32). Napping in the past 5 school days was only marginally associated with poor school performance with an OR of 1.08 (1.00-1.16). CONCLUSION: Poorer academic performance was associated with sleep debt, and symptoms of insomnia and OSA. Sleep compensation but not naps may be a protective factor of poor academic performance.

It remains unclear whether anxiety and depressive symptoms are more prevalent in adolescents with asthma when compared with healthy individuals. This meta-analysis aimed to evaluate the difference in the aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls and to explore the underlying moderators that potentially explain the heterogeneity of the effect size. A meta-analysis of published work was performed using the random effects model. The differences in aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls were determined. Meta-regression and subgroup analysis were performed to identify factors that may contribute to heterogeneity. A total of eight studies were eligible for analysis. The aggregate prevalence of depressive and anxiety symptoms was significantly higher among 3546 adolescents with asthma than that of 24,884 controls (depression, 0.27; 95% CI, 0.18.6-0.39 vs. 0.13; 95% CI, 0.09-0.19; anxiety, 0.33; 95% CI, 0.19-0.52 vs. 0.21; 95% CI, 0.12-0.33). The risk of developing depression and anxiety is significantly higher among adolescents with asthma when compared with controls (depression: pooled odds ratio, 2.09; 95% CI, 1.65-2.64; p < 0.001; anxiety: pooled odds ratio, 1.83; 95% CI, 1.63-2.07; p < 0.001). Meta-regression revealed that the proportions of Caucasian (p = 0.008) and smokers (p < 0.001) were significant moderators which explained the significant heterogeneity when comparing the risk of developing depressive symptoms among adolescent asthma patients vs. controls while age, gender, and severity of asthma were not significant. Family doctors, pediatricians, and healthcare providers should formulate strategies to detect depressive and anxiety symptoms in adolescents with asthma and offer psychological interventions to reduce the burden of psychiatric comorbidity.

A total of 4,746 Hong Kong students, aged 14–15, participated in the 2000–2001 Health Related Behavior Survey. Results produced by the logistic regression models revealed that non-private housing was significantly associated with ever-use of ecstasy in boys. Moreover, girls in non-private housing were significantly more likely to have been persuaded to use ecstasy, ketamine, and marijuana, as well as to have ever used ecstasy. Furthermore, having older siblings was significantly associated with ever-use of ecstasy in girls. These findings suggest that low family affluence and having older siblings may contribute to exposure to illicit drugs in early adolescence.

Background: Vaccination is an important preventive measure for preparing against the influenza pandemics. This study investigated the attitudes and perceptions of influenza vaccination among doctors and medical students in Hong Kong. Methods: A cross-sectional survey was conducted among 204 doctors and 242 medical students in a teaching hospital in 2009. Participants’ demographic and job characteristics, and influenza experience and vaccination in the previous year were assessed in the questionnaire. Logistic regression models were used to examine the associations between uptake of influenza vaccination and the perceived benefits. Results: Medical students were more likely to have receive an influenza vaccination in the previous year (66.9 vs. 39.7%) and acknowledged the related benefits than doctors. Moreover, uptake of influenza vaccine was associated with perceived benefits of vaccination in both doctors and medical students. Conclusions: The perceived benefits of influenza vaccination are an important factor in vaccine uptake for both doctors and medical students in Hong Kong, and should be reinforced in the professional training.

This study examined the associations of body esteem with gender, age, and Body Mass Index (BMI) among 905 Hong Kong adolescents using the Body-Esteem Scale (BES). Older age, male gender and lower BMI were associated with better body esteem. Multiple regression analyses indicated significant main effects of gender, age and weight on BES-Total. Significant interaction effects of gender × BMI and gender × age × BMI were also found on BES-Weight (beta = −0.149, p = .028) and BES-Total (beta = −0.139, p = .044). Improvement of body esteem with age may be associated with age-related BMI differences.

Introduction This study investigates the independent and combined effects of smoking of parents and best friend on smoking and the intention to initiate or quit smoking in adolescents. Methods In this school-based survey, 6,553 Hong Kong students aged 13-18 reported their demographic characteristics, smoking status of themselves, parents, and best friend; and intention to smoke (initiation among never-smokers and reinitiation among ex-smokers) or quit smoking among current smokers. Logistic regression yielded adjusted odds ratios (AORs) of student smoking (current/ever) and intention to smoke or quit smoking for parental (paternal/maternal/both parents vs. none) and best friend (yes vs. no) smoking. Results Parental smoking and having a smoking best friend were associated with adolescent current smoking, ever smoking, and intention to initiate smoking. Having a smoking best friend was also associated with reinitiating and quitting smoking. The AORs (95% CI) of current smoking for having a smoking best friend, in addition to smoking father, mother, or both were 19.14 (14.36-25.51), 20.38 (12.42-33.43), and 24.18 (15.89-36.77). The respective AORs of ever smoking were 8.30 (6.74-10.22), 8.92 (5.63-14.12), and 11.99 (8.05-17.87). Conclusions Parental smoking and best friend smoking have independent effects on adolescent smoking behaviors. Their combined effects on current and ever smoking were particularly large. Smoking prevention programs should pay special attention to adolescents with both best friend and parents who smoke.

The reliability and validity of Stunkard's Figure Rating Scale (FRS) as a measure of current body size (CBS) was established in Western adolescent girls but not in non-Western population. We examined the validity and test-retest reliability of Stunkard's FRS in assessing CBS among Chinese adolescents. Methods. In a school-based survey in Hong Kong, 5666 adolescents (boys: 45.1%; mean age 14.7 years) provided data on self-reported height and weight, CBS, perceived weight status, and health-related quality of life using the Medical Outcomes Study Short-Form version 2 (SF-12v2). Height and weight were also objectively measured. Spearman's correlation was used to assess construct validity, concurrent validity and test-retest reliability.Convergent and discriminant validity were good: CBS correlated strongly with weight and self-reported/measured BMI, but only weakly with SF-12v2. CBS correlated strongly with perceived weight status, showing concurrent validity. Spearman's correlation (r) for CBS was 0.78 for girls and 0.72 for boys indicating good test-retest reliability. Validity and reliability results did not differ significantly between senior and junior grade adolescents.Our findings support the use of Stunkard's FRS to measure body size among Chinese adolescents.

To investigate the association between weight misperception and psychosocial health problems among normal weight Chinese adolescent boys and girls.In the Youth Smoking Survey 2003-04, 20 677 normal weight students aged 11-18 years from 85 randomly selected schools throughout Hong Kong were analysed. Students who perceived themselves as very thin, thin, fat or very fat were classified as having weight misperception in contrast to the reference group who correctly perceived themselves as normal weight. Psychosocial health outcomes included headache, feeling stressful, feeling depressed, poorer appetite, sleepless at night, having nightmares and less confidence in getting along with friends. Logistic regression yielded adjusted odds ratios (ORs) for each outcome by weight misperception in boys and girls separately.In girls, misperceived fatness was associated with all outcomes, while misperceived thinness was associated with poorer appetite and less confidence. Boys who misperceived themselves as very thin or fat had greater odds of all outcomes except having nightmares. In general, greater ORs were observed for misperceived fatness than thinness in girls, but similar ORs were observed in boys. Misperceived thinness and fatness accounted for 0.6% to 45.1% of the psychosocial health problems in adolescents.Normal weight adolescents with weight misperception were more likely to have psychosocial health problems, and the associations were stronger for extreme misperceptions (i.e., very fat or very thin) in both boys and girls.

Background The psychometric properties of the Revised Restraint Scale (RRS) have been well established in western populations but not in Chinese adolescents. Purpose This study investigated the psychometric properties of RRS and its validity in different subgroups for Hong Kong Chinese adolescents. Method In 2007, 909 Hong Kong students aged 12 to 18 years (55.3% boys) completed a questionnaire including demographic items, RRS, Eating Attitudes Test (EAT-26), and Motivation for Eating Scale (MFES)-physical. Moreover, subjects’ height and weight were measured. To examine the factor structure of RRS, the whole sample was randomly split into two groups (sample 1: N=454 and sample 2: N=455) for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. Convergent and discriminant validity of RRS were investigated by correlating the RRS with EAT-26 and MFES-physical. Multigroup CFA was conducted to test the three-factor model of RRS in different sex, age, and weight status subgroups. Results Results of EFA for sample 1 revealed three strongly correlated factors for the RRS construct, and were supported by the CFA results in sample 2. Multigroup CFA further suggested that the three-factor model of RRS was stable across sex, age, and weight status subgroups. Conclusions A new three-factor model is proposed for Hong Kong adolescents in this study. In general, RRS is a reliable and valid measure of restrained eating for adolescents, regardless of sex, age, and weight status.

Aim: This study aimed to establish the normative values for the 12-item Short Form Health Survey version 2 (SF-12v2) and examine demographic differences among Hong Kong Chinese adolescents. Methods: A total of 28 981 Hong Kong Chinese adolescents aged 12–18 participated in a school-based survey in 2006–2007. Sex- and age-specific SF-12v2 scores were obtained. Ordinal logistic regression models and linear regression models were used to examine the demographic differences for the eight subscales including physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health, and two component summary scores of Physical Component Summary and Mental Component Summary. Results: The mean (standard deviation) Physical Component Summary score was 50.28 (6.82) for boys and 49.37 (6.47) for girls. The corresponding Mental Component Summary score was 45.86 (9.86) for boys and 44.77 (9.56) for girls. Ceiling effects were observed in some of the eight subscales but not the two component summary scores. Ordinal logistic regression showed that girls had significantly lower scores than boys in most subscales including physical functioning with odds ratio (95% confidence interval) of 0.89 (0.84–0.93); role physical, 0.94 (0.90–0.98); bodily pain, 0.76 (0.73–0.80); general health, 0.55 (0.53–0.57); vitality, 0.72 (0.69–0.75); role emotional, 0.78 (0.74–0.81); and mental health, 0.91 (0.88–0.95). In general, older and non-local-born adolescents had lower component summary scores than their peers. Conclusions: This study has provided norms and identified demographic differences of the Chinese SF-12v2.

To examine the effects of perceived availability of fast-food shops, restaurants, and convenience stores on adolescent dietary intakes.Survey data from 34 369 students in 42 Hong Kong secondary schools were collected in 2006-7. Respondents reported the availability of fast-food shops, restaurants and convenience stores in the neighbourhood, and their intakes of fruit, vegetables, high-fat foods and junk food/soft drinks. For intakes of high-fat foods and junk food/ soft drinks, ≤ once a week was defined as low consumption and the rest moderate/high consumption. At least three servings of vegetables and two servings of fruit daily were defined as sufficient consumption. Logistic regression yielded adjusted odds ratios (OR) for each dietary intake in relation to the reported food shops. Potential effect modifications by socio-demographic factors were also examined.Perceived availability of fast-food shops and convenience stores were positively associated with moderate/high consumptions of high-fat foods (OR(fast) =1.10 and OR(con) =1.15) and junk food/soft drinks (OR(fast)=1.10 and OR(con) =1.10). Significant negative associations of the perceived availability of restaurants with intakes of vegetables and fruit were observed (OR(veg) =0.87 and OR(fruit) =0.83). The positive relationship between reporting fast-food shops with intake of junk food/soft drinks were observed only in boys and those with low perceived family affluence. The negative association of reporting restaurants with fruit consumption was found in those with low and middle perceived family affluence only.Perceived availability of neighbourhood fast-food shops, restaurants, and convenience stores may have a negative impact on adolescent dietary intakes particularly for those from poorer families.

Objective To evaluate the construct validity of the standard Chinese Short Form (SF)-12v2 in adolescents. Study Design and Setting Data collected from the Hong Kong Student Obesity Surveillance project conducted in 2006–2007 were used. The standard Chinese SF-12v2 was first evaluated against clinical criteria previously used for the evaluation of SF-12 or SF-36. The data were then randomly split into training and validation halves for exploratory and confirmatory factor analyses, respectively. Results A total of 31,357 adolescents with mean age of 14.8 years (standard deviation = 1.9; range = 11.0–18.9) were included. The standard Chinese SF-12v2 effectively distinguished groups differing in doctor-diagnosed health problems, self-reported illnesses in the past 30 days, gender, perceived health in the past 3 months, and health compared with that 12 months back. The mental health scale had low internal consistency (Cronbach's alpha = 0.34). The exploratory factor analysis was influenced by method effects, but confirmatory factor analysis confirmed the hypothesized latent structure and the one-factor structure of the SF-12v2, providing fit indices within acceptable limits. Conclusion The two components and a single general health component of the standard Chinese SF-12v2 are appropriate health indicators for Chinese adolescents.

Aim: To assess the 5-year secular changes in sports participation, sedentary activity, and physical self-perceptions among Hong Kong adolescents. Methods: A total of 2932 and 5692 secondary students, aged 13–18 participated in the Health Related Behavior General (HRBG) Survey in 1995–1996 and 2000–2001, respectively. Extracurricular sports participation at least weekly or as a team member (none, 1–2 events, 3 or more events), sedentary activities (0–1 h/day, 2 h/day or more) including television/video watching and homework were assessed. Additionally, physical self-perceptions, physical fitness (fit/very fit, moderately fit, unfit/very unfit) and body weight (intention to lose weight, satisfied, intention to gain weight) were reported. Secular trends of sports participation, and sedentary activities and physical self-perceptions were assessed. Results: During the 5 years, the prevalence of sports participation (at least weekly or membership) decreased significantly in boys. The prevalence of both TV/video watching and homework for at least 2 h/day increased significantly in both sexes. The prevalence of being unfit/very unfit increased significantly in girls. No significant secular difference in weight perception was observed for both sexes. Conclusions: Sports participation decreased and sedentary activities increased during the 5-year period. Physical self-perceptions did not change significantly, except an increase in being physically unfit was observed in girls.

Respiratory ill-health effects due to particulate air exposure at different geographical locations in Hong Kong that aggregate individual living locations were estimated based on satellite information. We assessed the presence of respiratory symptoms of a frequent cough or sputum in school students aged 11-20 years old (n = 9,881). Daily particulate air pollution levels at students' living locations were derived from the surface extinction coefficients measured by satellite and measurements from the air pollutant monitoring stations at ground level. Adjusted odds ratio (OR) [95% CI] of respiratory symptoms was 1.047 [1.005, 1.091] per 10 microg m(-3) increase in PM(10) concentration. Specificity tests showed that adjusted OR of having other symptoms is not significant (p = 0.20-0.94). Exposures to PM(10) at different geographical locations is associated with increased odds of having respiratory symptoms (cough or sputum) but not with other symptoms unrelated to air pollution.

This study aimed to examine the reliability and validity of the Euthanasia Attitude Scale (EAS) in Hong Kong medical doctors. A total of 107 medical doctors (61.7% men) participated in a survey at clinical settings in 2008. The 21-item EAS was used to assess their attitudes toward euthanasia. The mean (standard deviation) and median of the EAS were 63.60 (60.31) and 63.00. Total EAS scores correlated well with ‘‘Ethical Considerations,’’ ‘‘Practical Considerations,’’ and ‘‘Treasuring Life’’ (Spearman ρ =.37-.96, P < .001) but not ‘‘Naturalistic Beliefs.’’ The construct validity of the 3-factor model was appropriate (Kaiser-Meyer-Olkin [KMO] value = 0.90) and showed high internal consistency (Cronbach α =.79-.92). Euthanasia Attitude Scale may be a reliable and valid measure for assessing the attitudes toward euthanasia in medical professionals.

Aim: To investigate the prospective effects of weight perception of self and weight comments by others on psychological health problems among Chinese adolescents. Methods: In the Hong Kong Student Obesity Surveillance project, 8716 adolescents (41.3% boys) aged 14.2 ± 1.7 years were followed prospectively. Logistic regression yielded odds ratios (ORs) for psychological health problems at 1-year follow-up by weight comments received and weight perception at baseline (2006), adjusting for each other sociodemographic factors and body mass index. Results: Perceived fatness at baseline predicted subsequent headache and feeling stressful with adjusted ORs (95% confidence intervals) of 1.17 (1.03–1.33) and 1.20 (1.03–1.39), respectively. Perceived thinness at baseline did not predict any subsequent health problems. Receiving incorrect weight comments at baseline also predicted headache, feeling stressful and feeling depressed at follow-up, with adjusted ORs of 1.19 (1.08–1.31), 1.26 (1.04–1.53) and 1.38 (1.10–1.74) respectively. No gender difference was found in the effects of weight perception and weight comments on psychological outcomes. Conclusions: In adolescents, perceived fatness and incorrect weight comments predicted psychological health problems at 1-year follow-up. Family members, peers and other social contacts should realize the potential adverse effects of their weight comments, and adolescents should be taught how to correctly assess their weight status.

To examine the independent, competing, and interactive effects of perceived availability of specific types of media in the home and neighborhood sport facilities on adolescents' leisure-time physical activity (PA).Survey data from 34 369 students in 42 Hong Kong secondary schools were collected (2006-07). Respondents reported moderate-to-vigorous leisure-time PA, presence of sport facilities in the neighborhood and of media equipment in the home. Being sufficiently physically active was defined as engaging in at least 30 minutes of non-school leisure-time PA on a daily basis. Logistic regression and post-estimation linear combinations of regression coefficients were used to examine the independent and competing effects of sport facilities and media equipment on leisure-time PA.Perceived availability of sport facilities was positively (OR(boys) = 1.17; OR(girls) = 1.26), and that of computer/Internet negatively (OR(boys) = 0.48; OR(girls) = 0.41), associated with being sufficiently active. A significant positive association between video game console and being sufficiently active was found in girls (OR(girls) = 1.19) but not in boys. Compared with adolescents without sport facilities and media equipment, those who reported sport facilities only were more likely to be physically active (OR(boys) = 1.26; OR(girls) = 1.34), while those who additionally reported computer/Internet were less likely to be physically active (OR(boys) = 0.60; OR(girls) = 0.54).Perceived availability of sport facilities in the neighborhood may positively impact on adolescents' level of physical activity. However, having computer/Internet may cancel out the effects of active opportunities in the neighborhood. This suggests that physical activity programs for adolescents need to consider limiting the access to computer-mediated communication as an important intervention component.

A new trailer truck-mounted attenuator protection system was designed and successfully crash tested according to the safety performance criteria presented in NCHRP Report 350. The new trailer is designed to be attached to a tow vehicle using a conventional pintle hitch and wiring harness. This simple attachment will allow the new trailer to be attached directly to many work trucks, such as striping vehicles to eliminate the need for secondary shadow vehicles. The trailer is manufactured from heavy gage, galvanized steel to provide the first practical solution to protecting motorists during snow plowing, sanding and salting operations. Five full-scale crash tests were successfully conducted with the trailer attached to a tow vehicle that was blocked against forward movement and rotation to simulate an infinitely heavy vehicle.

This 6 month prospective study systematically tested some multivariate models that advanced the understanding of the psychological mechanisms underlying Internet addiction and psychosocial maladjustment. On the basis of previous theories, avoidant coping and coping inflexibility were proposed as underlying mechanisms. Participants were 271 Chinese undergraduates (75% women, Mage=20.49) who took part in both phases of this study. Structural equation modeling was performed to obtain the best fit models for both the cross-sectional and the prospective data. The cross-sectional model testing revealed statistically significant mediating effects for both avoidant coping (β=0.149 [95% CI 0.071-0.226], p=0.002) and coping flexibility (β=0.048 [95% CI 0.013-0.081], p=0.032). The prospective model testing further showed that avoidant coping mediated the relationship between Internet addiction and Time 2 psychosocial maladjustment (β=0.141 [95% CI 0.065-0.216], p=0.005), as well as that between coping flexibility and Time 2 psychosocial maladjustment (β=-0.096 [95% CI -0.161 to -0.031], p=0.015). This study was the first to establish theory-driven models, which unveiled an inflexible, avoidant coping style as psychological mechanisms that explained the link between Internet addiction and psychosocial maladjustment.

This study examined the gender-specific associations between cohabitation with parents and stress using an econometric approach. A total of 13,565 (41.7% men and 58.3% women) Korean adults aged 20-59 years from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008 to 2011 were pooled. They reported their gender, age, marital status, education level, employment status, income, home ownership, and cohabitation status with their parents. The association of living with parents and stress, as well as the gender difference in the association, was investigated using propensity score matching and the average treatment effect on the treated. Adults with higher education and income, not owning a house, or living in larger cities were less likely to live with parents. Stress was associated with having children and participating in the labor market for both married men and women. Moreover, living with parents was a protective factor for stress among husbands, but a risk factor for wives in Korea. Gender differences existed in the association between cohabitation with parents and stress. Greater stress was related to cohabiting with parents and working for married women.

Aims: Traffic safety is a significant public health challenge, and vehicle crashes account for the majority of injuries. This study aims to identify whether drivers' characteristics and past traffic violations may predict vehicle crashes in Korea. Methods: A total of 500,000 drivers were randomly selected from the 11.6 million driver records of the Ministry of Land, Transport and Maritime Affairs in Korea. Records of traffic crashes were obtained from the archives of the Korea Insurance Development Institute. After matching the past violation history for the period 2004–2005 with the number of crashes in year 2006, a total of 488,139 observations were used for the analysis. Zero-inflated negative binomial model was used to determine the incident risk ratio (IRR) of vehicle crashes by past violations of individual drivers. The included covariates were driver's age, gender, district of residence, vehicle choice, and driving experience. Results: Drivers violating (1) a hit-and-run or drunk driving regulation at least once and (2) a signal, central line, or speed regulation more than once had a higher risk of a vehicle crash with respective IRRs of 1.06 and 1.15. Furthermore, female gender, a younger age, fewer years of driving experience, and middle-sized vehicles were all significantly associated with a higher likelihood of vehicle crashes. Conclusions: Drivers' demographic characteristics and past traffic violations could predict vehicle crashes in Korea. Greater resources should be assigned to the provision of traffic safety education programs for the high-risk driver groups.

There has been increased research examining the psychometric properties on the Internet Addiction Test across different ages and populations. This population-based study examined the psychometric properties using Confirmatory Factory Analysis and measurement invariance using Item Response Theory (IRT) of the IAT in adolescents from three Asian countries. In the Asian Adolescent Risk Behavior Survey (AARBS), 2,535 secondary school students (55.91% girls) in Grade 7 to Grade 13 (Mean age = 15.61 years; SD=1.56) from Hong Kong (n=844), Japan (n=744), and Malaysia (n=947) completed a survey on their Internet use that incorporated the IAT scale. A nested hierarchy of hypotheses concerning IAT cross-country invariance was tested using multi-group confirmatory factor analysis. Replicating past finding in Hong Kong adolescents, the construct of IAT is best represented by a second-order three-factor structure in Malaysian and Japanese adolescents. Configural, metric, scalar, and partial strict factorial invariance was established across the three samples. No cross-country differences on Internet addiction were detected at latent mean level. This study provided empirical support to the IAT as a reliable and factorially stable instrument, and valid to be used across Asian adolescent populations.

This study reports the knowledge, risk perceptions, and preventive precautions among 288 Hong Kong secondary school students during the 2009 influenza A (H1N1) pandemic. Only 28.1% of the students expressed knowledge of all 3 major routes of H1N1 transmission, and 58.1% perceived a high risk of H1N1 infection. Adoption of 4-5 preventive precautions was not prevalent (40.9%) and was significantly associated with female sex, better knowledge of transmission, and higher perceived risk of infection.

This study examined the ethnic differences in stressors, risk, and protective factors among people who attempted suicide in Singapore. A retrospective chart review of 626 attempted suicide cases at a hospital in Singapore between 2004 and 2006 collected information on diagnosis according to DSM-IV-TR criteria. Chi-square tests was used to compare the sociodemographic characteristics, stressors, risk factors, and protective factors among Chinese, Malay, Indian, and other ethnic groups. Logistic regression was used to determine the odds ratios of having two or more stressors, risk factors, or protective factors for the four ethnic groups. Women were more likely than men to attempt suicide, although they also were more likely to have two or more suicide protective factors than men. In general, older people were more likely to have two or more suicide risk factors than the younger groups. Ethnic differences were found in history of psychiatric illnesses and unemployment among the risk factors, and for most of the protective factors, but none of the stressors. Indians were more likely to have two or more protective factors than were Chinese (OR of 7.74, 95% CI [1.04, 8.72]. Future suicide prevention programs should target young adults and strengthen the protective factors among different ethnic groups.

This pilot study investigated the patterns of video and internet gaming habits and the prevalence and correlates of gaming addiction in Hong Kong adolescents. A total of 503 students were recruited from two secondary schools. Addictive behaviors of video and internet gaming were assessed using the Game Addiction Scale. Risk factors for gaming addiction were examined using logistical regression. An overwhelming majority of the subjects (94%) reported using video or internet games, with one in six (15.6%) identified as having a gaming addiction. The risk for gaming addiction was significantly higher among boys, those with poor academic performance, and those who preferred multiplayer online games. Gaming addiction was significantly associated with the average time spent gaming per week, frequency of spending money on gaming, period of spending money on gaming, perceived family disharmony, and having more close friends. These results suggest that effective educational and preventative programs or strategies are needed.

The Revised Chen Internet Addiction Scale (CIAS-R) was developed to assess Internet addiction in Chinese populations, but its psychometric properties in adolescents have not been examined. This study aimed to evaluate the factor structure and psychometric properties of CIAS-R in Hong Kong Chinese adolescents. 860 Grade 7 to 13 students (38 % boys) completed the CIAS-R, the Young’s Internet Addiction Test (IAT), and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) in a survey. The prevalence of Internet addiction as assessed by CIAS-R was 18 %. High internal consistency and inter-item correlations were reported for the CIAS-R. Results from the confirmatory factor analysis suggested a four-factor structure of Compulsive Use and Withdrawal, Tolerance, Interpersonal and Health-related Problems, and Time Management Problems. Moreover, results of hierarchical multiple regression supported the incremental validity of the CIAS-R to predict mental health outcomes beyond the effects of demographic differences and self-reported time spent online. The CIAS is a reliable and valid measure of internet addiction problems in Hong Kong adolescents. Future study is warranted to validate the cutoffs of the CIAS-R for identification of adolescents with Internet use problems who may have mental health needs.

Background:Little is known about the longitudinal relations of environment attributes and leisure-time physical activity (PA) in adolescents, and the moderating effects of individual characteristics. This study examined the longitudinal association of the perceived availability of neighborhood sport facilities with leisure-time PA, and the potential moderating effects of age, past PA behavior, and weight status in adolescents.Methods:Among 20,933 follow-up subjects (60.9% of 34,369 baseline subjects), 9993 from 32 Hong Kong secondary schools were successfully matched with baseline (mean duration 16 months; SD 1.7) and had complete information. At baseline and follow-up, respondents reported their leisure-time PA, weight, height, and the presence of sport facilities in the neighborhood.Results:Increased perceived availability of sport facilities from baseline to follow-up predicted more leisure-time PA at follow-up (β = 1.029; 95% CI: 1.011–1.047) overall. This effect was modified by baseline PA, with a significant effect observed only among those who had engaged in leisure-time PA more than 3 times a week.Conclusions:Increasing awareness of neighborhood sport facilities or building more such facilities may help active adolescents maintain or increase their leisure-time PA. However, more comprehensive multilevel interventions that aim at enhancing potential social, personal, and environmental PA-related factors may be needed to motivate inactive adolescents.

Previous research has indicated that both cognitive and behavioral variables mediate the positive effect of optimism on quality of life; yet few attempts have been made to accommodate these constructs into a single explanatory framework. Adopting Fredrickson’s broaden-and-build perspective, we examined the relationships between optimism, self-rated health, resilience, exercise, and quality of life in 365 Chinese university students using path analysis. For physical quality of life, a two-stage model, in which the effects of optimism were sequentially mediated by cognitive and behavioral variables, provided the best fit. A one-stage model, with full mediation by cognitive variables, provided the best fit for mental quality of life. This suggests that optimism influences physical and mental quality of life via different pathways.

The relationships between self-estimated adiposity using Stunkard's body silhouette scale with general and central adiposity in adolescents are unclear. This study examines the criterion validity of Stunkard's body silhouette scale as a self-estimated rating of adiposity against anthropometric measures of adiposity and percentage body fat in Hong Kong adolescents.The body composition of 903 adolescents (55.7% boys) was assessed by measured waist circumference (WC), waist-to-stature ratio (WSR), body mass index (BMI) and percentage body fat (%BF). Self-estimated adiposity was subjectively assessed using Stunkard's body silhouette scale. The association between self-estimated adiposity and body composition was examined by Spearman correlation coefficients and hierarchical multiple regression analyses.Self-estimated adiposity correlated significantly and positively with BMI (boys: r = 0.65; girls: r = 0.59), WC (boys: r = 0.62; girls: r = 0.51), WSR (boys: r = 0.55; girls: r = 0.42) and %BF (boys: r = 0.47; girls: r = 0.55).Self-estimated adiposity using the Stunkard's body silhouette scale was positively associated with actual measures of adiposity; however, the association was modest at best. It is unlikely that the Stunkard's body silhouette scale provides a suitably accurate substitute for actual body composition measures in Chinese adolescents.

Aim: Polymorphisms of the genes for encoding serotonin transporter, specifically, the length variation in the serotonin-transporter-linked polymorphic region (5-HTTLPR), a single nucleotide polymorphisms, in the 5-HTTLPR (RS25531), and variable number of tandem repeats (VNTR) in the second intron 2 (STin2) have been implicated in the development of post-stroke depression (PSD). We aimed at evaluating this association in the published literature. Methods: Random-effects meta-analyses were conducted among studies examining the relations between the polymorphisms of the genes encoding serotonin transporter and the risk of developing PSD. Meta-regression identified patient- and study-related factors that may contribute to heterogeneity. Results: Five studies consisting of patients suffering from PSD and stroke patients without PSD were included. Our analyses showed statistically significant evidence of the positive association between the homozygous short (S) variation allele genotype of the 5-HTTLPR (SS) and PSD (random-effects pooled odds ratio (OR) = 2.05, 95% Confidence Interval (CI) = 1.41-2.98, Z =3.79, p< 0.001 ). Our analyses also showed significant evidence of a negative association between the homozygous long (L) variation alleles of the 5-HTTLPR (LL) and PSD (random-effects OR = 0.52, 95% CI = 0.27-0.97, Z =- 2.07, p= 0.039). No statistically significant association of PSD with either heterozygous Short and Long allele genotype for the 5-HTTLPR or other polymorphisms with the RS25531 and the STin2 VNTR were found. Conclusion: Our meta-analysis suggests that the 5-HTTLPR SS genotype may be a risk factor for PSD while the 5-HTTLPR LL genotype may be a candidate protective factor against PSD

Polymorphisms of the gene encoding the serotonin transporter-specifically, length variation in the serotonin--transporter-linked polymorphic region (5-HTTLPR), a single-nucleotide polymorphism in the 5-HTTLPR (rs25531), and variable number of tandem repeats (VNTR) in the second intron 2 (STin2)--have been implicated in the development of post-stroke depression (PSD).To evaluate the association between polymorphisms of the serotonin transporter gene and PSD in the medical literature.Random-effects meta-analyses were conducted on cross-sectional, case-control and cohort studies examining relations between polymorphisms of the gene encoding the serotonin transporter and the risk of developing PSD.Four studies comprising 260 stroke patients with PSD and 381 without were included. Our analyses showed a significant and positive association between the homozygous short variation (S) allele genotype of the 5-HTTLPR (SS) and PSD (random-effects pooled OR 2.05, 95% CI 1.41 to 2.98, z=3.79, p0.001). Our analyses also showed a significant and negative association between the homozygous long variation (L) allele genotype of the 5-HTTLPR (LL) and PSD (random-effects OR 0.52, 95% CI 0.27 to 0.97, z=-2.07, p=0.039). No statistically significant association of PSD with heterozygous S and L allele genotype for 5-HTTLPR or other polymorphisms with rs25531 and STin2 VNTR was found. Heterogeneity and publication bias were not statistically significant. The major limitation of this meta-analysis is that we could not assess the interaction between stroke, environmental stress and PSD.The 5-HTTLPR SS genotype may be a risk factor for PSD. The 5-HTTLPR LL genotype showed a significant negative association with PSD. Further research to assess the sensitivity and specificity of predicting the risk of developing PSD by screening for the 5-HTTLPR genotype in stroke patients is required.

It remains unclear whether anxiety and depressive symptoms are more prevalent in adolescents with asthma when compared with healthy individuals. This meta-analysis aimed to evaluate the difference in the aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls and to explore the underlying moderators that potentially explain the heterogeneity of the effect size. A meta-analysis of published work was performed using the random effects model. The differences in aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls were determined. Meta-regression and subgroup analysis were performed to identify factors that may contribute to heterogeneity. A total of eight studies were eligible for analysis. The aggregate prevalence of depressive and anxiety symptoms was significantly higher among 3546 adolescents with asthma than that of 24,884 controls (depression, 0.27; 95% CI, 0.18.6-0.39 vs. 0.13; 95% CI, 0.09-0.19; anxiety, 0.33; 95% CI, 0.19-0.52 vs. 0.21; 95% CI, 0.12-0.33). The risk of developing depression and anxiety is significantly higher among adolescents with asthma when compared with controls (depression: pooled odds ratio, 2.09; 95% CI, 1.65-2.64; p0.001; anxiety: pooled odds ratio, 1.83; 95% CI, 1.63-2.07; p0.001). Meta-regression revealed that the proportions of Caucasian (p = 0.008) and smokers (p0.001) were significant moderators which explained the significant heterogeneity when comparing the risk of developing depressive symptoms among adolescent asthma patients vs. controls while age, gender, and severity of asthma were not significant. Family doctors, pediatricians, and healthcare providers should formulate strategies to detect depressive and anxiety symptoms in adolescents with asthma and offer psychological interventions to reduce the burden of psychiatric comorbidity.

Objectives Western culture has great influences on body dissatisfaction and related eating behaviors in adolescents. This study aimed to assess the sociocultural influences on eating attitudes and motivations among Hong Kong Chinese adolescents. Methods In 2007, 909 adolescents (mean age = 14.7 years, 55.3% boys) completed a survey with Stunkard's Figure Rating Scale (FRS), Motivation for Eating Scale (MFES), Eating Attitudes Test (EAT), Revised Restraint Scale (RRS), and Sociocultural Attitudes Towards Appearance Scale (SATAQ). In addition, their body mass index (BMI) was objectively measured. Results Our results indicated that Hong Kong adolescents, particularly girls exhibited a remarked level of body dissatisfaction, external, emotional, restrained and disordered eating behaviors. Hierarchical regression analyses indicated that age, sex and BMI were the most common contributing factors to individual eating styles. SATAQ significantly accounted for an additional variance of body dissatisfaction (2%), physical eating (2%), external eating (1%), emotional eating (3%), restrained eating (5%), and disordered eating (5%). Conclusions In Hong Kong, the sociocultural influences on body image and eating disturbance were supported.