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PubMed1988

Observer variation in assessing spinal curvature and skeletal development in adolescent idiopathic scoliosis.

Accurate measurements of spinal curvature and skeletal development are crucial in planning treatment and assessing curve progression in adolescent idiopathic scoliosis (AIS). An inter-rater agreement trial was undertaken to estimate the reliability of measuring these spinal parameters. Two orthopaedic surgeons and two trained technicians from a scoliosis clinic independently read 30 anteroposterior roentgenograms of AIS patients. Skeletal maturity was assessed using the six-point Risser sign scale, and spinal curvature was measured using the method of Cobb. Excellent agreement was observed in evaluating Risser signs (Kappa = 0.8) and primary Cobb angles (intra-class correlation coefficient, Rho = 0.98). The standard deviation of inter-observer error in measuring primary Cobb angles was 2.5 degrees, and the intra-reader error, based on one observer's reassessments of 15 films, was 1.9 degrees. Inter-rater agreement for assessing secondary Cobb angles was much lower (Rho = 0.52) because small curves (less than 20 degrees) were often not noticed. Differences in agreement between surgeons and technicians were relatively minor. These results indicate that personnel trained at this clinic are able to assess these spinal parameters reliably.

Adolescent↗
PubMed1994

Determinants of adolescent identity development: a cross-sequential study of boarding school boys.

A sociometric measure of identity status was developed based on Marcia's (1966) four ordinal levels of ego identity achievement: Identity Achievement, Moratorium, Foreclosure, and Diffusion. Boarding school adolescent boys (N = 197) rated their dormitory mates on each dimension twice with an interval of six months. Results indicate age differences in identity status for young adolescents, identity development associated with time, and a strong relation between adolescent behavior problems and levels of identity status. Efforts to relate identity status to child-rearing values, social problem-solving, stress, health concerns, and independence were inconclusive.

Adolescent↗
PubMed1999

Epistemological development in adolescence and adulthood: a multidimensional framework.

Theories of epistemological development are reviewed. A framework describing variations in adolescents' and adults' intuitive conceptions of knowledge is proposed. Within the proposed framework, naive epistemologies are conceptualized in terms of their assumptions concerning (a) the nature of the knowledge acquisition process, (b) the degree of correspondence between knowledge and reality, (c) the certainty of knowledge, (d) the commensurability of knowledge across individuals, (e) the degree to which knowledge forms or inheres in a coherent system of thought, (f) the nature of meaning, (g) the appropriate procedures for evaluating competing beliefs, (h) the nature and role of authorities as sources of knowledge and justification, and (i) the nature of reality. This framework is used to describe possible developmental changes in adolescents' and adults' concepts of knowledge and to suggest how future researchers might address core issues concerning epistemological development.

Adolescent↗
PubMed1996

Identity, sexuality and the self in late adolescence.

This paper explores the concepts of identity, sexuality and the self within the context of adolescent development. The development of the identity concept in adolescence is traced in Jung's theoretical, clinical and autobiographical writings. Jung's adolescent development is viewed as the matrix out of which the identity concept emerged within analytical psychology. This was later elaborated theoretically by Jung in Symbols of Transformation (1912/1956). One of Jung's clinical cases of a late adolescent is discussed in which themes related to the development of identity and sexuality emerged. An adolescent case from the author's analytic practice is presented where similar themes of identity, homosexuality and self emerged. The developmental and symbolic themes which emerged in the analysis are viewed within the context of the transference/countertransference relationship.

Adolescent↗
PubMed1988

Ethnicity as a mediating variable of early adolescent identity development.

The variables of race/ethnicity, sex and grade were examined as potential mediating factors of early adolescent identity development. The EOM-EIS was administered to 367 middle-school students in an urban southwestern setting. Results provided evidence that the EOM-EIS is an appropriate instrument for use with this age sample. Additionally, females and older students were found to be more developmentally sophisticated than other groups. Finally, ethnic minorities were found to be significantly more foreclosed than their non-minority counterparts. As the school was a mandatory desegregation site, implications of school desegregation were discussed.

Adolescent↗
PubMed1999

Tobacco, alcohol and drug use in eight- to sixteen-year-old twins: the Virginia Twin Study of Adolescent Behavioral Development.

OBJECTIVE: This study reports prevalences of lifetime and current alcohol, tobacco and drug use in adolescents; examines associations between substance use and a number of putative risk factors; and estimates the contribution of genetic, shared and unique environmental influences on substance use. METHOD: Substance use data were collected using the Child and Adolescent Psychiatric Assessment on a population sample of 1,412 male and female monozygotic and dizygotic twin pairs, aged 8 through 16, from the Virginia Twin Study of Adolescent Behavioral Development. RESULTS: Heritabilities were estimated to be 84% and 82% for liability to lifetime and current tobacco use, respectively. For alcohol use the role of genes and environment varied according to the context of reporting. Liability to lifetime alcohol use was estimated to be under environmental control, with 71% of the variation shared by members of a twin pair and 29% unique to individual twins. Lifetime alcohol use without the permission of a parent or guardian and current use of alcohol were predominantly explained by genetic factors (h2 = 72% and 74%). The role of genetic factors increased and that of unique environmental factors decreased with increasing severity of alcohol use. Lifetime use of any drug showed a heritability of 45%, with the shared environment accounting for 47% of the variation. Shared environmental factors explained most of the variation in marijuana use. CONCLUSIONS: Genetic factors explained a significant proportion of the variation in the use of tobacco, alcohol and other drugs. Shared environmental factors contributed significantly to lifetime alcohol use and other drug use.

Adolescent↗
PubMed1996

The Virginia Twin-Family Study of Adolescent Behavioral Development: assessing sample biases in demographic correlates of psychopathology.

The Virginia Twin-Family Study of Adolescent Behavioral Development (VTSABD) is a current longitudinal study of psychopathology in 1412 pairs of 8-16-year-old Caucasian twins and their parents. The primary aim of the study is to evaluate family-genetic and environmental risk factors for major domains of psychopathology in families representative of the Virginia Caucasian population. In this report, we utilize census-derived indices of neighbourhood income and urban residence to identify departures from population representation arising at the time of family enrollment in the twin registry and family participation in a psychiatric interview. Furthermore, we consider whether demographic sample biases influenced prevalence rates of adult psychopathology (including major depression, generalized anxiety disorder, alcohol dependence, phobias, and panic disorder) in the VTSABD. Results indicated that families that enrolled in the twin registry (83% of those identified by Virginia schools) and that participated in the home interview (75% of those targeted) resided in urban and rural communities with a range of per capita income levels representative of the Virginia population. However, participation biases operated throughout the study and were primarily characterized by losses of families living in low income, urban communities. There was also a smaller number of families living in high income neighbourhoods that did not enroll in the twin registry or that indefinitely postponed the psychiatric interview. These biases had small effects on prevalence rates of adult psychopathology in the VTSABD sample, even though neighbourhood income was significantly related to a subset of adult diagnoses. We emphasize the usefulness of the census methodology in evaluating sample biases in population-based psychiatric genetic studies.

Adolescent↗
PubMed2002

Autonomy development in adolescents with insulin dependent diabetes mellitus.

This descriptive study investigated autonomy development among young adolescents with insulin-dependent diabetes mellitus (IDDM); assessed relationships among behavioral, cognitive, and emotional autonomy; and determined the relationships between these types of autonomy and metabolic control. Developmental and family theory provided the framework for this study. This investigation suggested that the pattern of autonomy for adolescents with IDDM is congruent with that of adolescents without chronic illness. The three autonomy types are conceptually distinct and one aspect of emotional autonomy was related to poorer metabolic control. Daughters and adolescents in one-parent families scored higher on this component.

Adolescent↗
PubMedDate not supplied

Family-based treatment development for adolescent alcohol abuse.

A range of family-related risk factors have been linked to adolescent alcohol problems and predict escalation of use and alcohol dependence into adulthood. Family-based interventions have strong research and clinical traditions in the treatment of adult alcoholism and adolescent drug abuse, but have been infrequently applied to the unique problems of adolescent alcohol abuse and dependence. Researchers in the adolescent alcohol abuse specialty area have developed a robust developmentally oriented knowledge base about alcohol-specific risk and protective factors. Adolescent alcohol treatment researchers have made significant advances in recent years, including a deeper understanding of outcome trajectories. However youth relapse to alcohol use at high rates following standard community-based treatment, and few empirically supported treatments exist for adolescent alcohol abusers. Employing selected contemporary research findings, this article outlines specific areas of focus for a family-based intervention for alcohol abusing teens. We first review intervention-relevant research on the development of alcohol problems among adolescents with a focus on family risk and protective factors. Second, clinical research findings are presented supporting the use of family-based interventions with alcohol abusing youth. Finally, areas of intended focus in an empirically supported family-based intervention for adolescent alcohol problems are outlined. By addressing these gaps, empirically supported family-based interventions for adolescent alcohol abuse have significant potential to advance the field of adolescent alcohol treatment.

Adolescent↗
PubMed1997

The Virginia Twin Study of Adolescent Behavioral Development. Influences of age, sex, and impairment on rates of disorder.

BACKGROUND: The Virginia Twin Study of Adolescent Behavioral Development is a cohort-longitudinal epidemiological study that uses the genetic twin design to study the development and maintenance of child psychiatric disorders. We determined the rates of DSM-III-R disorders, disorders with impairment, and age, sex, and comorbidity effects. METHODS: Families of 2762 white twins aged 8 to 16 years participated. Twins and their parents were asked systematically about risk factors and current psychiatric symptoms by means of investigator-based psychiatric interviews and questionnaires. The DSM-III-R diagnoses were made for major depressive disorder, separation anxiety, overanxious disorder, simple phobia, social phobia, agoraphobia, oppositional defiant disorder, conduct disorder, and attention deficit hyperactivity disorder. RESULTS: The 3-month point prevalence for any DSM-III-R disorders was 413 per 1000, and that for disorders with associated impairment was 142 per 1000. Emotional disorders with impairment occurred in 89 per 1000, with girls being more commonly affected; behavioral disorders had a prevalence of 71 per 1000, with boys being more frequently affected. The proportion with disorder who also had functional impairment varied across disorders; anxiety and phobic disorders were particularly likely not to be accompanied by impairment. Rates of emotional and behavioral disorders increased over the age range. There was extensive comorbidity among disorders. CONCLUSIONS: The prevalence rates and patterns of findings from this study of twins are consistent with those of other epidemiological studies, supporting previous findings of few differences in rates of psychiatric disorder between twins and singletons. The importance of including measures of functional impairment is evident by its effect on rates of disorder and patterns of comorbidity.

Adolescent↗
PubMed1987

Longitudinal study of pulmonary function development in childhood, adolescence, and early adulthood. Development of pulmonary function.

The growth of pulmonary function between 5.5 and 25 yr of age was determined using 1,511 observations over time on 353 subjects from a representative population sample of white non-Mexican-Americans in Tucson. There was an average of 8.8 yr of follow-up, with a maximum of 12. The method used was shown to be robust for span of follow-up from 3 to 12 yr (3 to 7 observations), and the results were verified by standard statistical methods. The standard error of the estimate decreased linearly with follow-up, indicating the need for longitudinal evaluation. Respiratory symptoms and diagnoses had the biggest negative impact on growth of lung function, using FVC, FEV1, Vmax50, and size-compensated flows (Vmax50/FVC). Smoking had the next biggest negative impact. Smoking cessation was shown to have a positive impact on growth of pulmonary function. Using a second linear model to adjust for individual variability and the random variability over surveys, individual growth showed similar trends. Further negative impacts were due to parental smoking, especially as it interacts with active smoking and respiratory disease. Flows at end of follow-up (Vmax50, Vmax50/FVC) were more sensitive than FEV1 to the effects of concurrent disease and smoking, and more persistent effects of these factors in early adulthood.

Adolescent↗
PubMed1994

The effects of family cohesiveness and peer encouragement on the development of adolescent alcohol use: a cohort-sequential approach to the analysis of longitudinal data.

This article demonstrates a latent growth curve methodology for analyzing longitudinal data for adolescent alcohol use by combining information from different overlapping age cohorts to form a single developmental trajectory. Hypotheses concerning the form of growth in alcohol use, the extent of individual differences in the common trajectory over time, and covariates influencing both initial status and the form of growth were tested. Utilizing five separate age cohorts each measured over the same 4-year period, results suggested a common trajectory existed across the 8 years represented by the cohort-sequential analysis, with alcohol use increasing more rapidly during the adolescents' transition to high school. Family cohesion and peer encouragement for alcohol use were hypothesized to influence both initial status and the trajectory of alcohol consumption during adolescence. While family cohesion served to suppress initial levels of consumption delaying the upward trajectory of alcohol use, peer encouragement was related not only to initial, and elevated, levels of use, but was predictive of those changes that occurred during adolescence. Discussion involves the importance of family and peer influences in the development of adolescent alcohol use and the utility of the cohort-sequential approach in the analysis of longitudinal data.

Adolescent↗
PubMed1989

Longitudinal assessment of breast development in adolescent female patients with burns involving the nipple-areolar complex.

Long-term follow-up of breast development in adolescent female patients with burns of the anterior chest wall is poorly documented. Between 1971 and 1976, 28 female patients with photographic documentation of burns to the anterior chest wall involving the nipple-areolar complex were reviewed. All patients were followed at least until their early teens. The mean age at the time of thermal injury was 5.9 +/- 2.5 years, with a mean follow-up time of 8.9 +/- 2.6 years. Thirteen patients (46 percent) were admitted to the Shriners Burns Institute in Galveston for acute care of their burns. Fifteen patients (54 percent) were referred for long-term follow-up or specific reconstructive procedures following care of the acute burns. In spite of significant thermal injury to the anterior chest wall with involvement of the nipple-areolar complex, no patient failed to develop breasts. Twenty patients (71 percent) required releases of the anterior chest wall to assist breast development. All anterior chest wall releases were accomplished with the use of skin grafts or local skin flaps.

Adolescent↗
PubMed1993

Adolescence, social development, and psychotherapy.

Based on a clinical theory that guides an interpersonal approach to adolescent psychotherapy, the author advances the proposal that there is a developmental sequence of the capacity for relatedness from early to late adolescence: from a stage of Detachment in Relatedness through Disappointment in Relatedness to Mature Relatedness. In this paper, evidence from several broad-based studies of the social development of normal adolescents is presented in support of this proposal. These studies have attempted to track the developmental changes in intimacy, peer conformity, and qualities of friendship.

Adolescent↗