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PubMed2000

Predicting early adolescent substance use: do risk factors differ depending on age of onset?

This study was designed to identify different risk models associated with non-use, first use, and prior substance use among a group of early adolescents. A total of 582 students completed a self-report questionnaire at the beginning and end of sixth grade. Nine predictor variables were used in discriminant function analysis to classify adolescents into three groups. Five variables distinguished non-users (never used by the end of sixth grade) and new users (first used during sixth grade) from prior users (first used before sixth grade). Prior users were found to have weaker decision making skills, more susceptibility to peer pressure, more negative perceptions of school, less confidence in their skills, and an increased likelihood of being male. A second function indicated that new users were similar to prior users in that they had less positive peer relations, were more likely to come from single parent families, and had less knowledge about alcohol and drugs than did non-users. The similarities and differences between new and prior users have implications for future research and prevention programming.

Adolescent↗
PubMed1993

Quality assurance in graduate medical education: a peer review process.

The Accreditation Council for Graduate Medical Education in the United States has recently required institutions with residency and fellowship training programmes to develop an Institutional Policy Review Document outlining how the educational quality of these programmes is monitored. Whereas departments may have assumed this responsibility in the past, this is clearly a function of the institution. The purpose of this paper is to describe a long-standing, effective, internal peer review process to assure quality education in an institution.

Education, Medical, Graduate↗
PubMed1996

[Functional evaluation by treadmill in children and adolescent following correction of Tetralogy of Fallot].

AIM OF THE STUDY: The Authors have examined 22 children (16m and 6f), mean age 9.64 +/- 2.63 years, range 5-15, after total correction for Tetralogy of Fallot, to evaluate the response of their cardiovascular apparatus during an exercise testing on treadmill (Bruce protocol). METHODS: Parameters examined: exercise duration, maximal heart rate (HR), maximal systolic blood pressure (max BP), non invasive cardiac output at rest and at the peak of exercise (CO), arterial oxygen saturation; lung function test at rest, echocardiogram and 24 hours Holter monitoring. CONTROL GROUP: 22 healthy peers, same gender, height and weight, not practising competitive sports. RESULTS: The exercise duration was significantly lower in the first group (77.8 +/- 11.8%; 86.5 +/- 8.2%; P = 0.006). Also max HR and max BP were significantly lower (max HR: 162 +/- 12 b/m'; 187 +/- 8 b/m'; P = 0.000), (max BP: 119 +/- 9 mm Hg; 126 +/- 12 mm Hg; P = 0.042). There were no differences for CO at rest (3.70 +/- 1.09 l/m'; 3.95 +/- 1.07 l/m'). In the first group, CO at peak of exercise was lower but not significantly (6.51 +/- 2.56 l/m'; 7.95 +/- 2.77 l/m'; NS). CONCLUSIONS: These results make more complete the not invasive functional evaluation for a better follow-up of these patients and a better choice for their physical activity.

Adolescent↗
PubMed1976

A component analysis of attentional problems of educationally handicapped boys.

Seventy-three educationally handicapped (EH) and 78 regular class, normally achieving (NA) boys grades 3-8 were tested with a series of measures selected to test three components of attention: coming to attention, decision making, and maintaining attention over time. EH and NA samples were subdivided into three gropus by grade level (grades 3-4, 5-6, and 7-8). Based on a teacher-completed behavioral check list, the EH group was further subdivided according to pupils perceived by teachers as hyperactive or nonhyperactive. With the exception of the youngest group, EH and NA samples did not differ from each other on CA, but regular class boys had slightly higher IQs and better reading scores than did their EH peers; EH hyperactives and EH nonhyperactives differed significantly on reading scores, the difference favoring the nonhyperactives. All pupils were individually administered the Children's Embedded Figures Test (CEFT), the Matching Familiar Figures Test (MFFT), and the Children's Checking Task (CCT), the last designed specifically to assess ability to maintain attention over time. EH pupils did not function as efficiently or as accurately on the attentional tasks as did their normally achieving age peers. Significant differences between EH and NA samples were found for CEFT and MFFT errors, as well as for CCT errors of omission and commission. Analyses of the EH group according to hyperactive--nonhyperactive status were for the most part nonsignificant. Correlational analyses yielded low but statistically significant relationships among the attentional measures, but nonsignificant relationships between IQ and the attentional test scores. Findings were consistent with the interpretation that the three hypothesized components of attention are partially independent and thus may have differential influence on pupils performance in school.

Attention↗
PubMed1996

The role of adolescent peer affiliations in the continuity between childhood behavioral adjustment and juvenile offending.

This research reports on a structural equation model analysis of the relationships between childhood behavioral adjustment, adolescent peer affiliations, and adolescent offending using data gathered during the course of a 16-year longitudinal study of a birth cohort of New Zealand children. The model developed contained parameters that estimated (a) the continuities between early behavior and later offending, (b) the associations between early behavior and adolescent peer affiliations, and (c) the potentially reciprocal relationship between adolescent peer affiliations and adolescent offending behaviors. This analysis suggested that, when due allowance was made for reporting error, there was evidence of relatively strong continuity (r = .50) between early behavior and later offending. The model estimates suggested that these continuities arose from both direct continuities in behavior over time and from the effects of adolescent peer affiliations in reinforcing and sustaining earlier behavioral tendencies. The implications of the analysis for the understanding of the role of adolescent peer affiliations in behavioral continuities and discontinuities are discussed.

Adolescent↗
PubMed1996

Teaching preschool age autistic children to make spontaneous initiations to peers using priming.

Children with autism rarely initiate social interactions with their peers. Currently available interventions have not increased autistic children' spontaneous initiations in natural settings without extensive teacher involvement. A "priming" strategy consisting of a low demand, high reinforcement session prior to the regular school activity was used to increase the spontaneous social initiations of 2 preschool age autistic boys to typically developing peers in a regular preschool classroom. Peers were also trained to independently respond to initiations. Implications for developing practical ways to improve autistic children's social functioning in regular school settings are discussed.

Autistic Disorder↗
PubMed1990

Biomedical information, peer review, and conflict of interest as they influence public health.

The peer review process serves a vital role in the publication of biomedical information. When properly functioning, review should focus exclusively on questions of scientific validity and should avoid becoming enmeshed in questions such as "authorization" and "data ownership." We present a case in which the dissenting views of a coinvestigator were suppressed because the principal investigator and grantee institution informed a medical journal that the coinvestigator was not "authorized" to use the data generated by a publicly funded grant and because the editor of a scholarly journal refused to review the dissenting manuscript and to submit that dissent to external reviewers for peer review. The current peer review system, as shown by this case, is unable to embrace dissent within the peer review process and to use dissent to serve scientific truth and the public interest.

Biomedical Research↗
PubMed2000

Psychosocial treatments in schizophrenia: a review of the past 20 years.

Pharmacotherapy can improve some of the symptoms of schizophrenia but has limited effect on the social impairments that characterize the disorder and limit functioning and quality of life. Through computerized literature searches and bibliographies of published reports we identified peer reviewed studies of group, family, and individual therapy with schizophrenia and schizoaffective disorder patients. We identified 70 studies: 26 on group therapy, 18 on family therapy, and 11 on individual therapy. Additionally, treatment models were compared in 4 studies and combined in 11 others. Controls were included in 61 and all studies included medication. Benefits in symptoms as well as social and vocational functioning were associated with psychosocial treatments. Family therapy demonstrated the most promising findings and traditional social skills treatment yielded the least robust results. Adjunctive psychosocial treatments augment the benefits of pharmacotherapy and enhance functioning in psychotic disorders. Although these positive results have led to increased enthusiasm about psychosocial treatments for schizophrenia, questions remain about comparative benefits of specific treatment methods and additional benefits of multiple treatments.

Activities of Daily Living↗
PubMed2026

Effectiveness of peer recovery support services for substance use disorders: A systematic review of healthcare utilization, behavioral health, and engagement outcomes.

BACKGROUND: Peer recovery support services (PRS) delivered by individuals with lived experience of substance use, are increasingly incorporated into substance use disorder (SUD) care systems to improve care engagement, reduce acute care use, and support recovery. However, existing systematic reviews have focused on substance use outcomes, with limited attention to healthcare utilization, psychosocial functioning, and outcomes across settings, and populations. METHODS: This systematic review, registered in PROSPERO (CRD42023469279), synthesized peer-reviewed studies from 2003 to 2026 evaluating PRS for individuals with alcohol or drug-related SUD. Using MEDLINE, Embase, PsycINFO, and CINAHL, the review included 53 studies primarily conducted in high-income countries that reported quantitative outcomes across substance use, healthcare utilization, behavioral health, and treatment engagement. Risk of bias was assessed using Cochrane RoB 2, ROBINS-I, and ROBINS-E tools. RESULTS: Overall, evidence was most favorable for selected treatment-linkage and engagement outcomes, whereas findings for substance use, emergency department use, hospitalization, overdose, and mortality were inconsistent. Uncontrolled longitudinal studies frequently reported improvements in depression and anxiety, but no randomized trials evaluated these outcomes, limiting causal inference. Exploratory cross-study patterns suggested that sustained navigation, practical assistance, and repeated peer contact were more often present in programs reporting favorable outcomes; however, these components were not independently evaluated. Substantial heterogeneity, frequent multicomponent interventions, high risk of bias in many nonrandomized studies, and limited long-term and economic data constrain conclusions. CONCLUSIONS: Findings support the promise of PRS while underscoring the need for more rigorous comparative studies, cost-effectiveness data, and further research in low- and middle-income countries.

Humans↗
PubMed1992

[The effects of early manual instruction on the oral language development of two deaf children].

The speech and language training for deaf children at our clinic is performed using a multisensory method, which consists of reception and expression training for sign language and fingerspelling as well as auditory training, lip reading, and written language training (the Kanazawa Method). We have already reported that acquisition of written language is not dependent on oral language, and that written language is easier to learn than oral language for deaf children. In the present investigation, we analyzed the acquisition of comprehensible and expressive vocabulary in sign language and fingerspelling. The subjects were two children congenitally deaf at levels higher than 105dB. Recorded language samples by the age of 48 months were analyzed. Acquisition of sign language was found to be significantly easier than acquisition of oral language. The development of expressive noun words, function words, and Wh-question words in sign language at the early period was almost equivalent to that of hearing peers, and then the sign language appeared transfer to the oral language. These results suggest that early presentation of sign language with written and oral language is effective in the acquisition of communicative attitudes, function words and interrogative sentences which are most difficult for the hearing-impaired. It was shown that early presentation of sign language with written and oral language serves to promote acquisition of oral language.

Child↗
PubMed1998

Historical clues to the diagnosis of the dysfunctional child and other psychiatric disorders in children.

This article focuses on selected historical clues that can help the busy pediatrician identify children who are at risk for or already suffering from psychosocial dysfunction. Certain historical elements have been chosen because they reveal either common areas of childhood dysfunction or potentially dire outcomes. The major function realms of a child's life are covered, such as family, school, peer relationships, activities, and emotions, as well as related topics such as injury, poverty, substance abuse, and risk-taking behavior. Questions designed to elicit the relevant historical clues are suggested. Used as a set, these questions are intended to bring to light sufficient psychosocial history for pediatricians to identify most dysfunctional children.

Child↗
PubMed1982

Symptoms associated with menstruation.

Symptoms associated with menstruation during the teenage and young adult years may represent a spectrum of possibilities varying from a relatively benign deviation from normal to a serious life-threatening disease. Nevertheless, even for the young woman found to be without serious disease, menstrual problems have special meaning associated with the fear of being different from peers, concern about being less than complete or wholesome, and anxiety regarding future functioning as a normal woman. The physician must be aware of the adolescent's sensitivity in this area. Her apprehension should influence the manner in which the various abnormalities of menstruation are evaluated and managed. The physician must understand and appreciate the potential for profound emotional effects and psychological implications of menstrual conditions. The manner in which we care for the adolescent with menstrual symptoms will determine to a significant degree how successfully the patient will cope with abnormalities of menstruation.

Adolescent↗
PubMed1997

Clinical characteristics of psychiatrically referred adolescent outpatients with substance use disorder.

OBJECTIVE: There is increasing interest in the developmental relationship of psychopathology and substance use disorders (SUD) in youths. Because the bulk of literature is focused in inpatient or incarcerated youths, inferences and generalizations are limited in outpatient settings. The clinical characteristics of psychiatrically referred outpatients were studied to determine whether differences existed in the nature and severity of comorbid psychiatric disorders when substance abuse was involved. METHOD: All diagnoses were derived from structured psychiatric interviews completed on all youths on intake assessment. Adolescents with an identified SUD (n = 38) were compared with those without SUD (n = 321) on a number of variables including past and current psychopathology, cognitive and school functioning, and overall impairment. RESULTS: Eleven percent of referred outpatients (mean age = 15.9 +/- 1.3 years) met full criteria for a SUD by parental report. Controlling for age, adolescents with SUD had higher risk for mood and disruptive behavioral disorders compared with psychiatric controls. In the majority of cases, the onset of psychopathology preceded the onset of SUD by at least 1 year. The group with SUD also had lower overall functioning and more school dysfunction and psychiatric hospitalizations than their non-SUD peers. CONCLUSIONS: Despite the small number of adolescents with SUD in this sample, these data indicate that SUD is common in outpatient psychiatry referrals. Youths with SUD appear to be at increased risk for more psychopathology and dysfunction in a number of domains.

Adolescent↗
PubMed1995

Social competence in the school setting: prospective cross-domain associations among inner-city teens.

In this 6-month prospective study of 138 ninth-grade inner-city students, associations among different aspects of school-based social competence were examined. In addition, links between initial emotional adjustment and subsequent social competence at school were explored. Aspects of social competence examined included academic achievement, peer reputation, and teacher-related classroom behaviors. Emotional adjustment was measured based on self-reported internalizing and externalizing symptoms. Consonant with views positing continuity and coherence of development, high temporal consistency was found within each social competence domain. In addition, superior adjustment in one domain was sometimes associated with subsequent improvements in other spheres as well. Exceptions found to this pattern were that (a) both as an antecedent and as a consequent variable, peer-rated sociability was negatively linked with other indices of school-based functioning, and (b) among girls, high anxiety was related to improved performance at school over the year. Ecological influences in adolescent adjustment are discussed, and implications of the findings for future research are explored.

Adolescent↗
PubMed1997

Social and psychological adjustment of Soviet-born and Israeli-born adolescents: the effect of the family.

This study examined the impact of family functioning on the educational, social and emotional behavior of Soviet-born and Israeli-born adolescents in Israel. The parents of the Israeli-born adolescents were born in Russia; thus, this study controlled for their national background. The results showed that the two groups were similar in their perception about the way their families function. Both groups perceived that social and psychological well-being among adolescents were significantly related to family functioning. Multivariate analysis revealed that family functioning was the major factor predicting the level of self-esteem and peer relationships among adolescents, as well as a myriad of psychological symptoms. Directions for future research are discussed.

Adaptation, Psychological↗
PubMed1999

Treatment results in dental school orthodontic patients in 1983 and 1993.

The effect of incremental changes in materials and techniques on orthodontic treatment outcomes is difficult to evaluate objectively. Treatment results for two groups of patients whose treatments were completed approximately 10 years apart were evaluated using the peer assessment rating (PAR) index and the index of orthodontic treatment need (IOTN) using the Wilcoxon matched-pairs signed-rank test. Patients in the later group who had been treated by postgraduate students primarily (using fixed appliances) had significantly lower IOTN and PAR scores at the end of treatment and showed a significantly greater reduction in the PAR score than a similar group of patients in the earlier group. There were no significant differences in treatment results between patients in the early and late groups who were treated with removable appliances. Differences in treatment results were most likely the result of changes in materials and techniques that had occurred in the 10 intervening years.

Adolescent↗
PubMed1999

Psychological symptoms in chronic fatigue and juvenile rheumatoid arthritis.

OBJECTIVE: To determine if psychological morbidity in youth with chronic fatigue is caused by the stress of coping with a chronic illness. STUDY DESIGN: Case-control study comparing pediatric patients with debilitating chronic fatigue and matched subjects with juvenile rheumatoid arthritis, a chronic medical illness with similar functional sequelae. SETTING: Pediatric Infectious Diseases Clinic and Juvenile Rheumatoid Arthritis Clinic of Kosair Children's Hospital. PARTICIPANTS: Nineteen children and adolescents with debilitating chronic fatigue and 19 age- and sex-matched peers with juvenile rheumatoid arthritis. Outcome. Structured Interview, Kaufman Brief Intelligence Test, Child Behavior Checklist, and Youth Self-Report. RESULTS: Intellectual functioning on the Kaufman Brief Intelligence Test Composite was average (103, standard score) for both groups. Pediatric patients with chronic fatigue had higher levels of internalizing psychological distress than patients suffering from juvenile rheumatoid arthritis, despite the fact that both groups had a similar pattern of decline in social and physical activities. Duration of illness did not explain the difference in psychological symptoms. CONCLUSIONS: Psychological factors may play a more active role in debilitating chronic fatigue in pediatric patients than can be explained by the stress of coping with a similar chronic, non-life-threatening illness.

Adaptation, Psychological↗