Adolescent growth and development: update.
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BACKGROUND: The size asymmetry of cerebral hemispheres may predispose to head tilt and asymmetric blocking of the zygapophysial joints, potentially leading to the development of compensatory curvatures in the lower segments of the spine. OBJECTIVE: To analyze the effects of spinal manipulation, maintained by an exercise program, on the progression of idiopathic adolescent scoliosis in 2 children aged 6 and 10. CLINICAL FEATURE: The scoliosis found was 16 and 60 degrees. INTERVENTION AND OUTCOME: For diagnosis and monitoring of therapy, we recorded qualitative parameters of shoulder asymmetry, axillary line asymmetry, and scapular angle position. Manual treatment consisted of the examinations of all sliding motion in zygapophysial joints and both sacroiliac joints and removing the limitations of the sliding motions according to the method of Karel Lewit. The treatment procedure consisted of 3 or 4 manipulations within 17 months and an exercise program. The manipulation effects were maintained by the exercise program. The exercises were done in 2 or 3 sessions weekly for a year. In both patients we observed that scoliosis decompensation was successfully stopped and the effects of the correction persisted for 10 years. CONCLUSION: Brain and head asymmetry may be only a transient state, predisposing to asymmetric blocking at the atlanto-occipital level. Removal of blocking may prevent curve progression in children who had adolescent idiopathic scoliosis. The manipulative therapy may also have a promising effect on retarding curve progression when used in skeletally immature patient.
BACKGROUND: According to predictions from the Weak Central Coherence (WCC) theory for perceptual processing, persons with autism should display a tendency to focus on minute details rather than on a more general picture (Frith & Happé, 1994). However, the evidence for this theory is not consistent with findings of an enhanced detection of local targets (Plaisted, O'Riordan, & Baron-Cohen, 1998b; Plaisted, Swettenham, & Rees, 1999), but a typical global bias (Mottron, Burack, Stauder, & Robaey, 1999; Ozonoff, Strayer, McMahon, & Filloux, 1994). METHOD: Adolescents with high-functioning autism and CA- (approximately 15 years) and IQ- (approximately 105-110) matched typically developing adolescents were administered a series of global-local visual tasks, including a traditional task of hierarchical processing, three tasks of configural processing, and a disembedding task that involved rapid perceptual processing. RESULTS: No group differences were found on either the traditional task of hierarchical processing or on tasks of configural processing. However, group differences were found on the disembedding task as the search for embedded, in relation to isolated stimuli, was slower for the typically developing adolescents but similar for the participants with autism. CONCLUSIONS: These findings are consistent with other reports of superior performance in detecting embedded figures (Jolliffe & Baron-Cohen, 1997; Shah & Frith, 1983), but typical performance in global and configural processing (Mottron, Burack et al., 1999; Ozonoff et al., 1994) among persons with high-functioning autism. Thus, the notions of local bias and global impairment that are part of WCC may need to be reexamined.
PURPOSE: This study aimed at assessing the impact of physical training on psychological functioning at the onset of a prospective study of psychological and somatic maturation of adolescent female athletes. METHODS: Twenty-seven highly trained gymnasts aged 12.7 +/- 1.1 year (mean +/- SD, training load = 18-26 hr/week) and 16 age-matched but moderately trained swimmers (13.0 +/- 0.9 yr, training load 4-15 hr/wk) were submitted to standardized somatic and psychiatric examinations during training camps. RESULTS: Gymnasts were significantly shorter, lighter and thinner (p < 0.001) than swimmers. Their bone age was moderately but significantly retarded (-1.42 +/- 0.99 yr, p < 0.001) in contrast with swimmers in whom it was adequate for chronological age (+0.28 +/- 0.94 year, ns). Only 7.4% of gymnasts had already had menarche in contrast with 50% of age-matched swimmers (p = 0.003). Psychological functioning was considered as normal in all subjects. However, seven athletes including 3/27 gymnasts and 4/16 swimmers (p = 0.394) were considered as subjects "at risk" to develop a manifest mental disorder over time. Ten gymnasts (41.7%) presented with a global delay in psychological maturation, whereas no such case was observed among swimmers (p = 0.015). No correlation could be established between psychological delay and pubertal retardation (p = 0.210). CONCLUSION: Strenuous training in gymnastics for more than 1 yr has so far no detectable interference with the normal maturational events of adolescence. The outcome of athletes at risk to develop psychopathology as well as those with a global delay in psychological maturation who presented as if they were still in the latency period, remains uncertain.
The aim was to evaluate a 3-year randomised controlled trial of school-based fluoride mouth rinsing (FMR) on approximal caries development in 13- to 16-year-olds with low to moderate caries risk. The adolescents used F toothpaste at home and underwent prophylactic treatment at yearly check-ups at public dental clinics. Out of 788 randomly selected 13-year-olds, 622 completed the trial, carried out in 1999-2003. Supervised by a dental nurse, the subjects rinsed with a 0.2% NaF solution at different intervals. Group 1 rinsed their teeth on the first three schooldays every semester; group 2 on the first three and the last three schooldays every semester; group 3 on three consecutive days once a month during semesters; group 4 once every fortnight during semesters, and group 5 (control) did not rinse. Radiographic recording of approximal caries was performed. FMR on the three first and the three last schooldays every semester (group 2) had a prevented fraction of 59%, with approximal enamel lesions as a diagnostic threshold. Corresponding figures for groups 1, 3 and 4 were 30, 47 and 41%, respectively. The control group differed statistically from groups 2-4 for new enamel and dentin lesions and fillings (p < 0.01). Enamel lesions constituted more than 90% of the new caries lesions. Caries progression was low for all groups and no significant differences were found between groups. The main conclusion from this randomised controlled trial is that school-based FMR, as a supplement to the daily use of F toothpaste, reduces caries incidence on approximal surfaces in adolescents with low to moderate caries risk.
Adolescents and young adults make up 30% of the population of the Americas. Their health is a key factor in the social, economic, and political development of the region. Nevertheless, their needs are frequently excluded from governments' public and political agendas. The Pan American Health Organization (PAHO) advances a new conceptual framework focusing on human development and health promotion within the context of family and community, and of social, political, and economic development. The challenge in the near future is to use this framework for establishing comprehensive programs, collect disaggregated data, improve access to services, adolescents' environs, the ties between schools, families and communities, as well as improve and support the transition to adulthood through youth participation and interinstitutional and intersectoral collaboration.
We examined the impact on adolescent socioemotional functioning of maternal postnatal depression (PND) and attachment style. We also investigated the role of earlier aspects of the child's development-attachment in infancy, and 5-year representations of family relationships. Ninety-one mother-child pairs, recruited in the postnatal period, were followed up at 13 years. Adolescents were interviewed about their friendships, and their level of emotional sensitivity and maturity were rated. Emotional sensitivity was heightened in girls whose mothers experienced PND; notably, its occurrence was also linked to insecure attachment in infancy and raised awareness of emotional components of family relationships at 5 years. High emotional sensitivity was also associated with adolescent depressed mood. Raised social maturity was predicted by a secure maternal attachment style and, for girls, by exposure to maternal PND. Precursors of adolescent social maturity were evident in the narrative coherence of 5-year family representations. Higher social maturity in the friendship interview was also associated with overall good adjustment.
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BACKGROUND: In vivo imaging studies in adult bipolar patients have suggested enlargement of the amygdala. It is not known whether this abnormality is already present early in the illness course or whether it develops later in life. We conducted a morphometric MRI study to examine the size of specific temporal lobe structures in adolescents and young adults with bipolar disorder and healthy control subjects, as well as their relationship with age, to examine possible neurodevelopmental abnormalities. METHODS: Subjects included 16 DSM-IV bipolar patients (16 +/- 3 years) and 21 healthy controls (mean age +/- SD = 17 +/- 4 years). Measures of amygdala, hippocampus, temporal gray matter, temporal lobe, and intracranial volumes (ICV) were obtained. RESULTS: There was a trend to smaller left amygdala volumes in patients (mean volumes +/- SD = 1.58 +/- .42 mL) versus control subjects (1.83 +/- .4 mL; F = 3.87, df = 1,32, p = .06). Bipolar patients did not show significant differences in right or left hippocampus, temporal lobe gray matter, temporal lobe, or right amygdala volumes (analysis of covariance, age, gender, and ICV as covariates, p > .05) compared with healthy control subjects. Furthermore, there was a direct correlation between left amygdala volumes and age (r =. 50, p = .047) in patients, whereas in healthy controls there was an inverse correlation (r = -.48, p = .03). CONCLUSIONS: The direct correlation between left amygdala volumes and age in bipolar patients, not present in healthy control subjects, may reflect abnormal developmental mechanisms in bipolar disorder.
An appreciation of adolescent growth and development is essential to the understanding of problems faced by the adolescent athlete. Early adolescence (ages 10-15 years) can be characterized as the body period. Physical growth is genetically determined and can be influenced by disease, injury, and nutrition. Early maturers are subject to adult expectations which may lead to either failure or excessive acclaim. Middle adolescence (ages 15-18 years) is the sexuality period, with special emphasis on gender identity. Friendships are critical, and athletics can be a focal point for showing love and affection without social fear. Late adolescence (ages 18-22 years) is the separation period. Young people with athletic skills leave home to face greater athletic and academic pressure and competition in college. Adjustment to this final adolescent period is achieved through learning to lose as well as win with grace and dignity.
Forty-eight black adolescent girls, aged 8 to 16, from the inner city of Baltimore were divided into five groups according to breast and pubic hair development. Blood and hair zinc concentrations as analyzed by atomic absorption spectrophotometry were within ranges reported by other investigators. Hair zinc levels significantly increased (p less than .05) from the second to the last stage of puberty and were significantly correlated (p less than .05) with erythrocyte zinc levels, height, and weight. Mean dietary intakes of calories and protein, as measured from a 24-hour recall, were adequate and increased with stage of breast and pubic hair development. Mean zinc intakes reported in the 24-hour recall averaged 66% of the RDA in the latter half of puberty. It appeared that zinc nutriture was generally adequate in this population, even though the dietary intake of zinc was below the recommended level.
PURPOSE OF REVIEW: Our purpose is to illuminate health perspectives of adolescents in military service, who comprise the main bulk of military personnel. RECENT FINDINGS: Two views are emphasized: the soldier as a developing adolescent and the healthcare of adolescent soldiers. The capacity for abstract thinking and future planning, characteristic of late adolescence, opposes the military challenges of obedience, disengagement from the family, and potential threats for physical injury and mental stress, in addition to the requirement for responsibility beyond the individual's personal needs. On the other hand, at discharge from military service, the mature young adult faces questions of a 17-year-old adolescent. Health perspectives regarding adolescents in military service include physical and mental health screening before draft; recruiting adolescents with chronic illnesses; specific healthcare issues during service, including routine medical care, psychosocial problems of young people in service and approach to suicide and to risk behaviors; health aspects of adolescent women in military frameworks; and the dual commitment of physicians as military officers. SUMMARY: Professionals who care for the well-being of young people in their late teens and early 20s in military service need to consider the service period as an additional developmental stage within late adolescence that requires attention as part of the comprehensive healthcare.
OBJECTIVES: To develop and test psychometric characteristics of the Relationship Power Scale (RPS), which can be used to explore the relationship power of female adolescents in heterosexual relationships. METHODS: Cross-sectional design. Female adolescents in Kaohsiung City, Taiwan, who had a steady relationship with a boyfriend at the time of the study were recruited as study subjects (n=414) to test validity and reliability of the RPS. RESULTS: Confirmatory factor analysis revealed that a one-factor model with correlated uniqueness among the positively worded items best fits the data. There were significantly different scores in 3 different response groups on 2 items regarding who (participants, both themselves and their boyfriends equally, or their boyfriends) had more power in the relationship, and who was more emotionally involved in the relationship for all subjects. For subjects having sex with their steady boyfriends, RPS scores significantly differ among the 3 different response groups on 2 items regarding who had more say about having sex, and who had more say about using condoms. Cronbach's alpha for the RPS was .69. Test-retest reliability coefficients for the RPS were .83. CONCLUSIONS: The RPS exhibited acceptable reliability and validity. Further research is recommended to use the RPS in sex-related behavior research among heterosexual female adolescents.
This longitudinal study provides a comprehensive analysis of continuity and change in personality functioning from age 18 to age 26 in a birth cohort (N = 921) using the Multidimensional Personality Questionnaire (A. Tellegen, 1982). Data were analyzed using 4 different methods: differential continuity, mean-level change, individual differences in change, and ipsative change. Convergent evidence pointing toward personality continuity, as opposed to change, was found. The personality changes that did take place from adolescence to adulthood reflected growth in the direction of greater maturity; many adolescents became more controlled and socially more confident and less angry and alienated. Consistent with this, greater initial levels of maturity were associated with less personality change over time. The results indicate that the transition from adolescence to young adulthood is marked by continuity of personality and growth toward greater maturity.
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