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PubMed2000

Adolescent hepatitis B vaccination: comparison among 2 high school-based health centers and an adolescent clinic.

OBJECTIVE: To compare the completion rate of hepatitis B vaccination among adolescents who receive primary care at 2 comprehensive high school-based health centers (SBHCs) and a hospital-based adolescent health center (AHC) to assess predictors for successful immunization. METHODS: A retrospective chart review of patients seen for comprehensive history and physical examinations from September 1997 to March 1998 at 2 SBHCs and an AHC was conducted to determine the immunization status for hepatitis B. One SBHC (SBHC-A) had previously implemented an outreach strategy consisting of advertising through the school's loudspeaker, whereas the other SBHC (SBHC-B) and the AHC did not. Completion rates were assessed among all students requesting comprehensive history and physical examinations. A subset analysis among those without prior immunizations was performed. RESULTS: Of 510 records reviewed, 406 had documented data for hepatitis B immunization status, and 191 (37 for SBHC-A, 59 for SBHC-B, 95 for AHC) did not have any prior hepatitis immunizations. The completion rate of hepatitis B vaccination was significantly higher at SBHC-A (76%) compared with the other 2 sites (29% for SBHC-B and 24% for AHC) (P<.001). CONCLUSION: Patients with access to SBHC services that strongly emphasize outreach were more likely to complete the hepatitis B vaccination series.

Adolescent↗
PubMed1988

Risk factors for adolescent suicide. A comparison of adolescent suicide victims with suicidal inpatients.

The characteristics of adolescent suicide victims (n = 27) were compared with those of a group at high risk for suicide, suicidal psychiatric inpatients (n = 56) who had either seriously considered (n = 18) or actually attempted (n = 38) suicide. The suicide victims and suicidal inpatients showed similarly high rates of affective disorder and family histories of affective disorder, antisocial disorder, and suicide, suggesting that among adolescents there is a continuum of suicidality from ideation to completion. However, four putative risk factors were more prevalent among the suicide victims: (1) diagnosis of bipolar disorder; (2) affective disorder with comorbidity; (3) lack of previous mental health treatment; and (4) availability of firearms in the homes, which taken together accurately classified 81.9% of cases. In addition, suicide completers showed higher suicidal intent than did suicide attempters. These findings suggest a profile of psychiatric patients at high risk for suicide, and the proper identification and treatment of such patients may prevent suicide in high-risk clinical populations.

Adolescent↗
PubMed1984

A comparison of the psychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders.

Cognitive and projective psychological tests were administered to ten inpatient adolescents with anorexia nervosa and ten inpatient adolescents with conduct disorders. All subjects were selected on the basis of race, sex and overall intelligence. Results indicate that there are high numbers of neuropsychological deficits in both groups, but that neuropsychological deficits are especially numerous in the anorexia group. The two groups showed striking similarities in terms of some psychological functions, but results indicate that some aspects of personality style in the two groups are significantly different. A significant finding was that there were far more suicidal indicators on the Rorschach records of the anorectic group as compared with those found on the records of the conduct disorder group.

Adolescent↗
PubMed1990

Adolescents with obsessive-compulsive disorder: a case note review of consecutive patients referred to a provincial regional adolescent psychiatry unit.

A number of clinical descriptions of Obsessive-Compulsive Disorder (OCD) in adolescence are available but are often of small numbers of cases with highly selective recruitment methods. We describe the findings of a systematic case note review of 44 consecutive OCD patients referred to Oxford Regional Adolescent Unit between 1974 and 1984. The relative frequencies of previously described features of the condition in this age group are presented. Many patients had problems with peer relationships and social isolation, which often preceded the onset of other symptoms by many years. The management of the cases and outcome at discharge are outlined.

Adolescent↗
PubMedDate not supplied

The Adolescent Behavior Checklist: normative data and sensitivity and specificity of a screening tool for diagnosable psychiatric disorders in adolescents with mental retardation and other development disabilities.

Individuals with mental retardation are almost twice as likely to demonstrate severe behavioral problems or symptoms of mental illness as are nonmentally retarded individuals. At present, however, the ability to diagnose a mental disorder in an individual with mental retardation is difficult, and instruments are needed to help facilitate this process. The Adolescent Behavior Checklist was developed with this purpose in mind. This self-report scale is used to assess the likelihood that an adolescent with mild mental retardation or borderline intelligence has a diagnosable mental illness. The 86-item yes/no self-report scale renders scores on eight subscales derived from DSM III-R. The checklist has been found to have good criterion and congruent validity and good test-retest reliability. Data regarding interrater reliability and the sensitivity and specificity of the scale are presented, as are implications for future research.

Adolescent↗
PubMedDate not supplied

Validity of bone mineral density measurements in distal sites as an indicator of total bone mineral density in a group of pre-adolescent and adolescent women.

BACKGROUND: The study of bone mineral density (BMD) has received attention due to the importance of osteoporosis as a public health problem in Mexico. The objective of this study was to assess the validity of BMD measures in distal forearm and calcaneus with portable densitometers as indicators of BMD on other anatomic sites. METHODS: We conducted a cross-sectional study with 219 women from 9 to 22 years of age in Cuernavaca, Morelos, Mexico. We measured BMD in central sites (the entire skeleton, excluding head, proximal femur, and lumbar spine) using dual X-ray absorptiometry (DXA) and in peripheral sites (distal forearm and calcaneus) using a portable densitometer with DXA technology. Measurements of height, weight, body composition, physical activity, and demographic characteristics were collected. Agreement of measurements of BMD was assessed using correlation and regression analysis, and the method proposed by Bland and Altman. RESULTS: Higher levels of BMD were found in total skeleton (0.88 g/cm(2)) than in calcaneus (0.48 g/cm(2)) and distal forearm (0.38 g/cm(2)) (p <0.05). Moderate-to-high positive correlation coefficients (all significant) (p <0.05) were found between BMD in distal forearm and calcaneus vs. central anatomic sites, ranging from r = 0.49 to r = 0.78. BMD was higher in central sites compared with distal forearm and calcaneus. CONCLUSIONS: Measurement of BMD in distal forearm and calcaneus with portable densitometers provided valid indicators of BMD in central anatomic sites among pre-adolescent and adolescent women in Mexico.

Adolescent↗
PubMed1985

Seizures in adolescence. A review of patients admitted in an adolescent service.

The admissions of new seizure patients to an adolescent service over a 10-year period were retrospectively reviewed with regard to the patient's etiology, work-up, and outcome. Head trauma and pseudoseizures were common, 21% and 19%, respectively. In general, the outcome in adolescents appears to depend more on the underlying diagnosis than on how the seizure presents.

Adolescent↗
PubMed2002

Child and Adolescent Psychiatric Screening Inventory-Retrospect (CAPSI-R): a questionnaire for adults concerning child and adolescent mental disorders.

This study examines the properties of the Child and Adolescent Psychiatric Screening Inventory-Retrospect, CAPSI-R, a self-report 146-item questionnaire for adults concerning earlier child psychiatric symptoms, comprising both DSM-IV categories and functional impairment. The instrument was mailed to 359 former child psychiatric patients born between 1951 and 1977 (164 of whom responded) and to a matched control group (193 of whom responded). There was good internal consistency (Cronbach's alpha ranged between 0.62-0.93, and between 0.76-0.93 after elimination of one item). The lifetime prevalence of a mental disorder was 87.8% in the former patients' without considering impairment and 76.8% when impairment was considered. The corresponding figures for the control group were 49.7% and 10.4%, respectively. When the former patients' CAPSI-R diagnoses (with incorporation of the impairment criterion) were validated against the DSM-IV diagnoses based on information in their medical records, generally, an acceptable sensitivity and specificity were obtained. The overall kappa between CAPSI-R diagnoses and those from medical records was 0.79. The CAPSI-R shows promise for further evaluation and may be useful in recognising child and adolescent mental disorders in adults.

Adolescent↗
PubMed2003

Factors associated with self-esteem in pre-adolescents and adolescents with cerebral palsy.

Predictors of self-esteem were examined in 50 pre-adolescents and adolescents with cerebral palsy. On average, self-esteem was high, although 30% scored below a cut-point for low self-esteem. Self-esteem was bivariately associated with female gender, better physician-assessed functional ability, greater perception of the impact of the disability, and higher perceived parent overprotectiveness. In a multivariate model, only perceived impact of the disability remained significant.

Adolescent↗
PubMed2003

Eating disorders in adolescent boys: a review of the adolescent and young adult literature.

Although a number of studies have investigated eating disorders in adolescence and the topic has been thoroughly reviewed, these studies have typically focused on females, only to state that the approach and treatment should be similar in males. Recently, there have been a number of studies that have explored gender differences in eating disorders. In this article, we review the literature pertaining to two DSM-IV-defined disorders (anorexia nervosa and bulimia nervosa), a DSM-IV-defined research disorder (binge eating disorder), and two DSM-PC-defined disorders (dieting/body image and purging/binge-eating behaviors), highlighting those findings that pertain to disordered eating in adolescent boys.

Adolescent↗
PubMed1997

Psychiatric disorders associated with substance use among children and adolescents: findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study.

The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit substance use and substance use (SUD) and other psychiatric disorders were investigated among 1,285 randomly selected children and adolescents, aged 9 to 18, and their parents, from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Logistic regressions indicated that daily cigarette smoking, weekly alcohol consumption, and any illicit substance use in the past year were each independently associated with an elevated likelihood of diagnosis with SUD and other psychiatric disorders (anxiety, mood, or disruptive behavior disorders), controlling for sociodemographic characteristics (age, gender, ethnicity, family income). The associations between the use of specific substances and specific psychiatric disorders varied as a function of gender.

Adolescent↗
PubMed1994

The contribution of influence and selection to adolescent peer group homogeneity: the case of adolescent cigarette smoking.

Understanding the homogeneity of peer groups requires identification of peer groups and consideration of influence and selection processes. Few studies have identified adolescent peer groups, however, or examined how they become homogeneous. This study used social network analysis to identify peer groups (cliques), clique liaisons, and isolates among adolescents in 5 schools at 2 data collection rounds (N = 926). Cigarette smoking was the behavior of interest. Influence and selection contributed about equally to peer group smoking homogeneity. Most smokers were not peer group members, however, and selection provided more of an explanation than influence for why isolates smoke. The results suggest the importance of using social network analysis in studies of peer group influence and selection.

Adolescent↗
PubMed2006

Are multiracial adolescents at greater risk? Comparisons of rates, patterns, and correlates of substance use and violence between monoracial and multiracial adolescents.

Rates and patterns of substance use and violent behaviors among multiracial adolescents were examined and compared with 3 monoracial groups, European, African, and Asian Americans. The relationships between ethnic identity and the subjective experience of racial discrimination, substance use, and violent behavior were also examined. The authors found multiracial adolescents reporting higher rates of problem behaviors. Several significant relationships between ethnic identity and racial discrimination were found with these problem behaviors.

Adolescent↗
PubMed1999

Defining abstract entities: development in pre-adolescents, adolescents, and young adults.

Students ages 12, 15, 18, and 23 (n = 60 per group) wrote definitions for 16 abstract nouns (e.g., pride, courage, realization). Responses were analyzed for the Aristotelian style, a type of definition that mentions both the superordinate category term and one or more characteristics of the word (e.g., "Pride is a sense of delight about a possession or accomplishment"). This response type was of interest because it is a sophisticated and literate defining style that is modeled in classrooms, textbooks, and dictionaries-a style that is informative, concise, and efficient. The results indicated that a number of important changes occur in the ability to provide Aristotelian definitions for abstract nouns during the developmental period from late childhood to early adulthood. Specifically, there was an increasing tendency for students to mention the appropriate category to which a word belongs, core features of the word, and subtle aspects of meaning. The study contributes to the knowledge base concerning the nature of language development in pre-adolescents, adolescents, and young adults.

Adolescent↗
PubMed2001

Routine outcome measurement in a child and adolescent mental health service: an evaluation of HoNOSCA. The Health of the Nation Outcome Scales for Children and Adolescents.

OBJECTIVE: This paper evaluates a range of properties for a clinician-based instrument designed for routine use in a child and adolescent mental health service (CAMHS). METHOD: The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) is a new outcome measure with great promise. Case vignettes were used to examine interrater reliability. HoNOSCA was implemented for routine outpatient use by multidisciplinary staff with a return rate of 84%. The 305 ratings obtained at assessment were analysed by age, gender and diagnosis. A sample of 145 paired ratings with a 3-month interval were examined for the measurement of change over time. RESULTS: Interrater reliability of the total score indicates moderate reliability if absolute scores are used and good reliability if the total score is used for relative comparisons. Most scales have good to very good reliability. The scales discriminated between age and gender in the expected way. HoNOSCA correlated with clinicians' views of change and was sensitive to change over a 3-month period. The total score seemed a proxy for severity. CONCLUSION: Routine outcome instruments must be explored in settings where they will be used and with realistic training. HoNOSCA appears to be of value in routine outcome measurement and although questions remain about reliability and validity, the results strongly support further investigation.

Adolescent↗
PubMed1999

Weight and shape concerns and dieting behaviours among pre-adolescents and adolescents in Japan.

The attitudes towards body weight and shape, desire for thinness and dieting behaviours were investigated in pre-adolescent and adolescent girls and boys (547 elementary school students, 615 junior high school students, and 470 senior high school students) aged 10-17 years in Osaka Prefecture, Japan, by a self-report questionnaire. Forty-eight per cent of 10-year-old females and 84% of 17-year-old females categorized themselves as 'fat' or 'too fat'. The fear of weight gain and desire for thinness was reported in 35% and 51% of 10-year-old girls, respectively, and increased progressively with ageing to 79% and 87% of 17-year-old girls. In contrast, these were reported by 20-30% of boys in the corresponding age groups. Some practices to be slim were found in 22% of the 10-year-old girls, and increased to 37% among the 17-year-old girls, whereas they were found in around 20% of the boys at each age. The practices to be slim were found in 32% of the girls who were 85-90% of the standard body weight (SBW) and in 14% of the girls less than 85% of the SBW. These results suggest that significant concerns about weight and shape and dieting behaviours are present in young Japanese girls and increase progressively with age. These results are compatible with those in Western society.

Adolescent↗
PubMed2006

Neuropsychological functioning in adolescents and young adults at genetic risk for schizophrenia and affective psychoses: results from the Harvard and Hillside Adolescent High Risk Studies.

Siblings and offspring of persons with schizophrenia carry elevated genetic risk for the illness and manifest attentional and memory impairments. Because less is known about other neuropsychological functions and their specificity in adolescents, we conducted a genetic high-risk (HR) study of schizophrenia (HR-SCZ) and affective psychosis (HR-AFF). Participants (ages 12-25) were from the Harvard Adolescent High-Risk and Hillside Family studies, including 73 HR-SCZ, 18 HR-AFF, and 84 community controls (CCs) recruited in metropolitan Boston and New York. Groups were compared on overall neurocognitive functioning, 6 domains, and 13 test scores, controlling for age, parental education, and correlated data within families. The HR-SCZ group was significantly impaired overall, while the HR-AFF group demonstrated a trend toward overall impairment. HR-SCZ subjects showed significantly lower Verbal Ability (d = .73) and Executive Functioning/Working Memory (d = .47) than CCs. HR-AFF subjects showed reduced Verbal Ability (d = .64) compared to CCs. Excluding 12 CCs with a parental history of depression (without psychosis) led to larger differences between HR and CC groups across domains. Moreover, HR-SCZ and CC group differences in Verbal Memory (d = .39) and Visual-Spatial (d = .34) became statistically significant. There were no significant differences between HR-SCZ and HR-AFF groups. Data support a modest neuropsychological deficit in persons at genetic HR for psychosis, with a broader range of deficits in HR-SCZ. Future work should assess the relationship of neurocognition to adaptive functioning and possible onset of psychosis in HR samples. Ascertainment criteria for controls may markedly influence results and interpretation of group differences.

Adolescent↗
PubMed2001

Social information processing in adolescents: data from normally developing adolescents and preliminary data from their peers with traumatic brain injury.

OBJECTIVE: To assess aspects of social information processing in naturalistic conversations, using online videotape tasks. DESIGN AND PARTICIPANTS: The tasks were administered to 60 normally developing (ND) subjects ages 13 to 21, and 10 adolescents with traumatic brain injury (TBI). SETTING: University. MAIN OUTCOME MEASURE: Task accuracy scores and measures of reliability and validity. RESULTS AND CONCLUSIONS: ND group scores were generally high, without significant differences by race, sex or age. TBI group scores were significantly lower than ND group scores for both emotion recognition and detection of conversation skills. The results are discussed in light of the evaluation of pragmatic competence in adolescents with TBI.

Adolescent↗