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PubMed2001

Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. American Academy of Child and Adolescent Psychiatry.

This practice parameter reviews the literature on the assessment and treatment of children and adolescents with schizophrenia. Recommendations are based on the limited research available, the adult literature, and clinical experience. Early-onset schizophrenia is diagnosed using the same criteria as in adults, and it appears to be continuous with the adult form of the disorder. Noted characteristics of youth with schizophrenia include predominance in males, high rates of premorbid abnormalities, and often poor outcome. Differential diagnosis includes psychotic mood disorders, developmental disorders, organic conditions, and nonpsychotic emotional/behavioral disorders. Treatment strategies incorporate antipsychotic medications with psychoeducational, psychotherapeutic, and social and educational support programs. The advent of atypical antipsychotic agents has enhanced the potential for effective treatment.

Adolescent↗
PubMed2003

Adolescent precursors of cannabis dependence: findings from the Victorian Adolescent Health Cohort Study.

BACKGROUND: Dependence increases the likelihood of adverse consequences of cannabis use, but its aetiology is poorly understood. AIMS: To examine adolescent precursors of young-adult cannabis dependence. METHOD: Putative risk factors were measured in a representative sample (n=2032) of secondary students in the State of Victoria, Australia, six times between 1992 and 1995. Cannabis dependence was assessed in 1998, at age 20-21 years. RESULTS: Of 1601 young adults, 115 met criteria for cannabis dependence. Male gender (OR=2.6, P < 0.01), regular cannabis use (weekly: OR=4.9; daily: OR=4.6, P=0.02), persistent antisocial behaviour (linear effect P=0.03) and persistent cigarette smoking (linear effect P=0.02) independently predicted cannabis dependence. Neither smoking severity (P=0.83) nor persistent psychiatric morbidity (linear effect P=0.26) independently predicted dependence. Regular cannabis use increased risk only in the absence of persistent problematic alcohol use. CONCLUSIONS: Weekly cannabis use marks a threshold for increased risk of later dependence, with selection of cannabis in preference to alcohol possibly indicating an early addiction process.

Adolescent↗
PubMed1998

Adolescent school failure: failure to thrive in adolescence.

The role of the primary clinician in dealing with school failure can be critical by linking the epidemiological with the clinical and encompassing the pediatric/adolescent life span. It includes components of social and public health advocacy, preventive medicine, evaluation, education, treatment, and referral. The most effective interventions are early and multifaceted. The primary care role includes: community advocacy; counseling about prenatal drug and alcohol abuse; early detection and treatment for attentional disorders, underachievement, and learning disabilities; interviews addressing multiple risk factors, grades, school attitudes, behavior, and friends; anticipatory guidance; education about individual learning style and good "learning hygiene"; early referral and intervention for preadolescent conduct problems and parent-child conflict; early referrals for family distress; and prevention of substance abuse and adolescent pregnancy.

Adolescent↗
PubMed1996

Assessing adolescent problems: an overview of the adolescent problems inventory

The Adolescent Problems Inventory (API) and the Problem Inventory for Adolescent Girls (PIAG) are commonly employed in studies of antisocial and delinquent behaviour. This paper offers a review and critique of these inventories. The development and construction of the inventories are detailed, followed by discussion of their psychometric properties. The weight of evidence suggests that the inventories are related to behavioural indices associated with antisocial and delinquent behaviour. More recent studies have considered the factor structure of the API, suggesting several dimensions of social functioning. It is concluded that the API and PIAG are robust instruments that can yield valuable clinical and research data.

Journal Article↗
PubMed1997

Practice parameters for the assessment and treatment of children and adolescents with anxiety disorders. American Academy of Child and Adolescent Psychiatry.

Anxiety disorders comprise one of the most prevalent categories of psychopathology in children and adolescents. These revised practice parameters highlight the DSM-IV changes for anxiety disorders and review the literature related to the assessment and treatment of anxiety disorders in children and adolescents. Up-to-date information on longitudinal outcome data, assessment of anxiety, parent-child interventions, and use of selective serotonin reuptake inhibitors has been added to the previous parameters, published in September 1993. Recommendations for evaluation and multimodal approaches to treatment are presented.

Anxiety Disorders↗
PubMed1998

Stress-coping factors in adolescent substance use: test of ethnic and gender differences in samples of urban adolescents.

Investigated group differences in the relationship between stress-coping variables and substance (cigarette, alcohol, and marijuana) use with samples of inner-city students in sixth through eighth grades (N = 1,289) and metropolitan-area students in seventh through ninth grades (N = 1,702). Measures included affect, life events, parental support, and coping patterns. African-American adolescents had the lowest rate of substance use, Hispanics were intermediate, and Whites had the highest rate; there was no gender difference in overall substance use. Multiple regression analysis showed the strength of predictive relationships for stress-coping variables was lower for African Americans and was greatest for Whites; four methodological tests showed these differences were not attributable to statistical artifacts. Hispanic adolescents showed greater vulnerability than Whites at younger ages but this effect reversed at later ages. Implications for prevention research are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

[Evaluation of the psychoaffective development of adolescents aged 15-18. A study on adolescents in the town of Botucatu, SP-aspects of sexuality].

The authors present data obtained from the analysis of a questionnaire regarding sexuality among 1,437 adolescent students in the Botucatu municipal district. The student's age varied from 15 to 19 years. The results demonstrate the evolving characteristics of the student's sexuality and suggest that sexual orientation and guidance should be part of the child and adolescent educational process. The authors pointed out that the members of Health care team should stimulate the discussion of sexuality while providing medical advice.

English Abstract↗
PubMed1993

Psychiatric, Developmental, and Adolescent Medicine Issues in Adolescent Substance Use and Abuse.

After an overview of the developmental goals of early, middle, and late adolescence, the authors discuss the demographics and patterns of comorbidity. The high incidence both of psychiatric symptoms in the substance-abusing population and of drug abuse in the psychiatric population complicates diagnosis and treatment of both disorders, especially when treatment services are separate, as in the public sector. The adolescent medicine physician can perform a valuable role in bridging the gap.

Journal Article↗
PubMed1997

The relationships among parent-adolescent differentiation, sex role orientation and identity development in late adolescence and early adulthood.

This study had three main objectives. The first was an attempt to clarify inconsistencies in research on family characteristics and identity formation. The second was to test a model that has been discussed over the past several years based on Bowen's intergenerational family systems theory. Finally, gender differences were explored within the models hypothesized. The models included family differentiation variables, sex role orientation and adolescent identity development. The path models that included mother/adolescent and father/adolescent differentiation, masculinity and femininity scales, and ideological and interpersonal identity achievement in separate analyses were tested using LISREL VII. The results suggested that interpersonal and ideological identity domains were differentially related to differentiation in the family system and sex role orientation. There were also gender differences. These results are discussed in relation to previous research evidence about family characteristics that best support identity achievement for males and females.

Achievement↗
PubMed2006

Should we discuss weight and calories in adolescent obesity prevention and weight-management programs? Perspectives of adolescent girls.

The purpose of this pilot study was to explore adolescent girls' perspectives on potentially sensitive topics related to weight management. Data were collected using individual semistructured interviews. Thirty high school-aged girls, who were at risk for overweight and had participated in a school-based obesity prevention program, were interviewed. Data were analyzed using qualitative methodology. Girls were mixed on whether nutrition-related information and messages should emphasize weight control or health. Although girls expressed interest in weight-related issues, some had concerns that overemphasizing weight control might lead to unhealthful and excessive weight preoccupation. Whereas many girls want to receive information on weight and calories to guide their decision making about food choices, care must be taken to avoid unintended harmful consequences.

Adolescent↗
PubMed2004

Healthcare for adolescents in juvenile facilities: increasing needs for adolescent females.

In 1999, 2.4 million youth between the ages of 10 and 17 were arrested. On any given day that year, 133,000 juveniles were detained in long-term detention facilities. Since 1990, there has been a wide disparity in the number of minority youth in the juvenile justice system. In 1999, 41% of youth in this system were African American. Additionally, there has been growth in the percent of arrests of females (29% in 1999) and adolescents younger than 15 years of age (32%).

Adolescent↗
PubMed1998

A model for adolescent-targeted HIV/AIDS services: conclusions from 10 adolescent-targeted projects funded by the Special Projects of National Significance Program of the Health Resources and Services Administration.

This article describes a model of service for youth living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and youth at high risk for HIV, based on the lessons learned from a set of innovative service projects funded by the Health Resources and Services Administration Special Projects of National Significance (SPNS) Program. Although each project has a unique focus, all collectively seek to enroll youth with HIV into care through new or existing HIV service networks, and direct recruitment via street outreach and other similar methods. The use of various outreach methods tends to yield different patterns of engagement of youth in services. An ideal approach may use a combination of complementary outreach methods. Data at both the national and local levels point to five major elements that capture the innovations of the collective service model: (a) peer-youth information and dissemination; (b) peer-youth advisory groups; (c) peer-youth outreach and support; (d) professional, tightly linked medical social support networks; and (e) active case management and advocacy, for individual clients as well as the programs themselves, to link the various components together. One of the most important factors in the model's success is that youth and professionals share an equal partnership in all stages of program design, planning, and implementation. Youth and professionals each share their expertise in a dynamic process. In addition, active case management is crucial, not only to ensure that clients receive needed services, but also to ensure that the programs themselves run in a coordinated, tightly linked way. Given needs of adolescent clients and existing adult-oriented service networks, the use of active case management and the active participation of youth in the services system are critical.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[The Child and Adolescent Health Survey as a source of data for assessment of the essential aspects of health care in childhood and adolescence].

The German National Health Survey for Children and Adolescents aims at collecting representative data on the health status of the population in the 0 to 18 years age bracket. Examination of about 18.000 participants is planned. In this cross-sectional study relevant data concerning health services will be gathered. These include parameters of health care demands, health insurance, vaccination status and drug utilisation. The data collection will start in the first quarter of 2003 and will probably be terminated in the last quarter of 2005. The study design has been tested in a pilot study for one year and was adapted to the demands of this specific health survey. The instruments used for data collection are a self-administered questionnaire as well as a standardised, computer-based medical interview.

Adolescent↗
PubMed1998

Summary of the practice parameters for the assessment and treatment of children and adolescents with posttraumatic stress disorder. American Academy of Child and Adolescent Psychiatry.

This summary provides an overview of the assessment and treatment recommendations contained in the Practice Parameters for the Assessment and Treatment of Children and Adolescents With Posttraumatic Stress Disorder. Major recommendations include the use of clinical interviewing with specific questioning about posttraumatic stress symptoms to diagnose this disorder; recognition of developmental considerations that may impact on how posttraumatic stress disorder symptoms manifest in children; and the use of trauma-focused treatment interventions. Limitations and controversies regarding the present state of knowledge in the area of childhood posttraumatic stress disorder are also discussed.

Adolescent↗
PubMed2000

Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents.

OBJECTIVE: To investigate the risk and protective factors for previous and future suicide attempts among adolescents. METHOD: A representative sample of high school students (N = 9,679) in grades 7 through 12 (aged 12-20 years) were followed from 1992 to 1994. Response rate was 97% at initial testing and 80% at follow-up. Measures of psychiatric symptoms (depressed mood, eating problems, conduct problems), substance use, self-worth, pubertal timing, social network, and social integration were included. RESULTS: A total of 8.2% had ever attempted suicide and 2.7% reported an attempt during the 2-year study period. Logistic regression analysis showed that future attempts were predicted by previous attempt, female gender, young age, perceived early pubertal development (stronger among girls), suicidal ideation, alcohol intoxication, not living with both parents, and poor self-worth. CONCLUSIONS: The importance that the clinician ask about previous suicidal behaviors is underscored. Early pubertal timing (particularly among girls), loss of self-worth, and alcohol intoxication may serve as risk factors for future suicide attempts.

Adolescent↗
PubMed2000

AACAP official action. Summary of the practice parameters for the assessment and treatment of children and adolescents with schizophrenia. American Academy of Child and Adolescent Psychiatry.

These practice parameters review the literature on the assessment and treatment of children and adolescents with schizophrenia. Recommendations are based on the limited research available, the adult literature, and clinical experience. Early-onset schizophrenia is diagnosed using the same criteria as in adults, and it appears to be continuous with the adult form of the disorder. Noted characteristics of youths with schizophrenia include predominance in males, high rates of premorbid abnormalities, and often poor outcome. Differential diagnosis includes psychotic mood disorders, developmental disorders, organic conditions, and nonpsychotic emotional/behavioral disorders. Treatment strategies incorporate antipsychotic medications with psychoeducational, psychotherapeutic, and social and educational support programs. The advent of atypical antipsychotic agents has enhanced the potential for effective treatment.

Adolescent↗
PubMed2004

Culturally sensitive substance abuse intervention for Hispanic and African American adolescents: empirical examples from the Alcohol Treatment Targeting Adolescents in Need (ATTAIN) Project.

AIMS: This study presents preliminary analyses examining the effects of an alcohol and other drug use (AOD) intervention with minority juvenile offenders. Furthermore, the study investigates the impact of cultural factors on baseline AOD use among Hispanic and African American youth, as well as on treatment outcome. DESIGN, SETTING AND PARTICIPANTS: Participants were 213 juvenile offenders referred for treatment (mean age = 15.7 years), 97 of whom have completed treatment to date. The intervention was carried out in clinics placed within the neighborhoods in which the participants resided. Intervention Alcohol Treatment Targeting Adolescents in Need (ATTAIN) is a controlled clinical trial evaluating the effectiveness of a brief motivational, cognitive behavioral intervention, guided self-change (GSC). Participants are assigned randomly to the individual format of guided self-change (I-GSC), the family involved format of guided self-Change (F-GSC), choice of one of these two, or a waiting list control condition. Only participants involved in active intervention are included in the present report. MEASUREMENTS: Data were collected via structured face-to-face interviews. Alcohol and marijuana use measures were collected using the Time-line Follow-back interview (TLFB). FINDINGS: There were significant reductions in alcohol and marijuana use for all ethnic groups from baseline to post-intervention. Cultural factors (discrimination, acculturation, ethnic pride and cultural mistrust) were associated with pre-intervention levels of alcohol and marijuana use. Among Hispanics, pre-intervention level of substance use were higher among foreign-born than US-born youth. Analyses conducted with the US-born Hispanic group showed that ethnic orientation and ethnic pride were associated positively with greater reductions in alcohol use. CONCLUSIONS: The intervention provided through ATTAIN appears to be effective with a multi-ethnic population of juvenile delinquents. Cultural factors, such as ethnic orientation and ethnic mistrust, appear to constitute amenability to treatment factors, with US-born Hispanic youth lower in acculturation responding better to the intervention.

Adolescent↗
PubMed2004

Drinking patterns in mid-adolescence and psychosocial outcomes in late adolescence and early adulthood.

AIMS: To describe the pattern of drinking at age 16 and to relate this to outcomes at 16-21 years and 21-25 years across a number of psychosocial domains. DESIGN: A prospective birth cohort study with annual follow-up until age 16 then at 18, 21 and 25 years. SETTING: Christchurch, New Zealand. PARTICIPANTS: Of 1265 subjects, 953 were interviewed at age 16. MEASUREMENTS: Multiple measures of family background were collected from birth to 16 years. Alcohol consumption was measured in terms of frequency, usual or last quantity drunk and most drunk per occasion. Problems were also recorded. Questions about psychiatric symptoms enabled Diagnostic and Statistical Manual (DSM) criteria to be applied. Detailed reports on educational outcomes, employment, sexual behaviours and offending were collected. FINDINGS: Four latent classes were required to describe drinking at age 16, but these appeared to lie along a single dimension which strongly predicted outcomes at ages 16-21 and 21-25 across all domains (alcohol-related, substance dependence, mental health, education, sexual relationships and offending). After controlling for background and correlates only a small number of outcomes were still related consistently to drinking at age 16 over both periods: most alcohol-related outcomes, the number of sexual partners and the extent of violent offending. CONCLUSIONS: Drinking at age 16 is a clear indicator of future life-course over most domains in late adolescence and early adulthood. Many of these associations are due to other covariates. Outcomes specific to drinking at age 16 are alcohol outcomes, number of sexual partners and violence.

Adolescent↗