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PubMed2002

Vocal characteristics in pre-adolescent and adolescent children: a longitudinal study.

A number of cross-sectional studies have been reported for the fundamental frequency and formant frequency data in the voices of a group of 20 pre-adolescent children aged between 6 and 10 years (Whiteside, S P, Hodgson, C. Acoustic characteristics in 6-10-year old children's voices: some preliminary findings, Log Phon Vocol 1999; 24: 6-13, Whiteside, SP, Hodgson, C. Some acoustic characteristics in the voices of 6-10-year-old children and adults: a comparative sex and developmental perspective, Log Phon Vocol 2000; 25: 122-132). About 15 of the children who participated in these earlier studies, participated in a follow-up study approximately 42 months later. Their speech data were recorded and analysed acoustically to investigate longitudinal patterns of development in their voices by examining data for fundamental frequency and the first three formant frequencies of a phrase final vowel. Data obtained from this follow-up study (Time 2) were compared with earlier corresponding data (Time 1). The findings of this study indicated that there was evidence for maturation in the voice parameters of all subjects between Time 1 and 2, with changes being observed for the majority of comparisons for parameters, across age and sex. In addition there was also evidence of individual differences in the maturational patterns which were observed. These individual differences highlight the degree of variation which occurs in the developmental changes of voice characteristics.

Adolescent↗
PubMed1994

Pneumococcal and influenza vaccination levels among HIV-infected adolescents and adults receiving medical care in the United States. Adult and Adolescent Spectrum of HIV Disease Project Group.

OBJECTIVE: To assess pneumococcal and influenza vaccination coverage among HIV-infected adolescents and adults receiving medical care in the United States. DESIGN: Periodic medical record reviews. SETTING: More than 90 clinics, hospitals, and private medical practices in nine cities. PATIENTS: HIV-infected individuals aged > or = 13 years were included in the analyses of pneumococcal (n = 9737) and influenza (n = 6161) vaccination coverage. MAIN OUTCOME MEASURES: Documentation of receipt of pneumococcal and influenza vaccines in medical records during 6-18-month and 12-month periods, respectively. RESULTS: Overall, 37 and 33% of individuals received pneumococcal and influenza vaccines, respectively. In general, vaccination levels varied little by age group, race/ethnicity, or mode of HIV exposure. Having had at least five medical visits was significantly associated with having received pneumococcal and influenza vaccines [adjusted odds ratio (OR), 1.7 for each]. Having a CD4+ T-lymphocyte count < 200 x 10(6)/l (adjusted OR, 0.8) and being female (adjusted OR, 0.7) were associated with non-receipt of pneumococcal vaccine. Lower pneumococcal vaccination coverage among women was mostly accounted for by pregnancy. CONCLUSION: Until new, more effective means of preventing pneumococcal disease and influenza become available, efforts should be directed towards improving vaccination levels among HIV-infected individuals.

Adolescent↗
PubMed1994

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 children and adolescents with schizophrenia. Because this literature is sparse, information is also drawn from research with adults. Clinical features in youth with schizophrenia include predominance in males, high rate of premorbid abnormalities, increased family history of schizophrenia, and often poor outcome. Diagnostic issues include the overlap, and therefore potential for misdiagnosis, between the first presenting symptoms of schizophrenia and those of psychotic mood disorders, developmental disorders, organic conditions, and other nonpsychotic emotional/behavioral disorders. Treatment should include using antipsychotic medications in conjunction with psychoeducational, psychotherapeutic, and social and educational support programs.

Adolescent↗
PubMed1997

Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. American Academy of Child and Adolescent Psychiatry.

These practice parameters review the literature on children, adolescents, and adults with attention-deficit/hyperactivity disorder (ADHD). There are three types of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Together, they occur in as many as 10% of boys and 5% of girls of elementary school age. Prevalence declines with age, although up to 65% of hyperactive children are still symptomatic as adults. Frequency in adults is estimated to be 2% to 7%. Assessment includes clinical interviews and standardized rating scales from parents and teachers. Testing of intelligence and academic achievement usually are required. Comorbidity is common. The cornerstones of treatment are support and education of parents, appropriate school placement, and pharmacology. The primary medications are psychostimulants, but antidepressants and alpha-adrenergic agonists are used in special circumstances. Other treatments such as behavior modification, school consultation, family therapy, and group therapy address remaining symptoms.

Adolescent↗
PubMed1997

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

These practice parameters address the diagnosis, treatment, and prevention of conduct disorder in children and adolescents. Voluminous literature addresses the problem from a developmental, epidemiological, and criminological perspective. Properly designed treatment outcome studies of modern psychiatric modalities are rare. Ethnic issues are mentioned but not fully addressed from a clinical perspective. Clinical features of youth with conduct disorder include predominance in males, low socioeconomic status, and familial aggregation. Important continuities to oppositional defiant disorder and antisocial personality disorder have been documented. Extensive comorbidity, especially with other externalizing disorders, depression, and substance abuse, has been documented and has significance for prognosis. Clinically significant subtypes exist according to age of onset, overt or covert conduct problems, and levels of restraint exhibited under stress. To be effective, treatment must be multimodal, address multiple foci, and continue over extensive periods of time. Early treatment and prevention seem to be more effective than later intervention.

Adolescent↗
PubMed1998

Summary of the practice parameters for the assessment and treatment of children and adolescents with language and learning disorders. American Academy of Child and Adolescent Psychiatry.

This summary provides an overview of the recommendations contained in the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Language and Learning Disorders. These disorders are among the most common developmental disorders. The diagnosis of language and learning disorders requires a discrepancy, based on age and intelligence, between potential and achievement. The clinician collaborates with parents and school personnel to clarify the diagnosis, implement appropriate treatment and remediation, and monitor progress. The clinician also is instrumental in identifying and treating comorbid conditions. Long-term prognosis depends on the type and severity of the language or learning disorder, the availability of remediation, and the presence of a supportive family and school environment.

Adolescent↗
PubMed2000

Indications of proximal thoracic curve fusion in thoracic adolescent idiopathic scoliosis: recognition and treatment of double thoracic curve pattern in adolescent idiopathic scoliosis treated with segmental instrumentation.

STUDY DESIGN: A retrospective study. OBJECTIVES: To determine the indications of fusing the proximal thoracic curve when treating idiopathic thoracic scoliosis with segmental instrumentation. SUMMARY OF BACKGROUND DATA: Failure to recognize a significant proximal thoracic curve often results in postoperative shoulder asymmetry due to relative overcorrection of the lower thoracic curve. With segmental instrumentation that enhances the correction of the instrumented curve, the double thoracic curve pattern that needs fusion of both the proximal and the distal thoracic curves should be redefined. METHODS: Forty patients with thoracic adolescent idiopathic scoliosis with a right lower thoracic curve of more than 40 degrees and a left proximal thoracic curve of more than 25 degrees treated by segmental pedicle screw instrumentation were analyzed after a minimum follow-up of 2 years. RESULTS: Of the 40 patients, 18 were treated by fusion of both the proximal and the distal curves, whereas 22 were treated by fusion of the distal curve only. The postoperative shoulder height difference (SHD, in millimeters) was 0.9 x preoperative SHD + 5.3 for the fusion of both curves and 0.6 x preoperative SHD + 12 for the distal curve fusion (linear regression), showing that proximal thoracic curve fusion improved the SHD when the left shoulder was level with or higher than the right. CONCLUSIONS: Idiopathic thoracic scoliosis with a proximal thoracic curve of more than 25 degrees and level or elevated left shoulder should be considered a double thoracic curve pattern and should be treated by fusing both the proximal and the distal curves when using segmental instrumentation.

Adolescent↗
PubMed1985

Atherosclerosis precursors in Finnish children and adolescents. IV. Serum lipids in newborns, children and adolescents.

A multicentre study on atherosclerosis precursors in Finnish children and adolescents was carried out in five urban and 12 rural areas in the autumn of 1980 and spring of 1981. Serum lipids, i.e. cholesterol (TC), HDL-cholesterol (HDL-C) and triglyceride (TG) concentrations were determined and LDL-cholesterol (LDL-C) was calculated in 630 newborns and 3,596 children aged 3, 6, 9, 12, 15 and 18 years. In the newborns the mean serum TC concentration was 1.50 mmol/l, and the ratio of HDL-C to TC was 0.44. Newborn boys had lower mean TC, HDL-C and LDL-C values than the girls. In 3 to 18-year-old children the mean TC, LDL-C and HDL-C concentrations were 4.83 mmol/l, 3.09 mmol/l and 1.38 mmol/l, respectively. During puberty, TC mean values decreased, more so in boys. The serum levels of HDL-C also decreased, especially in boys, and after passing puberty boys had lower mean HDL-C levels than girls (1.26 vs. 1.39 mmol/l, p less than 0.001). The HDL-C/TC ratio was similar in all age groups (0.29). The mean TG value increased with age, being 0.88 mmol/l at the age of 18 yr. During sexual maturation, TG levels increased, more clearly in boys. There were no regional differences in serum lipid concentrations in the newborns, but in 3- to 18-year-old children the mean TC, LDL-C and TG values were lower in western than in eastern Finland. Mean TC and LDL-C values were lower in urban than in rural areas, but there was no difference in TG concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1977

Adolescent day treatment: a community alternative to institutionalization of the emotionally disturbed adolescent.

This paper describes the need, the formation, and the structure of a partial day treatment program for severely disturbed adolescents, which uses local resources to maintain clients in the community. Components of the program, including family therapy in the home, are outlined and case illustrations are offered. Applications to other community settings are discussed.

Adolescent↗
PubMed1981

A profile of aggression from adolescence to adulthood: an 18-year follow-up of psychiatrically disturbed and violent adolescents.

An 18-year follow-up of 66 aggressive and disturbed adolescents admitted to the children's unit of a large mental hospital in 1960 reveals a high degree of antisocial and criminal behavior persisting into adulthood, with lessening psychiatric involvement as the subjects matured. Factors contributing to this pattern of continuing antisocial behavior are identified, and implications for treatment programs are considered.

Adolescent↗
PubMed2005

Secretory dynamics of leptin in adolescent girls with anorexia nervosa and healthy adolescents.

Leptin, an adipocytokine that suppresses appetite and may regulate neuroendocrine pathways, is low in undernourished states like anorexia nervosa (AN). Although leptin exhibits pulsatility, secretory characteristics have not been well described in adolescents and in AN, and the contribution of hypoleptinemia to increased growth hormone (GH) and cortisol in AN has not been explored. We hypothesized that hypoleptinemia in AN reflects decreased basal and pulsatile secretion and may predict increased GH and cortisol levels. Sampling for leptin, GH, cortisol, and ghrelin was performed every 30 min (from 2000 to 0800) in 23 AN and 21 controls 12-18 yr old, and data were analyzed using Cluster and deconvolution methods. Estradiol, thyroid hormones, and body composition were measured. AN girls had lower pulsatile and total leptin secretion than controls (P < 0.0001) subsequent to decreased burst mass (P < 0.0001) and basal secretion (P = 0.02). Nutritional markers predicted leptin characteristics. In a regression model including BMI, body fat, and ghrelin, leptin independently predicted GH burst interval and frequency. Valley leptin contributed to 56% of the variability in GH burst interval, and basal leptin and fasting ghrelin contributed to 42% of variability in burst frequency. Pulsatile leptin independently predicted urine free cortisol/creatinine (15% of variability). Valley leptin predicted cortisol half-life (22% of variability). Leptin predicted estradiol and thyroid hormone levels. In conclusion, hypoleptinemia in AN is subsequent to decreased basal and pulsatile secretion and nutritionally regulated. Leptin predicts GH and cortisol parameters and with ghrelin predicts GH burst frequency. Low leptin and high ghrelin may be dual stimuli for high GH concentrations in undernutrition.

Adolescent↗
PubMed2006

Innovations: child & adolescent psychiatry: use of collaborative problem solving to reduce seclusion and restraint in child and adolescent inpatient units.

The authors describe "collaborative problem solving," a cognitive-behavioral approach for working with aggressive children and adolescents. The model conceptualizes aggressive behavior as the byproduct of lagging cognitive skills in the domains of flexibility, frustration tolerance, and problem solving. The goal is to train staff to assess specific cognitive skills that may be contributing to challenging behavior and to teach children new skills through collaborative problem solving. The authors present results from an inpatient unit that dramatically reduced rates of seclusion and restraint.

Adolescent↗
PubMed1991

Adolescent and pre-adolescent suicide in Newfoundland and Labrador.

This study investigated suicides by people aged ten to 19 in Newfoundland and Labrador from 1977 to 1988. It is the first study of suicide in the province to use the records of death from all eight hospital pathology departments in the province and from the office of the Chief Forensic Pathologist. Cases were selected for the study using standardized criteria, independent of the manner of death recorded on the death certificate. A suicide rate of 4.37 per 100,000 was found. This rate and the age- and sex-specific suicide rates are lower than the official figures for Canada but higher than those reported in earlier Newfoundland studies. The rate for males was nearly five times the female rate, and the rate for people aged 15 to 19 was nearly six times that of people aged ten to 14. Suicide rates for Labrador were higher than for the island portion of the province for both Native and for non Native adolescents. Extremely high rates of suicide were found only among the Native population living in Northern Labrador, while none were recorded for Native people elsewhere. Firearms accounted for 54% and hanging for 33% of all suicides. Thirty percent of suicides occurred on a Saturday. Only 36 of the 63 deaths included in this study were designated as suicide on death certificates. The higher rate of under-reporting of suicide than in other jurisdictions suggests that official rates may not be useful for comparisons. The reasons for the high rate of under-reporting are discussed.

Adolescent↗
PubMed2004

A prospective study of the consequences of marital disruption for adolescents: predisruption family dynamics and postdisruption adolescent adjustment.

This study employed data from the National Longitudinal Study of Adolescent Health to examine the consequences of marital disruption for youth prospectively. Using a diverse sample of 6,416 youth, we examined pre- and postdisruption group differences among youth in subsequently disrupting and continuously intact homes. We also examined the extent to which predisruption family dynamics (e.g., marital discord) accounted for both pre- and postdisruption group differences in youth functioning and examined the interaction between level of marital discord and marital disruption. Group differences in adjustment emerged at both time-points and were better explained by family-level variables than by marital disruption. Further, level of marital discord interacted with marital disruption, predicting differential youth outcomes. The implications of these findings for understanding and explaining the heterogeneity of divorce outcomes are discussed.

Adaptation, Psychological↗
PubMed1990

Adolescent drinking behavior: an observational study of the influence of situational factors on adolescent drinking rates.

Adolescent drinking behavior was observed on weekend nights (9 PM until midnight) in three youth bars, three youth centers and two discos located in the most southern part of the Netherlands. Drinking rates, individual characteristics, drinking group variables and aspects of the overall drinking situation were recorded. Boys and girls appeared to differ in the variables of influence on their drinking rates. Boys were observed to drink at a higher rate on evenings with loud music, when they participated in large, all-male groups and when their (estimated) age was less than 20. Together these variables explain 24% of the variance in boys' drinking rates. Girls drank less fast when they participated in a group not buying rounds and in a drinking group of constant composition. Although analysis showed that girls' drinking rates did not vary significantly with aspects of the overall situation and individual variables, still 14% of the total variance here could be explained by the drinking group variables. These results are to some extent consistent with findings from other observational studies on drinking behavior. Most of these studies showed males in large groups to drink at the highest rates. However, only a few observational studies were aimed exclusively at young people's drinking behavior and those studies did not include aspects of the overall drinking situation.

Adolescent↗
PubMedDate not supplied

[Developmental problems and risks of children and adolescents with severe hearing impairment--a challenge for intervention by child and adolescent psychiatrists].

Considering special developmental risks and burdens of this group of children the dimensions of the multiaxial classification system prove to be a useful diagnostic framework. Especially severe and multiple communication impairments are important specific abnormal psychosocial circumstances for deaf and severe hard-off hearing children and adolescents. Finally some modest but nevertheless important tasks for child and youth psychiatrists are pointet out.

Adolescent↗
PubMed1976

Responses to frustration: comparison of institutionalized and noninstitutionalized retarded adolescents and nonretarded children and adolescents.

Thirty adolescents (10 institutionalized retarded, 10 noninstitutionalized retarded, 10 nonretarded CA-matched) and 10 children (nonretarded MA-matched) were individually given the Rosenzweig Picture-Frustration Study (Children's Form). Responses were scored for direction of blame and reaction type, yielding nine frustration response categories. Three of the nine response categories showed significant group relationships. Retardation, institutionalization, and CA were all found to have an effect on responding, although analysis of response profiles showed all groups to be very similar in response pattern.

Adolescent↗