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PubMedDate not supplied

Playing for time: adolescent perspectives of lung transplantation for cystic fibrosis.

A single-case study approach was used to provide an in-depth examination of the special events surrounding the decision of a 21-year-old adolescent to undergo lung transplantation for end-stage cystic fibrosis. The central theme "playing for time" characterized the interplay between the disease progression and adolescent development as illustrated by 3 subthemes: (a) a strange balance; (b) playing chicken; and (c) being listed. The adolescent's developmental needs provided the context for the struggle with the competing demands of physiologic and psychologic readiness for the transplant, quality-of-life issues, and a renewed hope for the future. Developmental needs were more important to the adolescent than the opportunity for increased length of survival provided by lung transplantation. Advanced practice nurses are in an excellent position to provide continuity of care for chronic illness management over time and across settings.

Adaptation, Psychological↗
PubMed2002

From adolescence through young adulthood: psychosocial adjustment associated with long-term survival of HIV.

PURPOSE: To examine the psychosocial factors associated with long-term survival of pediatric human immunodeficiency virus (HIV) infection. METHODS: Children infected with HIV enrolled in clinical trials at the National Cancer Institute and their caregivers were interviewed and completed self-report measures 3 times, approximately 12 months apart, using the Child Behavior Checklist, Social Support Scale for Children, Self-Perception Profile for Children and Adolescents, and a structured interview designed by the investigators. Historical data were also extracted from patient medical charts. Average age of participants was 11.8 years at time 1 and 14 years at time 2; 56.3% of the original sample were male, racial composition was 72.2% white, 13.9% African-American, 6.9% Hispanic, and 6.9% "other"; 38.9% of participants contracted HIV perinatally, 34.7% through a hemophilia-related transfusion, and 26.4% through another type of transfusion. RESULTS: Pearson product-moment correlations revealed that disclosure was found to be positively related to social support, self-competence, and decreased problem behavior, except in the case of public disclosure, in which an independent-sample Student's t-test revealed that it was negatively associated with global self-competence. Social support was significantly negatively correlated with problem behavior. Chi-square analyses of the 5-year follow-up data indicated that participants aged 18 years and older were less likely to complete their academic education than their healthy peers (national norms). Adolescents who lost a parent were more likely to have suffered from depression during their lifetime. CONCLUSIONS: Social support and open communication about the diagnosis are essential, particularly at an age at which decisions about relationships, sexual activity, drug use, and plans for the future are the focus of adolescent development and individuation. With advances in medical treatment, HIV-infected children are more likely to survive into adolescence and beyond. Accordingly, their psychosocial needs are changing to more closely resemble the needs of the chronically ill individual, rather than the terminally ill. Families of HIV-infected children should seriously consider preparation for independent living.

Adolescent↗
PubMed1994

Differences in social support and loneliness in adolescents according to developmental stage and gender.

The purpose of this study was to examine differences in both perceived social support and loneliness according to the three stages of adolescent development (early, middle, and late), as determined by chronological age and gender. The sample consisted of 113 early adolescents, 106 middle adolescents, and 106 late adolescents. Data were collected in classroom settings. All participants responded to the PRQ85--Part II, A Social Support Measure; the Revised UCLA Loneliness Scale; and a demographic data sheet. Results of the study, which used the two-way analysis of variance, indicated that there were no statistically significant differences in perceived social support or loneliness across the three stages of adolescence. Findings also indicated that girls reported statistically significantly higher levels of perceived social support than boys; however, there were no statistically significant gender differences in loneliness.

Adolescent↗
PubMed1995

Adolescent character formation and psychoanalytic theory.

The foremost implication of the Freudian theories of adolescence has been that the analyst enters into an alliance with the patient's developmental process. During sessions, stock is routinely taken of the adolescent patient's defenses and drive fixations. The interpersonal and object relations theories of adolescents' character formation varied with each other and also with the assumptions of classical Freudian metapsychology. Yet, Sullivan, Fairbairn, and Winnicott all stressed relatedness in character formation. They each urged that the attitudes of the actual person in significant relationships, as well as the internal representations of the self and the object, shaped the character tendencies of the child or adolescent. Sullivan was very outspoken about his belief that there could be no uniformly valid theory of character, because people are unique. However, for Sullivan, the needs for the validation of self-worth, and for freedom from anxiety, were universal stimuli for the increasing organization of character trends. In both interpersonal theory and object relations theories, dissociative processes were of paramount importance as defensive operations. Dissociation by the adolescent resulted in further instances of ego splitting (for Fairbairn), of the bad me (for Sullivan), and of the false self (for Winnicott). Fairbairn, and to some extent Winnicott, used the language of classical Freudian theory in order to shape an object relations theory of adolescent development. In spite of their theoretical differences, Sullivan, Fairbairn, and Winnicott spoke with a singular voice in dismissing the exclusive significance of libidinal fixations in character consolidation. I now wish to review Freud's case of Dora as an addendum to this short critical appraisal. The analysis of Dora readily lends itself to a discussion of the confluence of the psychoanalytical models' clinical theories. Dora's unfortunate experience in treatment offered a compelling example of the precariousness of adolescents' adjustment in the midst of developmental and family turmoil.

Adolescent↗
PubMed2006

A low chronic ethanol exposure induces morphological changes in the adolescent rat brain that are not fully recovered even after a long abstinence: an immunohistochemical study.

Little is known about the morphological effects of alcoholism on the developing adolescent brain and its consequences into adulthood. We studied here the relationship between two neurotransmitter systems (the serotoninergic and nitrergic) and the astrocytic and neuronal cytoskeleton immediately and long after drinking cessation of a chronic, but low, ethanol administration. Adolescent male Wistar rats were exposed to ethanol 6.6% (v/v) in drinking water for 6 weeks and studied after ending exposure or after a 10-week recovery period drinking water. Control animals received water. Brain sections were processed by immunohistochemistry using antibodies to serotonin (5-HT); glial fibrillary acidic protein (GFAP); astroglial S-100b protein; microtubule associated protein-2 (MAP-2); 200 kDa neurofilaments (Nf-200); and neuronal nitric oxide synthase (nNOS). The mesencephalic dorsal and median raphe nucleus (DRN; MRN) and three prosencephalic areas closely related to cognitive abilities (CA1 hippocampal area, striatum and frontal cortex) were studied by digital image analysis. 5-HT immunoreactivity (-ir) decreased in the DRN and recovered after abstinence and was not changed in the MRN. In the three prosencephalic areas, astrocytes' cell area (GFAP-ir cells) increased after EtOH exposure and tended to return to normality after abstinence, while cytoplasmic astroglial S100b protein-ir, relative area of MAP-2-ir and Nf-200-ir fibers decreased, and later partially recovered. In the striatum and frontal cortex, nNOS-ir decreased only after abstinence. In conclusion, in the adolescent brain, drinking cessation can partially ameliorate the ethanol-induced morphological changes on neurons and astrocytes but cannot fully return it to the basal state.

Alcohol Drinking↗
PubMed2002

Treating adolescents with eating disorders in the family context. Empirical and theoretical considerations.

The author described the Maudsley approach for family treatment of adolescent AN and the empirical evidence supporting its use in this population. This treatment focuses on the family as a resource for recovery and puts the patients in charge of re-feeding their affected child. Its success seems to depend on the successful motivation of parents to take on this task and see it through while simultaneously supporting the processes of adolescent development as they reemerge. Although this treatment is promising, substantial data to support its being the best approach for adolescents with AN are lacking. The author also described a theoretical model for involving parents in CBT for adolescents with BN. Although CBT is accepted as the most efficacious treatment for adults with BN, it has not been tested systematically in adolescents. At the same time, it is clear that the adult models of CBT for BN are unlikely to be successful without modifications that take into account the realities of adolescence. Although CBT as a model is likely to be acceptable to adolescents, parents are needed to promote motivation, provide a supportive milieu for behavioral change, and provide guidance and support in stressful periods that lead to relapse. It is important that CBT that is appropriately modified to include parents be tested for its efficacy in adolescents with BN. Preliminary, uncontrolled results are promising.

Adolescent↗
PubMed1993

Development of the Adolescent Health Concerns Inventory.

Health concerns of adolescents are important factors to consider when developing and implementing school health education programs. In addition, an understanding of adolescent concerns compared to their teachers' and parents' beliefs about adolescents' concerns may enhance communication between adolescents and adults. Despite the need to identify the health concerns of adolescents and beliefs about them among parents and teachers, few instruments exist. The inventory described in this article is one approach to assessing adolescent health concerns. Three forms of the Adolescent Health Concerns Inventory (AHCI) were developed to assess: (1) the health concerns of adolescents, (2) teachers' beliefs about adolescent health concerns, and (3) parents' beliefs about adolescent health concerns. The final version of the instrument contained 150 health-related items grouped into 12 topical subscales. Reliability estimates for the 12 subscales as measured by Cronbach's alpha ranged from .76 to .92. A panel of experts was used to assess content validity. Construct validity was assessed using principal components factor analysis. All items were positively loaded on factor 1. Readability was estimated at the eighth grade as measured by the SMOG readability formula. Psychometric characteristics of the instrument and recommendations for the use of the ACHI are presented.

Adolescent↗
PubMed1987

Factor analysis of the Adolescent Reinforcement Survey Schedule (ARSS) with college freshmen.

A factor analysis of the Adolescent Reinforcement Survey Schedule (ARSS) with a male and female college freshman (N = 231) population yielded 10 interpretable factors: Heterosexual Dating, Peer Interaction, Sibling/Family Interaction, Sexual Pleasure, Anti-School/Work, Leisure/Work Activity, Drugs/Acting Out, Entertainment/Social Activity, Home Avoidance, and Romantic Fantasy Activity. The first three factors are similar to a Positive Social interaction factor identified in a study that used the adult form of the Reinforcement Survey Schedule with a male and female college population. Suggestions are made from the ARSS responses of the college freshmen re interventions to facilitate social skill competency and the relationship aspects of sexual activity. A recommendation is made to replicate the current study with groups of early and mid-adolescents in order to study reinforces during different periods of adolescent development.

Adolescent↗
PubMed2005

Shaping ethics: youth workers matter.

The authors propose that youth workers and educators committed to informing and shaping the ethical understandings of young people first need to explore and become aware of their own ethics. This requires front-line staff and caregivers to critically reflect on the impact their day-to-day choices and decisions have on youth. Once they become clearer about their own ethics and the consequences of their decisions, youth workers are then in a position to promote opportunities for youth to make ethical choices. The authors use observations and ideas from their experiences with the Minnesota Youth Work Institute. Their overarching aim is to promote ethical congruence between what is taught, how it is taught, and how it is practiced in daily work with youth.

Adolescent↗
PubMed1988

The adolescent activities checklist: reliability, standardization data, and factorial validity.

This study was conducted to provide standardization data and information on the reliability and factorial validity of the recently developed Adolescent Activities Checklist (AAC). A total of 563 adolescents in grades 7 through 12 served as subjects. Significant main effects for gender, race, and grade were obtained in a multivariate analysis of variance. On the basis of this information, standardization data were established for these three variables. Further investigation indicated that the internal consistency of the AAC was high. In addition, results of a principal components analysis conducted on the frequencies of the Unpleasant and Pleasant Activities subscales revealed four and three factors, respectively. For unpleasant activities, the major dimensions were found to occur in three situations--namely, social interactions, family situations, and school situations. Stressful events also occurred as one of the four unpleasant activities dimensions. For pleasant activities, three dimensions appeared: heterosocial behavior, reinforcing interpersonal situations, and social reinforcement.

Adolescent↗
PubMedDate not supplied

Development of the adolescent brain: implications for executive function and social cognition.

Adolescence is a time of considerable development at the level of behaviour, cognition and the brain. This article reviews histological and brain imaging studies that have demonstrated specific changes in neural architecture during puberty and adolescence, outlining trajectories of grey and white matter development. The implications of brain development for executive functions and social cognition during puberty and adolescence are discussed. Changes at the level of the brain and cognition may map onto behaviours commonly associated with adolescence. Finally, possible applications for education and social policy are briefly considered.

Adolescent↗
PubMed2004

Regulation of adolescent sleep: implications for behavior.

Adolescent development is accompanied by profound changes in the timing and amounts of sleep and wakefulness. Many aspects of these changes result from altered psychosocial and life-style circumstances that accompany adolescence. The maturation of biological processes regulating sleep/wake systems, however, may be strongly related to the sleep timing and amount during adolescence-either as "compelling" or "permissive" factors. The two-process model of sleep regulation posits a fundamental sleep-wake homeostatic process (process S) working in concert with the circadian biological timing system (process C) as the primary intrinsic regulatory factors. How do these systems change during adolescence? We present data from adolescent participants examining EEG markers of sleep homeostasis to evaluate whether process S shows maturational changes permissive of altered sleep patterns across puberty. Our data indicate that certain aspects of the homeostatic system are unchanged from late childhood to young adulthood, while other features change in a manner that is permissive of later bedtimes in older adolescents. We also show alterations of the circadian timing system indicating a possible circadian substrate for later adolescent sleep timing. The circadian parameters we have assessed include phase, period, melatonin secretory pattern, light sensitivity, and phase relationships, all of which show evidence of changes during pubertal development with potential to alter sleep patterns substantially. However the changes are mediated-whether through process S, process C, or by a combination-many adolescents have too little sleep at the wrong circadian phase. This pattern is associated with increased risks for excessive sleepiness, difficulty with mood regulation, impaired academic performance, learning difficulties, school tardiness and absenteeism, and accidents and injuries.

Adolescent↗
PubMed1995

The antecedents of menarcheal age: heredity, family environment, and stressful life events.

Variations in pubertal timing, specifically age at menarche, have been associated with several antecedents, both genetic and environmental. Recent research has considered a broader range of environmental stressors and their influence on the development of the reproductive system. In this investigation, the following possible antecedents were considered: (a) hereditary transmission, (b) weight and weight for height, (c) stressful life events, (d) family relations, (e) absence or presence of an adult male in the household, and (f) psychological adjustment. Subjects were 75 premenarcheal girls between the ages of 10 and 14 drawn from a larger longitudinal investigation of adolescent development. Girls were from white, well-educated, middle- to upper-middle-class families and attended private schools in a northeastern urban area. While breast development, weight, family relations, and depressive affect were predictive of age at menarche, family relations predicted age at menarche above the influence of breast development or weight. A trend for maternal age at menarche to predict adolescent's age at menarche was found. Weight for height, presence of an adult male in the household, and stressful events were not predictive of age at menarche. These complex interactions of biological and psychosocial development demonstrated here may account to some extent for the inter- and intraindividual variation observed in pubertal development.

Adolescent↗
PubMed2002

Internists and adolescent medicine.

Internists can assume a greater role in the provision of health care to adolescents. Adding an understanding of adolescent development to the skills and knowledge already possessed by internists will allow internists to interact more comfortably and effectively with adolescent patients. Learning about specific areas of importance such as adolescent morbidity and mortality, consent and confidentiality, interviewing techniques, and preventive health care will further enhance an internist's knowledge regarding adolescent health. There are numerous resources available to help intensive care for adolescent patients.

Adolescent↗
PubMed2001

Five images of maturity in adolescence: what does "grown up" mean?

This study focussed on the subjective meanings of maturity in adolescence, or what it means to adolescents to be grown up. Younger (6th grade) and older (9th grade) adolescents' descriptions (n=236) of their "grown-up" peers were examined through content analysis. This qualitative analysis revealed five images of maturity portrayed by adolescents: balanced maturity (adolescents who show psychosocial and behavioural maturity, and ability to balance work and play); an image focussed on privileges (adolescents who engage in problem behaviour and present what may be a facade of adult-like behaviour); an image focussed on responsibility (adolescents who may be psychosocially mature, but may have taken on inappropriately high levels of responsibility); an image focussed on power and status (adolescents who seem to have usurped an older status, by being bossy and controlling); and an image focussed on physical development (adolescents who show advanced levels of physical maturity). There were some gender and age differences in the frequencies of these five images. Discussion is directed at understanding the hallmarks of each image relative to scholarly notions of adult maturity.

Adolescent↗
PubMed2006

Aggression as a mediator of genetic contributions to the association between negative parent-child relationships and adolescent antisocial behavior.

Previous research suggests that the association between conflictual parent-child relationships and maladjustment among adolescents is influenced by genetic effects emanating from the adolescents. In this study, we examined whether these effects are mediated by childhood aggression. The data come from the Twin study of CHild and Adolescent Development (TCHAD), a Swedish longitudinal study including 1,314 twin pairs followed from age 13-14 to 16-17. Early adolescent aggression, parental criticism, and delinquency in later adolescence were rated by parents and children at different time points. Multivariate genetic structural equation models were used to estimate genetic and environmental influences on these constructs and on their covariation. The results showed that approximately half of the genetic contribution to the association between parental criticism and delinquency was explained by early adolescent aggression. It suggests that aggression in children evokes negative parenting, which in turn influences adolescent antisocial behavior. The mechanism proposed by these findings is consistent with evocative gene-environment correlation.

Adolescent↗
PubMedDate not supplied

Racism and children's health: issues in development.

It has been posited by some social scientists that racism has a negative impact on the health of certain minority groups in the United States. How racism affects the development of children and thus their health, has not been addressed by research in developmental psychology, despite a plethora of studies of racial/ethnic identity development. Existing developmental theories may be amenable to describing and possibly predicting the role that racism plays on child and adolescent development. A model is presented that attempts to explain how racism might affect a child's development and consequently his health by incorporating and synthesizing various developmental principles and social cognition theory. The need for empirical inquiry on this topic is indicated; design suggestions are offered.

Black or African American↗