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Adolescence and its discontents: attentional disorders among teenagers and young adults.

Attention deficit disorder (ADD) is the most commonly diagnosed childhood behavioral condition in the United States. This condition has important implications for and influences on adolescent development and adult functioning including emotional and conduct disorders, poor socialization, and school underachievement. In addition it has only been appreciated recently that some symptoms of ADD persist and can be identified among adolescents and young adults. In some situations, ADD may be newly identified during adolescence. Similar to younger children with ADD, a multi-modality approach to the management of adolescents with ADD is recommended.

Adolescent↗

Development of an adolescent alcohol and other drug abuse screening scale: Personal Experience Screening Questionnaire.

The development of a new adolescent alcohol and other drug abuse screening scale is summarized. The Personal Experience Screening Questionnaire (PESQ) is intended to meet the need for a quick, psychometrically adequate adolescent screening tool to measure the need for a comprehensive assessment. The development of the questionnaire's problem severity scale and evidence related to its reliability (internal consistency) and validity are described.

Adolescent↗

[Diabetes or hyperglycemia?].

An 11-year-old boy developed influenza with glucosuria. An oral glucose test performed during the infection revealed values within the diabetic range. Type 1 diabetes was wrongly diagnosed and insulin therapy initiated. A 19-year-old overweight adolescent developed pneumonia with hyperglycemia but without polydipsia or polyuria. Further investigation revealed incipient type 1 diabetes. As insulin therapy was not initiated the diabetes rapidly decompensated. It is recommended that further investigations be conducted in patients with hyperglycemia following infections.

Adult↗

Delinquency and substance use among gang-involved youth: the moderating role of parenting practices.

This study uses longitudinal data from an ethnically diverse sample of 300 ninth grade students to examine the moderating effect of parenting practices upon the relationship between gang involvement and adolescent problem behavior. Results of hierarchical linear modeling indicate that gang involvement is a highly significant positive predictor of each of three categories of problem behavior (minor delinquency, major delinquency, and substance use). Three of the four parenting variables (behavioral control, psychological control, parent-adolescent conflict, and warmth) are found to moderate the relationship between gang involvement and problem behavior, with the most consistent effects found for behavioral control and warmth. These findings indicate that intervention efforts aimed at reducing the impact of gang involvement on adolescent development should consider factors that may decrease the deleterious behavioral outcomes associated with youth gangs.

Adolescent↗

The Göteborg discotheque fire: posttraumatic stress, and school adjustment as reported by the primary victims 18 months later.

BACKGROUND: On October 29, 1998, around 400 young people were gathered in an old warehouse in Göteborg, Sweden, for a discotheque party. A fire erupted and spread explosively. Adolescents were exposed to dreadful scenes inside and outside the building. In all, 63 young people were killed and 213 physically injured. An 18-month follow-up with 275 adolescents (126 girls) who survived the fire, regarding the effects of the fire on symptoms of posttraumatic stress, school adjustment and performance, is reported. METHODS: Impact of Events Scale (IES), Clinician Administered Posttraumatic Stress Scale (CAPS) and an interview concerning background factors and issues of public and personal support. RESULTS: The level of posttraumatic stress was generally high, and highest among adolescents with an immigrant background. In all, 25% of the participants met DSM-IV criteria for PTSD. Twenty-three percent of the participants reported having either dropped out of school or repeated a class because of the fire. Students' ratings of how their own school handled the situation, and school absenteeism, were related to ratings of their own performance in school as well as to the level of posttraumatic stress. CONCLUSIONS: Traditional talking cures were more sought out by girls than boys. Broad-scale interventions must be complemented with special treatment opportunities for the most severely afflicted. Victims who suffer from high levels of posttraumatic stress need special support for a long period of time to minimise the effects on scholastic achievement and adjustment. Studies of the effects of traumatic events on child and adolescent development should measure school-related effects better than has hitherto been the case.

Adaptation, Psychological↗

Neuropsychological predictors of BOLD response during a spatial working memory task in adolescents: what can performance tell us about fMRI response patterns?

The relationship between standardized neuropsychological test performance and functional magnetic resonance imaging (fMRI) response during cognitive tasks is largely unknown. This exploratory investigation examined the relationship between neuropsychological test performance and fMRI response to a spatial working memory (SWM) task among 49 typically developing adolescents. Participants were administered a variety of neuropsychological tests in the domains of working memory, visuospatial skills, executive functioning, attention, learning and memory, visuomotor skills and processing speed, and language functioning. Neuropsychological domain scores were used to predict fMRI response during a SWM task. Results suggest that in many brain regions, neuropsychological performance negatively predicts fMRI response, suggesting that those teens with better neuropsychological abilities required fewer neural resources to adequately perform the task. This study provides further understanding of how neuropsychological abilities relate to neural activity during fMRI tasks, and provides an important link between neuropsychological and fMRI research.

Adolescent↗

The adolescent with a chronic condition. Part I: developmental issues.

The prevalence of chronic conditions among adolescents is difficult to assess due to the lack of quality data focusing specifically on this age group, as well as the diversity in methodology and definitions used. However, surveys carried out by self administered questionnaires among in-school adolescent populations indicate that around 10% of adolescents suffer from such a condition. The aim of this paper is to analyse the reciprocal effects of chronic conditions and adolescent development by reviewing the effect of chronic disease on growth and puberty and on psychosocial development, and the effect of developmental issues on the course and management of chronic disease.

Adolescent↗

Health care issues of gay and lesbian youth.

Gay and lesbian youth are adolescents who, in many ways, are no different from their peers. What distinguishes homosexual youth from other adolescent populations is the emotional, psychological and physical trauma resulting from the homophobia they experience in their daily lives. Although suicide, HIV infection, substance use, and violence appear to disproportionately affect this population, most homosexual youth grow up healthy and happy. Frequently lost in discussions of risk and risk behaviors is an appreciation of the strengths very much present in these young people. Health care providers must remain aware of the unique issues and health risks of homosexual youth but must also remember to address each patient as an individual within the context of general adolescent development. By doing so, pediatricians can play a vital role in preserving and enhancing the health of this "at-risk" population.

Adolescent↗

Factors associated with alcohol consumption, problem drinking, and related consequences among high school students in Taiwan.

This research evaluated the risk factors associated with alcohol consumption, problem drinking, and related consequences among high school students in Taiwan. A total of 779 10th grade students from four randomly selected high schools in eastern Taiwan were included in the survey. Survey data were self-reported by students and analyzed using logistic regression methods. The results showed that alcohol consumption and problem drinking was 2.22-2.71-fold greater in male than in female adolescents. Parents and peer groups were the determinants influencing alcohol consumption, and these influences could be enhanced particularly by the drinking behaviors of fathers and peer groups, and the relationship of students with their peer groups. The probability of developing adolescent problem drinking was fourfold greater in students whose fathers had habits of drinking. Ethnicity had a notable impact on the risk of problem drinking. The occurrence of problem drinking among indigenous adolescents was 2.98-fold higher than among Hans, indicating a diversity of biological factors, social norms, and expectation for alcohol drinking between these two ethnic groups. This study suggests that a policy for preventing alcohol abuse among high school students should start by addressing the two major associated problems: a need to earn peer group recognition, and the lack of family support among at-risk students.

Adolescent↗

Adolescence and changing family relations in the Central Canadian Arctic.

This paper reports on a ten-year longitudinal study of adolescent development and socialization conducted in the Copper Inuit community of Holman. This research has documented how demographic, social, and economic changes have dramatically altered the patterning and sequencing of traditional Inuit life stages, thus giving rise to a prolonged adolescent life stage which was non-existent in the precontact period. At the same time, Inuit family relations have undergone drastic changes as a result of population increase, population concentration, access to government housing, introduction of formal schooling, and the availability of social subsides. Today, the Copper Inuit family has lost its focus as the primary agent of socialization and learning, and many young Inuit now spend most of their time within the context of a greatly expanded peer group which has gradually acquired the values and aspirations of the southern adolescent sub-culture. This paper will discuss the impact of these changing attitudes upon parent-child relations as well as the social adjustment problems experienced by young Inuit as they strive to find a place in the North's changing social landscape.

Adolescent↗

Responsiveness of male adolescents with mental retardation to input from nondisabled peers: the summoning power of comments, questions, and directive prompts.

The expressive communication of individuals with cognitive impairments may be directly influenced by a partner's input, because such individuals often have limited conversational skills. Sequential analyses of dyadic interactions examined the effects of input by 32 normally developing adolescents on responses by male subjects with mental retardation whose communication modes included augmented communication. Results suggested that (a) verbal prompts in the form of questions were significantly more likely to receive responses from subjects with mental retardation than directive prompts, (b) comments were significantly more likely to receive responses from subjects with retardation than were directive prompts, when the nondisabled peer was male, and (c) male subjects with mental retardation were more likely to respond to input from male peers than from females. These data suggest that questions facilitate naturally occurring conversations but underscore the importance of evaluating gender-related effects on interaction involving persons with severe cognitive and communication impairments.

Adolescent↗

Health counseling of adolescents.

Health counseling is a fundamental aspect of health care for adolescents and is a natural extension of the concept of anticipatory guidance. It is a dynamic process involving active participation by adolescents. Pediatricians are a valued source of health-relevant information, but must also recognize how their attitudes and beliefs can affect the counseling process. Knowledge of the multitude of changes occurring during adolescence and an understanding of the role of health-risking behaviors in meeting various developmental needs are critical to successful counseling. Particular attention must be focused on ways to help adolescents develop the skills necessary to maintain health-promoting lifestyles and to resist peer pressure to engage in health-risking behaviors.

Adolescent↗

Adolescent focal theories: age-trends in developmental transitions

Focal theory is considered as a framework for looking at psychosocial and leisure transitions in middle and later adolescence. Although these transitions are examined from a different perspective in the present study, by utilising cross-sectional survey data from a representative sample of three age groups of young Scots (13-14, 15-16 and 17-18 year-olds), the results confirm and extend the general age-trends in relational issues and leisure involvement reported in original studies. Within this overall picture, few gender differences are found in age-related relational transitions, but gender differences are apparent in shifting focuses of leisure involvement with age. Further, the findings suggest a linkage between relational issues in adolescence and leisure contexts, where psychosocial processes are seen to be associated with contextual changes in young people's lives. Focal theory has been criticised for a failure to take true account of the social circumstances, constraints and contexts affecting adolescent development, but in the present study surprisingly few differences are found with respect to the young person's social class of family background, for example, with age-trends in developmental transitions similar for all social groups. By contrast, in later adolescence aspects of the young person's own socio-economic position, rather than that of their family background, are clearly linked to both relational issues and leisure involvement, for example, creating a disrupting effect on those young people who are currently unemployed or non-employed at this age.

Journal Article↗

Adolescent chronic pelvic pain.

The presentation of chronic pelvic pain in the adolescent can at times be quite daunting. A careful and insightful approach to obtaining the history and physical examination must be implemented while maintaining an appreciation of the various stages of adolescent development. The etiologies can range from gynecologic to nongynecologic causes. The ability to render an early diagnosis and appropriate treatment in this population of patients can significantly improve future reproductive health outcomes. The following minireview will outline a systematic approach to the adolescent with chronic pelvic pain.

Adolescent↗

Cocaine during adolescence enhances dopamine in response to a natural reinforcer.

The use of cocaine during adolescent development could alter the normal growth of brain regions affected by cocaine, specifically the reward system, and impact the adult mesolimbic system. However, there is scant literature aimed at determining whether animals are more vulnerable to the adverse effects of drugs during adolescence. The present study investigated whether cocaine pretreatment in either adolescence or adulthood altered the dopaminergic response to a naturally reinforcing substance in adulthood. To evaluate the responsivity of the mesolimbic system after repeated cocaine, sucrose was offered during the dialysis procedure and dialysates were collected. Regardless of age all saline pretreated rats had significant increases in sucrose-induced extracellular dopamine (DA) levels in the nucleus accumbens septi (NAcc) as compared to baseline levels. Rats pretreated with cocaine as adults also had significant increases in DA levels after sucrose. Interestingly, sucrose intake significantly enhanced DA levels in cocaine pretreated adolescent rats as compared to all other conditions. The results from the present study show that in rats pretreated with cocaine during adolescence there is an enhanced response of the dopaminergic system in animals exposed to a naturally reinforcing substance. Therefore, cocaine exposure during adolescence results in long-term functional changes in the mesolimbic pathway. Future studies need to ascertain the underlying mechanisms and their potential role in cocaine addiction.

Age Factors↗

Common predictors of cigarette smoking, alcohol use, aggression, and delinquency among inner-city minority youth.

The present study examined the prevalence rates and common predictors of substance use, aggression, and delinquency among inner-city minority youth entering middle school. A survey was administered to sixth grade students (N=5442) from 42 New York City schools. Aggressive behaviors were reported most frequently, followed by delinquent behaviors, alcohol use, and cigarette smoking. Across all behavioral outcomes, social and environmental influences explained the largest proportion of variance, followed by individual characteristics and skills, bonding to conventional institutions, and demographic variables. For the majority of predictor variables, there was substantial overlap in patterns of prediction across outcomes. These findings indicate that several factors that correspond to the predominant psychosocial theories of adolescent development explain variation across different problem behavior outcomes among inner-city minority youth.

Adolescent↗

Periadolescent exposure to ethanol and diazepam alters the aversive properties of ethanol in adult mice.

Evidence suggests that the developing adolescent brain may be especially vulnerable to long-term neurobehavioral consequences following ethanol exposure and withdrawal. In the present study, we examined the long-term effect of adolescent ethanol withdrawal on a subsequent EtOH-induced conditioned taste aversion (CTA). Periadolescent and adult C3H mice were exposed to 64 h of continuous (single withdrawal) or intermittent (multiple withdrawal) ethanol vapor. Following each ethanol exposure, animals received either 0, 1, 2, or 3 mg/kg diazepam (DZP) in an attempt to counteract the possible effect of ethanol withdrawal. About 6 weeks following ethanol and DZP treatment, animals were tested for an EtOH-induced CTA. As expected, exposure to EtOH during adolescence attenuated the EtOH-induced CTA as compared to controls. Unexpectedly, administration of DZP during withdrawal did not spare but rather mimicked the attenuation of the EtOH-induced CTA seen in animals exposed to ethanol in adolescence. This attenuation was not evident when EtOH and/or DZP was administered in adulthood. Given the similar mode of action of EtOH and DZP on the GABA system, the principal implication of the present findings is that the intoxicating effect of ethanol on the developing brain can result in long-term changes in the aversive properties of EtOH.

Animals↗

Cognitive-behavioral treatment for adolescents who sexually offend and their families: individual and family applications in a collaborative outpatient program.

This article describes an outpatient treatment program for adolescent sexual abusers that was established by a mental health agency in collaboration with a specialized probation program in the juvenile court. Individualized treatment is based on a comprehensive clinical assessment with the youth and guardian, for which examples are provided. Given the heterogeneity of this population, we describe several treatment strategies directed to various individual or family clinical targets, including psychiatric disorders, sexual deviance and sexuality, normal adolescent development and adaptive skills, and parent and family relationships. Ongoing collaborative and coordination issues are also reviewed. The integration of mental health and probationary services provides a balanced approach to the community management and treatment of the low-risk, primarily first-time, adolescent sexual offender.

Adolescent↗