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PubMed1996

Effects of parental divorce and youth unemployment on adolescent health.

The aim of this study is to gain more insight into the effects of two important events on adolescent health in the life course of youngsters, namely parental divorce and being unemployed. We made use of the dataset of the Utrecht Study of Adolescent Development, a longitudinal panel study, based on a representative sample of young people in the Netherlands (12-24 years old). We used the data of non-school-going youngsters who are at least 18 years old. Parental divorce does indeed have negative effects on adolescent health: however, this applies only for girls. Being unemployed or having been unemployed has negative effects on psychological health, especially for boys. But this experience does not have negative effects on physical health, either for boys or girls. Any conclusions on the consequences of parental divorce and youth unemployment for adolescent health have to be specified, at least for sex.

Adolescent↗
PubMed1996

Management of puberty in growth hormone deficient children.

At puberty there occur marked increases in gonadotropin, gonadal steroid and GH secretion. An important physiological synergism exists between the gonadal and somatotropic axes to permit the growth spurt and adolescent development; however, epiphyseal maturation is also accelerated leading to cessation of long-bone growth. GH deficiency may be absolute, but often is not and the diagnosis may be complicated by a constellation of physical and hormonal findings that are along a spectrum from low normal GH sufficiency to absent GH secretion. Growth hormone therapy not only accelerates the growth velocity, but also promotes the redistribution of adipose tissue stores to more peripheral sites. Given the remarkable physiological alterations in the activities of the GH and gonadotropin gonadal axes during adolescence in normal children, how should the therapeutic plan for the treatment of prepubertal GH deficiency be altered at puberty? Evidence for efficacy has been reported for each of the following for the treatment of GH deficiency at adolescence: 1) GH alone at the usual dosage (approximately 0.3 mg.kg-1.day-1); 2) Double or triple the amount of GH to mimic the finding of increased GH release at puberty. 3) GH at the usual or moderately increased dose and gonadotropin releasing hormone agonist analog to halt pubertal development. The latter two plans are at present hypotheses that must withstand the rigor of proper controlled trials. The end point is more than merely adult height, because of the significant psychological and skeletal system dysregulation that accompany decrements in the gonadal steroid hormones during adolescence.

Adolescent↗
PubMed2005

The impact of adolescent spirituality on depressive symptoms and health risk behaviors.

PURPOSE: The purpose of this study was to examine spirituality as a meaningful construct in adolescents' lives, and to examine the contribution of spirituality above and beyond that of religiosity to depressive symptoms and health-risk behaviors. METHOD: A total of 134 adolescents from a suburban high school completed a questionnaire assessing spirituality, religiosity, depressive symptoms, and health-risk behaviors. Spirituality was measured with 2 subscales: (1) religious well-being ("I believe that God loves/cares about me") and (2) existential well-being ("Life doesn't have much meaning"). Religiosity was assessed via belief in God/Higher Power and importance of religion. The Children's Depression Inventory-Short Form and the Youth Risk Behavior Survey (YRBS) were used to assess depressive symptoms and health-risk behaviors. RESULTS: The majority of the sample was Caucasian, with a mean age of 16.2 years. Eighty-nine percent reported a belief in God/Higher Power and 77% stated that religion was important in their lives. After controlling for demographics and religiosity, existential well-being and religious well-being accounted for an additional 29% of the variability in depressive symptoms and 17% of the variability in risk behaviors. Existential well-being was the only predictor significant in both final models (p < .01). CONCLUSIONS: Most of these adolescents reported some connection with religious and spiritual concepts, and those with higher levels of spiritual well-being, in particular, existential well-being, had fewer depressive symptoms and fewer risk-taking behaviors. This supports the inclusion of these concepts in our efforts to help promote resilience and healthy adolescent development, and in expanding our investigations beyond religious identification or attendance at religious services to broader concepts of spirituality.

Adolescent↗
PubMed1983

Learning disabilities in the junior high school: creating the six-hour emotionally disturbed adolescent?

Special education programs for the learning disabled, junior high school adolescent must ecologically analyze and address the myriad variables which potentially affect self-concept. The present article reviews and coordinates recent literature which has investigated the interaction between learning disabled adolescents' self-concept and academic, peer, family, and community systems. A unique behavioral pattern, the six-hour emotionally disturbed/learning disabled adolescent may result from continuous, negative self-concept experiences. This pattern occurs when learning disabled adolescents develop expectations of constant academic or social failure, choose to avoid these situations, and engage in maladaptive, "emotionally disturbing" behaviors as protective mechanisms. In the family and/or community systems, however, these students can be socially and adaptively successful. Preventive programming for the learning disabled, junior high school adolescent is discussed across the above interdependent systems.

Adolescent↗
PubMed1996

African-American adolescents residing in high-risk urban environments do use condoms: correlates and predictors of condom use among adolescents in public housing developments.

OBJECTIVE: African-American adolescents living in high-risk inner-city environments have been disproportionately affected by the epidemics of human immunodeficiency virus (HIV) and other sexually transmitted diseases. Understanding the factors that influence the use of condoms by adolescents is critical for developing effective behavioral interventions. The present study examined the demographic, psychosocial, and behavioral correlates of condom use among African-American adolescents residing in public housing developments in an HIV epicenter (San Francisco) and prospectively evaluated the stability of these significant cross-sectional variables to predict consistent condom use. DESIGN: A prospective study. SETTING: Two public housing developments in San Francisco. PARTICIPANTS: African-American adolescents and young adults between 12 and 21 years of age were recruited though street outreach and completed a theoretically derived research interview assessing HIV-related knowledge, attitudes, and behaviors. After a 6-month period, adolescents completed a follow-up interview similar to the baseline measure. Among adolescents reporting sexual activity in the 6 months before completing the baseline interview (n = 116), logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on consistent condom use. RESULTS: Adolescents who had high assertive self-efficacy to demand condom use (adjusted odds ratio [OR], 11), perceived peer norms as supporting condom use (OR, 4.2), had greater impulse control (OR, 3.7), were male (OR, 4.7), and were younger (OR, 2.9) were more likely to report consistent condom use. Frequency of sexual intercourse was inversely related to condom use; adolescents with higher numbers of sexual episodes were less likely to use condoms consistently. Prospective analyses identified the baseline level of condom use as the best predictor of condom use at the 6-month follow-up. Adolescents who were consistent condom users at baseline were 7.4 times as likely to be consistent condom users during the follow-up period. Of those adolescents changing their frequency of condom use during the follow-up interval, significantly more engaged in risky behavior; 33.3% changed from consistent to inconsistent condom use, whereas 20.6% changed from inconsistent to consistent use (OR, 1.6). CONCLUSIONS: The findings suggest that HIV prevention programs need to be implemented early, before high-risk behaviors are established and may be more difficult to modify.

Adolescent↗
PubMed1990

Computer-assisted strategies for substance abuse prevention: opportunities and barriers.

This article presents an analysis of the potential role that computer-assisted strategies could play in substance abuse prevention efforts in the future. Four primary areas are addressed. First, substance abuse prevention is discussed within the context of adolescent development. Second, computer-assisted instruction (CAI) is defined in terms of the opportunities it represents for substance abuse prevention. Third, a variety of barriers are described that must be addressed if the potential of CAI for enhancing substance abuse prevention efforts is ever to be realized. Finally, recommendations are made for coordinating research and development efforts, now and in the future, so that the potential of new technology for improving substance abuse prevention efforts will be adequately evaluated.

Adolescent↗
PubMedDate not supplied

Understanding the role of cigarette promotion and youth smoking in a changing marketing environment.

In 2001, $11.21 billion was spent on domestic cigarette advertising and promotion, an increase of 16.9% over 2000. This article explains how cigarette industry efforts stimulate demand and encourage smoking within the context of recent changes, including the 1998 Master Settlement Agreement (MSA) and resulting litigation, and variations in tobacco marketing policies. Communication concepts are combined with adolescent development concepts to explain how youth are impacted. Industry documents and current syndicated research data are used to reveal and explain key concepts.

Adolescent↗
PubMedDate not supplied

Predictors of running away from family foster care.

Running away is a frequent but little studied phenomenon among adolescents in foster care. Repeated running from care often leads to premature discharge and homelessness for youth. This article uses cumulative risk theory in the context of normative adolescent development to investigate predicators of running away from foster care. Results indicate risks stemming from individual, foster home, and child welfare system sources, which offer some insight for prevention and intervention.

Adolescent↗
PubMed1988

Parent-adolescent intimacy: impact on adolescent functioning.

This paper examines the influence of parent-adolescent intimacy on adolescent functioning. Intimacy for both adolescent males and females was assessed in relation to their mothers and fathers. Adolescent development was measured using two scales: self-esteem and problem behavior. No significant differences were found between males and females on the measures of self-esteem, problem behavior, and intimacy. However, mothers were found to share greater degrees of intimacy than did fathers for both male and female adolescents. A regression analysis revealed that father intimacy was a better predictor of positive adolescent functioning than was mother intimacy.

Adolescent↗
PubMed2000

Family problems and youth unemployment.

This study attempted to determine the extent to which family and personal characteristics relate to the employment situation of adolescents. Data were drawn from the Utrecht Study of Adolescent Development (USAD), which investigated, longitudinally, a national sample of Dutch youths aged 12 to 24 years in 1991. Specifically, two waves of a sample of 955 non-school-going respondents between 18 and 27 years old were analyzed. Parental divorce, parental unemployment (only for males), low parental affective involvement, and adolescent relationship problems were related to youth unemployment, but educational career and work commitment were not. For males, parental unemployment demonstrated the strongest correlation with youth unemployment. For females, only variables in the relational domain played a role in explaining unemployment; relationship variables were also important predictors of male unemployment. The results suggest that the family factors included in this study are better predictors of youth unemployment than are the classic individual (personal) variables.

Adolescent↗
PubMed1997

Gay, lesbian, and bisexual adolescents: providing esteem-enhancing care to a battered population.

Suicide, HIV infection, violent victimization, homelessness, and substance use are known to affect gay (gay males, lesbians, and bisexual persons of both genders) youths at disproportionately high rates. This article explores the difficulties gay youths experience in this society specific to their sexual orientation. These difficulties become internalized by many gay youths, leading to high rates of preventable morbidities and mortalities. Stages of the "coming out" process for gay persons are reviewed within the framework of child and adolescent development. Barriers within the health care system, as well as within other social systems, specific to gay youths are examined. Such barriers include language use by the provider, sexual and social history questions asked by the provider, environmental images in the health care setting, and the responses of the provider to the adolescent. Strategies such as the use of gender-neutral wording, homosexual inclusive questioning in history taking, and the use of inclusive environmental clues to allow gay adolescents to feel safe and accepted are discussed. Health care providers are encouraged to employ such strategies to help reduce these barriers within various health care settings.

Adolescent↗
PubMed2000

Drinking behaviour among teenagers in Switzerland and correlation with lifestyles.

UNLABELLED: Several criteria (frequency, hazardous use, drunkenness) were used to delineate four distinct groups and to analyse the relations between patterns of alcohol use and other health variables. In the 1993 Swiss Multicentre Adolescent Survey on Health, anonymous self-administered questionnaires were distributed to a national representative sample of in-school 15 to 20-year-old adolescents. Of the respondents, 25% answered a module targeting alcohol use (n = 2359) of whom 13% were totally abstinent, 55.1% were moderate drinkers (< or = 1 drink/week and < 3 times drunk), 21.7% were 'social' drinkers (> 3 times drunk and < twice driven when drunk) and 10.2% were 'problem drinkers' (> twice driven whilst drunk or > 1 drink/day). Differences between problem drinkers and the rest of the sample showed the former as being predominantly boys with an odds ratio (OR) of 6.3, having a higher lifetime prevalence rate of cannabis use (OR = 3.4), never using seat belts (OR = 2.5), having their family/peers more often involved in alcohol consumption (OR = 1.9), being predominantly apprentices (against high school pupils OR = 1.9), having cheated during courses (OR = 1.9), being a member of a gang (OR = 1.7), having stolen in a public area (OR = 1.7) and having considered suicide (OR = 1.8). CONCLUSION: Within the Swiss context, whereas moderate/occasional use of alcohol must be considered as part of an adolescents' development, regular use of alcohol, often associated with drunkenness and driving while drunk, is associated with various health hazards and problems. Preventive strategies should be built accordingly.

Adolescent↗
PubMed2004

Sex 'n' drugs 'n' rock 'n' roll: the meaning and social consequences of pubertal timing.

This is a brief review of the normal changes in adolescent behaviour and the interplay between biology and social factors that occur at and around puberty, in an attempt to explain when this transition may become problematic The onset of puberty is a biological marker for an individual's transition from a non-reproductive to a reproductive state. Adolescence is a normal developmental transition associated with clearly visible physical changes, reorganization and pruning of neuronal circuits in the brain and the occurrence of new behaviours and interests. It is a time when new life tasks (orientation towards peers of the other sex, romantic and sexual involvement and mastering an educational career) need to be mastered. Parent-child conflict increases and becomes more intense as the adolescent struggles for more independence while still requiring support. These normal changes can become problematic if biological and social expectations diverge e.g. entering puberty very early or very late. While early pubertal onset in boys is likely to have beneficial effects, in girls precocious pubertal timing may have a negative impact on body-image, affect (or emotional well-being) and sex-role expectations. Other individual biological predispositions and genetic endowment may interact with social factors (e.g. peers, parenting style, neighbourhood) making adolescence either an adaptive or a challenging transition. There is a lack of sufficiently large longitudinal studies that have been able to study this interaction between genetics, biology and social environment on adolescent development. The Avon Longitudinal Study of Parents and Children (ALSPAC) cohort provides a unique opportunity to investigate the impact of pubertal timing on social behaviour. Planned assessments and concepts are outlined.

Adolescent↗
PubMed1993

Reality, fantasy, and adolescence.

Psychoanalytic views of reality and fantasy are contingent upon a theory of ego/mind: A mental-apparatus-objective approach is distinguishable from an experiential-subjective approach. These two views are highly correlated with Being and Doing as underlying modalities of processing experience. Adolescent development necessitates the integration and amalgamation of these two modalities, which are reflected in relating to reality as objective and separate from, or as merged and fused with, the ego, with corresponding fantasy contents and ego states. As social reality exists as an independent variable, it poses real problems for such crucial aspects of adolescence as identity formation, psychosocial moratorium, and the generational gap.

Adolescent↗
PubMed2002

What determines knowledge of asthma among young people and their families?

In this analysis, we sought to determine factors that predicted the level of asthma knowledge in a sample of adolescents with asthma and their parents. Eighty-five young people aged 10-24 years attending tertiary care asthma clinics and 46 of their parents answered validated respiratory and asthma knowledge questionnaires. Older adolescents were more knowledgeable about asthma than were younger adolescents (r=0.36, p=0.001). Young people with severe asthma (p=0.015) scored higher on the asthma knowledge questionnaire than those with mild/moderate asthma. Asthma knowledge among young people was related to that of their mothers (r=0.47, p=0.014), however, only age and the asthma knowledge of fathers significantly predicted adolescent asthma knowledge. Adolescents develop increasing autonomy for asthma self-management as they mature, but parents remain an important source of information about asthma for young people.

Adolescent↗
PubMed2001

Sex-specific developmental changes in amygdala responses to affective faces.

It is hypothesized that adolescent development involves a redistribution of cerebral functions from lower subcortical structures to higher regions of the prefrontal cortex to provide greater self-control over emotional behavior. We further hypothesized that this redistribution is likely to be moderated by sex-specific hormonal changes. To examine developmental sex differences in affective processing, 19 children and adolescents underwent fMRI while viewing photographs of faces expressing fear. Males and females differed in the pattern of their amygdala vs prefrontal activation during adolescent maturation. With age, females showed a progressive increase in prefrontal relative to amygdala activation in the left hemisphere, whereas males failed to show a significant age related difference. There appear to be sex differences in the functional maturation of affect-related prefrontal-amygdala circuits during adolescence.

Adolescent↗
PubMed2002

Type 2 diabetes mellitus in adolescents.

While diabetes mellitus types 1 and 2 used to be distinguished largely by age at onset, in the past decade there has been an increase in the number of children presenting with diabetes that can be controlled with oral medications. This has lead to these children being diagnosed with type 2 diabetes mellitus despite their young age. This chapter offers an overview of presenting features, pathophysiology, treatment and prognosis of this disorder in the adolescent patient. Additionally, it offers information regarding the relationship between increasing childhood obesity and a rise in the reported cases of diabetes in children. Appropriate screening and laboratory tests and their results are explained, and the pros and cons of both pharmacologic and non-pharmacologic therapies are discussed. Some complications of diabetes in the developing adolescent differ from those adults will face, and the well-known complications of diabetes (hyperlipidemia, hypertension) must be addressed in a population that is not normally screened for these health concerns. It is hoped that by educating physicians to the potential for this disorder in their adolescent patients, long-term complications can be reduced and advanced sequelae of vascular and neurologic problems can possibly be avoided altogether.

Adolescent↗
PubMed1992

The pediatrician's role in the diagnosis and treatment of substance abuse.

Abuse of drugs and alcohol is pervasive in our society. The role of the pediatrician as a health-care provider from birth through young adulthood includes recognizing the stigmata in newborns of prenatally ingested drugs as well as being able to treat neonatal drug withdrawal syndromes. Questioning about drug use and other closely related topics should be incorporated into all health-care maintenance visits, starting at the age of 10 y, with parental participation and anticipatory guidance being offered. Physical examination and laboratory testing are not as helpful in confirming an impression of substance abuse as a comprehensive interview and a full appreciation of the warning signs of substance abuse. Treatment of the problematic user with a multidisciplinary team that understands adolescent development and behavior as well as the problem of substance abuse is crucial. The decision to treat the teen in an ambulatory or inpatient setting is determined by the extent of abuse, underlying medical problems and psychopathology, and the degree of family dysfunction. The pediatrician must not avoid addressing these issues with patients. If, however, upon identifying an adolescent or a newborn with a drug problem, the pediatrician feels uncomfortable or ill-prepared to manage the patient, appropriate professional referrals are warranted. Despite exercising the referral option for treatment, as advocate for child and family, the pediatrician remains professionally bound to track all drug abuse-related referrals while continuing to participate in the general ongoing care of the patient and family. Finally, the pediatrician should retain a public advocacy role in the community by offering educational, preventive, and supportive efforts in the continuing struggle against drug abuse.

Adolescent↗