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PubMed1998

Managing sexually transmitted diseases in adolescents.

Control of sexually transmitted diseases (STDs) in adolescents is a primary responsibility of health care providers. Using the tools of history and physical examination, and drawing on the awareness of different stages of adolescent development, health care providers can define at-risk for STDs. This article discusses screening practices, disease control through reporting and preventive counseling, and treatment guidelines for common STD syndromes.

Adolescent↗
PubMed1999

Creating a new framework for promoting the health of African-American female adolescents: beyond risk taking.

African-American female adolescents bear a disproportionate burden of poor health outcomes compared to young white women. The racial and gender disparities in adolescent health are readily apparent in the reported rates of human immunodeficiency virus (HIV) infection, poor nutrition, victimization and exposure to traumatic violence, incarceration, and mortality among young African-American women, especially those who are poor and living in inner cities. Risk behavior, the dominant construct explaining adolescent morbidity and mortality, is inadequate because it assumes that all adolescents develop similarly when, in fact, gender, race, and socioeconomic status force different developmental patterns and health outcomes. The author calls for interdisciplinary collaborations examining the structural inequities and combined consequences of sexism, racism, and inner-city poverty for young women of color in order to inform public health interventions to improve the health of African-American female adolescents.

Adolescent↗
PubMed1999

Prevention of youth injuries.

There are four categories of causes responsible for the majority of injuries in youth 10-19 years of age: 1) motor vehicle traffic; 2) violence (intra-familial, extra-familial, self, pregnancy-related); 3) recreational; and 4) occupational. This article presents data from the National Center for Health Statistics mortality data and the National Pediatric Trauma Registry morbidity data. Nationwide, the pediatric injury death rate is highest among adolescents 15-19 years of age. Motor vehicle-related deaths account for 41% and firearm-related deaths account for 36% of injury deaths in this age group. For youths aged 10-14 years, motor vehicle-related deaths account for 38% and; firearm-related deaths account for 26% of injury deaths. For both age groups, occupant motor vehicle-related deaths account for the majority of deaths and underscore the need for seat belt use. Using theoretical principles based on the Haddon matrix and a knowledge of adolescent development, proposed interventions to decrease injuries and deaths related to motor vehicles and firearms include graduated licensing, occupant restraint, speed limits, conflict resolution, and gun control. Occupational injuries, particularly injury associated with agricultural production, account for an estimated 100,000 injuries per year. Preventive strategies include OSHA regulations imposing standards for protective devices and further study for guidelines for adolescent work in agriculture. Injuries related to recreation include drowning and sports injuries. Preventive strategies may include proper supervision and risk reduction with respect to use of alcohol/drugs. The data presented support the use of primary prevention to achieve the most effective, safe community interventions targeting adolescents.

Accidents, Occupational↗
PubMed1997

Transitions in family structure and adolescent well-being.

This article examines the effects of transitions in family structure on physical health, thoughts of suicide, mental health, relational well-being, and employment situation of adolescents from four family structures: stable intact families, conflict intact families, single-parent families, and stepfamilies. Data were used from the Utrecht Study of Adolescent Development (USAD), a study of developments in the life course of young people during the 1990s. Results are presented from over 2,500 respondents between 15 and 24 years of age. Their parents were also interviewed on a number of topics. Transition in family structure after marital problems, divorce, and remarriage does appear to have significant long-term effects on a number of adolescent well-being variables. Young people from single-parent families have the lowest scores on the different indicators; they are more likely to have relational problems and experience unemployment as compared with youngsters from stable intact families. Adolescents from conflict intact families and stepfamilies have moderate scores. These effects remain after controlling for family income, gender, age, and educational level.

Adolescent↗
PubMed2006

Fear-related activity in the prefrontal cortex increases with age during adolescence: a preliminary fMRI study.

An emerging theory of adolescent development suggests that brain maturation involves a progressive "frontalization" of function whereby the prefrontal cortex gradually assumes primary responsibility for many of the cognitive processes initially performed by more primitive subcortical and limbic structures. To test the hypothesis of developmental frontalization in emotional processing, we analyzed the correlation between age and prefrontal cortex activity in a sample of 16 healthy adolescents (nine boys; seven girls), ranging in age from 8 to 15 years, as they viewed images of fearful and happy faces while undergoing functional magnetic resonance imaging (fMRI). During fear perception, age was significantly positively correlated with greater functional activity within the prefrontal cortex, whereas no significant relationship was evident between age and activity in the amygdala. Consistent with previous gender-related findings, age was significantly correlated with bilateral prefrontal activity for the sample of females, but was only significantly related to right prefrontal activity for the males. In contrast, similar age-related correlations were not evident during the perception of happy faces. These results suggest that the maturation of threat-related emotional processing during adolescence is related to the progressive acquisition of greater functional activity within the prefrontal cortex. The hypothesis of age related decreases in amygdala activity was not supported, but may have been due to low signal-to-noise and inadequate power in the present sample to resolve subtle changes in this small structure.

Adolescent↗
PubMed1986

The importance of peer group ("crowd") affiliation in adolescence.

Many researchers have speculated about the role peer groups play in adolescent development, but few have examined teenagers' own perspective on the importance of group affiliations. The two studies reported here, involving 1,300 7th to 12th graders in three Midwestern U.S. communities, assessed teenagers' valuation of belonging to a "crowd" as well as the reasons they cited to support or oppose crowd affiliation. The importance of crowd affiliation declined across age. Younger adolescents generally favored membership, emphasizing the crowd's ability to provide emotional or instrumental support, foster friendships and facilitate social interaction. Older respondents expressed dissatisfaction with the conformity demands of crowds and felt their established friendship networks obviated the need for peer group ties. The importance of crowd affiliation was not related to the strength of respondents' sense of identity but did vary significantly with their willingness to conform to peers and the centrality of their position in peer groups or the type of crowd to which they belonged. Findings emphasized that adolescent peer groups can serve multiple functions, whose salience shifts with age.

Adolescent↗
PubMed1976

Death anxiety in normal children and adolescents.

Instruments devised to measure death anxiety, depression, and manifest anxiety in adults were administered to 75 junior high-school students, 111 senior high-school students, and 38 adults in an effort ot determine the nature of any developmental differences among these groups. A number of significant differences were noted, with the senior high-school students showing greater anxiety, depression, and death anxiety than the other groups. These results are discussed in the context of tasks of adolescent development, and an item analysis of the death anziety questionnaire is presented. Developmental differences in the origin of death anxiety are related to previous studies of death anxiety in adults.

Adolescent↗
PubMedDate not supplied

Research on social support in adolescents with IDDM: a critical review.

This article provides a review of the findings of 32 scientific studies that examined the relationship between social support and adherence/metabolic control in adolescents with insulin-dependent diabetes mellitus. Social support included qualitative family support characteristics, communication patterns, sibling and peer relationships, and regimen-specific support behaviors. The literature was examined in the context of adolescent development. Although the results of these studies were somewhat inconsistent, some general patterns emerged that are described and discussed in detail. Methodological limitations and suggestions for future research are provided.

Adolescent↗
PubMed1984

[Central nervous system involvement in systemic lupus erythematosus].

Three cases are presented, in two of which the CNS lesions revealed the presence of systemic lupus erythematosus (SLE). The diagnosis of SLE was certain according to the criteria of the ARA, and it was further confirmed by results of renal needle puncture biopsy. Case 1: A 16-year-old adolescent developed choreic movements followed, one month later, by psychotic symptoms suggesting a mixed hebephrenic-catatonic schizophrenic affection. Cutaneous lesions and signs of renal insufficiency 3 months later established that these disorders were related to SLE. A favourable outcome was observed rapidly for the systemic signs, recovery from neuropsychic symptoms being obtained after 3 months only but then in a few days. This course suggests the diagnosis of a "functional psychosis" of lupus origin. Case 2: A 24-year-old woman developed left hemiparesis followed by febrile coma. The slowly favourable course of the disease led to the appearance of a progressive dementia, with numerous epileptic seizures. Although tests for antinuclear antibodies were negative and the ESR was normal, several minor biological anomalies were suggestive of a systemic disease and the diagnosis of SLE was finally established. Corticotherapy produced only slight transient improvement. This progression towards dementia with progressive cerebral atrophy is most probably related to cerebral lupus lesions, the initial coma in the absence of any other apparent cause possibly being the first sign. Case 3: A 47-year-old woman developed simultaneously or separately episodes of arthralgia and uveitis of unknown origin over a 12-year period, and attacks of regressive multilocular neurological deficiency over a 15-year period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1999

Relationships between parenting and adolescent adjustment over time: genetic and environmental contributions.

The predictive association between parenting and adolescent adjustment has been assumed to be environmental; however, genetic and environmental contributions have not been examined. This article represents one effort to examine these associations in which a genetically informative design was used. Participants were 395 families with adolescent siblings who participated in the Nonshared Environment in Adolescent Development (D. Reiss et al., 1994) project at 2 times of assessment, 3 years apart. There were 5 sibling types in 2 types of families: 63 identical twins, 75 fraternal twins, and 58 full siblings in nondivorced families and 95 full, 60 half, and 44 genetically unrelated siblings in stepfamilies. Results indicate that the cross-lagged associations between parental conflict-negativity and adolescent antisocial behavior and depressive symptoms can be explained primarily by genetic factors. These findings emphasize the need to recognize and examine the impact that adolescents have on parenting and the contribution of genetic factors to developmental change.

Adolescent↗
PubMed2006

Sleep and adolescence. Do New Zealand teenagers get enough?

AIM: The objective of this study is to describe the sleep patterns of secondary school students in New Zealand. METHODS: This study uses data from a national secondary school youth health survey conducted in 2001. A total of 9567 students completed the survey with an overall response rate of 64.3%. Students were asked if they felt they got enough sleep and the numbers of sleep hours were estimated from self-reported bedtimes and awakening times during the week and weekend. RESULTS: A significant proportion (21%) of students reported not getting enough sleep. Inadequate sleep was more common among older students and female students of Maori and New Zealand European ethnicity. The average amount of sleep secondary school students report in New Zealand is 8 h and 40 min during the week and 9 h and 23 min during the weekend. There was a shift towards later bedtimes and fewer total sleep hours among older students. Increasing hours of extracurricular activities and employment were generally associated with less sleep, especially among students engaging in more than 5 h a day of these activities. CONCLUSIONS: Significant numbers of secondary school students report inadequate sleep. Given the importance of adequate sleep on healthy adolescent development, parents and health professionals should be wary of the amount of extracurricular activities that young people engage in, especially part-time employment and the potential negative impact it may have on the adequacy of their sleep.

Adolescent↗
PubMed1990

The experience of time in the psychotherapy of hospitalized adolescents.

Individual psychotherapy of adolescents in extended hospital or residential treatment is shaped by the prominence of the issues around time that are fostered by such highly structured treatment programs. The author discusses how adolescents develop a sense of time and how they experience time at different points in treatment. She then examines the role of the hospital setting and the individual psychotherapy process in identifying and treating troubled youngsters' disturbances in the experience of time.

Adolescent↗
PubMed2002

Child/parent-assessed population health outcome measures: a structured review.

AIMS: To identify generic measures of health-related quality of life (HRQL) for children and adolescents developed for use within general populations. Instruments are evaluated on the basis of evidence relating to their reliability and validity. METHODS: Systematic literature searches were used to identify instruments, which were then assessed against predefined criteria. Information relating to instrument content, population, reliability and validity was extracted from published papers. RESULTS: Sixteen instruments were identified that had been evaluated among a general population of children or adolescents. Four instruments had reported data on both internal consistency and test-retest reliability. All except two instruments had undergone some degree of construct validation. CONCLUSIONS: The evidence suggests that the Child Health Questionnaire (CHQ) has been the most extensively evaluated for younger populations but is available as a parent-completed measure only. The new version of the Child Health and Illness Profile (CHIP-CE) is particularly promising and has parallel child- and parent-completed versions for young ages. The weight of evidence suggests that versions of these two instruments are suitable for older children. The Warwick Child Health and Morbidity Profile could be used where information on morbidity and health service contacts is required. Once basic psychometric criteria are fulfilled, instruments should be chosen by assessing their content and design in the light of the prospective application.

Adolescent↗
PubMedDate not supplied

Cervicovaginal smear abnormalities in sexually active adolescents. Implications for management.

OBJECTIVE: To assess the prevalence and spectrum of Pap smear (PS) abnormalities in sexually active adolescents in comparison to adult women in order to determine whether management of adolescents should differ from that of adults. STUDY DESIGN: Five hundred twenty-four adolescents who had an initial PS at our institution from January to September 1997 were followed for 36 months with repeat PS and/or cervical biopsy. Initial PS results were compared with those of adult women. The chi 2 test was used to calculate the statistical significance of differences between the two groups. The qualified atypical squamous cells of undetermined significance (ASCUS) cytologic diagnosis in adolescents was correlated with follow-up data. RESULTS: The overall prevalence of squamous intraepithelial lesions (SILs) in adolescents was 29% as compared to 23% in adults. Almost all initial squamous lesions were ASCUS and low grade squamous intraepithelial lesion (LSIL); only one case of high grade squamous intraepithelial lesion (HSIL) was detected. On follow-up 18% and 2.4% of adolescents developed LSIL and HSIL, with a LSIL/HSIL ratio of 8/1 as compared to 5/1 in adults. The average time from initial PS to detection of HSIL was 20 months. All patients with HSIL except one had had one or more previous abnormal PSs. The positive predictive values (PPVs) for subsequent dysplasia for ASCUS favor reactive (ASCUS.R), ASCUS not otherwise specified (ASCUS.NOS) and ASCUS favor dysplasia (ASCUS.D) in adolescents were .13, .17 and .31, respectively. ASCUS.NOS (P = .01) and ASCUS.D (P = .007) were strong indicators of dysplasia as compared to ASCUS.R. CONCLUSION: PS abnormalities are more common in sexually active adolescents, with a significantly higher prevalence of LSIL over HSIL as compared to adult women. Given the natural history of HPV infection, we recommend follow-up with cytology rather than colposcopy/biopsy for adolescents with ASCUS and LSIL PSs. Qualification of ASCUS is useful in determining which adolescents are at the highest risk of cervical dysplasia.

Adolescent↗
PubMed1989

Ethical questions in adolescent contraception.

Ethical problems often revolve around the conflicts of the models of beneficence and autonomy. Adolescents present a particular complication in their own struggle for autonomy. The physician is confronted with the further dilemma of sorting out the role of parents and the role of the adolescent patient in decision making. Furthermore, as adolescents develop their own moral code, they may lack consistency in their actions and opinions. The physician must examine the total context in arriving at a decision. The prescription of contraception is taken as an example of a common ethical dilemma.

Abortion, Induced↗
PubMed2005

Teachers' knowledge about adolescents: an interview study.

This paper presents the results of an interview study of twelve high school teachers to ascertain their general knowledge about adolescents, as well as their knowledge of issues important to adolescents. The results were as follows: (a) teachers lacked knowledge about what adolescents in previous studies have referred to as important issues in their lives; (b) teachers' general knowledge about adolescents was mainly based on experiential, as opposed to theoretical, knowledge; and (c) teachers were not interested in theoretical knowledge about normal adolescent development. These results are discussed in relationship to the Swedish school system, as well as their relationship to teacher training, which traditionally has focused on the what and how aspects of teaching, not on the aspect of whom one is teaching.

Adolescent↗
PubMed1998

On loneliness, narcissism, and intimacy.

The complex interplay between narcissistic vulnerability, adolescent development, and the capacity for intimate relatedness is viewed here from the perspective of two distinct but interrelated experiential modes of Being and Doing. I offer a view of loneliness that begins with a critical reappraisal of the concept of narcissistic relatedness in association with difficulties in establishing intimacy. These difficulties are due to failures in the developmentally prescribed intimacy. These difficulties are due to failures in the developmentally prescribed integration of the experiential modalities of Being and Doing during the course of late adolescence and young adulthood. The type of loneliness encountered in adult life, its particular cast and subjectively experienced nature, are determined by the specific modality around which it has become primarily organized. Clinical material is presented to illustrate the meaning of loneliness in the presence of the object, and the paradoxical inability to be both with the object and without it.

Adult↗
PubMedDate not supplied

The unwed pregnant adolescent: implications for the professional nurse.

To promote better care fo the unwed pregnant adolescent, an overview of adolescent development, feelings, and behaviors is given, followed by a generalized description of the patient herself. Then, to help enhance the care given to this patient, who needs strong support and encouragement during this crucial time, the role of the nurse if outlined.

Adaptation, Psychological↗