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PubMed2000

Genes on the X chromosome are important in undiagnosed mental retardation.

The clinical genetic diagnosis was reviewed in 429 subjects with intellectual disability in the Australian Child and Adolescent Development (ACAD) study of behavioural problems. With minor differences, the overall "general distribution by causation" was similar to that to that found by the Consensus Conference of the American College of Medical Genetics in 1995. There was a significant male excess in the whole series which was shown to reside in those with "autism," those with undiagnosed nonsyndromic mental retardation (NSMR) and those with X-linked monogenic disorders. It is argued that a substantial proportion of undiagnosed NSMR is caused by genes on the X chromosome. Some of the practical problems of assigning individuals to diagnostic groups are discussed.

Adolescent↗
PubMedDate not supplied

Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome.

OBJECTIVE: To report a pediatric case of central pontine and extrapontine myelinolysis, a rare neurological disease often associated with rapid correction of hyponatremia. DESCRIPTION: A 15 year-old female adolescent developed locked-in syndrome during severe hyponatremia. Brain magnetic resonance imaging was consistent with the diagnosis of central pontine and extrapontine myelinolysis. COMMENTS: Serum sodium correction should proceed slowly and cautiously, based upon a careful calculation of sodium deficit, in order to minimize metabolic stress and avoid the occurrence of this dreadful complication, which has a tragic outcome in most cases. There is no scientifically proved effective treatment for myelinolysis, and severe cases usually have a dismal prognosis.

Adolescent↗
PubMed1994

Clearing athletes for participation in sports. The North Carolina Medical Society Sports Medicine Committee's recommended examination.

The North Carolina Medical Society's Medicine Committee has reviewed current U.S. literature on preparticipation examinations and adopted a documentation form that fits the specific needs of our state. In spite of a recently published comprehensive monograph on preparticipation physical evaluation, no national consensus exists about whether comprehensive preparticipation exams or brief, focused examinations are better. With this in mind, we limited medical history questions to those determined by previous studies to identify specific problems. Also included are evaluations of blood pressure, musculoskeletal, and cardiovascular systems since studies have shown significant yield from these. The same studies find little benefit from the remainder of a comprehensive physical assessment. The recommended evaluation represents a minimal standard and addresses the core areas likely to prevent athletes from participating safely in sports. No recommended exam could cover all issues that affect school-age athletes--health prevention, adolescent development, general medical care, and psychological stresses--but physicians can use the recording form as a starting point and incorporate a more extensive evaluation into the assessment of athletes found to be at increased risk. Consistent use of this examination should promote better detection of sport-specific risks related to cardiovascular disorders, asthma, musculoskeletal problems, concussions, heat-related problems, and general medical problems. The Sports Medicine Committee wants to promote physical activity. Before disqualifying athletes physicians should remember that the disqualification rate in published studies averages only 1%. When questions about the need for disqualification arise, consultation may be advisable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

Serum-sickness-like reaction associated with minocycline therapy in adolescents.

OBJECTIVE: To describe a serum-sickness-like reaction in five adolescents treated with minocycline. CASE SUMMARY: Five adolescents developed a rash and arthralgias/arthritis after taking minocycline for 10-30 days. Symptoms resolved gradually after the medication was stopped. DISCUSSION: Serum sickness is not described in the pharmacology literature as an adverse effect of minocycline, and in the English literature there are only two case reports. The migration inhibitory factor assay and mast cell degranulation test were positive in four of the five patients. The results of these assays were consistent with a role for minocycline in causing these reactions. CONCLUSIONS: Clinicians should be aware of the possibility of serum-sickness-like reaction as an adverse effect of minocycline.

Adolescent↗
PubMed1979

[Giant aneurysm of the intracavernous carotid, complicated by subarachnoid haemorrhage. Emergency treatment by occlusive balloon and thrombosis in situ (author's transl)].

A 15-year-old adolescent developed a painful ophtalmoplegia and a subarachnoid haemorrhage secondary to fissuration of a giant intracavernous aneurysm. The choice of therapeutic abstention was not retained due to the dissuration. The site excluded any direct approach and ligation of the common carotid was not adopted because of its complications. The method chosen consisted of in situ coagulation of the aneurysmal sac, induced by injection of thrombin after occlusion of the internal carotid by a double-lumen balloon catheter. In case of emergency and when direct approach is impossible, this technique may be useful on the condition of close cooperation between clinicans and radiologists.

Adolescent↗
PubMedDate not supplied

[Psychodynamic aspects of corset treatment in adolescents].

Based on 41 psychoanalytical interviews with 14 adolescent corset patients it was intended to analyse in a pilot study the individual experience, the handling of the corset and the influence of corset therapy on the adolescent development. The indication for proceeding to corset therapy was either due to Scheuermann's disease or scoliotic disease. Contrary to the doctor's instructions all patients examined only wore the corset during certain periods of time according to a time schedule fixed with the parents only, therefore lacking any official authorization. It also happened that the therapy was interrupted without further notice and that patients openly refused wearing the corsets any longer. As for the indication of orthese therapy, the authors recommend to take psychosocial aspects into account and submits concrete proposals as far as the care for the corset patients is conserned.

Adaptation, Psychological↗
PubMed1997

Males with eating disorders: challenges for treatment and research.

Males represent only 10 percent of eating disorder cases. This gender discrepancy is among the most extreme in psychiatry and medicine. Determining what differences in etiology and mechanism best explain the discrepancy presents an intellectual challenge. Beginning at about the third grade, boys and girls diverge in social development. Boys show significantly less desire to lose weight, express dissatisfaction with the upper rather than the lower body, and use dieting to achieve specific external goals rather than as a cultural norm. Males reach a significantly higher body mass index (BMI) than females do before they beginning dieting. (27.2 versus 24.3, p < .01). While overall treatment principles are similar, males in treatment require attainment of a different hormonal milieu (testosterone), attention to past and future sexual role, amelioration of perception of stigma, and preparation for return to male social roles. Males and females suffer comparable degrees of osteopenia and brain shrinkage during anorexia nervosa. The effectiveness of antidepressants in males with eating disorders (compared with that in females) has not been well studied. Male gender is not an adverse factor in short-term or long-term treatment outcome. Understanding the lower frequency of these illnesses in males may lead to more effective means of protecting girls from eating disorders and from the culturally induced distress about normal body size and shape that burdens adolescent development and adult life.

Antidepressive Agents↗
PubMed2001

Reducing the harms caused by cannabis use: the policy debate in Australia.

The debate about cannabis policy in Australia has revolved around the harms that cannabis causes to users and the community, on the one hand, and the harms that are caused by the prohibition of its use, on the other. This paper assesses evidence on: (1) the harms caused to users and the community by cannabis use (derived from the international scientific literature) and (2) the harms that arise from prohibition (as reflected in Australian research). The most probable harms caused by cannabis use include: an increased risk of motor vehicle accidents; respiratory disease; dependence; adverse effects on adolescent development; and the exacerbation of psychosis. The harms of the current prohibition on cannabis use policy are less tangible but probably include: the creation of a large blackmarket; disrespect for a widely broken law; harms to the reputation of the unlucky few cannabis users who are caught and prosecuted; lack of access to cannabis for medical uses; and an inefficient use of law enforcement resources. Cannabis policy unavoidably involves trade offs between competing values that should be made by the political process. Australian cannabis policy has converged on a solution which continues to prohibit cannabis but reduces the severity of penalties for cannabis use by either removing criminal penalties or diverting first time cannabis offenders into treatment and education.

Adolescent↗
PubMedDate not supplied

An art future image intervention to enhance identity and self-efficacy in adolescents.

The authors describe the content, implementation, and findings concerning an "Art Future Image Intervention" (AFI) for adolescents. The AFI was designed to help adolescents develop a positive identity and to enhance their self-efficacy by encouraging them to consider their ideal future goals, vocation, and body image. Two randomly selected classes of South Carolina high school students participated in the AFI (N = 158). The data indicated that the future images of these teenagers included realistic and unrealistic future goals and self-images. Ninety three percent of these teenagers evaluated the AFI positively. Eligible students who elected to participate in the AFI protocol had the lowest baseline self-efficacy. Both intervention and control students' mean self-efficacy scores decreased from baseline (fall 1990) to post-intervention (spring 1991); however, intervention students had less of a decrease.

Adolescent↗
PubMed1979

The relationship of adrenal androgens to the secretory patterns for cortisol, prolactin, and growth hormone during early puberty.

Serum concentrations of dehydroepiandrosterone (DHA), dehydroepiandrosterone sulfate (DHA-sulfate), cortisol, prolactin, and growth hormone were measured at half-hour intervals for 24 hr in five healthy children aged 8--13 yr. Their adolescent development was assessed by clinical staging, plus determinations of serum FSH, LH, testosterone and estradiol during both wakefulness and sleep. Correlative analysis indicates that there was synchronous secretion of DHA and cortisol, implying regulation of both by ACTH. With advancing age and sexual maturation, there was a progressive rise in mean serum DHA and DHA-sulfate levels, but no similar change in serum cortisol concentrations. There was evidence for enhanced secretion of both growth hormone and prolactin during sleep in all subjects (including one who was hyperprolactinemic), but there was no obvious relationship between levels of these pituitary hormones and the early pubertal rise in adrenal androgens.

Adolescent↗
PubMed2004

Hindu and Buddhist children, adolescents, and families.

The language of psychotherapy that focuses on the individual may be problematic for Hindu and Buddhist families. The focus on child and adolescent development as a separation-individuation process that moves the child into an independent life with individual goals may run contrary to family cultural values and to the Hindu and Buddhist views of interconnectedness. For the Hindu family, however, when therapy can be seen as being compatible with an evolution toward the higher self and is consistent with the shared sense of family belonging, the goals can be complementary. With the fundamental views in Buddhism that suffering derives from emotional and conceptual misunderstandings and from the resultant actions, and that change is necessary to relieve that suffering, therapy and practice may share goals. The spiritual teachings can work alongside the therapeutic work, and the improved functioning is also spiritual growth.

Acculturation↗
PubMed2004

Trajectories of adolescent emotional and cognitive development: effects of sex and risk for drug use.

Adolescence has been widely accepted as a time for notable alterations in brain functioning. The objective of this longitudinal study was to compare trajectories of emotional and cognitive development in adolescent girls and boys with low- versus high-risk for future drug use. Nineteen healthy adolescents (aged 13.9 +/- 2.0 years; 10 girls), stratified into low- and high-risk groups based on family history of drug abuse, were examined at baseline and after one year. Emotional intelligence was assessed using the Bar-On Emotional Quotient Inventory, the Multidimensional Anxiety Scale for Children, and the Perceived Stress Scale. The neurocognitive test battery was designed to evaluate academic achievement, executive function, verbal memory and learning, and included the Wide Range Achievement Test, Stroop Color-Word Interference Test, Rey Auditory Verbal Learning Test, and Digit Span and Digit Symbol subtests of the Wechsler Adult Intelligence Scale-Revised. Improvements in academic achievement, executive function, and working memory were observed at the one-year follow-up. Notable sex differences also were evident in emotional intelligence, academic achievement, and memory. Interestingly, these sex-related differences interacted with risk status; improvement in cognitive performance in boys and low-risk girls was generally superior to high-risk girls, who tended to show modest, if any, improvement at the one-year follow-up. These preliminary findings provide evidence of sex differences in emotion intelligence and cognitive function. Furthermore, these data also suggest that history of familial drug abuse may have a more pronounced impact on emotional and cognitive development in adolescent girls than boys.

Adolescent↗
PubMed2004

Genetic and environmental influences on mothering of adolescents: a comparison of two samples.

This study examined 2 samples of adolescents and mothers using a child-based design (Nonshared Environment in Adolescent Development [NEAD] project, N = 395 families) and a parent-based design (Twin Moms [TM] project, N = 236 twin family pairs) to compare genetic and environmental influences on mothering. For both samples, the same measures of positivity, negativity, control, and monitoring were used. The use of matched child-based and parent-based samples enabled passive and nonpassive genotype-environment (GE) correlations to be approximated, providing information about process. Passive GE correlations were suggested for mother's positivity and monitoring. For mother's negativity and control, primarily nonpassive GE correlations were suggested. In several cases, both types of GE correlation were indicated. Finally, observer ratings of negativity and monitoring were influenced only by environmental factors.

Adolescent↗
PubMed1999

Possible confounds and their resolution in multivariate genetic analyses: comment on Bussell et al. (1999)

Assumptions behind the twin, sibling, and stepsibling design used in the Nonshared Environment in Adolescent Development study are considered. The D. A. Bussell et al. (1999) analyses of behavior in relationships indicate effects of both genetic and common-environment factors. Possible real and artifactual sources of the common environment include assortative mating, sibling interaction, failure of the equal environments assumption, and contaminated measures. Another potential source, specific to this study, is the effect of an individual in the mutual ratings of relationship with sibling, which would lead to a larger common-environment effect across variables than within variables. This alternative model did not indicate that there was a mutual rating effect. Univariate analyses confirm that the common-environment effect is present for both sibling and parent-child relationships. Most other potential sources of common environment, such as sibling interaction, do not account for the data.

Adolescent↗
PubMed1987

Short stature and pubertal delay in cystic fibrosis.

Survival of the patient with cystic fibrosis has been considerably extended in the last two decades due to improved therapy of pulmonary infection, nutritional management, and an organized system of centralized care. Psychological and social aspects of cystic fibrosis may be intensified during adolescence: developing independence in the face of required daily care; developing self-esteem in the face of illness-associated problems such as discolored teeth, malabsorption, short stature, and cough; and participating in group activities despite physical limitations and the disruption in peer relationships when recurrent acute illness is interposed. Pubertal delay is more common in the cystic fibrosis population than the general population, and attendant psychologic dysfunction may be particularly common in males. Comparative studies suggest that this pubertal delay is a function of malnutrition rather than intrinsic to the disease. Normal growth potential may be postulated from somatomedin studies and has been demonstrated in patients treated with long-term aggressive nutritional management. Intervention utilizing testosterone enanthate in males with cystic fibrosis and pubertal delay has resulted in improved rate of growth, progression through puberty, and self-image.

Adolescent↗
PubMed1999

The importance of shared environmental influences in explaining the overlap between mother's parenting and sibling relationships: reply to Neale (1999)

This article addresses concerns raised by M. C. Neale (1999) in his commentary on the D. A. Bussell et al. (1999) Nonshared Environment in Adolescent Development (NEAD) study. These concerns fall into two categories: (a) model assumptions and sample design and (b) testing of alternative models. The validity of the assumptions of quantitative genetic models is a concern for all researchers in this area. Discussion of those assumptions in this reply is brief and focuses on those most relevant to the NEAD sample. The two alternative models proposed by Neale were designed to provide alternatives to the large shared environmental effect found in the original report of Bussell et al. Because these alternative models did not provide a better fit, the appropriateness of Bussell et al.'s basic model and the importance of shared environmental influences for explaining the association among family subsystems are supported.

Adolescent↗
PubMed2001

The well-being of youngsters coming from six different family types.

Families, or rather parents are in a state of flux: sometimes they row a lot, they divorce, they go and live together again and they die. This is why more and more children grow up in family forms other than the nuclear families with their biological fathers and mothers. What, in the long run, is the effect of this on the well-being of adolescents and young adults between 12-30? We have examined intact families that function well, mediocre or badly, one-parent families and stepfamilies after a divorce and one-parent families after being widowed. The data derive from the Dutch longitudinal panel study "Utrecht Study of Adolescent Development" (USAD). The results of 1772 respondents between 12 and 30 years old are presented from the third wave by the end of 1997. Compared to youngsters of well functioning nuclear families, the youngsters of discordant nuclear families show a worse physical and mental health, their parental fixation is not so strong, they tend to drink more alcohol, smoke more cigarettes and use more soft drugs. Children of divorced families are notable for their relational behaviour: they enter into relations at an early age, usually they are more sexually experienced and they report more relational problems. Children of widowed one-parent families do well. In other family types girls suffer a little more from the burden of life than boys. It appears that the effects are hardly different when the children leave home.

Adaptation, Psychological↗
PubMed1993

Risk factors for early adolescent drug use in four ethnic and racial groups.

OBJECTIVES: It is widely believed that risk factors identified in previous epidemiologic studies accurately predict adolescent drug use. Comparative studies are needed to determine how risk factors vary in prevalence, distribution, sensitivity, and pattern across the major US ethnic/racial groups. METHODS: Baseline questionnaire data from a 3-year epidemiologic study of early adolescent development and drug use were used to conduct bivariate and multivariate risk factor analyses. Respondents (n = 6760) were sixth- and seventh-grade Cuban, other Hispanic, Black, and White non-Hispanic boys in the 48 middle schools of the greater Miami (Dade County) area. RESULTS: Findings indicate 5% lifetime illicit drug use, 4% lifetime inhalant use, 37% lifetime alcohol use, and 21% lifetime tobacco use, with important intergroup differences. Monotonic relationships were found between 10 risk factors and alcohol and illicit drug use. Individual risk factors were distributed disproportionately, and sensitivity and patterning of risk factors varied widely by ethnic/racial subsample. CONCLUSIONS: While the cumulative prevalence of risk factors bears a monotonic relationship to drug use, ethnic/racial differences in risk factor profiles, especially for Blacks, suggest differential predictive value based on cultural differences.

Adolescent↗