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PubMed1997

Human immunodeficiency virus risk behavior among white and Asian/Pacific Islander high school students in the United States: does culture make a difference?

PURPOSE: This article analyzes sexual behavior among white and Asian/Pacific Islander (API) adolescents, to determine the risk for human immunodeficiency virus (HIV) transmission from a multicultural point of view. METHODS: A total of 5,385 white and 408 API high school students were included. The national school-based Youth Risk Behavior Survey (YRBS 1991) was used. RESULTS: After controlling for academic performance, white students were 2.3 times more likely to communicate about acquired immunodeficiency syndrome (AIDS)/HIV, 2.7 times more likely to be sexually experienced, and 2.5 times more likely to use alcohol or other drugs before sex than APIs. There were no significant differences between these two groups in the age of initiating sex, the number of lifetime partners, the proportion of being currently sexually active (having had sex during the past 3 months), and condom use behavior. Although APIs had a low rate of AIDS/HIV, they have behaviors at as high a risk as white students once they became sexually experienced, and they have an even greater number of recent partners if they are currently sexually active. Use of alcohol or other drugs before sex and condom use is significantly related. CONCLUSIONS: Given the importance of attention to risks among API adolescents, this study underscores the need for more research to explore how culture values play a role among all API students, those who are sexually experienced, and those who are currently sexually active API students, to develop culturally sensitive AIDS/HIV prevention programs.

Adolescent↗
PubMed1997

Protecting against hopelessness and suicidality in sexually abused American Indian adolescents.

PURPOSE: The purpose of this study was to identify factors protective against the adverse health correlates of sexual abuse in reservation-based American Indian and Alaskan Native adolescents. METHODS: Data were taken from the National American Indian Adolescent Health Survey administered in 1988-1990 to 13,923 youths. Included in this analysis were 991 females and 166 males who reported a history of sexual abuse. Chi-square analysis was used to identify significant protective factors in sexually abused youths who did not report suicidality or hopelessness. Discriminant function analysis was used to determine which factors distinguished this group from those who experienced adverse health correlates. RESULTS: Separate multivariate analyses for boys and girls demonstrated that for girls, family attention, positive feelings toward school, parental expectations, and caring exhibited by family, adults, and tribal leaders were associated with absence of suicidality and hopelessness. For suicidality in boys, significant protective factors were enjoyment of school, involvement in traditional activities, strong academic performance, and caring exhibited by family, adults, school people, and tribal leaders. No significant protective factors against hopelessness were identified for boys. CONCLUSIONS: To minimize hopelessness and suicidal involvement among youth who have been sexually abused, strategies should be planned, implemented, and evaluated that support family caring and connectedness, strengthen school attachment and performance, and improve tribal connectedness.

Adolescent↗
PubMed2000

Developmental risk factors for youth violence.

PURPOSE: To replicate earlier research findings on risk factors for youth violence and to explore the effects on violent behavior of constructs shown to increase risk for other problem behaviors, within a developmental frame. METHODS: Data were from the Seattle Social Development Project (SSDP), a prospective study involving a panel of youths followed since 1985. Potential risk factors for violence at age 18 years were measured at ages 10, 14, and 16 years. Bivariate relationships involving risk factor constructs in the individual, family, school, peer and community domains and violence were examined at each age to assess changes in their strength of prediction over time. Attention was also given to the additive strength of increasing numbers of risk factors in the prediction of violence at age 18 years. A final set of analyses explored the extent to which youths were correctly classified as having committed a violent act (or not) at age 18 years on the basis of their overall level of risk at ages 10, 14, and 16 years. RESULTS: At each age, risk factors strongly related to later violence were distributed among the five domains. Ten of 15 risk factors constructs measured at age 10 years were significantly predictive of violence at age 18 years. Twenty of 25 constructs measured at age 14 years and 19 of 21 constructs measured at age 16 years were significantly predictive of later violence. Many constructs predicted violence from more than one developmental point. Hyperactivity (parent rating), low academic performance, peer delinquency, and availability of drugs in the neighborhood predicted violence from ages 10, 14, and 16 years. Analyses of the additive effects of risk factors revealed that youths exposed to multiple risks were notably more likely than others to engage in later violence. The odds for violence of youths exposed to more than five risk factors compared to the odds for violence of youths exposed to fewer than two risk factors at each age were seven times greater at age 10 years, 10 times greater at age 14 years, and nearly 11 times greater at age 16 years. However, despite information gained from all significant risk factors, the overall accuracy in predicting youths who would go on to commit violent acts was limited. CONCLUSIONS: Findings from the study have important implications for preventive intervention programs. Prevention efforts must be comprehensive and developmentally sensitive, responding to large groups or populations exposed to multiple risks.

Adolescent↗
PubMed2003

School reactivation programs after disaster: could teachers serve as clinical mediators?

Mental health interventions are known to prevent the progressive worsening of symptoms in young victims of disaster and, subsequently, to prevent a decline in their academic performance and self-esteem [8,46]. The tremendous needs that emerge after a disaster and the reluctance shown by most victims to seek professional help require mental health leaders to adopt a proactive stance and implement relief programs in the child's most natural setting. The school as institution and the teachers as empowered mediators offer the appropriate conditions for implementing an effective large-scale intervention program. Well-intentioned child professionals who deal with school administrators and teachers must take into account that, as stated by Pfefferbaum et al [25], "avoidance is at the core of the posttraumatic response, and it sometimes involves avoidance of treatment." For child mental health professionals, routine collaboration across systemic boundaries may prove critical for the rapid mobilization of resources during mass traumatic emergencies. Further studies are needed to identify the protective and risk factors that predict resilience and pathology, respectively, and factors that facilitate or aggravate factors that predict improvement, resistance, and deterioration in response to treatment.

Analysis of Variance↗
PubMed1999

Substance use disorders among adolescents in Taiwan: prevalence, sociodemographic correlates and psychiatric co-morbidity.

BACKGROUND: This paper reports prevalences, sociodemographic correlates and psychiatric co-morbidity of substance use disorders (SUDs) among adolescents in Taiwan. METHODS: A random sample of ninth grade students (N = 774) was selected from an urban, a suburban and a rural community. Two-stage case identification was employed with a brief screening tool and a modified Chinese version of the Kiddie-SADS conducted by child psychiatrists. RESULTS: The overall prevalence of any SUD was 11.0%, with nicotine (96.0%) as the most prevalent substance. The prevalences of SUDs were significantly higher in boys, rural community and classes with poor academic performance. Sixty-two per cent of all SUD cases suffered from other concurrent psychiatric disorders. The most common co-morbid conditions were conduct disorder, attention deficit hyperactivity disorder and mood disorders. CONCLUSIONS: High prevalences of SUDs were found among adolescent school children in Taiwan. Effects of urbanization, selective migration and the availability of substances are possible explanations for the urban-rural difference on the risk for SUDs. Psychiatric co-morbid conditions for SUD among adolescents in Taiwan were similar to those in Western societies.

Adolescent↗
PubMed2004

Trajectories of marijuana use from adolescence to young adulthood: predictors and outcomes.

Semiparametric group-based mixture modeling was used with data from an adolescent school sample (N = 1205) for three purposes. First, five trajectory groups were identified to characterize different patterns of change in the frequency of marijuana use across four waves of assessment during adolescence. These trajectory groups were labeled Abstainers, Experimental Users, Decreasers, Increasers, and High Chronics. Second, trajectory group comparisons were made across eight adolescent risk factors to determine distinctive predictors of the trajectory groups. Findings indicated, for example, that the High Chronic group, relative to the other trajectory groups, had higher levels of delinquency, lower academic performance, more drug using friends, and more stressful life events. Third, adolescent trajectory group comparisons were made across 10 risk behaviors in young adulthood (average subject age = 23.5 years) and the occurrence of psychiatric and substance abuse disorders. Findings indicated some consistency across adolescence to young adulthood with regard to risk factors, and specificity with regard to the prediction of disorders. Adolescent trajectory group membership was significantly associated in young adulthood with cannabis and alcohol disorders but not with major depressive disorders or anxiety disorders.

Adolescent↗
PubMed2000

A longitudinal examination of the transition into senior high school for adolescents from urban, low-income status, and predominantly minority backgrounds.

The current 6-year study investigates the impact of the elementary (K-8)-to-high school (9-12) transition on the school completion outcomes of 107 adolescents from urban, minority, low-income status backgrounds. Descriptive findings provide a longitudinal profile of students' enrollment status throughout high school. Students who had graduated or were Active in the school system at the end of the study evidenced more marked change in perceptions of social support following the transition to the ninth grade compared to Inactive students, dropouts, who evidenced little change. With respect to academic performance, while both groups evidenced declines following the transition and failed to recover sustained losses, Inactive students declined more sharply in grades and attendance. Findings are discussed in terms of the mixed support for the transitional life events perspective. In addition, study limitations and directions for future research are discussed, including variables that should be considered in research with the targeted group.

Adaptation, Psychological↗
PubMed2001

Factor structure and criterion validity of secondary school teacher ratings of ADHD and ODD.

Attention-Deficit Hyperactivity Disorder (ADHD) is currently viewed as a heterogeneous disorder with two factors: inattention and impulsivity-hyperactivity. This conceptualization of ADHD is based primarily on research with children or samples that mix children and adolescents. To examine if the 2-factor ADHD model is appropriate for adolescents and if the ADHD factors are distinct from Oppositional Defiant Disorder (ODD) in adolescents, teacher rating data were collected for 2 samples of adolescents. The results of a confirmatory factor analysis supported the convergent and divergent validity of a model with separate but correlated factors for inattention, impulsivity-hyperactivity, and defiant behavior. Further evidence of construct validity was found when factor scores were examined relative to the criterion variables of academic performance and rule-breaking behavior. The results support the utility of teacher ratings of ADHD and ODD in the assessment of adolescents, and the applicability of the DSM-IV conceptualization of these disorders to adolescents.

Adolescent↗
PubMed2001

Academic achievement of low birthweight children at age 11: the role of cognitive abilities at school entry.

We examine the extent to which deficits in academic achievement in low birthweight (LBW) children at age 11 are explained by deficits in cognitive abilities at school entry. Data come from a longitudinal study of a stratified sample of LBW and normal birthweight (NBW) children from an innercity and middle class suburbs in the Detroit area. Woodcock-Johnson Psychoeducational Battery-Revised was used to measure reading and math at age 11. WISC-R and specific neuropsychologic tests were administered at age 6. On reading, the LBW-NBW difference was -3.6 points (SE = 1.2). The difference was explained almost entirely by IQ at age 6. On math, the LBW-NBW difference was -6.1 points (SE = 1.1). The difference on math was trivial and not significant, when IQ and neuropsychological tests at age 6 were controlled. Level of LBW was unrelated to reading, but it had a gradient relationship with math, with birthweight < or = 1,500 g associated with a greater deficit than heavier LBW. The results imply that most of the LBW-NBW gap in academic achievement at age 11 could be eliminated by eliminating differences in cognitive abilities at age 6. Interventions to improve academic performance of LBW children should focus on the preschool years.

Achievement↗
PubMed2001

Reliability and validity of admissions tools used to select students for the health professions.

The selection of students for the health professions is typically a very competitive multi-staged process that includes assessment of both cognitive abilities and personal qualities. The need for reliable and valid assessment measures is obvious. This review of the health professions literature examines the evidence to support the use of various selection tools. It is clear that pre-admission overall grade point average (GPA) is the best predictor of academic performance in all of the health professions; however, the relationship between pre-admission GPA and clinical performance is less clear. The Medical College Admission Test is a good predictor of performance of medical students in terms of in-course grades and licencing examination scores but a similar test does not exist in the other health professions. Controversy remains as to the value of personal interviews and written submissions as selection tools, although it is clear that training of assessors and explicit rating guidelines enhance their reliability and validity. Ongoing research is needed to find more reliable and valid ways of assessing non-cognitive characteristics of applicants.

Canada↗
PubMed2001

Protective factors associated with American Indian adolescents' safer sexual patterns.

OBJECTIVES: This paper presents findings from a research partnership with rural American Indian communities to identify protective factors associated with their adolescents' health-related behaviors including 1) delay of sexual debut; 2) not having had intercourse in the past 3 months; 3) birth control use among sexually active adolescents in the past 3 months; 4) condom use in the past 3 months. Our goal was to identify salient characteristics of students and their perceptions of family, school, and friends which could be incorporated or supported in future program planning for adolescents. METHODS: A written survey was administered to 484 Indian students in Grades 6-12 from five rural schools. The survey measured several potential protective factors identified by Problem Behavior Theory, along with self-efficacy and cultural interest and knowledge. Logistic regression assessed the relationship of the protective factors and positive sexual behaviors. RESULTS: Factors significantly associated with abstention from intercourse and/or consistent use of birth control included perceived lower health-risk behavior of friends, higher perceived parental support, higher perceived parental knowledge and monitoring of the adolescent's activities and friends, a higher value on scholastic achievement, higher reported academic performance, and higher self-efficacy for safer sexual behaviors. CONCLUSIONS: This research suggests that Indian adolescents have several protective factors indigenous to their communities which are modifiable. Building on the unique cultural heritage of Indian communities, many of these factors may be addressed through community planned prevention programs.

Adolescent↗
PubMed2002

Young adult outcome of children with "situational" hyperactivity: a prospective, controlled follow-up study.

To examine the importance of symptom pervasiveness in ADHD, we conducted a prospective, 12-year follow-up study of boys (ages 6-12) considered hyperactive at school and home (Pervasive ADHD), boys considered hyperactive by teachers but not parents (School Only ADHD), boys considered hyperactive by parents but not teachers (Home Only ADHD), and nonhyperactive comparisons. Follow-up was completed on 82-94% participants. Clinicians interviewed participants and their parents, blind to childhood status. At follow-up, antisocial disorder was significantly more prevalent among Pervasive and School Only ADHD (29% for both) than Home Only ADHD (0%) and comparisons (8%). In a similar manner, severity of behavioral problems distinguished groups (Pervasive, School > Home, comparisons), as did educational attainment and academic performance (poorest for Pervasive and School). These findings stress the validity of teacher reports in the diagnosis of ADHD.

Achievement↗
PubMed2003

On-line story representation in boys with attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) face an increased risk of poor achievement in school. Thus, knowledge of the cognitive processing abilities of children with ADHD is critical to understanding and improving their academic performance. Although many studies have focused on the specific nature of the attention deficit experienced by children with ADHD, few have examined higher order cognitive processing such as comprehension of stories. The present study examined the processes of encoding story information, building a story representation, and modifying a story representation in boys with ADHD and nonreferred boys. Boys were asked to narrate a story from a picture book twice. Boys with ADHD showed deficits in representing goals and goal plans in their narrations, as compared to nonreferred boys. Boys with ADHD also committed more errors than nonreferred boys, but did correct certain types of errors on their second telling. Implications are discussed in terms of future research needed to identify the cognitive deficits that account for these narrative deficits.

Attention↗
PubMed1999

Peer networks, parental attributes, and drug use among Asian-Indian adolescents born in the United States.

This study examined the interrelationships among peer networks, parental attributes, and drug use among Asian-Indian adolescents born in the United States whose parents emigrated from India. The sample consisted of 200 Asian-Indian adolescents, 116 males and 84 females, aged 13 to 18, who were born in the United States and resided in the greater New York metropolitan area. The subjects were interviewed using a semistructured instrument adapted from relevant validated scales and items from other researchers. Adolescent-reported data were analyzed using descriptive and univariable techniques. Of the 200 subjects, 32.5% had tried some form of tobacco, alcohol, or other drug, and 67.5% did not report drug use of any kind. The adolescents stated whether they had ever (at least one time) smoked cigarettes (16.5%), drank beer (18%), drank wine (20.5%), or smoked marijuana (2.5%). The parents' communication of the harmful consequences of drug use and approval of the adolescents' peer networks correlated (p < .05) independently with less drug use by the adolescents. The parents' concern for education was positively correlated (p < .05) with the adolescents' academic performance. The prevalence of drug use among Asian-Indian adolescents is low. Parents' awareness of their children's school performance, peer networks, and concerns related to the consequences of drug use can be used as an effective mechanism to communicate the prevention of drug use among adolescents.

Journal Article↗
PubMed2003

Teachers' screening for attention deficit/hyperactivity disorder: comparing multinational samples on teacher ratings of ADHD.

This study evaluates a measurement model for Attention Deficit/Hyperactivity Disorder (ADHD). The DSM-IV divides 18 symptoms into two groups, inattentive and hyperactive/impulsive. Elementary school teachers rated 21,161 children in 4 locations: Spain, Germany, urban US, and suburban US. Confirmatory factor analysis suggested that the 2-factor model (inattention, hyperactivity/impulsivity) shows the best fit. A third factor, impulsivity, was too slight to stand-alone. Children with academic performance problems were distinguished by inattention, but children with behavior problems typically had elevations in inattention, hyperactivity, and impulsivity. Between-site differences were statistically significant, but so small that we conclude that same measurement model fits all 4 samples in 2 continents.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

Trauma-related symptomatology among American Indian adolescents.

The Diagnostic Interview Schedule for Children (DISC-2.1C), including the postraumatic stress disorder (PTSD) module, was administered to 109 American Indian adolescents from a Northern Plains reservation. In response to the DISC's open-ended probes, 61% of respondents reported at least one traumatic event. Despite high rates of trauma and substantial numbers of subsyndromal PTSD symptoms, the prevalence rate of diagnosable PTSD was found to be only 3%. The reporting of traumatic events was associated with increased prevalence of behavioral disorders and substance abuse or dependence diagnoses. There was, however, no significant difference in academic performance (grade point average or scholastic aptitude test scores) between those who reported traumatic events, or PTSD symptoms, and those who did not.

Adolescent↗
PubMed1999

Additive effect of three noradrenergic genes (ADRA2a, ADRA2C, DBH) on attention-deficit hyperactivity disorder and learning disabilities in Tourette syndrome subjects.

Halperin et al. (Halperin JM. Newcorn JH, Koda VH, Pick L, McKay KE, Knott P. Noradrenergic mechanisms in ADHD children with and without reading disabilities: a replication and extension. J Am Acad Child Adolesc Psychiatry 1997: 36: 1688 1696) reported a significant increase in plasma norepinephrine (NE) in attention-deficit hyperactivity disorder (ADHD) children with reading and other cognitive disabilities compared to ADHD children without learning disabilities (LD). We examined the hypothesis that ADHD + LD was associated with NE dysfunction at a molecular genetic level by testing for associations and additive effects between polymorphisms at three noradrenergic genes the adrenergic alpha2A receptor (ADRA2A), adrenergic alpha2C receptor (ADRA2C), and dopamine beta-hydroxylase (DBH) genes. A total of 336 subjects consisting of 274 individuals with Tourette syndrome (TS) and 62 normal controls were genotyped. Regression analysis showed a significant correlation between scores for ADHD, a history of LD, and poor grade-school academic performance that was greatest for the additive effect of all three genes. Combined, these three genes accounted for 3.5% of the variance of the ADHD score (p = 0.0005). There was a significant increase in the number of variant NE genes progressing from subjects without ADHD (A-) or learning disorders (LD-) to A + LD - to A - LD + to A + LD + (p = 0.0017), but no comparable effect for dopamine genes. These data support an association between NE genes and ADHD, especially in ADHD + LD subjects.

Adolescent↗
PubMed1991

A reconsideration of testing for competence rather than for intelligence.

David C. McClelland's 1973 article has deeply influenced both professional and public opinion. In it, he presented five major themes: (a) Grades in school did not predict occupational success, (b) intelligence tests and aptitude tests did not predict occupational success or other important life outcomes, (c) tests and academic performance only predicted job performance because of an underlying relationship with social status, (d) such tests were unfair to minorities, and (e) "competencies" would be better able to predict important behaviors than would more traditional tests. Despite the pervasive influence of these assertions, this review of the literature showed only limited support for these claims.

Achievement↗