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Adolescent and parent perceptions of media influence on adolescent sexuality.

Empirical evidence suggests that television and other media influence adolescents' attitudes and behaviors. Much of the research in this area is based on surveys in which adolescents are asked to rank the relative importance of a fixed set of factors such as parents, peers, and media. We reviewed data from focus groups conducted with adolescents and their parents to examine the extent to which adolescents identify--without prompting--media as a source of influence on sexual behavior. Adolescents seemed indifferent to media influence (e.g., media influence was mentioned in only one adolescent focus group), but their parents expressed significant concern about media influence. Future research should investigate the extent to which influences exist outside of adolescents' consciousness. For now, parents and sexuality educators may need to convince adolescents that concerns about the media are valid before trying to change media-influenced behavior.

Adolescent↗

Adolescents' reports of parental knowledge of adolescents' use of sexual health services and their reactions to mandated parental notification for prescription contraception.

CONTEXT: Legislation has been proposed that would mandate parental notification for adolescents younger than 18 years (minors) obtaining prescription contraception from federally funded family planning clinics. OBJECTIVE: To determine the extent to which parents are currently aware that their teenage daughters are accessing reproductive health services and how minors would react in the face of mandated parental involvement laws for prescription birth control. DESIGN, SETTING, AND PARTICIPANTS: A total of 1526 female adolescents younger than 18 years seeking reproductive health services at a national sample of 79 family planning clinics were surveyed between May 2003 and February 2004. MAIN OUTCOME MEASURES: Proportions of minor females who reported that a parent or guardian was aware that they were at the family planning clinic and, under conditions of mandated parental involvement, proportions of minors who would access prescription contraceptives at family planning clinics or engage in unsafe sex. RESULTS: Sixty percent of minors reported that a parent or guardian knew they were accessing sexual health services at the clinic. Fifty-nine percent of all adolescents would use the clinic for prescription contraception even if parental notification were mandated. This response was less common (29.5%) among adolescents whose parents were unaware of their clinic visits and more common (79%) among those whose parents were aware. Many adolescents gave more than 1 response to mandated parental involvement. Forty-six percent would use an over-the-counter method, and 18% would go to a private physician. Seven percent said that they would stop having sex as one response, but only 1% indicated this would be their only reaction. One in 5 adolescents would use no contraception or rely on withdrawal as one response to mandated notification. CONCLUSIONS: Most minor adolescent females seeking family planning services report that their parents are aware of their use of services. Most would continue to use clinic services if parental notification were mandated. However, mandated parental notification laws would likely increase risky or unsafe sexual behavior and, in turn, the incidence of adolescent pregnancy and sexually transmitted diseases.

Adolescent↗

Assessment of health-related quality of life of adolescent cancer patients using the Minneapolis-Manchester Quality of Life Adolescent Questionnaire.

BACKGROUND: Improved survival after childhood cancer has shifted the focus to health-related quality of life (HRQL)-an understudied problem, especially among adolescents. PROCEDURE: We assessed HRQL among adolescents utilizing a validated self-report tool, the Minneapolis-Manchester Quality of Life (MMQL) Adolescent Form, consisting of 46 items comprising seven domains: physical, cognitive, psychological and social functioning, body image, intimate relations, and outlook on life, and computed an overall QoL score. The MMQL Adolescent Form was administered to 226 adolescent survivors of childhood cancer a median of 7.8 years from diagnosis (off therapy-median age: 16.2 years), 136 adolescent cancer patients undergoing therapy (on therapy-median age: 16.4 years), and 134 healthy adolescents (controls-median age: 15.5 years). Primary diagnoses included leukemia (46%), lymphoma (26%), brain tumors (5%), and other solid tumors (23%). RESULTS: Compared to healthy controls, on-therapy patients were at increased risk for reporting poor overall QoL [Odds Ratio (OR) = 3.3, P = 0.002)] and poor physical functioning (OR = 11.8, P < 0.001). Off-therapy survivors did not differ significantly from healthy controls for overall QoL (OR = 1.6, P = 0.5) or any HRQL domains. Female patients, both on- and off-therapy, were more likely to report poorer overall QoL, physical, psychological and cognitive functioning as well as poorer body image when compared with male patients. CONCLUSIONS: While adolescent cancer patients undergoing active therapy report poor physical functioning, there is no evidence of long-term QoL sequelae.

Adolescent↗

Parent-completed and adolescent-completed CDIs: relationship to adolescent social and cognitive functioning.

The purpose of this study was to examine the relationship of both young adolescents' scores on the Children's Depression Inventory (CDI) and their mothers' ratings of the adolescents' depression (parent-completed CDI) to indices of their social and cognitive functioning obtained from a source outside the home. Subjects consisted of a nonclinic sample of 85 young adolescents (11-15 years of age), their mothers, and their social studies teachers. Recent school grades and teacher-completed measures served as the indices of adolescent social and cognitive competence. The results indicated that both adolescents' and mothers' CDI scores were significantly and negatively correlated with measures of adolescent cognitive and social functioning. Multiple regression analyses, utilizing adolescent- and parent-completed CDI scores as predictors, indicated that both predictor variables entered into the equations for cognitive functioning while only the mother-completed CDI entered into those for social functioning. When maternal depression was also entered into the multiple regressions, the findings regarding mother- and adolescent-completed CDI scores were not altered. The relationship of these findings to other somewhat disparate findings concerning the utility of mother and child reports of child depression is discussed.

Adolescent↗

Adolescent's perceptions of parenting behaviours and its relationship to adolescent Generalized Anxiety Disorder symptoms.

This study examined the relationship between how adolescents perceived parenting behaviours and adolescent Generalized Anxiety Disorder (GAD) symptom scores. The 1106 junior high and high school students (12-19 years old; 49.6% males and 50.4% females) completed questionnaires regarding their perception of parenting behaviours and self-rated symptoms of GAD. The findings of this study demonstrate that adolescent perceptions of parental alienation and rejection are strongly associated with adolescent GAD symptom scores. Additionally, mid-adolescence females perceive more parental alienation in relation to their GAD symptom scores than both early and mid-adolescent males. And early adolescent males perceive more parental rejection in relation to their GAD symptom scores than mid-adolescent males.

Adolescent↗

Relations between parent and adolescent problems among adolescents presenting for family-based marijuana abuse treatment.

Family-based treatments for adolescent substance abuse demonstrate efficacy and are becoming a treatment of choice. Family risk factors for substance abuse may present barriers to or suggest targets for modification during treatment. The sample included 149 adolescents presenting for substance abuse treatment and their parents. Structural equation modeling tested the hypothesis that parent psychological problems, parent substance use, and parenting behaviors influence adolescent psychological problems and substance use. This study is among the first to examine the unique impact of maternal and paternal variables on adolescent problems within one analytical model. Results indicated that parental psychological problems were directly associated with adolescent psychological problems after controlling for parent substance use and parenting behaviors. Paternal positive involvement and poor monitoring were also independently associated with adolescent substance use. Results suggest that both mothers' and fathers' symptoms of psychopathology play an important role in the symptoms of adolescents in treatment for substance abuse. Findings highlight the need for family-based assessment in adolescent treatment populations to address important clinical and research questions.

Adolescent↗

Psychosocial characteristics of adolescents with a past history of dysthymic disorder: comparison with adolescents with past histories of major depressive and non-affective disorders, and never mentally ill controls.

Little is known about the psychosocial functioning of persons who have recovered from dysthymic disorder. Such information might be useful in identifying trait markers for dysthymia, and for guiding continuation and maintenance treatment. We explored this issue using data from the Oregon Adolescent Depression Project, a large community-based study of the epidemiology of psychiatric disorders in a high school population. Four groups of adolescents were identified: 38 with a past history of dysthymic disorder; 217 with a past history of major depressive disorder; 142 with a past history of non-affective disorders; and 1079 with no lifetime history of psychopathology. The groups were compared on an extensive battery of psychosocial variables. The most consistent and diagnostically specific finding was that adolescents with a past history of dysthymic disorder reported having a significantly lower level of social support from friends than each of the other three groups of adolescents. Adolescents with a past history of dysthymic disorder also reported significantly higher levels of depressive, internalizing and externalizing symptoms and daily hassles than adolescents with no lifetime history of psychopathology. In addition, they reported higher levels of depressive symptoms and self-consciousness, but fewer externalizing symptoms than adolescents with a past history of non-affective disorders. These data suggest that adolescents with dysthymic disorder continue to experience significant difficulties in psychosocial functioning even after recovery.

Adolescent↗

The ecology of adolescent maltreatment: a multilevel examination of adolescent physical abuse, sexual abuse, and neglect.

This study examined the individual characteristics, family relations, and stress/social support of 50 maltreated adolescents and their mothers. Dyads were divided into 4 demographically similar groups: neglect, physical abuse, sexual abuse, and nonmaltreatment control. Results show that adolescent neglect was primarily associated with extrafamilial difficulties and social isolation. Adolescent physical abuse was linked more with rigidity in family relations, poorer maternal understanding of child developmental skills, and adolescent externalizing behaviors. In contrast, adolescent sexual abuse was related to maternal emotional problems and adolescent internalizing behaviors. In general, each group of maltreated adolescents experienced lower levels of family cohesion, more attention problems, and more daily stress than did their nonmaltreated counterparts. Findings are consistent with an ecological model of adolescent maltreatment.

Adaptation, Psychological↗

Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study.

OBJECTIVE: To compare rates of DSM-IV psychiatric disorders between (1) a clinical study group of extremely obese adolescents and young adults, (2) gender-matched population-based obese controls and (3) a population-based control group of the same age range. DESIGN: Rates of psychiatric disorders were assessed in (1) the clinical study group of obese adolescents and (2) the population based sample of obese adolescents, and compared to (3) a large population-based control group using a standardized psychiatric interview. SUBJECTS: (1) Clinical study group: 30 female and 17 male extremely obese adolescents and young adults (age range: 15-21 y; mean BMI:42.4 kg/m2). (2) Thirty females and 17 males with the highest BMI (age range 15-21 y; mean BMI: 29.8 kg/m2) of a population-based control group encompassing 1655 (805 males) adolescents and young adults. (3) The population based control group excluding the 30 females and 17 males with the highest BMI (n = 1608; 788 males). MEASUREMENTS: Munich-Composite International Diagnostic Interview (M-CIDI) allowing for DSM-IV diagnoses. RESULTS: High rates of mood, anxiety, somatoform and eating disorders were detected in the clinical sample of obese adolescents which exceeded those observed in population controls (all P-values < 0.01). Rates between population-based obese adolescents and young adults and population controls did not differ. In most patients the psychiatric disorders set in after onset of obesity. 57% and 35% of the female and male patients, respectively, reported eating binges with lack of control. However, less than one-half of these patients qualified for a DSM-IV diagnosis of an eating disorder. CONCLUSIONS: Extremely obese adolescents and young adults who seek long-term inpatient treatment have a high lifetime prevalence for affective, anxiety, somatoform and eating disorders. Because the mean BMI of the clinical study group was considerably higher than that of the obese population controls, we were not able to clarify whether the high rate of psychopathology in the study group was related to the extreme obesity or to their treatment-seeking behavior.

Adipose Tissue↗

Spanish-language services assessment for children and adolescents (SACA): reliability of parent and adolescent reports.

OBJECTIVE: To assess test-retest reliability of the service utilization screening section of the Services Assessment for Children and Adolescents (SACA) interview among Spanish-speaking parents and adolescents, correspondence between parent and adolescent reports, and the correlation between reliability and participants' demographic and service use characteristics. METHOD: The English SACA was translated and administered from September 1999 through January 2000 in Los Angeles County, California, on two separate occasions to eligible parents with a child (4-17 years old) who was a client of a local public mental health authority. Adolescents of these parents (12-17 years old) were also interviewed. Reliability was measured by the kappa statistic. RESULTS: Adult and adolescent reports about lifetime and previous year service setting use exhibited good reliability, but concordance of parents and adolescents did not. Children's service utilization appears to be correlated with reliability of parent reports, and child gender appears to be correlated with reliability of adolescent reports. CONCLUSION: The SACA appears to be a useful tool for screening Spanish-speaking families about child and adolescent mental health service use. These findings must be considered preliminary until replicated in a larger sample of culturally diverse Spanish-speaking families.

Adolescent↗

Teenagers are right--parents do not know much: an analysis of adolescent-parent agreement on reports of adolescent substance use, abuse, and dependence.

BACKGROUND: Previous studies have shown that when assessing child psychopathology, parents tend to report more symptoms than children for externalizing disorders such as attention deficit hyperactivity disorder (ADHD), whereas children tend to report more symptoms for internalizing disorders such as major depression. Whether for clinical or research purposes, parents are also frequently asked to report on their children's experiences with alcohol and drugs. The purpose of this study was to analyze correspondence between adolescent and parent reports of adolescent substance use and abuse or dependence. METHODS: In the current study, 591 subjects 12 to 17 years old were interviewed using the child version of the Semi-Structured Assessment for the Genetics of Alcoholism (C-SSAGA) as part of the Collaborative Study on the Genetics of Alcoholism (COGA). One parent was also interviewed about each adolescent using the parent version of the C-SSAGA. Sensitivities, specificities, and kappa coefficients were calculated to assess parental agreement with adolescent reports of lifetime substance use and Diagnostic and Statistical Manual of Mental Disorders-Third Revision substance abuse or dependence. RESULTS: The results indicate that parents are somewhat knowledgeable about their children's use of substances, particularly those that are used most commonly. For example, 55% of adolescents who had smoked cigarettes, 50% who had used alcohol, and 47% who had used marijuana had a parent who knew that they used. However, parents were less aware of substance-related problems experienced by their offspring, agreeing with adolescent reports only 27% of the time for diagnoses of alcohol abuse or dependence and 26% of the time for diagnoses of marijuana abuse or dependence. Parent reports added few cases of substance use for 12- to 13 year-olds and essentially no cases for 16- to 17-year-olds. Parent reports added a nominal number of diagnoses of substance abuse or dependence for older adolescents. CONCLUSIONS: Whether for clinical or research purposes, the results emphasize the importance of directly assessing adolescents regarding alcohol and other substance use disorders. Furthermore, investigators should consider the specific disorder(s) being investigated and the ages of the children being studied when determining whether to include parent reports as part of study design.

Adolescent↗

The Dating Anxiety Scale for Adolescents: scale development and associations with adolescent functioning.

Given the importance of romantic and dating relationships during adolescence, the purpose of the study was to develop and evaluate the psychometric properties of the Dating Anxiety Scale for Adolescents (DAS-A). Participants were 757 high school students (56% girls, ages 15 to 18 years). Adolescents completed the DAS-A, the Social Anxiety Scale for Adolescents (SAS-A), a Dating Questionnaire, and the Revised Beck Depression Inventory-II (BDI-II). Factor analysis of the DAS-A yielded a 3-factor solution with acceptable internal consistencies: fear of negative evaluation in dating situations (FNE-Dating); social distress when interacting with real or potential dating partners (SD-Date); and social distress when in a group of mixed-sex peers (SD-Group). Confirmatory factor analysis confirmed the 3-factor solution. Results indicated that younger adolescents reported more dating anxiety than older adolescents, and boys reported more SD-Group than girls. Dating anxiety was associated with peer-related anxiety and depressive symptoms and was a significant predictor of adolescents' current and usual dating status, even when controlling for adolescents' peer-related social anxiety. The findings provide support for the reliability and validity of the DAS-A. Clinical and research implications are discussed.

Adolescent↗

Prevalence of obesity in adolescents and the impact of sexual maturation stage on body mass index in obese adolescents.

OBJECTIVE: Puberty is a high-risk period for the development of obesity. The aim of this study was to determine the prevalence of obesity in adolescents admitted to an outpatient adolescent clinic and investigate the relationships between the increase of body mass index and sexual maturation stages in obese adolescents. MATERIAL AND METHODS: We recruited 6,462 adolescents, aged 9-16 years, admitted to the outpatient clinic of our Adolescent Unit, between May 1999 and September 2000. BMI was calculated as weight per height with weight in kilograms and height in meters. Adolescents with a BMI > or = 95th percentile for age and sex were defined as obese, with BMI's > or = 90th percentile but < 95th percentile were defined as overweight and considered at risk for obesity. Obese adolescents, with endocrine problems identified to cause obesity, were excluded from this study. Pearson correlation coefficients were used to assess the relationships between BMI and age. The differences between the sexual maturation stages were evaluated with Mann-whitney U Test. RESULTS: Out of 6,462 cases screened, 151 obese adolescents were found. Prevalence of obesity for the total sample surveyed was estimated at 2.3%. BMI values were significantly correlated with age in both sexes. In girls, only the increase of BMI values from stage I to stage II was found to be statistically significant. In boys, BMI values did not differ significantly between the sexual maturation stages but the number of obese cases were high in stages I and II. DISCUSSION AND CONCLUSION: The pubertal growth spurt (timing determined by sexual maturation stage) effects the amount of fat accumulation and the distribution of fat in different ways in boys and girls. So, not only the age and sex but also the sexual maturation stage has to be taken into account while evaluating the BMI values for investigating the risk of obesity in puberty.

Adolescent↗

The relationship of parental drug use and parents' attitude concerning adolescent drug use to adolescent drug use.

The purpose of this study was to examine the relationship of two variables, parental drug use and parental attitude toward adolescent drug use, both as perceived by the adolescent respondent to his or her own use or nonuse of drugs. A sample of 106 drug-using and 96 nondrug-using adolescents was obtained through the use of the anthropological " snowball " technique. All respondents were administered a drug use history profile and a personal data questionnaire. In order to be classed as drug users, respondents had to have been using two or more recreational substances on a regular basis. Nondrug users were those who used no recreational drugs, although individuals who had tried alcohol or tobacco experimentally were included in this group. On the personal data form, respondents were asked to describe their parents' use of alcohol, tobacco, or other substances, and to indicate their parents' attitudes concerning adolescent use of drugs. Parental attitudes were classed as permissive if the respondent indicated that parents were indifferent about drug use, if they accepted a certain range of drugs, or if the decision were left up to the youth. A nonpermissive attitude was defined as one which would not accept drug use by the adolescent. Four 2 x 2 Chi-square analyses were used to determine significance of the relationship between adolescent drug use and parents' use or nonuse of drugs, parents' attitudes about adolescent use or nonuse and actual adolescent use or non-use, and this same attitudinal relationship looking at parent users and nonusers separately.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Measuring binge eating in adolescents: adolescent and parent versions of the questionnaire of eating and weight patterns.

OBJECTIVE: This study investigated the psychometric properties of an adolescent version of the Questionnaire of Eating and Weight Patterns (QEWP-A). METHOD: Male and female adolescents between 10-18 years completed the QEWP-A and measures of depression and eating attitudes. Height and weight were also measured. Parents completed a parental version (QEWP-P) that was referenced to their children. Adolescent and parent responses to the QEWP were independently categorized into no diagnosis (ND), nonclinical binge eating (NCB), and binge eating disorder (BED) groups. RESULTS: Adolescent and parental agreement over the diagnostic categories was as follows: 81.6% for ND, 15.5% for NCB, and 25% for BED with an overall kappa of. 19. Adolescents with BED had significantly higher levels of depression than the other two groups with NCB being higher than ND. For eating attitudes, BED adolescents were more deviant than the other two groups who did not differ from one another. DISCUSSION: The QEWP-A displayed adequate concurrent validity. The low overall agreement between adolescents and their parents was influenced by high and low base rates in the NCB and BED categories, respectively. This lack of agreement is consistent with other behavioral problems such as depression. The data suggest that parental perceptions of eating problems approximate those of their children when no problem is present. However, parents are not as likely to be aware of eating difficulties when they actually exist.

Adolescent↗

Adolescent egocentrism: a comparison among adolescents and adults.

Reformulation of adolescent egocentrism suggests that personal fable and imaginary audience ideations extend into adulthood. To test this proposition, adolescents (aged 14-18) and adults (aged 20-89) completed subscales of the adolescent egocentrism, self-consciousness and interpersonal reactivity scales. An across scale comparison first ensured that adolescent egocentrism measures were comparable across age. Next, MANOVAs revealed higher egocentrism scores for adolescents vs. adults (p<0.05), but no difference between adolescents and younger (19-30) adults after splitting adults into younger (19-30), middle (31-59) and older (60+) subgroups. Results suggest that personal fable and imaginary audience are not confined to adolescence.

Adolescent↗

Adolescents with attention deficit hyperactivity disorder: mother-adolescent interactions, family beliefs and conflicts, and maternal psychopathology.

A group of 83 adolescents with attention deficit hyperactivity disorder (ADHD) were subdivided into those with ADHD alone (n = 27) and those with ADHD and oppositional defiant disorder (ADHD/ODD, n = 56). They were compared to each other and a community control group (n = 77) on measures of family conflicts, family beliefs, maternal adjustment, and observations of mother-adolescent interactions during both a neutral and conflict discussion. Both ADHD groups had more topics on which there was conflict and more angry conflicts at home than control adolescents on parent reports. Only the ADHD/ODD adolescents reported more such conflicts, endorsed more extreme and unreasonable beliefs about their parent-teen relations, and demonstrated greater negative interactions during a neutral discussion than the control teenagers. Similarly, only mothers of the ADHD/ODD teens displayed greater negative interactions during a neutral discussion, more extreme and unreasonable beliefs about their parent-teen relations, greater personal distress, and less satisfaction in their marriages than the mothers in the control group. Most findings for the ADHD only group were between the control group and the group with mixed ADHD/ODD but did not differ from either group. Results imply that it is the combination of ODD symptoms with those of ADHD that is associated with the greater-than-normal conflicts, anger, poor communications, unreasonable beliefs, and negative interactive styles seen in ADHD adolescents. These same characteristics typify their mothers' interactions as well such that both the adolescents' ODD symptoms and maternal psychological distress (hostility) make unique contributions to the degree of conflict and anger in the parent-teen relations of ADHD adolescents.

Adolescent↗

Distressing and positive experiences and important aspects of care for adolescents treated for cancer. Adolescent and nurse perceptions.

Distressing and positive experiences for adolescents with cancer with regard to being told the diagnosis, receiving chemotherapy and being admitted to the ward, and important aspects of care for adolescents with cancer was investigated. Data were gathered through semi-structured interviews with 23 adolescents and 21 nurses, and analysed by content analysis. The findings indicate that cancer during adolescence is connected with a range of negative experiences such as fears of alienation, fears of altered appearance, fears of dying, and various physical concerns. Positive experiences include positive relations to staff and being well cared for. Important care for adolescents treated for cancer consists mainly of meeting nice, friendly, supportive, and competent staff, who provide them with age-appropriate information. The findings indicate that adolescents with cancer experience a range of negative and positive experiences related to disease and treatment and that good care for adolescents with cancer is a broad, complex, and multidimensional phenomenon.

Adaptation, Psychological↗