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PubMed1996

The younger sisters of childbearing adolescents: their attitudes, expectations, and behaviors.

To examine the precursors of the disproportionately high rates of early childbearing among the younger sisters of adolescent mothers, this study compared the attitudes, expectations, and behaviors of early adolescent girls (M age = 12.93) who had an adolescent childbearing sister (n = 75) to those of early adolescent girls who had only adolescent nonchildbearing sisters (n = 348). Results indicated that the younger sisters of childbearing adolescents were consistently different from the younger sisters of nonchildbearing adolescents on key characteristics known to be correlated with early sexual activity and adolescent childbearing: that is, they were more accepting of nonmarital adolescent childbearing, perceived younger ages for typical life-course transitions (best age to get married, have first child), had more pessimistic school and career expectations, and were more likely to have engaged in problem behaviors (smoke cigarettes, skip school). These younger sister characteristics were associated with a nonvirgin sexual status in the current sample and with high closeness and high rivalry with the childbearing sister but could not be accounted for by such within-family experiences as subjects' mothers' permissiveness or lack of mother-daughter communication. Findings suggest the mechanisms by which the younger sisters of childbearing teens themselves become vulnerable to early parenthood.

Adolescent↗
PubMed1994

Adolescent measles vaccination. Response rates to mailings addressed to patients vs parents.

OBJECTIVE: To determine the measles vaccination rate in adolescents that could be achieved with a mailed notification of the recommendation, and to determine if the response rate differed if the mailing was addressed to the parents or to the adolescents. DESIGN: Randomized trial. SETTING: A family medicine residency training clinic serving a low-socioeconomic population. PATIENTS OR OTHER PARTICIPANTS: Four hundred forty-nine adolescents aged 12 through 18 years who were seen in the clinic within the previous 21 months without receiving a documented second dose of measles vaccine were randomized into two groups. INTERVENTION: A letter recommending measles revaccination was sent to the parents in one group (parent group) and to the adolescents themselves in the second group (adolescent group). The content of both letters was basically the same, but they differed in style and reading level. MAIN OUTCOME MEASURE: Measles vaccinations administered to adolescents during the 2-month period following mailing of the letters. RESULTS: Twenty-eight patients were excluded after randomization. Fifty-six letters were undeliverable after two mailing attempts. Eleven (6.3%) of 176 adolescents in the parent group and five (2.6%) of 189 adolescents in the adolescent group received the measles vaccination (P > .05). CONCLUSIONS: Although the adolescents whose parents received the letter were twice as likely to be vaccinated, the response rate was poor in both groups. The letter campaign was not an effective method to reach adolescents for measles revaccination.

Adolescent↗
PubMed1999

The epidemiology of adolescent homicide in North Carolina from 1990 to 1995.

BACKGROUND: Rates of homicides by adolescents under age 18 years tripled from 1984 to 1994. Most studies report data on urban adolescents and young adults as a single age group (age 15-24 years), but homicide characteristics among adolescents, especially those younger than 15 years, may differ from those of young adults. OBJECTIVE: To describe the homicide characteristics among adolescents age 11 to 18 years in North Carolina from 1990 to 1995. METHODS: A retrospective, descriptive analysis of adolescent homicides using the medical examiner database. Police interviews provided additional information for cases from 1993 to 1995. RESULTS: There were 419 victims from 1990 to 1995 (average annual rate: 9.7 per 100000 adolescents; 9.9 in urban counties, 7.1 in rural). Victims were mostly ages 15 to 18 years (85%), male (79%), and black (76%); 48% lagged behind in school, and, by police report, 40% had a criminal record. Only 23% of the identified perpetrators were strangers. Firearms (59% were handguns) were used in 83% of homicides. Proportionally more younger adolescents (age 11-14 years) were killed by means other than firearms than 15- to 18-year-olds (chi2 = 24.2, P = .007). Drug-related motives (23%) were most common, followed by non-drug-related altercations (20%) and retaliations (17%). CONCLUSIONS: Proportionally more North Carolina adolescents than urban young adults (ages 15-24 years) were killed by firearms (83% vs. 75%). Proportionally fewer adolescents were killed by police, strangers, or intimate partners. Interventions should include reducing access to firearms and drugs, and helping adolescents develop nonviolent strategies to resolve disputes. Efforts should be focused on adolescents who lag behind in school and have criminal records.

Adolescent↗
PubMed2002

Interventions for preventing eating disorders in children and adolescents.

BACKGROUND: Eating disorders represent an extremely difficult condition to treat and patients consume an enormous amount of mental health energy and resources. Being young, female, and dieting are some of the few identified risk factors that have been reliably linked to the development of eating disorders, and several prevention eating disorder prevention programs have been developed and trialed with children and adolescents. The purpose of this systematic review is to evaluate the effectiveness of eating disorder prevention programs for children and adolescents both in the general population and those determined to be at risk. OBJECTIVES: 1. To determine if eating disorder prevention programs are effective in promoting healthy eating attitudes and behaviours in children and adolescents; 2. To determine if eating disorder prevention programs are effective in promoting psychological factors that protect children and adolescents from developing eating disorders; 3. To determine if eating disorder prevention programs are effective in promoting satisfactory physical health in children and adolescents; 4. To determine if eating disorder prevention programs have a long-term, sustainable, and positive impact on the mental and physical health of children and adolescents; and, 5. To determine the safety of eating disorder prevention programs in terms of possible harmful consequences on the mental or physical health of children and adolescents. SEARCH STRATEGY: Relevant trials are identified through searching the Cochrane Controlled Trial Register (CCTR) and relevant biomedical and social science databases. All terms necessary to detect prevention programs and the participant groups are used. A strategy to locate randomised controlled trials is used. Other sources of information are the bibliographies of systematic and non-systematic reviews and reference lists from articles identified through the search strategy. In order to identify unpublished studies, experts in the field are contacted by letter and/or electronic mail. SELECTION CRITERIA: Randomised controlled trials (RCT) with a major focus on eating disorder prevention programs for children and adolescents, where there is no known DSM-IV diagnosis of an eating disorder, are eligible for inclusion in the review. Trials must include a control group and at least one objective outcome measure (eg. BMI) or a standardised psychological measure used with the intervention and control group, pre- and post-intervention. DATA COLLECTION AND ANALYSIS: A total of 1379 titles have been identified through the search to date. 13 studies were located that reported use of a randomised controlled trial methodology and were critically appraised by two independent reviewers. Five (5) studies were excluded as data were not reported in a useable form or useable data could not be obtained from the trial authors, one dissertation could not be obtained, one study had no "true" no-treatment or usual treatment control group, and one study did not use a pre-test outcome measure. Eight (8) studies met the selection criteria outlined above. MAIN RESULTS: Only one of eight pooled comparisons of two or more studies using similar outcome measures and similar intervention types demonstrated the statistically significant effect of a particular type of eating disorder prevention program for children and adolescents. Combined data from two eating disorder prevention programs based on a media literacy and advocacy approach indicate a reduction in the internalisation or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (Kusel, unpublished; Neumark-Sztainer2000) [SMD -0.28, -0.51 to -0.05, 95% CI]. However, there is insufficient evidence to conclude that this approach also demonstrated a significant impact on awareness of societal standards relating to appearance. There is insufficient evidence to support the effect of four programs designed to address eating attitudes and behaviours and other adolescent issues on body weight, eating disorder symptoms, associated eating disorder psychopathology or general psychological and physical well-being in the general sample or those classified as being at high risk for eating disorder (Buddeberg-F 1998; Killen 1993/1996; Santonastaso 1999; Zanetti 1999). Given only one program used a psychoeducation approach to prevent bulimia nervosa (Jerome, unpublished) and only one program adopted a focus on self-esteem (O'Dea 2000), the effect of these approaches could not be evaluated via meta-analyses. In relation to potential harmful effects, there is not sufficient evidence to suggest that harm resulted from any of the prevention programs included in the review. REVIEWER'S CONCLUSIONS: The one significant pooled effect in the current review does not allow for any firm conclusions to be made about the impact of prevention programs for eating disorders in children and adolescents, although none of the pooled comparisons indicated evidence of harm. From a clinical perspective, the development and refinement of prevention programs is complicated by a lack of knowledge about risk factors associated with eating disorders and the need to strike a balance between delivering preventive interventions for eating disorders and considering the potential to cause harm. From a research perspective, the idea of "thresholds" for identifying young people at risk of developing eating disorders has been raised, and denial of concern or denial of illness represents a further issue complicating early identification in relation to eating disorder symptomatology. Longer-term effects of the intervention approaches will need to be monitored across development in order to demonstrate a decline in the incidence of eating disorders and associated risk factors.

Adolescent↗
PubMed2003

Neuroblastoma in adolescents.

BACKGROUND: Less than 5% of neuroblastomas are diagnosed in adolescent patients. Previous studies of patients who were treated with less intensive chemotherapy regimens relative to currently available regimens suggested that adolescents survived longer than younger children, and this finding was related to a lack of myc-N amplification. Those reports prompted the authors to study a cohort of adolescent patients who had been included in more recent trials. METHODS: The authors investigated the presentation, treatment, and outcome in 28 adolescent patients who were enrolled in studies of the French Society of Pediatric Oncology during the period from 1987 to 1999 and who were older than age 10 years at the time they were diagnosed with neuroblastoma. The results were used to compare this subpopulation with a control group of children. RESULTS: None of the six patients with Stage I-II disease either developed recurrent disease or died. At 5 years, disease progression was high (progression-free survival [PFS], 28%) for the 9 adolescents with Stage III disease, but so was survival (overall survival [OS], 86%). The 13 adolescent patients with metastatic neuroblastoma had very poor outcomes (PFS, 18%; OS, 27%). Despite intensive therapy, advanced neuroblastoma appeared to carry a poorer prognosis in adolescent patients compared with children, although patients with Stage III disease had a more indolent course. No difference was found between adolescent patients and children regarding the clinical presentation, treatment schedule, or doses and tolerance of chemotherapy. The incidence of elevated urinary catecholamine metabolite secretion was lower in adolescents compared with children. CONCLUSIONS: Adolescent patients with advanced neuroblastoma had less favorable outcomes compared with children, even if survival in adolescents with Stage III disease seemed longer.

Abdominal Neoplasms↗
PubMed1993

Relation of parental support and control to adolescents' externalizing symptomatology and substance use: a longitudinal examination of curvilinear effects.

Past research has generated inconsistent findings regarding the relation of parental control and support to adolescent problem behaviors. Using two waves of data collected 1 year apart, the current study examined the influence of parental control and support on adolescents' externalizing symptoms, alcohol use, and illicit substance use. A sample of adolescents and their parents (N = 454) was studied, within which approximately half of the adolescents were at high risk because of parental alcoholism. Multiple-regression analyses of cross-sectional data showed a negative quadratic relation between parental control and adolescent externalizing symptomatology, and between parental control and adolescent illicit substance use. Parental control had a negative linear relation to adolescent alcohol use. Parental support showed a negative quadratic relation to adolescent illicit substance use, and negative linear relations to adolescent alcohol use and externalizing symptoms. Although longitudinally adjusted contemporaneous results were consistent with cross-sectional findings, parental support and control were prospectively related only to adolescent alcohol use. The quadratic relations suggest that adolescents who receive either extreme of parental support or control are at risk for problem behaviors.

Adolescent↗
PubMed1995

The Diagnostic Interview Schedule for Children (PC-DISC v.3.0): parents and adolescents suggest reasons for expecting discrepant answers.

To identify reasons for discrepancies between parent and child reports of child/adolescents's psychiatric symptoms, parents and adolescents (51 pairs) were asked to guess what the other would answer to questions from the PC-DISC about the adolescent's psychiatric symptoms, and to explain why they expected disagreement when the answer they provided for the other was different from their own. Adolescents' explanations for expecting (1) parental denial of symptoms the adolescent reported were: the parent was unaware of, forgot about, assumed the adolescent could not have, or trivialized the symptom; and (2) parental report of symptoms the adolescent denied were: the parent misread or exaggerated the adolescent's symptom, had too high expectations for the adolescent's behavior, put a negative label on or did not trust the adolescent. Parents' reasons for expecting their children to (1) deny symptoms the parents reported were: the adolescent did not remember how s/he felt, lied, did not recognize or minimized the importance or frequency of the symptom; and (2) report symptoms the parents denied were: the adolescent lied, exaggerated the importance of or interpreted the symptom differently.

Adolescent↗
PubMed1989

Evidence for two paths of alcohol use onset in adolescents.

Research is needed to identify risk factors specifically associated with the development of substance abuse. The current study explored the possibility that adolescents classified as having a problem behavior prone orientation (Type II) are predisposed to more rapid alcohol use onset compared to more normally socialized (Type I) adolescents. It was hypothesized that both types of adolescents would increase their alcohol use over time, but that problem behavior prone adolescents would increase their rates of alcohol consumption more rapidly than would normally socialized adolescents. Using ANCOVA (with baseline alcohol use as a covariate) and t tests (examining only nondrinkers at baseline), the hypotheses were strongly supported. Both Type I and Type II adolescents significantly increased their alcohol use over a one-year period. Type II adolescents, in comparison to Type I adolescents, had significantly higher alcohol use. The greater alcohol use among Type II adolescents was attributed to their problem behavior prone orientation. The findings suggest the existence of two different developmental pathways of alcohol use onset, one initiated by normally socialized adolescents and the other by adolescents with a problem behavior prone orientation. Future alcohol abuse prevention programs may benefit from tailored intervention strategies which take into account population specific risk factors.

Adolescent↗
PubMed1994

Emergency department utilization by adolescents.

PURPOSE: To review adolescents' utilization of a hospital emergency department (ED) in a rural area, to identify their characteristics, and to explore their motivation to seek health care in this setting. METHODS: A retrospective chart survey of all 4932 adolescent visits (ages 12-18 years, 55.5% females) to the ED in a small town with a population of 55,000 serving a rural area was conducted for the calendar year 1989. Chief complaints and diagnoses were retrospectively categorized according to six groups: injury, pulmonary problems, Ob/Gyn, infection, nonspecific pain (complaint)/no diagnosis (diagnoses), and "other." RESULTS: There was an increasing number of visits with increasing age. Adolescents with private insurance, who accounted for 50% of patients, were more likely than self-paying adolescents (14%) and adolescents on Medicaid (36%) to have a primary care source and to have access to a telephone. Injury was the most common diagnosis with motor vehicle accidents (MVA) accounting for 15% of all injuries. Self-paying adolescents and those on Medicaid were more likely to be diagnosed with an infection or an Ob/Gyn problem than adolescents with health insurance. Only 5.9% of adolescents were admitted to the hospital service. 8.5% of adolescents were discharged from the ED without a diagnosis. 78% of these had complained about nonspecific pain. CONCLUSIONS: Many adolescents in this rural area were found not to have an identified primary care source and to seek health care in EDs. Illnesses that could have been prevented or treated in a more cost-effective setting thus become "emergencies." Primary care sources are needed that are accessible and acceptable to adolescents.

Adolescent↗
PubMed2005

Indoor tanning by adolescents: prevalence, practices and policies.

Despite known acute and chronic health effects from the use of indoor tanning, including the potential for all forms of skin cancer, the practice is popular in the United States (US) and Europe. A review of the scientific literature that examines adolescents and indoor tanning use was undertaken, summarising what is known about prevalence and practices among adolescents, characteristics associated with adolescent use, and policies that regulate adolescent access to indoor tanning facilities. The prevalence of indoor tanning is consistently found to be higher among girls than boys and to increase with age in both Europe and the US. An examination of other demographic characteristics, skin cancer risk factors, knowledge, attitudes and social factors points to higher prevalence of the behaviour among adolescents with positive attitudes towards tans and whose friends or parents also tan indoors. Adolescent access to indoor tanning is rarely regulated in the US or Europe, and where regulations exist, business compliance is low. In addition, businesses actively market their product to adolescents as they organise to limit further regulations prohibiting adolescent access. Pricing, licensure, advertising restrictions and media campaigns, in combination with adolescent-targeted interventions, are possible strategies that could be tested for their effectiveness to reduce adolescent indoor tanning use. Harm reduction policies, such as eye protection, that reduce risk for adolescents who choose to tan indoors, are also important.

Adolescent↗
PubMed2006

Gender-based differences in fertility beliefs and knowledge among adolescents from high sexually transmitted disease-prevalence communities.

PURPOSE: Limited information is available about adolescents' beliefs about fertility in women and its link to sexually transmitted disease (STD) and whether men and women differ in their beliefs. This information may be useful for developing messages intended to motivate youth to seek STD screening while they are asymptomatic. The purpose of this study was to examine gender-based differences in fertility beliefs and knowledge. METHODS: Data were derived from the Adolescent Health Study, a population-based telephone survey study in which urban household adolescents from a high STD-prevalence community were queried about their sexual experience, fertility-related knowledge, beliefs related to timing of childbearing, and risk assessment of future fertility problems. Chi2 and regression analyses were used to evaluate group differences. RESULTS: The majority of adolescents reported that having children was somewhat or very important, but that the 15- to 19-year-old age group was not the optimal time for a woman to have a child. Regression analyses indicated that female adolescents were more likely than male adolescents to identify chlamydia and pelvic inflammatory disease as causes of fertility problems. Seventy-two percent of adolescent girls thought there was some chance they would have future fertility problems and 58% thought they had little or no control over developing fertility problems in the future. CONCLUSION: Additional health education is needed if we are to motivate adolescents to participate in asymptomatic STD screening programs. Involving male adolescents may be a more significant challenge given that fewer male adolescents understand the link between female fertility and common STD-related conditions. Given our findings, fertility preservation may be a valuable teaching tool and social marketing agent for STD prevention in adolescents.

Adolescent↗
PubMed2006

The role of friendship in the lives of male and female adolescents: does diabetes make a difference?

PURPOSE: We examined differences in the nature of friendship between adolescents with diabetes and healthy adolescents. We also examined whether friend support and negative relations with friends were related to health for both groups. METHOD: We interviewed 127 adolescents with diabetes and 129 healthy adolescents on two occasions, separated by one year. We measured aspects of friendship and psychological health among both groups as well as self-care behavior and metabolic control among adolescents with diabetes. We used logistic regression analysis to predict the presence of friends, repeated measures analysis of covariance to predict changes in friendship over time, and hierarchical multiple regression analysis to examine the relations of friendship to psychological health, self-care behavior, and metabolic control. RESULTS: Both groups of adolescents were equally likely to have a best friend and boyfriend/girlfriend, but healthy adolescents were more likely to have an other-gender friend. Adolescents with diabetes and healthy adolescents reported similar levels of friend support, but support increased over the year for healthy girls only. Boys with diabetes had the lowest levels of friend support. Negative relations with friends were inversely related to psychological health and predicted a decline in psychological health over time. Negative relations also predicted poor metabolic control and a deterioration of metabolic control over time. CONCLUSION: There are similarities and differences in the nature of friendship for adolescents with diabetes compared with healthy adolescents. Friendship serves a protective function for psychological health for both groups and has implications for physical health among those with diabetes.

Adaptation, Psychological↗
PubMed2006

Overweight status and weight control behaviors in adolescents: longitudinal and secular trends from 1999 to 2004.

BACKGROUND: This study examined 5-year longitudinal and secular trends in weight status and the use of healthy and unhealthy weight control behaviors in adolescents. METHODS: Project EAT-II followed 2516 adolescents from Minnesota longitudinally from 1999 to 2004. The population included two cohorts allowing for the observation of transitions from early to middle adolescence (junior high school to high school) and from middle to late adolescence (high school to post-high school). RESULTS: The prevalence of overweight (females: 28.7%; males: 28.0%) was high in early adolescence and remained high throughout adolescence. In females, between early and middle adolescence, there were steep longitudinal increases in the use of unhealthy weight control behaviors (48.6% to 58.8%, P = 0.001) and extreme weight control behaviors (9.4% to 17.9%, P < 0.001), and between middle and late adolescence, extreme weight control behaviors increased from 14.5% to 23.9% (P < 0.001). In males, extreme weight control behaviors doubled from middle to late adolescence (3.4% to 6.3%, P = 0.023). Use of diet pills doubled from 7.5% to 14.2% from 1999 to 2004 (P = 0.004) in high school females. One fifth (19.9%) of females in late adolescence reported taking diet pills. CONCLUSIONS: Overweight status and unhealthy weight control behaviors in adolescents are major public health concerns that warrant interventions addressing both problems.

Adolescent↗
PubMedDate not supplied

[Sleep in adolescents and its disorders. A survey in schools].

OBJECTIVES: Numerous studies emphasized the high prevalence of sleep problems in adolescents. However, it remains to be seen whether these problems are developmental or if they are related to pathological conditions. In order to try to answer this question, we conducted an epidemiological study investigating the prevalence and correlates of sleep disorders in a population of high school adolescents. METHOD: The sample for this investigation consisted of 652 high school students (344 males and 308 females), aged 13 to 19 years (mean age: 15.1 1.2 years), attending colleges in the North of France. Data for the study were obtained by means of revised versions of the INSERM self-report questionnaires for adolescents. One questionnaire included 113 response choice items investigating the sleep parameters and the sociodemographic, behavioural, health, and environmental condition of the subject. This questionnaire was completed by a self-portrait questionnaire including 27 response choice items about mood, anxiety, instability and the quality of relations with others. In addition, a clinical examination was performed by the clinicians of the school health department in order to investigate the medical history of the subject and his (her) pubertal development. RESULTS: In a first step, statistical analysis showed some significant differences in sleep rates and troubles between males and females. If the total sleep time was found similar in males and females, females were found exhibiting significantly earlier bedtime (p<0.01) and waking time (p<0.005) than males. In addition, trouble falling asleep (p<0.0001), nightmares (p<0.001), need for daytime sleep (p<0.05), and stimulant pill intake (p<0.05) were found significantly more frequent in females. Then, the adolescents were classified into two subgroups. "Insomnia group" included the students who answered "often" or "always" to one of the five questions about: having trouble falling asleep, the occurrence of early awakenings, their need for daytime sleep, sleeping pill intake, and bad sleep quality. "Non insomnia group" included those who answered "never" or "sometimes" in response to the five questions. Results showed that 233 adolescents (35.7%) exhibited persistent sleep disorders, insomnia type. 40.2% of females and 31.6% of males were included in the "insomnia group" (p<0.05). Pubertal development was found significantly more advanced in the "insomnia group" adolescents, more particularly in females. In the same way, concerns about body weight (46.7% vs 38.8%; p<0.005), size and shape (15% vs 8%; p<0.01) were found significantly more frequent in the "insomnia group"; 32.3% of the "insomnia group" adolescents vs 17.9% in the "non insomnia group" reported health problems (p<0.0001). School difficulties were found significantly more frequent in the "insomnia group" compared to the "non insomnia group". The proportion of subjects who have previously repeated at least one school year (p<0.01), who reported bad school performances (p<0.01), and who reported to be "sometimes" or "often" away from school (p<0.01) was significantly higher in the "insomnia group" than in the "non insomnia group". In the same way, data showed that school investing was also significantly weaker in the "insomnia group" adolescents (p<0.01). The proportion of subjects who believed that their relations with parents (12.4% vs 6%; p<0.05), teachers (21.4% vs 10.5%; p<0.0001), or peers (10.2% vs 4.1%; p<0.002) was found significantly higher in the "insomnia group". Risk behaviours were also significantly more frequent in the "insomnia group" adolescents: suicidal ideation (25.1% vs 11.7%; p<0.001), suicide attempt (7.3% vs 3.6%; p<0.05), psychotropic drug use (11% vs 4.9%; p<0.02), regular stimulant drug use (10% vs 5.1%; p<0.005), regular tobacco use (7.8% vs 2.2%; p<0.001), regular alcohol use (13.3% vs 8.3%; p<0.05), and illicit drug use (5.2% vs 1%; p<0.001). Lastly, all the dimensions of the self-portrait were found significantly more affected or negative in the "insomnia group" than in the "non insomnia group". For example, the proportion of subjects who described themself usually sad (10.2% vs 3.4%; p<0.001), anxious (54.9% vs 40.5%; p<0.0001), downcast (41.1% vs 32.6%; p<0.05), or instable (56.9% vs 41.7%; p<0.0001) was significantly higher in the "insomnia group". CONCLUSION: In this descriptive study, if some data suggest that pubertal development may be involved in the sleep rates or troubles observed in adolescents, the results also show that persistent sleep disorders are significantly associated with physical, psychological or social difficulties. In summary, this study shows that it is essential to take an interest in the quality of sleep in adolescents, which may be a way to approach their psychosocial difficulties.

Adolescent↗
PubMed1997

Black-white differences in body size perceptions and weight management practices among adolescent females.

OBJECTIVE: This study compares body size perceptions and weight management practices of black and white adolescent females. DESIGN: Subjects were selected through a statewide, three-stage sampling procedure designed to provide a sample statistically representative of high school students in South Carolina. SUBJECTS: Participants included black (n = 1824) and white (n = 2256) females, 14-18 years of age, enrolled in South Carolina public high schools. METHODS: Respondents were asked to assess their perceived body size as overweight, underweight, or about right. Self-reported weight management practices included dieting (reducing caloric intake), exercise, and other methods (including diet pills and vomiting). Chisquare analysis was used to assess the differences in body size perception and weight management behaviors. Polychotomous logistic regression was performed to examine association while controlling for socioeconomic status. RESULTS: Forty-one percent of the white adolescents and 29% of the black adolescents perceive themselves as overweight (p < 0.005). In the week prior to the survey, 28% of the white adolescents and 13% of the black adolescents reported dieting 34% of the while versus 23% of the black adolescents reported exercising to lose weight; and 45% of the white and 16% of the black students reported both dieting and exercising. Polychotomous logistic regression analysis showed that white adolescent girls were almost twice as likely to perceive themselves as overweight as black adolescent girls. The white students had 6.04 [95% confidence interval (CI), 1.77, 20.67] times the odds of using pills and vomiting and 3.76 (95% CI, 2.99, 4.72) times the odds of engaging in dieting and exercising as methods of weight management compared to the black students. CONCLUSIONS: These findings suggest that white adolescents are more likely to perceive themselves as overweight than black adolescents and are more likely to engage in unhealthy weight management practices than black adolescents.

Adolescent↗
PubMed1999

Differential parental communication with adolescents who are disabled and their healthy siblings.

PURPOSE: To examine the levels of parental communication and differential conversational styles with adolescents who are disabled and their healthy siblings, to better understand why the adolescent who is disabled has a higher risk of psychosocial problems during the transition into adulthood. METHODS: Families who had a disabled adolescent and at least one other adolescent who was not disabled were videorecorded during dinner at home. Twenty adolescents (12 girls and 8 boys) and their families participated. Analyses were conducted on the 392 interactions. RESULTS: Not only did the healthy adolescents participate in family interactions at higher frequencies than the adolescents who were disabled F(1, 383) = 14.00, p < .001, but the interactions were also more meaningful with healthy adolescents, F(2, 383) = 5.25, p < .01. Furthermore, healthy siblings had significantly greater conversational control than did their siblings with disabilities, chi2 (1) = 14.36, p < .001. Parents responded more negatively when adolescents who were disabled initiated a topic in comparison with their response to the healthy siblings, F(2, 69) = 5.44, p < .01. Finally, adolescents with disabilities were ignored more often than their healthy siblings, z = -3.75, p < .001, and they did not monopolize the conversation as often as did their healthy siblings, z = -3.91, p < .001. CONCLUSION: These results suggest that adolescents who are disabled may be at a disadvantage when engaged in family interactions in contrast with their healthy siblings.

Adolescent↗
PubMed2006

Characteristics of adolescent suicide attempters admitted to an acute psychiatric ward in Taiwan.

BACKGROUND: To investigate the characteristics of adolescent suicide attempters in Taiwan, compare with Western reports and provide reference for suicide preventive interventions in adolescence. METHODS: During a 3-year period, the charts of 109 adolescent psychiatric inpatients were retrospectively reviewed. Twenty-eight adolescents admitted to an acute psychiatric ward as a result of recent suicide attempts were investigated to unravel factors related to suicide. Fifty-five adolescents with at least 1 suicide attempt recently or in the past were analyzed for risk factors of suicidal behavior compared to others. RESULTS: Of the 109 adolescents admitted, 28 (25.6%) patients had been admitted due to recent suicide attempt. The most common diagnosis was depressive disorder (50%), followed by bipolar disorder (14.3%), schizophrenia (14.3%), and finally adjustment disorder (10.7%). There were significantly more girls than boys who attempted suicide. Suicide attempts increased with age, but this trend was not statistically significant. The most common precipitating factors were school stress (46%), parent-child conflict (25%), and psychopathology (25%) including feeling of hopelessness and psychotic symptoms. Adolescents with substance abuse or panic symptoms comprised a higher risk group for suicide. After discharge, 34.9% (38/109) of patients were lost to follow-up, and 15.5% (11/71) of the follow-up patients continued to manifest suicidal behavior. CONCLUSION: Our study confirms some previous Western reports that adolescents with depressive disorders commonly manifest suicide attempts. There are, however, some cultural differences in risk factors. School-related problems play an important role in Taiwan among the adolescent suicides, and prior suicide attempts predict future suicidal behavior. Enhancing school-based screening for adolescents with suicide risk and transferring them to psychiatric professionals for intervention is important. We should focus suicide prevention resources mainly on the adolescent population with psychiatric illness, prior suicide attempts, and with high risk factors.

Adolescent↗
PubMed2002

Diet and nutritional status of rural adolescents in India.

OBJECTIVE: To study the current diet and nutritional status of rural adolescents in India. DESIGN: Cross-sectional study with household as the unit of randomization. SETTING: National Nutrition Monitoring Bureau collected information in the rural areas of the nine States. METHODS: In each State, 120 villages were selected from eight districts. From each of the selected villages, 20 households (HHs) were selected from five clusters. The information on socio-demographic profile was collected in all the 20 HHs, while anthropometric data such as weight, height and clinical signs of nutritional deficiency was collected on all the available adolescents in the selected households. In every fourth sampled household, ie five HHs, dietary information on all the members was collected using 24 h dietary recall. The outcome measures for nutritional status were proportion of underweight (<median -2 s.d. of NCHS standards of weight for age), stunted (<median -2 s.d. of NCHS standards of height for age) and body mass index. The nutrient intakes were compared with recommended dietary allowances (RDA). RESULTS: Anthropometric and socio-economic information on 12 124 adolescent boys and girls and dietary information on 2579 individuals in 1996-1997 was available for the analysis. The major occupation of the heads of the households surveyed was agriculture. More than a third (37.3%) of the families with adolescents did not possess any land. The per capita income per month was about Rs 250/- at 1996-1997 prices. About 23% of the adolescent girls were married before the age of 18 y. About a quarter of the married adolescent girls had short stature and 18.6% were underweight. They considered as 'at risk'. About 39% of the adolescents were stunted (<Median -2 s.d. of NCHS height for age) irrespective of sex. The prevalence of undernutrition (<median -2 s.d. of NCHS weight for age) is higher (53.1%) in boys than in girls (39.5%). The extent of stunting was higher (42.7%) among adolescents belonging to the scheduled caste community. In the case of girls, the extent of underweight was considerably less in each age group than their male counterparts. About 70% of adolescents consumed more than 70% of RDA for energy. The intakes of micronutrients such as vitamin A and riboflavin were woefully inadequate. CONCLUSIONS: The extent of undernutrition was high among adolescents and was higher among boys than girls. Adolescent girls in the rural areas could be at greater risk of nutritional stress because of early marriage and early conception before completion of their physical growth.

Adolescent↗