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PubMed2005

The Bath Adolescent Pain Questionnaire (BAPQ): development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents.

Chronic pain causes significant problems in the lives of many adolescents, considerably affecting their physical, psychological and social functioning. The assessment of the multidimensional impact of chronic pain is an essential clinical task. This study reports on the development and psychometric evaluation of the Bath Adolescent Pain Questionnaire (BAPQ); an assessment tool designed specifically for use with adolescents who experience chronic pain. A sample of 222 adolescents (11-18 years) experiencing chronic pain completed the 109-item draft inventory. Participants were recruited from two different UK clinics. All participants responded to items using a 5-point frequency scale. Psychometric evaluation of the data resulted in a reduced inventory length of 61 items. Internal consistency of all seven questionnaire subscales was established using Cronbach's alpha. Comparative validity was undertaken by comparison of all individual subscales with existing validated measures (SCAS, CDI-S, FDI, Brief FAM. PCS and CASAFS). The temporal reliability of each inventory subscale was established using a sub-sample of 30 adolescent participants over a 17-day period. Psychometric evaluation of the data suggests the inventory yields both a reliable and valid assessment of the impact of chronic pain on the lives of adolescents. The BAPQ may offer a comprehensive way to assess the widespread deleterious impact of adolescent chronic pain in both a research and clinical setting. Further investigation is needed on the predictive validity of the subscales. Additional data from samples of patients with diagnoses that are not musculoskeletal in origin would be of great assistance.

Adolescent↗
PubMed2006

Navigating adolescence with a chronic health condition: a perspective on the psychological effects of HAIR-AN syndrome on adolescent girls.

HAIR-AN syndrome is a subphenotype of polycystic ovary syndrome and is characterized by acne, obesity, hirsutism, and acanthosis nigricans. It usually manifests in early adolescence, a time of significant developmental change in females across physical, cognitive, social, and emotional domains. We contend that adolescent development for females is difficult, even in the best of circumstances, and having a chronic health condition, like HAIR-AN syndrome, will likely impact the afflicted individual's development and psychological well-being. While many researchers have discussed the long-term health effects of HAIR-AN and similar disorders, little has been written about the potential psychological sequelae of HAIR-AN on the adolescent girl. We discuss the normal developmental sequence for adolescent girls across early, middle, and late adolescence; discuss common mental health problems that adolescents experience; define HAIR-AN syndrome and its clinical manifestations; and discuss its likely psychological impact on adolescent girls. We also make suggestions for future clinical interventions and research in the area of HAIR-AN syndrome and its psychological sequelae.

Adolescent↗
PubMedDate not supplied

Concerns about pain management among adolescents with cancer: developing the Adolescent Barriers Questionnaire.

Investigators have examined barriers to pain management in adults with cancer, but these patient-related barriers have rarely been studied in adolescents. This article summarizes 2 studies used in the development and initial psychometric testing of the Adolescent Barriers Questionnaire (ABQ). Building on the Barriers Questionnaire-II, the ABQ is designed to measure the extent to which adolescents with cancer have concerns about reporting pain and using analgesics. Study 1 was a qualitative study investigating pain management concerns of 5 adolescents with cancer. Concerns emerged that could potentially impede pain management such as fear of addiction and worry about communicating pain to parents and providers. Each of the adolescents revealed at least 1 concern about pain management or held fatalistic beliefs that cancer pain cannot be relieved. In study 2, content validity of the preliminary ABQ (52 items assessing 13 barrier sub-scales) was assessed by 2 panels, adolescents with cancer and clinicians. Based on results, the ABQ was modified to contain 45 items that assess 11 barriers. Further examination of barriers in adolescents with cancer is warranted.

Activities of Daily Living↗
PubMed1998

Attitudes of the physician membership of the society for adolescent medicine toward medical abortions for adolescents.

OBJECTIVE: To document the practices and attitudes of the US physician members of the Society for Adolescent Medicine (SAM) regarding adolescent abortion and contraception, as well as physician willingness to prescribe medical abortion if approved by the Food and Drug Administration (FDA). DESIGN: Cross-sectional questionnaire survey. Participants. The entire physician membership of SAM (N = 1001) was surveyed. A total of 713 physicians responded, with 668 usable surveys yielding an adjusted response rate of 70%. RESULTS: Of the respondents, 81% were trained as pediatricians; 58% had additional adolescent medicine training. Ninety-six percent prescribed contraception for their patients. Sixty-one percent of respondents identified abortion as an option for pregnant adolescents in all circumstances, whereas 4% believed abortion should never be an option. Eighty-nine percent referred their patients for abortions; 90% were aware of medications to induce abortions medically. If these medications (methotrexate and misoprostol, RU-486) were FDA-approved, 42% would prescribe them for their patients; 34% were unsure. Fifty-four percent believed if medical abortions were routinely available, they should be available from primary care physicians. Physicians were significantly more likely to consider prescribing medical abortions if the physician were female, offered postcoital contraception, performed Norplant insertions, referred adolescents for abortions, or performed postabortion medical checkups. Physicians were no more likely to consider prescribing medical abortions according to physician age, specialty training, or date of residency training. Religious affiliation per se was not associated with likelihood of prescribing medical abortions, but Catholic physicians were significantly less likely to consider prescribing medical abortions. CONCLUSIONS: Virtually all SAM physician respondents (96%) reported that abortion for pregnant adolescents should be available under some circumstances. Forty-two percent would prescribe medical abortion if the medications were FDA-approved, suggesting that medical abortion would potentially be available to adolescents from a larger group of physicians than is currently available.

Abortifacient Agents↗
PubMedDate not supplied

[The Croatian Society for Infant, Child and Adolescent Psychiatry: present state and proposals for improving the development of child and adolescent psychiatric services in Croatia].

The paper presents the current state of child and adolescent psychiatry in the Republic of Croatia. Thirty-seven psychiatrists practicing child and adolescent psychiatry in the entire Republic point to the lack of staff in this subspecialty profession. The subspecialty was approved by the Ministry of Health in 1994. The city of Zagreb satisfies the criteria of some European countries as regards the number of staff, but not as regards the organization of the service for child and adolescent psychiatry (e.g. lack of university hospital department as the base for medical teaching and further specialist training). In other and larger centers in the Republic the situation is well below the criteria achieved in this profession, particularly in the countries of the European Union and the USA. Still, psychiatric services in some towns tend to support the development of child and adolescent psychiatry in their environment by providing facilities and staff. There are still attempts, even in the health service itself, to overcome this lack of personnel and organization by transferring numerous cases from the domain of child and adolescent psychiatry to experts in other medical specialties or non-medical professionals, instead of improving the development of child and adolescent psychiatry. In some countries of the European Union and the USA it has already reached the monospecialty status, a tendency supported by the UEMS, which also makes efforts to coordinate programs of specialist training in the European countries. The described situation certainly has consequences in the of mental health care of children, adolescents and their families, because their treatment often begins only when a disorder has visibly developed. Its clinical manifestations can take very different forms.

Adolescent↗
PubMed2005

Male and female delinquency trajectories from pre through middle adolescence and their continuation in late adolescence.

This study of male and female adolescent delinquency trajectories focuses on the prediction of late adolescence delinquency, based on earlier delinquency and social support. In this 3-wave longitudinal survey, 270 Dutch adolescents (113 males and 157 females) ages 12 to 14, were followed for a period of 6 years. For males, the level of delinquent activity in late adolescence strongly depends on earlier delinquent activities (R2 = .33, p < .0005). In contrast, the level of female delinquency in late adolescence is far less predictable (R2 = .18, p < .001), and could not be predicted from delinquent activities during pre and early adolescence, while support from the mother during late adolescence was associated with reduced delinquency for females. Different models may be needed to explain the development of delinquency for males versus females.

Adolescent↗
PubMed1994

Romanticism and self-esteem among pregnant adolescents, adolescent mothers, and nonpregnant, nonparenting teens.

Feelings of romanticism and self-esteem among pregnant adolescents, adolescent mothers, and a control group of nonpregnant, nonparenting adolescents were investigated. The Bachman Self-Esteem Scale (Bachman, O'Malley, & Johnston, 1978) and the Dean Romanticism Scale (Dean, 1961) were distributed to 649 U.S. female adolescents--255 pregnant adolescents, 121 adolescent mothers, and 273 teenagers in the control group. For romanticism, the results indicated a significant main effect for group (pregnant teens, teen mothers, and a control group consisting of nonpregnant, nonparenting teenagers) and ethnicity (White, Hispanic, African American, and Asian) but not for age (13 to 15 years and 16 to 19 years). The pregnant teens and teen mothers thus had a higher degree of romanticism than the control group did. For self-esteem, there was a significant main effect for race, but not for group or for age. This main effect was qualified by a significant interaction between ethnicity and age.

Adolescent↗
PubMed1997

Number of sexual partners and health lifestyle of adolescents. Use of the AMA Guidelines for Adolescent Preventive Services to address a basic research question.

OBJECTIVE: To expand understanding of the behavioral epidemiology of an important sexually transmitted disease risk factor within a clinical framework of the AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale. DESIGN: Cross-sectional analysis of the fourth year of a longitudinal study of adolescent health behavior. SETTING: High schools in a single major urban school district. PARTICIPANTS: Nine hundred and forty-six white, African American, and Hispanic sexually active adolescents. MAIN OUTCOME MEASURES: Number of sexual partners in previous year and other health-risk and health-protective behaviors. Measures are operationalized according to guidelines for adolescent preventive services recommendations. RESULTS: Adolescents with 3 or more sexual partners annually were more involved with potentially health-harming behaviors such as illicit substance use and less involved with potentially health-protective behaviors such as seat belt use. These relationships were independent of sex, ethnic group, or socioeconomic status. CONCLUSIONS: The number of sexual partners may be considered part of a larger pattern of adolescent health-risk and health-protective behaviors. The guidelines may provide a useful framework for clinical assessment of these patterns as part of a routine health care visit of adolescent patients.

Adolescent↗
PubMed2005

Behaviour evaluation for risk-taking adolescents (BERTA): an easy to use and assess instrument to detect adolescent risky behaviours in a clinical setting.

UNLABELLED: To create an instrument to be used in an outpatient clinic to detect adolescents prone to risk-taking behaviours. Based on previous research, five identified variables (relationship with parents and teachers, liking going to school, average grades, and level of religiosity) were used to create a screening tool to detect at least one of ten risky behaviours (tobacco, alcohol, cannabis and other illegal drugs use; sexual intercourse and sexual risky behaviour; driving while intoxicated, riding with an intoxicated driver, not always using a seat belt, and not always using a helmet). The instrument was tested using the Barcelona Adolescent Health Survey 1993. A Receiver Operating Characteristics curve was used to find the best cut-off point between high and low risk score. Odds ratios and 95% confidence intervals were calculated to detect at least one risky behaviour and for each individual behaviour. In order to assess its predictive value, the analysis was repeated using the Barcelona Adolescent Health Survey 1999. In both cases, analyses were conducted for the whole sample and for younger and older adolescents. Adolescents with a high-risk score were more likely to take at least one risky behaviour both when the whole sample was analysed and by age groups. With very few exceptions, the Behaviour Evaluation for Risk-Taking Adolescents showed significant odds ratios for each individual variable. CONCLUSION: The Behaviour Evaluation for Risk-Taking Adolescents has shown its potential as an easy to use instrument to screen for risk-taking behaviours. Future research must aim towards assessing this instrument's predictive value in the clinical setting and it's application to other populations.

Accidents, Traffic↗
PubMed1999

Can the Harter Self-Perception Profile for Adolescents (SPPA) be used as an indicator of psychosocial outcome in adolescents with chronic physical disorders?

To explore the Harter Self-Perception Profile for Adolescents (SPPA) as an indicator of psychosocial outcome in adolescents with chronic physical disorders, we administered the questionnaire along with other well-established measures of psychosocial outcome (the semistructured Child Assessment Schedule (CAS) interview and the Youth Self Report (YSR) and Child Behavior Checklist (CBCL) questionnaires) to one group of diseased adolescents with good psychosocial adjustment (juvenile chronic arthritis, JCA) and one with a high level of psychosocial maladjustment (anorectal anomalies, ARA). The adolescents with ARA had significantly lower scores of global self-worth, school competence, and social acceptance as compared to the adolescents with JCA. However, global self-worth in neither group was impaired as compared with that of the general Norwegian adolescent population. Perceived physical appearance was the single self-concept domain accounting for the variance in global self-worth (R2 = 0.71, p < 0.001). Among the other measures of psychosocial outcome, global self-worth was most strongly related to mood according to the CAS interview (r = -0.53, p < 0.001) and to the YSR internalizing score (r = -0.53, p < 0.001). Our findings indicate that the SPPA has limited ability to identify chronically diseased adolescents with adverse psychosocial outcome.

Adaptation, Psychological↗
PubMed1989

Dentists' professional satisfaction with adolescent dentistry and its association with adolescent dental health behavior.

This study examines dentists' perceptions of behaviors felt to interfere with providing adequate dental care to adolescents. We analyzed gender differences, and whether the dentists' perceptions of adolescent patients were associated with their professional satisfaction. A stratified random sample of 227 graduates (males = 180, females = 47) from a Southern dental school were asked to complete a questionnaire assessing professional satisfaction. Based on Kruskall-Wallis analysis of variance tests, female dentists expressed generally higher levels of satisfaction than males with adolescent dentistry, diagnosis and treatment planning, patient education, preventive procedures, and the adolescent dentistry curricula during dental school. Male dentists felt that the male adolescents' failure to keep appointments, communication problems, seeking dental care only in emergency situations, and resentment of authority interfered more with their providing adequate dental care than did female dentists. Male dentists also felt that the female patients' menstrual period, communication problems, low tolerance of pain, seeking dental care only in emergency situations, and resentment toward authority were more significant problems than did the female dentists. Communication problems with both male and female adolescents were more strongly correlated with the dentists' satisfaction with adolescent dentistry than any other variable.

Adolescent↗
PubMed2005

Do school surroundings matter? Alcohol outlet density, perception of adolescent drinking in public, and adolescent alcohol use.

The aim of the present study was to investigate the relationship between alcohol outlet density, perception of adolescent drinking in public (both assessed at the school level), and adolescent drinking and drunkenness at individual level. Hierarchical linear regression models were calculated based on data from 1194 ninth graders in Switzerland (mean age=15.3, S.D.=0.7) and their schoolmasters (n=61). Apart from the positive main effects, the results reveal a negative interaction of alcohol outlet density and perception of adolescent drinking in public in predicting individual alcohol use among adolescents. In regions with a high density of shops, it appears that the schoolmasters' perception reflects the general drinking norm of the area where the school is located rather than the actual drinking level of adolescents. More research is needed, particularly in Europe and among adolescent populations, to reach a better understanding of school level predictors of adolescent alcohol use.

Adolescent↗
PubMed1999

Adolescent physical activity and inactivity vary by ethnicity: The National Longitudinal Study of Adolescent Health.

OBJECTIVES: To determine the extent to which physical activity and inactivity patterns vary by ethnicity among subpopulations of US adolescents. STUDY DESIGN: Nationally representative data from the 1996 National Longitudinal Study of Adolescent Health of >14,000 US adolescents (including 3135 non-Hispanic blacks, 2446 Hispanics, and 976 Asians). METHODS: Hours per week of inactivity (TV viewing, playing video or computer games) and times per week of moderate to vigorous physical activity were collected by using questionnaire data. Multinomial logistic regression models of physical activity and inactivity were used to adjust for sociodemographic factors. RESULTS: Large ethnic differences are seen for inactivity, particularly for hours of television or video viewing per week (non-Hispanic blacks, mean = 20.4; non-Hispanic whites, mean = 13.1). Physical activity (>/=5 bouts of moderate to vigorous physical activity per week, 5-8 metabolic equivalents) is lowest for female and minority adolescents. Ethnic differences are far greater for inactivity than for moderate to vigorous physical activity. CONCLUSION: Minority adolescents, with the exception of Asian females, have consistently higher levels of inactivity. Results vary by sex; males have higher inactivity and physical activity, whereas lowest physical activity is found for non-Hispanic black and Asian females, although Asian females also have low inactivity and low levels of overweight. Overall, efforts to reduce the problem of adolescent overweight should focus on increasing activity levels of adolescents, particularly female, older, and major minority subpopulations.

Adolescent↗
PubMed2004

Mothers' and fathers' knowledge of adolescents' daily activities: its sources and its links with adolescent adjustment.

To elucidate the benefits ascribed to parental monitoring, the authors examined links between parental knowledge and methods of obtaining knowledge about adolescents' activities, and links between these constructs and adolescent adjustment. The roles of parent gender, adolescent gender, and family earner status in these associations were also studied. Participants were 95 adolescents (ages 10 to 17 years, 60% male and 40% female) and their parents. Mothers knew more about adolescents' activities than did fathers and were more likely than fathers to gain information by active supervision or voluntary disclosure from the adolescent. Fathers, more than mothers, received information via spouses. Active methods of supervision predicted more knowledge among fathers and mothers from dual-earner families but not among mothers from single-earner families. More maternal knowledge predicted lower adolescent deviance. No method of gaining knowledge predicted adjustment directly.

Adaptation, Psychological↗
PubMed2004

Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health.

BACKGROUND: No nationally representative longitudinal data have been analyzed to evaluate the incidence of obesity in the transition between adolescence and adulthood. OBJECTIVE: The objective was to examine dynamic patterns of change in obesity among white, black, Hispanic, and Asian US teens as they transitioned to young adulthood. DESIGN: We used nationally representative, longitudinally measured height and weight data collected from US adolescents enrolled in wave II (1996; ages 13-20 y) and wave III (2001; 19-26 y) of the National Longitudinal Study of Adolescent Health (n = 9795). Obesity incidence was defined on the basis of International Obesity Task Force (IOTF) cutoffs (wave II), which link childhood body mass index (BMI) centiles to adult cutoffs (BMI > or = 30; wave III), for comparability between adolescence and adulthood. In addition, the more commonly used cutoff of BMI > or = 95th percentile for age- and sex-specific cutoffs from the 2000 Centers for Disease Control and Prevention growth charts for adolescents (wave II) were compared with adult cutoffs (BMI > or = 30; wave III). RESULTS: On the basis of the IOTF cutoffs, obesity incidence over the 5-y study period was 12.7%; 9.4% of the population remained obese and 1.6% shifted from obese to nonobese. Obesity incidence was especially high in non-Hispanic black (18.4%) females relative to white females. The prevalence of obesity increased from 10.9% in wave II to 22.1% in wave III, and extreme obesity was 4.3% at wave III on the basis of a BMI > or = 40. CONCLUSIONS: During a 5-y transitional period between adolescence and young adulthood, the proportion of adolescents becoming and remaining obese into adulthood was very high. This upward trend is likely to continue. Effective preventive and treatment efforts are critically needed.

Adolescent↗
PubMedDate not supplied

Parent-adolescent interactions after traumatic brain injury: their relationship to family adaptation and adolescent adjustment.

OBJECTIVE: To examine changes in parent-adolescent interactions after traumatic brain injury (TBI) and their relationship to parent and adolescent adjustment. DESIGN: Concurrent cohort, cross-sectional study. Analysis of variance was used to examine group differences and regression analysis to assess associations between interactional measures and concurrent adjustment. SETTING: Four hospitals in north-central Ohio. PARTICIPANTS: Adolescents with severe TBI (25), moderate TBI (22), and orthopedic injuries (35) and their parents. MAIN OUTCOME MEASURES: Observer ratings of parent-adolescent interactions, Conflict Behavior Questionnaire (CBQ), Family Burden of Injury Interview (FBII), Brief Symptom Inventory (BSI), Family Assessment Device (FAD), Child Behavior Checklist, Vineland Adaptive Behavior Scale, and Children's Depression Inventory. RESULTS: No group differences were found on ratings of parent-adolescent interaction or the parent or child CBQ. However, observed criticism/coldness and self-rated conflict had stronger associations with the FBII, BSI, and FAD in the severe TBI group than in the orthopedic injury group, suggesting that conflict is more disruptive after TBI. Ratings of criticism/coldness and parent and adolescent CBQ scores were also associated with parent and adolescent adjustment. CONCLUSIONS: Results support the utility of observational measures in assessing dyadic interactions after TBI.

Adaptation, Psychological↗
PubMed2006

The Ponseti method for treatment of congenital club foot.

PURPOSE OF REVIEW: This review of the Ponseti technique for the treatment of congenital club foot covers a topic of recently renewed interest. Pediatric orthopedists and parents have become increasingly enthusiastic about the success of this technique, which has been practiced continuously at the University of Iowa since 1948 but only recently become widely utilized. RECENT FINDINGS: Current literature has emphasized the reproducibility of these excellent results among multiple centers throughout the world. In addition, the role of the Internet, and accessibility of medical information have been central elements in the development of this phenomenon. SUMMARY: The current research should convince physicians that all children should be managed by the Ponseti technique at the outset. This research should also reassure physicians and parents that the overwhelming majority of children with club feet can be successfully managed, without the need for major reconstructive surgery.

Braces↗
PubMedDate not supplied

Cross-validation and discriminant validity of Adolescent Health Promotion Scale among overweight and nonoverweight adolescents in Taiwan.

This study used cross-validation and discriminant analysis to evaluate the construct and discriminant validity of Adolescent Health Promotion (AHP) scale between the overweight and nonoverweight adolescents in Taiwan. A cross-sectional survey method was used and 660 adolescents participated in this study. Cluster and discriminant analyses were used to analyze the data. Our findings indicate that the AHP is a valid and reliable scale to discriminate between the health-promoting behaviors of overweight and nonoverweight adolescents. For the total scale, cluster analyses revealed two distinct patterns, which we designated the healthy and unhealthy groups. Discriminate analysis supported this clustering as having good discriminant validity, as nonoverweight adolescents tended to be classified as healthy, while the overweight tended to be in the unhealthy group. In general, overweight adolescents practiced health-related behaviors at a significantly lower frequency than the nonoverweight. These included exercise behavior, stress management, life appreciation, health responsibility, and social support. These findings can be used to further develop and refine knowledge of adolescent overweight and related strategies for intervention.

Adolescent↗