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PubMed2000

Are adolescents being screened for sexually transmitted diseases? A study of low income African American adolescents in San Francisco.

OBJECTIVES: To determine the proportion of sexually experienced African American adolescents who report having been screened for sexually transmitted diseased (STDs), and to determine the proportion who report having been screened for STDs among those adolescents who have had a preventive primary healthcare visit in the past 2 years. METHODS: A telephone survey of a population based sample of African American 12-17 year old adolescents residing in a low income San Francisco neighbourhood with a high prevalence of STDs. RESULTS: Of the 302 adolescents surveyed, 118 (39%) reported a history of sexual intercourse. Of these, 26% of the males and 59% of the females had been screened for an STD in the previous 12 months. 31% of the males and 63% of the females had been screened for an STD in the previous 24 months. Of the 93 participants who had had a preventive primary care visit since their first episode of sexual intercourse, 26% of the males and 60% of the females had been screened for an STD in the previous 24 months. CONCLUSIONS: Sexually experienced African American adolescents in San Francisco are being screened for STDs at rates well below that recommended by current clinical guidelines. A low rate of screening was found even in those adolescents who had been seen for a preventive primary care visit since they first had sex. This suggests that the preventive primary care visit is not being used to its full potential as an opportunity to screen and treat adolescents for STDs. Capitalizing on this opportunity to screen may increase the number of STDs diagnosed and, thus, decrease rates of STDs in this population.

Adolescent↗
PubMedDate not supplied

Adolescents' behavioral autonomy related to diabetes management and adolescent activities/rules.

PURPOSE: The purpose of this preliminary study was to describe and explore the behavioral autonomy (both independent functioning and decision making) of adolescents with type 1 diabetes. METHODS: A sample of 34 adolescents with type 1 diabetes completed checklists on independent functioning and decision making for daily and nondaily diabetes management as well as typical adolescent activities/rules. RESULTS: Independent functioning in daily diabetes management was greater for older adolescents. Independent functioning and decision making for daily diabetes management, nondaily diabetes management, and typical adolescent activities/rules were strongly correlated. Independent decision making, but not independent functioning for daily diabetes management, was significantly correlated to metabolic control. CONCLUSIONS: The strong relationship between independent decision making and functioning suggests that both aspects are important parts of behavioral autonomy to be assessed by healthcare professionals working with adolescents with type 1 diabetes. Healthcare professionals should encourage parental involvement that facilitates adolescents' independent decision making, which was related to better metabolic control in this study.

Adolescent↗
PubMed2004

Relationship between nutritional and psychological status of pregnant adolescents and non-adolescents in Brazil.

This study compared the nutritional and psychological status of 855 pregnant adolescents and non-adolescents and assessed their relationships at three interviews (gestational age < or = 16 weeks, 20-26 weeks, and 30-36 weeks). The instruments used were: anthropometry, state-trait anxiety inventories (STAI), general health questionnaire (GHQ), and perceived stress scale (PSS). More adolescents were thinner, had higher scores of the trait anxiety inventory (TAI), wished to abort their children, and were worried about changes in their bodies than non-adolescents. Multiple linear regression analyses (controlling for toxic exposure, socioeconomic, demographic and obstetric factors) detected negative associations between weight gain in the first interview and distress (GHQ) for both the groups of women and weight gain in the second interview and the variable "worry about body's change" for the non-adolescent group. The negative associations between body mass index and chronic anxiety (TAI) were present in the three interviews for non-adolescents. This study detected a relationship between the nutritional and the psychological status of pregnant women, although there were more associations for non-adolescents.

Adolescent↗
PubMedDate not supplied

Adolescents and their music. Insights into the health of adolescents.

During adolescence, teenagers are expected to develop standards of behavior and reconcile them with their perceptions of adult standards. In this context, music, a powerful medium in the lives of adolescents, offers conflicting values. The explicit sexual and violent lyrics of some forms of music often clash with the themes of abstinence and rational behavior promoted by adult society. Identification with rock music, particularly those styles that are rejected by adults, functions to separate adolescents from adult society. Some forms of rock music extend well beyond respectability in fulfilling this definitional role. Total immersion into a rock subculture, such as heavy metal, may be both a portrait of adolescent alienation and an unflattering reflection of an adolescent's perception of the moral and ethical duplicity of adult society. Physicians should be aware of the role of music in the lives of adolescents and use music preferences as clues to the emotional and mental health of adolescents.

Adolescent↗
PubMed1997

[Deficits in the support for adolescents at risk for drug addiction-- results of questioning of experts, users and adolescents].

Consumption of alcohol and illegal drugs is a widespread phenomenon in Germany. The first contact with drugs usually takes place during adolescence. Experimental use of drugs is an integral part of personal development during adolescence. The aim of this paper is to analyse the supporting infrastucture available to adolescents who are at risk of substance abuse, with special focus on its structural deficits. In addition to epidemiological data for alcohol and illegal drugs, the professional support system is described. The support system for adolescents who have already begun with experimental usage with drugs is analysed on the basis of three interview studies: 1) professionals from support and care institutions, 2) adolescents with health hazardous drug consumption patterns, and 3) those who seek the services of health care institutions. The results show that the existing treatment does not meet the needs and demands of adolescents in most cases, because the professional support institutions cannot cope with the real context of adolescent drug abuse. Recommendations for improvements of the support institutions are finally discussed.

Adolescent↗
PubMed2006

Adolescent immunizations: a position paper of the Society for Adolescent Medicine.

New vaccines are being targeted to help protect the adolescent population from disease. The Society for Adolescent Medicine strongly urges compliance with adolescent vaccination recommendations provided by the Advisory Committee on Immunization Practices. These vaccines will significantly impact the health and well-being of the adolescent population. To enhance vaccination compliance and access to prevention health care and promotion, the Society supports linking vaccination to the three distinct comprehensive preventive health care visits already recommended by multiple organizations during early, middle, and late adolescence. In addition, multiple provider strategies should be used to increase vaccination rates among adolescents.

Adolescent↗
PubMed1998

Short adolescence in early hominids: infantile and adolescent growth of the human femur.

Did the first hominids have a short developmental period similar to that of the great apes or a longer period closer to that of modern humans? Evidence from studies on dental and facial growth favors the first point of view. Additional evidence presented in this report is provided by a morphogenetic analysis of the lower limb. Some morphological modifications undergone by the human femur during infantile and adolescent growth are shown to be excellent markers of different developmental stages. The angular remodelling of the femoral diaphysis, which results in femoral bicondylar angle, is a marker of infancy, while the reshaping of the distal femoral epiphysis is a marker of adolescence. This reshaping of the bony epiphysis consists of the strong projection of the external lip of the femoral trochlea, the increase of the radius of curvature of the external condyle, and the anteroposterior lengthening of the whole epiphysis. The growth spurt in linear dimensions of the femur, characteristic of human adolescence, is shown to be associated with qualitative changes of the distal femoral epiphysis engendered by the late closure of the distal epiphysis. The femur of the first hominids (Australopithecus afarensis) shows only features of infantile growth, whereas characters of both precocious and later growth are typical of later hominids (Homo). The absence of the derived epiphyseal features in Australopithecus would be linked to their early epiphyseal closure and short adolescent growth period; their presence in Homo would have been promoted by their delayed epiphyseal closure and prolonged adolescent growth period. The transition from Australopithecus to Homo appears to have involved a heterochronic process of time hypermorphosis (Gould, [1977], Ontogeny and Phylogeny [Cambridge: Harvard University Press]) in which the size of the femur increases, the epiphysis is modified, and the period of peripubertal growth is prolonged. The shape of the distal epiphyses of KNM-WT 15000, an immature Homo erectus (Brown et al. [1985] Nature 316:788-792), lies clearly within the range of modern human adolescents. In contradiction to Smith's ([1993] in A. Walker and R. Leakey [eds.]: The Nariokotome Homo erectus Skeleton [Cambridge: Harvard University Press], pp. 195-220) hypothetical reconstruction of life span of Homo erectus, we infer that a growth spurt had begun with Homo erectus but was probably less pronounced and of shorter duration than in modern humans. Our findings on the femur are consistent with studies of the growth on the hominid pelvis (Berge [1996] in LF Marcus, M Corti, A Loy, G Naylor, and DE Slice [eds.]: Advances in Morphometrics [Chicago: Plenum Publishing Corp.], pp. 441-448). It is suggested that the lengthening of the adolescent growth period, from Australopithecus to Homo, would have been also associated with the shape changes of the pelvis and with the lengthening of the lower limbs.

Adolescent↗
PubMed2006

Parent-adolescent relationships and the development of weight concerns from early to late adolescence.

OBJECTIVE: This work describes the developmental course of adolescents' weight concerns and examines links with changes in parent-adolescent relationships for girls and boys. METHOD: Adolescents and parents in 191 families participated in 3 annual home interviews; adolescents rated their weight concerns and their intimacy and conflict with parents. Parental knowledge was measured based on the match between adolescents' and parents' reports of youth's experiences each day during 7 evening telephone calls. RESULTS: Girls' weight concerns increased from age 11 to 16 and then declined, whereas boys' concerns declined beginning at age 11. Increases in girls' weight concerns were linked to increases in conflict with mothers and fathers and decreases in maternal intimacy and knowledge. At a trend level, declines in boys' weight concerns were associated with declines in father conflict. CONCLUSION: Mothers and fathers may have unique influences on adolescent weight concerns. Intervention programming should target parent-adolescent relationships.

Adolescent↗
PubMed2005

Suicidal behaviour in adolescents: associations with parental marital status and perceived parent-adolescent relationship.

BACKGROUND: Because equivocal findings exist with regard to the relationship between adolescents' suicidal behaviour and parental marital status, the aim of this study was to investigate this relationship and in particular the effect of the perceived parent-adolescent relationship on this association, taking into account the role of gender. METHOD: For this purpose, self-report surveys were administered to a representative school-based sample of 2707 adolescents in Antwerp (Belgium). RESULTS: 1) Boys living in a single parent family reported more suicidal ideations and self-harming behaviour than boys living in an intact family or in a remarried family; 2) Girls living in a remarried family reported more suicidal ideations and self-harming behaviour than girls living in an intact or in a single parent family; 3) Even after controlling for the levels of perceived parent-adolescent relationship, these associations remained significant. LIMITATIONS: The cross-sectional design, the retrospective assessment of suicidality and changes in family structure, the lack of external information and the assessment of the parent-adolescent relationship for both parents together, may have influenced the findings. CONCLUSIONS: When assessing risk factors for adolescent suicidality, marital status of the parents may bear clinical importance. In contrast to other studies, the perceived parent-adolescent relationship did not alter this association, a finding that needs further study.

Adolescent↗
PubMed1980

Psychologic effects of illness in adolescence. II. Impact of illness in adolescents--crucial issues and coping styles.

Adolescent perceptions of the impact of illness were measured through the administration of an original questionnaire to 345 healthy adolescents and 168 adolescents with diabetes mellitus, cystic fibrosis, cancer, and cardiac, renal, or rheumatologic diseases. Total impact of illness (e.g., leukemia or colds) did not differ between ill and healthy respondents, and the nature of adolescent concerns were similar for both groups. Restriction of freedom was seen as the major disruption brought about by illness, with other areas of impact including relations with peers, siblings, and parents. Adolescents with cancer were most likely to view treatment as highly disruptive and, along with rheumatologic patients, expressed greatest disruption of body image secondary to disease and treatment. Perceived school disruption was most common in cardiac and oncologic patients, with the former also expressing a high degree of concern about sexuality. Females in all groups reported more impact of illness on physical appearance than did males; this difference was greatest in adolescents with cancer, rheumatologic diseases, and cystic fibrosis. The essentially healthy psychologic status of chronically ill adolescents is noted, as is the generally hopeful and positive quality of patient responses.

Adolescent↗
PubMed2000

Adolescents with learning disabilities: risk and protective factors associated with emotional well-being: findings from the National Longitudinal Study of Adolescent Health.

PURPOSE: To identify differences in emotional well-being among adolescents with and without learning disabilities and to identify risk and protective factors associated with emotional distress. METHODS: Cross-sectional analysis of adolescent in-home interview data of the National Longitudinal Study of Adolescent Health. A total of 20,780 adolescents were included in this study of whom 1,301 were identified as having a learning disability. Initially, emotional distress, suicidal behaviors, and violence involvement were compared among those adolescents with and without learning disabilities using Student's t-test for the continuous or semicontinuous variables and Chi-square for the dichotomous variables. Subsequently, logistic regression analyses were conducted to identify which variables were most strongly associated with risk and protective factors for emotional distress. RESULTS: Adolescents with learning disabilities had twice the risk of emotional distress, and females were at twice the risk of attempting suicide and for violence involvement than their peers. While educational achievement is below that of peers, connectedness to school is comparable. So, too, is connectedness to parents. Connectedness to parents and school was identified as most strongly associated with diminished emotional distress, suicide attempts, and violence involvement among adolescents with learning disabilities. CONCLUSIONS: Given the increased association with emotional distress, suicidal attempts, and violence involvement, clinicians need to assess social and emotional as well as educational and physical functioning of these young people. We also need to be aware of the role protective factors play in the lives of young people with learning disabilities.

Adaptation, Psychological↗
PubMed2002

Dissimilarity in adolescent and maternal representations of Type 1 diabetes: exploration of relations to adolescent well-being.

PURPOSE: To compare the illness representations of adolescents with Type 1 diabetes and their mothers, and to explore how congruence and incongruence influences adolescent psychological adjustment. METHODS: A total of 30 adolescents (13-19 years) with Type 1 diabetes completed self-report questionnaires of illness representations and psychological well-being; 26 mothers completed the illness representation questionnaire. RESULTS: t-Test and correlation analyses showed convergence on the majority of the illness representation dimensions with maternal representations differing significantly on only two dimensions: perceiving their adolescent's diabetes to have more serious consequences and to have a greater emotional impact. Computation of dissimilarity scores between mothers and adolescents, showed mothers to maximize the seriousness of diabetes across several dimensions, but no significant associations were found with adolescent psychological well-being. CONCLUSIONS: Chronic illness in children and young people exists in a social context and the management of diabetes requires an ongoing supportive relationship between parent and child. The results show a high degree of consistency in the beliefs adolescents and their mothers hold, and such congruence is presumed to benefit psychological well-being. However, the mediators and moderators for family belief processes are unclear and several possibilities are discussed.

Adaptation, Psychological↗
PubMed2002

Mental health of adolescents in custody: the use of the "Adolescent Psychopathology Scale" in a Tasmanian context.

OBJECTIVE: To investigate the incidence of mental health problems based on the DSM-IV [1] among adolescents in custody in Tasmania, using the Adolescent Psychopathology Scale (APS) [2]. METHODS: The APS was administered to 50 adolescents admitted consecutively to a youth detention centre in Tasmania, Australia, using a structured interview format. RESULTS: In this sample 46% scored positively for a mood disorder, 36% for posttraumatic stress disorder (PTSD), and 32% for an anxiety disorder excluding PTSD. CONCLUSIONS: Tasmania is no exception to the rule that adolescents in custody have a high proportion of mental health problems. This study confirmed findings of previous studies that detained adolescents had a roughly equivalent level of mental health problems as young people referred to mental health services and five times more than adolescents in the community. Therefore, all detained adolescents should be assessed for mental health problems as their risk is equivalent to that of young people referred to mental health services in the community. Youth detention centres are able to provide significant opportunities for individual therapy and group programmes for young people with mental health problems. However, to achieve a realization of this potential, detention facilities need to develop philosophies and procedures, which facilitate the development of therapeutic, as opposed to "punishing", environments.

Adolescent↗
PubMed1995

Adolescents' attitudes toward confidentiality between the school counsellor and the adolescent client.

It is increasingly acknowledged that confidentiality is relative rather than absolute in any counselling relationship. This is particularly the case for minors receiving counselling at school, where third parties such as parents and teachers frequently have access to information about an adolescent client. The Australian Psychological Society's Code of Professional Conduct (1986) states that minors are unable to provide voluntary, informed consent in consulting relationships, although current research does not necessarily support this view. The current study investigated adolescents' attitudes to confidentiality in situations that may commonly arise in school counselling. The study also investigated the third parties to whom adolescents believed information should be disclosed by a counsellor. Respondents were 303 male and 254 female students attending three single-sex nongovernment schools. Ages ranged from 13 to 18 years. Results suggested that the adolescents' attitudes to confidentiality generally corresponded with adult views. Many adolescents wanted more autonomy regarding disclosure of information obtained in a counselling situation than the APS code provides. Parents were the only third party to whom the adolescents generally believed disclosure should be made. There were few age differences, but a wide range of opinions were evident, with female adolescents consistently more strongly in favor of confidentiality than males.

Attitude↗
PubMed2006

Brief report: initial testing of scales measuring parent and adolescent Perceptions of Adolescents' Assumption of Diabetes Management.

OBJECTIVE: This study tested parallel adolescent and parent versions of the Perceptions of Adolescents' Assumption of Diabetes Management scales. METHODS: First, 78 items developed from interview data were reviewed by a panel of adolescent and diabetes experts. Next, the scales were piloted with 43 adolescents with type 1 diabetes and their parents and, finally, tested with 100 dyads. Item and principal component analyses were performed. RESULTS: Following content validity and item analyses, five and four items remained in the advantages and disadvantages scales, respectively. One factor accounted for between 54 and 63% of variance, and internal consistency reliability ranged between .78 and .84 for the various versions of the scales. CONCLUSIONS: The Perceptions of Adolescents' Assumption of Diabetes Management scales show promise as parsimonious and reliable tools for use in research and practice related to parent-adolescent relationships in regard to adolescents' assumption of diabetes management.

Adolescent↗
PubMedDate not supplied

The application of laparoscopic bariatric surgery for treatment of severe obesity in adolescents using a multidisciplinary adolescent bariatric program.

The evolution of laparoscopic surgery has made bariatric surgery acceptable for weight loss; however, much controversy exists about its appropriateness for adolescents. Despite the controversial issues, the growing epidemic in adolescent obesity has resulted in rising numbers of applications for bariatric surgery. There are few bariatric surgical programs designed for adolescents. Pediatric settings face high start-up costs and poor reimbursement and lack established bariatric surgeons. Even so, bariatric surgery is increasingly being performed on adolescents in alarming numbers. To avoid adverse physical and psychosocial outcomes, the application of the principles of growth and development is essential. The program should be established as a multidisciplinary approach to management of adolescents and should be in institutions capable of meeting the guidelines for surgical treatment outlined by the American Society of Bariatric Surgery. To prevent postoperative complication, a multidisciplinary team of experienced medical and surgical specialists is needed for optimal preoperative decision making and postoperative management and long-term follow-up. Laparoscopic Roux-en-Y gastric bypass is a safe procedure and an effective means to treat obesity-related morbidity in the adolescent. Results have been excellent and justify a clinical trial to confirm the safety and efficacy of bariatric surgery in the adolescent population.

Adolescent↗
PubMed1991

To whom do adolescents turn for help? Differences between disturbed and nondisturbed adolescents.

The focus of this investigation was to 1) identify those adolescents experiencing distress; 2) examine the formal and informal helping agents that adolescents seek out for help for emotional problems; and 3) describe adolescents' perceptions of the helpfulness of selected helping agents. Adolescents (N = 497) from three high schools in a large metropolitan area in the Midwest, representing a broad socioeconomic spectrum, were administered instruments related to self-image, delinquency, symptomatology, and help seeking. The prevalence rate of disturbance was 22.3%. Results show that disturbed adolescents sought help from alcohol/drug abuse centers, teenage drop-in centers, and mental health professionals more frequently than nondisturbed adolescents. In additional, both groups frequently sought help from parents and friends and perceived this help as beneficial. Implications of these findings for the development of adolescent mental health services are discussed.

Adaptation, Psychological↗
PubMed2002

Identifying faking bad on the Minnesota Multiphasic Personality Inventory-Adolescent with Mexican adolescents.

This study examined the extent to which the validity scales of the Minnesota Multiphasic Personality Inventory-Adolescent identified Mexican adolescents who were instructed to fake bad. Validity scales data were used to differentiate between nonclinical adolescents instructed to fake bad and both clinical and nonclinical adolescents who received standard instructions. Participants were 59 male and 87 female Mexican high school students and 59 male and 87 female Mexican adolescents from clinical settings. This is the first study onfaking with adolescents in Mexico. The F, Fl, and F2 Scales and the F-K index discriminated adequately between the three different groups. Results were similar to those previously reportedfor adults and adolescents in Mexico and the United States. High positive and negative predictive powers and overall hit rates were obtained in this study. Higher cut scores were needed to discriminate between the groups of girls than between the groups of boys.

Adolescent↗