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PubMed2004

Assessing sexual behavior in high-risk adolescents with the adolescent clinical sexual behavior inventory (ACSBI).

This study examined the reliability and validity of the Adolescent Clinical Sexual Behavior Inventory (ACSBI), a new 45-item measure, designed to elicit parent-and self-report regarding a range of sexual behaviors in high-risk adolescents. Using this measure, this study also investigated predictors of adolescent sexual behavior. Participants were 174 adolescents and their parents consecutively admitted to one of three clinical settings (i.e., inpatient treatment, partial hospital program, and outpatient clinic). Parent-and self-reports of adolescent sexual behavior were moderately correlated, and there was a strong relationship between high-risk sexual behavior and adolescent emotional and behavioral problems, as well as sexual concerns, distress, and preoccupation. In addition to sexual abuse, physical abuse, life stress, and impaired family relationships also significantly predicted sexual behavior in adolescents.

Adolescent↗
PubMed2002

Parent-adolescent interaction: influence on the academic achievement of African American adolescent males.

As the achievement gap between African American and while students persists, an examination of factors outside the school setting are essential. Acknowledging the dynamics of family environment as perceived by African American adolescent males is apposite to understanding the relationship between family environment and academic achievement. Utilizing an ecological perspective, this study describes the characteristics of family process variables and analyzes the adolescents' perception of parent-adolescent interaction and its influence on their psychological well-being. Results indicate that a substantial proportion of the 179 adolescent males who perceived parent-adolescent interaction as positive and were identified as having a stable psychological well-being, were more likely to have average to above-average grade point averages, high Stanford Nine scores and high achievement group membership, than those adolescent males who did not perceive parent-adolescent interaction as positive.

Adolescent↗
PubMed2000

[Comparison of suicide attempts by male and female adolescents. Results of a 10-year patient population of a child and adolescent psychiatry clinic].

OBJECTIVE: This study examines the way in which suicide attempts differ between male and female adolescents. METHODS: The characteristics of 173 female and 62 male adolescents who were treated at a clinic for child and adolescent psychiatry over a period of 10 years were investigated. RESULTS: Suicide attempts by adolescents in the patient population did not decrease in accordance with suicides in the same age-group among the general population. Male adolescents more often attempted suicide in a place where they were less likely to be discovered, but did not use a "harsher" method than female adolescents. The diagnosis rendered according to ICD-10 in 36% of cases was not always typical for the respective sex. CONCLUSIONS: The ways in which adolescents attempt suicide have clearly changed over the past years. Diagnoses that are untypical for the respective sex may represent a risk factor.

Adolescent↗
PubMed1989

Acquired immunodeficiency syndrome and adolescents: knowledge, attitudes, beliefs, and behaviors in a New York City adolescent minority population.

In this survey, the knowledge, attitudes, beliefs, and behaviors concerning acquired immunodeficiency syndrome (AIDS) in a group (N = 196) of innercity adolescents in New York City were assessed. Sexual activity was the major risk factor for AIDS in this population; 58% of the adolescents had engaged in sexual intercourse; 12% of these had never used contraception. There were small reported rates of homosexuality, anal intercourse, and prostitution. Of respondents, 22% reported alcohol use and 22% had tried recreational drugs. None had ever taken drugs intravenously. Knowledge of human immunodeficiency virus (HIV) transmission was generally good, although there were prominent misconceptions. For example, 52% of the adolescents believed that donating blood could transmit HIV. Of respondents, 47% "never" or "rarely" worried about the disease. Of the total group, 39% reported behavior changes because of concern about AIDS in the previous 6 months. Those who changed behaviors tended to have a greater perceived risk, worry more frequently about the disease, and have a better knowledge of means of HIV transmission. Of those reporting behavior changes, 66% (25% of the total study group) claimed to be using condoms currently, and 16% (6% of the total study group) claimed to be abstemious. More black adolescents than Hispanic adolescents instituted behavior changes. Of black female adolescents, 71% were sexually active, as compared with 30% of Hispanic female adolescents.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1996

The status of psychic reality in adolescence. An adult female patient's quasi-adolescent material and the analyst's counter transference response.

The author holds that the crisis of adolescence is in fact one of psychic reality, its elements being loss of boundaries, externalisation and the involvement of a third party. In this view, it is essential to conceive of adolescence differently from adulthood, in that, for example, an adolescent's acting out may not be solely a matter of regression but to a considerable extent a consequence of his or her physical development. It is noted that the boundaries between psychic and material reality are fluid throughout life and that adolescents crave identificatory models. The author stresses the importance of the psychic reality of the other in the adolescent's crisis. After considering various views, including those of Freud, on psychic reality and the crises of adolescence, he illustrates his thesis by the clinical example of two adolescent episodes of perversion forming part of an adult female patient's material. In the author's view, these instances of acting out had helped the patient to regain her auto-erotic capacity in the pleasure of fantasy life. He considers that a mutative interpretation must touch upon the primal fantasy and therefore involve the entire person of the analyst in the transference.

Acting Out↗
PubMed1997

Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health.

CONTEXT: The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. OBJECTIVE: To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. DESIGN: Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. PARTICIPANTS: A total of 12118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90118 adolescents from 80 high schools plus their feeder middle schools. SETTING: The interview was completed in the subject's home. MAIN OUTCOME MEASURES: Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. RESULTS: Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12: P<.001) and violence (grades 7-8: P<.001; grades 9-12: P<.001). Access to substances in the home was associated with use of cigarettes (P<.001), alcohol (P<.001), and marijuana (P<.001) among all students. Working 20 or more hours a week was associated with emotional distress of high school students (P<.01), cigarette use (P<.001), alcohol use (P<.001), and marijuana use (P<.001). Appearing "older than most" in class was associated with emotional distress and suicidal thoughts and behaviors among high school students (P<.001); it was also associated with substance use and an earlier age of sexual debut among both junior and senior high students. Repeating a grade in school was associated with emotional distress among students in junior high (P<.001) and high school (P<.01) and with tobacco use among junior high students (P<.001). On the other hand, parental expectations regarding school achievement were associated with lower levels of health risk behaviors; parental disapproval of early sexual debut was associated with a later age of onset of intercourse (P<.001). CONCLUSIONS: Family and school contexts as well as individual characteristics are associated with health and risky behaviors in adolescents. The results should assist health and social service providers, educators, and others in taking the first steps to diminish risk factors and enhance protective factors for our young people.

Adolescent↗
PubMed1981

The hospitalized adolescent interaction scale: an instrument to measure patient behavior on an adolescent medicine ward.

The Hospitalized Adolescent Interaction Scale was developed to assess the behavior of adolescents on an adolescent unit. This 30-item checklist was utilized to measure the behavior of patients hospitalized on adolescent units in two hospitals. The type and level of behavior of the adolescents were similar at the two hospitals. Adolescents spent only a small percentage of their time interacting with each other (3-8%), while over half their time was spent in solitary activities (33-37%) or doing nothing at all (21-17%). In rank order, the four most frequent activities at both institutions were: (1) television on, (2) visitor in room, (3) patient watching TV, and (4) visitor and patient talking.

Adolescent↗
PubMedDate not supplied

The impact of epilepsy on the adolescent adolescent.

Epilepsy is the most common serious neurologic condition affecting adolescents, coinciding with a time of dramatic change in growth, hormones, psychology, and social situations. Adolescents with epilepsy are sensitive to peer norms and beliefs and may limit disclosure of their chronic illness to feel less different or stigmatized. They may also explore the world of alcohol and recreational drugs, like others in their peer group, as well as experiment with their own medications. The goal of treatment should be maintenance of a normal lifestyle with complete seizure control, minimal adverse effects, and achievement of normal adolescent milestones. Adolescents with epilepsy have an increased incidence of depression because of the combination of the unpredictable nature of epilepsy, a perceived lack of control, uncontrollable adverse events, and negative perceptions of themselves. The purpose of this article is to summarize the physical, developmental, emotional, and cognitive effects of epilepsy on adolescents. By increasing the awareness of healthcare providers, interventions designed to prevent further negative consequences can be considered for adolescents with epilepsy.

Adaptation, Psychological↗
PubMed2005

Neighborhood context and sexual behaviors among adolescents: findings from the national longitudinal study of adolescent health.

CONTEXT: Adolescent sexual behaviors are a significant public health concern because of the risks of STDs and the negative social consequences of teenage pregnancies. Associations between neighborhood characteristics and adolescents' initiation of sex and contraceptive use are poorly understood. METHODS: Multilevel logistic regression analyses of data from 14,151 adolescents in grades 7-12 in Wave 1 of the National Longitudinal Study of Adolescent Health examined the relationships between four neighborhood dimensions (socioeconomic characteristics, norms and opportunity structure, social disorganization, and racial and ethnic composition) and the initiation of sex and contraceptive use at first and most recent sex. Individual- and household-level covariates were family income, parental education, race and ethnicity, age and family structure. Multivariate analyses were stratified by gender. RESULTS: All four dimensions of neighborhood context were independently associated with sexual initiation. For females, living in a neighborhood with a greater concentration of youth who were idle or black residents was associated with increased odds of sexual initiation, whereas a greater concentration of married households or Hispanic residents was associated with decreased odds of initiation. Higher initiation among males was associated with a higher concentration of poverty or idle youth, while lower initiation was found with a higher concentration of affluent households or working women. The sole association with contraceptive use was that females in neighborhoods with more idle youth had a reduced likelihood of having used contraceptives at first sex. CONCLUSIONS: Neighborhood context appears to be modestly associated with the sexual initiation of adolescents. However, little support was found for neighborhood influence on contraceptive use, suggesting that other factors may play a more important role in shaping adolescents' contraceptive behaviors.

Adolescent↗
PubMedDate not supplied

A longitudinal study of parenting and adolescent adjustment in Chinese adolescents with economic disadvantage.

This longitudinal study examines the relationship between parenting behavior and adolescent adjustment (psychological well-being, substance abuse and delinquent behavior) in Chinese adolescents with economic disadvantage (N = 199). Results showed that parenting characteristics were concurrently and longitudinally related to measures of adolescent adjustment, particularly adolescent problem behavior. Compared with the norm based on adolescents of a community sample, poor adolescents perceived parenting characteristics to be more negative and they had relatively lower life satisfaction. Paternal parenting was perceived to be more negative than maternal parenting and parenting behavior was perceived to deteriorate over time.

Adolescent↗
PubMed2002

Factors associated with HIV testing among HIV-positive and HIV-negative high-risk adolescents: the REACH Study. Reaching for Excellence in Adolescent Care and Health.

OBJECTIVE: To describe human immunodeficiency virus (HIV) testing patterns among high-risk, uninfected adolescents and HIV-infected adolescents, and factors associated with testing. METHODS: HIV-infected adolescents (N = 246) and high-risk, uninfected adolescents (N = 141) at 15 sites nationwide were asked about the number of times they were tested for HIV, the type of agency at which testing occurred, and reasons for testing. RESULTS: The majority of participants reported being influenced to obtain testing by health care providers (53.1% of the HIV-infected group and 66.1% of the HIV-uninfected group, respectively). Female participants were somewhat more likely to have used a confidential or anonymous site for the most recent test, compared with male participants (73.5% and 67.5%, respectively). Among the HIV-infected group, feeling sick was the only factor associated with number of tests. Among the HIV-uninfected group, having more male partners, marijuana use in the past 3 months, white race, and having had same-gender partners in their lifetime (males only) were associated with number of tests. Multivariate analyses identified 2 significant models. Modeling the probability of having been tested 3 or more times, black participants were less likely to be tested than white participants (odds ratio [OR] = 0.4), and participants who felt sick were more likely to be tested than those who did not (OR = 1.7). Modeling the probability that the last test would be positive, black participants were more likely than white participants to test positive (OR = 2.3); those who were tested because they thought they might have gotten HIV from sex (OR = 3.0) or they felt sick (OR = 3.9) were more likely to test positive; participants who were tested because a health care professional recommended it were actually less likely (OR = 0.5) to test positive. CONCLUSIONS: Overall, these findings highlight the importance of making HIV testing more routinely available to sexually active adolescents. More work needs to be done to normalize HIV testing among adolescents, and more innovative approaches need to be implemented on a wide scale.

AIDS Serodiagnosis↗
PubMed1994

[Adolescence: viewpoints from adolescent psychiatry].

Adolescence is a phase of human development which is marked by a high vulnerability due to the ongoing psycho-physiological transformations. The regulation of the self-esteem is especially in danger in youngsters who went into adolescence with a marked burden of conflicts or who lived in families with disturbed intrafamilial dynamics. To be present as a partner and not to find the solutions for the adolescents' conflicts, to accept their questioning of what is established and to recognize their movements of reconciliation are the quite complex demands put on to the world of the adults. Adolescents urge us to a review of our own adolescence, to a balancing of hate and love, openness and rigidity, and to dialectic movements between disintegration and reintegration as well as between the generations. Any help, be it on the physical, the social or the psychic level, should be directed toward a restitution of the intrapsychic, intrafamilial or intergenerational balance; sociocultural factors have also always to be respected. The helpers--especially in a culture with rapid change--are often confronted with their own adolescence, which took place a generation before and mostly under totally different conditions.

Adolescent↗
PubMed1998

Parent-adolescent congruency in reports of adolescent sexual behavior and in communications about sexual behavior.

Agreement between mothers' and adolescents' reports of communication about sex, satisfaction with the parent-child relationship, maternal disapproval of adolescent sexual activity, and adolescent sexual behavior was investigated in a sample of 745 African American adolescents (ages 14-17) and their mothers. Congruence between the 2 sets of reports tended to be low. Adolescent perceptions and reports were found to be more predictive of adolescent sexual behavior than maternal reports. Mothers tended to underestimate the sexual activity of their teens and teens tended to underestimate their mother's level of disapproval of their engaging in sexual activity. Reasons for these misperceptions were explored.

Adolescent↗
PubMedDate not supplied

Health behavior and related factors in adolescents with a history of abortion and never-pregnant adolescents.

Although prevention of unintended births among adolescents is health promoting, abortion, as one of those methods, has not been examined from a health promotion perspective. The authors describe and compare health behaviors, problem-solving appraisal, self-image, age, and use of contraceptives at first and most recent coitus in adolescents with a history of abortion and never-pregnant adolescents. A cross-sectional design with 26 pairs of adolescents matched on age, race, grade level, and Medicaid status was used. No significant differences were found between the 2 groups. The matched pairs' health behaviors and problem-solving scores were less favorable than those reported in the literature for nonmetropolitan women. Although the 2 groups of adolescents had similar self-image scores, they were significantly below those of the norm reference group. The matched pairs initiated coitus at an earlier age, and a smaller proportion used contraceptives at first and last coitus than national norms. These findings support the need for early intervention to enhance self-image, problem-solving confidence, and coitus delay. The findings point to the importance of aggressive family planning interventions and maintenance of access to abortion services.

Abortion, Induced↗
PubMed1988

Physicians' values and experience during adolescence. Their effect on adolescent health care.

The values and experience of physicians as adolescents can effect their care of adolescent patients. Eighty residents were studied using extensive personal data gathered from a structured interview, a questionnaire of perceived clinical skills, and a videotape with a simulated patient. A "values" and "risk-taking during adolescence" score was constructed and related to the resident's perceived skills for and attitudes about adolescent health care. Residents with higher values scores (more conservative) were more likely to be pediatric than internal medicine residents and less likely to prescribe birth control pills to an adolescent. Residents with higher risk-taking scores considered themselves more skilled in dealing with substance abuse and sexually transmitted diseases and in recognizing psychologic problems. Values or risk-taking scores were not related to the resident's perceived skill in areas such as evaluating hypertension or performing Tanner staging. These data suggest that certain values and experiences may be influential in the physician's ability and approach to dealing with certain issues related to adolescent health care.

Adolescent↗
PubMed2006

Adolescents involved in weight-related and power team sports have better eating patterns and nutrient intakes than non-sport-involved adolescents.

OBJECTIVE: To examine eating habits and energy and nutrient intake among adolescents participating in weight-related and power team sports and non-sport-involved adolescents. DESIGN: Data were drawn from Project EAT (Eating Among Teens), which was conducted with 4,746 adolescents from 31 middle and high schools in the Minneapolis/St Paul metropolitan area. SETTING: Urban secondary schools. SUBJECTS: Adolescents reporting participation in a weight-related sport, a power team sport, or no consistent participation in a sport. MAIN OUTCOME MEASURES: Meal and snack frequency, mean energy and nutrient intake, and mean physical activity. STATISTICAL ANALYSES PERFORMED: Analyses were conducted by sex across the three groups. General linear models were used to compare mean energy and nutrient intake, composite nutrient adequacy, and mean physical activity across the three groups. Percentages of youth meeting nutrient recommendations were compared across the three groups using chi(2) tests. RESULTS: For both males and females, youth involved in weight-related sports ate breakfast more frequently than non-sport-involved peers (females: 3.6 and 3.2 times per week, respectively, P<0.01; males: 4.7 and 3.7 times per week, respectively, P<0.01). Weight-related and power team sport-involved youth also had higher mean protein, calcium, iron, and zinc intakes than non-sport-involved peers. However, adolescent females had low calcium intake, regardless of sports involvement (weight-related sports 1,091 mg/day, power team sports 1,070 mg/day, and non-sport-involved 1,028 mg/day, P<0.05). CONCLUSIONS: Sport-involved adolescents have better eating habits and nutrient intake than their non-sport-involved peers. However, they are still in need of nutrition interventions, particularly around calcium intake.

Adolescent↗
PubMed1987

Developmental processes in early adolescence: relationships between adolescent adjustment problems and chronologic age, pubertal stage, and puberty-related serum hormone levels.

Relations between adolescent psychosocial adjustment problems and markers of biologic development, including chronologic age, pubertal status, and serum hormone levels, were examined in 56 normal boys and 52 normal girls, ages 9 to 14 years. Adolescent psychosocial adjustment was assessed by adolescent self-ratings of various aspects of self-image (Offer Self-Image Questionnaire for Adolescents) and parent ratings of adolescent behavior problems (Child Behavior Checklist). The pubertal status measure used in the analyses was Tanner genital stage for boys and Tanner breast stage for girls. The hormone measures, determined by radioimmunoassay, were serum levels of gonadotropins (luteinizing hormone and follicle stimulating hormone), sex steroids (testosterone and estradiol), and adrenal androgens (dehydroepiandrosterone and its sulfate, and androstenedione). The testosterone/estradiol ratio also was computed. Overall, findings were stronger, more consistent, and more generalized for boys than for girls. For boys, adjustment problems typically were associated with a multivariate profile that may be characteristic for later maturers: relatively low sex steroid levels, or lower pubertal stage, and relatively high adrenal androgen (androstenedione) levels, frequently in conjunction with higher chronologic age. Univariate relations predominated for girls; that is, associated with adjustment problems for girls were relatively high levels of gonadotropins, relatively low levels of dehydroepiandrosterone sulfate, and relatively high levels of androstenedione on their own or in conjunction with lower pubertal stage. Higher levels of androstenedione, a steroid particularly responsive to stress, were associated with adjustment problems in both boys and girls. This relation may reflect the stress of later maturation, which could result from environmental factors, such as adolescent self-comparisons with same-age peers, or endogenous effects of hormones.

Adolescent↗
PubMed2002

Prevention and risk of adolescent substance abuse. The role of adolescents, families, and communities.

Adolescents as young as 12 to 14 years of age are engaging in substance use [16]. Those who use substances are at risk for immediate and future consequences that affect morbidity and mortality. The theoretical models of substance use in adolescents provide a framework for understanding risk and protective factors. These risk and protective factors are pertinent to all contexts, including the individual traits, interpersonal relationships, and greater society. Knowledge of these factors should help the clinician in assessment of the individual adolescent. Knowledge of these factors also should help the clinician provide appropriate interventions. In the case of primary prevention, clinicians can advocate for families and communities to teach children how to be more goal-oriented, insightful, and in tune with their cultures and beliefs. Parents also can be encouraged to set clear limits, monitor their adolescents' behaviors, be good role models, and provide a loving and supportive environment. Advocacy to address some of the societal factors that are less easily changed also has its place. Addressing media portrayal of drug use, availability of substances, and poverty would have a broad impact on the problem of adolescent substance use and would help to improve the health status of many adolescents in the United States.

Adolescent↗