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PubMed1986

Appropriate and inappropriate use of psychotherapeutic medications for institutionalized mentally retarded persons.

Evaluation of psychiatric treatment in institutions must be based not only on the numbers and types of drugs prescribed but also on diagnoses and other characteristics of the patients. We crosstabulated psychotherapeutic medication regimens against diagnoses for 242 institutionalized mentally retarded adolescents and adults selected for psychiatric treatment. The drugs had generally been prescribed by nonpsychiatrists, but diagnoses were determined by consensus of evaluation teams that included fully trained psychiatrists. According to widely accepted standards for psychopharmacologic treatment, 45.4% to 60.9% of the regimens were rated as appropriate and 39.1% to 54.6% were rated as inappropriate for the conditions diagnosed.

Adolescent↗
PubMedDate not supplied

Intellectual impairment in adolescent psychosis. A controlled psychometric study.

The relationship of cognitive impairment to the course of schizophrenia remains uncertain. By studying psychotic adolescents, 90% of whom were hospitalized for the first time, we hoped to reduce the influence of such confounding variables as lengthy disease process, neuroleptic treatment, and institutionalization. 39 psychotic adolescent subjects who fulfilled DSM-III criteria for schizophrenia, schizophreniform psychosis, paranoid schizophrenia, or atypical psychosis were compared to 41 non-psychotic adolescent psychiatric controls. Subjects were administered the Wechsler Intelligence Scale for Children-Revised, Peabody Individual Achievement tests of reading, reading comprehension, and mathematics, Bender-Gestalt, and Purdue Pegboard test within 3 weeks of admission to a psychiatric hospital. Performance IQ was significantly lower in the psychotic group (72 versus 93, P = 0.03). Thus, the IQ pattern in adolescent psychotic patients at an early stage in their illness was similar to the pattern displayed by chronic adult schizophrenic patients. Results were not consistent with theories of left hemisphere involvement in schizophrenia. Academic achievement was similar in both groups despite marked differences in performance IQ. Psychotropic medication had no significant impact on the results. In summary, deficits in processing novel material seem at the very least to be present at the onset of the psychotic disorder, though they may be non-progressive thereafter.

Adolescent↗
PubMed1979

Measuring the use of a principle by retarded adolescents and nonretarded children on a Redundancy Series Test.

A series test composed of geometric figures placed in redundant patterns was designed to measure the ability of retarded adolescents to use of principle. It was administered to institutionalized and noninstitutionalized retarded adolescents and to nonretarded children from nursery school through fourth grade. Results revealed that four of the items accounted for most of the errors and that these four critical items were particularly sensitive to an inadequate scanning strategy. The retarded groups showed a mental age lag at least 1 year, 6 months and did not perform above chance on the critical items.

Child↗
PubMed2004

Adolescent propensity for depressed mood and help seeking: race and gender differences.

BACKGROUND: Studies investigating the correlates of adolescent depression and suicidal tendencies have found that the probability of such tendencies vary by race and gender. However, while there exists evidence that most adolescents suffering from the above problems fail to seek (and obtain) help, the role of race and gender in determining the propensity to seek help for depression remains largely unexplored. AIMS OF STUDY: The study uses data from the 1996 round of Health Behavior in School-Aged Children' (HBSC), USA, which surveys a representative sample of more than 9000 adolescents enrolled in grades 6-10. Respondents are asked if they suffered from persistent depressed moods (lasting two weeks or more) over the past year, and whether they sought help while suffering from depressed mood, and if so, from whom. Questions are also asked about whether the respondent had self-injury ideation or actually attempted self-injury. Demographic and other information on respondents is also provided. The primary aim is to test whether there are significant differences between genders, and between non-Hispanic whites, non-Hispanic blacks, Hispanics and Asians in the likelihood of seeking help, and from whom, when depressed. Gender and race-ethnicity differences in the likelihood of being depressed are also explored to find if they correspond to results in the extant literature. METHODS: Multinomial logit models are used to estimate the likelihood of being depressed or at self-injury risk, and help-seeking behavior in event of depressed mood. Models are estimated for the full-sample and sub-samples who report depressed mood or are at self-injury risk. In addition to race and gender, all models control for additional demographic characteristics such as age, family structure, and family socio-economic status. RESULTS: Adolescent females are significantly more likely than adolescent males to suffer from depressed mood. However, adolescent males are less likely to ask for help than females (odds ratio: 0.72). All minority groups are more likely to suffer from depressed mood compared to non-Hispanic whites, but blacks are at lower self-injury risk. Blacks and Asians are especially prone not to ask for help, with the problem being particularly acute in case of black males and Asian males. DISCUSSION: The lower propensity of adolescent males to seek help for depression compared to females are in keeping with previous research. However, predicted values show that the majority of males and females with depressed mood or at self-injury risk do not seek help from anyone. Certain racial groups are also at greater risk for not asking for help for depression. This may have implications regarding racial differences in suicide rates, as well as racial differences in future life outcomes. The study suffers from the drawback that because the survey is confined to those enrolled in school, adolescents who are institutionalized for mental health problems or who have dropped out of school due to problems related to depression are not represented in it. IMPLICATIONS FOR HEALTH POLICIES: There have been efforts in the USA to educate the population about the problems of adolescent depression. However, the above results suggest that it may be useful to have additional educational efforts targeted at specific population groups, to educate them about the risks associated with depression, help overcome any stigma associated with depression and encourage help-seeking when suffering from depressed mood. IMPLICATIONS FOR FURTHER RESEARCH: A number of directions of future research are suggested. It would be useful to obtain information on the outcomes of help seeking - whether it actually led to obtaining help. It would also be useful to know the probability of an adolescent being diagnosed with depressed mood (perhaps by a primary care physician) even without actively seeking help. Regarding the racial differences, it would be useful to examine the extent to which such differences arise from immigration status, and also to have more extensive information about attitudes, familial expectations, religiosity, community ties, confidence in the medical system and other factors, so as to analyze further why some races are more prone to depression and averse to seeking help for depression than others. Finally, it would be useful to periodically revisit this topic with more contemporary data to see whether recent efforts at awareness raising has increased the odds of help-seeking among adolescents with depressed mood.

Adolescent↗
PubMed2004

[Change to the power of three--counselling for adolescents in a society which causes uncertainty].

The conditions for becoming adult have changed perceptibly for young people in the course of social modernization processes. Adolescents find themselves in increasingly complex and contradictory areas of life which offer them more choices of action, but also require of them more self-organisation and more decision-making processes in uncertain conditions. The adolescents primarily at risk of failing due to the changes in learning- and development-related tasks are those denied access to necessary coping resources. Owing to the profound effects of social change (for example, changed forms of family life, increased educational pressure) it can generally be assumed that young people have an intensified counselling need. Against this background, the present paper examines which new requirements for action arise in the institutionalized counselling of adolescents. In regard to this, hints are provided in the results of an evaluation study by the present author, within the scope of which adolescents were interviewed about their counselling experiences. Finally, counselling approaches are described which can contribute to facilitating access for young clients, and to structuring counselling in a more suitable way for adolescents (peer counselling).

Adaptation, Psychological↗
PubMed1989

Sexual victimization of child and adolescent patients.

Extrafamilial abuse of hospitalized or institutionalized patients has not often been studied. Five categories of caregivers (N = 272) reported physical, psychological and "socially acceptable" instances of abuse, with most incidents occurring one or more times per week. Abuse of children, especially sexual abuse, was singled out for further study. Case reports supplement the presentation. Implications for understanding abuse, for practice and for research are presented.

Adolescent↗
PubMed1982

Cognitive processes and perceived language performance of retarded persons.

The relationship between coding processes and ratings of the language performance of institutionalized, moderately retarded adolescents and adults was studied using an information processing model developed by Das, Kirby & Jarman (1975). Simultaneous and successive coding processes were found to relate to relational thought and to contextual grammatical structure (syntax). These results were discussed in terms of the relationship between coding and auditory-visual processing and the development of suitable language training programmes for retarded residents.

Adult↗
PubMed1985

"Mummies and babies" and friends and lovers in Lesotho.

This paper examines an institutionalized friendship among adolescent girls and young women in southern Africa. Lesotho's economy is based on migrant male labor which leaves the women dependent on male earnings or subsistence from the land, and also creates unstable marital relations. Young girls in the modern schools develop close relationships, called "mummy-baby," with slightly older girls. Sexual intimacy is an important aspect of these relationships. Mummy-baby relationships not only provide emotional support prior to marriage, but also a network of support for married and unmarried women in new towns or schools, either replacing or accompanying heterosexual bonds.

Adolescent↗
PubMed2007

Sexual behavior in high-functioning male adolescents and young adults with autism spectrum disorder.

Group home caregivers of 24 institutionalized, male, high-functioning adolescents and young adults with Autism Spectrum Disorder, were interviewed with the Interview Sexuality Autism. Most subjects were reported to express sexual interest and to display some kind of sexual behavior. Knowledge of socio-sexual skills existed, but practical use was moderate. Masturbation was common. Many subjects were seeking physical contact with others. Half of the sample had experienced a relationship, while three were reported to have had sexual intercourse. The number of bisexual orientations appeared high. Ritual-sexual use of objects and sensory fascination with a sexual connotation were sometimes present. A paraphilia was present in two subjects. About one third of the group needed intervention regarding sexual development or behavior.

Adolescent↗
PubMed1991

The Aberrant Behavior Checklist with children and adolescents with dual diagnosis.

The Aberrant Behavior Checklist (ABC; Aman, Singh, Stewart, & Field, 1985a, 1985b) is a 58-item third-party informant rating scale originally developed for institutionalized, low-functioning adolescents and adults. The present study investigated the appropriateness of the scale for youngsters with dual diagnosis of mental retardation and psychiatric disturbance. Over a period of 2 1/2 years, 204 patients (199 after data reduction) from a child psychiatry unit were rated twice daily by direct care staff. Data analysis addressed internal consistency, interrater reliability, criterion validity, and robustness of the factor structure. Internal consistency was satisfactory with alpha coefficients ranging from .82 to .94. Interrater reliability varied between subscales but was relatively low (Pearson correlations between .39 to .61). In terms of its criterion validity, the ABC was sensitive to psychiatric diagnoses and age and the original 5-factor structure was robust (congruence coefficients ranged between .80 to .89). Yet, only a relatively small proportion of the variance (31.5%) was explained by factor analysis indicating possible limitations of the ABC for this population. Given the paucity of assessment instruments for this particular population and the difficulty involved in developing new population-specific instruments, the ABC can be recommended for children and adolescents with dual diagnosis.

Adolescent↗
PubMedDate not supplied

[The consumption of tobacco, alcohol and other drugs by adolescent Spanish students].

OBJECTIVES: This study was undertaken in the mid-1990s (1994) to describe the use of tobacco, alcohol, and non-institutionalized drugs among pre-adolescent and adolescent Spanish students. METHODS: Information was collected within the framework of a periodic transversal study of life styles among European students, with particular emphasis on health-related habits. In the current study we present the results of the last survey carried out in Spain within the context of this study (1994), which involved a representative sample of Spanish students 11, 13, 15, 17 and 18 years-old (n = 6,711). An anonymous questionnaire was completed by the students in class. The survey sampling uses proportionate stratification and multistage sampling. RESULTS: In 1994, 49% of the Spanish students in this age group had tried tobacco. Twenty-four percent were sporadic or regular smokers. There was a large proportion of female smokers than male smokers (27% vs 20%). The overall proportion of smokers increased from 3% at 11 years to 47% at 18 years. One third (33%) of the 18-year-old students smoked daily. Eighty-four percent of the students of this age indicated that they had tried one or more types of alcoholic beverage. Twenty-one percent consumed alcohol regularly (at least once a week). Regular alcohol use was somewhat more common among males (24%) than among females (19%). Forty-six percent of the 18-year-old students consumed alcoholic beverages regularly and 66% had been intoxicated one or more times. Almost one fifth (18%) of the 13-to-18 year-old students indicated that they had tried some type of non-institutionalized drug, although the current rate of consumption was 8%. Cannabis was the drug most frequently tried (18%) and the drug most often consumed at present (8%), followed by cocaine and heroin. More males than females had tried non-institutionalized drugs. DISCUSSION: Analysis of the data revealed that adolescent tobacco use is increasingly frequent among females. Alcohol use continues to be widespread among Spanish pre-adolescents and adolescents. Alcohol use begins in childhood and becomes consolidated in adolescence. The results suggest, in relation to gender differences in the use of tobacco, alcohol, and non-institutionalized drugs, that there is a strong tendency toward the homogenization of these habits between genders. It is necessary to emphasize the preventive measures of drug dependence among Spanish pre-adolescents and adolescents.

Adolescent↗