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Adolescent suicidal risk: psychological, problem solving, and environmental factors.

This study examined the life stress and problem-solving interactional model of suicide proposed by Clum, Patsiokas, and Luscomb (1979). Thirty-three hospitalized suicidal adolescents were compared with 21 adolescents hospitalized for other psychiatric problems and with 89 controls. The assessment battery was composed of psychological measures, problem-solving measures, and environmental and family measures. The discriminant analyses revealed that the suicide group could be discriminated from the psychiatric control group but not from the high school control group. Unexpectedly, life stresses did not contribute to the identification of current suicide risk. The results suggest the importance of assessing suicide risk at the time of admission to minimize any subsequent changes in the risk group.

Adaptation, Psychological↗

The validity of the Carlson Psychological Survey with adolescents.

The present study examined the factorial and predictive validity of the Carlson Psychological Survey with male adolescent offenders (n = 350). Factor analysis revealed that, in general, the Carlson is well represented by five scales. Of the four content scales, Antisocial Tendencies proved to be the best of a variety of predictors of institutional adjustment. Thought Disturbance and Self-Depreciation were unrelated to staff ratings on the Behavior Problem Checklist 'Personality Problem' Scale; however, they were positively correlated with the Social Anxiety and Withdrawal scales of the Jesness Inventory. The pattern of these correlations, as well as those between Antisocial Tendencies and the behavioral data, suggest that the Carlson Psychological Survey may be a good indicator of internalizing versus externalizing behavioral and attitudinal styles.

Acting Out↗

Clinical and psychological characteristics of adolescents at risk of mood disorders compared with adolescents with suicidal behavior.

Suicide is one of the leading causes of death among adolescents, yet little is understood about the biopsychosocial factors related to suicidality. The demographic, clinical, and biological characteristics of adolescents with and without psychiatric histories may help inform mechanistic approaches to treatment of mood disorders and suicidality. The 'characterizing the inflammatory profile and suicidal behavior in adolescents' and 'RAD arm of the Texas Resilience Against Depression' studies aimed to characterize the clinical and biological profiles of youth with suicidal behavior and youth at risk for mood disorders, compared to healthy adolescents (n&#xa0;=&#xa0;75 in each group). Here, we report the descriptive baseline clinical and psychological characteristics of adolescents at risk of mood disorders and those with suicidal behavior. The adolescents with suicidal behavior reported 3.53 lifetime suicidal events on average, predominantly reported moderate to very severe depression (34.7%, 24%, to 9.3%), moderate to severe anxiety (58.6%), low optimism (91.9%), and mild (39.2%) to moderate (28.4%) degree of hopelessness. The at-risk adolescents predominantly reported no depression (60%) or anxiety (68.9%), moderate optimism (50%), and a positive outlook (85.7%). Healthy adolescents predominantly reported no depression (88.3%) or anxiety (93.2%), moderate optimism (59%), and a positive outlook (87%). The adolescents with suicidal behavior and those at risk of mood disorders exhibited significantly higher irritability and borderline personality disorder features (uncorrected p&#xa0;=&#xa0;0.02 to p&#xa0;<&#xa0;0.001) and lower resilience compared to healthy adolescents. Ongoing investigations using the longitudinal clinical and biological data will help identify the immune biosignatures of suicidality in youth.

Humans↗

[Subjective health complaints and psychological distress in adolescents aged 15-19 years in Poland].

AIM: To analyse the relationships between selected subjective health complaints and psychological distress of 15-19 yrs old adolescents in Poland. MATERIAL AND METHODS: The health survey of the population was conducted by the Central Statistical Office in 1996 in 19203 households inhabited by 62749 people. Dates were received from 5407 adolescents of 15-19 yrs, using AZD-2 questionnaire. Questions concerning subjective health complaints and psychological distress, tested by modified scale GHQ-12 (General Health Questionnaire), was answered by 3708 adolescents. RESULTS: Subjective health complaints reported 1.9-27.5% of adolescents in the age of 15-19. They experienced feeling nervous and irritability the most often (more than 20% under survey), the most rarely -- insomnia and apathy. Every tenth questioned adolescent at the age 15-19 experienced psychological distress. Psychological distress occurred more often in girls, people living in town and raised with age. Risk of subjective health complaints was higher for people with distress. The highest risk (8 times) was for apathy and insomnia. Psychological distress increased the risk of subjective health complaints for boys more than for girls.

Adolescent↗

Reflex sympathetic dystrophy in children.

Reflex sympathetic dystrophy is a syndrome characterized by pain in one or more extremities, usually associated with vasomotor changes. Its occurrence in childhood has long been thought to be rare. We describe six cases of pediatric reflex sympathetic dystrophy and suggest that this syndrome could be underdiagnosed in children and adolescents. Psychologic problems frequently play a role in this disorder, which often can be treated conservatively. We also point out that the diagnosis is mainly clinical. An early diagnosis can avoid unnecessary tests and potentially can improve response to treatment, and prognosis.

Adolescent↗

Adolescent sexuality.

Adolescent sexuality is surveyed from three angles: the emergence of adult sexual functions, the participation in sexual behaviors, and the relationship of sexuality to the developmental tasks of adolescence. Common medical problems arising from adolescent sexual activity are also discussed.

Adolescent↗

Postoperative psychological functioning of adolescent transsexuals: a Rorschach study.

The Rorschach Comprehensive System was used to assess postoperative psychological functioning in transsexuals who applied for sex reassignment in adolescence. We investigated a group of 22 consecutive adolescent transsexuals, who were otherwise psychologically well adapted. Nineteen subjects provided valid Rorschach protocols before and after sex reassignment. The most notable change found was an increase in X + %, reflecting a decrease in both distorted perception and idiosyncratic perception. Little support was found for the idea of major psychological deterioration for the patients as a group. Rather, the results suggest stability in psychological functioning over time. The Rorschach findings are consistent with questionnaire data from earlier studies, with the exception that the Rorschach data may point to some improvement in reality testing.

Adolescent↗

Psychological factors and adolescent illicit drug use: ethnicity and sex differences.

Of four psychological factors examined in a representative sample of New York State secondary school students, only two, depressive mood and normlessness, show a positive relationship with the use of illicit drugs, especially drugs other than marihuana. The association of depressive mood and normlessness with illegal multiple drug use varies by ethnicity and sex, being consistently stronger among girls and among whites. In addition, depressive mood is negatively related to multiple drug use for black and Puerto Rican boys. These findings suggest that psychological factors play a different role in adolescent drug involvement within various social and cultural groups.

Adolescent↗

The relationship between weight and psychological functioning among adolescent girls.

This study investigated whether Body Mass Index (BMI) was associated with various aspects of psychological functioning in a sample of largely Caucasian adolescent girls. Three hundred sixty-five adolescent girls ranging from ages 14 through 19 were assessed for general psychological functioning utilizing the Symptom Checklist-90-Revised (SCL-90-R), and functioning specific to eating, shape and weight utilizing the Eating Disorders Inventory (EDI). Excess weight was associated with higher scores on the Bulimia, Body Dissatisfaction and Drive for Thinness subscales of the EDI. Excess weight was not, however, associated with general psychopathology or any of the subscales of the SCL-90-R. The results suggest that excess weight may carry risk for pathology specifically related to eating, shape and weight in adolescent girls, but not for general forms of psychopathology.

Adolescent↗

Parent factors and adolescent sickle cell disease: associations with patterns of health service use.

OBJECTIVE: To examine relationships among parent characteristics (parent-adolescent relationship, parents' illness knowledge, and parents' perceptions of illness-related burden) and use of routine and urgent health services among adolescents with sickle cell disease (SCD). METHOD: Seventy adolescents, ages 12-18, and their parents completed questionnaires assessing illness knowledge, perceptions of illness burden, parent-adolescent relationships, and adolescents' psychological functioning. Information about pain, routine services (i.e., care at home, clinic visits) and urgent service use (i.e., emergency department visits, hospitalizations) was obtained from parents and medical records. RESULTS: After we controlled for disease severity and life events, parents' perception of more illness-related stress was the strongest predictor of both types of service use. Greater parental knowledge about SCD also related to higher frequency of routine service use. Disease severity was strongly associated with frequency of urgent service use. CONCLUSIONS: Both parent characteristics and disease severity were associated with patterns of service use. Enhancing aspects of parental functioning may help families make adaptive decisions regarding health care services for SCD pain management.

Adolescent↗

Validity and reliability of the Parent Satisfaction Questionnaire.

The development of a postal consumer satisfaction questionnaire for a child and adolescent psychology service is reported. A preliminary analysis of content, construct and concurrent validity suggests that the questionnaire has an acceptable degree of validity. Factor analysis identified five factors with three being identifiable as relating to the outcome of contact, appointments and the timing of contact. The remaining two factors were minor dyads which were difficult to interpret. The reliability and utility of the questionnaire is good, proving a useful way of identifying service shortfalls and directing service change. The need to methodologically evaluate consumer satisfaction questionnaires is stressed and their routine use in monitoring and assuring service quality highlighted.

Adolescent↗

Teenage sexual behaviour: attitudes towards and declared sexual activity.

Although the teenage pregnancy rates in the UK are falling in the 16 to 19 year old range, they are still rising in the 13 to 15 year olds. Overall, they remain one of the highest within Western Europe. Teenagers continue to present a challenge to the health services due to the increase in their sexual risk taking behaviour, the earlier age at which they are starting sexual activity and a reluctance to utilise services available to them. In an attempt to develop current services and make them more 'user friendly', a sexual health needs assessment was carried out on teenagers, part of which looked at their attitudes towards risk taking sexual behaviour and their declared sexual behaviour. A quantitative survey, using a questionnaire in schools, was answered by 1500 pupils aged between 13 and 18 years old, and showed that the majority of teenagers had declared some form of sexual contact with a partner with a degree of sexual activity increasing with age. Twenty per cent of 13 year olds reported that they had already had either full or oral sexual intercourse with a partner. Feeling peer pressure, not knowing the facts about sexual risk taking and a declared intent that would increase the likelihood of putting themselves or others at risk sexually were significantly more likely in the younger teenage boys surveyed. This study confirms that there remain many different factors involved in teenagers' decision-making processes, about their developing attitudes towards sex and their resultant behaviour. Despite a lack of maturity, such opinions and attitudes are bringing about definite views and sexual behaviour patterns in teenagers as young as 12 or 13 years old who are becoming fully sexually active. In particular teenage boys are becoming fully sexually active at a younger age than the girls and are taking risks in doing so. They are being influenced by peer pressure, condoning promiscuity and are declaring the intent to practice unsafe sexual intercourse. Their level of maturity would appear to be inadequate for them to comprehend the implications and consequences of their actions. This study has shown a need for developing adequate education and provision of sexual health services for teenagers, particularly for teenage boys, and that this may go some way in helping to address the imbalances found.

Adolescent↗

ACUTE CATATONIC REACTION OF ADOLESCENCE.

In a study of 21 cases of catatonic schizophrenic reaction of adolescence, sexual conflict situations and stern religious orientation of the family were noted in most cases. Incest was a factor in four of the female patients and masturbatory guilt was a prominent reaction in the remainder. Sex education was mostly misinformation and threats of dire consequences for sexual activity. Fourteen of the cases involved broken homes for significant periods of childhood or adolescence. It was hypothesized that sexual conflict situations grew out of incompatible socio-cultural attitudes and normal adolescent psychological and physiological drives. We formulated the "defined body contact" technique as a means of facilitating the reversal of the catatonic behavior, which we saw as the primary device whereby the patient limited physical contacts. The contacts we used in this technique were defined explicitly and implicitly as non-sexual.The catatonic symptoms remitted in days to several weeks in 13 of the cases. Seven patients required electroshock therapy. Twenty of the 21 patients returned to their homes or to non-institutional residences. The length of hospitalization was materially influenced by the degree of readiness of the outside environment to accept the returnee.

Adolescent↗

Evidence-based assessment of child and adolescent disorders: issues and challenges.

The main purpose of this article and this special section is to encourage greater attention to evidence-based assessment (EBA) in the development of a scientifically supported clinical child and adolescent psychology. This increased attention is especially important in light of (a) the omission of assessment considerations in recent efforts to promote evidence-based treatments for children and (b) ongoing changes in the nature of clinical child assessment. We discuss several key considerations in the development of guidelines for EBA, including the purposes of assessment, the role of disorder or problem specificity, the scope of assessment, assessment process parameters, possible "cross-cutting" assessment issues, psychometric considerations, and issues related to the clinician's integration of assessment data. We conclude the article with suggestions for how current, summary information on EBA can be developed, maintained, and disseminated.

Adolescent↗