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Parental satisfaction with intervention: differences between respondents and non-respondents to a postal questionnaire.

Parental satisfaction with a child and adolescent psychology service was assessed by postal questionnaire. Follow-up interviews were conducted with 88 percent of the sample, 36 postal questionnaire respondents and 21 non-respondents. Questionnaire non-respondents were more likely to have dropped out of therapy, had fewer appointments, evaluated the service more negatively and differed from respondents in their particular sources of dissatisfaction. They were significantly more dissatisfied with where they met the psychologist and in what family composition they were seen whereas questionnaire respondents were more dissatisfied with the wait before first appointment and the total number of appointments offered. The implications for future studies are discussed and the need to assess the satisfaction of postal non-respondent emphasized.

Adolescent Psychiatry↗

Ethnicity, social deprivation and psychological distress in adolescents: school-based epidemiological study in east London.

BACKGROUND: In adults the prevalence of psychological distress varies in different ethnic groups, and this has been explained by differences in socio-economic status. Is this also the case in adolescents? AIMS: To examine whether ethnic differences in prevalence of psychological distress in adolescents are associated with social deprivation. METHOD: A cross-sectional questionnaire survey was used to assess 2790 male and female pupils, aged 11-14 years, from a representative sample of 28 east London secondary schools. RESULTS: Rates of psychological distress were similar to rates in UK national samples in boys and girls. Bangladeshi pupils, although highly socially disadvantaged, had a lower risk of psychological distress (OR=0.63, 95% CI 0.4-0.9). Non-UK White girls had higher rates of depressive symptoms (OR=1.54, 95% CI1.1-2.2). CONCLUSIONS: High rates of depressive symptoms in non-UK White girls may be related to recent migration. Low rates of psychological distress in Bangladeshi pupils in this sample relative to White pupils, despite socio-economic disadvantage, could be associated with cultural protective factors that require further investigation.

Adolescent↗

The ability of adolescents to predict future outcome. Part I: Assessing predictive abilities.

Because adolescents are generally viewed as "risk-takers," an assessment of planning and decision-making skills during the teenage years may reveal why this developmental group tends to engage in dangerous behaviors. One area in which these abilities have significant consequences for future outcome is pregnancy, a condition that requires a decision to either give birth or abort. Previewing, a process by which caregivers introduce infants to the physical sensations of imminent developmental change and the implications of such change on their relationship, may affect the adolescent's ability to predict upcoming change. This paper explores previewing skills during the adolescent years and how this capacity affects the teenager's orientation toward future outcomes.

Adolescent↗

Adolescents' views regarding sexual history taking.

To address the health needs of adolescents, health care providers need to understand adolescent perceptions of the sexual history taking process. Adolescents (n = 113) were recruited from two sources of health care to complete a questionnaire regarding sexual history taking issues. The results revealed that there were differences in demographics, practice characteristics, and communication strategies between the private office and the hospital clinic. Attitudes and beliefs related to the discussion of sensitive issues were similar. Most adolescents would like health care providers to discuss sensitive topics directly. It is important for health care providers to feel comfortable initiating discussion of sensitive issues directly.

Adolescent↗

Psychological aspects in children and adolescents with hypopituitarism.

Psychological studies in children with stunted growth have partly shown inconsistent results due to heterogeneity of samples and the use of non-standardized test procedures. We have examined patients with proven hypopituitarism using a selection of standardized and age-related psychological tests. Forty-eight patients, 32 male, 16 female, age 6 to 26 years with isolated growth hormone deficiency (n = 22) and multiple pituitary deficiencies (n = 26) were investigated. The patients had had hormonal substitution therapy for 0.1-16.8 years. Test procedures included evaluation of intelligence and various personality parameters. Full score IQ was in the average range. Despite these findings a high percentage of patients had delayed schooling or had to repeat a class. They were normal regarding emotional balance and frustration tolerance and did not show any tendency towards depression or psychosomatic disorders. Social behavior was characterized by an infantile attitude toward their personal environment. The patients showed a tendency to avoid aggressiveness in frustrating situations. In contrast to the results of these tests, a non-standarized interview demonstrated that the majority of patients had serious problems because of their short stature, including difficulties in finding social contacts. Continuous medical and psychological guidance is therefore recommended.

Adolescent↗

Preventing teen pregnancy through persuasive communications: realities, myths, and the hard-fact truths.

Effective campaigns are desperately needed to combat the serious social problem of teen pregnancy. However, public health campaigns are most often noted for failures, rather than successes. One reason for a campaign failing to have the intended effect is lack of theoretical guidance at the formative evaluation stage. The study reported here is a theoretically-based formative evaluation with inner city teens. Six focus groups were conducted to determine knowledge, attitudes, beliefs, and recommendations for effective campaigns to deter teen pregnancy. The results indicate that campaign messages need to combat positive attitudes toward pregnancy, negative attitudes toward birth control, the perception of personal invulnerability, and emphasize the negative consequences of sexual intercourse. This study's findings also suggest that campaigns with these messages need to start at an early age in order to effectively prevent teen pregnancy.

Adolescent↗

Contraceptive method choices among adolescents in a Nigerian tertiary institution.

This study was undertaken to describe adolescents, use of contraceptive methods and to examine factors that motivate their choice. Face-to-face interview of single, randomly selected 971 males and females aged 18-24 years in a Nigerian tertiary institution was conducted. Among sexually active males and females 72 percent and 81 percent respectively had ever used contraception. The commonest methods ever used by the males and females respectively were the condom (43 percent) and rhythm (31 percent). While females were mainly motivated by pregnancy prevention irrespective of the sexual relationship, the males were more concerned about disease prevention in unstable sexual relationships. However, adolescents whose choice was motivated by disease prevention did not choose the condom significantly more frequently than other methods. The college clinic, complimented by other programmes, should be strengthened for reproductive health services.

Adolescent↗

Teenagers' knowledge of human sexuality and their views on teenage pregnancies.

There is concern about poor knowledge of human sexuality and a high rate of teenage pregnancies among Blacks. The primary aim of the study was to measure the knowledge that teenagers have on human sexuality and to identify the sources from which they obtain such knowledge. The secondary aim was to detect how teenagers perceive the teenage pregnancy problem and its consequences. A descriptive study was undertaken. Questionnaires were handed out and collected from 210 teenagers in two Senior Secondary Schools at a Black township near Empangeni. The study revealed that teenagers have reasonable knowledge about the anatomy and development of the reproductive organs at puberty but lacked sex counselling which resulted in their failure to understand the implications of sexual behaviour. The levels of knowledge an utilisation of the Youth Health Services was found to be low. The study also revealed a high level of awareness of the negative consequences of teenage pregnancies. The teenagers had numerous suggestions to make for the prevention of teenage pregnancies.

Adolescent↗

Why pregnant adolescents say they did not use contraceptives prior to conception.

OBJECTIVE: In this study we attempted to learn why childbearing adolescents failed to use contraceptives prior to conception. We hypothesized that among adolescents who elect to bear their children, positive and/or ambivalent feelings about having a baby are the most frequently cited reasons for not having used contraceptives. STUDY DESIGN: This is a cross-sectional, clinic-based survey of a racially and ethnically diverse group of 200 consecutively enrolled, poor, pregnant, 13-18-year-old patients in an adolescent-oriented maternity program. The participants completed a self-administered questionnaire which elicited information about environmental and personal risk factors for inconsistent use of contraceptives and information about the reasons they had not used contraceptives consistently prior to conception. Student's t-tests, Chi-square, and logistic regression analyses were used. RESULTS: The most frequently cited reasons for not using contraceptives prior to conception were: "I didn't mind getting pregnant" (20%) and "I wanted to get pregnant" (17.5%), followed by "I was using birth control but it didn't work (broke)" (12%), "I thought there was something wrong with me and I couldn't get pregnant" (9%) and "I just didn't get around to it" (9%). Teenagers who cited positive and/or ambivalent attitudes toward childbearing as their primary reason for not using contraceptives at the time of conception did not differ from others with regard to age, Medicaid status, gravidity, parity, frequency of living with parents, partner's age, depressive symptoms, or perceived family support. They were, however, more likely to have known the father of the baby for more than 6 months at the time of conception [odds ratio (OR) 2.53; 95% confidence interval (CI) 1.22-5.26) and to have dropped out of school (OR) 2.15; 95% CI 1.10-4.26]. CONCLUSIONS: The study hypothesis was supported. The absence of negative attitudes toward having babies rather than negative attitudes toward contraceptives is the most commonly cited reason for nonuse of contraceptives among childbearing adolescents. The results of this study may enable health care and social service providers to design more effective programs for preventing first and subsequent adolescent pregnancies.

Adolescent↗

The younger sisters of childbearing adolescents: their attitudes, expectations, and behaviors.

To examine the precursors of the disproportionately high rates of early childbearing among the younger sisters of adolescent mothers, this study compared the attitudes, expectations, and behaviors of early adolescent girls (M age = 12.93) who had an adolescent childbearing sister (n = 75) to those of early adolescent girls who had only adolescent nonchildbearing sisters (n = 348). Results indicated that the younger sisters of childbearing adolescents were consistently different from the younger sisters of nonchildbearing adolescents on key characteristics known to be correlated with early sexual activity and adolescent childbearing: that is, they were more accepting of nonmarital adolescent childbearing, perceived younger ages for typical life-course transitions (best age to get married, have first child), had more pessimistic school and career expectations, and were more likely to have engaged in problem behaviors (smoke cigarettes, skip school). These younger sister characteristics were associated with a nonvirgin sexual status in the current sample and with high closeness and high rivalry with the childbearing sister but could not be accounted for by such within-family experiences as subjects' mothers' permissiveness or lack of mother-daughter communication. Findings suggest the mechanisms by which the younger sisters of childbearing teens themselves become vulnerable to early parenthood.

Adolescent↗

A comparison between adolescent and adult women on prenatal anxiety and self-confidence.

The purpose of this study was to investigate anxiety and self-confidence in adolescent and adult pregnant women. Thirty-five adolescents, ages 13 to 16, and 58 adult women, ages 21 to 33, participated in this study. The majority of the sample was black and unmarried, and all attended a low-risk prenatal clinic for a first pregnancy. Spielberger's State-Trait Anxiety Inventory (STAI) and Pharis' Self-Confidence Scale were administered during the women's second trimester of pregnancy. Results indicated significant negative correlations for both state and trait anxiety during pregnancy and self-confidence for all women, but no significant differences in anxiety and self-confidence between the two groups. Results indicate the need for nurses to develop and implement plans for decreasing anxiety and enhancing self-confidence of all pregnant women.

Adolescent↗

Abuse of adolescents: what can we learn from pregnant teen-agers?

One of the most perplexing issues for nurses working with abused women is the extent of violence experienced by teen-agers. This article presents research findings from a study of pregnant women and teen-agers in Baltimore and Houston that found 32% of pregnant teen-agers reported having been physically or sexually abused in the prior year. The rate of abuse during pregnancy was 22% for teen-agers. Teen-age violence is discussed in terms of possible reasons for teen-agers to be reluctant to report abuse and nursing considerations in the assessment and intervention of adolescents experiencing abuse.

Adolescent↗

The Women's Centre in Jamaica: an innovative project for adolescent mothers.

In 1978 the Jamaican Women's Bureau established the Women's Centre, the first project in the developing world to help pregnant teenagers avoid the usual hardships of poverty and dependence. The women take courses in academic subjects and prenatal and postnatal health, and receive good medical care. Fathers and parents are involved in counseling sessions where practical life skills, including family planning, are emphasized. The young mothers improve dramatically in self-confidence, self-esteem, and in their ability to take care of their babies. The Centre's success has helped to loosen the policies of the Jamaican government on the education of pregnant school-age women.

Adolescent↗

Prospective study of psychological development of adolescent female athletes: initial assessment.

PURPOSE: This study aimed at assessing the impact of physical training on psychological functioning at the onset of a prospective study of psychological and somatic maturation of adolescent female athletes. METHODS: Twenty-seven highly trained gymnasts aged 12.7 +/- 1.1 year (mean +/- SD, training load = 18-26 hr/week) and 16 age-matched but moderately trained swimmers (13.0 +/- 0.9 yr, training load 4-15 hr/wk) were submitted to standardized somatic and psychiatric examinations during training camps. RESULTS: Gymnasts were significantly shorter, lighter and thinner (p < 0.001) than swimmers. Their bone age was moderately but significantly retarded (-1.42 +/- 0.99 yr, p < 0.001) in contrast with swimmers in whom it was adequate for chronological age (+0.28 +/- 0.94 year, ns). Only 7.4% of gymnasts had already had menarche in contrast with 50% of age-matched swimmers (p = 0.003). Psychological functioning was considered as normal in all subjects. However, seven athletes including 3/27 gymnasts and 4/16 swimmers (p = 0.394) were considered as subjects "at risk" to develop a manifest mental disorder over time. Ten gymnasts (41.7%) presented with a global delay in psychological maturation, whereas no such case was observed among swimmers (p = 0.015). No correlation could be established between psychological delay and pubertal retardation (p = 0.210). CONCLUSION: Strenuous training in gymnastics for more than 1 yr has so far no detectable interference with the normal maturational events of adolescence. The outcome of athletes at risk to develop psychopathology as well as those with a global delay in psychological maturation who presented as if they were still in the latency period, remains uncertain.

Adolescent↗

Attitudes, knowledge, and behavior regarding condom use in urban black adolescent males.

This study was conducted to determine male adolescent behavior, attitudes, and knowledge concerning the use of condoms. Subjects were 241 sexually active black adolescent males attending an inner-city adolescent medicine clinic who were surveyed using a structured interview technique. Factors associated with condom use included higher grade level, > or = 2 sexual partners in the past six months, communication about contraception with sexual partner(s), desire for sexually transmitted disease (STD) prevention when contracepting, and parental suggestion to use condoms. Variables not associated with condom use included older age, minimal level of knowledge about condom use, history of having impregnated a partner or of having contracted an STD, desire for pregnancy prevention, suggestion by friends to use condoms, or partner dissatisfaction with condoms. Using multivariate logistic regression analysis, the following variables in combination were able to correctly classify respondents as condom users or nonusers in 74% of cases: higher knowledge score, reported communication about contraception with one's partner(s), > or = 2 partners in the past six months, and higher socioeconomic status. These findings suggest that, for the study population, interventions directed toward improving knowledge about condoms, school achievement, and communication with parents and partners may be effective in increasing condom use.

Adolescent↗

The effects of rational stage directed imagery on self-concept and reduction of psychological stress in adolescent delinquent females.

This study examined the effect of four treatment conditions on self-concept and reduction of psychological stress in adolescent delinquent females. The treatments were Rational State Directed Imagery, a cognitive behavioral approach that utilized intensive muscle relaxation and vivid-emotive-imagery, a rational (cognitive) restructuring treatment, a placebo condition, and a no treatment control. Ss were assigned randomly to one of these treatment groups, which met 1 hour per week for 6 consecutive weeks, with in-vivo homework assignments also utilized. Statistically scale were noted for the RSDI group at the posttest and at a 2-month follow-up, which supports the therapeutic efficacy of this treatment. Support was found for the effectiveness of the rational (cognitive) restructuring approach immediately posttreatment; however these effects disappeared at the 2-month follow-up. The placebo and control groups showed no significant effects at either posttreatment or the follow-up. These results suggest that RSDI has potential for use as a short-term psychotherapeutic approach when self-concept modification is a primary goal.

Adolescent↗