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Results for “ADOLESCENT PSYCHOLOGY”
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Why adolescent gynecology? Pediatricians and pelvic examinations.
Gynecologic issues are an important part of the medical care of adolescent females. All diagnostic possibilities must be considered in assessing such patients. It is vital that pediatricians feel comfortable approaching these issues and provide reassurance and expertise to their adolescent patients.
Psychiatric aspects of adolescent pregnancy.
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Threat of war in minds of children.
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Adolescent abortions in the United States.
Despite the fact that adolescent females have a more negative reaction to abortion than older women, they are apparently more likely to use legal abortion to prevent unplanned births. The most important variable affecting abortions among teenagers is the significantly later gestational age at which their procedures are performed. After adjusting for this factor, teenagers have generally lower morbidity and mortality rates from legally induced abortions than do older women. The scientific literature is inconclusive about whether present abortion methods will have any harmful effect on subsequent desired pregnancies. Current efforts to restrict abortion services for teenagers will probably produce a negative public health impact by encouraging delay in obtaining abortions after deciding to terminate a pregnancy.
The effectiveness of contraceptive programs for teenagers.
This paper critically reviews the effectiveness of adolescent family planning programs in the United States. Various models for evaluating family planning programs and the findings from empirical studies of adolescent programs are reviewed. During the past decade there have been major increases in the availability and utilization of contraceptive services by adolescents. Most of those who are sexually active are now aware that these services exist. Program continuation rates among adolescents are not high, in part, because of the sporadic nature of adolescent sexual activity. Data on contraceptive continuation and pregnancy rates in these programs are limited, since few studies follow up clinic noncontinuers. Among clinic continuers pregnancy rates are relatively low, suggesting that at least some programs are effective in reducing pregnancy and/or fertility rates (number of children born) in their target populations. Ecological analyses seem to indicate that programs have had an impact on adolescent marital fertility.
Parenting knowledge among adolescent mothers.
The parenting knowledge of first-time adolescent mothers who chose to receive special services from the public school system was measured. These data are thought to be the first reported on the adolescent's awareness that parenting influences the present and future well-being of the infant and mother. Knowledge level was high and no different from that of adult primiparous mothers of comparable socioeconomic status. Correct response to individual items on the infant Caregiving Inventory (ICI) ranged from 84% to 96% for adolescents. These results are contrary to the previous reports of deficient parenting by adolescents. They reflect the need for continuing investigation of adolescent mothers' parenting knowledge in evaluating their effectiveness as parents.
Adolescent sexual risk behavior: a multi-system perspective.
Adolescents are at high risk for a number of negative health consequences associated with early and unsafe sexual activity, including infection with human immunodeficiency virus, other sexually transmitted diseases, and unintended pregnancy. As a result, researchers have attempted to identify those factors that influence adolescent sexual risk behavior so that meaningful prevention and intervention programs may be developed. We propose that research efforts so far have been hampered by the adoption of models and perspectives that are narrow and do not adequately capture the complexity associated with the adolescent sexual experience. In this article, we review the recent literature (i.e., 1990-1999) pertaining to the correlates of adolescent sexual risk-taking, and organize the findings into a multisystemic perspective. Factors from the self, family, and extrafamilial systems of influence are discussed. We also consider several methodological problems that limit the literature's current scope, and consider implications of the adoption of a multisystemic framework for future research endeavors. We conclude with a discussion of the implications of the available research for practitioners working to reduce sexual risk behavior among adolescents.
An assessment of nicotine dependence among pregnant adolescents.
Studies have reported that between 28 and 62% of pregnant teenagers smoke (Cornelius, Taylor, Geva, & Day, 1995; Trollestrup, Frost, & Starzyk, 1992). Because smoking is prevalent among pregnant teenagers, the purpose of this research is to assess nicotine dependence in this high-risk group. This study analyzed baseline data from a sample of pregnant teen smokers who had volunteered to participate in a smoking cessation study (N = 94). Nicotine dependence was measured by adapting the Fagerstrom Tolerance Questionnaire (FTQ; Prokhorov, Pallonen, Fava, Ding, & Niaura, 1996), and by a 6-item withdrawal symptom scale. The overall FTQ score found among pregnant adolescents was 3.10 (SD = 2.3) compared to the mean overall FTQ score among vocational-technical students of 4.27 (SD = 2.2) (Prokhorov et al., 1996). Duration of smoking in years was significantly correlated with the overall FTQ score (r = 0.43, p < .01). Quantity of smoking, as measured by average number of cigarettes smoked, significantly correlated with overall FTQ scores (r = 0.67, p < .01). Lighter smokers were more likely to have previously attempted to quit, however, among the quit attempters, those who smoked 10+ cigarettes per day reported greater severity of withdrawal symptoms than those who smoked less per day. Prenatal education and smoking cessation programs for pregnant teenagers, and pregnant women in general, need to consider that nicotine dependence is an important issue. Early pregnancy may be an opportune time to intervene among pregnant smokers; incentives may be necessary to attract those women who are the heaviest smokers, and possibly the most dependent on nicotine.
Risky choices: the dangers of teens using self-induced abortion attempts.
Although researchers and practitioners alike have long been aware of the existence and dangers of self-induced abortions, virtually no research exists on this topic. This article describes methods of self-induced abortion from current and historical literature. A case study of an adolescent using quinine is discussed to highlight both the reasons some adolescents choose to self-abort and the possible dangers of using such methods. Serious risks to the adolescent are associated with any self-induced abortion attempt. Nurse practitioners are in a key position to assess an adolescent's risk factors for self-induced abortion attempts and to educate about the dangers of such attempts.
Homelessness and adolescents.
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Preventing the high-risk sexual behavior of adolescents: focus on HIV/AIDS transmission, unintended pregnancy, or both?
Adolescents are at high risk for negative health outcomes associated with unprotected sexual intercourse including infection with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and unintended pregnancy. That unprotected sexual intercourse is the risk behavior common to both problems has not been fully capitalized on in prevention programs. Limited knowledge about the effects of type-of-outcome expectancy (i.e., disease vs. pregnancy) on the association between risk perceptions and precautionary or health-protective sexual behavior makes it difficult to determine what preventive approach would be most effective with adolescents. The literature suggests that pregnancy prevention is a greater concern for adolescents than disease prevention. This review focuses on the implications of these differential risk perceptions for HIV/AIDS prevention programs targeting adolescents.
Perceived consequences of teenage childbearing among adolescent girls in an urban sample.
PURPOSE: The purpose of this study was to examine the perceived positive consequences of teenage childbearing among female adolescents, and to determine whether perceived consequences of teenage childbearing are associated with other attitudes and sexual risk behaviors. METHODS: The sample consisted of 584 female students attending three urban high schools in Los Angeles, California. The respondents' mean age was 15.8 years, and 72% were Hispanic/Latina. Respondents completed a paper-and-pencil survey assessing their attitudes and risk behaviors relevant to teenage pregnancy. Multiple regression and logistic regression analyses were used to examine the associations between perceived consequences of teenage childbearing and demographic variables, educational variables, parental characteristics, psychosocial variables, attitudes, and sexual behavior. RESULTS: Higher scores on a scale of perceived positive consequences of teenage childbearing were associated with increased risk of sexual intercourse and unprotected sexual intercourse. Higher scores on this scale were found among girls who were Latinas, were non-U.S. natives, had low levels of expected educational attainment, had low parental monitoring, had good communication with parents, and wished to have many children. CONCLUSION: Potential strategies for preventing adolescent pregnancy include educating girls about the difficulties of teenage childbearing, countering their positive illusions about the expected benefits, and teaching them more adaptive ways to meet their emotional needs.
African-American and Latina adolescent mothers' infant feeding decisions and breastfeeding practices: a qualitative study.
PURPOSE: To explore minority teen mothers' perceptions of breastfeeding and the influences on infant feeding choices. METHODS: A qualitative study using semistructured ethnographic interviews and focus groups involving 35 Latina and African-American girls in Chicago between the ages of 12 and 19 years who were primiparous and were currently pregnant or had delivered within the past 3 months. RESULTS: Adolescents identified three main influences on infant feeding decisions and practices: (a) their perceptions of the benefits of breastfeeding, (b) their perceptions of the problems with breastfeeding, and (c) influential people. In this study, teens reported no single influence which determined infant feeding choices. The decision to breastfeed was a dynamic process. Teens recognized that breastfeeding offered many benefits including facilitating maternal-child bonding and promoting the baby's health, but concern was raised regarding a potential for excessive attachment between teen mother and baby. Fear of pain, embarrassment with public exposure, and unease with the act of breastfeeding acted as barriers for teenagers who were considering breastfeeding. Teenagers discussed the breast pump as a strategy in dealing with these barriers. The adolescents' mothers continued to be an important influence. CONCLUSIONS: The ranges of perceptions and influences that minority adolescent mothers have identified as affecting their infant feeding choices, illustrated and explained in the teens' own words, are helpful to health care providers as they counsel teen mothers about infant feeding options.
Listening to youth: teen perspectives on pregnancy prevention.
PURPOSE: To ascertain views of public high school students on preventing teen pregnancy. The authors hypothesized that students at varying risk for pregnancy (e.g., abstinent, consistent contraceptors, inconsistent contraceptors) would have differing views which would have implications for future pregnancy prevention programming. METHODS: A 75-question anonymous survey designed for this study was administered in six Boston high schools. The sample consisted of 49% females and 51% males in 10th and 11th grades from diverse racial and ethnic backgrounds. One thousand surveys were received and analyzed using Chi-square tests to assess statistically significant differences in student responses. RESULTS: Sixty-three percent of the students had had sexual intercourse: 72% of males and 54% of females. Of these, 35% were consistent contraceptors and 65% were inconsistent. Students believed that having more information on pregnancy and birth control (52%), education about relationships (33%), parental communication (32%), improved contraceptive access (31%), and education about parenting realities (30%) would prevent teen pregnancy. Abstinent teens were more likely (58%) to say that information on pregnancy and birth control was important (p<.05), whereas consistently contracepting teens were more likely (40%) to identify greater access to birth control (p <.01). Males were more likely than females to prefer their information on contraception from parents (23% vs. 18%) and health education classes (16% vs. 7.5%), whereas females were more likely than males to prefer the health arena (51% vs. 27%) (p<.001). Teens using contraception were also more likely to be having frequent conversations with parents (49%) (p<.001). When asked why they had not used contraception, inconsistent contraceptors were more likely than others to say that they never thought of it (15%) (p<.001). CONCLUSIONS: Teens report that having more information from parents, school, and health arenas can prevent pregnancy. Abstinent, consistent contraceptors, and inconsistent contraceptors have different preferences regarding strategies. This information has important implications for educational content and policy discussions.
Comparison of continuation rates for hormonal contraception among adolescents.
BACKGROUND: Inadequate contraception is common among sexually active female adolescents, resulting in a high incidence of unwanted pregnancy. The authors were interested in comparing continuation rates for the different forms of hormonal contraception in this age group. METHODS: A retrospective chart review. The setting was an urban clinic in a large Midwestern city. Participants were 64% black, 34% white, and the average age was 15.5 years (+/- 1.6 SD), with implant users significantly older than oral contraceptive pill (OCP) users (P < .05). Interventions were self-selection to depo-medroxyprogesterone acetate (Depo-Provera; DMPA), levonorgestrel implants (Norplant), or oral contraceptive pills (OCPs). Previous pregnancy was significantly more prevalent in implant and DMPA users than in OCP users (P < .001). Over 4 years of follow-up, continuation rates were significantly higher for implant users than for the other hormonal groups (P < .001). At 1 year, continuation rates were as follows: 82% implants, 45% DMPA, and 12% OCPs. Combining these rates with those of the subsample who switched without interruption to another hormonal method, "continued protection" rates were much higher after 1 year: 96% implants, 83% DMPA, and 49% OCPs. Calculations of contraceptive "restarts," i.e., hormonal method use in those who discontinued and then restarted after a gap of time, also increased to the prevalence of contraceptive protection. CONCLUSION: Continuation rates for levonorgestrel implants were significantly higher than those for DMPA and OCPs, the latter group having the lowest continuation rates. Factoring in switches and restarts to other hormonal methods further boosted the prevalence rates of contraceptive use in the adolescent population.
Adolescent sexual risk assessment.
This article describes the use of a self-administered event history calendar and interviews about sexual partners, sexual activity, and contraception within the broader context of the adolescent's life. Constant comparative analysis was used to analyze the event history calendar interview data. Detailed 5- to 9-year sexual histories were obtained on the event history calendars, including patterns of sexual activity progression and triggers for unintended sexual intercourse. Discussions of protective and risky sexual decision making were stimulated by adolescents' self-report of sexual risk behavior in their own words and reflective responses on the event history calendar. Both the adolescents and the interviewers thought the calendars encouraged recall and discussion of sexual risk behavior.