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Predicting adolescent risk behaviors based on an ecological framework and assets.

OBJECTIVES: To examine the relationship between an aggregate risk score (smoking, drinking, and number of sex partners) and measures of youth assets in a sample of 3439 youth aged 14-18 years. METHODS: Linear regression models for African American and white males and females predicted an aggregate risk score. RESULTS: After adjustments, the youth asset most predictive of risk was self/peer values regarding risk behaviors. Perceived school support was also predictive. CONCLUSIONS: Taking an ecological approach to the measurement of adolescent health behaviors contributes to our understanding of these risk behaviors.

Adolescent↗
PubMed1995

Family and peer influences on smoking behavior among American adolescents: an age trend.

PURPOSE: To study the age trend of family and peer influence on adolescent smoking behavior using a national sample. METHODS: Adolescents (N = 6,900), ages 14 through 18 years, from the 1988-89 Teenage Attitudes and Practices Survey, were selected for analyses. Data collected included measures for smoking status of the adolescent and their family and peers. RESULTS: Peer influence, such as the smoking status of best male/female friends, proved to be the most significant and consistent predictor across all ages, while parental influence had little effect on adolescent smoking status. Gender-specific effects were noted in the peer influence of adolescent smoking. CONCLUSIONS: The peer influence on adolescent smoking, across ages 14 through 18 years, confirmed previous literature. However, no differential effect of family and peer influence on adolescent smoking was evident.

Adolescent↗
PubMed1987

[Evaluation of the single-case analytic effect of training and promoting work and social behavior in adolescents].

Reports on prognostic factors of anorexia nervosa differentiate positive, negative and irrelevant data. However, these fields stand in parallel without quantification and thus without aspiring a hierarchical order. Establishing such an order by relative importance is the aim of this study in which we report on n = 113 patients. Among these prognostic factors from the time before, during and after hospitalization are investigated empirically. The patients' present state acts as a criterion (follow-up after 6.4 years). The relevant factors are set up hierarchically and investigated by multivariate analysis with special respect to relative importance of somatic, psychological or social variables. Finally we give therapeutic recommendations.

Adolescent↗
PubMed1992

Adolescent sexual behavior.

Pregnancy and sexually transmitted diseases among adolescents is considered a major problem in our society. The purpose of this study is to review the past five years of professional literature on adolescent sexuality to determine the factors which influence this social phenomenon as well as effective interventions. The importance of the family and religion on sexual attitudes and behaviors, how sexual activity is related to other age-related behaviors and delinquency, the relationship between early coital behaviors and the risk of pregnancy and sexually transmitted diseases, and attitudes toward contraception and abstinence are discussed. Also addressed are the possible psychological effects of sexual activity on the development of the adolescent.

Adolescent↗
PubMed2000

Health status and risk behavior of adolescents in the north of Madrid, Spain.

PURPOSE: To study the health status and risk behavior in an adolescent population of Madrid, Spain. METHODS: An anonymous self-administered questionnaire was completed by 2831 pupils aged 14-20 years from urban, suburban, and rural populations in the north of Madrid. A large number of questions were from the Minnesota Adolescent Health Survey questionnaire, which included sociodemographics, health status, drug use, sexual practices, suicidal thoughts, emotional problems, and injury risk. Student's t-test, analysis of variance, and Chi-square statistics are used for analyzing associations between the different variables. RESULTS: A majority (80%) of students thought they are in good or very good health (better for males than females); 18.3% had had intercourse, the average age of the first intercourse was 15.4 years +/- 1.68 SD for males and 16.1 years +/- 1.46 SD for females. Most (73%) had used some kind of contraception. Eighty-five percent had tried alcohol, and regular use (frequently or every day) was as high as 24%. Males drank more than females (28% vs. 20%); 58.2% of the population drink only during weekends, the percentage increasing with age. Seventy percent of the sample had smoked at least once; 34. 5% reported regular tobacco use and this increased with age. Males smoked less than females (27% vs. 42%); 3.2% smoked more than 20 cigarettes/day. The consumption of illegal drugs was very low (20% had tasted cannabis and use by males was higher). Cocaine, heroin, etc. were used by less than 5%. CONCLUSION: In general, our adolescents are in good health with most problems being preventable. Sexual activity was lower than in other European and American countries. The consumption of tobacco and alcohol started early and in general was high. Our study confirms the relationship among different health-compromising behaviors. There is a need to implement health promotion and preventive programs for adolescents.

Adolescent↗
PubMed1998

Negative life events and adolescent suicidal behavior: a critical analysis from the stress process perspective.

In the present review we examine empirical evidence concerning relationships between negative life events and adolescent suicidal behavior. Separate critical analyses were made for suicidal ideation, suicide attempts and completed suicide, suggesting common and differential aspects. Although there is evidence supporting the hypothesis that life events may comprise a risk factor for adolescent suicidal behavior, their contribution tends to be moderate or weak. A problem with past research is that it has not adequately incorporated mediating and moderating variables into pathways that link psychosocial stressors and suicidal outcomes. A stress process model is presented as a possible alternative to better understanding the relationships between stress and suicide, and to provide a conceptual and heuristic framework for future research.

Adolescent↗
PubMed1995

Clinical preventive services efficacy and adolescents' risky behaviors.

OBJECTIVE/BACKGROUND: To analyze the value of studying or implementing office-based clinical preventive services for adolescents. Most adolescent mortality and morbidity is attributable to risky behaviors, yet clinical preventive services to reduce risky behaviors are often challenged because their efficacy has not been demonstrated. DESIGN: A cost-effectiveness model of adolescents' risky behaviors that compares standard practice with a program of screening visits for all adolescents and counseling visits for youth identified as high risk. We considered two risky behaviors, alcohol abuse and unsafe sexual activity, and five outcomes. MAIN OUTCOME MEASURES: Baseline cost-effectiveness of the program, minimum efficacy at which the program would be cost-effective, and sample sizes required for a trial of the program. RESULTS: Assuming that the program is 5% effective at preventing risky behaviors, it would cost $3035 to prevent any one adverse outcome and $471,000 to prevent a death from an automobile crash or from human immunodeficiency virus infection. Assuming society were willing to pay $600,000 to prevent a death (a generally accepted figure), the program would be cost-effective only if it were 5.6% effective at changing behavior. At this efficacy, the program would have a cost per year of life saved comparable to or better than many other accepted medical interventions. However, to demonstrate changes in outcomes at this efficacy would require a clinical trial with between 4000 and 95 million adolescents in each treatment group, depending on the outcome measured. CONCLUSIONS: Studying the ability of clinical preventive services to prevent outcomes of adolescents' risky behaviors would be impractical. The decision to implement these programs should be made based on current knowledge and beliefs; their efficacy can probably be studied only as part of widespread implementation.

Adolescent↗
PubMed2002

The association between axis I and II psychiatric symptoms and high-risk sexual behavior during adolescence.

This study was conducted to investigate the association between psychiatric disorders and high-risk sexual behavior among adolescent primary care patients. Interviews assessing anxiety, conduct, depressive, eating, substance use, and personality disorders (PDs), as well as histories of sexual behavior were administered to 119 male and 284 female adolescent primary care patients. Results indicated that, after co-occurring psychiatric disorders were controlled statistically, adolescents with elevated PD symptom levels were more likely than adolescents without elevated PD symptom levels to report a high number of sexual partners during the past year and during their lifetime. Adolescents with a history of conduct disorder were more likely than adolescents without such a history to report a high number of lifetime unsafe sexual partners. Elevated antisocial, dependent, and paranoid PD symptom levels were associated with high-risk sexual behavior after co-occurring psychiatric disorders were controlled. Further, certain specific antisocial, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, and schizotypal PD symptoms were independently associated with high-risk sexual behavior after co-occurring psychiatric disorders and overall PD symptom levels were controlled. The association between overall PD symptom levels and the number of sexual partners was significantly stronger among the females than among the males in the sample. Increased recognition and treatment of PDs, coupled with increased recognition of high-risk sexual behavior may facilitate the prevention of sexually transmitted diseases and teenage pregnancy among adolescents.

Adolescent↗
PubMed1998

Co-occurrence of health-risk behaviors among adolescents in the United States.

PURPOSE: Although it is common for adolescents to experiment with several health-risk behaviors before reaching adulthood, little is known about the co-occurrence of these behaviors. The purposes of this study were to determine the co-occurrence of specific health-risk behaviors among a nationally representative sample of adolescents, and to examine whether the distribution of multiple risk behaviors varies by age, sex, and school enrollment status. METHODS: This study analyzed survey data from a United States national probability sample (n = 10,645) of youth aged 12-21 years. Survey items measuring current seat belt use, weapon carrying, tobacco, alcohol, and other drug use, and sexual behavior were included in the analysis. RESULTS: The majority of adolescents aged 12-17 years did not engage in multiple health-risk behaviors. However, the prevalence of multiple risk behaviors increased dramatically with age. While only 1 in 12 adolescents aged 12-13 years engaged in two or more of these behaviors, one-third of those aged 14-17 years and half of the college-aged youth (18-21 years) did so. Male respondents and out-of-school youth aged 14-17 years were more likely to engage in multiple health-risk behaviors than were other respondents. CONCLUSIONS: These results suggest that the likelihood that adolescents engage in multiple health-risk behaviors is related to age and that many adolescents engage in these behaviors serially rather than at the same time.

Adolescent↗
PubMed2000

Neurobehavioral characteristics of adolescents with behavioral dysregulation disorder.

BACKGROUND: There is growing recognition that violence and other forms of conduct problems increase during adolescence. The exact relationship between biological, psychological, and social variables has not been defined yet. OBJECTIVES: To analyze whether Intelligence Quotients (IQS), neurological history, child behavioral problems, executive functions, and soft neurological signs (SNS) can differentiate between undisciplined and unreliable adolescents (Behavioral Dysregulation Disorder subjects, BDD) and normal controls. METHOD: Twenty-five 13 to 16-year-olds, adolescents with BDD and 25 matched controls were used in this study. WISC-R, executive function assessment, neurological history, child behavioral problems, and SNS scores were analyzed using a Multivariate Analysis of Variance (MANOVA). A Multiple Regression Stepwise with Criteria Probability of F Analysis was used for predicting criteria variable variance. RESULTS: WISC-R Verbal IQ (VIQ), Information, Similarities, and Vocabulary subtests presented statistically significant differences between BDD and controls (p < .001). No Performance IQ (PIQ) variables established significant differences between both groups. Executive function scores did not detect significant differences between groups either. Prenatal, neonatal, and neurological history scores were similar between both groups. Two child behavioral problem variables were significantly different, with higher scores in BDD group: use of weapons and drug-use (p < .05). A Multiple Regression Stepwise (Criteria Probability of F < .05) model, entering the predictive variables in each domain (intelligence, executive function, neurological antecedents, child behavioral problems, and SNS), and using the score on the criteria variable as dependent variable, found two predictive models: (1) WISC-R Information (Ad-R-SQ = 0.172 F-Ch. = 11.176, p < .01); and (2) WISC-R Information and drug-use (R-SQ: 0.26; F-Ch = 9.605 p < .001). CONCLUSIONS: A verbal factor and drug-use predicted fairly 30% of the variance of the criteria variable used for classifying adolescents with BDD. These results would mean that a language underlying factor and an environmental drug-use factor would be related to the BDD in adolescents.

Adolescent↗
PubMed2001

Quality of life and health-risk behaviors among adolescents.

PURPOSE: To assess the association between health-risk behaviors and self-perceived quality of life among adolescents METHODS: A sample of 2801 students (957 seventh and eighth graders and 1844 ninth through twelfth graders) completed the Teen Assessment Survey (TAP) and the surveillance module of the Youth Quality of Life Instrument (YQOL-S). TAP responses were used to determine health-risks related to tobacco use, alcohol use, illicit drug use, and high risk sexual behavior. Separate multivariate analyses of variance showed mean differences in contextual and perceptual items of the YQOL-S for each health-risk behavior. Differences among engagers (adolescents who often engage), experimenters (occasionally engage), and abstainers (never engage) in the health-risk behavior were evaluated by gender and junior/senior high school groups. RESULTS: In general, adolescent abstainers reported higher quality of life (QoL) than engagers and experimenters on YQOL-S items. Adolescents who engaged in multiple risk behaviors scored even lower than those who engaged in only one health-risk behavior. Experimenters tended to rate their QoL more similar to that of abstainers than to that of engagers. CONCLUSIONS: The framework of QoL proved useful in the evaluation of adolescents' engagement in health-risk behaviors. Additionally, assessing the areas of QoL that differ between the groups may provide information for planning interventions aimed at risk reduction among engagers and experimenters.

Adolescent↗
PubMed2004

The influence of parental occupation and the pupils' educational level on lifestyle behaviors among adolescents in Belgium.

PURPOSE: To analyze the associations of lifestyle behaviors with educational level and social background based on parental occupation in adolescence. METHODS: Data from secondary school pupils participating in the Belgian (Flemish) Health Behavior in School-aged Children (HBSC) survey of the year 2002 (N = 12,490) were analyzed. Multiple logistic regressions adjusting for age and gender were used to assess the effects of parental occupation and pupil educational level on the selected lifestyle behaviors. RESULTS: Pupils of lower educational level reported less healthy food habits, less teeth brushing, less seatbelt use, more TV watching, more smoking, more drunkenness, more use of hashish, and more lifetime use of Ecstasy. Pupils of parents with lower socioeconomic status (SES) (based on the occupation of the head of the household) reported less healthy food habits, less teeth brushing, more TV watching, and less seatbelt use. Daily smoking and the lifetime use of Ecstasy varied among pupils of different parental occupation, although the effect disappeared when the pupils' educational level was introduced into the models. Regular drunkenness and regular use of hashish did not vary among pupils of different SES backgrounds. However, after controlling for educational level, an effect of parental occupation on regular hashish use became visible, with a higher percentage of regular users among the pupils of higher parental occupation. CONCLUSION: A lower educational level is associated with higher prevalence of indicators of an unhealthy lifestyle. The results are less straightforward for the relationship between SES and lifestyle behaviors.

Adolescent↗
PubMed1997

Covariations of eating behaviors with other health-related behaviors among adolescents.

PURPOSE: The study objectives are: (1) to examine and compare patterns of covariation of a wide range of health behaviors among adolescent boys and girls; (2) to determine whether eating behaviors are part of a larger construct of health-related behaviors and to identify the behaviors with which they share underlying similarities; and (3) to determine whether youth engaging in other health-compromising behaviors are at risk for unhealthy eating. METHODS: Data were analyzed from the Minnesota Adolescent Health Survey, a classroom-administered questionnaire, completed by 36,284 adolescents, in grades 7-12 from 1986-87. RESULTS: Among boys, factor analysis revealed five factors: (1) risk-taking behaviors, (2) school-related behaviors, (3) "quietly" disturbed behaviors (e.g., frequent dieting, self-induced vomiting, suicide attempts), (4) health-promoting behaviors; and (5) exercise. Eating behaviors loaded on the construct of health-promoting behaviors with brushing teeth and seat belt use. Among girls, four similar factors emerged; however, exercise loaded on the construct of health-promoting behaviors. Therefore, eating behaviors loaded with brushing teeth, seat belt use, and exercise among girls. Logistic regression analyses, controlling for sociodemographic and personal variables, revealed that boys and girls engaging in health-promoting behaviors were less likely to have unhealthy eating behaviors, while those engaging in quietly disturbed behaviors, risk-taking behaviors, and problematic school behaviors were more likely to have unhealthy eating behaviors. CONCLUSIONS: Eating behaviors appear to be part of a health-promoting behavioral construct and should not be viewed in isolation from other behaviors. Although eating behaviors do not appear to be part of the "problem behavior syndrome," youth engaging in a wide range of health-compromising behaviors are at risk for unhealthy eating; emphasizing the need to target high-risk youth with health promotion programs.

Adolescent↗
PubMed1997

Influence of sexual abuse on HIV-related attitudes and behaviors in adolescent psychiatric inpatients.

OBJECTIVE: To investigate the associations between sexual abuse and human immunodeficiency virus (HIV)-related attitudes and behaviors of adolescents with a psychiatric disorder. METHOD: HIV-related knowledge, attitudes, and behaviors were examined by self-report assessment of adolescents admitted to a psychiatric hospital (N = 100). A subsample (n = 30) completed a role-playing exercise regarding HIV-preventive behavior that was scored for the degree of effective communication by raters blind to the subjects' abuse history. RESULTS: HIV-related risk behaviors were prevalent, including unprotected sexual intercourse (67%) and multiple partners (27%) among the sexually active (71% of the total). Also frequent were alcohol and drug use (25%) and sharing cutting instruments (22%) among those engaged in self-cutting behavior (62%). The 38% of the sample identified as having a history of sexual abuse indicated significantly poorer self-efficacy concerning condom use than their peers. Abused females scored significantly lower on the self-efficacy of condom use scale and reported significantly more frequent alcohol use than nonabused females (p = .003). A hierarchical multiple regression that controlled for consistency of condom use and tolerance of people with acquired immunodeficiency syndrome found that abuse history uniquely accounted for 16% of the variance in condom use self-efficacy. Analysis of the videotaped role-play found that abused adolescents were significantly less competent and had more difficulty in effective communication than their peers (p = .003). CONCLUSION: A history of sexual abuse is associated with impaired safe sexual decision-making and HIV-preventive communication skills, even in this already at-risk group. This study also underscores the importance of actively addressing these issues in the context of clinical care.

Adolescent↗