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Frontal-lobe cognitive dysfunction in conduct disorder adolescents.

Behavioral similarities between antisocial behavior disorders and frontal-lobe cerebral impairment have led to suggestions that conduct disorders are attributable to disinhibition deficit associated with frontal-lobe cerebral functions. This study compared the performance of 21 conduct disorder adolescents on measures of cognitive processes associated with frontal-lobe functions with that of a matched comparison sample. Conduct disorder adolescents performed more poorly on measures sensitive to frontal-lobe dysfunction (conceptual perseveration, poorly sustained attention, impaired sequencing on memory and motor tasks), but not on non-frontal-lobe specific cognitive measures. Although the findings support a neurobehavioral explanation of antisocial behavior as a product of cerebral disinhibition, caution is urged in overinterpreting causal relationships through neurobehavioral data.

Adolescent↗

Sexual knowledge, attitudes, fears and behaviors of adolescents in Finland (the KISS study).

In 1986 and 1988, a structured questionnaire on sexual knowledge, attitudes, fears and behaviors was administered to 13, 15 and 17 year olds in Finnish public schools; 5289 (88% response rate) responses were recorded. With the exception of a few small differences in attitudes, no significant regional differences were recorded--suggesting that the results are representative of all Finnish adolescents. Except for 13 year olds, knowledge level was satisfactory. With increasing age, most attitudes showed increasing tolerance towards sexual matters and liberalism. Although several fears increased, AIDS was not perceived as an exceptionally great personal danger. By comparison with data from surveys 20 years previously, the age of first experience of sexual intercourse was lower--especially among women. About a third of the adolescents surveyed used no birth control and about 60% used a condom. Implications for educational policy and planning are discussed.

Adolescent↗

Use of psychoactive substances and sexual risk behavior in adolescents.

This study investigated the relationship between the use of illicit drugs and sexual-risk-behavior in a sample of students aged 14 to 21 years at a public high school in São Paulo in 1997. A total of 689 useable questionnaires documented the sample in consumption of psychoactive substances and sexual behavior. Sexual behavior of drug users and non-users was compared regarding history of complete sexual intercourse, age at first sexual intercourse, use of condoms, sexual intercourse with sex workers, and prostitution. Drug users (N = 366) presented a higher frequency of complete sexual intercourse (80.8% of users versus 53.5% of non-users), (N = 323, p < .001), a younger age at first sexual intercourse (on average 15.2 years in users versus 15.7 among non-users, p < .005), a trend toward lower use of condoms (56.7% among users versus 65.3% among non-users, p < .1), and more sexual intercourse with sex workers (31.1% among users versus 15% among non-users, p < .001). Sexual-risk-behavior increased with the number of drugs used. Alcohol and marijuana use were associated with the highest sexual-risk-behavior. These data are essential for the development of more specific preventive strategies, focusing on male alcohol and marijuana users.

Adolescent↗

Risk factors for suicidal behavior in adolescents.

Adolescent suicide is today a public health problem among the leading cause of mortality among adolescents and young adults. There seems to be many reasons for this increase (which has different trends in different populations), but associations have been found with increased substance abuse, television and video violence, socio-economic status and easy access to firearms. Gender differences have also been observed with crime, suicide and substance abuse higher among males, while eating disorder, depression and suicidal behavior more prevalent among females. This paper will review prevalence and incidence of adolescent suicidal behavior, socio-demographic and psychological risk factors, associated cognitive factors and socio-economic factors. Risk factors include previous suicide attempts, a history of others in the family who have been suicidal, mental illness, alcohol and drug use, and other self-destructive behaviors as well as consideration being given to hopelessness, hostility, negative self-concept and isolation. At the individual difference level, factors such as trait depression, anger and hostility, perfectionism and social sensitivity would seem critical variables, as would age, gender and intellectual functioning. Sociological and family-related factors may also be implicated including dysfunctional family organizations, a history of physical or psychological abuse (sexual abuse) and limited extent of social support networks. A frequently reported precipitating event of suicidal behavior is family adversity including rejection, separation and interpersonal conflict. At a socio-economic level it would seem essential to provide comprehensive document about the social and economic conditions from which the adolescent comes.

Adolescent↗

Depression, family environment, and adolescent suicidal behavior.

OBJECTIVE: To assess the specific influence of family relationship difficulties, over and above the effect of depression, on the risk of adolescent suicidal behavior. METHOD: The study was based on the clinical data summaries, "item sheets," of children and adolescents who attended the Maudsley Hospital during the 1970s and 1980s. Two hundred eighty-four cases of suicidal behavior, defined as suicidal ideas, attempts, or threats (mean age 13.9 years, SD 2.6), were compared with 3,054 nonsuicidal controls, using stepwise logistic regression controlling for age and sex. RESULTS: The following variables were each independently associated with suicidal behavior: an operationally defined depressive syndrome, odds ratio (OR) = 4.4 (95% CI 3.1 to 6.3); family discord, OR = 1.5 (95% CI 1.1 to 2.0); disturbed mother-child relationship, OR = 1.5 (95% CI 1.1 to 2.0); and familial lack of warmth, OR = 1.6 (95% CI 1.1 to 2.3). Twenty-seven percent of the suicidal cases met operational criteria for depression. In a separate analysis of nondepressed cases (n = 198), female gender, OR = 2.4 (95% CI 1.7 to 3.2), and conduct symptoms, OR = 1.4 (95% CI 1.02 to 1.95), were independent risk factors for suicidal behavior. Among the depressed cases (n = 73), gender and conduct symptoms did not affect the risk of suicidal behavior. CONCLUSIONS: Although depression is the largest single risk factor for teenage suicidal behavior, family relationship difficulties make a significant independent contribution to this risk. Depression also interacts with gender, so that the excess risk of suicidal behavior in females is confined to nondepressed cases.

Adolescent↗

Automatic and controlled processes and the development of addictive behaviors in adolescents: a review and a model.

This paper presents a review and a model of the development of addictive behaviors in (human) adolescents, with a focus on alcohol. The model proposes that addictive behaviors develop as the result of an imbalance between two systems: an appetitive, approach-oriented system that becomes sensitized with repeated alcohol use and a regulatory executive system that is not fully developed and that is compromised by exposure to alcohol. Self-regulation critically depends on two factors: ability and motivation to regulate the appetitive response tendency. The motivational aspect is often still weak in heavy drinking adolescents, who typically do not recognize their drinking as problematic. Motivation to regulate use often develops only years later, after the individual has encountered serious alcohol-related problems. Unfortunately, at that point behavioral change becomes harder due to several neurocognitive adaptations that result from heavy drinking. As we document, there is preliminary support for the central elements of the model (appetitive motivation vs. self-regulation), but there is a paucity of research directly addressing these mechanisms in human adolescents. Further, we emphasize that adolescent alcohol use primarily takes place in a social context, and that therefore studies should not solely focus on intra-individual factors predicting substance use and misuse but also on interpersonal social factors. Finally, we discuss implications of the model for interventions.

Adolescent↗

Sexual activity and other high-risk behaviors in adolescents with chronic illness: a review.

This article is a literature review of high-risk behaviors, including sexual activity, in adolescents with chronic illness. Three different models describing biopsychosocial constructs for risky behaviors are discussed. Regarding specific behaviors, findings from the literature include a substantial prevalence of sexual activity, but low level of knowledge and low prevalence of contraceptive use, in youth with chronic illness. Regarding substance use, alcohol was the most commonly used substance regardless of medical condition. Overall, substance use, as well as delinquent behavior, was lower among youth with chronic illness when compared to that in comparison groups. Results were mixed regarding the prevalence and determinants of unhealthy eating habits in these populations. Although high-risk behaviors in teenagers with chronic illness may be a normal part of development, awareness of their prevalence, along with early identification and counseling are important in order to anticipate adverse effects on their medical conditions.

Adolescent↗

Aggressive and nonaggressive antisocial behavior in adolescence.

This study examined whether a distinction between aggressive and nonaggressive antisocial behavior can be empirically verified in a large (254 girls and 254 boys) nonclinical (community) sample of Dutch adolescents between 12 and 18 years old. The results of confirmatory factor analysis for both boys and girls shows that aggressive and nonaggressive antisocial behaviors do not represent a single underlying dimension, but two separate constructs with moderate independence among them. These findings suggest that the conceptualization of adolescent antisocial behavior as a one-dimensional phenomenon is of questionable utility and supports growing evidence that aggressive antisocial behavior is distinct from other forms of antisocial behavior.

Adolescent↗

Functional analysis and treatment of social-communicative behavior of adolescents with developmental disabilities.

This investigation used functional analyses to identify the social variables that maintained the inappropriate social-communicative behaviors of 2 adolescent students with mental retardation. Analyses were performed in the students' classrooms with the assistance of peers and teachers. The results of these assessments were used to identify appropriate, functionally equivalent behaviors that the students were taught to self-monitor. Findings showed substantial decreases in inappropriate social responding and increases in the use of appropriate social skills.

Adolescent↗

Personality and the predisposition to engage in risky or problem behaviors during adolescence.

Longitudinal data from a representative sample of 1,978 Black and White adolescents were used to examine the role of personality in multiple risk or problem behaviors. Results indicate that covariation among diverse behaviors (educational underachievement, delinquent behavior, substance use, sexual behavior) can be adequately modeled by a single higher order factor, and that impulsivity and avoidance coping serve as generalized risk factors for involvement in these behaviors. Whereas none of the personality variables examined explained change in problem behaviors once established, avoidance coping prospectively predicted involvement among a subgroup of adolescents with little or no prior involvement. Results suggest that dysfunctional styles of regulating emotions and emotionally driven behaviors are core features of risky or problem behaviors during adolescence.

Adaptation, Psychological↗

Impact of the media on adolescent sexual attitudes and behaviors.

BACKGROUND: Adolescents in the United States are engaging in sexual activity at early ages and with multiple partners. The mass media have been shown to affect a broad range of adolescent health-related attitudes and behaviors including violence, eating disorders, and tobacco and alcohol use. One largely unexplored factor that may contribute to adolescents' sexual activity is their exposure to mass media. OBJECTIVE: We sought to determine of what is and is not known on a scientific basis of the effects of mass media on adolescent sexual attitudes and behaviors. Method. We performed an extensive, systematic review of the relevant biomedical and social science literature and other sources on the sexual content of various mass media, the exposure of adolescents to that media, the effects of that exposure on the adolescents' sexual attitudes and behaviors, and ways to mitigate those effects. Inclusion criteria were: published in 1983-2004, inclusive; published in English; peer-reviewed (for effects) or otherwise authoritative (for content and exposure); and a study population of American adolescents 11 to 19 years old or comparable groups in other postindustrial English-speaking countries. Excluded from the study were populations drawn from college students. RESULTS: Although television is subject to ongoing tracking of its sexual content, other media are terra incognita. Data regarding adolescent exposure to various media are, for the most part, severely dated. Few studies have examined the effects of mass media on adolescent sexual attitudes and behaviors: only 12 of 2522 research-related documents (<1%) involving media and youth addressed effects, 10 of which were peer reviewed. None can serve as the grounding for evidence-based public policy. These studies are limited in their generalizability by their cross-sectional study designs, limited sampling designs, and small sample sizes. In addition, we do not know the long-term effectiveness of various social-cultural, technologic, and media approaches to minimizing that exposure (eg, V-Chips on television, Internet-filtering-software, parental supervision, rating systems) or minimizing the effects of that exposure (eg, media-literacy programs). CONCLUSIONS: Research needs to include development of well-specified and robust research measures and methodologies; ongoing national surveillance of the sexual content of media and the exposure of various demographic subgroups of adolescents to that content; and longitudinal studies of the effects of that exposure on the sexual decision-making, attitudes, and behaviors of those subgroups. Additional specific research foci involve the success of various types of controls in limiting exposure and the mitigative effects of, for example, parental influence and best-practice media-literacy programs.

Adolescent↗

Having a good relationship with their mother: a protective factor against sexual risk behavior among adolescent females?

STUDY OBJECTIVE: To assess whether having a good relationship with their mother was a protective factor against risky sexual behavior for female adolescents and whether it was independent of family structure. DESIGN: Cross-sectional survey of in-school adolescents aged 14-19 years. SETTING: Catalonia, in northeast Spain. PARTICIPANTS: A total of 3677 females divided according on whether they had a good (n=3335) or a bad (n=342) relationship with their mother. MAIN OUTCOME MEASURES: Rates of sexual activity and sexual behavior. RESULTS: Adolescents in the good relationship group were significantly younger, more likely to live in an intact family, to have a good relationship with their father and siblings, and to talk about sexuality and their partner with their mother. They were also less likely to have ever had sexual intercourse. Among those sexually experienced, they were significantly older at first intercourse and less likely to have multiple partners or a history of STI. After adjusting for potential confounders, females in the good relationship group were less likely to be sexually active and to have had multiple partners, independently of family structure. CONCLUSIONS: Having a good relationship with their mother is a protective factor against sexual intercourse and having multiple sexual partners independently of family structure. Communication between generations and having a good relationship with their father and siblings also play an important role.

Adolescent↗

Religious identity and smoking behavior among adolescents: evidence from entering students at the American University of Beirut.

This survey investigation examines the association between religious identity and smoking behavior in a sample of older adolescents entering the university in Beirut, Lebanon. A culturally appropriate item of religiosity was developed for data collection. Results suggest that religious identity is inversely associated with regular smoking among male and female adolescents, after adjusting for sociodemographic, behavioral, personal, and environmental risk factors. The pattern of associations between weak religious identity, other risk factors, and smoking suggests that risk mechanisms may be gender-differentiated. Overall, findings suggest functional religiosity in late adolescence may assist in promoting the health and decreasing the morbidity of both men and women. Implications for future research are discussed.

Adolescent↗

Social influences on the sexual behaviors of adolescent girls in at-risk circumstances.

OBJECTIVE: To describe social influences on girls' sexual behaviors. DESIGN: Descriptive, exploratory study using interviews with five focus groups. SETTING/PARTICIPANTS: 48 adolescent girls, ages 12 to 16 years, who were confined in a juvenile detention center for a variety of charges. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Girls' perceptions of influences on their sexual behaviors. RESULTS: The analysis revealed three themes: the influence of traditional gender roles, a lack of power in heterosexual relationships, and an ongoing search for romance. CONCLUSIONS: The social context of adolescent girls' lives can promote sexual activity and unprotected sex. Effective prevention efforts must acknowledge the context within which sexual risk occurs and address motivations and barriers in the target population.

Adolescent↗

Sexual behavior among adolescent women at high risk for sexually transmitted infections.

BACKGROUND: The temporal pattern of partners and sexual encounters may be key factors in the acquisition and transmission of sexually transmitted diseases (STDs). Behavior among adolescent women is of particular interest because they frequently have the highest prevalence and incidence of infection. GOAL: To examine coital diary data collected during a 7-month longitudinal study of young women at high risk of STDs and to describe their sexual behaviors, with particular attention to issues of partner sequence and overlap. STUDY DESIGN: A 7-month longitudinal study of young women infected with or having a sexual contact infected with Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis attending the STD clinic or one of four neighborhood adolescent health clinics. Data were collected at enrollment and at 1, 3, 5, and 7-month follow-up visits. Coital diaries were kept between visits. RESULTS: The average frequency of coital events was 0.94 per week. The median number of sexual partners during the follow-up period was one, and overlapping of partnerships was an uncommon occurrence. The number of days between the last coital event of a current relationship and the first encounter of a new relationship differed for those choosing a new partner (mean, 20.6 days) and those who returned to a previous partner (mean, 7.9 days; P < 0.001). CONCLUSION: Although at high risk for STDs, high-risk behavior was not common among the study population. Partner choice and the behavior of these partners may be more important elements than personal high-risk behavior in accounting for the high prevalence of sexually transmitted infections among inner-city adolescent women.

Adolescent↗

Social competence and problem behavior of adolescent girls with learning disabilities.

Estimates of social competence and problem behavior were obtained using the Child Behavior Checklist (Achenbach & Edelbrock, 1983) for a sample of 51 adolescent girls with learning disabilities. Results identified poor social competence and elevated problem behaviors, in comparison to a normative group of nonhandicapped adolescents. Implications for both diagnosis and research are addressed.

Adolescent↗