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PubMed2003

The effect of social context on psychiatrists' judgments of adolescent antisocial behavior.

BACKGROUND: The DSM assumes that mental disorders can be identified by the presence of specific co-occurring symptoms associated with certain duration and impaired functioning, independent of the social context in which symptoms occur. The validity of this assumption was tested using the judgments of experienced psychiatrists. We hypothesized that psychiatrists would judge an identical set of adolescent antisocial behaviors, meeting the DSM-IV diagnostic criteria for conduct disorder, as indicative of mental disorder or non-disordered problem-in-living, depending on the social context. METHOD: A representative sample of 483 psychiatrists in the United States read one of three experimentally manipulated vignettes depicting adolescent antisocial behavior and responded to questions concerning its nature, prognosis, cause, and response to various treatments. RESULTS: Results supported our hypothesis. Under some circumstances, a youth may exhibit behaviors that meet the DSM-IV diagnostic criteria for conduct disorder, but be judged by psychiatrists as not having a mental disorder. In addition, as predicted, psychiatrists reached different judgments about course, etiology, and treatment responsiveness when the identical behaviors occurred in different social contexts. CONCLUSIONS: The findings illuminate weaknesses in the validity of classification systems based on behavioral criteria independent of their social context. Implications of findings are discussed.

Adolescent↗
PubMed1999

Self-reported abuse history and adolescent problem behaviors. I. Antisocial and suicidal behaviors.

PURPOSE: To examine the associations of self-reported abuse and sexual molestation with self-reported antisocial behavior and suicidal ideation/behavior in a general population of adolescents. METHODS: We used a stratified cluster sampling procedure with replacement to sample 4790 students in Washington State public schools in Grades 8, 10, and 12. Students were asked in a self-administered questionnaire whether they had ever been abused by an adult and whether they had ever been sexually molested. They were also asked about antisocial behavior and suicidal ideation and behavior in the past year. We conducted polytomous logistic regressions, controlling for gender and grade, using Software for the Statistical Analysis of Correlated Data (SUDAAN). RESULTS: Reported abuse history was associated with antisocial behavior and with suicidal ideation and behavior. The associations were stronger for abuse and molestation than for nonsexual abuse or molestation alone, and stronger at higher levels of severity (e.g., suicide attempts vs. suicidal thoughts). For example, adjusted odds ratios and 95% confidence intervals (in parentheses) for abuse and molestation were 4.4 (3.1-6.2) for suicidal thoughts, 6.8 (4.4-10.4) for suicide plan, 12.0 (7.9-18.4) for noninjurious suicide attempt, and 47.1 (23.3-95.3) for injurious suicide attempt. For abuse alone, these figures were 2.3 (1.7-3.2), 3.1 (2.1-4.6), 5.1 (3.3-7.8), and 11.8 (4.4-31.9), respectively. CONCLUSIONS: Efforts to reduce antisocial behavior and suicidal ideation/behavior in adolescence, particularly early or severe manifestations of the behaviors, should consider the possible role of a history of maltreatment, especially the possibility of sexual abuse.

Adolescent↗
PubMed2000

Weight-related behaviors among adolescent girls and boys: results from a national survey.

OBJECTIVE: The study objectives were to assess (1) the prevalence of dieting and disordered eating among adolescents; (2) the sociodemographic, anthropometric, psychosocial, and behavioral correlates of dieting and disordered eating; and (3) whether adolescents report having discussed weight-related issues with their health care providers. DESIGN: Cross-sectional school-based survey. STUDY POPULATION: A nationally representative sample of 6728 adolescents in grades 5 to 12 who completed the Commonwealth Fund surveys of the health of adolescent girls and boys. MAIN OUTCOME MEASURES: Dieting and disordered eating (binge-purge cycling). RESULTS: Approximately 24% of the population was overweight. Almost half of the girls (45%) reported that they had at some point been on a diet, compared with 20% of the boys. Disordered eating was reported by 13% of the girls and 7% of the boys. Strong correlates of these behaviors included overweight status, low self-esteem, depression, suicidal ideation, and substance use. Almost half of the adolescents (38%-53%) reported that a health care provider had at some point discussed nutrition or weight with them. Discussions on eating disorders were reported by lower percentages of girls (24%) and boys (15%). CONCLUSIONS: The high prevalence of weight-related concerns suggests that all youth should be reached with appropriate interventions. Special attention needs to be directed toward youth at greatest risk for disordered eating behaviors, such as overweight youth, youth engaging in substance use behaviors, and youth with psychological concerns such as low self-esteem and depressive symptoms.

Adolescent↗
PubMed2000

Impact of perceived parental monitoring on adolescent risk behavior over 4 years.

PURPOSE: To determine the stability of perceived parental monitoring over time and its long-term effect on health risk behaviors among low-income, urban African-American children and adolescents. DESIGN: Prospective, longitudinal follow-up (4 years). SUBJECTS: A total of 383 African-American youth aged 9-15 years at baseline recruited from nine recreation centers serving three public housing communities in an Eastern city. OUTCOME MEASURES: A six-item measure assessing perceived parental monitoring and an 11-item self-reported measure assessing unprotected sex, drug use, and drug trafficking were administered at baseline and at regular intervals over the subsequent 4 years. ANALYSIS: Concordance was assessed by Pearson correlation coefficients at the level of scale and by kappa scores at the level of items. The association between the monitoring score and risk involvement was determined by stepwise multiple regression analysis including parental monitoring, age, gender, intervention status, and two-way interactions between parental monitoring and age, gender, intervention status as independent variables. RESULTS: The perception of being monitored demonstrated consistency over time. Parental monitoring was inversely correlated with all three targeted risk behaviors cross-sectionally and prospectively. CONCLUSION: These data provide evidence for an inverse relationship between perceived parental monitoring and risk involvement cross-sectionally and longitudinally. These data support the long-term effect of perceived parental monitoring on risk behaviors among urban, low-income African-American children and adolescents. Coupled with some evidence suggesting that directed interventions might be able to increase parental monitoring, this study provides a solid platform for reinforcing the importance of parental monitoring and directing intervention efforts at strengthening parental monitoring to reduce adolescent risk behaviors.

Adolescent↗
PubMed1987

Identifying coronary-prone behavior in adolescents using the Bortner Self-Rating Scale.

Brief measures to identify coronary-prone (Type-A) behavior in young persons are greatly needed for longitudinal epidemiologic study of cardiovascular diseases. We examined the suitability of a modified 14-item Bortner Self-rating Scale (ABS) for use in an adolescent population. Responses of 549 racially mixed, low to middle income urban high school students were analyzed to see if ABS measurement properties matched those of the parent version. Construct validity was explored by correlating ABS scores with measures of anger expression, social support, life satisfaction, academic achievement and blood pressure. Results disclosed that the distribution and factor structure of adolescent ABS responses closely resembled findings obtained with adults. Scale validity was supported by significant associations of ABS scores with degree of overt anger expression, lack of social support, and dissatisfaction with school and life in and life in general. Academic achievement and blood pressure were found not to correlate with adolescent ABS scores. Possible race and sex differences are considered.

Adolescent↗
PubMed1995

Prevalence estimates and adolescent risk behavior: cross-cultural differences in social influence.

Prevalence estimates and prototype perceptions related to health risk behaviors were assessed in comparable samples of Danish and American adolescents (ages 13-15 years). Partly on the basis of observation and previous research, the assumption was made that the American sample would report more self-enhancement tendencies than would the Danish sample. Consistent with this assumption, which was supported by the data, 2 hypotheses were tested: (a) The Americans would overestimate the prevalence of the various risk behaviors (among their peers) more so than would the Danes and (b) those estimates would be more closely linked to their own risk behaviors for the American sample. Results supported both hypotheses; motivational explanations were proposed for both effects. In addition, perceptions of the prototypes associated with particular risk behaviors were assessed and were found to predict smoking behavior and willingness to engage in unprotected sexual intercourse for both samples. Implications for the study of adolescent risk behavior are discussed.

Adolescent↗
PubMed1995

Assessing adolescents' prosocial behavior: the Family Helping Inventory.

This study examined the structure and psychometric properties of a self-report measure of adolescents' helping behavior within the family--the Family Helping Inventory (FHI)--and of its two scales, the Sibling Helping Scale (SHS) and the Parent Helping Scale (PHS). The FHI was administered to 202 adolescents along with several existing measures of prosocial tendencies and with a measure of Machiavellianism. Factor analyses yielded four internally consistent subscales for the SHS and five for the PHS, all of which were conceptually related to inventories reflecting family support among adults. Both convergent and discriminant validity were demonstrated as well.

Adolescent↗
PubMed1992

Teenagers' knowledge of the acquired immunodeficiency syndrome and associated risk behaviors.

Adolescents are now recognized as being at high risk for contracting the human immunodeficiency virus (HIV), the presumed cause of acquired immunodeficiency syndrome (AIDS). This article reports the findings of a survey that examined AIDS knowledge, risk behaviors, and informational sources for AIDS in a group of suburban New Jersey high school students (N = 152). This group had knowledge of HIV and its transmission, but results indicated that students also participated in behaviors considered "risky" for the transmission of HIV. These behaviors included unprotected sexual intercourse (40% of sexually active males) and sexual intercourse with multiple partners over a period of time (23% of sexually active males).

Acquired Immunodeficiency Syndrome↗
PubMed1993

Structure of health-enhancing behavior in adolescence: a latent-variable approach.

The structure of the interrelations among a variety of health-enhancing behaviors was examined using structural equation modeling analyses of questionnaire data from 1,280 middle school students and 2,219 high school students. The health-enhancing behaviors included seat belt use, adequate hours of sleep, attention to healthy diet, adequate exercise, low sedentary behavior, and regular toothbrushing. In the middle school sample, all of the health-enhancing behaviors correlated significantly but modestly with each other, except for sleep with toothbrushing. In the high school sample, all but three of the 15 correlations among the behaviors were significant. The results further show that a single underlying factor can account for the modest correlations among these health-enhancing behaviors in both samples. The generality of the single-factor model was also established for male, female, White, Hispanic, and Black students at each school level. These findings provide some support for the existence of health-related lifestyles in adolescence.

Adolescent↗
PubMed2006

Abnormal eating behaviors in adolescent and young adult women from southern Brazil: reassessment after four years.

OBJECTIVE: To investigate whether abnormal eating behaviors in young women could predict eating disorders after 4 years. METHOD: 56 women were identified as presenting abnormal eating behaviors in a cross-sectional study (Eating Attitudes Test-26 and Edinburgh Bulimic Investigation Test). They were matched for age and neighborhood to two controls (n = 112). Four years later, they were re-assessed with the two screening questionnaires plus the Composite International Diagnostic Interview (CIDI 2.1). RESULTS: Women with abnormal eating behaviors at baseline showed a high probability of presenting abnormal eating behaviors but it was not associated with eating disorders 4 years later. They were also at higher risk for obsessive-compulsive disorder, post-traumatic stress disorder, and specific phobia. DISCUSSION: Abnormal eating behaviors were related to the maintenance of the disturbed behavior over the years, and were associated with increased probability for psychiatric diagnoses.

Adolescent↗
PubMed1986

Determinants of sexual and dating behaviors among adolescents.

The study of adolescent sexual development has typically focused on the incidence and age of onset of particular behaviors. Recent developments in the analysis of covariance structures permit more powerful simultaneous tests of the determinants of adolescent sexual behavior. These new methods allow the assessment and evaluation of the interrelatedness between unobserved, latent constructs. Data were obtained from 183 males and 193 females ranging in age from 12 to 18 years old, selected from three birth cohorts using a stratified random sample. Eight latent constructs--Sexual and Dating Involvement, Self-Acceptance, Feminist Sex Role Attitudes, Deviant Social Network, Importance of Dating, Lack of Heterosexual Competence, Sexually Active Social Network, and Stressful Change Events--were hypothesized to explain the variance in 26 observed variables. Several causal models were tested that specified structural relationships among the latent constructs. A theoretically meaningful model was arrived at that linked the eight, error-free factors.

Adolescent↗
PubMed1993

Behavioral and emotional problems among Thai and American adolescents: parent reports for ages 12-16.

We studied adolescents' behavioral and emotional problems in the United States and in Thailand, a Buddhist country in which, reportedly, aggression is discouraged and self-control, emotional restraint, and social inhibition are encouraged. Standardized parent reports on 118 problems revealed 45 Thai-U.S. differences. Thai adolescents were reported to show more overcontrolled problems (e.g., shyness, compulsivity, inhibition of talking, fearfulness, and constipation) than American adolescents (p < .0001). The two groups did not differ reliably in total undercontrolled problems, but Americans showed higher levels of direct, overt, and interpersonally aggressive undercontrol (e.g., fighting and bullying), whereas Thais showed more indirect and subtle undercontrol that was not interpersonally aggressive (e.g., sulking and sullenness). The findings suggest that different cultures may be linked to different styles of adolescent problem behavior.

Adolescent↗
PubMed1984

Father absence and adolescent "problem behaviors": alcohol consumption, drug use and sexual activity.

Among the issues faced by adolescents are problems relating to alcohol consumption, drug use, and sexual behavior. A survey of 813 adolescents found that adolescents are most likely to discuss these problems with peers and least likely to discuss them with parents, especially fathers. However, father absence from the home resulted in greater use of and problems with alcohol, marijuana, and sexual activity. This was the case especially for boys. The results obtained underscore the significance of the father as a key figure in the transmission of values and as a deterrent to certain behaviors. The results point to adolescents from fatherless homes, especially boys, as being at risk for problems in the areas noted. This suggests that community agencies providing services to adolescents should make special efforts to incorporate into their programs specially designed services to meet the particular needs of this group. Aspects of such programs are discussed.

Adolescent↗
PubMedDate not supplied

Adolescents' smoking behaviors, beliefs on the risks of smoking, and exposure to ETS in Juárez, Mexico.

OBJECTIVE: To assess the smoking behaviors, beliefs about the risks of smoking, and exposure to ETS among adolescents in Juárez, Mexico. METHODS: A cross-sectional study was conducted with sixth-grade students (N=506), aged 11-13 years old, attending 6 randomly selected schools. Schools were classified by school setting and SES. RESULTS: Students attending a low SES school setting were more likely to have smoked (P < 0.01), be current smokers (P < 0.01), be exposed to ETS at home and in public (P < 0.01) than were students attending a middle or high SES school. CONCLUSION: Smoking interventions should target students attending school in low SES settings.

Adolescent↗