Adolescent residential treatment: an alternative to institutionalization.
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Acting Out↗
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Results for “Adolescent, Institutionalized”
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[Adolescents faced with addictive substances: tobacco, alcohol and noninstitutionalized drugs].
BACKGROUND: A large share of premature mortality is Spain in related with the abuse of addictive substances: tobacco, alcohol and non-institutionalized drugs. Adolescence is a key period for the adoption of their use. An accurate knowledge of the attitudes, beliefs, environmental perceptions and behaviours of teen-agers is necessary for the design and evaluation of preventive interventions. METHODS: Data were obtained from a survey conducted in 1992 on smoking, alcohol and non-institutionalized drugs in 8th grade students (13-14 years old) of a representative sample of the schools of the city of Barcelona (Catalonia, Spain). RESULTS: Up to 44.1% have ever smoked, 10.9% are regular smokers and 15.5% have bought tobacco at some point. There are no differences in smoking patterns by sex at this age. Even if 35.5% never drink alcohol, 1.7% drink it daily, 15.5% drink on week-ends and 62.9% at family celebrations, while 13.5% have bought alcohol at some point and 22.4% report having got drunk at least once. There are no differences by sex in alcohol use at this age. Concerning non-institutionalized drugs, 35.4% of the students think that many adults use them, and 22.4% say that some friends have tried them. CONCLUSIONS: The results show the increasing penetration of tobacco and alcohol in the personal environment of the students, and the process of initiation. Compared with previous studies in this population, we can estimate a modest and non-significant reduction of regular smoking, and a reduction in daily and regular alcohol use.
Adolescent↗
[Personality traits of delinquent and non-delinquent minors placed in an institution].
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Adolescent↗
[The affective-behavioral orientations of teenagers with an unequal social status].
The study aims at establishing the affective-behavioral orientation in adolescents from the Homes for Children and Adolescents by examining their anxiety and readiness for aggression. In the investigation are included 227 children from 15 to 18 years old. The study is realized by using the questionnaire of Buss Durky for assessing the aggression, questionnaire for anxiety after Ch. Spilburgur and inquiry card for studying the problem of communication, directness of the personality etc. It is presumed that the unequivalant social conditions of life of adolescents from the Homes for Children and Adolescents have negative influence on the affective-behavioral orientation of the latter. We expect the raised aggressiveness to be with dominating hostile affective-cognitive orientation and in compliance with the high levels of uneasyness. The studying of predictors for emotional and behavioral derangements give us a possibility to reveal some subjective and social prerequisites, affecting the behavioral orientation and effective adaptation of juveniles from the Homes for Children and Adolescents.
Adolescent↗
Delinquency and Jesness Inventory Scores.
Investigated validity implications of the Jesness Inventory for institutionalized male adolescent delinquents. This population showed deviant mean T scores on this inventory's Asocial Index (69.5) and on its Social Maladjustment (65.2) subscale. Scores on 4 of the 10 subscales, Social Maladjustment, Value Orientation, Autism, and Manifest Aggression, correlated positively (p less than .0001) with both frequency of prior arrests and number of previous institutionalizations. This pattern of significant relationship is consistent with research reported in other studies and it was concluded that the present results provide additional support for the research and diagnostic uses of this instrument in assessing adolescent social maladjustment.
Adolescent↗
[Adolescents, does their health need looking after? Review of adolescent health needs for the sake of health professionals].
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Accidents, Traffic↗
Assessment of level of intellectual functioning among juvenile boy delinquents in Alexandria and its relation to behavioral deviance.
Sixty-five institutionalized boy delinquents in Alexandria aged 11 to 21 years were screened for intellectual functioning (I.Q. level) in relation to behavioral deviance. Findings revealed that the mean I.Q. score on the intelligence scale was within the average level of intelligence. The presence of behavior disorder varied insignificantly as a function of intellectual level. Results of this study do not indicate the prevalence of behavior disorders in relation to intellectual functioning in the total population of delinquent children not officially declared. However, the results could be a valid index of the demand for mental health services for the delinquent children, in whom "nonintellectual factors" (familial and psychosocial) might have a significant role in shaping their behavior.
Adolescent↗
[Conduct problems in a sample of institutionalized minors with previous mistreatment].
PURPOSE: The present study tries to analyse the maltreatment effects and the expected relation, according to the reviewed literature, with behaviour problems in a sample of children in residential care in a protection centre in Seville county (Spain). METHOD: The sample was conformed by a group of maltreated subjects in a protection setting (n = 30) and two groups of equivalent comparison (n = 30 and n = 30). The first group was conformed by subjects living in a marginal area of Sevilla, similar to the origin setting of the study group, and the second group comes from a wealthy area of this city. The behaviour problems index CBC of Achenbach (1978; 1979; Achenbach & Edelbrock, 1983) was used. RESULTS: No significant differences between groups in the CBC total score was found. However, significant differences were found in the extemalising dimension and in the delinquency, somatic anxiety, somatic problems, and social withdrawal dimensions. Victims of corruption presented higher scores on the CBC total score, extemalising dimension, and delinquency. CONCLUSIONS: Young people, victims of child maltreatment and living in an institution, showed problems of withdrawal. Victims of corruption or emotional abuse presented more psychopathological problems.
Adolescent↗
Omeprazole: therapy of choice in intellectually disabled children.
OBJECTIVE: To study extensively the therapeutic approach of gastroesophageal reflux disease in intellectually disabled children. DESIGN: We studied the effect of omeprazole sodium on healing and symptom relief in 52 institutionalized intellectually disabled children (male-female, 21:31; mean age, 15.4 years; range, 4-19 years). INTERVENTION: Endoscopically proven esophagitis (grades I-IV, Savary-Miller classification) was treated with omeprazole sodium, 40 mg/d (20 mg/d for children weighing <20 kg) as healing dose for 3 months, and 20 mg/d (10 mg/d for children weighing <20 kg) as maintenance dose for another 3 months. After 3 and 6 months, results of treatment were evaluated using symptom scoring and/or endoscopy. For patients with relapse, the dose was increased. RESULTS: At first endoscopy, 19 patients (36%) of 52 showed grade I esophagitis; 20 (38%), grade II; 6 (12%), grade III; and 7 (13%), grade IV. In 44 (86%) of 51 patients, treatment was effective in healing esophagitis and keeping patients in remission, independent of the severity of esophagitis. In 7 patients (14%), a symptomatic relapse was observed after decreasing the dose. However, these patients became symptom free again after increasing the dose and showed healing on endoscopy at the end of the study. One child did not finish the study for reasons not related to therapy. Marked improvement of persistent vomiting, regurgitation, food refusal, iron deficiency anemia, and signs of depression was seen at the end. CONCLUSIONS: Omeprazole is highly effective for all grades of esophagitis in intellectually disabled children, without adverse effects. The dose needed to maintain the remission can be titrated according to the reflux symptoms. One disadvantage of medical therapy is that it is open ended, in contrast to operation, but surgery in this population has high mortality and complication rates.
Adolescent↗
Adolescent psychiatric hospitalization and mortality, distress levels, and educational attainment: follow-up after 11 and 20 years.
BACKGROUND: Adolescents with early psychiatric hospitalization are likely to be at a significant risk for long-term difficulties. OBJECTIVE: To examine early adulthood outcomes of psychiatrically hospitalized adolescents. DESIGN: Inception cohort recruited from 1978 to 1981 and observed until 2002. SETTING: Northeastern United States. PARTICIPANTS: Adolescents (aged 12-15 years) from 2 matched cohorts were recruited and assessed repeatedly across 20 years: 70 psychiatrically hospitalized youths and 76 public high school students. MAIN OUTCOME MEASURES: Death, emotional distress, high school completion, and educational attainment. RESULTS: Psychiatrically hospitalized youths were significantly more likely to die and to report higher levels of emotional distress. Hospitalized youths were significantly less likely to graduate from high school and complete college and graduate school. CONCLUSIONS: The association between psychiatric symptoms sufficient to result in psychiatric hospitalization during adolescence and later mortality, emotional distress, high school completion, and educational attainment is striking. Further study is needed to identify and understand linkages between adolescent psychiatric impairment and decrements in adult functioning, particularly the processes that may underlie these linkages. Increasing school completion and educational attainment among hospitalized youths may minimize decrements in adult adaptation.
Adolescent↗
Construct validity of the miniature situations test. II. The performance of institutionalized delinquents and public school adolescents.
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Adaptation, Psychological↗
A comparison of perceptions regarding the process of institutional placement.
The use of institutional placement in juvenile justice, mental health, and child welfare continues to be widespread. Yet there is little information about the decision-making processes connected with the choice of this alternative for adolescents. Focus groups were held with administrators, staff, and youth in a variety of institutional placements. The discussions of these groups were qualitatively analyzed for content regarding the factors that motivated reliance on placement in institutional care and the effects of policies to regulate this practice. Agreement about the diversity of adolescents in institutions, the difficulties of (but necessity for) preventive interventions with families, and possible causes for reliance on institutional care emerged. Differences about the risks and benefits of institutional placement were noted.
Adolescent↗
Correlates of violence risk in hospitalized adolescents.
Forty adolescent inpatients with histories of frequent interpersonal violent behavior were compared with 36 hospitalized adolescents without histories of overt violence using self-report questionnaires that measured violence risk, depression, impulsivity, and suicide risk. The two groups did not differ in terms of their demographic characteristics, but the violent patients had a higher prevalence of substance abuse and borderline personality disorder diagnoses. Violent adolescents were more impulsive and at higher suicide risk than nonviolent adolescents. In addition, violent adolescents had more positive histories of suicide attempts and had significantly higher family histories of attempted and completed suicide. In the total sample of adolescents, violence risk was significantly correlated with impulsivity and suicide risk, but not with depression.
Adolescent↗
Secure accommodation for very difficult adolescents: some recent research findings.
The appropriate use of secure accommodation for very difficult adolescents continues to cause concern. Research in the 1970s highlighted the variety of young people admitted to secure units and the difficulties of fashioning treatment programmes. As a result, gate-keeping and admission criteria have been tightened. Recent research has further clarified the needs and problems of young people in secure units and has highlighted the relationship between provision offered in child-care, penal and health services. New research findings, particularly those arising out of studies of young people in Youth Treatment Centres, are discussed in the light of these issues.
Adolescent↗
[Physical and psychological abuse: follow-up of abused and delinquent adolescents].
Physical and Psychological Abuse: A Follow-up of Abused Delinquent Adolescents. This is a follow-up study of abused, very aggressive adolescent boys who had to be placed in an institution. A group of 252 boys were admitted between 1950 and 1977 in a limited freedom institution near Paris (France) because of delinquency or very difficult behaviour. Thirty-three of them had been abused either in their family or in other institutions during childhood. These adolescents proved to be three times more aggressive (i.e., they were involved in aggression episodes three times more often) as compared with their schoolmates who had not been abused previously. An inquiry about the subsequent life course of 22 of these 33 adolescents, made 3 to 30 years following their discharge, revealed that officially unlawful behaviour was recorded twice as often as in the life of their peers. The abused aggressive adolescents are therefore more difficult to rehabilitate than other non-abused adolescent with difficult behaviour. The author stresses this difference, which seems to be linked with a strong feeling of abandonment, and with an extreme difficulty to establish affective contacts with adults. The relationship with adults is always very fragile, and requires a large amount of tolerance regarding their aggressive behaviour.
Adolescent↗
[Violence and negligence to children and adolescents in institutions].
Institutional abuse comprises a structural aspect directly bound to the institutional area itself as well as direct abuses of all kinds which are committed by members of the staff. Such direct abuses can be felt by those who enact them or by observers as being legal in their context or as illicit and therefore concealed. Information about violence in institutions is rarely found in scientific literature. Some books, usually underground, and newspapers deal with the problem. Testimony from professionals working within institutions may not be justified or may be flawed by ulterior motive. However, when correctly decyphered and interpreted, it is absolutely necessary. Enquiries are difficult and not always conclusive. The paper presents a typology of "violent" institutions and proposes some recommendations to make this problem better known.
Adolescent↗
Incarcerated adolescents. The need for the development of professional ethical standards for institutional health care providers.
Large numbers of children are incarcerated in juvenile correctional facilities each year in the United States. These children suffer from a wide range of physical and psychiatric illnesses and are in critical need of professional health care services. This article summarizes the health care needs of these children and documents the ethical problems faced by health care professionals who work in juvenile institutions. The adequacy of current ethical standards as a source of guidance and support for institutional health care professionals is reviewed and a series of recommendations for the development of comprehensive health care standards is set forth.
Adolescent↗
Health risk behavioral survey from 39 juvenile correctional facilities in the United States.
PURPOSE: The study surveyed adolescents in juvenile detention facilities to determine the incidence of health risk behaviors. METHODS: A modified version of the United States Centers for Disease Control Youth Risk Behavior Surveillance System was administered to 1801 minors at 39 facilities in the United States. RESULTS: Risky behavior begins early, the initiation plateauing at age 15 or 16 years. Girls and boys reported comparable rates of drinking, binge drinking, and illicit drug use. North American Natives and those individuals who designated themselves as being other than any of the offered choices for racial designation ("Other") began drinking at earlier ages, had more binge drinking, more illegal drug use, and the most fight-related behavior. By age 12 years 62% reported onset of sexual intercourse and by age 14 years 89% were sexually active. Fighting was reported by 69% of detainees. Fight-related injuries within the past year were reported by 25% of the respondents. Nearly 47% belonged to a gang. Drug/alcohol use, fighting, and gang membership were related. Suicide was considered by 22% of the detainees, planned by 20%, tried by 16%, 8% were injured because of a suicide attempt. Younger teens (White, N.A. Natives, and "Other") had the most frequent suicide ideation. Drug/alcohol use correlated with suicidal thoughts. Onset of sexual intercourse was at an average age of 12. Multiple partners and pregnancy, was highest among blacks and "Others". Blacks had the highest sexually transmitted disease (STD) rate. Less than half of all respondents used condoms at last intercourse. STDs were related to being female, being black, and having multiple sexual partners. Pregnancy was related to multiple sexual partners and violent behavior. CONCLUSION: Male and female detainees report a high incidence and early onset of risky behaviors. N.A. Natives and those of "other" races reported the highest incidence of risk behaviors.
Adolescent↗