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Cigarette smoking in the adolescent children of drug-abusing fathers.

OBJECTIVE: This study examined the longitudinal predictors of cigarette smoking in a sample of at-risk adolescents whose fathers were drug abusers (N = 296). METHODS: At time 1, structured interviews were administered, separately and in private, to male and female youth (X age = 16.3) and their fathers; adolescents were reinterviewed approximately 1 year later (at time 2). Structural equation modeling was used to examine the interrelationship of time 1 paternal tobacco and illicit drug use, father-child relations, adolescent psychological adjustment, and peer group factors and adolescent smoking at time 2. A supplementary analysis assessed the same model with control on the adolescent's age, gender, frequency of contact with the father, and the father's treatment status. RESULTS: The structural equation model showed a mediational pathway linking paternal tobacco and drug use to a weak and conflictual father-child relationship, which was associated with greater adolescent maladjustment, which in turn was related to deviant peer affiliations, which predicted adolescent smoking at time 2. There was also a direct path from paternal tobacco and drug use to adolescent time 2 smoking. The supplementary analysis found no significant differences between the models with and without control. CONCLUSIONS: Findings provide evidence of the mechanisms that underlie the association between paternal drug use characteristics and smoking in the adolescent child. Clinical implications suggest the importance of the father-child relationship to smoking prevention programs for at-risk youth.

Adolescent↗

Psychological correlates of adolescent depression.

PURPOSE: To identify psychological correlates of adolescent depression. METHODS: The subjects (N = 156) represented a convenience sample of adolescents who were attending public high schools in four Midwestern rural communities. Instruments used were: The Center for Epidemiologic Studies Depression Scale of Children, Loneliness Inventory-Short Form, Rosenberg Self-Esteem Scale, Family Strengths Inventory, and Parent-Adolescent Communication Inventory. FINDINGS: Higher levels of depression were associated with loneliness (r = .646, p < or = .001) and low self-esteem (r = .596, p < or = .001). Depression was negatively related to family strengths (r = -.293, p < or = .001). Older adolescents were more depressed than younger adolescents (r = .332, p < or = .001). A stepwise regression identified three pertinent factors associated with depression: loneliness, self-esteems, and age. CONCLUSION: Implications for nursing practice include interventions that minimize the exacerbating factors associated with depression in the adolescent population.

Adolescent↗

Assessing psychologic symptoms in adolescents.

Assessing the meaning of psychologic symptoms in adolescents can be a difficult task. Pediatricians, internists, and family practitioners are often the first professionals consulted by families worried that their teen-agers may be in psychologic distress. The practitioner is faced with the difficult decision of meeting the adolescent's need himself or referring the patient to an adolescent psychiatrist for further evaluation and possible treatment. In making this decision the practitioner must carry out a complex assessment task which requires the simultaneous evaluation of multiple clinical variables. This paper presents a conceptual scheme for evaluating the psychologic status of an adolescent patient.

Adolescent↗

Stress and coping with scoliosis: psychological effects on adolescents and their families.

The psychological, functional, and family impact of brace treatment for idiopathic scoliosis was assessed in a cross-sectional follow-up study. Eighty-four percent of parents described the initial bracing period in stressful terms. Establishing a daily routine facilitated coping with bracewear treatment. While bracewear did not necessarily affect participation in many common activities, subjects perceived limitations in sports, physical activities, and social events. There was no evidence of overt psychopathology among the subjects, although the initial bracewear period was associated with lower levels of self-esteem. Recommendations that can minimize the stresses attendant to bracewear treatment are given.

Adaptation, Psychological↗

Family functioning and psychological well-being, school adjustment, and problem behavior in chinese adolescents with and without economic disadvantage.

Using an indigenously developed measure of family functioning, the author examined the association between family functioning and adolescent adjustment in 1,519 Chinese adolescents. Results showed that family functioning was significantly related to measures of adolescent psychological well-being (existential well-being, life satisfaction, self-esteem, sense of mastery, general psychiatric morbidity), school adjustment (perceived academic performance, satisfaction with academic performance, and school conduct), and problem behavior (delinquent and substance abuse behavior). Family functioning was generally more strongly related to measures of adolescent adjustment for adolescents with economic disadvantage than for adolescents without economic disadvantage.

Achievement↗

Gender-specific pathways between maternal depressive symptoms, family discord, and adolescent adjustment.

Relations among maternal depressive symptoms, family discord, and adolescent psychological adjustment were examined in a sample of 443 middle adolescents and their mothers. Histories of maternal depressive symptoms, gathered at 3 occasions with 6-month intervals, were related to subsequent adolescent reports of depressive symptoms, conduct problems, and academic difficulties for girls but not for boys. Mediational tests indicated that girls' greater vulnerability to family discord (e.g., marital discord, low family intimacy, parenting impairments) accounted for the impact of maternal depressive symptoms on their social and emotional adjustment. Analyses suggest that family discord is a strong mediator in the development of girls' conduct disturbances and a modest mediator of girls' depressive symptoms. Results are discussed within a framework that integrates interpersonal models of parental depressive symptoms with the gender intensification hypothesis.

Adaptation, Psychological↗

Stability of psychological symptoms: drug use consequences and intervening processes.

We integrate aspects of coping response, impaired ability, and motivational explanations for the causes and consequences of drug abuse, all which were cast previously as competing or alternative paradigms. We projected a model of 1) continual daily drug use as a consequence of early adolescent psychological symptoms and 2) continual daily drug use as an influential variable in maintaining or exacerbating these symptoms over the young adult life-course. Gender, race, and education also were modeled explicitly according to their presumed theoretical importance. Finally, we modeled contemporaneous factors such as physical health and employment status as the common consequences of the shared independent variables in order to reduce bias in the estimated structural relationships. We found that continual daily drug use is significantly dependent on early psychopathology and increases psychological symptoms significantly. Daily proximate drug use has direct negative effects on education. Education, in turn, improves both mental and physical symptoms significantly. During young adulthood, psychological symptoms are related significantly to contemporaneous unemployment and physical health limitations; thus modeling these symptoms as common consequences reduces potentially biased estimates of the effect of shared independent variables.

Adaptation, Psychological↗

Incremental validity of the MMPI-A content scales in the prediction of self-reported symptoms.

The incremental contribution of the MMPI-A (Butcher et al., 1992) content scales to the prediction of scores on self-report measures of psychopathology was examined in a sample of 62 adolescents in inpatient treatment and 59 adolescents from the community. All participants completed the MMPI-A and a battery of criterion measures. A series of hierarchical regression analyses was conducted in which the MMPI-A clinical and content scales served as the independent variables and the criterion measures as the dependent variables. The content scales were found to have incremental validity beyond the clinical scales in predicting variance in the criterion measures. Similarly, the clinical scales also demonstrated incremental validity over the content scales in making these predictions. Both sets of scales made independent contributions to the prediction of sample membership (clinical vs. nonclinical). Findings suggest that both the clinical and content scales of the MMPI-A make significant contributions to the assessment of adolescents' psychological functioning.

Adolescent↗

Pediatric pain management.

It is now recognized that from the newborn period onwards, children are capable of experiencing pain. This includes the premature infant. The challenge for healthcare providers is to incorporate methods of pain assessment and treatment into their daily practices. The child's understanding of pain closely follows the cognitive and behavioral model developed by Jean Piaget. Based on these developmental stages, pain assessment measures have been developed. Pharmacologic advances have accompanied this improved understanding of infant, child, and adolescent psychology. While acute pain accounts for the majority of children's experiences, recurrent/chronic pain states do occur (e.g. sickle cell related and neuropathic) and can be effectively treated.

Acute Disease↗

Understanding the practical advantages of modern ANOVA methods.

Examined the fundamental problems associated with standard hypothesis testing techniques. This article explains why many articles have failed to detect problems due to nonnormality and discusses the basics of modern methods aimed at correcting these problems. Based on hundreds of published articles, it is now known that when groups differ, the analysis of variance (ANOVA) F test and related techniques that assume normality and homoscedasticity (equal variances) can perform poorly. In practical terms, if researchers interested in clinical child and adolescent psychology want to detect important differences among groups and accurately assess how the groups differ, and by how much, modern technology has much to offer. In fact, even highly nonsignificant results based on an F test can become significant. Moreover, modern methods offer improved control over the probability of a Type I error and more accurate confidence intervals.

Adolescent↗

Interparental conflict and adolescent adjustment: why does gender moderate early adolescent vulnerability?

The role of child gender in the relationship between interparental conflict and adolescent psychological symptoms was examined in a sample of 924 children 10 to 15 years old and 172 of their mothers. Interparental conflict was a significantly stronger predictor of adolescent internalizing symptoms for girls than boys across type of informant (i.e., mother or child). In examining why the risk posed by interparental conflict differed by gender, further analyses indicated that girls' tendencies to experience elevated levels of communion partly accounted for their greater vulnerability to interparental conflict.

Adolescent↗