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Clinical and psychological characteristics of adolescents at risk of mood disorders compared with adolescents with suicidal behavior.

Suicide is one of the leading causes of death among adolescents, yet little is understood about the biopsychosocial factors related to suicidality. The demographic, clinical, and biological characteristics of adolescents with and without psychiatric histories may help inform mechanistic approaches to treatment of mood disorders and suicidality. The 'characterizing the inflammatory profile and suicidal behavior in adolescents' and 'RAD arm of the Texas Resilience Against Depression' studies aimed to characterize the clinical and biological profiles of youth with suicidal behavior and youth at risk for mood disorders, compared to healthy adolescents (n&#xa0;=&#xa0;75 in each group). Here, we report the descriptive baseline clinical and psychological characteristics of adolescents at risk of mood disorders and those with suicidal behavior. The adolescents with suicidal behavior reported 3.53 lifetime suicidal events on average, predominantly reported moderate to very severe depression (34.7%, 24%, to 9.3%), moderate to severe anxiety (58.6%), low optimism (91.9%), and mild (39.2%) to moderate (28.4%) degree of hopelessness. The at-risk adolescents predominantly reported no depression (60%) or anxiety (68.9%), moderate optimism (50%), and a positive outlook (85.7%). Healthy adolescents predominantly reported no depression (88.3%) or anxiety (93.2%), moderate optimism (59%), and a positive outlook (87%). The adolescents with suicidal behavior and those at risk of mood disorders exhibited significantly higher irritability and borderline personality disorder features (uncorrected p&#xa0;=&#xa0;0.02 to p&#xa0;<&#xa0;0.001) and lower resilience compared to healthy adolescents. Ongoing investigations using the longitudinal clinical and biological data will help identify the immune biosignatures of suicidality in youth.

Humans

Family socialization and adolescent personality and their association with adolescent use of marijuana.

This study examines family socialization practices and adolescent personality/attitudinal characteristics, their interrelation, and association with adolescent use of marijuana. Two hundred and eighty-four adolescents and their mothers served as Ss. As hypothesized, parental socialization factors and adolescent personality/attitudinal attributes each had an independent effect on adolescent use of marijuana and each comprised its own set of sufficient conditions for adolescent marijuana use.

Adolescent

Are adolescents the victims of raging hormones: evidence for activational effects of hormones on moods and behavior at adolescence.

The literatures on hormone changes at adolescence, hormonal influences on moods and behavior in nonhuman animals and adult humans, and mood and behavioral changes at adolescence and the small but burgeoning literature on hormonal influences at adolescence are examined. The focus is on moods and behaviors often identified as typically adolescent (e.g., mood lability, mood intensity, irritability, conflict with parents) and the primary hormones of puberty (i.e., the adrenal androgens, gonadotropins, and sex steroids). Through an integration of these literatures evidence is assessed for specific hormone-mood and hormone-behavior associations, as well as for more general types of hormone-outcome relations that transcend specific hormones or outcomes. Non-biological factors that appear to be important in moderating the role of hormones in adolescent moods and behavior are identified. Implications for the design of future studies in this area are detailed.

Adolescent

Adjustment in diabetic adolescent girls: II. Adjustment, self-esteem, and depression in diabetic adolescent girls.

The Rosenberg Self-Esteem Scale, Beck Depression Inventory, and Sullivan Diabetic Adjustment Scale were administered to 105 adolescent girls with diabetes. Results indicate that levels of self-esteem and depression highly correlate with the level of adjustment as assessed on the Diabetic Adjustment Scale (DAS). That is, the adjustment of adolescent diabetic girls in peer and family relationships, dependence-independence conflicts, and attitudes toward diabetes is significantly related to self-esteem; and the level of depression is significantly related to all these adjustment factors as well as body image. The results point to the usefulness of the DAS as a potential screening device for low self-esteem and depression in adolescent girls who have diabetes. The importance of diabetes as a scapegoat for normal adolescent concerns is discussed. It was also hypothesized that depression in adolescents may be expressed through concerns about diabetes. The importance of exploring relationships with peers and fathers is emphasized.

Adolescent

Study of psychiatric illness in adolescence, psychiatric breakdown in adolescence: diagnosis and prognosis.

A discussion on the pitfalls of studying adolescent psychiatric breakdown emphasises two difficulties, firstly that of delineating the age of adolescence, and secondly the difficulty in applying adult diagnostic criteria. A study of 52 adolescents has been made to establish an initial, and a two year follow-up diagnostic formulation, and to attempt through a detailed survey of the adolescent's early history to identify prognostic indices. The difficulty of formal diagnoses is shown, but prognostic factors of relevance can be identified in the group which have helpful predictive value. Outcome in a group of 50 treated adolescents showed a satisfactory conclusion at two year follow-up, in 70% of cases.

Adjustment Disorders

A comparison of self-esteem, dogmatism and fantasy in psychiatric inpatient adolescents and their parents with non-hospitalized adolescents and their parents.

Forty in-patient adolescents and 40 non-hospitalized adolescents, comparable in age, sex, education, birth position and socioeconomic level, and their parents were administered the Rokeach Dogmatism Scale, Barksdale Self-Esteem Evaluation Scale, the Singer and Antrobus Imaginal Process Inventory, and the Elms Empathic Fantasy Scale. Distinct differences were found between the in-patient adolescent and his/her parents in aspects of fantasy, empathy, dogmatism, and self-esteem, while the non-hospitalized adolescents were very similar in fantasy with both parents. In addition, both parents of the nonhospitalized adolescents had greater levels of self-esteem with less dogmatism evident in the fathers. The results are discussed in terms of the identification process and modeling, the socialization process with its suppression or reduction of taboo drive manifestations and fantasy as a means of achieving unattainable drives.

Adolescent

Co-Use of Some Substances Associated With Higher Doses in Adolescents: Findings From the Adolescent Brain Cognitive Development Study.

PURPOSE: Adolescence is a critical developmental period marked by heightened vulnerability to initiating substance use, with long-term implications for health and behavior. Nicotine, alcohol, and cannabis are the most commonly used substances among adolescents. Their use often co-occurs but few studies have described or quantified the patterns and doses of substance co-use in this vulnerable population. METHODS: We used data from six waves of the Adolescent Brain Cognitive Development study. Substance use was measured through a web-based timeline followback interview, and outcomes are operationalized into substance use quantity (in standard units), single use, and co-use (use of two substances on the same day) of alcohol, cannabis, and nicotine. Group differences of average dose in standard units between single use and co-use for each substance class were analyzed using linear mixed-effects modeling in years 4-6. RESULTS: The average dose of nicotine was significantly higher when co-used with alcohol (4.32; 95% confidence interval [CI]: 2.55-6.09; p < .001) or when co-used with cannabis (4.41; 95% CI: 2.76-6.05; p < .001) in year 6; nicotine trends were similar in years four and five. In year 6, the average dose of alcohol was higher when co-used with cannabis (1.87; 95% CI: 0.37-3.36; p = .004) or co-used with nicotine (1.64; 95% CI: 0.06-3.22; p = .03) compared to single use of alcohol. The average dose of cannabis was not significantly different when used singularly or co-used with either alcohol or nicotine in our study years. DISCUSSION: During adolescence, the co-use of substances (namely alcohol and nicotine) may lead to higher average doses compared to single-substance use.

Humans

Management of the suicidal adolescent on a nonpsychiatric adolescent unit.

Suicide attempts by adolescents far outnumber suicide fatalities, yet there is lack of agreement regarding the optimal approach to their immediate care. Since 1968, we have admitted all such patients to a general adolescent in-patient unit. A review of the first 100 admissions of adolescents who had attempted suicide was undertaken to determine the safety, economy, and efficacy of this practice. During an average six-day hospitalization, 12 patients required constant nursing observation for more than one day, and six received tranquilizers. No major disruption on the unit, suicide attempts, or self-abusive acts occurred. Twelve patients required subsequent transfer to in-patient psychiatric facilities because of on-going suicidal ideation or psychosis or both. Hospitalization on a general unit for adolescent survivors of suicide attempts is safe, usually adds minimal cost to ordinary hospital care, permits meticulous medical attention for poisoning, and provides a stabilizing influence following a major life crisis.

Adolescent

Autonomy, coping, and self-care agency in healthy adolescents and in adolescents with spina bifida.

This study compared the behaviors of autonomy, coping, and self-care agency among 22 adolescents with spina bifida with those of healthy adolescents matched for age, gender, grade in school, and socioeconomic status. Responses on the Adjective Checklist (Autonomy scale), the Ways of Coping Check List (Problem-Focused Coping scale), and the Denyes Self-Care Agency Instrument were analyzed. Adolescents with spina bifida demonstrated significantly lower scores on autonomy when compared with healthy controls. The absence of differences in coping and self-care agency suggests that similar therapeutic approaches may be appropriate for adolescents with and without spina bifida.

Adaptation, Psychological

Adolescent parricide: a comparison with other adolescent murder.

The authors examined the available data for 10 adolescents who had been charged with parricide and compared these with data for matched groups of 10 adolescents charged with murdering another relative or a close acquaintance and 10 charged with murdering a stranger. They found significant differences between parricidal adolescents and other homicidal adolescents on personality, family, social, and follow-up adjustment variables.

Adolescent

Selected volunteer adolescents in adolescent group therapy.

Twenty-one adolescents had therapy in a group containing three volunteer adolescents over a period of ten months. Fifteen adolescents came to five sessions or more. A description of the group shows how many of the group members model their behavior and attitudes on those of the volunteers. It is suggested that using volunteers is a useful method of initiating and maintaining a group of adolescents.

Adjustment Disorders

[Comparison of the blood levels of insulin and growth hormone in healthy adolescents, adolescents with excessive weight and with hereditary loading with regard to diabetes mellitus].

Changes in insulin and growth hormone secretion were studied in 112 children and adolescents (50 healthy ones, 40 with excessive weight, and 22 with heredity aggravated by diabetes mellitus). Three types of these changes were distinguished in healthy adolescents: normoreactive, hyperreactive, and inert. The same type of growth hormone secretion changes corresponded to each type of insulin secretion changes. There was revealed a negative correlation between the insulin and growth hormone levels in the group of healthy adolescents. Dynamic relation was noted between the indices of the mentioned hormones in the course of the test: it was stronger during the ascending than during the descending phase of the test. Glucose load proved to change the correlation between the hormones level. In the group of healthy adolescents correlation between the insulin and the growth hormone levels was greater before carbohydrate load than after it. In case of excessive weight or heredity aggravated by diabetes mellitus glucose load disturbed the correlation between the hormones: when a negative correlation existed between the insulin and growth hormone levels before the load no correlation was revealed after in. This fact confirmed the role played by excessive carbohydrate consumption in the pathogenesis of diabetes mellitus.

Adolescent

Cardiovascular response to mental stress in normal adolescents with hypertensive parents. Hemodynamics and mental stress in adolescents.

The hemodynamic response to mental stress (mental arithmetic) was studied in adolscents with varying risk factors for essential hypertension (EH), One group (genetic) consisted of normotensive well adolescents who had at least one parentnt with EH. Another group (labile) consisted of adolescents with labile hypertension each of whom also had at least one pare with EH. The control population consisted of normotensive adolescents with a negative family history of EH. Subjects with labile hypertension demonstrated a sustained increase in systolic and diastolic pressure and heart rate during stress. This response was significantly different than the control population (P less than THE CONTROL POPULATION (P LESS THAN 0.001). The stress response of the normotensive genetic population was qualitatively similar to the group with labile hypertension and significantly different than the controls in diastolic pressure and heart rate (p less than 0.001, less than 0.02). Post-stress plasma catecholamines were higher in the labile hypertensive and genetic groups than in the control group. These findings demonstrate increased central nervous system mediated adrenergic activity and cardiovascular response in labile hypertension and also in some normotensive subjects with a genetic risk for hypertension.

Adolescent

Differences between adolescent suicide attempters and depressed adolescents.

Most of the characteristics differentiating between adolescent attempters and nonattempters do not have discriminative power in comparing 48 adolescents who recently attempted suicide with 66 depressed adolescents. These characteristics may probably be attributed to an affective disorder that is present in most of the suicide attempters. However, suicide attempters, compared with the depressed group, live in more problematic circumstances (such as family disruption or sexual abuse) and have a cognitive style that promotes a more negative evaluation of events and situations. Their depressive symptoms are distinguished from the depressed group by withdrawal and isolation, besides maintaining a hopeless and negative expectation of the future. Furthermore, there are reasons to accept the idea that suicidal behavior is a serious alternative within their behavioral repertoire. Based on these findings, a psychological interpretation is given concerning the dynamics leading to a suicide attempt. Also, intervention strategies are discussed.

Adolescent

[Transcultural problems of child and adolescent psychiatry or sequelae of inverse migration? On diagnosis and treatment of children and adolescents of former East Germany in West Germany of the past].

Against a background discussion whether there has been a different cultural development within the two former German states, the question is raised, whether this possible difference could lead to different influences on psychiatric illness among children and adolescents. Problems in ethnological research in general together with problems found within cross cultural psychiatry are discussed. A study of a group of 19 children and adolescents, presenting at a psychiatric clinic with the historically significant if not seldom experience of inverse migration is described. From this population only n = 4 children appeared to be significantly affected by their new surroundings. It is proposed that further investigations is needed to ascertain whether the experience of inverse migration does indeed constitute a psychological stress for children and adolescents from the former GDR.

Acculturation

Violence and illegal drug use among adolescents: evidence from the U.S. National Adolescent Student Health Survey.

The relationships between violence, drug use, and victimization were examined in a representative sample of American adolescents. The commonly used illegal drugs (marijuana, amyl/butyl nitrites, psychedelics, amphetamines, and cocaine) and alcohol were considered. Drug users, compared to nonusers, fought more, took more risks which predisposed them to assault, and were assaulted more both at school and outside school supervision. Adolescents who were victims at school were also more likely to be victimized outside of school supervision. This study clearly demonstrates that the aggressor may also be the victim, and that illegal drug/alcohol use is related to victimization.

Adolescent