Chronic illness in adolescence

Adolescents experience numerous changes. Coping with a chronic illness adds yet another dimension to their lives. This paper reviews the literature on chronically ill adolescents, addressing social, biological, psychological, cognitive, and cultural issues.     

Meanings of gender and suicidal behavior during adolescence

In the United States, gender differences in suicidal behavior rates emerge during adolescence, when females are more likely to engage in suicidal behavior, but are less likely to die as a result of a suicidal act than males. These gender patterns of suicidal behavior are common but not universal, suggesting cultural influences. This article reviews the highlights of the research on cultural meanings of gender and suicidal behavior. Studies suggest that U.S. adolescents perceive nonfatal suicidal behavior as more "feminine" and less potent than killing oneself. Persons who are suicidal in response to a relationship problem are considered more "feminine" than persons who become suicidal in response to an achievement failure. Males are more critical and avoidant of suicidal persons than females, especially when the suicidal person is a male. These beliefs may play a role in decisions about suicidal behavior (what kinds of suicidal behavior are chosen, and under what conditions). Cultural narratives of gender and suicidal behavior may be particularly influential for adolescents because adolescents are in the process of defining their identity, and often take cultural messages about "appropriate" gender behavior more seriously and more literally than adults. The implications of the findings from the research on cultural meanings of gender and suicidal behavior for prevention programs are outlined.     

The emergence of gender difference in depressed mood during adolescence: the role of intensified gender socialization

The prevalence of depressive mood was examined in a representative and nationwide sample of approximately 12,000 Norwegian adolescents. From the age of 14, girls scored 0.5 SD above boys in depressed mood, a difference that was stable throughout the adolescent period. At the age of 12, no gender difference was found. The gender difference was due to girls becoming more depressed from 13 to 14 years of age. An extended version of the gender intensification hypothesis (J. P. Hill & M. E. Lynch, 1983) was tested as an explanation for the gender difference in depressed mood. Structural equation modeling and regression analyses showed that the gender difference could be explained, in part, by increased developmental challenges for girls--pubertal development, dissatisfaction with weight and attainment of a mature female body, and increased importance of feminine sex role identification. Depressed mood was not associated with masculinity or school change, as had been predicted.     

Love and dating experience in early and middle adolescence: grade and gender comparisons

The experience of being "in love" was studied in a sample of 186 early to middle adolescent males and 199 early to middle adolescent females. Results indicated that amount of dating experience of adolescents varied widely at each age. Being "in love" co-occurred with a reciprocal on-going relationship about half the time. Boys fell in love earlier and more often than girls, and both genders seemed to employ an increasingly narrow prototypical conception of being "in love". Qualitative analyses suggested that early and middle adolescents are actively reasoning about the nature and meaning of romantic feelings and experiences. Results are interpreted from the standpoint of psychosocial developmental theory, and implications for interventions with adolescents are discussed.     

Parental autonomy granting during adolescence: Exploring gender differences in context.

This study investigated the ways in which 2 indicators of parental autonomy granting, adolescents' decision-making input and parental knowledge of adolescents' daily experiences, differed as a function of contextual factors (i.e., parents' gender role attitudes or sibling dyad sex composition) and boys' and girls' personal qualities (i.e., gender, pubertal status, developmental status, or birth order) in a sample of 194 families with firstborn (M?=?15.0 years) and second-born (M?=?12.5 years) adolescents. Firstborns were granted more autonomy than second-borns, especially in families with firstborn girls and second-born boys. Girls in families marked by traditional maternal gender role attitudes were granted fewer autonomy opportunities. Postmenarcheal second-born girls were granted more opportunities for autonomy than were premenarcheal second-born girls, but only in families with less traditional maternal gender role attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment after spinal cord injury: Relationship to gender and race.

The 2 primary goals of the current study were: (1) to generate data on gender and race differences on subjective well-being (life satisfaction, adjustment, and problems) and (2) to develop an improved measure of subjective outcomes after spinal cord injury. Ss were 125 Caucasian females, 109 Caucasian males, 96 minority males, and 30 minority females who completed the multidimensional adjustment profile (MAP). Mean age of Ss was 38.8 yrs. 10 subjective scales were developed from the MAP, 9 of which were based on factor analysis of sets of 20 life satisfaction items and 31 problem items. Compared with minority Ss, Caucasian Ss reported higher levels of career satisfaction and fewer problems with skills deficit and financial limitations. Interactions between gender and race were observed for 3 scales (emotional distress, physical discomfort, and adjustment), with more positive scores reported by minority males and Caucasian females. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Darwin on race, gender, and culture.

Darwin's theories of natural selection and sexual selection are significant scientific achievements, although his understanding of race and gender was defined and limited by his own life circumstances and the sociohistorical context within which he worked. This article considers the ways in which race, gender, and culture were represented and explained by Darwin and the ways in which his observations and opinions on gender and race were taken up by others and, more often than not, misapplied. Whereas the challenge of race (for Darwin) was to demonstrate the fundamental similarity and, hence, the common origin, of human races, the challenge of gender (for Darwin) was to identify a mechanism that could account for differences between women and men that, to him, were obvious, fundamental, and significant. The article concludes by considering the implications of Darwin's views for contemporary scientific psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shame and gender issues in pathological narcissism.

Discusses the importance of monitoring the emotion of shame, which is closely linked to identity, in psychoanalysis. Shame is distinguished from guilt, and its relationship to pathological narcissism is discussed. A typology of narcissistic pathology is also described, which is mediated by the extent to which grandiosity is consciously experienced by the patient. Specifically, where grandiosity is conscious and central, there is a distinct shame avoidance quality. Males tend to be overrepresented in this category. Where grandiosity is disavowed, although unconsciously present, there is a heightened sensitivity to shame. Women seem to cluster here. Case illustrations of each type are included, and theoretical approaches to treatment are discussed. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress and smoking in adolescence: A test of directional hypotheses.

The authors conducted a comparative test of the hypotheses that (a) stress is an etiological factor for smoking and (b) cigarette smoking causes increases in stress (A. C. Parrott, 1999). Participants were a sample of 1,364 adolescents, initially surveyed at mean age 12.4 years and followed at 3 yearly intervals. Measures of negative affect, negative life events, and cigarette smoking were obtained at all 4 assessments. Latent growth modeling showed negative affect was related to increase in smoking over time; there was no path from initial smoking to change in negative affect. Comparable results were found for negative life events, with no evidence for reverse causation. Results are discussed with respect to theoretical models of nicotine effects and implications for prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The emergence of gender differences in depression during adolescence.

There are no gender differences in depression rates in prepubescent children, but, after the age of 15, girls and women are about twice as likely to be depressed as boys and men. In this article, 3 models for how gender differences in depression might develop in early adolescence are described and evaluated. According to Model I, the causes of depression are the same for girls and boys, but these causes become more prevalent in girls than in boys in early adolescence. According to Model 2, there are different causes of depression in girls and boys, and the causes of girls' depression become more prevalent than the causes of boys' depression in early adolescence. According to Model 3, girls are more likely than boys to carry risk factors for depression even before early adolescence, but these risk factors lead to depression only in the face of challenges that increase in prevalence in early adolescence. Evidence for the variables most commonly thought to contribute to gender differences in depression in children and adolescents is reviewed, and this evidence is related to the 3 models for how these differences develop. It is concluded that Model 3 is best supported by the available data, although much more research is needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic physical illness and sexual behavior: Psychological issues.

States that the impact of chronic physical illness on sexual behavior is often overlooked in clinical care and research and that psychological adaptations of patients and their partners are often ignored as contributing to sexual difficulties. A model of sexual behavior and chronic illness must take into account the mutual feedback mechanisms between biological and psychological disease-related processes. Chronic physical illness threatens basic personal resources—sexual identity and self-esteem, personal control over body functions, intimacy, and generativity—that affect sexual behavior after diagnosis. Psychological processes of cognitive appraisal, emotional expression, and coping strategies that are triggered by chronic disease play a vital role in sexual adaptations. Psychologists have a critical role to play in assessments and interventions as well as in providing guidance for other professionals in more effectively and sensitively meeting the sexual needs of seriously ill persons. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Educating about gender and sexuality issues in graduate training: Introduction.

The topic of gender issues and sexuality has been a concern in counseling and psychotherapy since the days of Freud. The purpose of the next four articles is to provide an overall understanding of issues related to sex roles and gender that need to be addressed in graduate education and to suggest the direction that this education might take. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Race and gender on the brain: Electrocortical measures of attention to the race and gender of multiply categorizable individuals.

The degree to which perceivers automatically attend to and encode social category information was investigated. Event-related brain potentials were used to assess attentional and working-memory processes on-line as participants were presented with pictures of Black and White males and females. The authors found that attention was preferentially directed to Black targets very early in processing (by about 100 ms after stimulus onset) in both experiments. Attention to gender also emerged early but occurred about 50 ms later than attention to race. Later working-memory processes were sensitive to more complex relations between the group memberships of a target individual and the surrounding social context. These working-memory processes were sensitive to both the explicit categorization task participants were performing as well as more implicit, task-irrelevant categorization dimensions. Results are consistent with models suggesting that information about certain category dimensions is encoded relatively automatically. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The intersection of race and gender: Examining the politics of identity in women's studies.

Although race and gender are often treated as discrete dimensions of social identity, their conceptualization as intersecting categories has become central in some feminist critiques of existing theory. This study examined women's awareness of the intersection of race and gender in relation to attitudes regarding 2 issues manifesting identity politics in women's studies: (a) the marginalization of women of color and (b) proposals for separate women of color studies programs. Identity and attitude measures were completed by 110 female students enrolled in a women's studies program. The results of a structural equation model lend support to the hypotheses that attitudes toward a separate women of color studies program would be determined by an awareness of the race/gender intersection, and by a perception that women of color are marginalized in existing programs. Responses to issues regarding race and gender in women's studies are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Who's in, who's out: Examining race, gender and the cohort community.

Many teacher education programs have adopted a cohort structure which offers attractive administrative and organizational benefits while promoting classroom community. This study examines one urban teacher preparation program that employed a cohort model. Using focus groups and survey data, this mixed methods study compared results on the basis of race and gender. Findings suggest that while the cohort structure created a strong classroom community among the majority of students, specific minority populations in the program (men and students of color) were excluded from the social benefits associated with the cohort model. This study identified active social systems of silencing and exclusion and outlines implications for hiring practices, curriculum, and faculty development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnicity and gender in late childhood and early adolescence: Group identity and awareness of bias.

The current study examined awareness of gender and ethnic bias and gender and ethnic identity in 350 African American, White/European American, and Latino/Hispanic students (Mage = 11.21 years, SD = 1.59) from the 4th, 6th, and 8th grades of diverse middle and elementary schools. The study collected (a) qualitative data to best capture the types of bias that were most salient to children and (b) daily diaries and individual measures to examine the multiple components of children's gender and ethnic identities. Results revealed ethnic, gender, and grade-level differences in awareness of ethnic and gender bias. Overall, more children were aware of gender bias than ethnic bias. This effect was most pronounced among White/European American youths. Among those in 4th grade, African American and Latino youths were more likely to be aware of ethnic bias than were White/European American youths. Analyses also examined how awareness of bias was related to gender and ethnic identity. For example, children who had a salient and important gender identity, and a devalued ethnic identity, were less likely than other children to be aware of ethnic bias. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Relationship between gender and holistic representations of health and illness

Steady-state arterial spin tagging MRI approaches were used to quantitate regional cerebral blood flow increases during finger tapping tasks in seven normal subjects. Statistically significant increases in cerebral blood flow were observed in the contralateral primary sensorimotor cortex in all seven subjects and in the supplementary motor area in five subjects. The intrinsic spatial resolution of the cerebral blood flow images was approximately 4 mm. If no spatial filtering was applied, the average increase in cerebral blood flow in the activated primary sensorimotor cortex was 60 +/- 10 cc/100 g/min (91 +/- 32%). If the images were filtered to a spatial resolution of 15 mm, the average increase in cerebral blood flow in the activated primary sensorimotor cortex was 23 +/- 7 cc/100 g/min (42 +/- 15%), in agreement with previously reported 133Xe and PET results.     

Perceived barriers and biases in the medical education experience by gender and race

This study examined barriers and biases in the medical education experience by surveying fourth-year medical students. There were 270 female and 288 male respondents; their racial background was: 21% Asian, 13% underrepresented minorities, and 66% white. Women reported that the careers they were encouraged to pursue were affected by their gender (44% versus 15%) and they were often mistaken for a nonphysician (92% versus 3%). More importantly, women reported that the lack of a mentor of either gender as a large barrier (27% versus 19%). Underrepresented minorities reported that their race caused them to feel that they had to be twice as good to be treated as an equal to other students (52% versus 6%). Underrepresented minorities identified the lack of a same-race mentor (23% versus 4%) and role model (40% versus 1%) as a large barrier. Underrepresented minorities also noted an overall lack of mentors as a large barrier (25% versus 19%). Women and underrepresented minorities from the class of 1996 reported having a medical school experience characterized by similar barriers to their professional development.