Multiple-risk behaviour in adolescents and young adults

OBJECTIVES: This article examines the prevalence of four risk behaviours among teenagers and young adults: smoking, binge drinking, sex with multiple partners, and sex without a condom. DATA SOURCE: The data are from a Health Canada-sponsored supplement to the 1994/95 National Population Health Survey. The analysis is based on 905 respondents aged 15 to 19 and 1,055 respondents aged 20 to 24. ANALYTICAL TECHNIQUES: Prevalence estimates of the four risk behaviours were calculated for males and females in each age group. An index of multiple-risk behaviour was derived by summing the four risk behaviours. Hierarchical multiple regression was used to examine how sets of variables are related to multiple-risk behaviour. MAIN RESULTS: Multiple-risk behaviour was higher among young people who had never married, who were not students, and who did not live with a parent. Feeling distressed was positively linked with multiple-risk behaviour, while regular attendance at religious services was negatively linked with such conduct.     

A study of introspectiveness in adolescents and young adults

The purpose of this study was to examine the relationship between introspectiveness and the theoretically related variables of close friend solidarity, self-esteem, and symptom patterns in early, middle, and late adolescents, as well as in young adults. Samples of early (n = 103), middle (n = 107), and late adolescents (n = 101) as well as young adults (n = 70) completed the Introspectiveness Scale, the Close Friend Solidarity Instrument, the Rosenberg Self-Esteem Scale, and the Symptom Pattern Scale in classroom settings. Hypotheses were tested using Pearson correlations, with a one-tailed test of significance. Introspectiveness was statistically, significantly, and positively related to close friend solidarity in all adolescents but not in young adults; introspectiveness was statistically, significantly, and inversely related to self-esteem in all adolescents but not in young adults. Finally, introspectiveness was statistically, significantly, and positively related to symptom patterns in all adolescents and in young adults.     

A brief HIV intervention for adolescents and young adults

The delivery format of an HIV prevention program that had been efficacious with youths at high risk was modified from seven relatively short sessions over a one- to two-month period to three longer sessions over a one- to two-week period. In contrast to youths in the seven-session program, no change in sexual behavior was observed among those in the redesigned program at three-month follow-up. However, change was apparent in the mediators of high-risk behavior over the same period.     

Prevalence of mental disorders and psychosocial impairments in adolescents and young adults

Graves' disease is the predominant cause of hyperthyroidism in the pediatric age group. Other disorders must be recognized, however, because adequate management relies on a precise diagnosis. Careful monitoring of the thyroid status is required during this active phase of growth and development.     

Parent and peer relationships and relational spirituality in adolescents and young adults.

Research showing the protective qualities of Relational Spirituality, the experience of an ongoing dynamic personal relationship with G-d, against psychopathology in adolescents prompted the current investigation of its developmental correlates. Relational Spirituality in adolescence has been shown to have an unfolding heritable contribution and to be intertwined with a process of spiritual individuation, to which the current study adds the contribution of parents and peers to the developmental process. Participants were 615 adolescents and young adults representing a diverse range of ethnicities and religious affiliations. To measure parenting and friend variables, the Parental Bonding Instrument (PBI), Parental Spiritual Support Scale, and Friends Spiritual Support Scale were utilized. Relational Spirituality was measured using items from several subscales of the Brief Multidimensional Measure of Religiousness/Spirituality to obtain a composite score. Findings of multivariate regression analyses indicated that Maternal Spiritual Support, Paternal Care, and Friends Spiritual Support were significantly positively associated with Relational Spirituality, with Maternal Spiritual Support influencing the selection of peers who offer Friends Spiritual Support. These results underscore the importance of parents and peers in facilitating the development of Relational Spirituality, particularly through maternal openness to discussion about spirituality/religiosity and through paternal affection. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Personal values and goal orientations of chronically ill adolescents and young adults

For all those involved in the care of the chronically ill, to provide support in a professional manner implies to strive for a comprehensive understanding of the specific coping strategies in the light of the individual person's priorities. Coping research has yet to present a systematic analysis of personal values, goals and expectations of the chronically ill. The reader is invited to approach the topic by a review of the relevant literature and presentation of our own study on the classification of individual values and goals in 164 chronically ill adolescents and young adults (cystic fibrosis, Crohn's disease, haemophilia). Regarding personal values, the responses by the young patients were allocated to three main categories: pursuit of social contacts, striving for acceptance of the disease, the striving for joyful and intense living. Finally the relevance of personal values for appropriately coping with a serious illness is discussed.     

DSM-IV alcohol disorders in a general population sample of adolescents and young adults

AIMS/DESIGNS: As part of the Early Developmental Stages of Psychopathology (EDSP) study, results from the baseline cross-sectional assessment of DSM-IV alcohol disorders are presented for a sample of 14-24-year-olds residents in Munich, Germany (N = 3021; 71% response rate). FINDINGS: Life-time prevalence of DSM-IV alcohol abuse (men: 15.1%; women; 4.5%) was found to be considerably more prevalent than dependence (men: 10.0%; women 2.5%) with few cases among respondents younger than 16 years of age; 12-month prevalence of abuse was 8.4% among men and 2.7% among women and of dependence was 7.3% among men and 2.2% among women. Results show that peak incidence of alcohol disorders occurs at 16-17 years of age and that early initiation into alcohol use is associated with an increasing odds of disorder onset, especially for dependence among women. Exploratory analysis of retrospectively assessed diagnostic stability show: a temporal progression to abuse and then dependence, that nearly half of past abuse diagnoses are in remission, abuse remission is more common than progression to dependence, and dependence is highly persistent, especially among women. CONCLUSIONS: Alcohol disorders are frequent in adolescent and young adults being characterized by transient abuse and less prevalent but persistent dependence syndromes. The relatively high prevalence of dependence diagnoses in this young population wit few years of alcohol use is discussed with regard to the clinical validity of DSM-IV criteria in adolescents and young adults.     

The symptomatic expression of major depressive disorder in adolescents and young adults.

Data from the Oregon Adolescent Depression Project were used to examine the symptomatic expression of major depressive disorder (MDD) as a function of age and gender. The objective was to investigate the phenomenological nature of MDD among a cohort of adolescents as they progressed into early adulthood. The analyses were based on 564 participants who had experienced MDD in their lifetime. No systematic differences in the relative rate of occurrence of specific symptoms across episodes and only minor symptom differences between male and female participants were found. Age did not significantly influence the symptom picture. Stability of specific symptoms and episode severity across episodes was low. The results are discussed within the context of a stressor-symptom matching model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anemia in primary hyperparathyroidism

Although anemia has not been widely appreciated as a complication of primary hyperparathyroidism, 5.1% of the individuals with this disorder seen at the Massachusetts General Hospital since 1962 had a normochromic, normocytic anemia that could not be related to blood loss,a deficiency state, or uremia. The anemic group had more advanced bone disease and higher levels of serum calcium, alkaline phosphatase, and parathyroid hormone than the nonanemic group. Results of bone marrow biopsies performed in five patients showed variable degrees of myelofibrosis. However, none of the patients had hepatosplenomegaly, a myelophthisic peripheral blood smear, leukopenia, or thrombocytopenia. Removal of the abnormal parathyroid glands led to improvement or correction of the anemia.     

Surgery in primary hyperparathyroidism

Data were reviewed on 26 patients suffering from primary hyperparathyroidism (PHPT). The diagnosis of PHPT is increasing in frequency, due to greater awareness and better methods of detection. Delay in recognition has gradually decreased, thus permitting earlier treatment. No single test or any combination of tests can be considered satisfactorily pathognomonic of PHPT. Hypercalcemia is the most satisfactory finding suggestive of PHPT. Cervical exploration should be an integral part of the diagnostic work-up. Removal of a distinct adenoma is adequate therapy if the other parathyroid glands are normal. Subtotal parathyroidectomy should be performed only in cases of hyperplasia of all parathyroid glands.     

Perceptual and motor inhibition in adolescents/young adults with childhood-diagnosed ADHD.

Objective: This study examined perceptual and motor inhibition in a longitudinal sample of adolescents/young adults who were diagnosed with ADHD in childhood, and as a function of the relative persistence of ADHD. Method: Ninety-eight participants diagnosed with ADHD in childhood were reevaluated approximately 10 years later. Eighty-five never-ADHD controls similar in age, IQ, sociodemographic background, and gender distribution served as a comparison group. Participants were administered a psychiatric interview and the Stimulus and Response Conflict Tasks (Nassauer & Halperin, 2003). Results: Participants with childhood ADHD demonstrated slower and less accurate responses to both control and conflict conditions relative to the comparison group, as well as more variable responses in both conditions of the motor inhibition task; there was no specific effect of childhood ADHD on perceptual or motor inhibition. ADHD persisters and partial remitters did not differ in overall accuracy, speed or variability in responding, but relative to partial remitters, persisters demonstrated greater slowing in response to perceptual conflict. Conclusions: These findings are consistent with theories positing state regulation, but not inhibitory control deficits in the etiology of ADHD, and suggest that improved perceptual inhibition may be associated with better outcome for ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence and connotative meaning of cigarette smoking among Thai adolescents and young adults

Prevalence and evaluative opinions about smoking among 527 adolescents and young adults were quantified in order to assess the efficacy of Thailand's mass media antismoking campaign. The reactions of subjects to the smoking of (a) father, (b) mother, (c) boys, (d) girls, and (e) myself were obtained using a semantic differential measure. Virtually all subjects had seen antismoking adds on television and the overall perception of smoking was highly disapproving with significant gender and age differences being present. Older males were more likely to smoke and had less critical attitudes about this harmful behavior than their younger peers and female participants. Reactions to female smoking (mother and girls) were more derogatory than to the same behavior among males (father and boys). Results suggest that smoking will continue as a serious problem among Thai males and demonstrate the addictive nature of cigarette smoking which persists in spite of the increasingly negative evaluative attitudes of users.     

Usefulness of electron beam tomography in adolescents and young adults with heterozygous familial hypercholesterolemia

BACKGROUND: Because of the success of secondary prevention of coronary events by intense risk factor modification, a more precise measure of atherosclerosis in youth would have great clinical value both in the design of clinical trials for the demonstration of the usefulness of coronary disease prevention early in life and in guiding therapy. Identification of calcium in coronary arteries by electron beam tomography has been associated with severity of atherosclerosis in adults. METHODS AND RESULTS: Twenty-nine youths 11 to 23 years old with familial hypercholesterolemia (average LDL cholesterol, 5.95 mmol/L) underwent electron beam tomography as well as comprehensive risk factor assessment with measurement of total cholesterol, triglycerides, HDL cholesterol, lipoprotein (a), apolipoprotein E phenotype, blood pressure, body mass index, and history of tobacco use. Significant coronary calcium was identified in 7 of 29 subjects. Increased body mass index was significantly associated with the presence of coronary calcium (25.3 versus 20.6 kg/m2, P<0.03). No other risk factors were associated with the presence of coronary calcium. CONCLUSIONS: Coronary calcium, uncommonly identified before the fourth decade, was found in a significant percentage of adolescents and young adults with familial hypercholesterolemia. Overweight may increase the likelihood of coronary calcium being present in individuals already at high risk.     

Neurobiological and memory models of risky decision making in adolescents versus young adults.

Predictions of fuzzy-trace theory and neurobiological approaches are examined regarding risk taking in a classic decision-making task—the framing task—as well as in the context of real-life risk taking. We report the 1st study of framing effects in adolescents versus adults, varying risk and reward, and relate choices to individual differences, sexual behavior, and behavioral intentions. As predicted by fuzzy-trace theory, adolescents modulated risk taking according to risk and reward. Adults showed standard framing, reflecting greater emphasis on gist-based (qualitative) reasoning, but adolescents displayed reverse framing when potential gains for risk taking were high, reflecting greater emphasis on verbatim-based (quantitative) reasoning. Reverse framing signals a different way of thinking compared with standard framing (reverse framing also differs from simply choosing the risky option). Measures of verbatim- and gist-based reasoning about risk, sensation seeking, behavioral activation, and inhibition were used to extract dimensions of risk proneness: Sensation seeking increased and then decreased, whereas inhibition increased from early adolescence to young adulthood, predicted by neurobiological theories. Two additional dimensions, verbatim- and gist-based reasoning about risk, loaded separately and predicted unique variance in risk taking. Importantly, framing responses predicted real-life risk taking. Reasoning was the most consistent predictor of real-life risk taking: (a) Intentions to have sex, sexual behavior, and number of partners decreased when gist-based reasoning was triggered by retrieval cues in questions about perceived risk, whereas (b) intentions to have sex and number of partners increased when verbatim-based reasoning was triggered by different retrieval cues in questions about perceived risk. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Multiple sexual partners among U.S. adolescents and young adults

CONTEXT: Because many teenagers and young adults fail to use condoms correctly and consistently, the number of sexual partners they have is an important risk factor for sexually transmitted diseases, including HIV. Identifying factors that are associated with having multiple partners can help in the design of disease interventions. METHODS: Data on 8,450 males and females aged 14-22 who participated in the 1992 Youth Risk Behavior Survey were used to examine the prevalence of and factors associated with young people's having multiple partners. RESULTS: In all, 63% of female respondents and 64% of males were sexually experienced. Among those who had had sex during the three months before the survey, 15% and 35%, respectively, had had two or more partners during that period. At each age, the majority of sexually experienced respondents had had more than one lifetime partner; between ages 14 and 21, the proportion who had had six or more rose from 8% to 31% among females and from 14% to 45% among males. In logistic regression analyses, alcohol use, illicit drug use and young age at first coitus were associated with increased odds that females had had two or more partners in the previous three months, and being married lowered the odds; black or Hispanic race or ethnicity, alcohol use and young age at first coitus increased the odds for males, and being married reduced the odds. As the number of reported alcohol-related behaviors increased, the adjusted proportion of respondents who had recently had multiple partners rose from 8% to 48% among females and from 23% to 61% among men. CONCLUSIONS: The strong association between alcohol use and having multiple sexual partners underscores the need to educate young people about the effects of alcohol on partner choice and the risk of infection with sexually transmitted diseases.     

Clinical profile of cholera in young children--a hospital based report

Clinical profile of cholera was studied in children attending Diarrhea Training and Treatment Unit from January-December 1993. Out of a total 8714 cases of acute watery diarrhea, 64 children (0.7%) were suspected to have cholera on the basis of acute onset loose water/rice watery stools, high purge rate with or without excessive vomiting and/or severe dehydration. Stool culture was positive for cholera in 33 cases (51.6%). All the isolates were V. cholerae 01 biotype El Tor serotype Ogawa. Sixty four per cent of stool culture positive cases were below 5 years of age. The results assume importance because out of 28 children < 2 years with clinical suspicion of cholera, 11 cases (39.3%) were culture positive for V. cholerae, youngest child being 3 months old. Comparison of various parameters revealed that presence of vomiting > 4 episodes/ day (p < 0.005), frequency of stools >12/24 hours (p <0.002), rice watery stools (p < 0.01) and presence of severe dehydration (p < 0.01) were significant parameters associated with positive stool culture. Beside examination of stool sample by hanging drop method was an excellent diagnostic tool (p < 0.001) with a sensitivity of 51.5%, specificity 100% and positive predictive value of 100%. The isolates of V. cholerae were susceptible to furazolidone, cephelexin, nalidixic acid, norfloxacin and gentamicin. Our observations indicate that cholera is not uncommon in infants and young children. Like children in the older age group, acute onset diarrhea with watery/rice watery stools and high purge rate with or without excessive vomiting and/or rapid development of severe dehydration should arouse suspicion of cholera in younger children also. They should be investigated for cholera even in non-endemic areas and in the absence of cholera outbreaks.     

Measuring friendship quality in late adolescents and young adults: McGill Friendship Questionnaires.

This research established the psychometric properties of 2 friendship questionnaires; the McGill Friendship Questionnaire–Respondent's Affection (MFQ–RA) taps respondents' feelings for a friend and friendship satisfaction, and the McGill Friendship Questionnaire–Friend's Function (MFQ–FF) taps respondents' assessments of the degree to which a friend fulfills 6 friendship functions (stimulating companionship, help, intimacy, reliable alliance, self-validation, and emotional security). Ss were 227 junior-college students (aged 16–21 yrs). Factor analysis supported the subscale structure of each questionnaire. The subscales showed high internal consistency, covaried with the duration of being a best friend and with a self-esteem subscale regarding close friends, but not with other self-esteem measures. Women reported higher positive feelings for their friend than did men and evaluated the friend higher on friendship functions. Finally, positive feelings and satisfaction covaried with each friendship function subscale. It is concluded that the MFQ–RA and the MFQ–FF, though brief and easy to administer, provide reliable and valid assessments of friendship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)