Self-report of health problems and health care use among maltreated and comparison adolescents

The study aims were to compare maltreated and comparison adolescents' health problems and to identify how individual, family and home characteristics and maltreatment status affect adolescents' self-report of health status and health care use. The sample was 224 maltreated adolescents (mean age = 18.3 years) and 128 comparison adolescents (mean age = 18.15 years). Comparison adolescents reported more cold and pain symptoms during the previous 30 days but no differences in other physical health problems, self-assessment of their physical and mental health or health care use compared to maltreated adolescents. Girls were more likely to have had a dental checkup, to have seen a psychological counselor, and to self-identify their physical health as poor compared to boys. Older adolescents were less likely to have had a medical checkup or seen a psychological counselor than younger adolescents. A history of maltreatment was not related to health or health care disparities for adolescents growing up in the same low-income environment as adolescents without a maltreatment report. The environmental context and geographical location in which these adolescents grew up may be the primary driver in their health behaviors and health problems and not the experience of maltreatment.     

Parental and peer attachment and adolescents' behaviors: The mediating role of psychological suzhi in a longitudinal study

We examined whether psychological suzhi mediated the associations between attachment (paternal, maternal, and peer) and young adolescents' behavior (internalizing, externalizing, and prosocial) in a longitudinal study. Psychological suzhi reflects the positive psychological traits that facilitate adolescents' positive adaptation to the school and social environment. Five hundred and ninety-five junior high school students (48% male; aged 11–15 years, M = 12.86 years, SD = 0.71) completed measures of attachment and psychological suzhi at Times 1 and 2 (a six-month interval), while students' parents completed measures of adolescents' behavior at Time 3 (another six months later). We observed significant longitudinal correlations between attachment, psychological suzhi, and behavior. Prospective analyses using bootstrapping demonstrated significant indirect effects of attachment on adolescent behavior via psychological suzhi. These findings highlighted the importance of attachment and psychological suzhi as protective factors in the developmental course of early adolescents' behavior.     

Parents,friends, and depression: A multi-country study of adolescents in South Asia

PurposeThis study investigates the association between social support networks, as measured by parental involvement and close friendships, and depression among adolescents in South Asia.MethodsNationally representative samples of adolescents between the ages of 12 and 16 + years (n = 16,592) from the Global School Based Health Surveys from India, Sri Lanka, Pakistan, and Myanmar were analyzed to provide prevalence rates of depression. Additionally, differences in past year depressive symptoms were compared cross-sectionally by social support from parents and friends, separately. This was done by computing prevalence ratios adjusting for potential confounders and demographic factors.ResultsOf all adolescent respondents in the study, 14.5% met the criteria to be screened for depression, while 50% reported having three or more close friends, and 80% reported having very involved parents. Adjusted prevalence ratios indicated that those with close friendships were much less likely to be screened for depressive symptoms compared to their counterparts, as were adolescents with very involved parents. However, low and moderate levels of parent involvement were not found to be significantly associated with adolescents' propensity for being screened for depressive.ConclusionSocial support is a social determinant of adolescent mental health in South Asia that has received little scholarly attention to date. This study highlights the importance of research and interventions involving parents and close friends in building programs for adolescents that target mental health.     

Cyberbullying victimization and fatalism in adolescence: Resilience as a moderator

The present study used quantitative data to address two gaps in cyberbullying research. First, to examine the relationship between fatalism and cyberbullying victimization in an adolescent sample not previously explored. Second, despite investigating these relationships from a main effects perspective, the present study extended research by examining fatalism from an interaction effects perspective. Specifically, this study examined adolescents' resilience as a moderator of the relationship between cyberbullying victimization and fatalism. A total of 643 adolescents (M_age = 14.56; SD = 1.45) from grades 7 to 10 of compulsory education participated in this study. Cyberbullying was associated with higher levels of fatalism. The key finding was that resilience was a moderator of the relationship between cyberbullying victimization and fatalism. These findings emphasize the importance of the protective function of resilience in cyberbullying victimization outcomes.     

Future orientation climate in the school class: Relations to adolescent delinquency,heavy alcohol use,and internalizing problems

It is well known, based on previous research, that adolescents' thoughts and feelings about their future are related to the risk of delinquency, alcohol use as well as health. However, other well-known facts are that adolescents' actions are substantially shaped in interaction with peers and that, during adolescence, individuals spend a considerable amount of the day at school, in interaction with classmates. Despite this, there is an almost complete lack of studies exploring to what extent the school climate, as measured by thoughts and feelings about the future, can influence individual adolescents. The aim of the current study is to investigate whether the future orientation (FO) climate, measured at the school class level, is related to delinquency, alcohol use and internalizing problems at the individual level, among a sample of Swedish students 14–15 years of age. The data used come from the Swedish part of the Youth in Europe (YES!) study, which is part of the larger project Children of Immigrants - Longitudinal Survey in Four European Countries (CILS4EU). In the present paper, we use data from the first wave, collected among 8th grade students in 2010/11 (n = 4119–4364). The method used was multilevel modeling (linear probability models (LPM) and linear regression analysis). The results showed that, in school classes where a high proportion of students had a positive future orientation, the risk of heavy alcohol use at the individual level was lower, also after adjusting for individual FO and for individual- and class-level socioeconomic conditions. A similar, but not statistically significant, tendency was found for delinquency. In addition, having a high proportion of students with a positive FO in a school class was associated with fewer internalizing problems, also after controlling for individual FO and socioeconomic conditions at the individual and school class level. We conclude that the surrounding school class, in terms of its general future orientation climate, may play a role for individual outcomes in the form of problem behaviors and mental health.     

Associations between discussions of racial and ethnic differences in internationally adoptive families and delinquent behavior among Korean adopted adolescents

Internationally adopted adolescents may have more delinquent behavior than non-adopted adolescents. One explanation is that these adolescents experience discrimination and loss of culture, and adoptive parents are not adequately addressing these experiences. However, studies have not examined the effects of family discussions of racial and ethnic differences within adoptive families on adopted adolescents' delinquent behavior. To test this relationship, this study utilized data from 111 U.S. internationally adoptive families with 185 South Korean adopted adolescents (55% female, M age = 17.75). During an observational assessment, families discussed the importance of their racial and ethnic differences, and adolescents completed a delinquent behavior questionnaire. Analysis of covariance showed differences in adolescent delinquent behavior across three ways adoptive families discussed racial and ethnic differences; adolescents whose families acknowledged differences had the fewest mean delinquent behaviors. There were no significant differences in delinquent behavior between adolescents whose families acknowledged or rejected the importance of racial and ethnic differences. However, adopted adolescents whose families held discrepant views of differences had significantly more problem behavior than adolescents whose families either acknowledged or rejected the importance of racial and ethnic differences. Clinicians, adoption professionals, and other parenting specialists should focus on building cohesive family identities about racial and ethnic differences, as discrepant views of differences are associated with the most adoptee delinquent behavior.     

Self-esteem: A mediator between peer relationships and behaviors of adolescents in foster care

Youth in foster care have been shown to be at risk for a range of negative behaviors. Developmental research has highlighted the important role that peer relationships can play in an adolescent's development. For youth in foster care, peer relationships can also play an important role in both youths' internal perception of themselves and their enacted behaviors. This study utilized National Survey of Child and Adolescent Wellbeing, a national secondary dataset to analyze the connection between peer relationships for youths in long-term foster care and their report of internalizing, externalizing, and delinquent behaviors (n = 188). Additionally, the self-esteem of adolescents was explored as a potential mediator between peer relationships and these behaviors. Preliminary analyses indicated that peer relationships had a significant association with all three of the identified behaviors: internalizing, externalizing, and delinquent behaviors of youths in foster care. Self-esteem was found to be a significant mediator between peer relationships and adolescents' report of their internalizing, externalizing, and delinquent behaviors. Clinical implications for therapeutic services that focuses on the adolescent's self-image and potential policy implications are discussed.     

The subjective well-being of adolescents in residential care compared to that of the general population

The aim of this research is to study the subjective well-being of adolescents in residential care and compare it with that of the general population of the same age in Catalonia. Two samples were used: one from the general population in the first year of secondary education (n = 491; 50% boys; mean age = 12.1 years) and another from the residential care population aged 12–13 years (n = 226; 56% boys; mean age 12.5). The questionnaire of the International Survey of Children's Well-Being (ISCWeB) was used. It includes two psychometric scales: the Personal Well-Being Index—School Children (PWI-SC7) and the Overall Life Satisfaction (OLS); the former being adapted for the in-care population. To test the validity of the factorial structure of data for the two groups, a Confirmatory Factor Analysis (CFA) of the PWI-SC7 and different multi-group structural equation models (SEMs) were conducted. The CFA of the PWI-SC7 showed a good fit with the pooled sample and good comparability of correlations and regressions between the two groups. The SEM with constrained loadings allowed us to compare the contribution of the different items on the PWI-SC7 latent variable which was higher in all cases for adolescents in care. Likewise it showed a high correlation between OLS and PWI-SC7 in both populations, being it more intense among adolescents in care. Scores on the OLS and on the PWI-SC7 are significantly lower among adolescents in care. However, according SEM results mean scores of the PWI-SC7 are not strictly comparable between groups. Results challenge public policy concerning children by increasing efforts to promote equal opportunities for the in-care community and improve satisfaction with particular life domains, such as school and residential homes.     

Internalizing symptoms and safe sex intentions among adolescents in mental health treatment: Personal factors as mediators

Little is known about why some adolescents with internalizing symptoms engage in sexual behaviors that increase their risk for HIV. This study tested a mediation model of internalizing symptoms and safe sex intentions among adolescents receiving mental health treatment. Self-efficacy for HIV prevention, HIV knowledge, and worry about HIV were hypothesized to mediate associations between internalizing symptoms and safe sex intentions among sexually active and non-active adolescents receiving mental health treatment (N = 893, M age = 14.9). Significant indirect effects from internalizing symptoms to safe sex intentions varied according to sexual experience: for sexually non-active adolescents, HIV worry and knowledge mediated this link, whereas for sexually active adolescents, HIV self-efficacy was the significant mediator. Increasing both HIV knowledge and self-efficacy for HIV prevention are important targets for HIV prevention with adolescents with internalizing symptoms, and careful attention should be paid towards targeting these interventions to sexually experienced and inexperienced youth.     

Perspectives on disclosure among children living with HIV in India

BackgroundFollowing the widespread uptake of anti-retroviral therapy (ART), young children living with HIV are entering adolescence and beyond, necessitating disclosure of HIV status. However, few studies have described children's experiences following disclosure.MethodsWe assessed disclosure status among children attending HIV clinics at two tertiary-care centers in southern India. Children who had disclosure were administered a pre-tested questionnaire assessing their knowledge about HIV, ART, experiences following disclosure, perceived stigma and ideas about their future. The association of the children's responses with social desirability bias was examined using a modified social desirability scale.ResultsTwenty-four caregiver-child dyads participated in this study. They constituted a subset of children who had been told of their HIV diagnosis from a larger study of 247 dyads. Mean age at disclosure was 10.9 ± 2.5 years. Medical personnel were responsible for disclosure to 14 children, parents/caregivers to 3 children, both medical and care personnel together to 4 children and other relatives to remaining 3 children. Disclosure was met with acceptance by one-third of the children. Despite disclosure, five children did not know how HIV spreads, and three were unaware about how infection could be prevented. Notwithstanding their positive status, 20 children felt that they were treated well at school and by their immediate relatives, although 11 children mentioned that they needed to hide while taking ART. Social desirability bias did not play a role in the responses given by these children.ConclusionsThe rate of disclosure of HIV status among children living with HIV in India was low, even among older children. Most children accepted their status, but knowledge about HIV and ART was inadequate. Disclosure was predominantly performed by medical personnel, rather than the primary caregiver. Incorporating disclosure into the care process for older children is likely to be beneficial, and should be recognized as an iterative process with a need for incorporating cultural sensitivities and a comprehensive approach to health education.     

Familism and depressive symptoms among Italian adolescents: The mediating effect of parental attachment

Familism refers to “a culturally grounded way of valuing family that emphasizes an ideal for family relationships to be warm, close, and supportive and that family be prioritized over self”. It is considered a core value of Latino culture and a crucial protective factor of psychological health among Latino populations. However, scant research has addressed the possible value of familism and the association between familism and psychological health and the underpinning mechanisms among Italian adolescents. The current study aimed to test the relation of familism to depressive symptoms and the mediating effect of parental attachment in an Italian adolescent sample. Participants (N = 513) completed self-report measures assessing familism, parental attachment, and depressive symptoms. Results of the total effect model showed that familism was negatively related to depressive symptoms. In the indirect effect model, it was found that the relationship between familism and depressive symptoms was mediated by both maternal attachment and paternal attachment. Moreover, results of multi-group path analyses revealed that the associations among familism, parental attachment, and depressive symptoms did not differ by sex but by developmental period (i.e., early- vs. middle adolescence). In conclusion, this research suggests the protective role of familism in Italian adolescents' depressive symptoms.     

A cross-lagged model of the relationship between violent video game exposure and moral disengagement in middle school and high school students

Previous studies have proved that violent video game exposure might have an association with moral disengagement; however, the directionality of this correlation remains unclear. Therefore, we examined the reciprocal effects between violent video game exposure and moral disengagement in a longitudinal study. The sample included 1393 adolescents (48.7% boys) in the seventh (middle school students, n = 694, M_age = 13.15 years) and tenth (high school students, n = 699, M_age = 15.93 years) grades at six Chinese secondary schools. The results showed that high school students' levels of moral disengagement were higher than those of middle school students, and violent video game exposure was positively associated with moral disengagement. The cross-lagged panel model suggested that violent video game exposure predicted moral disengagement (six months later) in all participants, with a slightly stronger effect in middle school students. The finding also indicated differences in the development of perspective regarding the association between violent video game exposure and moral disengagement, which observed a predictive effect for middle school students but a lagged effect for high school students. Thus, different preventions and interventions should be distinguished for middle school and high school students.     

Differences between risk factors for truancy and delinquency in Dutch adolescents

The present study examined differences in risk factors for truancy and delinquency. Research questions were: (1) Which risk factors are significantly different between truants and delinquents? (2) Which risk factors make the strongest distinction between truancy and delinquency? Participants were Dutch adolescents (N = 365) who received a penal sanction in the Netherlands. 83% (n = 304) of them had violated the penal law, and 17% (n = 62) received the penalty for truancy. Differences in risk factors for truancy and delinquency were found for age and parental punishment. Binary logistic regression showed that only parental punishment retained its predictive effects when controlling for other differences. Truants experienced more parental punishment than delinquent adolescents. The present study shows that addressing dysfunctional home circumstances could be more important for truants, indicating that existing interventions do not differentiate enough between truants and delinquents.     

How an intervention project contributes to social inclusion of adolescents and young people of foreign origin

This article presents the results of the impact study of the Nightingale Project, a social mentoring project, whose aim is to support the welcoming and social inclusion processes of adolescent students of foreign origin who recently arrived in Catalonia and who are currently enrolled in the country's schools. The more than one hundred mentoring pairs (mentor and mentee) that took part in the intervention project were administered a questionnaire (N = 58). This same questionnaire was also given to a group of adolescents with the same profile but who did not participate in the project (N = 128) and who were treated as a control group.After six months of intervention (which corresponds to the duration of the Nightingale Project), results show that students who participate in mentoring learn the language faster, create broader and more diverse networks of friends in school, develop higher educational aspirations and expectations, are better acquainted with the reception context (municipality they live in), and improve standards of self-confidence and self-esteem, among other characteristics. The research also demonstrates that mentoring aimed at adolescents, as is the case of the Nightingale Project, plays a key role in avoiding development of an oppositional identity and, conversely, helps facilitate a process of resilience in adolescents in the new context of reception.     

Factors associated with treatment attrition for Medicaid-enrolled youth with serious emotional disturbances

Premature discontinuation from treatment is a significant problem that undermines the delivery of effective mental health services and increases the risk for relapse and poor outcomes. However, factors associated with treatment attrition in children and adolescents are not well understood. This retrospective longitudinal cohort study examines factors associated with attrition for Medicaid-enrolled youth, aged 5 to 17 with “new episodes” of ICD-9-CM diagnosed serious emotional disturbance (N = 43,122). Information on individual-level (demographic and clinical characteristics) and contextual-level variables (county socio-demographic, economic, and health care resources) were abstracted from Medicaid claim files and the Area Resource File. Multilevel modeling was used to assess the association between individual and contextual-level variables and attrition. Of the 43,122 youth in the study sample, 4056 (9.4%) discontinued treatment. The odds of treatment attrition were significantly higher for youth who were male (OR = 1.16, p < 0.001), black compared to white (OR = 1.19, p < 0.001), had a co-occurring substance abuse disorder (OR = 1.35, p = 0.01), and lived in a county with a larger percentage of minorities (OR = 1.02, p = 0.01). In contrast, youth diagnosed with bipolar and depressive disorders compared to ADHD (OR = 0.78, p < 0.001 and OR = 0.87, p = 0.01, respectively), with comorbid psychiatric (OR = 0.74, p < 0.001) and medical disorders (OR = 0.82, p < 0.001), and a prior history of two or more psychotropic medications compared to no medications (OR = 0.76, p < 0.001) had lower odds of attrition. Residence in a county with a larger number of pediatricians and psychologists also reduced the odds of attrition (OR = 0.97, p = 0.05 and OR = 0.99, p = 0.03 respectively). Overall, this study suggests that a combination of individual factors, demographic and clinical, and contextual factors impact attrition in children's mental health outpatient treatment.     

The effects of organizational context on autonomy-enhancing policies in assisted living

This study examines the effects of facility size, ownership, chain membership, and residents' characteristics on autonomy-enhancing policies in assisted living. The theoretical framework for the study is based on the open systems perspective, which views organizations as being influenced by environmental context (e.g., ownership and chain membership). Data were collected from interviews with administrators of 60 facilities in Maryland. Autonomy-enhancing policies were assessed with the MEAP Policy Choice and Resident Control scales. Facility size and residents' disability were strong predictors of autonomy-enhancing policies (R² = .39, p < .001). Higher levels of policies that foster resident autonomy were associated with larger facility size (β = .54, p < .001) and lower residents' disability (β = .23, p < .05). Chain membership had an indirect influence on autonomy-enhancing via facility size and residents' disability. Chain-related facilities were larger, and their residents were less disabled. The study contributes to a better understanding of the mechanism through which organizational factors influence resident-oriented policies.     

Significance of action plans in the development of occupational well-being in the schools of Finland and Estonia

This article is part of a long term project “Promoting the Occupational Well-Being of School Staff—Action Research Project in Finland and Estonia, 2009–2014.” The purpose of this article is to describe the significance of action plans in the promotion of the occupational well-being of primary and upper secondary school staff in Finland and Estonia from 2010 to the turn of the year 2011–2012. An electronic open questionnaire was sent to occupational well-being groups in Finland (N = 18) and in Estonia (N = 39). In Finland, the questionnaire was responded to by 16 (n = 16) occupational well-being groups, and in Estonia, by 38 (n = 38) groups. The qualitative data were analyzed using the inductive-deductive method and content analysis. The obtained results indicate that the schools had named goals for action plans in all aspects of the promotion of occupational well-being in schools (worker and work, working conditions, professional competence, working community) and that these goals were mainly realized in the schools in a systematic way. Schools felt that the action plan for occupational well-being helped them to set goals for occupational well-being and that the planned actions were realized in a more systematic way than before.     

The role of fathers in reducing dating violence victimization and sexual risk behaviors among a national sample of Black adolescents

PurposeStructural equation modeling (SEM) was used to explore the impact of father-figures' involvement on reducing both dating violence and sexual risk among a national sample of Black American youth well as the possible mediating effect of dating violence on the relationship between father figure involvement and sexual risk behaviors.MethodsTo explore this phenomenon, sexually active Black adolescents between the ages of 13–21 with a romantic partner in the previous 18 months were selected (N = 422) from wave II of the National Longitudinal Study of Adolescent Health.ResultsThe analyses indicated that overall, perceived closeness to father figures reduced dating violence victimization among Black youth. When separated by gender, our hypothesis for male respondents was supported indicating that perceived closeness with their father figures resulted in a reduction in dating violence. However, the same hypothesis was not supported for female respondents. On the other hand, perceived closeness to father figures resulted in lower sexual risk behaviors for girls.ConclusionGiven the study's findings, researchers, practitioners, and policy makers should consider the importance of the father–child relationship in reducing problem behaviors among Black adolescents. In particular, emphasis should be given to the quality of the father–child relationship rather than general father involvement in reducing dating violence victimization and risky sexual behavior among sexually experienced Black adolescents.     

The effectiveness of intervention for adolescents exposed to domestic violence

The purpose of this study is to evaluate the effectiveness of a 10-week group intervention for adolescents who were exposed to domestic violence in their home, and compare behavioral and emotional symptoms between adolescents with direct or indirect exposure to domestic violence. Participants of the group intervention (N = 32) reported an increase in knowledge of domestic violence based on quiz scores of pre- and post-tests. Compared to those without direct exposure to domestic violence, the participants that were directly exposed to domestic violence presented greater symptoms in the subscales of the Child Behavioral Checklist and the Revised Children's Anxiety and Depression Scale. Such findings are discussed along with previous literature. The study also discusses limitations related to internal and external validity threats and suggestions for future replication of the group intervention toward adolescents who were exposed to domestic violence and the related program evaluation.