Gender differences in victimized homeless adolescents

Most of what we know about sexual abuse comes from efforts to examine female children victimized by men. Although some researchers have identified similarities between male and female victims of sexual abuse, few studies have examined gender-specific factors associated with sexual health practices among homeless adolescents. The aim of this study was to explore how gender and history of sexual abuse influence cognitive-perceptual and behavioral factors associated with sexual health practices of homeless adolescents. This study was a secondary analysis of data collected for a cross-sectional study of the sexual health practices of homeless adolescents. The sample consisted of 414 youths (104 males who reported sexual abuse and 124 who did not; and 95 females who reported sexual abuse and 75 who did not; 16 did not provide these data). Homeless adolescent females with a history of sexual abuse scored higher (indicating a shorter perspective) on a measure of future time perspective than females with no sexual abuse. Males who reported no sexual abuse scored higher than abused females on perceived health status and higher than abused males on assertive communication. With respect to perceived health status, males who reported no sexual abuse scored significantly higher than females who reported sexual abuse (p = .04). Males with no sexual abuse had significantly higher assertive communication scores than did males who had experienced sexual abuse (p = .015). We found that male and female abuse victims differ in terms of their cognitive-perceptual and behavioral factors associated with sexual health practices. Early identification of those who have been abused is critical so that interventions can be developed. Effective short-term interventions are needed for the adolescent victims of Child Sexual Abuse (CSA), particularly those who are homeless and prone to further sexual victimization.     

Utilizing Creative Expressive Techniques and Group Counseling to Improve Adolescents of Divorce Social-Relational Capabilities

Adolescents of divorce present challenges for mental health counselors unfamiliar with issues this population encounters. Problems such as negative societal perceptions and low behavioral self-efficacy can combine, causing long-lasting problems. Specifically, adolescents of divorce appear to be at risk for developing inadequate social/relational capabilities. To improve adolescents’ relational and social competencies, the authors advocate for a creative combination of expressive techniques and group counseling. This brief, six-week intervention may be a viable, creative tool for counselors working with this distinct client population.     

Gendered adversity and mental health of adolescents orphaned by AIDS in a rural South African community: An exploratory study

This study explored gender differences in adversity and mental health among South African adolescents orphaned by AIDS. Adolescents (N = 121; females = 45.5%; mean age 14.14 years, SD = 2.09) self-reported their childhood adversities and probable mental ill health on the Child Trauma and General Health Questionnaire. Results revealed that female participants orphaned by AIDS were significantly more likely to report childhood adversity at total score level as compared to male participants. However, both male and female participants reported comparable scores on subscales of childhood adversity (emotional abuse, physical abuse, sexual abuse, and physical neglect). Moreover, female participants displayed higher composite mental ill health and all its subscales except for social dysfunction. Our findings suggest that gender-sensitive programmes and policies to address the effect of childhood adversity and mental ill health among adolescents orphaned by AIDS, are urgently needed.     

Adolescents' perceptions of outpatient mental health services

Thirty-three adolescents from three mental health service settings were interviewed regarding their perceptions of the purpose, goals, expectations, frustrations and benefits of mental health experiences. They provided satisfaction ratings and importance rankings of seven domains of satisfaction: (a) Convenient/Accessible, (b) Meeting Needs, (c) Staff Competence, (d) Personal Relationship with Staff, (e) Effectiveness of Treatment, (f) Comfort/Appropriateness of Center, and (g) Costs and Paperwork. In addition, participants completed the Client Satisfaction Questionnaire (CSQ-8). Results indicated that, in general, the adolescents were very satisfied with the services they received. Gender, race/ethnicity and treatment site were not related to satisfaction scores, nor was the adolescent's perceived choice in seeking services. Some significant gender differences were found both in terms of the rankings of satisfaction domains, as well as in the adolescents' perceptions of their reasons for initiating counseling and the perceived goals and benefits of counseling. Additional differences in perceptions of services were found for treatment site and race/ethnicity. In general, adolescents were able to generate informative, sophisticated responses to questions regarding their perceptions of mental health services, and demonstrated that they are capable of evaluating services they receive.     

555例危险行为高危青少年的心理干预：来自个体辅导和团体辅导的效果对照

对有较高风险发展为危险行为青少年的高危群体实施有针对性的心理干预是非常有价值的。本研究对青少年危险行为高危人群进行结构化的个体与团体心理干预,评估两种干预的即时效果和六个月的预后情况。采用《青少年健康相关危险行为问卷》等量表对16所中职院校的学生进行筛查,共555名学生参加本研究,被随机分为个体、团体和对照组并分别进行干预。结果发现：干预后,个体心理干预组被试的危险行为水平、心理健康以及抑郁和焦虑情绪均获得显著改善,并且6个月的预后效果依然明显,而接受团体辅导干预组仅在抑郁指标上有所改善,在危险行为评分、焦虑和心理健康水平上均没有明显的改善。研究认为,对危险行为易感青少年的心理干预应以经过良好设计的个体心理干预为主、团体干预为辅的方式进行。     

The influence of targeted digital advertising on consumers' purchase intention: Comparative analysis based on the perspective of ads content source

Targeted digital advertising (TDA) is immensely popular among marketing practitioners; investigating its effects is increasingly becoming a subject of academic research. Brands can push advertisements of the same product from different sources to consumers in a targeted manner; however, the differences in the impact on consumers of TDA with different content sources are surprisingly understudied. Therefore, this study analyzes the consumers' purchase intentions in the context of TDA with different content sources (stars vs. bloggers vs. top e-commerce streamers), and the perceived differences between consumers with different thinking styles. Through two experimental studies, this study finds that TDA with top e-commerce streamers' recommendation source can better improve consumers' purchase intentions more than TDA with a star endorsement and TDA with a blogger evaluation. For consumers who prefer the rational thinking style, TDA with a star endorsement and TDA with top e-commerce streamers recommendation can be better; For consumers who prefer the empirical thinking style, TDA recommended by bloggers and TDA with top e-commerce streamers recommendation can be better. Furthermore, this study finds that consumers' mental simulation and perceived usefulness can mediate the relationships described above, and that the two play a chain mediation role. The findings contribute to the precision marketing literature by enriching the understanding of the psychological mechanism underlying consumers' perceptions of and decision factors toward the TDA.     

Family Support and Mental Health Service Use Among Suicidal Adolescents

Despite the fact that multiple evidence-based treatments exist for suicidal adolescents, these youth are unlikely to engage in mental health treatment. While family members can be influential in connecting adolescents to mental health care, suicidal youth are more likely to be exposed to family environments characterized by abuse, neglect, and to have poorer parent–child attachment quality than non-suicidal youth. This study analyzed data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine the relationships between perceived levels of parental support, symptom severity, and mental health service use in a nationally representative sample of suicidal adolescents in the U.S. (n = 1804). Higher levels of parental support were associated with a lower likelihood of mental health service use, lower levels of depression, and lower likelihood of an actual suicide attempt. Additionally, the presence of a suicide attempt and higher levels of depression were associated with a higher likelihood of mental health service use. When mediation effects were tested, the presence of a suicide attempt partially mediated the relationship between parental support and mental health service use. Implications discussed include the protective nature of parental support the need for more family-based interventions for this population.     

Supporting the Need for an Integrated System of Care for Youth with Co-occurring Traumatic Stress and Substance Abuse Problems

Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.     

Definitions of physical abuse: A preliminary inquiry into children's perceptions

Research and policy-makers have frequently called for operational definitions of child abuse, however neither group has considered including children's perceptions of what constitutes abuse. The purpose of this study was to expand the discussion on definitions of child abuse by examining children's perceptions of physical abuse. This was done by collecting data to begin to document abused children's ratings of the seriousness of various abusive acts and to begin to examine gender and age differences in children's perceptions. The data revealed significant differences in children's perceptions of the seriousness of specific acts of abuse and a significant interaction between age and type of abuse. Although young children generally produced lower seriousness ratings than older children, their ratings were significantly lower on only a few types of abuse. When children's ratings were compared to similar ratings reported in earlier studies of adolescents, community members, and mental health professionals, the children in this study rated the abusive acts as less serious than the adolescents or community members, but very similar to the professionals who work in the area of child abuse and neglect. Although this must be considered a preliminary investigation, the potential implications for various legal and social contexts are discussed.     

The relationship between childhood sexual abuse and sexual health practices of homeless adolescents

This study explored the gender differences in sexual self-concept, personal resources for sexual health, safe sex behaviors, and risky sexual behaviors among homeless adolescents with and without histories of sexual abuse. Data for this secondary analysis were collected in 2003 to 2004 in the first phase of a larger repeated-measures sexual health intervention study; 371 homeless youth between 16 and 23 years of age (M = 19.26, SD = 1.83) were recruited from a street outreach center. The majority (64.6%) of participants were males. Self-report instruments were completed at the outreach center via audio computer-assisted self-interview (A-CASI) format. It was found that female participants were better off than males on numerous measures of sexual health behaviors and attitudes. Sexually abused participants had significantly less future time perspective (p = .05), fewer sexual self-care behaviors (p = .04), and less social support than nonabused participants (p = .01) and almost significantly more sexual risk-taking (p = .08). However, no significant differences were found between abused and nonabused participants on sexual self-concept, self-efficacy or intention to use condoms, safe sex behaviors, AIDS knowledge, assertive communication, or self-efficacy to perform testicular/ breast self-exams. Overall, participants who did not report a history of sexual abuse had significantly more sexual health resources and engaged in fewer sex-risk behaviors than those who reported having been abused. These differences have notable implications for screening adolescents for a history of sexual abuse. Adolescents who report sexual abuse should receive risk counseling and be screened regularly for the development of sexual risk behaviors.     

Mental Health, Social Environment and Sexual Risk Behaviors of Adolescent Service Users: A Gender Comparison

We examined individual mental health problems (depression, conduct disorder, and substance abuse) and social environment (family, peer, and neighborhood) factors associated with the sexual risk behaviors of male and female adolescents. Interviews with 778 adolescents, aged 14 to 18, showed that both mental health problems and social environment were related to adolescents' involvement in sexual risk behaviors. Conduct disorder symptoms, substance abuse or dependence symptoms, and the interaction between peer misbehavior and neighborhood problems were significantly associated with risky sexual behaviors. Peer misbehavior was a particularly strong factor related to sexual risk behaviors for youths who lived in neighborhoods with multiple problems. The only gender differences were found in age, with older males more likely to report engaging in high risk sexual behaviors. This study suggests the utility of multidimensional intervention strategies to deal with various adolescent problem behaviors, including risky sexual behaviors, within the context of their social environment.     

青少年和父母对心理咨询认识的质性研究

用访谈法探讨8个已求助和5个未求助家庭的青少年和父母对心理咨询的认识;比较已求助者和未求助者、青少年和父母对心理咨询认识的差异。结果显示,青少年和父母从6个方面描述心理咨询:功能、形式、适用问题、服务提供者、求助者和效果,各方面提及次数最多的分别是问题解决、谈话法、心理困扰、心理医生、心理有病的人和有帮助;误解包括心理咨询是针对心理有病的人,只有严重问题才需要求助。已求助者比未求助者更了解心理咨询,提及问题解决、心理困扰和有帮助的次数更多。青少年更多认为心理咨询是心理老师处理正常群体的心理困扰;父母更多认为心理咨询是心理医生处理心理疾病。青少年和父母对心理咨询的认识趋于理性和准确,但仍有误解需要澄清。     

The Pre-Adult Health Decision-Making Model: linking decision-making directedness/orientation to adolescent health-related attitudes and behaviors.

In light of the broad consequences of the acquired immunodeficiency syndrome (AIDS) epidemic, as well as the increased rates of sexually transmitted diseases (STDs), pregnancy, and alcohol and drug abuse among adolescents, there is a great need to understand how adolescents make health decisions. This paper presents a model for adolescent health behavior, the Pre-Adult Health Decision-Making Model (PAHDM), which takes into account the differential information processing from peer sources, parent sources, or through critical or reflexive self-analysis. Also presented is a review of the large corpora of psychological and sociological literature on adolescent development, adolescent health behaviors, and, more specifically, AIDS and other STDs as a public health problem. The need for additional research in the area of adolescent health decision-making, and for a health behavior model that is specific to the "lifeworld" of the adolescent, is stressed.     

The Counseling Profession in Russia: Historical Roots,Current Trends,and Future Perspectives

Psychology was established in Russia before the Communist era. The social work profession was created in 1991 for a society in turmoil after the collapse of the Soviet Union. In 2011, the counseling profession officially emerged as a branch of social work called social psychological help. Professional counseling associations are in the formative stage. Concern about mental health issues, particularly substance abuse, suggests that the counseling profession could continue to grow in Russia.     

Preventing substance abuse in American Indian and Alaska native youth: promising strategies for healthier communities

Substance abuse has had profoundly devastating effects on the health and well-being of American Indians and Alaska Natives. A wide variety of intervention methods has been used to prevent or stem the development of alcohol and drug problems in Indian youth, but there is little empirical research evaluating these efforts. This article is an overview of the published literature on substance use prevention among Indian adolescents, providing background epidemiological information, a review of programs developed specifically for Indian adolescents, and recommendations for the most promising prevention strategies currently in practice.     

Relationships between Parental Maltreatment and Adolescents’ School Adjustment: Mediating Roles of Self-Esteem and Peer Attachment

Parental maltreatment of children has been steadily increasing in Korea despite national efforts to curb it. Children and adolescents who experience maltreatment develop psychological and social maladjustment. Therefore, mediating variables alleviating the negative effects of parental maltreatment on child development should be investigated to develop effective intervention programs. We identified the direct effects of parental abuse and neglect on adolescents’ school adjustment and the mediating effects of adolescents’ self-esteem and peer attachment on the relationships between parental abuse and neglect and their school adjustment. We used data from 2351 middle school students who participated in the Korean Children and Youth Panel Survey. Structural equation modeling revealed the following: child neglect directly and negatively related with adolescents’ school adjustment, whereas child abuse did not. Further, while adolescents’ self-esteem and peer attachment mediated the relationship between child neglect and school adjustment, adolescents’ self-esteem alone mediated the relationship between child abuse and school adjustment. These findings imply that there is a need to develop different intervention programs based on child maltreatment types. Finally, we suggested that the negative effects of parental neglect on adolescents’ school adjustment could be alleviated by adolescents’ self-esteem recovery resulting from peer support. On the other hand, in the case of adolescents experiencing parental abuse, self-esteem recovery through education and counseling provided by teachers or respected adults could be prioritized.     

Genetic counseling for pregnant adolescents

The genetic counseling literature has a paucity of information on how to provide genetic counseling services to adolescents, especially those who are pregnant. The adolescent population should be viewed as a separate culture, complete with their own beliefs and viewpoints, which are dependent upon the developmental growth tasks of puberty. The completion of these tasks is complicated by pregnancy, which has its own set of developmental goals. The adolescent struggle with developmental goals interferes with the ability to identify consequences, predict future outcomes, and communicate self-revealing statements or decisions effectively. Instead, the adolescent has an egocentric frame of reference and seeks peer approval. The genetic counseling dilemmas presented by pregnant adolescents are illustrated through two case reports. A model based on our own experience and a literature review for successful counseling of adolescents is presented, and utilizes the foundation of trust, patience, and nonjudgmental behavior. Techniques that address the adolescent's concern for autonomy and peer approval are important, and can be achieved through nonthreatening, open-ended questions that promote self-expression. Incorporation of these techniques in genetic counseling and in graduate training will enhance genetic counseling services to the adolescent population.     

Nonfatal and fatal self-harm injuries among children aged 10-14 years--United States and Oregon, 2001-2003

Fatal and nonfatal injuries due to suicidal behavior among younger adolescents are of growing concern for many communities. We examined the incidence and patterns of these injuries among persons aged 10-14 years using three databases, two national and a third from Oregon. Suffocation and firearm gunshot were the leading external causes of suicide; poisoning and cutting/piercing were the leading causes of nonfatal self-harm injuries. The most common psychosocial factors associated with those treated in emergency departments for self-harm injuries were psychological conditions; drug/alcohol involvement; and adverse circumstances, including family discord, school problems, and physical/sexual abuse. Analysis of population-based data from these databases are part of the public health approach and can help direct much needed research and prevention efforts that address self-harming behavior in these younger adolescents.     

Sexual Abuse Prevention for Individuals with Mental Retardation: Considerations for Genetic Counselors

It is now widely recognized that children, adolescents, and adults with mental retardation are especially vulnerable to sexual abuse. Because at least 10% of genetic conditions are reported to include mental retardation as a feature, the provision of services to individuals with mental retardation represents a substantial portion of the case load for many genetic counselors. Our objective is to educate genetic counselors and other health professionals about this vulnerable population in order to enhance the frequency and efficacy of inquiry into sexual education and sexual abuse prevention training for patients with mental retardation. The following review article is intended to assist genetic counselors by increasing their knowledge of factors that lead to sexual abuse and provides recommendations for integrating this information into the counseling interaction.