Adolescent Health Care Training in Predoctoral Psychology Internship Programs: A Model of Interdisciplinary Training Needs in Health Care

This needs assessment of predoctoral psychology programs in a large southeastern state reveals that although many programs include adolescent health issues and often involve the psychiatry discipline in their curricula, many trainees do not have exposure to medicine, nutrition, or nursing disciplines. Opportunities for greater interdisciplinary adolescent health care training exist in psychology training programs in this southeastern state. Integrating such training into psychology programs may enhance psychology's ability to function as a vital component of adolescent health care teams within academic medical centers across the country.     

Adolescent health care: an assessment of referral activities

The referral activities of 45 agencies (90% of the sample originally polled) in a moderate-sized midwest community were investigated with respect to agency referral patterns and professionals' appraisal of adolescents' health care status. A combined analysis of qualitative and quantitative data provided valuable insight into the problems of unmet adolescent health care needs and underutilization of adolescent health care services. Referral activity characteristics which may hinder the successful networking of services for adolescents are highlighted.     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.     

Adolescent health. Challenges for behavioral scientists

Clearly, the role of behavioral scientists in adolescent health is not limited to service delivery. They also have a role to play via their contributions to basic knowledge of adolescent health and development, their involvement with the design and evaluation of health systems, their efforts to design and evaluate interventions to reduce adolescent morbidity and mortality, and their contributions to adolescent health policy. The once popular view of adolescence as a period of inevitable storm and stress has been replaced by one that emphasizes the potential of this developmental stage for constructive adaptation and maturation. Behavioral scientists have an important role to play in assuring that the potential of this life stage is reached for future generations of youth.     

Depression, self-esteem, loneliness, and social support among adolescent mothers participating in the new parents project

The purpose of this pilot study was to examine levels of depression, self-esteem, loneliness, and social support, and the relationships between these variables, among adolescent mothers participating in the New Parents Project (formerly called the Young Parents Project). The sample consisted of 21 adolescent mothers recruited from three primary health care practices in different Midwestern cities. It was found that depression scores were in the high range (CES-DC > 15) for 53% of the participants. Strong, significant relationships were found, except between depression and self-esteem. The implications for enhancement of the New Parents Project, so as to better meet the psychological needs of adolescent mothers, are discussed.     

A determination of the health-protective behaviors of female adolescents: a pilot study

In this study, the unique needs and developmental stage of adolescent females were considered in the determination of health-protective behaviors and needs. Through the use of a questionnaire, 211 female freshman dormitory residents (17-22 years of age) attending a small, private, midwestern university, were surveyed to assess their knowledge, utilization, and perceived teaching needs regarding selected health-protective behaviors. Findings indicated that almost all of them identified basic forms of health-protective behaviors. However, a majority exhibited inadequate knowledge and use of basic health care practices. The health-teaching needs identified most frequently were in the areas of: stress control; rape/suicide prevention; safety; and prevention/care of minor illnesses. Suggestions for program design and implications for health promotion are presented.     

Religiosity and Adolescent Narcissism: Implications for Values Counseling

The authors show that the distinctive character of values counseling as a therapeutic intervention can be justified on empirical grounds. The fact that religiosity has been consistently associated with positive mental health outcomes is a warrant for counselors to explore the resources of one's religious tradition for therapeutic change. The authors also argue that pastoral counseling is particularly suited for addressing the ego development needs of adolescents and that the vicissitudes of adolescent narcissism can be effectively mobilized to support self-transcendence and relational autonomy, tasks that have both developmental and religious significance.     

Adolescent Religiosity as a Mediator of the Relationship Between Parental Religiosity and Adolescent Health Outcomes

Studies have demonstrated the positive impacts of both parent and adolescent religiosity on adolescent outcomes; however, the relationships among these variable have not been studied. Our study was conducted to assess whether adolescent religiosity mediates the relationship between parent religiosity and adolescent emotional and behavioral health outcomes. A sample of 491 late adolescents ages 18–22 completed surveys that assessed their parents’ religious practices, their own religious practices, deviant behaviors, and internalizing behaviors. Findings suggest that adolescent religiosity mediates the relationship between parents’ religiosity and adolescent health outcomes such as drug and alcohol use and depression.     

The Development,Pilot, and Process Evaluation of a Parent Mental Health Literacy Intervention Through Community Sports Clubs

The mental health literacy of parents may be critical in facilitating positive child and adolescent mental health outcomes. The purpose of this study was to develop, pilot, and evaluate a targeted parent mental health literacy intervention through community sports clubs. Sixty six parents (M_age?=?44.86?±?5.2 years) participated in either a brief mental health literacy intervention workshop delivered through community sporting clubs (n?=?42) or a community-matched control group (n?=?24). Participants’ mental health literacy was assessed at baseline, post-intervention and at 1 month follow-up. A mixed methods process evaluation was conducted with intervention participants to determine the acceptability and feasibility of the intervention. Participants in the experimental group showed greater increases in depression literacy, anxiety literacy, knowledge of help seeking options and confidence to assist an adolescent experiencing a mental health disorder, compared to those in the control group. Post-intervention changes in the experimental group were maintained at 1 month follow-up. A mixed methods process evaluation revealed that parents found the intervention content engaging, relevant to their needs, and practically useful in terms of actively supporting adolescent mental health. Findings provide evidence that a brief, targeted intervention through community sports clubs might be a particularly useful method of improving parental mental health literacy and facilitating positive youth mental health outcomes.     

Adolescent Brain Development and the Risk for Alcohol and Other Drug Problems

Dynamic changes in neurochemistry, fiber architecture, and tissue composition occur in the adolescent brain. The course of these maturational processes is being charted with greater specificity, owing to advances in neuroimaging and indicate grey matter volume reductions and protracted development of white matter in regions known to support complex cognition and behavior. Though fronto-subcortical circuitry development is notable during adolescence, asynchronous maturation of prefrontal and limbic systems may render youth more vulnerable to risky behaviors such as substance use. Indeed, binge-pattern alcohol consumption and comorbid marijuana use are common among adolescents, and are associated with neural consequences. This review summarizes the unique characteristics of adolescent brain development, particularly aspects that predispose individuals to reward seeking and risky choices during this phase of life, and discusses the influence of substance use on neuromaturation. Together, findings in this arena underscore the importance of refined research and programming efforts in adolescent health and interventional needs.     

Interdisciplinary Knowledge Translation: Lessons Learned from a Mental Health: Fire Service Collaboration

Collaborative approaches are being increasingly advocated for addressing a variety of health, mental health and social needs for children, youth and families. Factors important for effective knowledge translation of collaborative approaches of service delivery across disciplines, however, have not been rigorously examined. TAPP-C: The Arson Prevention Program for Children is an intervention program for child and adolescent firesetters provided collaboratively by fire service and mental health professionals. The present study examined the adopter, innovation, and dissemination characteristics associated with TAPP-C implementation, protocol adherence and extent of collaboration by 241 community-based fire service professionals from communities across Ontario. Results revealed that dissemination factors are particularly important for understanding program implementation, adherence and cross-discipline collaboration. Moreover, the findings of this study show significant benefits to both within discipline (intra-disciplinary) and across discipline (interdisciplinary) knowledge translation strategies.     

Smoking involvement during adolescence among African Americans and Puerto Ricans: risks to psychological and physical well-being in young adulthood

The major aim of this study was to examine the longitudinal association between adolescent smoking involvement and self-reported psychological and physical outcomes in young adulthood. Participants included 333 African Americans and 329 Puerto Ricans who were surveyed in 1990 in their New York City schools and interviewed in 1995 and 2000-2001, primarily in their homes. The psychological outcomes included ego integration, symptoms of depression, anxiety, and interpersonal difficulty. The physical health measures included a general health rating, number of illnesses, and symptoms of ill health. Also, three scales measured problems due to alcohol, marijuana, and other illicit drug use. Smoking involvement varied by age, sex, and ethnicity but not by socioeconomic status nor by late adolescent parental status. Analysis showed that the relationships between adolescent smoking involvement and psychological and physical health problems in young adulthood remained significant even with control on demographic factors, earlier levels of the outcome variables, and marijuana use. The relationships between smoking behavior and problems with alcohol, marijuana and other illicit drug use were particularly strong. Thus, adolescent smoking seems to have a wide range of clinical implications for young adulthood.     

Counsellors perceptions of adolescence

School mental health professionals' attitudes toward their potential client populations can determine what strategies they apply vis-à-vis their clients. Therefore, it is important that they be aware of their personal orientations. In this vein, the present study investigates, through both quantitative and qualitative methods of collection and analysis of data, the perceptions Israeli secondary-school counsellors have of adolescence. Questionnaires filled by 199 counsellors showed that, in general, counsellors have a favourable view of adolescents and do not perceive adolescence as a 'difficult stage'. Counsellors also believe that they are perceived positively by their adolescent students. Interviews conducted with 41 counsellors (a group randomly selected from the initial sample of counsellors) revealed a more complex view of adolescence. The interviewed counsellors identified five type of adolescents: the drive-oriented adolescent, the intellectually-oriented adolescent, the grouporiented adolescent, the community-oriented adolescent, and the isolated adolescent. The study also explores counsellors' opinions regarding each of these types' main characteristics, the leading reasons that may prevent adolescents from approaching a counsellor, and the considerations that may influence them to independently refer to a counsellor. Implications for school mental health professionals are discussed.     

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.     

Different Effects of Paternal and Maternal Attachment on Psychological Health Among Chinese Secondary School Students

Many studies have demonstrated the beneficial effects of parental attachment on adolescent development. However, few studies have specifically investigated the different effects of paternal attachment and maternal attachment on adolescent development. The current study examined the different effects of paternal attachment and maternal attachment on adolescent psychological health (e.g., self-esteem, depression, life-satisfaction), and the moderating roles of gender, age, and one-child status. Participants were 1506 secondary school students (50.2 % male, grades 7–12) from six regions of China. Results suggested that paternal attachment had stronger effects on adolescents’ depressive symptoms than did maternal attachment after controlling for all covariates (e.g., family setting, gender, grade, one-child status, father’s and mother’s education levels). Moreover, multi-group analysis indicated that the stronger impact of paternal attachment on depressive symptoms in comparison to maternal attachment was only evident in high school boys and only children. This study demonstrated the important role of father–adolescent attachment in adolescent psychological health. Future research, clinical implications, and limitations of the present study are discussed.     

A qualitative evaluation of a mental health literacy intervention for parents delivered through community sport clubs

Intervention studies have rarely targeted parent mental health literacy despite its importance for adolescent mental health. This qualitative study evaluated the experiences of parents (n = 352) who participated in the Ahead of the Game mental health literacy workshop delivered through community sport clubs. Moreover, the study aimed to investigate the relevance, retention and use of intervention content by parents, assess the acceptability and feasibility of delivering mental health education through community sport clubs, and identify strategies for increased engagement. In total, 17 parents (13 mothers, four fathers) participated in semi-structured interviews up to one month after the workshop. Reflexive thematic analysis revealed that parents perceived mental health education as important and valuable, and believed the community sport club was an appropriate setting to discuss adolescent mental health. Parents reported increased awareness and knowledge of mental health disorders and help-seeking options, and increased confidence and preparedness to communicate and assist someone experiencing a mental health issue. The workshop stimulated conversation about mental health between parents and their children, and between parents within and outside the sport club community. Parents used information and resources provided in the workshop to help those in their networks and reflected back on the workshop when noticing changes in their adolescent’s behavior. Potential additions to the workshop (as suggested by parents) included increased discussion among parents as well as opportunities for further information sessions or tailored online material. Future research might look to engage more fathers, actively encourage parents to aid in the recruitment of others, and investigate long-term adolescent mental health outcomes.     

Multidimensional Family Therapy HIV/STD Risk-Reduction Intervention: An Integrative Family-Based Model for Drug-Involved Juvenile Offenders

Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies ( http://www.cjdats.org ). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.     

Does Human Facial Attractiveness Honestly Advertise Health? Longitudinal Data on an Evolutionary Question

Inspired by the evolutionary conjecture that sexually selected traits function as indicators of pathogen resistance in animals and humans, we examined the notion that human facial attractiveness provides evidence of health. Using photos of 164 males and 169 females in late adolescence and health data on these individuals in adolescence, middle adulthood, and later adulthood, we found that adolescent facial attractiveness was unrelated to adolescent health for either males or females, and was not predictive of health at the later times. We also asked raters to guess the health of each stimulus person from his or her photo. Relatively attractive stimulus persons were mistakenly rated as healthier than their peers. The correlation between perceived health and medically assessed health increased when attractiveness was statistically controlled, which implies that attractiveness suppressed the accurate recognition of health. These findings may have important implications for evolutionary models.     

Parental employment status and adolescents’ health: The role of financial situation,parent-adolescent relationship and adolescents’ resilience

The paper deals with parental employment status and its relationship to adolescents’ self-reported health. It studies the role of the financial situation, parent–adolescent relationship and adolescent resilience in the relationship between parental employment status and adolescents’ self-rated health, vitality and mental health. Multiple regression analyses were used to analyse questionnaire data obtained from 2799 adolescents (mean age 14.3) in 2006. The results show a negative association of the father’s, but not mother’s unemployment or non-employment with adolescents’ health. Regression analyses showed that neither financial strain nor a poor parent–adolescent relationship or a low score in resilience accounted for the relationship between the father’s unemployment or non-employment and poorer adolescent health. Furthermore, resilience did not work as a buffer against the negative impact of fathers’ unemployment on adolescents’ health.