Association Between Socio-Ecological Risk Factor Clustering and Mental,Emotional, and Behavioral Problems in Hispanic Adolescents

Compared to non-Hispanic whites, Hispanic adolescents in the U.S. report higher rates of several mental, emotional, and behavioral problems such as substance use, sexual risk behaviors, and internalizing and externalizing problems. There is evidence of common pathways in the development of mental, emotional, and behavioral problems with certain subgroups of Hispanic adolescents being at greater risk. In the present article, we report analysis of baseline data for 959 Hispanic adolescents who participated in one of two randomized controlled trials evaluating a family-based preventive intervention. Utilizing latent class analysis, we identified subgroups of Hispanic adolescents based on socio-ecological risk and protective factors (e.g., parent–adolescent communication, parental involvement in school). Three distinct socio-ecological risk subgroups (high, medium, and low risk) were identified and exhibited significant differences from each other across a majority of socio-ecological risk and protective factors. Adolescents in higher socio-ecological risk subgroups reported greater mental, emotional, and behavioral problems across all outcomes. Individual comparisons revealed significant differences between the low socio-ecological risk group and both the medium and high socio-ecological risk group in lifetime alcohol use, smoking, and sex, as well as internalizing and externalizing problems. Implications for intervention include focusing on specific risk subgroups and targeting shared risk and protective factors rather than specific mental, emotional, and behavioral outcomes.     

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.     

Development of an Intervention for Foster Parents of Young Foster Children with Externalizing Behavior: Theoretical Basis and Program Description

Foster parents are often faced with serious externalizing behaviors of their foster child. These behavioral problems may induce family stress and are related to less effective parenting and often increase. Foster children with behavioral problems are also more at risk of placement breakdown. An intervention to support foster parents of young foster children with externalizing behaviors is necessary to improve the effectiveness of foster placements. Based on research on effective parenting interventions and special needs of foster children, a treatment protocol was developed. This paper describes theoretical foundations for the content and form of the intervention and gives an overview of the modular treatment protocol. Preliminary outcomes of this intervention as well as challenges and future developments and research activities are discussed.     

Risk Reduction Therapy for Adolescents: Targeting Substance Use and HIV/STI-Risk Behaviors

This paper describes a family-based intervention for addressing both substance use and unprotected sexual behavior in adolescents presenting for outpatient substance use treatment. The intervention combines contingency management (CM) for adolescent substance use, which is a behavioral intervention modeled on the Community Reinforcement Approach, with a sexual risk reduction protocol that mirrors aspects of the CM model. As a family-based intervention, caregivers attend every session and actively collaborate with the therapist to address their youth’s behavior problems. The treatment is criterion-based with treatment duration determined by the youth’s achievement of reduced substance use and unprotected sexual behavior goals. A case study describes the implementation of this treatment with an adolescent presenting a history of polysubstance use and unprotected sexual intercourse. Following the adolescent and caregiver’s participation in weekly sessions, the adolescent demonstrated improvements in substance use, unprotected sexual behavior, and other behavior problems. Clinical summary data from two outpatient clinics reveal similar positive outcomes for youth receiving the intervention. This paper illustrates the potential utility of an integrated treatment approach targeting substance use and unprotected sexual behavior in an adolescent population.     

Father absence and adolescent "problem behaviors": alcohol consumption, drug use and sexual activity

Among the issues faced by adolescents are problems relating to alcohol consumption, drug use, and sexual behavior. A survey of 813 adolescents found that adolescents are most likely to discuss these problems with peers and least likely to discuss them with parents, especially fathers. However, father absence from the home resulted in greater use of and problems with alcohol, marijuana, and sexual activity. This was the case especially for boys. The results obtained underscore the significance of the father as a key figure in the transmission of values and as a deterrent to certain behaviors. The results point to adolescents from fatherless homes, especially boys, as being at risk for problems in the areas noted. This suggests that community agencies providing services to adolescents should make special efforts to incorporate into their programs specially designed services to meet the particular needs of this group. Aspects of such programs are discussed.     

Sexual behavior in Spanish adolescents of divorced parents

Marital breakup has been associated with numerous behavioral problems in children, such as sexual risk behaviors. This research is the first to examine sexual behaviors of Spanish adolescents related to whether their parents were married or divorced. Participants were 342 boys and girls aged between 14 and 18 years. The sample provided confidential information about their sexual behavior and birth control methods. Significant differences were only found in percentages of adolescents who had engaged in mutual masturbation, intercourse, or oral sex, and who had practiced these sexual relations in the last six months, in both cases, they were higher when the parents had broken their marital relationship. Regarding adolescents of divorced parents, engaging in intercourse is more likely in older teenagers who live with a stepparent. Moreover, older adolescents who were younger when parents divorced and who live in a reconstituted family, have more sexual partners. These and other findings are discussed.     

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。     

Mothers’ and Adolescents’ Perceptions of Family Environment and Adolescent Social-Emotional Functioning

Research has emphasized the importance of the relationship between family functioning and adolescent behavioral development. The present study examines family environment and social-emotional functioning of primarily minority adolescents, viewed from both adolescents’ and mothers’ perspectives. Participants were a school-based sample of adolescents with and without risk for emotional and behavioral disabilities and their mothers (N = 86 dyads). Results suggested an association between the mothers’ views of their adolescent children’s problem behaviors and the adolescents’ self-ratings of risk-taking behaviors across 5 years. Overall, mothers of the at risk youth receiving special education services reported higher ratings of youth problem behaviors, but results also indicated that mothers of the at risk adolescent boys not receiving special education services perceived greater depressive symptoms in their children and more family conflict in their homes. Mothers of youth at risk but not receiving special education services experienced higher levels of stress associated with being a parent than mothers of the not-at-risk adolescents. The parent measures of adolescent behavior and depressive symptoms, family conflict, and parental stress were not predictive of the social-emotional functioning of these adolescents in the multilevel models. Implications of these findings for early identification and family focused intervention programs 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.     

Ethical problems in research on risky behaviors and risky populations

The articles by Brooks-Gunn, Fisher, Hoagwood, Liss and Scott-Jones (all in this issue) present a panoply of real-world ethical issues in conducting scientific research on risky behaviors of children, adolescents, and their parents, particularly those from vulnerable populations. The universal, ethical principles of beneficence, justice, and respect for others are always applicable, but they do not resolve issues of child assent, parental consent, legal reporting requirements for illegal behaviors, and the special problems of studying risky behaviors in risky populations. Taken as a group, the articles raise some of the most interesting ethical problems that arise in developmental research. My discussion elaborates some issues and fails to resolve others. I hold the view that both science and ethics can be served by thoughtfully designed and implemented research on important social issues, but that the studies themselves cannot simultaneously solve the many societal problems of participants and be scientifically credible.     

WHY NO GUIDELINES FOR BEHAVIOR MODIFICATION?

This paper reviews the guidelines for behavioral programs published by the National Association of Retarded Children. The review discusses a number of reasons why guidelines should not be enunciated for behavior modification, e.g., the procedures of behavior modification appear to be no more or less subject to abuse and no more or less in need of ethical regulation than intervention procedures derived from any other set of principles and called by other terms. The review recommends alternative methods for protecting the rights of clients who participate in behavioral programs. Specifically, behavioral clinicians, like other therapists, should be governed by the ethics codes of their professions; also, the ethics of all intervention programs should be evaluated in terms of a number of critical issues.     

The Protective Effects of Religious Beliefs on Behavioral Health Factors Among Low Income African American Adolescents in Chicago

Religious involvement has long been argued to have protective effects for negative behavioral health outcomes for vulnerable youth. This study builds on the existing resilience literature and need for more studies that examine protective factors associated with behavioral health. A sample of 638 low-income African American adolescents in Chicago to examine within group variations of the influence of religious involvement on delinquency, school engagement, substance use and sexual risk behaviors, and whether such relationships differ by gender, sexual orientation, and socioeconomic status. Logistic regression findings documented that greater religious involvement was protective with regards to lower rates of delinquency, drug use, risky sexual behaviors and higher rates of school engagement, and that gender, sexual orientation and socioeconomic status varied for several of these relationships. Overall findings are discussed with regards to future research.     

The impact of a history of sexual abuse on high-risk sexual behaviors among females attending alternative schools

The goal of this study was to explore whether a history of sexual abuse is associated with high-risk sexual behaviors among female adolescents attending alternative schools in a large urban city in the southwestern United States, and to examine the role of depression and substance abuse in explaining this association. One hundred eighty-four sexually active female adolescents constituted the sample for this analysis. Forty-nine (26.6%) reported that they were forced to have sex. Having a history of sexual abuse substantially increased sexual risk behaviors. Adolescents reporting a history of sexual abuse, compared to those who did not report such a history, were significantly more likely to have initiated sexual activity (intercourse) before age 14, to have had three or more sexual partners in the last 3 months, and to have had a history of sexually transmitted diseases. These associations remained significant after controlling for age, ethnicity, and family income. Depression and substance abuse did not explain the association between sexual abuse and high-risk sexual behaviors. It seems reasonable to conclude that adolescents with a history of sexual abuse have greater difficulty practicing safe sexual behaviors than do those who have not been sexually abused. Given the prevalence of child sexual abuse and the extent of its impact, it is critical that intervention strategies for adolescent females address the issue of abuse and help them adopt self-protective sexual behaviors. The findings also highlight the importance of targeting adolescents who attend alternative schools.     

Increasing Positive Health Behaviors in Adolescents with Nutritional Goals and Exercise

Research has documented that low-income urban youth are at risk for obesity and related health problems. Our goal was to develop a brief, developmentally informed intervention to increase positive health behaviors (e.g., diet and exercise) among low-income, minority adolescents. Our study was designed to examine the feasibility and potential impact of our single session intervention that was delivered in a primary care setting. The participants were 100 adolescents from an urban adolescent medicine clinic who were randomly assigned to one of two conditions: a) a 3–5?min goal-only session or b) a 15–20?min motivationally enhanced intervention. Health behaviors and individual characteristics (i.e., autonomous motivation, self-efficacy) were assessed at baseline and re-assessed at follow-up 1 month later with 53?% of the youth completing the follow-up assessment. Those in the enhanced intervention group were more likely to participate in the follow-up as were those who reported higher baseline motivation and self-efficacy. Both groups reported statistically significant health behavior improvements over time and older adolescents reported more improvements. The two conditions did not significantly differ in reported health improvements. Self-efficacy predicted improvements in self-reported fruit and vegetable intake at follow-up. Results support that a brief “chat” with adolescents about their personal goals and values appears to have the potential to increase their positive health behaviors and appears to be useful as a preparatory intervention for weight management efforts for urban teens. The study demonstrates the feasibility and potential efficacy of implementing this 20?min intervention into primary care settings, thereby helping urban youth focus on their individualized goals, values, and motivations for health.     

A Cognitive Behavioral Adherence Intervention for Adolescents with Type 1 Diabetes

This study examined the impact of a cognitive behavioral intervention for nonadherent adolescents with type 1 diabetes. Six youths having problems following the diabetes regimen received training in cognitive restructuring and problem solving during individual sessions. A multiple baseline design across participants was used. Treatment effectiveness was assessed through 24-hr recall adherence interviews with adolescents and frequency of testing data was downloaded from glucose meters. Data was also collected for diabetes-specific stress. Five youths displayed improvement on at least one self-care behavior. Furthermore, the results suggest that the cognitive behavioral intervention was effective in diminishing diabetes-related stress in two participants. Cognitive behavioral interventions show promise for increasing self-care behaviors among nonadherent youths with type 1 diabetes. However, individual youths varied in their response to treatment. Further research is needed in developing procedures to better meet the needs of youths, improve youth participation, and enhance treatment effectiveness.     

Finding the Lost Sheep: A Panel Study of Business Students' Intrinsic Religiosity,Machiavellianism, and Unethical Behavior Intentions

This research investigates 266 business students' panel data across 4 time periods and tests a theoretical model involving intrinsic religiosity, the love of money (Time 1), Machiavellianism (Time 2), and propensity to engage in unethical behaviors (PUB; Times 3 and 4). There was a short ethics intervention between Times 3 and 4. We identified good apples and bad apples using the PUB measure collected at Time 4. From Time 3 to Time 4, good apples became more ethical, whereas bad apples became less ethical after the ethics intervention. Moreover, for the whole sample, intrinsic religiosity deterred unethical intentions not only directly but also indirectly through the absence of Machiavellianism. Before the ethics intervention, intrinsic religiosity curbed unethical intention directly for good apples but indirectly for bad apples. After the intervention, only the indirect effect was significant for bad apples. Intrinsic religiosity offers us hope to open the hearts of the lost sheep and bring them home. Research results were discussed in light of this study's theoretical, empirical, and practical contributions; Judeo-Christian ethics and values; challenging roles of educators and executives in educating Gen-Yers; creating a sea change of the ethical social norm in schools, organizations, and society, or ethical community building, and promoting ethical behavior; and future directions for research.     

Perceived Organizational Ethics and the Ethical Decisions of Sales and Marketing Personnel

Using a scenario-based approach, this study analyzed data collected from marketers with sales backgrounds and investigated the impact of perceived organizational ethics on their ethical issue recognition, ethical judgments, and ethical behavioral intentions. The results indicated that perceived organizational ethics, which was operationalized with two separate measures, was positively related to both the ethical judgments and expressed behavioral intentions of respondents. Further, ethical issue recognition was positively associated with ethical judgments and expressed behavioral intentions, and ethical judgments were positively related to ethical behavioral intentions. The findings suggest that, in order to enhance sales professionals’ ethical reasoning, organizations should focus on developing an ethical context that is relevant to the issues confronted by sales professionals in their work and that is as specific as possible with regard to these ethical dilemmas.     

Brief counseling to reduce AIDS risk in intravenous drug users and their sexual partners: Preliminary results

Intravenous drug users (N = 88) and their sexual partners (N = 45) were randomly assigned to either a brief counseling intervention or an information-brochure only condition (aimed at reducing behavioral risk for HIV infection). At 10 day follow-up, intravenous drug users exposed to brief counseling were more knowledgeable about risk behaviors, and reported higher levels of self-efficacy and communication skill, and more frequent use of condoms and sterilisation of needles. At 90 day follow-up, intravenous drug users were more accepting of guidelines to reduce sex-related risk and reported greater self-efficacy in relation to drugs. Sexual partners who received brief counseling showed a small reduction in unprotected sex (at 90-day follow-up), while those receiving brochures were slightly less likely to use condoms. Methodological problems of the study are discussed.     

A study of the intensity and frequency of crisis intervention for students enrolled in a school for the severely emotionally disturbed

The present study explored the characteristics of students with a marked need for disciplinary crisis intervention (a modified time-out procedure). The study's sample consisted of 62 adolescents enrolled at a school serving the severely emotionally disturbed. Data on student background characteristics (IQ, academic achievement), behavioral adjustment, and sociometric ratings were gathered and related to intensity and frequency of crisis intervention. Data were subjected to correlational and multiple regression statistical procedures. One noteworthy finding is that students with a pronounced need for crisis intervention were rejected by their peers, yet indicated having positive perceptions of them. However, the central finding is that students with strong crisis intervention needs displayed a range of behaviors that can be characterized as a disturbance in conduct. Thus, this study supports the use of therapeutic interventions aimed at enhancing behavioral control for these students.     

The Role of Families in Adolescent HIV Prevention: A Review

Recent research has highlighted the significant contribution families make in the prevention of HIV risk behaviors among adolescents. As the most proximal and fundamental social system influencing child development, families provide many of the factors that protect adolescents from engaging in sexual risk behaviors. Among these are positive family relations, effective communication about sexuality and safer sexual behaviors, enhancement and support of academic functioning, and monitoring of peer activities. HIV risk behaviors occur in a social context, and it is becoming clear that the earliest and most effective way to intervene is in the context where one initially learns about relationships and behavior—the family. Both the Centers for Disease Control and Prevention and the National Institute for Mental Health have taken steps to support and emphasize research that will further elucidate our understanding of the role of families in HIV prevention. This article uses Ecodevelopmental Theory to guide and organize the findings of this promising research area. Within this context, and with special attention to the comorbidity of adolescent problem behaviors, this article reviews empirical research on the role of families in HIV prevention, discusses current intervention efforts that involve families and ecosystems, and addresses prospects and implications for future research and interventions.