Lay concepts of health and illness from a developmental perspective

Abstract

The concepts of children, adolescents and their mothers with regard to different aspects of health and illness in general and five specific diseases were explored in this study. An exploration with fully standardised questions and open answers was subjected to a content analysis. A reliable rating system was developed to score the sophistication of the answers. The study included 99 Ss of the age groups 5, 8, 12 and 16 years, as well as 48 mothers of the children. Many children and adolescents were able to define health positively (well-being) and not merely as the absence of illness. The definition of illness in general was frequently composed of somatic symptoms and disorders, feeling poorly and things one would like to accomplish but can't. The causality explanations of illness in general were dominated by contagion. The concepts of the older children and the mothers were richer, more elaborated, less concrete and less action-oriented than those of the younger children. However, abstract formulations and complex aspects of illness were very rarely expressed. In addition, concepts regarding the characteristics (definition, symptoms, causality, treatment and prevention) of five diseases (cold, measles, heart infarction, cancer and AIDS) were measured. The pattern of results was strongly influenced by age. By and large, the development of most disease concepts was linear with significant differences between age groups. Conversely, within a given age group, significant differences were found in the cognitive level of disease characteristics, either with respect to the same disease or between different diseases (“horizontal shifts”).     

Explaining adolescents’ cigarette smoking: A comparison of four modes of action control and test of the role of self-regulatory mode

The present study compared how well four modes of action control (intentional, habitual, reactive and stereotype activation) explain adolescents’ cigarette smoking, and examined whether individual differences in self-regulation (locomotion and assessment tendencies; Higgins, Kruglanski, & Pierro, 2003 Higgins, ET, Kruglanski, AW and Pierro, A. 2003. Regulatory mode: Locomotion and assessment as distinct orientations. Advances in Experimental Social Psychology, 25: 293–344.  [Google Scholar]) moderate the behavioural impact of the respective modes. Findings from a prospective questionnaire survey showed that (a) willingness, prototype perceptions and past behaviour–but not intention–predicted smoking behaviour, and explained 63% of the variance, and (b) the assessment mode of self-regulation moderated the past behaviour–future behaviour relation such that past behaviour had less impact on future smoking behaviour at high levels of assessment. These findings suggest that adolescents’ smoking is controlled by stereotype activation, habitual and reactive processes. Implications of the results for designing effective adolescent smoking cessation programmes are considered.     

Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.     

The role of stress and area‐specific self‐esteem in adolescent smoking

Stress and self‐esteem have been shown to be important risk factors for adolescent cigarette smoking, and self‐esteem has previously been implicated as a stress‐moderating and a stress‐mediating variable. This study aimed to examine the associations between stress, area‐specific self‐esteem, and adolescent smoking, and to investigate whether specific areas of self‐esteem moderate or mediate the relationship between stress and smoking. Four hundred and ninety‐five adolescents (aged 14–19) responded to a questionnaire that examined these variables. Results showed that self‐esteem in the areas of school subjects and parent relations were related to smoking. Adolescents with low self‐esteem in these areas were more likely to smoke than their high self‐esteem counterparts. Highly stressed adolescents were more likely to smoke than those with low stress. However, the relationship between stress and smoking was completely mediated by self‐esteem in the area of school subjects. No moderation was revealed. Thus, high global self‐esteem may not be sufficient to reduce the risk of smoking. To maximise benefit, prevention and intervention efforts should target self‐esteem in the areas of school subjects and parent relations. Initiatives focusing on stress are only likely to decrease smoking to the extent that they influence self‐esteem in the area of school subjects.     

Life design counselling effects on the career adaptability of learners in a selective independent school setting

This collective case study applied life design counselling to augment the career adaptability of learners in a South African independent school setting. Five purposively selected learners attending Grade 11 (age range: 16–18) completed eight group-based life design counselling sessions. Data on their career adaptability pre- and post-intervention were gathered from sessional notes. The data were thematically analysed. Following the intervention the participants displayed improved career adaptability as evidenced by their demonstrated efforts to address aspects related to career concern, control, curiosity and confidence. Life design counselling appeared to have a positive effect on the career adaptability of learners in an independent school setting.     

Parental Involvement in Career Development among Disadvantaged Adolescents

The study investigated perceived parental involvement in career development amongst disadvantaged adolescents. Participants were 14 Grade 9 learners (8 boys and 6 girls: mean age =14 years) from a disadvantaged community in North-West Province in South Africa. Data were collected using semi-structured interviews, and analyzed thematically. Perceived constructive verbal persuasion or encouragement was influential in parents' facilitation of career development in their adolescent children. One-way communication from the parents to the adolescents was perceived to be non-supportive of their career development. Vicarious learning was manifested in the adoption of well-known people as role models in the absence of parental role models.     

Sport and Thought. Football as therapy: A year in the life of an inner city project

‘Sport and Thought. Football as therapy, A year in the life of an inner city project’ is a paper based on a way of working that fuses football and psychodynamic thinking. The project was set up at inner city all-boys secondary school in London and was created in response to the growing need for a therapeutic intervention which was accessible to adolescent boys who would not engage via more traditional therapeutic routes. The project works with adolescents experiencing behavioural and emotional difficulties. Sport and Thought is a way of working with adolescents that fuses the sport of football, psychodynamic thinking and theory to create a space to encourage thought and act as a catalyst to promote emotional and behavioural change. Sport and Thought believes an individual’s reactions within a sporting context are no different to a societal one, and thus the sport of football can be used to enable participants to consider their own emotional and behavioural traits, and the underlying reasoning behind them.     

The Invisible Griever

Many people are equipped, through crisis intervention strategies and plans, to handle the immediate ramifications of a death within a particular school or community system. However, after the crisis has passed the question generally surfaces as to how one can help the children who have been greatly impacted by the death and are in the midst of the grieving process. The grieving child has often been invisible to adult caregivers like counselors, teachers, and school psychologist. The means of helping a child who has experienced a death in his family can be greatly enhanced by the developmcnt of grief support groups. Through the use of support groups children can learn to share their feelings, discover that they are not alone, and move through the grieve process.     

A Self-Modeling Intervention for High School Students with Public Speaking Anxiety

ABSTRACT

The study investigated the effectiveness of self-modeling as an intervention for public speaking anxiety. The participants were six high school students with elevated levels of self-reported public speaking anxiety. Students presented public speeches to randomly selected peer audiences. Direct observations measured the behavioral manifestations of public speaking anxiety. In the intervention phase, students viewed self-modeling videotapes that were edited to remove speech dysfluencies and behavioral symptoms of speech anxiety. The self-modeling tapes depicted only adaptive, exemplary behavior with an edited-in audience feature making it appear that the students were producing a fluent speech to an audience of their peers. All of the participants evidenced substantial decreases in behavioral symptoms of speech anxiety and these changes were maintained throughout follow-up. The range of the participants' effect sizes was 2.7 to 4.9. Self-report measures of state anxiety and confidence as a speaker were used to assess additional effects of treatment. For all participants, there were also substantial decreases in self-reported public speaking anxiety and state anxiety from baseline to follow-up. A post-treatment interview revealed high social validity and self-reported generalization of treatment.     

Clinical Management of Gender Dysphoria in Adolescents

SUMMARY

This paper aims to provide professionals working with adolescents with gender-dysphoric feelings practical clinical guidelines for diagnosis and treatment. The different phases of the assessment procedure and treatment process are described. Differential diagnostic considerations and possible psychotherapeutic treatment options are given. Physical interventions, including GnRH analogues to inhibit puberty and cross-sex hormones, are described with consideration of eligibility and readiness issues. We end with discussion of post-treatment evaluation.