Same-sex attracted youths: Suicide and related factors

Same-sex attracted youths comprise 10 percent to 11 percent of the secondary school population although not all of those who experience same-sex attraction will adopt a gay, lesbian, transgender or transsexual lifestyle. Most, if not all, will experience homophobia in one or more of its forms. Many of these young people will cope well with the heterocentric attitudes and prejudices prevalent in secondary schools and the wider community and make the transition into adulthood having learned how to mask their sexual preferences or develop effective coping mechanisms to deal with homophobia. Some will succumb to the pressures they experience and seek less ideal solutions that include drug use and promiscuity. Some will take their own lives. This article draws attention to the complications of same-sex attraction and argues for a school and community response that recognises and appreciates the positive contributions that diversity of sexual preference brings to any community.

Relationships of activity and sugar drink intake on fat mass development in youths

Purpose: To determine whether a significant relationship exists between fat mass (FM) development and physical activity (PA) and/or sugar-sweetened drink (SD) consumption in healthy boys and girls aged 8-19 yr. Methods: A total of 105 males and 103 females were assessed during childhood and adolescence for a maximum of 7 yr and a median of 5 yr. Height was measured biannually. Fat-free mass (FFM) and FM were assessed annually by dual x-ray absorptiometry (DXA). PA was evaluated two to three times annually using the PAQ-C/A. Energy intake and SD were assessed using a 24-h dietary intake questionnaire also completed two to three times per year. Years from peak height velocity were used as a biological maturity age indicator. Multilevel random effects models were used to test the relationship. Results: When controlling for maturation, FFM, and energy intake adjusted for SD, PA level was negatively related to FM development in males (P < 0.05) but not in females (P > 0.05). In contrast, there was no relationship between SD and FM development of males or females (P > 0.05). There was also no interaction effect between SD and PA (P > 0.05) with FM development. Conclusion: This finding tends support to the idea that increasing PA in male youths aids in the control of FM development. Models employed showed no relationship between SD and FM in either gender.

Working with involuntary clients: Perceptions and experiences of outreach social workers in Hong Kong

The outreach social work service is one of the dominant youth work approaches in dealing with delinquents and youths 'at-risk' in Hong Kong. Yet this approach presents particular challenges. Outreach social workers usually play an active role in initiating and establishing contacts with young people, yet young people are reluctant to engage with the outreach social workers and are resistant towards therapeutic change. To date, little is known about what strategies and techniques are most effective in dealing with client resistance in this context. The aims of this paper are to gain a better understanding of the common resistant behaviours that outreach social workers usually encounter in their day-to-day practice, and to investigate how the outreach social workers respond to their clients' resistance with reference to case examples given in the in-depth interviews. The findings of this study provide evidence that whilst client resistance is common in the outreach social work setting, social workers' patience as well as sensitivity are essential in resolving resistance and building up a rapport with clients.

The role of self-efficacy in predicting rule-following behaviors in shelters for homeless youth: A test of the theory of planned behavior

Through a prospective study of 70 youths staying at homeless-youth shelters, the authors tested the utility of I. Ajzen's (1991) theory of planned behavior (TPB), by comparing the constructs of self-efficacy with perceived behavioral control (PBC), in predicting people's rule-following behavior during shelter stays. They performed the 1st wave of data collection through a questionnaire assessing the standard TPB components of attitudes, subjective norms, PBC, and behavioral intentions in relation to following the set rules at youth shelters. Further, they distinguished between items assessing PBC (or perceived control) and those reflecting self-efficacy (or perceived difficulty). At the completion of each youth's stay at the shelter, shelter staff rated the rule adherence for that participant. Regression analyses revealed some support for the TPB in that subjective norm was a significant predictor of intentions. However, self-efficacy emerged as the strongest predictor of intentions and was the only significant predictor of rule-following behavior. Thus, the results of the present study indicate the possibility that self-efficacy is integral to predicting rule adherence within this context and reaffirm the importance of incorporating notions of people's perceived ease or difficulty in performing actions in models of attitude-behavior prediction.

Psychotropic medication utilization in a child and adolescent mental health service

Objectives: This study aimed to identify rates and correlates of psychotropic drug utilization in children and adolescents in inpatient and outpatient settings. Methods: A retrospective chart review examined 122 inpatient and 126 outpatient charts from a metropolitan child and youth mental health service in Brisbane, Australia. Results: Inpatients received more psychotropic medication than outpatients (71% vs. 25%; p < 0.01). Patients receiving medication were older, had longer hospital admissions, and more complex presentations, including history of abuse or suicide attempts and more diagnoses (all p < 0.01). Selective serotonin reuptake inhibitors (SSRIs) were the most frequently used drug class (44% inpatients; 14% outpatients), primarily indicated for mood disorders (31%). SSRIs and newer antidepressants (ADs) were used more frequently in patients with a high suicide risk (p < 0.01). Atypical antipsychotics (APs) were also used (inpatients 23%; outpatients 3%), primarily for behavioral disturbances. Half of those receiving medication (51%) received polypharmacy (> 1 concurrent drug), with up to four drugs used at one time. Rates of polypharmacy were highest among patients receiving antipsychotics. Conclusions: Use of psychotropic medication is frequent in this population. Future research should initially focus on inpatients and intensive treatment settings and examine both safety and efficacy of interventions for depression in young people, atypical antipsychotics for behavioral disturbances, and polypharmacy.

Lifetime suicide risk in major depression: sex and age determinants

Background: Recent work has demonstrated that the lifetime suicide risk for patients with DSM IV Major Depression cannot mathematically approximate the accepted figure of 15%. Gender and age significantly affect both the prevalence of major depression and suicide risk, Methods: Gender and age stratified calculations were made on the entire population of the USA in 1994 using a mathematical algorithm. Sex specific corrections for under-reporting were incorporated into the design. Results: The lifetime suicide risks for men and women were 7% and 1%, respectively. The combined risk was 3.4%. The male:female ratio for suicide risk in major depression was 10:1 for youths under 25, and 5.6:1 for adults. Conclusions: Suicide in major depression is predominantly a male problem, although complacency towards female sufferers is to be avoided. Diagnosis of major depression is of limited help in predicting suicide risk compared to case specific factors. The male experience of depression that leads to suicide is often not identified as a legitimate medical complaint by either sufferers or professionals. Increasing help-accessing by males is a priority. Clinical implications: Patients with a history of hospitalisation; comorbidity, especially for substance abuse; and who are male, require greater vigilance for suicide risk. It may be that for males che threshold for diagnosing and treating major depression needs to be lowered. Limitations: This research is based on a mathematical algorithm to approximate a life-long longitudinal study that identifies community cases of depression. Our findings therefore rely on the validity of the statistics used. Extrapolation is limited to populations with an actual suicide rate of 17/100,000 or less and a lifetime prevalence of major depression of 17% or more. (C) 1999 Elsevier Science B.V. All rights reserved.

Young people's perceptions of police: The impact of race and ethnicity

The continuing problematic nature of interactions between police and youth, especially those of particular ethnic and racial groups, is well-documented. However, our understanding of the development of those attitudes is less well-understood. Using a sample of 14-year-olds from 5 state schools in eastern Australia, we examine how race and ethnicity structure youths' perceptions and assessments of police, and their attitudes towards legal authority. In particular, we explore racial/ethnic differences in the intergenerational transmission of perceptions of police.