Qualitative study of adversity activated development and resilience in adolescents and young adults with congenital heart disease and their parents

What is it like to have a medical condition that few people have ever heard about? How does it feel to have to question whether daily physical activities are dangerous for you, whilst you watch your friends enjoy those activities without a care? Can you imagine that you need to have a complicated heart surgery, with risks such as paralysis or death? Or even imagine facing the painful recovery period and scars after such a surgery? Then imagine that you are a child or teenager dealing with this medical condition when all your friends are simply occupied with school and normal life. Now consider that surgery has been undertaken to extend your lifespan, but the operation is so new that the long-term outcomes are just not known? All you really know is that you might have ‘surgical repairs’ to your heart and symptoms may be relieved or managed by medications or cardiac devices, but you are never going to be cured. What if you had already experienced painful, frightening, lonely and tedious hospitalisations and you were forced to put your life on hold to re-enter that situation, time and time again. This may be your life, as a Congenital Heart Disease or CHD patient. How do such patients cope and in many cases even thrive? This chapter will review current international literature regarding the medical and personal impact of CHD. Our qualitative study of the perspectives of young CHD patients and their parents contributes to the Australian story of CHD, as well as highlighting the potential for CHD related adversity to promote personal development.

Protective factors associated with young passenger intervening in risky driving situations

While the negative influence of passengers on driving is usually studied, young passengers may protect against young drivers’ crash involvement by speaking out and trying to stop unsafe driving behavior. This study sought to examine psychosocial constructs of young passengers who are likely to intervene in their friends’ risky driving. Method: University students aged 17 to 25 years who were single (n = 123) or in a romantic relationship (n = 130) completed an online survey measuring protective factors. Results: The combination of individual, friend and (for participants in a relationship) romantic partner protective factors predicted self-reported passenger intervening intentions. Impact on Industry: Since peer passengers often increase young drivers’ crash risk, research on passenger intervening has significant implications for road safety strategies. The findings provide support for the operationalization of protective factors in strategies that target passenger intervening behavior.

A psychosocial model of young adult passengers’ intervening in unsafe driving of their friends

Young adults are over-represented in motor vehicle crashes and the carrying of same passengers puts them at greater risk of crashing. The current study examined characteristics of the passengers who might play a positive role in reducing friends’ crashes by actively engaging in strategies to protect such friends. A psychosocial theoretical model of prosocial behavior including self-process and contextual cues explained intervening behavior among primarily novice driver college students (n=242) with the exception of the self-process, perspective taking. The results of this study provide support for countermeasure development that accounts for the positive role of peers to increase road safety, and reduce the incidence of crashes, among young adults.

Differentiating first episode substance induced and primary psychotic disorders with concurrent substance use in young people

Objective: Substance use is common in first-episode psychosis, and complicates the accurate diagnosis and treatment of the disorder. The differentiation of substance-induced psychotic disorders (SIPD) from primary psychotic disorders (PPD) is particularly challenging. This cross-sectional study compares the clinical, substance use and functional characteristics of substance using first episode psychosis patients diagnosed with a SIPD and PPD. Method: Participants were 61 young people (15-24 years) admitted to a psychiatric inpatient service with first episode psychosis, reporting substance use in the past month. Diagnosis was determined using the Psychiatric Research Interview for DSM-IV Substance and Mental disorders (PRISM-IV). Measures of clinical (severity of psychotic symptoms, level of insight, history of trauma), substance use (frequency/quantity, severity) and social and occupational functioning were also administered. Results: The PRISM-IV differentially diagnosed 56% of first episode patients with a SIPD and 44% with a PPD. Those with a SIPD had higher rates of substance use and disorders, higher levels of insight, were more likely to have a forensic and trauma history and had more severe hostility and anxious symptoms than those with a PPD. Logistic regression analysis indicated a family history of psychosis, trauma history and current cannabis dependence were the strongest predictors of a SIPD. Almost 80% of diagnostic predictions of a SIPD were accurate using this model. Conclusions: This clinical profile of SIPD could help to facilitate the accurate diagnosis and treatment of SIPD versus PPD in young people with first episode psychosis admitted to an inpatient psychiatric service.

Does the addition of integrated cognitive behaviour therapy and motivational interviewing improve the outcomes of standard care for young people with comorbid depression and substance misuse?

Background: The high rates of comorbid depression and substance use in young people have been associated with a range of adverse outcomes. Yet, few treatment studies have been conducted with this population. Objective: To determine if the addition of Motivational Interviewing and Cognitive Behaviour Therapy (MI/CBT) to standard alcohol and other drug (AOD) care improves the outcomes of young people with comorbid depression and substance use. Participants and Setting: Participants comprised 88 young people with comorbid depression (Kessler 10 score of > 17) and substance use (mainly alcohol/cannabis) seeking treatment at two youth AOD services in Melbourne, Australia. Sixty young people received MI/CBT in addition to standard care (SC) and 28 received SC alone. Outcomes Measures: Primary outcome measures were depressive symptoms and drug and alcohol use in the past month. Assessments were conducted at baseline, 3 and 6 months follow up. Results and Conclusions: The addition of MI/CBT to SC was associated with a significantly greater rate of change in depression, cannabis use, motivation to change substance use and social contact in the first 3 months. However, those who received SC had achieved similar improvements on these variables by 6 months follow up. All young people achieved significant improvements in functioning and quality of life variables over time, regardless of the treatment group. No changes in alcohol or other drug use were found in either group. The delivery of MI/CBT in addition to standard AOD care may offer accelerated treatment gains in the short-term.

Active versus passive screen time for young children

In this paper, we report some initial findings from our investigations into the Australian Government’s Longitudinal Study of Australian Children dataset. It is revealed that the majority of Australian children are exceeding the government’s Screen Time recommendations and that most of their screen time is spent as TV viewing, as opposed to video game play or computer use. In light of this finding,we review the body of research surrounding children’s engagement in Screen Time activities and the associated positive and negative effects. Based on existing evidence,we define two categories of Screen Time—Active Screen Time and Passive Screen Time. It is proposed that this distinction provides a more accurate classification of Screen Time and a more informative lens through which to consider the associated benefits and detrimental effects for young children.

Carers' hope, wellbeing and attitudes regarding recovery

Carers are important to the recovery of their relatives with serious mental disorder however, it is unclear whether they are aware of, or endorse recent conceptualisations of recovery. This study compared carers’ and mental health workers’ recovery attitudes, and undertook multivariate predictions of carers’ wellbeing, hopefulness and recovery attitudes. Participants were 82 Australian family members caring for a relative with psychosis. Carers’ average recovery attitudes were less optimistic than for previously surveyed staff. Carers’ recovery attitudes were predicted by perceptions that their relative’s negative symptoms were more severe. Hopefulness and wellbeing was predicted by more positive and less negative caregiving experiences. Hopefulness was also predicted by less frequent contacts with their affected relative, and unexpectedly, by perceptions of more severe psychotic symptoms. Carers’ wellbeing was further predicted by having a partner and having no lifetime history of a mental disorder. Hope and wellbeing are affected by everyday challenges and positive experiences of caregiving.

A sociological quantitative study about Chineseness and Chinese heritage language for young Chinese Australian adults in urban Australia

The relationship between Heritage Language and ethnic identity has gained significant research ground in North America. However, there is a dearth of similar research conducted in other regions of the world. There seems to be little if any work investigating the link between Chinese Australians’ ethnic identity and their Chinese Heritage Language. This sociological quantitative study interpreted Chinese Australians’ “Chineseness” as their ethnic identity, linked this “Chineseness” to their Chinese Heritage Language, and did so by virtue of Bourdieu’s key concept ‘habitus’. 227 cases were analyzed by Structural Equation Modelling. The result demonstrated a statistically significant strong positive relationship between Chinese Australian urban young adults’ “Chineseness” and their self-perceptions of their Chinese Heritage Language proficiency (r=.73). This paper explained the findings in light of Bourdieu’s (1991) contention that people make choices about languages according to the habitus they have.

Iterative development of MobileMums : a physical activity intervention for women with young children.

Background To describe the iterative development process and final version of ‘MobileMums’: a physical activity intervention for women with young children (<5 years) delivered primarily via mobile telephone (mHealth) short messaging service (SMS). Methods MobileMums development followed the five steps outlined in the mHealth development and evaluation framework: 1) conceptualization (critique of literature and theory); 2) formative research (focus groups, n= 48); 3) pre-testing (qualitative pilot of intervention components, n= 12); 4) pilot testing (pilot RCT, n= 88); and, 5) qualitative evaluation of the refined intervention (n= 6). Results Key findings identified throughout the development process that shaped the MobileMums program were the need for: behaviour change techniques to be grounded in Social Cognitive Theory; tailored SMS content; two-way SMS interaction; rapport between SMS sender and recipient; an automated software platform to generate and send SMS; and, flexibility in location of a face-to-face delivered component. Conclusions The final version of MobileMums is flexible and adaptive to individual participant’s physical activity goals, expectations and environment. MobileMums is being evaluated in a community-based randomised controlled efficacy trial (ACTRN12611000481976).

Heritage language for young Chinese Australian adults in urban Australia : Capital and habitus in fields

Studies of Heritage Language learners‟ commitment and their ethnic identity are increasing, yet there is scant sociological research addressing topics relating to Chinese Heritage Language learners. Drawing on Bourdieu‟s signature notions of „habitus‟, „capital‟, and „field‟, this mixed methods study investigates two problems: (1) impacts of “Chineseness” and accessible resources on Chinese Heritage Language proficiency of young Chinese Australian adults in urban Australia; and (2) the meanings of Chinese Heritage Language to these young people.

‘My people right here…’ Indigenous young people, alienation and paint sniffing in inner Brisbane

This paper describes and explains the social worlds of a group of young Murris who are engaged in chroming (paint sniffing) and who sleep rough in inner Brisbane. In particular, the paper considers the ways young Indigenous drug users describe their marginalisation from wider society and its structures of opportunity, but it also includes some reflections from their youth worker and a young man who frequents the young people’s squat. The paper demonstrates the centrality of racism and material disadvantage to the experience of a group of young Aboriginal and Torres Strait Islander sniffers, a perspective largely unreflected in the literature on Indigenous volatile substance misuse. Further, the young people’s ways of interacting with the broader society are described to explain the ways their rejection of mainstream norms form a significant political response to their marginality and reflect, at least in part, the wider Indigenous historical experience. The work draws on theories of alienation and subculture to analyse the young people’s descriptions of their social estrangement and the formation of the ‘paint sniffer group’. It is concluded that paint sniffing among urban Indigenous youth is, at least in part, an obnoxious and encoded distillation of a wider Indigenous rebuttal of broader societal norms, and that the dominant — normalising — modes of treatment risk further alienating an already oppositional group of young people.

Children, young people and their social and spatial citizenship rights

The use of public space by children and young people is a contentious issue in a number of developed and developing countries and a range of measures are frequently deployed to control the public space which usually deny the rights of children and young people to claim the space for their use. Child and youth curfews, oppressive camera surveillance and the unwarranted attentions of police and private security personnel as control measures in public space undermine attempts to secure greater participation by children and young people in constructing positive strategies to address concerns that impact on them and others in a local area. Evidence from research in Scotland undertaken by Article 12 (2000) suggests that young people felt strongly that they did not count in local community matters and decision making and the imposition on them of a curfew by the adult world of the local area created resentment both at the harshness of the measure and disappointment at an opportunity lost to be consulted and involved in dealing with perceived problems of the locality. This is an important cluster of linked issues as Brown (1998:116) argues that young people are ‘selectively constructed as “problem” and “other” with their concerns marginalised, their lifestyles problematised and their voices subdued’, and this flows into their use of public space as their claims to its use as an aspect of social citizenship are usually cast as inferior or rejected as they ‘stand outside the formal polity’ as ‘non persons’. This has major implications for the ways in which young people view their position in a community as many report a feeling of not being wanted, valued or tolerated. The ‘youth question’ according to Davis (1990) acts as a form of ‘screen’ on which observers and analysts project hopes and fears about the state of society, while in the view of Loader (1996:89) the ‘question of young people’ sits within a discourse comprising two elements, the one being youth, particularly young males, as the ‘harbinger of often unwelcome social change and threat’ and the other element ‘constructs young people as vulnerable’. This discourse of threat is further exemplified in the separation of children from teenagers as Valentine (1996) suggests, the treatment of younger children using public space is often dramatically different to that of older children and the most feared stage of all, 'youth'

Email as an arena for authoring a dialogical self among gifted young adolescents : a qualitative study

This paper describes a qualitative study that investigated young adolescents’ self-constructions within the context of online (email) communication. Drawing from dialogical perspectives of self as multiply-situated and complex phenomena, the study focused on the everyday narratives of individual young adolescents interpreted as different “I” voices. With the assumption that computer mediation offers cultural relevance and empowerment to young adolescents, techniques of personal journal writing were used in combination with email as an alternative to face-to-face methods. Twelve participants aged 10 to 14 years were recruited online and by word-of-mouth with an invitation to write freely about their lives over a six month period in a participant-led email journal project. The role of the researcher was to develop a supportive voice of listener/responder that was intended to facilitate the emergence of participants’ own ‘self’ voices within an interactive space for relatively autonomous self-expression. Data as email texts were analysed using a close listening method that synchronised with the theory by revealing multi-layered patterns and shifts of voices in order to give a nuanced understanding of participants’ self and other evaluations. The paper shows that narrative methods used online and in concert with dialogical concepts have potential to heighten self-reflection and strengthen agency as a means to access rich and nuanced data from young adolescent individuals. The study’s findings contribute to a growing interest in the use of dialogical concepts to explore the ways people engage in active meaning-making while embedded in their specific social and cultural environments.