Parent Loss in Adolescence and its Impact on Sense of Self: When an Adolescent Boy Loses His Mother.

Adolescence is a developmental phase that involves physical, emotional, and cognitive changes. Often this period is one of transition that requires significant adjustment both with the individual and the family. It is considered to start with puberty, sometime between the ages of 10 and 13, and end with the transition into adulthood (Kruse & Walper, 2008). Puberty is a term that is used to describe the physical changes that generally occur during adolescence. It is an aspect of the changes that occur during the overarching phase of development. Within adolescence, individuals are confronted with many developmental tasks such as establishing an individual identity, making decisions about the future, and moving from dependence on families to independence (Austrian, 2008).There are many changes that occur during adolescence, including sexual maturation and functioning, endocrine developments, and skeletal and muscular changes. Boys will see a growth of body, pubic, and facial hair, their voice will deepen, and they will begin having erections and wet dreams (Kruse & Walper, 2008). The accelerated transformation of this phase generally has an emotional impact and individuals may feel concerned or self-conscious about their appearance. Ausubel, Montemayor, and Svajian (1977) suggest that adolescents may be more sensitive during this period of development. This sensitivity may be in part due to the rapid growth resulting in a sense of awkwardness in appearance and physical coordination.

The Psychology of Adolescent Out-of Wedlock Pregnancy and Childbearing

Illegitimate adolescent pregnancy creates a variety of problems, beginning with the difficult decision about whether or not to terminate the pregnancy. If the pregnancy is carried to term, choices follow regarding marriage or single parenthood and keeping or relinquishing the child. All of these choices involve consequences for the adolescent, many of them negative ones. This paper examines the problem of out-of-wedlock teen pregnancy and its possible psychological sources. It also introduces a method for analyzing the psychology of unwed teen pregnancy and childbearing and reviews the literature on the subject by this method. NOTE: Approvals page submitted to digital archive lacks signatures

Measure of Maturity: The Montana Adolescent Maturity Assessment

The construct of maturity is often discussed in the realm of adolescent development; however, relatively little research has been devoted to developing a comprehensive, reliable, and valid measure with which to assess it. The purpose of this study was to investigate the concurrent validity of the Montana Adolescent Maturity Assessment - III (MAMA-III), a proxy measure completed by clinicians regarding an adolescent's functioning, with the immaturity scale (IMM) of the MMPI-A. To provide more specified results, a factor analysis of the IMM was undertaken. Results yielded a low but significant correlation between the MAMA-III and the IMM, as well as significant convergent correlations between individual factors of the MAMA and IMM scales. Correlations among the MAMA-III factors, the IMM factors, and the ten clinical scales of the MMPI-A were also analyzed with the goal of better understanding what each measures. Implications are discussed regarding the clinical distinctions between the two measures, and the prospect of a more comprehensive understanding of the construct of maturity.

Knowledge and attitudes of Spanish adolescent girls towards human papillomavirus infection: where to intervene to improve vaccination coverage

Background: HPV vaccine coverage is far from ideal in Valencia, Spain, and this could be partially related to the low knowledge about the disease and the vaccine, therefore we assessed these, as well as the attitude towards vaccination in adolescent girls, and tried to identify independently associated factors that could potentially be modified by an intervention in order to increase vaccine coverage. Methods: A cross sectional study was conducted in a random selection of schools of the Spanish region of Valencia. We asked mothers of 1278 girls, who should have been vaccinated in the 2011 campaign, for informed consent. Those that accepted their daughters’ participation, a questionnaire regarding the Knowledge of HPV infection and vaccine was passed to the girls in the school. Results: 833 mothers (65.1%) accepted participation. All their daughters’ responded the questionnaire. Of those, 89.9% had heard about HPV and they associated it to cervical cancer. Only 14% related it to other problems like genital warts. The knowledge score of the girls who had heard about HPV was 6.1/10. Knowledge was unrelated to the number of contacts with the health system (Pediatrician or nurse), and positively correlated with the discussions with classmates about the vaccine. Adolescents Spanish in origin or with an older sister vaccinated, had higher punctuation. 67% of the girls thought that the vaccine prevented cancer, and 22.6% felt that although prevented cancer the vaccine had important safety problems. 6.4% of the girls rejected the vaccine for safety problems or for not considering themselves at risk of infection. 71.5% of the girls had received at least one vaccine dose. Vaccinated girls scored higher knowledge (p = 0.05). Conclusion: Knowledge about HPV infection and vaccine was fair in adolescents of Valencia, and is independent to the number of contacts with the health system, it is however correlated to the conversations about the vaccine with their peers and the vaccination status. An action to improve HPV knowledge through health providers might increase vaccine coverage in the adolescents.

Idiopathic Adolescent Scoliosis: Living with a Physical Deformity

A qualitative, phenomenological, hermeneutical study with the aim of explaining the experience of having a body deformity diagnosed as idiopathic adolescent scoliosis. A semistructured interview conducted with scoliosis patients admitted to the unit of spinal cord at the Vall d’Hebron Hospital was used. The youth defined their scoliosis based on how they perceived their deformity. They spoke of pain and deformity as characteristic symptoms of suffering, and explained how this symptom affected their social relationships. Their deformity was associated with words such as “horrible”, “shame”, “complex” and “problem.” It is concluded that the symptommost referred is pain and the biggest concern of the youth was their body aesthetic and feelings associated with it. They attempt to solve this problem by adapting the way they dress and through surgery. Surgery can resolve the body deformity but not self-perception of their body image.

The Developmental Experiences of Adolescent Females in Structured Basketball Programs

The purpose of the present study was to determine whether adolescent females had unique developmental experiences in different types of basketball programs. The Youth Experiences Survey 2.0 [YES] (Hansen & Larson, 2005) was used to measure the learning experiences of 14 and 15 year old females (n = 212) who were enrolled in a school, recreational, or competitive basketball program. Interviews with organization representatives were conducted to determine the structure of each basketball program (n= 16) from which participants were drawn. One-way ANOVAs and Bonferroni comparisons were used to compare YES 2.0 positive experience scale scores of participants in school, recreational and competitive basketball programs. Results revealed that females in recreational programs had significantly lower scores than those in competitive and school programs on numerous positive experiences scales. Mann-Whitney U tests found that those in school and competitive programs reported higher stress levels. Interview results indicate that four characteristics of competitive and school programs may contribute to participants in these programs reporting more growth experiences: 1) time commitment, 2) coaches’ training and background, 3) competition, and 4) volunteer opportunities.

Examining Adolescent Sport Dropout and Prolonged Engagement from a Developmental Perspective

This study examined youth sport dropout and prolonged engagement from a developmental perspective focusing on physical and psychosocial factors. Twenty-five dropout and 25 engaged adolescent swimmers, matched on key demographic variables, participated in a retrospective interview. Results indicated that dropouts were involved in fewer extra-curricular activities, less unstructured swimming play, and received less one-on-one coaching throughout development. Dropouts reached several developmental milestones (i.e., started training camps, started dry land training, and were top in club) earlier than engaged athletes. Dropouts were more likely to have had parents who were high-level athletes in their youth, were more likely to be the youngest in their training group, and were less likely to have a best friend at swimming. Findings are discussed in relation to past research; future directions and implications for researchers, sport programmers, coaches, and parents are suggested.

Understanding Dropout and Prolonged Engagement in Adolescent Competitive Sport

Objectives: The purpose of this study is to gain understanding of training patterns and roles of significant others (i.e. coaches, parents, peers, and siblings) in adolescent swimmers’ sport participation patterns. Design: The developmental model of sport participation [Côté, J., Baker, J., & Abernethy, B. (2003). From play to practice: A developmental framework for the acquisition of expertise in team sport. In J. Starkes, & K. A. Ericsson (Eds.), Recent advances in research on sport expertise (pp. 89–114). Champaign, IL: Human Kinetics; Côté, J., & Fraser-Thomas, J. (2007). Youth involvement in sport. In P. R. E. Crocker (Ed.), Introduction to sport psychology: A Canadian perspective (pp. 266–294). Toronto: Pearson Prentice Hall] was used as a framework. Method: Ten dropout and 10 engaged swimmers, matched on key demographic variables participated in a semi-structured qualitative interview. Results: Groups had many similar experiences (e.g. early training, supportive and unsupportive coaches, involved parents). However, only dropouts spoke of early peak performances, limited one-on-one coaching, pressuring parents during adolescence, lack of swimming peers during adolescence, and sibling rivalries. In contrast, only engaged athletes spoke of clubs’ developmental philosophies, coaches’ and parents’ open communication, school friends’ support, and siblings’ general positive influences. Conclusions: Findings highlight the importance of appropriately structured programs and the fragility of athletes’ relationships with significant others during the adolescent years. Implications for sport programmers, coaches, and parents are discussed.

Bullying Victimization and Perpetration Among Adolescent Sport Teammates

Purpose: Bullying is a specific pattern of repeated victimization explored with great frequency in school-based literature, but receiving little attention within sport. The current study explored the prevalence of bullying in sport, and examined whether bullying experiences were associated with perceptions about relationships with peers and coaches. Method: Adolescent sport team members (n = 359, 64% female) with an average age of 14.47 years (SD = 1.34) completed a pen-and-paper or online questionnaire assessing how frequently they perpetrated or were victimized by bullying during school and sport generally, as well as recent experiences with 16 bullying behaviors on their sport team. Participants also reported on relationships with their coach and teammates. Results: Bullying was less prevalent in sport compared with school, and occurred at a relatively low frequency overall. However, by identifying participants who reported experiencing one or more act of bullying on their team recently, results revealed that those victimized through bullying reported weaker connections with peers, whereas those perpetrating bullying only reported weaker coach relationships. Conclusion: With the underlying message that bullying may occur in adolescent sport through negative teammate interactions, sport researchers should build upon these findings to develop approaches to mitigate peer victimization in sport.

Synthèse systématique des écrits : les instruments d’évaluation de la comorbidité psychiatrique présentée par les adolescent(e)s

Ce mémoire présente les résultats d’une synthèse systématique (SS) des écrits traitant des instruments d’évaluation multidimensionnelle des troubles concomitants qui peuvent être présentés par les adolescent(e)s. La SS a permis d’identifier 11 instruments en mesure d’évaluer les troubles comorbides de l’Axe I du DSM-IV, incluant chaque fois les troubles liés à l’utilisation de substances psychoactives (TUS). Une fois les instruments répertoriés, une seconde recherche fut effectuée afin identifier les études les ayant mis à l’épreuve du point de vue de leur validité et de leur fidélité diagnostique : 57 études furent identifiées. La robustesse méthodologique de ces études fut analysée à l’aide de la grille du QUADAS-2 et 47 études furent retenues pour l’échantillon final. Les résultats sont présentés par diagnostics (troubles liés à l’utilisation des substances (TUS) (obligatoire), trouble d’anxiété généralisée (TAG), épisode dépressif majeur (ÉDM), troubles des conduites (TC), trouble du déficit de l’attention /hyperactivité (TDA/H), état de stress post-traumatique (ÉSPT) et par instrument retenu. Suite à l’analyse des données recueillies, il s’avère difficile de comparer les instruments les uns aux autres, étant donnée la très grande diversité des échelles qu’ils contiennent, ainsi que les devis fort différents des études qui les ont mis à l’épreuve. Par contre, deux instruments se distinguent par la robustesse méthodologique des études à leur sujet, ainsi que leur excellente performance globale. Il s’agit du ChIPS et du K-SADS.

Adolescent Illicit Drug Use and Subsequent Academic and Psychosocial Adjustment : an Examination of Socially-Mediated Pathways

Background: Questions remain regarding the consequences of illicit drug use on adolescent adjustment and the nature of mechanisms that may explain these consequences. In this study, we examined whether early-onset illicit drug use predicts subsequent academic and psychosocial adjustment and whether associations are socially-mediated by decreased school engagement and increased peer deviancy. Method: 4885 adolescents were followed throughout secondary school. We used regressions to determine whether illicit drug use in grade 7 predicted academic achievement, school dropout, depressive symptoms, and conduct problems in grades 10–11, adjusting for potential confounders. We used path analysis to test whether significant associations were mediated by school engagement and peer deviancy in grade 8. Results: Illicit drug use predicted conduct problems and school dropout, but not academic achievement and depressive symptoms. The association between illicit drug use and conduct problems was fully mediated by increased peer deviancy. The association between illicit drug use and school dropout was partially mediated by increased peer deviancy, but remained mostly direct. No indirect association via decreased school engagement was found. Examination of reverse pathways revealed that conduct problems and academic achievement in grade 7 predicted drug use in grades 10–11. These associations were mediated by peer deviancy and school engagement (conduct problems only). Conclusion: Adolescent illicit drug use influences the risk of school dropout and conduct problems in part by contributing to deviant peer affiliation. Reciprocal social mediation characterizes the association between drug use and conduct problems. A reverse mechanism best explains the association with academic achievement.

Adolescent Trajectories of Depressive Symptoms : co-development of Behavioral and Academic Problems

Purpose: Increasing evidence suggests the existence of heterogeneity in the development of depressive symptoms during adolescence, but little remains known regarding the implications of this heterogeneity for the development of commonly co-occurring problems. In this study, we derived trajectories of depressive symptoms in adolescents and examined the codevelopment of multiple behavioral and academic problems in these trajectories. Methods: Participants were 6,910 students from secondary schools primarily located in disadvantaged areas of Quebec (Canada) who were assessed annually from the age 12 to 16 years. Trajectories were identified using growth mixture modeling. The course of behavioral (delinquency, substance use) and academic adjustment (school liking, academic achievement) in trajectories was examined by deriving latent growth curves for each covariate conditional on trajectory membership. Results: We identified five trajectories of stable-low (68.1%), increasing (12.1%), decreasing (8.7%), transient (8.7%), and stable-high (2.4%) depressive symptoms. Examination of conditional latent growth curves revealed that the course of behavioral and academic problems closely mirrored the course of depressive symptoms in each trajectory. Conclusions: This pattern of results suggests that the course of depressive symptoms and other adjustment problems over time is likely to involve an important contribution of shared underlying developmental process(es).

Adolescent suicide attempts and adult adjustment

Background: Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were asso- ciated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (objective 1) and whether these impairments were better accounted for by concurrent adolescent confounders (objective 2). Method: Eight hundred and sixteen adolescents were assessed using interviews and question- naires at four time points from adolescence to adulthood. We examined whether lifetime suicide attempts in adolescence (by T2, mean age 17) predicted adult out- comes (by T4, mean age 30) using linear and logistic regressions in unadjusted models (objective 1) and adjusting for sociodemographic background, adolescent psychopathology, and family risk factors (objective 2). Results: In unadjusted analyses, adolescent suicide attempts predicted poorer adjustment on all outcomes, except those related to social role status. After adjustment, adolescent attempts remained predictive of axis I and II psychopathology (anxiety disorder, antisocial and borderline personality disorder symptoms), global and social adjustment, risky sex, and psychiatric treatment utilization. However, adolescent attempts no longer predicted most adult outcomes, notably suicide attempts and major depressive disorder. Secondary analyses indicated that associations did not differ by sex and attempt characteristics (intent, lethality, recurrence). Conclusions: Adolescent suicide attempters are at high risk of protracted and wide-ranging im- pairments, regardless of the characteristics of their attempt. Although attempts specifically predict (and possibly influence) several outcomes, results suggest that most impairments reflect the confounding contributions of other individual and family problems or vulnerabilites in adolescent attempters.

Group-Based Symptom Trajectories in Indicated Prevention of Adolescent Depression

Background: Adolescent depression prevention research has focused on mean intervention outcomes, but has not considered heterogeneity in symptom course. Here, we empirically identify subgroups with distinct trajectories of depressive symptom change among adolescents enrolled in two indicated depression preven- tion trials and examine how cognitive-behavioral (CB) interventions and baseline predictors relate to trajectory membership. Methods: Six hundred thirty-one participants were assigned to one of three conditions: CB group intervention, CB bibliotherapy, and brochure control. We used group-based trajectory modeling to identify trajectories of depressive symptoms from pretest to 2-year follow-up. We examined associations between class membership and conditions using chi- square tests and baseline predictors using multinomial regressions. Results: We identified four trajectories in the full sample. Qualitatively similar trajectories were found in each condition separately. Two trajectories of positive symptom course (low-declining, high-declining) had declining symptoms and were dis- tinguished by baseline symptom severity. Two trajectories of negative course (high-persistent, resurging), respectively, showed no decline in symptoms or de- cline followed by symptom reappearance. Participants in the brochure control condition were significantly more likely to populate the high-persistent trajectory relative to either CB condition and were significantly less likely to populate the low-declining trajectory relative to CB group. Several baseline factors predicted trajectory classes, but gender was the most informative prognostic factor, with males having increased odds of membership in a high-persistent trajectory rel- ative to other trajectories. Conclusions: Findings suggest that CB preventive interventions do not alter the nature of trajectories, but reduce the risk that adolescents follow a trajectory of chronically elevated symptoms.

Synthèse systématique des écrits : les instruments d’évaluation de la comorbidité psychiatrique présentée par les adolescent(e)s.

Ce mémoire présente les résultats d’une synthèse systématique (SS) des écrits traitant des instruments d’évaluation multidimensionnelle des troubles concomitants qui peuvent être présentés par les adolescent(e)s. La SS a permis d’identifier 11 instruments en mesure d’évaluer les troubles comorbides de l’Axe I du DSM-IV, incluant chaque fois les troubles liés à l’utilisation de substances psychoactives (TUS). Une fois les instruments répertoriés, une seconde recherche fut effectuée afin identifier les études les ayant mis à l’épreuve du point de vue de leur validité et de leur fidélité diagnostique : 57 études furent identifiées. La robustesse méthodologique de ces études fut analysée à l’aide de la grille du QUADAS-2 et 47 études furent retenues pour l’échantillon final. Les résultats sont présentés par diagnostics (troubles liés à l’utilisation des substances (TUS) (obligatoire), trouble d’anxiété généralisée (TAG), épisode dépressif majeur (ÉDM), troubles des conduites (TC), trouble du déficit de l’attention /hyperactivité (TDA/H), état de stress post-traumatique (ÉSPT) et par instrument retenu. Suite à l’analyse des données recueillies, il s’avère difficile de comparer les instruments les uns aux autres, étant donnée la très grande diversité des échelles qu’ils contiennent, ainsi que les devis fort différents des études qui les ont mis à l’épreuve. Par contre, deux instruments se distinguent par la robustesse méthodologique des études à leur sujet, ainsi que leur excellente performance globale. Il s’agit du ChIPS et du K-SADS.