Just say no? The influence of personal goals, beliefs, psychosocial adjustment, and parental relationships in drug use by adolescents

The study in its entirety focused on factors related to adolescents decisions concerning drug use. The term drug use is taken here to include the use of tobacco products, alcohol, narcotics, and other addictive substances. First, the reasons given for drug use (attributions) were investigated. Secondly, the influence of personal goals, the beliefs involved in decision making, psychosocial adjustment including body image and involvement with peers, and parental relationships on drug use were studied. Two cohorts participated in the study. In 1984, a questionnaire on reasons for drug use was administered to a sample of adolescents aged 14-16 (N=396). A further questionnaire was administered to another sample of adolescents aged 14-16 (N=488) in 1999. The results for both cohorts were analyzed in Articles I and II. In Articles III and IV further analysis was carried out on the second cohort (N=488). The research report presented here provides a synthesis of all four articles, together with material from a further analysis. In a comparison of the two cohorts it was found that the attributions for drug use had changed considerably over the intervening fifteen-year period. In relation to alcohol and narcotics use an increase was found in reasons involving inner subjective experiences, with mention of the good feeling and fun resulting from alcohol and narcotics use. In addition, the goals of alcohol consumption were increasingly perceived as drinking to get drunk, and for its own sake. The attributions for the adolescents own smoking behavior were quite different from the attributions for smoking by others. The attributions were only weakly influenced by the participants gender or by their smoking habits, either in 1984 or 1999. In relation to participants own smoking, the later questionnaire elicited more mention of inner subjective experiences involving "good feeling. In relation to the perceived reasons for other people s smoking, it elicited more responses connected with the notion of "belonging. In the second sample, the results indicated that the levels of body satisfaction among adolescent girls are lower than those among adolescent boys. Overall, dissatisfaction with one's physical appearance seemed to relate to drug use. Girls were also found to engage in more discussions than boys; this applied to (i) discussion with peers (concerning both intimate and general matters), and (ii) discussion with parents (concerning general matters). However, more than a quarter of the boys (out of the entire population) reported only low intimacy with both parents and peers. If both drinking and smoking were considered, it seemed that girls in particular who reported drinking and smoking also reported high intimacy with parents and peers. Boys who reported drinking and smoking reported only medium intimacy with parents and peers. In addition, having an intimate relationship with one's peers was associated with a greater tendency to drink purely in order to get drunk. Overall, the results seemed to suggest that drug use is connected with a close relationship with peers and (surprisingly) with a close relationship with parents. Nevertheless, there were also indications that to some extent peer relationships can also protect adolescents from smoking and alcohol use. The results, which underline the complexity of adolescent drug use, are taken up in the Discussion section. It may be that body image and/or other identity factors play a more prominent role in all drug use than has previously been acknowledged. It does appear that in the course of planning support campaigns for adolescents at risk of drug use, we should focus more closely on individuals and their inner world. More research on this field is clearly needed, and therefore some ideas for future research are also presented.

Adulthood with Turner Syndrome: Quality of life, psychosocial adjustment and clinical management in 70 Italian women

Abstract Background: Turner syndrome (TS) is a chromosomal abnormality (total or partial absence of one of the sexual chromosomes in some or all cells of the body), which affects approximately 1:2000 female. Principal characteristics are short stature and gonadal disgenesis. Clinical management consist of Growth Hormone (GH) treatment and oestrogen replacement therapy (HRT), to induce development of secondary characteristics and to avoid the sequelae of oestrogen deficiency. Aim of the study: To assess clinical management, quality of life (QoL) and general psychosocial adjustment of women with TS. Population: 70 adult Caucasian females with TS (mean age: 27.8, ± 7.6; range 18-48 y.). Setting: Specialist service for Rare Disease care, University Hospital. Methods: Subjects were required to fill in questionnaires collecting ASR, WHOQOL, and 8 open questions. Data were compared with those of the Italian population or to those collected in a comparison group (70 healthy females, mean age: 27.9, ±7.3, range 21-48 y.). Results: Women with TS are educated as well as the Italian Population, but they have a less successful professional life. They show good QoL in general, but they appeared less satisfied in social area. They had statistically higher scores than the comparison group for depression, anxiety and withdrawal. Are less involved in a love relationship. Diagnosis communication was mostly performed by doctors or parents, satisfaction was higher when information was given by parents. Main preoccupation about TS are infertility, feeling of being different and future health problem. Conclusions: Italian people with TS were generally well adapted and have a good QoL, but lived more often with parents and show impaired sentimental and sexual life. They have higher degree of psychological distress compared to a comparison group. Psychological intervention should firstly address parents in order to encourage an open communication on diagnosis issues and on sexual education.

Cohort and Gender Differences in Psychosocial Adjustment to Later-Life Widowhood

Objectives. Despite the large body of literature on bereavement, little is known about the impact of sociohistorical context on individual reactions to spousal loss. This study examines the effect of marital status, time period and gender on physical and mental health, and whether reported difficulties following spousal loss differ at 2 distinctive time periods. Method. Two cohorts of older bereaved persons (n = 753) in Switzerland, surveyed in 1979 and 2011, were compared regarding their reports of difficulties related to marital loss. The bereaved spouses were also compared with a group of married contemporaries (n = 1,517) regarding subjective health and depressive symptoms. Results. Marital status and gender each have independent effects on subjective health and depressive symptoms. The effects of widowhood on subjective health differed significantly at both time points. Widowed individuals in 2011, especially women, reported fewer social and financial difficulties than their counterparts in 1979. However, the effect of widowhood on depressive symptoms and psychological difficulties did not differ significantly across time points. Discussion. Social changes in the late 20th century may be protective for older adults’ physical, social, and financial well-being in the face of spousal loss, yet these changes do not alleviate widow(er)s’ psychological distress.

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 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.

On the developmental continuity /discontinuity of early adolescent patterns of racial identity salience: Relations with later identities and psychosocial adjustment

Given the significant amount of attention placed upon race within our society, racial identity long has been nominated as a meaningful influence upon human development (Cross, 1971; Sellers et al., 1998). Scholars investigating aspects of racial identity have largely pursued one of two lines of research: (a) describing factors and processes that contribute to the development of racial identities, or (b) empirically documenting associations between particular racial identities and key adjustment outcomes. However, few studies have integrated these two approaches to simultaneously evaluate developmental and related adjustment aspects of racial identity among minority youth. Consequently, relations between early racial identity developmental processes and correlated adjustment outcomes remain ambiguous. Even less is known regarding the direction and function of these relationships during adolescence. To address this gap, the present study examined key multivariate associations between (a) distinct profiles of racial identity salience and (b) adjustment outcomes within a community sample of African-American youth. Specifically, a person-centered analytic approach (i.e., cluster analysis) was employed to conduct a secondary analysis of two archived databases containing longitudinal data measuring levels of racial identity salience and indices of psychosocial adjustment among youth at four different measurement occasions.^ Four separate groups of analyses were conducted to investigate (a) the existence of within-group differences in levels of racial identity salience, (b) shifts among distinct racial identity types between contiguous times of measurement, (c) adjustment correlates of racial identity types at each time of measurement, and (d) predictive relations between racial identity clusters and adjustment outcomes, respectively. Results indicated significant heterogeneity in patterns of racial identity salience among these African-American youth as well as significant discontinuity in the patterns of shifts among identity profiles between contiguous measurement occasions. In addition, within developmental stages, levels of racial identity salience were associated with several adjustment outcomes, suggesting the protective value of high levels of endorsement or internalization of racial identity among the sampled youth. Collectively, these results illustrated the significance of racial identity salience as a meaningful developmental construct in the lives of African-American adolescents, the implications of which are discussed for racial identity and practice-related research literatures. ^

Indirect Effects of Parental Coping on Children’s Psychosocial Adjustment in the Context of Pediatric Cancer

Thesis (Ph.D.)--University of Washington, 2016-08

Psychosocial functioning in patients with alcohol-related liver disease post liver transplantation

Emotional and role functioning difficulties are associated with chronic alcohol use and liver disease. Little is known about prospective changes in psychological and psychosocial functioning following orthotopic liver transplantation (OLT) amongst patients with alcoholic liver disease (ALD). We aimed to assess the functioning of this patient group post liver transplantation. Comprehensive psychosocial assessment of depression (Beck Depression Inventory [BDI]), anxiety (State-Trait Anxiety Inventory-Form X [STAI]) and psychosocial adjustment (Psychosocial Adjustment to Illness Scale-Self-Report version [PAIS-SR]) was conducted with 42 ALD patients available for pre and post OLT testing. Dependence severity was assessed by the Brief Michigan Alcoholism Screening Test (bMAST). Significant reductions in average anxiety and depression symptoms were observed 12-months post-OLT. Significant improvements in psychosocial adjustment to illness were also reported. Patients with higher levels of alcohol dependence severity pre transplant assessment improved comparably to those with lower levels of dependence. In summary, the study found that OLT contributed to reducing overall levels of mood and anxiety symptoms in ALD patients, approximating general (non-clinical) population norms. Psychosocial adjustment also improved significantly post liver transplantation.

Psychosocial well-being of African migrant children in Ireland: a cultural orientation

This thesis explores the psychosocial wellbeing of sub-Saharan African migrant children in Ireland. A sociocultural ecological (Psychosocial Working Group, 2003) and resilience lens (Masten & Obradovic, 2008; Ungar, 2011) is used to analyse the experiences of African migrant children in Ireland. The research strategy employs a mixed-methods design, combining both an etic and emic perspective. Grounded theory inquiry (Strauss and Corbin, 1994) explores the experiences of African migrant children in Ireland by drawing on multi-sited observations over a period of six months in 2009, and on interviews and focus group discussions conducted with African children (aged 13-18), mothers and fathers. An emically derived ‘African Migrant Child Psychosocial Well-being’ scale was developed by drawing on data gathered through rapid ethnographic (RAE) free listing exercises carried out in Cork, Dublin and Dundalk with sixty-one participants (N=21 adults, N=28 15-18-year-olds, N=12 12-14-year-olds) and three African community key informants to elicit local understandings of psychosocial well-being. This newly developed scale was used alongside standardised measures of well-being to quantitatively measure the psychosocial adjustment of 233 African migrant children in Cork, Dublin and Dundalk aged 11-18. Findings indicate that the psychosocial wellbeing of the study population is satisfactory when benchmarked against the psychosocial health profile of Irish youth (Dooley & Fitzgerald, 2012). These findings are similar to trends reported in international literature in this field (Georgiades et al., 2006; Gonneke, Stevens, Vollebergh, 2008; Sampson et al., 2005). Study findings have implications for advancing psychosocial research methods with non-Western populations and on informing the practice of Irish professionals, mainly in the areas of teaching, psychology and community work.

Physical function, psychosocial adaptation, and hardiness post stroke

Introduction: Stroke is a chronic condition that significantly impacts on morbidity and mortality (Balanda et al. 2010). Globally, the complexity of stroke is well documented and more recently, in Ireland, as part of the National Survey of Stroke Survivors (Horgan et al. 2014). There are a number of factors that are known to influence adaptation post stroke. However, there is a lack of research to explain the variability in how survivors adapt post stroke. Hardiness is a broad personality trait that leads to better outcome. This study investigated the influence of hardiness and physical function on psychosocial adaptation post stroke. Methods: A quantitative cross-sectional, correlational, exploratory study was conducted between April and November 2013. The sample consisted of stroke survivors (n=100) who were recruited from three hospital outpatient departments and completed a questionnaire package. Results: The mean age of participants was 76 years (range 70-80), over half (56%) of the participants achieved the maximum score of 20 on the Barthel Index indicating independence in activities of daily living. The median number of days since stroke onset was 91 days (range 74-128). The total mean score and standard deviation for hardiness was 1.89 (0.4) as measured by the Dispositional Resilience Scale, indicating medium hardiness (possible range 0-3). Psychosocial adaptation was measured using the Psychosocial Adjustment to Illness Scale, the total weighted mean and standard deviation was 0.54 (0.3) indicating a satisfactory level of psychosocial adaptation (possible range 0-3). A hierarchical multiple linear regression was performed which contained 6 independent variables (hardiness, living arrangement, and length of hospital stay, number of days since stroke onset, physical function and self-rated recovery). Findings demonstrated that physical function (p<0.001) and hardiness (p=0.008) were significantly related to psychosocial adaptation. Altogether, 65% of the variation in psychosocial adaptation can be explained by the combined effect of the independent variables. Physical functioning had the highest unique contribution (11%) to explain the variance in psychosocial adaptation while self-rated recovery, hardiness, and living arrangements contributed 3% each. Conclusion: This research provides important information regarding factors that influence psychosocial adaptation post stroke at 3 months. Physical function significantly contributed to psychosocial adaptation post stroke. The personality trait of hardiness provides insight into how behaviour influenced adaptation post stroke. While hardiness also had a strong relationship with psychosocial adaptation, further research is necessary to fully comprehend this process.

Relations Between Political Violence and Child Adjustment: a four-wave test of the role of emotional insecurity about community

This study further explored the impact of sectarian violence and children's emotional insecurity about community on child maladjustment using a 4-wave longitudinal design. The study included 999 mother-child dyads in Belfast, Northern Ireland (482 boys, 517 girls). Across the 4 waves, child mean age was 12.19 (SD = 1.82), 13.24 (SD = 1.83), 13.61 (SD = 1.99), and 14.66 years (SD = 1.96), respectively. Building on previous studies of the role of emotional insecurity in child adjustment, the current study examines within-person change in emotional insecurity using latent growth curve analyses. The results showed that children's trajectories of emotional insecurity about community were related to risk for developing conduct and emotion problems. These findings controlled for earlier adjustment problems, age, and gender, and took into account the time-varying nature of experience with sectarian violence. Discussion considers the implications for children's emotional insecurity about community for relations between political violence and children's adjustment, including the significance of trajectories of emotional insecurity over time.

Longitudinal relations between sectarian and nonsectarian community violence and child adjustment in Northern Ireland

Although relations between political violence and child adjustment are well documented, longitudinal research is needed to adequately address the many questions remaining about the contexts and developmental trajectories underlying the effects on children in areas of political violence. The study examined the relations between sectarian and nonsectarian community violence and adolescent adjustment problems over 4 consecutive years. Participants included 999 mother-child dyads (482 boys, 517 girls), M ages = 12.18 (SD = 1.82), 13.24 (SD = 1.83), 13.61 (SD = 1.99), and 14.66 (SD = 1.96) years, respectively, living in socially deprived neighborhoods in Belfast, Northern Ireland, a context of historical and ongoing political violence. In examining trajectories of adjustment problems, including youth experience with both sectarian and nonsectarian antisocial behaviors, sectarian antisocial behavior significantly predicted more adjustment problems across the 4 years of the study. Experiencing sectarian antisocial behavior was related to increased adolescent adjustment problems, and this relationship was accentuated in neighborhoods characterized by higher crime rates. The discussion considers the implications for further validating the distinction between sectarian and nonsectarian violence, including consideration of neighborhood crime levels, from the child's perspective in a setting of political violence. Copyright © Cambridge University Press 2013.

EXPLORING THE DEVELOPMENT AND PSYCHOSOCIAL CORRELATES OF SPIRITUALITY /RELIGIOSITY ACROSS ADOLESCENCE

The goal of the four studies that comprised this dissertation was to examine how spirituality/religiosity (SIR), as both an institutional and personal phenomenon, developed over time, and how its institutional (i.e., religious activity involvement) and personal (i.e., sense of connection with the sacred) components were uniquely linked with psychosocial adjustment. In Study 1, the differential longitudinal correlates of religious service attendance, as compared to involvement in other clubs, were evaluated with a sample of adolescents (n=1050) who completed a survey in grades 9, 11 and 12. Religious attendance and involvement in non-religious clubs were uniquely associated with positive adjustment in terms of lower substance use and better academic marks, particularly when involvement was sustained over time. In Study 2, the direction of effects was tested for the association between religious versus non-religious activities and both substance use and academic marks. Participants (n= 3993) were surveyed in grades 9 through 12. Higher religious attendance (but not non-religious club involvement) in one grade predicted lower levels of substance use in the next grade. Higher levels of nonreligious club involvement (but not religious service attendance) in one grade predicted higher academic achievement in the next grade, and higher academic achievement in one grade predicted more frequent non-religious club involvement in the next grade. The results suggest that different assets may be fostered in religious as compared to nonreligious activities, and, specifically, religious activity involvement may be important for the avoidance of substance use. The goal of Study 3 was to assess the unique associations between the institutional versus personal dimensions of SIR and a wide range of domains of psychosocial adjustment (namely, intrapersonal well-being, substance use, risk attitudes, parental relationship quality, academic orientation, and club involvement), and to examine the direction of effects in these associations. Participants (n=756) completed a survey in grades 11 and 12. Personal and institutional dimensions of SIR were differentially associated with adjustment, but it may only be in the domain of risk-taking (Le., risk attitudes, substance use) that SIR may predict positive adjustment over time. Finally, in Study 4, the goal was to examine how institutional and personal aspects of SIR developed within individual adolescents. Configurations of mUltiple dimensions of spirituality/religiosity were identified across 2 time points with an empirical classification procedure (cluster analysis), and sample- and individual-level development in these configurations were assessed. A five cluster-solution was optimal at both grades. Clusters were identified as aspirituallirreligious, disconnected wonderers, high institutional and personal, primarily personal, and meditators. With the exception of the high institutional and personal cluster, the cluster structures were stable over time. There also was significant intraindividual stability in all clusters over time; however, a significant proportion of individuals classified as high institutional and personal in Grade 11 moved into the primarily personal cluster in Grade 12. This program of research represented an important step towards addressing some of the limitations within the body of literature; namely, the uniqueness of religious activity involvement as a structured club, the differential link between institutional versus personal SIR and psychosocial adjustment, the direction of effects in the associations between institutional versus personal SIR and adjustment, and the way in which different dimensions of SIR may be configured and develop within individual adolescents over time.