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Decision-making and cognitive control in adolescent suicidal behaviors: a qualitative systematic review of the literature. Eur Child Adolesc Psychiatry 2021; 30:1839-1855. [PMID: 32388626 DOI: 10.1007/s00787-020-01550-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive variables and adolescent suicidal behaviors. The online search strategy identified 17 neurocognitive studies examining either cognitive control or decision-making processes in adolescents with past suicidal behaviors. Several studies have reported that adolescents with a history of suicidal behaviors present neuropsychological differences in the cognitive control (using Go/NoGo, suicide Stroop Test, continuous performance test, suicide/death Implicit Association Test), and decision-making (Iowa Gambling Task, Cambridge Gambling Task, cost computation, delay discounting, loss aversion tasks) domains. Due to a lack of replication or conflicting findings, our systematic review suggests that no firm conclusion can be drawn as to whether altered decision-making or poor cognitive control contribute to adolescent suicidal behaviors. However, these results collectively suggest that further research is warranted. Limitations included scarcity of longitudinal studies and a lack of homogeneity in study designs, which precluded quantitative analysis. We propose remediating ways to continue neuropsychological investigations of suicide risk in adolescence, which could lead to the identification of novel therapeutic targets and predictive markers, enabling early intervention in suicidal youth.
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Sun YJ, Xu LZ, Ma ZH, Yang YL, Yin TN, Gong XY, Gao ZL, Liu YL, Liu J. Health-related risky behaviors and their risk factors in adolescents with high-functioning autism. World J Clin Cases 2021; 9:6329-6342. [PMID: 34434999 PMCID: PMC8362546 DOI: 10.12998/wjcc.v9.i22.6329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/25/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Health-related risky behaviors generally refer to behaviors that have a negative impact on health and quality of life. Health-related risky behaviors in adolescents with high-functioning autism (HFA) have not been well understood so far. Adolescents with HFA may have more health-related risky behaviors than neurotypical adolescents.
AIM To investigate health-related risky behaviors and their risk factors with HFA.
METHODS This is an observational study. Our study enrolled 110 adolescents aged 12-19-years-old meeting Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria for HFA. They were recruited from Peking University Sixth Hospital. There were also 110 age, sex and nationality matched controls enrolled who came from a public school in Beijing, China. Both groups completed the Adolescents Health-related Risky Behavior Inventory. Nonparametric tests were carried out for comparison of the Adolescents Health-related Risky Behavior Inventory scores between the two groups. Expression recognition, the Inventory of Subjective Life Quality for Child and Adolescent, Chinese Wechsler Intelligence Scale for Children, Wechsler Intelligence Scale for Adult-Chinese Revised, Theory of Mind test and Autism Spectrum Screening Questionnaire were assessed in the autism group to explore factors associated with health-related risky behaviors. Multivariate regression analysis was conducted to explore the risk factors of health-related risky behaviors in the HFA group.
RESULTS The results showed that the total score of the Adolescents Health-related Risky Behavior Inventory and scores of “aggression and violence,” “suicide and self-injury,” “health compromising behavior” and “unprotected sex” subscales in the HFA group were significantly higher than those in the control group (Z range -4.197 to -2.213, P < 0.05). Among the associated factors, poor emotional experience (B = -0.268, P < 0.001), depression (B = -0.321, P < 0.001), low score of intelligence (B = -0.032, P = 0.042), low score of Theory of Mind test (B = -1.321, P = 0.003) and poor adaptation to school life (B = -0.152, P = 0.006) were risk factors. These risky behaviors may promote the occurrence of health-related risky behaviors in adolescents with HFA.
CONCLUSION This study showed that adolescents with HFA were more likely to be involved in health-related risky behaviors. Different health-related risky behaviors have different reasons.
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Affiliation(s)
- Ya-Jing Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Ling-Zi Xu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Zeng-Hui Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Yu-Lu Yang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Ting-Ni Yin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Xiao-Yun Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Zi-Lin Gao
- Quanzhou Children’s and Women’s Hospital, Quanzhou 362000, Fujian Province, China
| | - Yan-Ling Liu
- Department of Mathematics, Changzhi Medical College, Changzhi 046000, Shanxi Province, China
| | - Jing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
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Sun Y, Li X, Xu L, Ma Z, Yang Y, Yin T, Gao Z, Gong X, Li L, Liu Q, Tang X, Liu J. Health-related risky behaviors in Chinese adolescents with autism: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2021; 15:39. [PMID: 34330314 PMCID: PMC8325271 DOI: 10.1186/s13034-021-00390-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/20/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Health-related risky behaviors (HRB) generally refer to behaviors that have a negative influence on health and quality of life. HRB in adolescents with autism have not been well understood so far. We aim to explore health-related risky behaviors and their risk factors with autistic adolescents. METHODS In this study, 150 adolescents with autism and 150 neurotypical adolescents were enrolled. Participants in both groups completed the Adolescent Health-Related Risky Behavior Inventory (AHRBI). Autism Spectrum Screening Questionnaire (ASSQ), Wechsler Intelligence Scale, Theory of Mind (ToM) Test, Zung Self-rating Anxiety Scale (SAS), Zung Self-rating Depression Scale (SDS), and Self-Esteem Scale (SES) were also assessed in the autism group to explore risk factors. RESULTS The results showed that the total score of AHRBI and scores of "aggression and violence (AV)", "suicide or self-injury (SS)", "health-compromising behavior (HCB)", and "unprotected sex (US)" subscales in the autism group were significantly higher than those in the control group (Z value = - 4.58 ~ - 2.26, all P < 0.05). Anxiety, depression, low self-esteem, low IQ score, low ToM test score, increasing age, and communication disorder were found as risk factors for health-related risky behaviors in autistic adolescents. CONCLUSIONS Adolescents with autism have more health-related risky behaviors than neurotypical adolescents. We should pay attention to the emotional state, self-esteem, cognitive function, and verbal communication levels of autistic adolescent with health-related risky behaviors.
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Affiliation(s)
- Yajing Sun
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Xue Li
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Lingzi Xu
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Zenghui Ma
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Yulu Yang
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Tingni Yin
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Zilin Gao
- Children’s and Women’s Hospital, Quanzhou, 362000 China
| | - Xiaoyun Gong
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Lei Li
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Qinyi Liu
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Xinzhou Tang
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
| | - Jing Liu
- Peking University Institute of Mental Health, Peking University Sixth Hospital, Key Laboratory of Mental Health, National Health Commission (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing, 100191 China
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Safa A, Valiee S, Fazel Darbandi A, Aghajani M. Risky Behaviors and Sensation-Seeking in Adolescence: A Descriptive Correlational Study. Compr Child Adolesc Nurs 2019; 43:260-273. [PMID: 31233367 DOI: 10.1080/24694193.2019.1628115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Risky behaviors are common in developing countries, especially in adolescence. Moreover, sensation seeking is an important factor in personality. This study was conducted to evaluate the relationship between risky behaviors and sensation-seeking in a sample of Iranian adolescents. This study used a cross-sectional method with 400 high school adolescents (age between 15 and 21 years old) in Kashan city from multistage random sampling. The research instrument consisted of three parts: a socio-demographic questionnaire, the Youth Risk Behavior Surveillance System (YRBSS) and the Zuckerman Sensation-Seeking Scale-V (SSS-V). Data analysis was performed using the t-test, ANOVA, chi-square, regression and Spearman correlation coefficient in SPSS v 11.5. Risky behaviors were found in 51.2% of students, and a significant difference was found between the male and female students in this regard (p < .021). The overall sensation-seeking score and the scores in the dimensions of experience seeking, disinhibition, and boredom susceptibility were higher in males than females (p < .0001). All dimensions of sensation-seeking other than disinhibition dimension could significantly predict risky behavior. Sensation seeking can be used as an indicator for screening risky behaviors. Detailed planning on the part of the health care system and public authorities is recommended for appropriate screening and counseling adolescents with risky behaviors.
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Affiliation(s)
- Azade Safa
- Trauma Nursing Research Center, Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences , Kashan, Iran
| | - Sina Valiee
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences , Sanandaj, Iran
| | - Alireza Fazel Darbandi
- Department of Curriculum Planning, Kashan Directorate General of Employment and Training , Kashan, Iran
| | - Mohammad Aghajani
- Infectious Diseases Research Center, Department of Psychiatric nursing, Kashan University of Medical Sciences , Kashan, Iran
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Xavier A, Cunha M, Pinto-Gouveia J. Validation of the Risk-Taking and Self-Harm Inventory for Adolescents in a Portuguese Community Sample. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1080/07481756.2018.1435189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Ana Xavier
- University of Coimbra, Coimbra, Portugal
| | - Marina Cunha
- University of Coimbra, Coimbra, Portugal
- Instituto Superior Miguel Torga, Coimbra, Portugal
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Brown MRG, Benoit JRA, Juhás M, Dametto E, Tse TT, MacKay M, Sen B, Carroll AM, Hodlevskyy O, Silverstone PH, Dolcos F, Dursun SM, Greenshaw AJ. fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behavior in adolescents. Front Syst Neurosci 2015; 9:124. [PMID: 26483645 PMCID: PMC4586270 DOI: 10.3389/fnsys.2015.00124] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 08/20/2015] [Indexed: 12/27/2022] Open
Abstract
High-risk behavior in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behavior and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behavior. We recruited 21 adolescents (age 14–17) with a wide range of high-risk behavior tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behavior Screen (ARBS). ARBS risk scores correlated highly (0.78) with impulsivity scores from the Barratt Impulsivity scale (BIS). Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI) while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behavior and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behavior tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents.
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Affiliation(s)
- Matthew R G Brown
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada ; Department of Computing Science, University of Alberta Edmonton, AB, Canada
| | - James R A Benoit
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Michal Juhás
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Ericson Dametto
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Tiffanie T Tse
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Marnie MacKay
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | - Bhaskar Sen
- Department of Computing Science, University of Alberta Edmonton, AB, Canada
| | - Alan M Carroll
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
| | | | | | - Florin Dolcos
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada ; Psychology Department, Neuroscience Program, and the Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign Urbana, IL, USA
| | - Serdar M Dursun
- Department of Psychiatry, University of Alberta Edmonton, AB, Canada
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Stevens A, Coulton S, O'Brien K, Butler S, Gladstone B, Tonkin J. RisKit: The participatory development and observational evaluation of a multi-component programme for adolescent risk behaviour reduction. DRUGS: EDUCATION, PREVENTION AND POLICY 2014. [DOI: 10.3109/09687637.2013.787526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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Humphrey K, McDowell A. Sense of coherence as a predictor of risky health behaviours amongst teenage girls on a targeted youth development programme. JOURNAL OF PUBLIC MENTAL HEALTH 2013. [DOI: 10.1108/jpmh-10-2012-0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Kirsty Humphrey
- Research Health Psychologist based at Teens and Toddlers, London, UK
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Wang M, Yi J, Cai L, Hu M, Zhu X, Yao S, Auerbach RP. Development and psychometric properties of the health-risk behavior inventory for Chinese adolescents. BMC Med Res Methodol 2012; 12:94. [PMID: 22770389 PMCID: PMC3431231 DOI: 10.1186/1471-2288-12-94] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 07/07/2012] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is a growing body of research investigating adolescent risk behaviors in China, however, a comprehensive measure that evaluates the full spectrum of relevant risk behaviors is lacking. In order to address this important gap, the current study sought to develop and validate a comprehensive tool: the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA). METHODS Adolescents, ages 14-19 years (n = 6,633), were recruited from high schools across 10 cities in mainland China. In addition, a clinical sample, which included 326 adolescents meeting DSM-IV criteria for Conduct Disorder, was used to evaluate predictive validity of the HBICA. Psychometric properties including internal consistency (Cronbach's alpha), test-retest reliability, convergent validity, and predictive validity were analyzed. RESULTS Based upon item analysis and exploratory factor analysis, we retained 33 items, and 5 factors explained 51.75% of the total variance: Suicide and Self-Injurious Behaviors (SS), Aggression and Violence (AV), Rule Breaking (RB), Substance Use (SU), and Unprotected Sex (US). Cronbach's alphas were good, from 0.77 (RB) to 0.86 (US) for boys, and from 0.74 (SD) to 0.83(SS) for girls. The 8 weeks test-retest reliabilities were moderate, ranged from 0.66 (AV) to 0.76 (SD). External validities was strong, with Barratt Impulsiveness Scale-11 was 0.35 (p < 0.01), and with aggressive behavior and rule-breaking behavior subscales of the Youth Self Report were 0.54 (p < 0.01) and 0.68 (p < 0.01), respectively. Predictive validity analysis also provided enough discriminantity, which can distinguish high risky individual effectively (cohen' d = 0.79-2.96). CONCLUSIONS These results provide initial support for the reliability and validity of the Health-Risk Behavior Inventory for Chinese Adolescents (HBICA) as a comprehensive and developmentally appropriate assessment instrument for risk behaviors in Chinese adolescents.
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Affiliation(s)
- Mengcheng Wang
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, #139 Ren-Min Zhong Road, Changsha 410011, China
| | - Jinyao Yi
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, #139 Ren-Min Zhong Road, Changsha 410011, China
| | - Lin Cai
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, #139 Ren-Min Zhong Road, Changsha 410011, China
| | - Muli Hu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, #139 Ren-Min Zhong Road, Changsha 410011, China
| | - Xiongzhao Zhu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, #139 Ren-Min Zhong Road, Changsha 410011, China
| | - Shuqiao Yao
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, #139 Ren-Min Zhong Road, Changsha 410011, China
| | - Randy P Auerbach
- Child and Adolescent Mood Disorders Laboratory, McLean Hospital, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA
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Christopherson TM, Conner BT. Mediation of late adolescent health-risk behaviors and gender influences. Public Health Nurs 2012; 29:510-24. [PMID: 23078422 DOI: 10.1111/j.1525-1446.2012.01007.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study explored how multiple bioecological constructs operate to explain health-risk behaviors in late adolescence and to test for moderator effects of gender. DESIGN AND SAMPLE This was a descriptive, cross-sectional study with a convenience sample of 437 predominately Caucasian late adolescents with an average age of 19 years who lived in Northern California. MEASURES Parental Attachment, Shyness, Loneliness, Law Abidance, and Youth Risk Behaviors were measured with self-report tools and analyzed using structural equation modeling. RESULTS Confirmatory factor analysis indicated that the data fit the model well. Analysis of group differences revealed that gender moderated the relationships among the measured variables; thus, data were analyzed in independent gender-based models. Structural modeling demonstrated good model fit for each gender. Shyness and parental attachment each were associated with loneliness. Loneliness was associated with smoking. Loneliness linked the relationship between shyness, parental attachment, and smoking. Parental attachment was associated with law abidance. Law abidance was associated with sexual behaviors for female adolescents only. CONCLUSIONS This study provides valuable insights for public health nurses as it pertains to late adolescent health-risk behaviors. Nurses should use screening tools and techniques to ensure appropriate referrals and interventions to meet the needs of at-risk adolescents.
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Affiliation(s)
- Toni Michelle Christopherson
- Clinical Education, Practice, and Informatics, Kaiser Permanente Sacramento Medical Center, Sacramento, CA 95825, USA.
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Ozechowski TJ, Waldron HB. Assertive outreach strategies for narrowing the adolescent substance abuse treatment gap: implications for research, practice, and policy. J Behav Health Serv Res 2010; 37:40-63. [PMID: 18690540 PMCID: PMC2807895 DOI: 10.1007/s11414-008-9136-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 05/29/2008] [Indexed: 12/27/2022]
Abstract
In any given year, only about 10% of the nearly two million adolescents exhibiting substance abuse or dependence in the United States receive substance abuse treatment. Given this state of affairs, it is unlikely that the massive effort and expenditure of resources over the past decade on developing, testing, and disseminating effective treatments for adolescent substance abuse will have an appreciable impact on the prevalence of substance use disorders among the adolescent population. In order to substantially diminish the pervasive gap between levels of need for and utilization of adolescent substance abuse treatment, specialized assertive outreach strategies may be needed. This paper outlines a framework for assertive outreach for adolescents with substance use disorders and proposes specific types of strategies for identifying and enrolling such adolescents into treatment. Implications for practice and policy pertaining to adolescent substance abuse treatment service delivery are considered.
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Mechanisms underlying heightened risk taking in adolescents as compared with adults. Psychon Bull Rev 2008; 15:272-7. [PMID: 18488639 DOI: 10.3758/pbr.15.2.272] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Self-report surveys and behavioral tasks indicate greater risk-taking behavior in adolescents as compared with adults. However, the underlying causes of these behavioral differences remain unclear. The present study examined the possibility that adolescents may be more susceptible to immediate positive and negative outcomes than adults. We compared the behavior of adolescents and adults on a modified version of the Balloon Analogue Risk Task (Lejuez et al., 2002). The task required that participants press a button to "inflate" a series of balloons on a computer screen. Balloons inflated until either the participant released the button ("saved" balloons) or the balloon "burst." Accumulated points increased as the duration of the buttonpress increased; however, simultaneously, the likelihood that the balloon would burst also increased. Adolescents inflated balloons to a larger size prior to saving them than adults did, suggesting relatively higher levels of risk taking, although the adolescents' behavior was not uniformly risk prone. Further, in comparison with adults, behavior in adolescents was more influenced by whether a balloon was saved or had burst on the preceding trial, suggesting that sensitivity to immediate consequences is one mechanism that underlies the observed difference in risk taking.
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Abstract
OBJECTIVE To examine the risk factors associated with adolescent (ages 12-17) misuse of opioids, stimulants, tranquilizers, and sedatives using a nationally representative sample. The characteristics associated with symptoms of abuse and/or dependence related to prescription medication misuse among adolescents were also analyzed. METHOD These questions were addressed using the 2005 National Survey on Drug Use and Health. Screening and full interview response rates were 91% and 76%, respectively, and data from 18,678 adolescents were used. Regression analyses, using population-based weights, were performed to identify characteristics associated with past year misuse of prescription medications and the presence of past year abuse or dependence symptoms related to misuse. RESULTS Among adolescents, 8.2% misused a medication and 3.0% endorsed symptoms of a substance use disorder related to prescription medication misuse in the past year. The predictors of misuse from multivariate analyses were poorer academic performance (odds ratio [OR] 2.9, 95% confidence interval [CI] 2.37-3.52), past year major depression (OR 3.1, 95% CI 2.62-3.74), higher risk-taking levels (OR 3.6, 95% CI 3.13-4.20), past year use of alcohol (OR 7.3, 95% CI 6.19-8.59), cigarettes (OR 8.6, 95% CI 7.43-9.91), marijuana (OR 9.9, 95% CI 8.53-11.44), or past year use of cocaine or an inhalant (OR 10.7, 95% CI 8.98-12.72). Past year major depression (OR 1.5, 95% CI 1.03-2.25), past year cocaine or inhalant use (OR 1.7, 95% CI 1.21-2.41), or >or=10 episodes of past year prescription misuse (OR 3.0, 95% CI 2.13-4.17) was associated with having symptoms of abuse of or dependence among adolescent prescription medication misusers. CONCLUSIONS These risk factors could help clinicians identify those at risk for significant problems due to prescription misuse, allowing for prevention or early treatment in this population.
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