Mindful Coping and Mental Health among Adolescents

The aim of the research described here is to provide knowledge of adolescents and their coping strategies through the construct of mindful coping. Little is known about the contributions of mindfulness to the enhancement of mental health in adolescents. Inspired by dialectical behaviour therapy (Linehan, 1993a, b), we discuss the mindful coping process and investigate how different aspects of this process are related to mental health in a non-clinical adolescent sample. The empirical approach consisted of a cross-sectional study of 652 high-school students from two high schools, covering all streams. The relations between the four proposed mindful coping aspectsawareness, distraction, preventing negative emotions and constructive self-assertionwith psychological symptoms (PS), as well as how these four aspects moderated the relationship of perceived life strains (LS) with PS, were studied. The results show that coping by preventing negative emotions and constructive self-assertion were associated with fewer PS and/or weaker association between LS and PS, whereas coping by use of distraction was related to more PS and did not moderate the association between LS and PS. Finally, coping by use of awareness was related to a stronger association of LS with PS. The results only partly supported our expectations, providing challenging and important knowledge for future research on mindful coping in adolescents.     

School-Based Prevention Efforts Addressing the Sociocultural Risk Factors of Eating Disorders

Today's young people are surrounded by sociocultural messages that promote thinness and create high levels of body dissatisfaction. Children and adolescents consequently develop disordered eating behaviors and experience detrimental effects to their development in physical, social-emotional, and academic arenas. Given the many barriers to the effective treatment of full-blown eating disorders, there is currently a push towards administering early prevention efforts within schools. In particular, school mental health programs can work with school staff to create a supportive environment to encourage higher levels of body satisfaction, counter negative sociocultural messages, and help to prevent the development of eating disorders. This article will explore and define the relationship between sociocultural risk factors and the prevalence of eating disorders, supply a rationale for addressing eating disorders within school-based mental health programs, provide a brief review and analysis of some important prevention programs within schools, and suggest recommendations for further research and school-based program development.     

Laparoscopic Adjustable Gastric Banding in Adolescents: The Austrian Experience

Background: Morbid obesity is a rising problem in adolescents in the industrial nations. Up to 25% of children have a body mass index (BMI) higher than the 85th age- and sex-adjusted percentile. Obesity in youth is associated with increased risk for morbidity and mortality in adulthood. In addition, these patients suffer from psychological problems and decreased quality of life. Bariatric procedures have shown effective long-term results in adults, but they are still discussed controversially in adolescent patients. Methods: Between 1998 and 2004, 50 adolescent patients with a mean age of 17.1±2.2 years (range 9-19 years) underwent laparoscopic adjustable gastric banding (LAGB) in Austria. The psychological changes were analyzed by using Moorehead-Ardelt/BAROS questionnaire. Results: The mean BMI decreased from 45.2±7.6 kg/m² at time of surgery to 32.6±6.8 kg/m² after a mean follow-up of 34.7±17.5 months. The mean excess weight loss was 61.4±35.5%. Most of the adolescents showed remarkable improvements in their quality of life. The outcome was regarded as "excellent or very good" in 32 patients, "good" in 12 patients and "fair" in 5 patients. Only one patient noticed no alterations after surgery. Two-thirds of the preoperative co-morbidities resolved, and one-third improved during follow-up. Except for one port dislocation, no peri- or postoperative complications arose. Conclusion: LAGB is an effective and attractive treatment option in very carefully selected obese adolescents, because of its adjustability and the preservation of the gastrointestinal passage. The majority of patients showed a remarkable improvement in their quality of life.     

Psychosocial Factors and High-Risk Sexual Behavior: Race Differences Among Urban Adolescents

Adolescence is a period of sexual experimentation. We examined psychosocial predictors of high-risk sexual behavior and condom use. The sample included 824 ninth-graders, most of whom are African American. We conducted separate analyses for whites and African Americans. Predictors included alcohol and substance use, delinquency, prosocial behaviors, and family and peer influences. We found that problem behaviors predicted high-risk sexual behavior, but the effects were stronger for white youth. We also found that friends' behaviors were more predictive than family influences, except for family conflict. In general, the models explained more variance for white youths than for African-American youths. The results suggest that problem behavior theory and social interactions theory may be most relevant for white youth and that other models may be necessary to explain high-risk sexual behavior among African-American youths.     

The Pediatric Cancer Quality of Life Inventory-32 (PCQL-32). II. Feasibility and Range of Measurement

The Pediatric Cancer Quality of Life Inventory-32 (PCQL-32) has been developed to be a standardized assessment instrument to assess systematically pediatric cancer patient's health-related quality of life (HRQOL) outcomes. Multidimensional serial measurement of pediatric cancer patients' HRQOL in Phase III randomized controlled clinical trials is increasingly being recognized as an essential component in evaluating the comprehensive health outcomes of modern antineoplastic treatment protocols. The 32-item PCQL-32 short form was empirically derived from the PCQL long form (84-87 items), which was administered to 291 pediatric cancer patients and their parents during various stages of treatment. The feasibility (percentage of missing values per item) and range of measurement [percentage of minimum (floor effect) and maximum (ceiling effect) possible scores] was calculated for the five PCQL-32 scales and the total scale score. Feasibility for the PCQL-32 was very good, with less than .01% missing values. Range of measurement was full, with no ceiling effects (higher symptoms/problems) and low to moderate floor effects (lower symptoms/problems). The PCQL-32 demonstrated very good feasibility and range of measurement. In its short form, the PCQL-32 is practical for Phase III clinical trials. Future studies will test the utility of the PCQL-32 as a brief serial measure for monitoring the HRQOL outcomes for children and adolescents with cancer.     

Influence of Positive Life Events on Blood Pressure in Adolescents

It has been reported that adults suffering from refractory essential hypertension experience significantly fewer positive life events than healthy peers. However, the influence of positive life events on blood pressure (BP) in adolescents has been largely ignored. Therefore, we examined the relationship between selfreported positive life events and BP in 69 sixth graders with a mean age of 11.7 years. Positive life events were assessed with the Adolescent Perceived Events Scale and resting blood pressure was measured with a mercurial sphygmomanometer. Correlational analyses showed an inverse relationship between positive life events and diastolic BP, suggesting that adolescents experiencing more positive life events were more likely to have lower diastolic BP's. Hierarchical regression analyses revealed that physical activity level, dietary sodium-to-potassium ratio, parental history of hypertension, and measures of body composition predicted 24.6% of the variance in systolic BP and 34.6% of the variance in diastolic BP. Moreover, positive life events predicted an additional 4.3% of the variance in diastolic BP when statistically controlling these established risk factors for hypertension. These results suggest that increased perceptions of positive life events may act as a buffer to elevated BP in adolescents.     

The impact of a high versus a low glycaemic index breakfast cereal meal on verbal episodic memory in healthy adolescents

Abstract

In this study, healthy adolescents consumed either (i) a low glycaemic index breakfast cereal meal or (ii) a high glycaemic index breakfast cereal meal, before completing a test of verbal episodic memory in which the memory materials were encoded under conditions of divided attention. Analysis of remembering/forgetting indices revealed that the high glycaemic index breakfast group remembered significantly more items relative to the low glycaemic index breakfast group after a long delay. The superior performance observed in the high glycaemic index group, relative to the low glycaemic index group, may be due to the additional glucose availability provided by the high glycaemic index meal at the time of memory encoding. This increased glucose availability may be necessary for effective encoding under dual task conditions.     

Reconsidering the Term ‘Emotional Disturbance’: A Report from Maryland

The term ‘emotional disturbance’ (ED) has been a source of controversy in the United States (U.S.) since its introduction in 1975 (as part of legislationthe Education for All Handicapped Children Act). The lack of connection to diagnostic criteria and the stigma attached to the term have been associated with its criticism from a broad and diverse range of stakeholder groups, including young people, families, researchers, educators, and mental health professionals. In relation to these concerns a survey was developed to consider terminology preferences across different stakeholder groups. A statewide steering group in one U.S. state (Maryland) distributed the survey to educators, clinicians, family advocates, families, and young people to assess the preferred terminology to describe ED. The term with the greatest frequency of endorsement (30%) was ‘emotional/behavioral disability’ (EBD). The term EBD was preferred by all groups with the exception of students, whose responses indicated a greater preference for the terms ‘emotional or behavioral disorder’ (30%) or ‘emotional disability’ (30%). The findings reinforce the need for further discussion of the acceptability and fit of the label in describing students with pronounced emotional and behavioral needs.     

A Pilot Study of Symptoms of Neurotoxicity and Injury among Adolescent Farmworkers in Starr County,Texas

Abstract

Little is known regarding the relationship between neurotoxicity symptoms and injury, particularly among adolescent farmworkers. This pilot study utilized logistic regression to analyze injury prevalence in relation to self-reported symptoms of neurotoxicity among adolescent farmworkers along the US-Mexico border in Texas. Respondents reporting at least five symptoms had 8.75 (95%CI, 1.89–40.54) times the prevalence of injury compared with those reporting zero or one symptom. Significant associations were observed for six items: trouble remembering things, family noticing memory loss, making notes, irritated for no reason, heart pounding, and tingling. This pilot study suggests a relationship between symptoms of neurotoxicity and injury among adolescent farmworkers, supporting the need for more rigorous investigations.