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Singh, Rashmi, and J. K. Nayak. "Parent-adolescent conflict and choice of conflict resolution strategy." International Journal of Conflict Management 27, no. 1 (2016): 88–115. http://dx.doi.org/10.1108/ijcma-04-2014-0025.
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Purpose – The purpose of this paper is to investigate the impact of family communication patterns (FCPs) on adolescents’ choice of conflict resolution strategies during family holiday planning. Design/methodology/approach – The paper is framed by and builds on the literature on the adolescents’ choice of conflict resolution strategies and the FCP. The sample was collected using a survey among 400 adolescents in India. Exploratory factor analysis, confirmatory factor analysis and structural equation modelling have been used to analyse the data. Findings – The paper provides a significant relationship between FCP and the choice of conflict resolution strategies. The study findings suggested that adolescents’ choice of resolution strategy depends on the type of communication environment in the family. It has been seen that adolescents have more say in concept-oriented families and use different types of resolution strategies compared to socio-oriented families. Practical implications – The present study has considerable implications for the marketers and the academicians. Through FCP, marketers will be able to segment the families and, hence, may introduce efficient and competent marketing strategies and promotional campaigns. Originality/value – The paper offers insights into the choice of conflict resolution strategy by adolescents’ in different FCPs. The study has originality and offers value to marketers as it focuses on adolescents, and explores their perceptions about their influence during the decision process.
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Sorkhabi, Nadia. "Sources of Parent-Adolescent Conflict: Content and Form of Parenting." Social Behavior and Personality: an international journal 38, no. 6 (2010): 761–82. http://dx.doi.org/10.2224/sbp.2010.38.6.761.
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Parent-adolescent conflicts are examined as a function of parental rule construction, use of reason at points of disagreement, and regulation of personal, moral, conventional, and prudential social domains. Multiple regression analyses of interviews with mothers, fathers, and adolescents revealed that, across all perspectives, variations in parental use of reason explain unique variance in conflict frequency above and beyond rule construction or regulation of domains. Furthermore, based on mothers' reports about their parenting and adolescents' reports of their mothers, the domains mothers regulate do not explain unique variance in conflict frequency but fathers' reports about their parenting and adolescents' reports of their fathers do. Differences in parents' and adolescents' perspectives are examined and it is concluded that content and form of parenting are both important in explaining conflict in differential ways between mother-adolescent and father-adolescent dyads.
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Zhao, Hongyu, Yan Xu, Fang Wang, Jiang Jiang, and Xiaohui Zhang. "Influence of Parent—Adolescent Conflict Frequency on Adolescent Family Satisfaction and Self-Satisfaction in China: Conflict Coping Tactics as Moderators." Psychological Reports 117, no. 3 (2015): 897–915. http://dx.doi.org/10.2466/21.10.pr0.117c28z7.
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Elbedour, Salman, Joel M. Hektner, Mohammed Morad, and Soleman H. Abu-Bader. "Parent-Adolescent Conflict and Its Resolution in Monogamous and Polygamous Bedouin Arab Families in Southern Israel." Scientific World JOURNAL 3 (2003): 1249–64. http://dx.doi.org/10.1100/tsw.2003.99.
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The purpose of this study was twofold: (1) to compare whether children from polygamous family structures significantly differ from children from monogamous family structures with regard to the frequency of parent-child conflict, and (2) whether children from these two structures employ different patterns of family conflict resolution.To address these questions, a random sample of 212 high school students (60.8% monogamous) completed a self-administered survey. The results of MANOVA show no significant differences (p > 0.05) between these two structures with regard to the frequency of parent-child conflict. The results also show similar conflict management styles between these two family structures within each of the following five domains (privacy, school and career, money spending, going out and leisure, and physical appearance).This study is unique in that it is the first empirical research to be conducted in the field of conflict resolution among youth and adolescents in polygamous marital structures and therefore, further investigation is needed to replicate these results utilizing different cross-cultural populations practicing polygamy.
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Marceau, Kristine, Carolyn Zahn-Waxler, Elizabeth A. Shirtcliff, Jane E. Schreiber, Paul Hastings, and Bonnie Klimes-Dougan. "Adolescents’, mothers’, and fathers’ gendered coping strategies during conflict: Youth and parent influences on conflict resolution and psychopathology." Development and Psychopathology 27, no. 4pt1 (2015): 1025–44. http://dx.doi.org/10.1017/s0954579415000668.
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AbstractWe observed gendered coping strategies and conflict resolution outcomes used by adolescents and parents during a conflict discussion task to evaluate associations with current and later adolescent psychopathology. We studied 137 middle- to upper-middle-class, predominantly Caucasian families of adolescents (aged 11–16 years, 65 males) who represented a range of psychological functioning, including normative, subclinical, and clinical levels of problems. Adolescent coping strategies played key roles both in the extent to which parent–adolescent dyads resolved conflict and in the trajectory of psychopathology symptom severity over a 2-year period. Gender-prototypic adaptive coping strategies were observed in parents but not youth, (i.e., more problem solving by fathers than mothers and more regulated emotion-focused coping by mothers than fathers). Youth–mother dyads more often achieved full resolution of conflict than youth–father dyads. There were generally not bidirectional effects among youth and parents’ coping across the discussion except boys’ initial use of angry/hostile coping predicted fathers’ angry/hostile coping. The child was more influential than the parent on conflict resolution. This extended to exacerbation/alleviation of psychopathology over 2 years: higher conflict resolution mediated the association of adolescents’ use of problem-focused coping with decreases in symptom severity over time. Lower conflict resolution mediated the association of adolescents’ use of angry/hostile emotion coping with increases in symptom severity over time. Implications of findings are considered within a broadened context of the nature of coping and conflict resolution in youth–parent interactions, as well as on how these processes impact youth well-being and dysfunction over time.
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Warren, Ron, and Lindsey Aloia. "Parent–Adolescent Communication Via Mobile Devices: Influences on Relational Closeness." Journal of Family Issues 39, no. 15 (2018): 3778–803. http://dx.doi.org/10.1177/0192513x18793924.
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Previous studies have shown mixed results regarding families’ cell phone use and family outcomes. Some research has shown that mobile devices might isolate family members, but families in other studies report higher levels of closeness because they can reach one another more often. This study looks at parents’ and adolescents’ motivations for mobile communication as mediators of the link between cell phone use and relational closeness. We analyzed data from 504 parent–child dyads regarding the frequency of and reasons for their mobile communication, as well as their perceptions of closeness to one another. Our results indicate that relation-centric uses of mobile devices (e.g., expressing support, handling conflict) are predictive of feelings of closeness. On the other hand, more functional uses (e.g., coordinating schedules, sharing content) do not predict closeness. These findings are discussed within the context of family life cycle positions and adolescent development.
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Yau, Jenny, and Judith Smetana. "Adolescent-Parent conflict in Hong Kong and Shenzhen: A comparison of youth in two cultural contexts." International Journal of Behavioral Development 27, no. 3 (2003): 201–11. http://dx.doi.org/10.1080/01650250244000209.
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This study examined adolescent–parent conflict among 188 5th-, 7th-, 10th-, and 12th-grade Chinese adolescents, 93 from Hong Kong and 95 from Shenzhen, PRC. Individually interviewed Chinese adolescents reported disagreements with parents over everyday issues, primarily choice of activities, schoolwork, interpersonal relationships, and chores. Conflicts were relatively few in number, moderate in frequency, and mild in intensity, and across contexts, conflicts were more intense in early adolescence (5th and 7th grades) than in late adolescence (12th grade). There were more conflicts over chores and interpersonal relationships in Hong Kong than in Shenzhen and more conflicts over schoolwork in Shenzhen than in Hong Kong, particularly among 7th and 12th graders. As expected, adolescents primarily justified conflicts, particularly conflicts over choice of activities and homework, by appealing to personal jurisdiction, and across contexts, personal reasoning increased with age. Conflicts were resolved primarily by giving in to parents, although adolescents desired more autonomy in decision making than they reported having. Although adolescent–parent conflict among Chinese youth appears to reflect the development of adolescent autonomy, culturally specific processes influence its expression.
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Singh, Rashmi, and Jogendra Kumar Nayak. "Effect of family environment on adolescent compulsive buying: mediating role of self-esteem." Asia Pacific Journal of Marketing and Logistics 28, no. 3 (2016): 396–419. http://dx.doi.org/10.1108/apjml-05-2015-0082.
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Purpose – The purpose of this paper is to investigate the mediating role of self-esteem in the relationship between parent-adolescent relationship and adolescent compulsive buying behaviour. Using a sample of 300 adolescents (15-18 years) in India and the structural equation modelling technique, the findings reveal that self-esteem mediates the relationship between parent-adolescent relationship and adolescent compulsive buying behaviour. Design/methodology/approach – The present study is the first to experimentally manipulate important parent-adolescent relationship and measures its impact on compulsive buying among a sample of 15-18-year old adolescents. Next, the authors investigate the mediating role of self-esteem for the above relationship. Confirmatory factor analysis and structural equation modelling have been used in the study. Findings – The study also establishes that familial conflict and cohesion acts as major sources of adolescent compulsivity. The authors have also examined the mediating role of self-esteem on the above relationships and found that adolescents’ compulsivity varies with the level of self-esteem (i.e. higher level of self-esteem leads to lower levels of adolescents’ compulsivity). The practical and theoretical implications are discussed within the context of adolescents’ compulsivity. Originality/value – The study makes some inimitable and significant contributions to the literature. It portrays one of few studies to investigate compulsive buying during adolescence period – a hard to reach population. Here authors experimentally manipulate parent-adolescent relationship to investigate its impact on compulsive buying. The study’s findings in regard to mediating effect of self-esteem on the parent-adolescent relationship and adolescents’ compulsive buying behaviour suggest that compulsive buying begins during adolescence period and is a common coping strategy for both boys and girls.
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Inusa, Baba, SallyAnn Wakeford, and Fenella Kirkham. "Overnight Respiratory Support for Prevention of Morbidity in Sickle Cell Disease (POMS 2a) - Parent and Child Preferences." Blood 126, no. 23 (2015): 4457. http://dx.doi.org/10.1182/blood.v126.23.4457.4457.
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Abstract PURPOSE: Obstructive sleep apnea and nocturnal hypoxemia are common in children with sickle cell disease (SCD) and some degree of improvement has been reported following adenotonsillectomy(Finch et al., 2013). NOT and continuous positive airways pressure (CPAP) have shown some benefits in children and adolescent patients(Hargrave, 2003). While NOT and CPAP are offered to children with or without co-morbidities, there are concerns about acceptability and safety(Makani et al., 2009). The data on patient preference is limited in childhood and more so for those with SCD. To achieve optimal adherence to therapy in SCD, Auto-Adjusting Positive Airways Pressure (APAP), where airway pressure is delivered only when obstruction occurs, may be a more acceptable option than CPAP(Marshall et al., 2009). Therefore prior to designing Phase II and III trials that are adequately powered, this study sought to: i) identify parent/caregiver and child treatment preference; ii) assess whether parent/caregiver or child should manage the electronic pain diary; iii) assess any treatment effect on Health Related Quality of Life (HRQOL) in children; and iv) explore the relationship of treatment adherence to: a) experience of pain, and b) overall clinical benefit from the intervention. HYPOTHESES: 1. Treatment adherence of children or adults with would be directly related a) HRQOL quantitative measures, and b) improvement in symptoms reported through semi-structured interviews of patients; 2. Children >8 years would be able to record their experience of pain in an appropriate electronic pain diary; 3. Treatment adherence would be predictive of effect on pain frequency. METHOD: We utilised mixed-methods to explore the primary endpoint of patient experience of treatment intervention, and the secondary endpoint of pain, in a sample of 11 children (aged >8 years) with homozygous SCD. The statistician was blinded to order of intervention. Two interventions NOT and APAP were conducted for one week each in randomized order, with a washout week between interventions. Qualitative data was obtained through in-depth interviews with children and their parents/caregivers conducted by a research psychologist using content method of analysis; quantitative measures were explored employing the Pediatric Quality of Life InventoryTM (PedsQL)(Panepinto et al., 2013) including the sickle module. All analyses were preliminary, exploratory and mainly descriptive. The secondary endpoint of pain was captured utilizing a pain rating scale and symptom assessment on smart technology via an iPad(Jacob et al., 2012). Other secondary outcomes included adverse events, daytime oxygen saturation, and lung function.. All variables were reported for three time points: baseline, post-intervention 1 and post-intervention 2. RESULTS: Analysis of interviews between children and parents/caregivers revealed similarities in expectations prior to treatment, and variations in post-study perception of treatment. Parents/caregivers and children emphasised impact on other family members, practical concerns and challenges as objective criteria for treatment preference, while children additionally emphasized night time positive/negative sensory experiences: e.g. airflow, dreams, breathing, sound, as influences for treatment preference. Belief that treatment is beneficial only for children with breathing difficulties emerged as an influence on both expectation and perception of positive benefits. In 7 children for whom APAP adherence data were available, pain was noted after 3 nights with a median adherence of 5.23 (range 4.0-6.1) hours and was not noted after 38 nights with a median adherence of 8.03 (range 3.21-10.19) hours (p=0.2). For 4 children with pain recorded on 2, 2, 2 and 4 days in the pre-treatment week, 3 recorded no pain on APAP and the child with 4 days pre-treatment recorded 2 days on APAP. CONCLUSIONS: These data reveal some variation in approaches toward treatment preferences between parents/caregivers and children, and supports an inclusive approach to facilitate appropriate treatment choice. Adherence data are not available for oxygen but there is some evidence for reduction in pain in relation to APAP adherence. This trial will contribute to understanding in participant feasibility and acceptability for therapeutic intervention. Research results will be used to inform design of the Phase II and III trials. Disclosures No relevant conflicts of interest to declare.
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Li, Yong, and Yuqi Guo. "The Relation between Acculturation and Psychological Well-Being among Adolescents of Asian Origin." International Journal of Social Science Studies 6, no. 4 (2018): 1. http://dx.doi.org/10.11114/ijsss.v6i4.2938.
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The current study aimed to test the direct and indirect effects of acculturation on the psychological well-being among the adolescent children of Asian origin. Subgroup analysis was conducted to compare these effects between Asian refugee and non-refugee children. Data were from the follow-up survey of the Children of Immigrants Longitudinal Study (CILS). The analytic sample included adolescents from Asian refugee families (N = 563) and non-refugee families (N = 779). Adolescent acculturation was assessed by three proxy measures: nativity, time in the United States, and U.S. preference. Family dynamics were measured by adolescents’ perceptions about parent-child conflict and family cohesion. Multi-group structural equation modeling was used to analyze the data. Findings suggested that the direct effects of acculturation on psychological well-being were dependent upon the proxy measure of acculturation and the immigration type. Mediation analyses showed that higher level of acculturation was generally related to higher parent-child conflict and lower family cohesion, which, in turn, were associated with lower psychological well-being in the refugee subsample, but not the non-refugee subsample. Our findings call for programs that can take advantage of the protective role of family cohesion and reduce the negative impact of parent-child conflict. Special attention needs to be paid to the refugee population from Asia.
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Anderson, B. J., J. Brackett, J. Ho, and L. M. Laffel. "An office-based intervention to maintain parent-adolescent teamwork in diabetes management. Impact on parent involvement, family conflict, and subsequent glycemic control." Diabetes Care 22, no. 5 (1999): 713–21. http://dx.doi.org/10.2337/diacare.22.5.713.
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Leung, Grace S. M., Anna Y. Zhang, Eddie H. K. Yu, and Johnson C. S. Cheung. "From spectator to spect-actor: The proactive involvement of chinese parents in their conflicts with adolescents through a forum theatre format." Journal of Psychologists and Counsellors in Schools 30, no. 1 (2019): 73–81. http://dx.doi.org/10.1017/jgc.2019.21.
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AbstractParent-adolescent conflict seems to be common when adolescents negotiate power with their parents. Forum theatre (FT), an interactive and participatory theatre form, is recommended as a community-based intervention to assist Chinese parents in managing the challenges of parent-adolescent interaction. FT proposes that solutions to daily struggles can be reached through concerted efforts of the participants. This article documents the impact of FT on parents who took on the role of ‘spect-actor’. The spect-actor is an active spectator who acts on stage to test solutions to a problem. The results indicate that parents gained more awareness of their children’s needs, which helped them to relax their control over their children. FT is recommended as a means of parent education in schools.
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Jones, Elizabeth A. K., Amal K. Mitra, and Azad R. Bhuiyan. "Impact of COVID-19 on Mental Health in Adolescents: A Systematic Review." International Journal of Environmental Research and Public Health 18, no. 5 (2021): 2470. http://dx.doi.org/10.3390/ijerph18052470.
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Due to lack of sufficient data on the psychological toll of the COVID-19 pandemic on adolescent mental health, this systematic analysis aims to evaluate the impact of the pandemic on adolescent mental health. This study follows the PRISMA guidelines for systematic reviews of 16 quantitative studies conducted in 2019–2021 with 40,076 participants. Globally, adolescents of varying backgrounds experience higher rates of anxiety, depression, and stress due to the pandemic. Secondly, adolescents also have a higher frequency of using alcohol and cannabis during the COVID-19 pandemic. However, social support, positive coping skills, home quarantining, and parent–child discussions seem to positively impact adolescent mental health during this period of crisis. Whether in the United States or abroad, the COVID-19 pandemic has impacted adolescent mental health. Therefore, it is important to seek and to use all of the available resources and therapies to help adolescents mediate the adjustments caused by the pandemic.
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Chhabra, GS, and MK Sodhi. "Impact of Family Conflict on the Psychosocial Behaviour in Male Adolescents." Journal of Nepal Paediatric Society 32, no. 2 (2012): 124–31. http://dx.doi.org/10.3126/jnps.v32i2.6147.
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Introduction: Accepting and supportive family relationships during childhood and adolescence may have long-term associations with psychosocial functioning into adulthood. Cross-sectional studies provide evidence by which positive family relationships promote adolescent health by increasing the likelihood of positive outcomes including higher educational and occupational attainment and reducing the risk for negative outcomes including suicidal behaviour and poor health. Materials and Methods: The sample consisted of 500 male adolescents from the urban and rural field practice areas in the vicinity of Sri Guru Ram Das Medical College Amritsar. Cross sectional study was conducted to examine the relation between familial conflict problems and psychosocial/behavioural disorders in adolescents. Results: Almost one third (33%) adolescents were having parental and family dispute problems. These problems were significantly higher in middle adolescence (14-16 years), adolescents of large extended families (>8 members) and in lower socioeconomic status. Residence had no significant relation to family problems in the adolescents. On correlation, poor and unhealthy family atmosphere had more chances in adolescents of having greater academic problems, depression, suicidal thoughts, substance abuse and more sexual activity. Conclusion: Family involvement, family structure, parental values, parental monitoring and parent-child communication are important factors influencing critical life choices in teens. The family support and communication should be improved through these education programs to develop healthy psychosocial and sexual attitudes and counteract unsafe behaviours in the adolescents. Future research is needed to identify additional pathways underlying this association, and the extent to which these factors are modifiable.J. Nepal Paediatr. Soc. 32(2) 2012 124-131 doi: http://dx.doi.org/10.3126/jnps.v32i2.6147
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Bountress, Kaitlin E., Amanda K. Gilmore, Isha W. Metzger, et al. "Impact of disaster exposure severity: Cascading effects across parental distress, adolescent PTSD symptoms, as well as parent-child conflict and communication." Social Science & Medicine 264 (November 2020): 113293. http://dx.doi.org/10.1016/j.socscimed.2020.113293.
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Avdeeva, N. N., and B. A. Hoffman. "Current research on adolescents’ relationships with parents." Современная зарубежная психология 8, no. 4 (2019): 69–78. http://dx.doi.org/10.17759/jmfp.2019080407.
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The article is based on the materials of foreign sources and discusses the current trends in the relationship of adolescents and their parents. The following problems are discussed: influence of upbringing styles and parental attitudes on various aspects of psychological development of adolescents; contribution of relationships with parents and peers into social and personality development in adolescence; peculiarities of teenagers’ attachments to parents; child-parent conflicts. The recent studies of family education and its influence on psychological development confirm the positive role of authoritative parenting style, the negative impact of rigid parenting style on adolescent aggression and so on. It is shown that excessive parental control does not contribute to the development of self-esteem and increases self-criticism in adolescent girls. In relatively new researches devoted to "technoference" the negative impact of technical means (phone, gadgets) on interaction between parents and children is shown. The article stresses the importance of attachment to parents in adolescence; the role of the quality of attachment in formation of autonomy; capacity to solve problems and cope with difficulties associated with Internet addiction; aggression and school performance. The article also presents studies of positive and negative aspects of the impact of conflict with parents on the personality development of adolescents, gender differences in behavior during the conflict between mother and father, the contribution of marital conflicts to psychological development in adolescence.
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Essau, C. A., S. I. Ishikawa, and S. Sasagawa. "Early learning experience and adolescent anxiety: A cross-cultural comparison between Japan and England." European Psychiatry 26, S2 (2011): 2046. http://dx.doi.org/10.1016/s0924-9338(11)73749-x.
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Anxiety disorders are among the most common psychiatric conditions in children and adolescents. One of the most consistent findings across studies is that anxiety disorders tend to run in families. While these high prevalence rates suggest that anxiety may be “transmitted” within the family, the exact mechanism involved in this transmission is still unclear. An area that has been suggested in the transmission of anxiety from parents to children is the role of learning experiences (i.e., through modeling and information transfer). While these studies have enhanced our knowledge on the association between learning experience and anxiety symptoms, it is not known whether these findings which were based on studies conducted in Western culture could be replicated in Eastern culture.The present study compared the frequency of anxiety symptoms among adolescents in Japan and England, and examined the association between early learning experiences and anxiety symptoms. 299 adolescents (147 from England and 152 from Japan) were investigated. Adolescents in England reported significantly higher levels of anxiety symptoms than adolescents in Japan. No significant differences emerged between the two countries for parent punishment/reinforcement of anxious behavior. However, for non-anxiety symptoms, adolescents in England scored significantly higher in parent punishment and the Japanese sample scored higher in parent reinforcement. Parent verbal transmission about the danger of anxiety and cold symptoms was more common in Japan than in England. The impact of learning experience on adolescent's anxiety seemed to differ across cultures, which underscore the importance of cultural factors on adolescent's anxiety.
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Overcash, Francine, Cynthia Davey, Youjie Zhang, and Marla Reicks. "Evening Meal Types and Family Meal Characteristics: Associations with Demographic Characteristics and Food Intake among Adolescents." Nutrients 12, no. 4 (2020): 886. http://dx.doi.org/10.3390/nu12040886.
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Evening meal types and family meal characteristics among adolescents may vary by demographic characteristics and weight status and can negatively impact dietary intake. We used cross-sectional Family, Life, Activity, Sun, Health, and Eating Study data from parent and adolescent dyads (12–17 years) to examine associations of adolescent evening meal types and family meal characteristics with adolescent and family demographic characteristics, weight status, and dietary intake. Multiple logistic regression models were used to evaluate associations of evening meal types and family meal characteristics with daily intake frequency of foods of interest, adolescent demographic characteristics, SES indicators, and weight status. All evening meal types that were not cooked from scratch showed associations with higher daily intake frequencies of less healthy food groups (fast food, convenience foods, sugar-sweetened beverages). Fast food eaten at home and heat-and-serve/box evening meals were associated with lower daily intake frequency of fruits and vegetables. Weight status, race/ethnicity, and age accounted for differences in associations with agreement regarding family meal characteristics. Agreement with often watching TV while eating, often eating alone and the importance of eating together were associated with daily intake frequency of some food groups. Evening meal types focused on convenience and negative family meal characteristics may adversely influence dietary intake among adolescents.
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Conger, Rand D., Monica J. Martin, April S. Masarik, Keith F. Widaman, and M. Brent Donnellan. "Social and economic antecedents and consequences of adolescent aggressive personality: Predictions from the interactionist model." Development and Psychopathology 27, no. 4pt1 (2015): 1111–27. http://dx.doi.org/10.1017/s0954579415000711.
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AbstractThe present study examined the development of a cohort of 279 early adolescents (52% female) from 1990 to 2005. Guided by the interactionist model of socioeconomic status and human development, we proposed that parent aggressive personality, economic circumstances, interparental conflict, and parenting characteristics would affect the development of adolescent aggressive personality traits. In turn, we hypothesized that adolescent aggressiveness would have a negative influence on adolescent functioning as an adult in terms of economic success, personality development, and close relationships 11 years later. Findings were generally supportive of the interactionist model proposition that social and economic difficulties in the family of origin intensify risk for adolescent aggressive personality (the social causation hypothesis) and that this personality trait impairs successful transition to adult roles (the social selection hypothesis) in a transactional process over time and generations. These results underscore how early development leads to child influences that appear to directly hamper the successful transition to adult roles (statistical main effects) and also amplify the negative impact of dysfunctional family systems on the transition to adulthood (statistical interaction effects). The findings suggest several possible points of intervention that might help to disrupt this negative developmental sequence of events.
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Nur Endah Sary, Yessy. "Hubungan Sosial Ekonomi Orang Tua Tunggal Dengan Frekuensi Makan Dan Status Gizi Remaja." Oksitosin : Jurnal Ilmiah Kebidanan 8, no. 2 (2021): 93–99. http://dx.doi.org/10.35316/oksitosin.v8i2.762.
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Parental status as a single parent affects the foster pattern of young children who have an impact on child nutrition status. The pattern of the mother's feeding to the child is influenced by education, knowledge of nutrition, economics, family support and employment. The purpose of this study was to analyze the socio-economic relationship of single parents with the frequency of eating and adolescent nutritional status. The study population was a teenager (son/daughter) aged 14-16 to 91 people. Sampling technique with simple random sampling. Inclusion criteria were teenagers (sons/daughters) who do not live in huts, single parents (father alone or mother only). Samples in the study of 87 people. The instruments used for research are brief questionnaires about demographic data (adolescence, single parents, single parent causes, parental education, parental work). Questionnaire for special data frequency meal in a day. Observation sheet to analyze the weight and height of teenagers. Analysis of research data using Chi Square. The results showed that the acquired value P = 0,000 means there is a relationship between the social economy of a single parent with the frequency of adolescent eating and P = 0,003 means there is a relationship between a single parent social economy with a nutritional status of teenagers.
Keywords: Socio-Economic, Single Parents, Eating Frequency, Adolescent Nutritional Status
ABSTRAK
Status orang tua tunggal mempengaruhi pola asuh terhadap anak yang beranjak remaja yang berdampak kepada status gizi anak. Pola pemberian makan orang tua kepada anak dipengaruhi oleh tingkat sosial ekonomi keluarga. Tujuan dari penelitian ini menganalisis hubungan sosial ekonomi orang tua tunggal dengan frekuensi makan dan status gizi remaja. Populasi penelitian remaja (putra/putri) usia 14-16 tahun sebanyak 91 orang. Teknik sampling dengan simple random sampling. Kriteria inklusi adalah remaja (putra/putri) yang tidak tinggal di pondok, orang tua tunggal (ayah saja atau ibu saja). Sampel dalam penelitian 87 orang. Instrumen yang digunakan kuesioner singkat tentang data demografi (umur remaja, orang tua tunggal, penyebab orang tua menjadi tunggal, pendidikan orang tua, pekerjaan orang tua). Kuesioner untuk data khusus frekuensi makan dalam sehari. Lembar observasi untuk menganalisi berat badan dan tinggi badan remaja. Analisis data menggunakan Chi Square. Hasil penelitian menunjukkan diperoleh nilai p=0,000 berarti ada hubungan antara sosial ekonomi orang tua tunggal dengan frekuensi makan remaja dan p=0,003 berarti ada hubungan antara sosial ekonomi orang tua tunggal dengan status gizi remaja.
Kata kunci : Sosial Ekonomi, Orang Tua Tunggal, Frekuensi Makan, Status Gizi Remaja
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Bourdeau, Beth, Brenda A. Miller, Hilary F. Byrnes, W. Gill Woodall, David B. Buller, and Joel W. Grube. "Efficacy of a Web-Based Intervention (Smart Choices 4 Teens) for Facilitating Parent-Adolescent Communication About Relationships and Sexuality: Randomized Controlled Trial." JMIR Pediatrics and Parenting 4, no. 2 (2021): e19114. http://dx.doi.org/10.2196/19114.
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Background There is a need for interventions that promote healthy decision making among adolescents and leverage the ongoing impact of parental relationships through older adolescence and young adulthood. These interventions should maximize adolescent engagement and be easily accessible to families in terms of cost, duration, and logistics related to participation. Objective This study aims to test the efficacy of the healthy relationships and sexual decision-making component of a web-based intervention for older adolescents and their parents, ascertain whether the efficacy varies by gender, and assess its efficacy over time. Methods A randomized controlled trial was conducted for the web-based, self-paced intervention Smart Choices 4 Teens from 2014 to 2015. Families (N=411) with adolescents aged 16-17 years were randomly assigned to the intervention or control condition. Surveys assessing aspects of sexual communication were administered at baseline and at 6, 12, and 18 months. Generalized estimating equations were used to determine the impact of exposure to the relationships component of the intervention on sexual communication by parents, as reported by adolescents. Results Less than half (88/206, 42.7%) of the intervention group participated in the third and final intervention component, which was focused on relationships and sexual decision making. Participation in the relationships component increased the frequency of parental sexual communication and increased the number of dating rules after accounting for other significant adolescent characteristics. The impact of the intervention varied little by gender, although it did demonstrate an impact on communication reports over the follow-up survey administrations. Conclusions Smart Choices 4 Teens demonstrated efficacy in increasing the frequency of sexual communication between parents and adolescents in the long term. Trial Registration ClinicalTrials.gov NCT03521115; https://clinicaltrials.gov/ct2/show/NCT03521115
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Li, Ji-Bin, Li-Fen Feng, Anise M. S. Wu, et al. "Roles of Psychosocial Factors on the Association Between Online Social Networking Use Intensity and Depressive Symptoms Among Adolescents: Prospective Cohort Study." Journal of Medical Internet Research 23, no. 9 (2021): e21316. http://dx.doi.org/10.2196/21316.
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Background The potential mechanisms underlying the association between online social networking use intensity and depressive symptoms are unclear and underresearched. Objective We aimed to investigate the potential roles of interpersonal psychosocial factors on the association between online social networking use intensity and depressive symptoms among early adolescents. Methods A total of 4237 adolescents from a 9-month longitudinal study were included. Score changes (indicated as △) for the social function use intensity (SFUI) and entertainment function use intensity (EFUI) subscales of the Online Social Networking Activity Intensity Scale and for friendship quality, perceived family support, perceived friend support, parent–adolescent conflict, social nonconfidence, and depressive symptoms were analyzed. The potential mediation effects of unfavorable psychosocial factors and suppression effects of favorable psychosocial factors on the association of △SFUI with △CES-D and the association of △EFUI with △CES-D were tested using hierarchical regression models. Results The association between △SFUI and △CES-D was partially mediated by △mother–adolescent conflict (mediation effect size 5.11%, P=.02) and △social nonconfidence (mediation effect size 20.97%, P<.001) but partially suppressed by △friendship quality, △perceived family support, and △perceived friend support, with suppression effects of –0.011 (P=.003), –0.009 (P=.003), and –0.022 (P<.001), respectively. The association between △EFUI and △CES-D was partially mediated by △social nonconfidence (mediation effect size 30.65%, P<.001) but partially suppressed by △perceived family support and △perceived friend support, with suppression effects of –0.036 (P<.001) and –0.039 (P<.001), respectively. Conclusions The association between online social networking use intensity and depressive symptoms was partially mediated through the indirect increase in social nonconfidence and mother–adolescent conflict; however, better perceived social support and friendship quality would partially compensate for the harmful impact of online social networking use intensity on depressive symptoms among early adolescents.
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Bau, Anne-Madeleine, Sarah Krull, Andrea Ernert, and Birgit Babitsch. "Eating behaviour and its association with social living conditions and weight status among adolescent girls: results of the cross-sectional Berlin School Children's Cohort study." Public Health Nutrition 14, no. 10 (2011): 1759–67. http://dx.doi.org/10.1017/s1368980011000541.
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AbstractObjectiveTo capture a more holistic picture of eating behaviour by investigating the impact of the social living conditions and weight status of parents and daughters on food consumption frequency, the context of meals and daily portion sizes.DesignCross-sectional Berlin School Children's Cohort study.SettingA total of sixty-nine schools in Berlin (3 400 000 inhabitants, eastern Germany) participated in the present study.SubjectsA total of 1519 girls aged 11–14 years were selected. Bi- and multivariate analyses were performed to examine the impact of age, migration background, socio-economic status (SES), parental education, family situation and the weight status of parents and daughters on three different eating behaviour scores according to nutritional recommendations.ResultsFor the three dependent eating behaviour variables, different patterns of influencing factors emerged. Multivariate regression (model 1) revealed that low and middle SES, two-parent migration background and older age were significant risk factors. Meal context was also significantly influenced by living with a single parent. Similar results were obtained for the daily portion size scores and maternal overweight status was the most influential. Model 2 succeeded in showing that, within the composite variable of family SES, mothers’ level of education was the dominant component.ConclusionsSES as a whole, and especially the component of mothers’ level of education and two-parent migration background, was the strongest risk factor for an unfavourable eating pattern among adolescent girls. The results clearly indicated preventive potential. Using three different measures of eating behaviour simultaneously provided an in-depth understanding of general patterns and potential risk factors.
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Pandia, Weny Savitri S., Margaretha Purwanti, and Debri Pristinella. "Parental Mediation with Adolescent Users of I.T. Devices." ANIMA Indonesian Psychological Journal 34, no. 4 (2019): 222–30. http://dx.doi.org/10.24123/aipj.v34i4.2582.
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A parental strategy in relation to the influence of media usage (parental mediation), in this case that of the Internet on adolescents, is greatly needed. The ideal strategy is a combination of active mediation (discussion regarding the content), and restrictive mediation (determination of rules for media usage), however what is normally employed is still restrictive mediation and co-using mediation (the joint use of media with the child, but without parent-child interaction to explain media content and impact). In this research, the aim was to look at an illustration of parental mediation towards the child. Quantitative research, with purposive sampling was conducted, on 94 parents and 423 information technology-based junior high school students, using questionnaires based upon the Perceived Parental Media Mediation Scale (the reliability of the parental scale being .84, and that of the student scale being .84). From frequency analysis and correlation testing, it was found that the strategy of restrictive mediation was the dominant one used by parents. This was supported by the perceptions of the students. Types of employment, numbers of children, and education levels did not influence the type of parental mediation; however, the greater the ages of parents, the greater was the imposition of restrictions. From the research, a picture may be gained of the allocation of devices to students. Explanation is required, to parents, of the importance of active mediation, and the positive utilization of I.T. devices (hereinafter called ‘devices’) by students.
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Waylen, A., and D. Wolke. "Sex 'n' drugs 'n' rock 'n' roll: the meaning and social consequences of pubertal timing." European Journal of Endocrinology 151, Suppl_3 (2004): U151—U159. http://dx.doi.org/10.1530/eje.0.151u151.
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This is a brief review of the normal changes in adolescent behaviour and the interplay between biology and social factors that occur at and around puberty, in an attempt to explain when this transition may become problematic The onset of puberty is a biological marker for an individual's transition from a non-reproductive to a reproductive state. Adolescence is a normal developmental transition associated with clearly visible physical changes, reorganization and pruning of neuronal circuits in the brain and the occurrence of new behaviours and interests. It is a time when new life tasks (orientation towards peers of the other sex, romantic and sexual involvement and mastering an educational career) need to be mastered. Parent-child conflict increases and becomes more intense as the adolescent struggles for more independence while still requiring support. These normal changes can become problematic if biological and social expectations diverge e.g. entering puberty very early or very late. While early pubertal onset in boys is likely to have beneficial effects, in girls precocious pubertal timing may have a negative impact on body-image, affect (or emotional well-being) and sex-role expectations. Other individual biological predispositions and genetic endowment may interact with social factors (e.g. peers, parenting style, neighbourhood) making adolescence either an adaptive or a challenging transition. There is a lack of sufficiently large longitudinal studies that have been able to study this interaction between genetics, biology and social environment on adolescent development. The Avon Longitudinal Study of Parents and Children (ALSPAC) cohort provides a unique opportunity to investigate the impact of pubertal timing on social behaviour. Planned assessments and concepts are outlined.
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Andayani, Friska Tri, and Endang Ekowarni. "Peran Relasi Orang Tua-Anak dan Tekanan Teman Sebaya terhadap Kecenderungan Perilaku Pengambilan Risiko." Gadjah Mada Journal of Psychology (GamaJoP) 2, no. 2 (2018): 138. http://dx.doi.org/10.22146/gamajop.33097.
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Cluver, Lucie D., Franziska Meinck, Janina I. Steinert, et al. "Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa." BMJ Global Health 3, no. 1 (2018): e000539. http://dx.doi.org/10.1136/bmjgh-2017-000539.
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ObjectiveTo assess the impact of ‘Parenting for Lifelong Health: Sinovuyo Teen’, a parenting programme for adolescents in low-income and middle-income countries, on abuse and parenting practices.DesignPragmatic cluster randomised controlled trial.Setting40 villages/urban sites (clusters) in the Eastern Cape province, South Africa.Participants552 families reporting conflict with their adolescents (aged 10–18).InterventionIntervention clusters (n=20) received a 14-session parent and adolescent programme delivered by trained community members. Control clusters (n=20) received a hygiene and hand-washing promotion programme.Main outcome measuresPrimary outcomes: abuse and parenting practices at 1 and 5–9 months postintervention. Secondary outcomes: caregiver and adolescent mental health and substance use, adolescent behavioural problems, social support, exposure to community violence and family financial well-being at 5–9 months postintervention. Blinding was not possible.ResultsAt 5–9 months postintervention, the intervention was associated with lower abuse (caregiver report incidence rate ratio (IRR) 0.55 (95% CI 0.40 to 0.75, P<0.001); corporal punishment (caregiver report IRR=0.55 (95% CI 0.37 to 0.83, P=0.004)); improved positive parenting (caregiver report d=0.25 (95% CI 0.03 to 0.47, P=0.024)), involved parenting (caregiver report d=0.86 (95% CI 0.64 to 1.08, P<0.001); adolescent report d=0.28 (95% CI 0.08 to 0.48, P=0.006)) and less poor supervision (caregiver report d=−0.50 (95% CI −0.70 to −0.29, P<0.001); adolescent report d=−0.34 (95% CI −0.55 to −0.12, P=0.002)), but not decreased neglect (caregiver report IRR 0.31 (95% CI 0.09 to 1.08, P=0.066); adolescent report IRR 1.46 (95% CI 0.75 to 2.85, P=0.264)), inconsistent discipline (caregiver report d=−0.14 (95% CI −0.36 to 0.09, P=0.229); adolescent report d=0.03 (95% CI −0.20 to 0.26, P=0.804)), or adolescent report of abuse IRR=0.90 (95% CI 0.66 to 1.24, P=0.508) and corporal punishment IRR=1.05 (95% CI 0.70 to 1.57, P=0.819). Secondary outcomes showed reductions in caregiver corporal punishment endorsement, mental health problems, parenting stress, substance use and increased social support (all caregiver report). Intervention adolescents reported no differences in mental health, behaviour or community violence, but had lower substance use (all adolescent report). Intervention families had improved economic welfare, financial management and more violence avoidance planning (in caregiver and adolescent report). No adverse effects were detected.ConclusionsThis parenting programme shows promise for reducing violence, improving parenting and family functioning in low-resource settings.Trial registration numberPan-African Clinical Trials Registry PACTR201507001119966.
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Thompson, Debbe, Chishinga Callender, Caroline Gonynor, et al. "Using Relational Agents to Promote Family Communication Around Type 1 Diabetes Self-Management in the Diabetes Family Teamwork Online Intervention: Longitudinal Pilot Study." Journal of Medical Internet Research 21, no. 9 (2019): e15318. http://dx.doi.org/10.2196/15318.
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Background Family conflict can reduce adolescent adherence to type 1 diabetes management tasks. The Family Teamwork in-person intervention was shown to be efficacious in reducing conflict and low adherence to diabetes-related tasks. Its reach and potential impact, however, were limited by the need to deliver the intervention sessions in person. Relational agents (ie, computerized versions of humans) have been shown to appeal to diverse audiences and may be an acceptable replacement for a human in technology-based behavior change interventions. Objective The purpose of this paper is to present the results of a pilot study assessing feasibility and acceptability of Diabetes Family Teamwork Online, an adapted version of the Family Teamwork intervention, delivered over the internet and guided by a relational agent. Methods Parent-adolescent dyads were recruited through a diabetes care clinic at a large tertiary care hospital in the southwestern United States. A one-group design, with assessments at baseline, immediate postintervention, and 3 months later, was used to assess feasibility. A priori feasibility criteria included an assessment of recruitment, completion, attrition, program satisfaction, therapeutic alliance, attitudes toward the relational agent, and data collection. The institutional review board at Baylor College of Medicine approved the protocol (H-37245). Results Twenty-seven adolescents aged 10 to 15 years with type 1 diabetes and their parents were enrolled. Criteria used to assess feasibility were (1) recruitment goals were met (n=20), (2) families completed ≥75% of the modules, (3) attrition rate was ≤10%, (4) program satisfaction was high (≥80% of families), (5) therapeutic alliance was high (average score of ≥60/84), (6) families expressed positive attitudes toward the relational agent (average item score of ≥5 on ≥4 items), (7) ≥80% of data were collected at post 1 and post 2, and (8) few technical issues (≤10%) occurred during intervention delivery. All feasibility criteria were met. Qualitative data confirmed that adolescents and parents had positive reactions to both the content and approach. Conclusions The Diabetes Family Teamwork Online intervention proved to be a feasible and acceptable method for enhancing communication around diabetes management tasks in families with an adolescent who has type 1 diabetes. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.5817
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Gilmore, Rose, Leanne Sakzewski, Jenny Ziviani, et al. "Multicentre, randomised waitlist control trial investigating a parent-assisted social skills group programme for adolescents with brain injuries: protocol for the friends project." BMJ Open 9, no. 8 (2019): e029587. http://dx.doi.org/10.1136/bmjopen-2019-029587.
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IntroductionAdolescents with brain injury frequently have difficulties with social competence, which persist into adulthood affecting their participation in daily life. To date, there has been limited research into the efficacy of social competence interventions in this population. Research from the Program for the Education and Enrichment of Relational Skills (PEERS) has demonstrated significant improvements in social competence skills, maintained at 1-year to 5-year follow-up, for adolescents with autism spectrum disorder. PEERS has not yet been tested among adolescents with brain injury. This protocol describes a pragmatic, parallel two-group pre-test post-test randomised waitlist control trial across two sites in Australia, which aims to evaluate the feasibility, acceptability and efficacy of PEERS in adolescents with brain injury compared with usual care.Methods and analysisForty adolescents with an acquired brain injury or cerebral palsy will be randomly assigned to either the 14-week PEERS group or waitlist care as usual group. The waitlist group will then receive PEERS following the 26-week retention time point. Outcomes will be assessed at baseline, 14 weeks (immediately postintervention) and 26 weeks follow-up (retention). The primary outcomes are self-report and parent report on the Social Skills Improvement System Rating Scales immediately post PEERS at 14 weeks. Secondary outcomes include increased frequency of get-togethers with peers with reduced conflict and increased adolescent self-reported knowledge of social skills. Acceptability and feasibility will be examined through qualitative analysis of focus group data collected after the completion of each group.Ethics and disseminationEthics approval has been granted by the Medical Research Ethics Committee Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/17/QRCH/87), The University of Queensland (2017000864) and the Cerebral Palsy Alliance Ethics Committee (20170802/HREC:EC00402). The findings will be disseminated in peer-reviewed journals, by conference presentation and newsletters to consumers.Trial registration numberACTRN12617000723381.
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Burkhardt, Birgit, Ilske Oschlies, Wolfram Klapper, et al. "Non-Hodgkin Lymphoma in Adolescents: Experiences in 378 Adolescent NHL Patients Treated According to Pediatric NHL-BFM Protocols." Blood 114, no. 22 (2009): 102. http://dx.doi.org/10.1182/blood.v114.22.102.102.
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Abstract Abstract 102 There are considerable differences with respect to incidence, biology, treatment and outcome of Non-Hodgkin Lymphoma (NHL) between children and adults. Patients of adolescent age are forming a separate group that falls between those categories. Even though recent reports pay increasing attention to these patients, the impact of adolescent age on the characteristics and outcome of NHL remains yet to be determined. Therefore, the current analyses aimed to analyze the outcome of adolescents treated according to BFM protocols for childhood NHL. Patients were treated according to the subsequent protocols NHL-BFM 86, 90, 95, 04, ALCL 99, and EURO-LB 02. Treatment subgroups were: 1) lymphoblastic lymphoma (LBL), 2) mature B-cell NHL including Burkitt lymphoma/leukemia (BL/B-AL), diffuse large B-cell lymphoma of centroblastic subtype (DLBCL-CB) and primary mediastinal B-cell lymphoma (PMLBL), and 3) anaplastic large cell lymphoma (ALCL). From October 1986 to December 2007, a total of 2915 protocol patients (pts) were registered in the NHL-BFM study center. Of these, 378 pts (13%) were of adolescent (15-18 years (y)) at diagnosis. Within the adolescent age group BL/B-AL were the largest subgroup (101 pts), followed by ALCL (74 pts), DLBCL-CB (55 pts), T-LBL (45 pts), PMLBL (24 pts), pB-LBL (13 pts) and other rare or not further specified NHL subtypes (66 pts). The 5-year event free survival (pEFS) was 79±2% for adolescents compared to 85±1% in pts aged <15y (p 0.014). Regarding histological subtypes, pEFS was inferior in adolescents compared to children in BL/B-AL pts (82±4% vs 88±1%, p 0.06) and in DLBCL-CB (pEFS 85±5% vs 96±2%, p 0.002). There was no difference in outcome for adolescents compared with children in T-LBL (pEFS (5y) 87±6% vs 82±2%, p 0.24), ALCL (70±6% vs 70±3%) and PMLBL (57±10% vs 68±8%, p 0.55). Further analyses in adolescents revealed a higher frequency of advanced stages of disease (> stage II) in females (94/119) vs males (177/259, p 0.04), but less frequent CNS disease in females (3/119 vs 23/259; p 0.03). pEFS (5y) was inferior for adolescent females (70±5% vs 84±2% in males, p 0.004). This was mainly due to the unfavorable pEFS for adolescent female pts with T-LBL (pEFS 57±17% vs 97±3%, p 0.001) and DLBCL-CB (pEFS 71±9% vs 97±3%, p 0.007). For the other histological NHL-subtypes there were no statistically significant differences in outcome according to gender. Adolescents with NHL treated according to pediatric NHL-BFM protocols have an acceptable outcome that is marginally inferior to that in children. Within the adolescent age group, female pts are diagnosed more frequently with advanced stages of disease. In adolescent pts with T-LBL and DLBCL-CB, female gender is associated with a worse prognosis. Disclosures: No relevant conflicts of interest to declare.
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Liu, Yin, Elizabeth B. Fauth, Myles Maxey, and Troy Beckert. "FACE-TO-FACE AND FACEBOOK ACROSS THE LIFESPAN: SOCIAL INTERACTIONS BUFFER STRESS ON MOOD, BUT ONLY FOR ADOLESCENTS." Innovation in Aging 3, Supplement_1 (2019): S694—S695. http://dx.doi.org/10.1093/geroni/igz038.2558.
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Abstract Social support serves as a protective factor, buffering stress in both adolescents and adults, however Socioemotional Selectivity Theory suggests developmental differences in stress reactivity and social support. It is unclear how modern forms of social contact, such as social media buffer stress, and the extent to which this differs across the lifespan. We utilized ecological momentary data to examine the moderating effects of age and two distinct types of social contacts the person had experienced in prior hours (frequency of face-to-face, or social media contacts) on the association between daily stress and momentary mood. Participants were recruited initially through Amazon.com’s Mechanical Turk (adolescents referred by a parent). A total of 119 adolescent (n = 44; Agemean= 15.73) and middle-aged/older adult participants (n = 75; Agemean= 59.67) provided momentary data three times a day, on three consecutive days, every two weeks, for up to 12 weeks. Multi-level models showed significant 3-way interactions between stress appraisal of avoiding an argument, age group, and frequency of social contact via face-to-face (β = 1.698, se = 0.542, p = .002) and social media (β = 3.341, se = 0.984, p = .001). Older adults experienced better mood than adolescents. When avoiding an argument was appraised as more stressful, both age groups displayed worse mood. Whereas high levels of recent social contact (both face-to-face and social media) seemed to exacerbate the impact of this stressor on poorer mood for older persons, high levels of recent social contact, particularly social media, had stress-buffering benefits for adolescents.
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Hardy, Steven J., Sarah E. Bills, and Linda J. Herbert. "Mental Health Screening in a Pediatric Sickle Cell Disease Clinic: Acceptability and Impact on Mental Health Discussions, Referrals, and Patient Satisfaction." Blood 134, Supplement_1 (2019): 4687. http://dx.doi.org/10.1182/blood-2019-131875.
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Introduction: Mental health (MH) problems are relatively common in children with sickle cell disease (SCD). Psychological factors are known to directly and indirectly affect pain perception, functional impairment, and other patient-reported health outcomes. Therefore, it is essential to consider these domains in order to provide comprehensive, evidence-based care to youth with SCD. However, it can be challenging for hematology providers without substantive training in MH assessment to recognize symptoms and discuss impressions and treatment recommendations with families. We examined the acceptability and outcomes of a MH screening program in a pediatric SCD clinic. Methods: During an initial data collection period ("Phase A"), patients' parents (n = 57) were interviewed after hematology clinic visits, providing details about any MH discussions that occurred during the visit and completing Press Ganey® patient satisfaction questions. During a secondary phase ("Phase B"), patients (ages 8-17) and parents (of children ages 5-17) completed the PROMIS Pediatric Profile-25, which assesses 6 domains (fatigue, anxiety, depression, pain interference, mobility, and peer relationships), via iPad in the clinic waiting room. Raw scores were entered into an electronic form, which calculated T scores and generated tailored MH recommendations for hematologists to review before seeing each patient. Parents (n = 32) completed the same post-visit interviews. Results: At baseline (Phase A), 83% of parents reported that their child's hematologist asked questions about MH during the visit. Across Phases A and B, 97% of parents who reported that their child's hematologist asked about MH reported that they liked that these questions were asked. Of the parents who said MH was not discussed, 27% said that they wished their hematologist would have asked about it. All parents reported that the 25-item PROMIS Pediatric Profile was an appropriate length and that the screening survey was easy to complete on an iPad. Additionally, 100% of parents reported feeling that it was a good idea to ask the screening questions on an iPad prior to the hematology visit. Most parents (94%) agreed or strongly agreed that the survey questions were appropriate for the care of their child. In Phase B, hematologists stated that they referred to the MH screening summary to guide part of their patient visit 90% of the time and they described the screening summary as "Very Useful" 92% of the time. Parent reports of the frequency of MH discussions were not significantly different between Phase A (no screening) and Phase B (screening) (84% to 81%; p = .772). However, when asking hematologists whether specific issues were discussed during the visit, significant increases were observed in the rates of discussions about the impact of pain on daily activity (72% to 94%; χ2(1) = 8.87, p = .004), anxiety (4% to 36%; χ2(1) = 17.08, p < .001), and depression (6% to 30%; χ2(1) = 10.57, p = .001). Hematologists reported a nonsignificant increase in the rate of referral for MH services in Phase B (9% to 14%; p = .548). In regards to patient/parent satisfaction, there was a statistically significant increase in the proportion of "Very Good" ratings on the item asking about satisfaction with the degree to which the physician talked using words the parent could understand (88% to 100%; χ2(1) = 4.27, p = .046), and clinically meaningful but statistically nonsignificant increases on items about satisfaction with the amount of time the physician spent with the patient (88% to 97%; p = .250) and the likelihood of the parent recommending the physician to others (84% to 94%; p = .315). Conclusions: This study demonstrated the acceptability of MH screening in a pediatric SCD clinic. Although hematologists already discussed MH frequently prior to implementing the screening program, increases in discussions about anxiety, depression, and the functional impact of pain were noted after introducing MH screenings. Rates of referrals for MH treatment rose following implementation of the screening program, but this increase was not statistically significant. Hematologists found a brief MH screening summary to be useful and certain aspects of patient/parent satisfaction showed improvement. Pediatric SCD clinics could integrate MH screenings to increase consideration of the role of psychological factors in patients' presentations and positively affect patient/parent satisfaction. Disclosures No relevant conflicts of interest to declare.
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Weller, Joshua A., Leslie D. Leve, Hyoun K. Kim, Jabeene Bhimji, and Philip A. Fisher. "Plasticity of risky decision making among maltreated adolescents: Evidence from a randomized controlled trial." Development and Psychopathology 27, no. 2 (2015): 535–51. http://dx.doi.org/10.1017/s0954579415000140.
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AbstractChildhood maltreatment has lasting negative effects throughout the life span. Early intervention research has demonstrated that these effects can be remediated through skill-based, family-centered interventions. However, less is known about plasticity during adolescence, and whether interventions are effective many years after children experience maltreatment. This study investigated this question by examining adolescent girls' ability to make advantageous decisions in the face of risk using a validated decision-making task; performance on this task has been associated with key neural regions involved in affective processing and executive functioning. Maltreated foster girls (n= 92), randomly assigned at age 11 to either an intervention designed to prevent risk-taking behaviors or services as usual (SAU), and nonmaltreated age and socioeconomic status matched girls living with their biological parent(s) (n= 80) completed a decision-making task (at age 15–17) that assessed risk taking and sensitivity to expected value, an index of advantageous decision making. Girls in the SAU condition demonstrated the greatest decision-making difficulties, primarily for risks to avoid losses. In the SAU group, frequency of neglect was related to greater difficulties in this area. Girls in the intervention condition with less neglect performed similarly to nonmaltreated peers. This research suggests that early maltreatment may impact decision-making abilities into adolescence and that enriched environments during early adolescence provide a window of plasticity that may ameliorate these negative effects.
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Liu, Wei, Yin Ting Cheung, Tara M. Brinkman, et al. "Parent-Reported and Self-Perceived Behavioral and Psychiatric Symptoms in Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia." Blood 128, no. 22 (2016): 3594. http://dx.doi.org/10.1182/blood.v128.22.3594.3594.
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Abstract Introduction: Limited data are available on combined parent and self-reported behavioral symptoms in long-term survivors of childhood acute lymphoblastic leukemia (ALL) after treatment with contemporary chemotherapy only protocols. This study evaluated associations between chemotherapy exposures, parent emotional distress and reported child behavioral and psychiatric symptoms in survivors enrolled on a single institutional protocol. Methods: Survivors of childhood ALL (n=162; 49.0% male; mean [SD] age 12.1[2.6] years; time since diagnosis 7.5[1.6] years), who were at least 5 years post diagnosis and between 8-17 years of age, self-reported behavioral symptoms (Conners' Rating Scale) during a long-term follow-up visit. Parent-report of child behavioral symptoms was collected (Behavior Assessment System for Children) during the same visit. Age- and sex-adjusted standard scores were calculated for both measures, with impairment defined as a symptom level above the 90th percentile compared to normative data. Parents also completed the Diagnostic Interview for Children and Adolescents to determine whether their child met clinical criteria for psychiatric disorders. The proportion of children meeting criteria was compared to reported frequencies in the general population. Exposures to high-dose IV methotrexate, number of intrathecal therapy doses (cytarabine, methotrexate and hydrocortisone), and age at diagnosis were analyzed with multivariable Poisson regression as predictors of child behavioral symptoms and psychiatric condition. Association of Parent education level with child outcomes was examined using univariate Poisson regression model. Parent emotional distress was assessed using the Brief Symptom Inventory 18 (BSI-18), and raw scores were converted into sex specific T-scores using national normative data. T-scores ≥ 63 were considered to represent clinically significant emotional distress. Symptoms of parent posttraumatic stress (PTS) were evaluated using the Impact of Event Scale-Revised (IES-R) and levels of stress were calculated for three subscales (thought intrusions, avoidance, and hyperarousal), consistent with PTS diagnostic criteria. Associations between parent- and self-reported symptoms in children with parent emotional distress and PTS were examined with Fisher's exact test. Results: Compared to the expected population frequency of 10%, significantly more survivors self-reported symptoms of inattention (27.7%), hyperactivity/impulsivity (25.8%) and oppositional behavior (20%), all p's<0.0001 (corrected for False Discovery Rate [FDR]). Parents reported their children to have more symptoms of depression (16.5%), multiple symptoms of internalizing problems (i.e. anxiety/depression; 17.1%), and attention problems (24.7%) with all p's<0.05 (FDR). Compared to a US national survey of psychiatric conditions, parents identified significantly higher frequencies of Generalized Anxiety disorder (3.2% vs. 1.1%), Obsessive-Compulsive Disorder (10.3% vs. 1-3%), Simple/Social Phobias (22.3% vs. 15.8%) and Oppositional Defiant Disorder (15.9% vs. 8.3%), all p's<0.05 (FDR), but not Attention-Deficit/Hyperactivity Disorder (7% vs 6.5%; Table1). Risk of significant symptoms of internalizing problems increased 8% per additional intrathecal therapy injection (Table2). Parent emotional distress was significantly associated with their report of child Obsessive-Compulsive Disorder, Simple/Social Phobias, and Oppositional Defiant Disorder, all p's<0.05. Risk of behavior symptoms decreased 10-21% (p's<0.05) per each additional year of parent education. Risk of self-reported hyperactivity problems increased 2.6 times among survivors whose ALL was diagnosed less than 5 years of age (95% CI=1.2-5.4, p=0.01). Conclusion: Although most long-term child survivors of ALL appear emotionally healthy, a substantial proportion appear to exhibit significant symptoms of inattention, anxiety/depression and oppositional behavior based on child and parent report. Treatment exposures are not associated with the majority of these symptoms. However, sociodemographic factors such as parent education and parental psychological status influence these outcomes providing basis for targeting vulnerable families for intervention. Disclosures No relevant conflicts of interest to declare.
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Salehi, Maryam, Amie Hwang, Julia Simon, Thomas M. Mack, Tim Waterboer, and Wendy Cozen. "Past Infection and Risk of Adolescent/Young Adult Hodgkin Lymphoma." Blood 136, Supplement 1 (2020): 26. http://dx.doi.org/10.1182/blood-2020-143270.
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Background: Adolescent/young adult (AYA) Hodgkin lymphoma (HL) is one of the most common cancers in this age group in developed countries. High socioeconomic status, small sibship size and lack of crowding in childhood are risk factors. We also found that among twins, the twin who had more oral exposures in early life was 80% less likely to develop AYA Hodgkin lymphoma. These risk factors are compatible with the hygiene hypothesis. We wanted to further explore additional risk factors consistent with this etiologic model. Methods: In a case-family control study, we examined past exposure to 12 infections in serum samples from 291 AYA HL cases and 194 of their unaffected family members. Cases were ascertained from the USC International Twin Registry (n=36) and the USC Cancer Surveillance Program (n=255). We measured antibodies to HSV1, HSV2, VZV, EBV, HHV7, HCMV, HHV6, KSHV, T. gondii, H. pylori, Rubella virus and Parvovirus B19 using a multiplex serology bead array (Luminex) (Waterboer Laboratory, German Cancer Research Center). A positive history of exposure to each infection was determined by a titer threshold specific for each infection. We did not examine the association between antibody levels and risk because of the possible impact of AYA HL diagnosis or treatment. We made the assumption that disease or treatment would not affect detection of a low level of antibody indicating previous exposure. A logistic regression model was used to calculate the odds ratio (OR) and 95% Confidence Interval (95% CI) adjusting for age at blood draw, sex and family. The sample was mostly non-Hispanic white, thus we did not adjust for race/ethnicity. We performed stratified analysis for histologic subtype where possible. Linear regression was used to calculate the p-for trend for 0, 1 or 2 fecal-oral or respiratory infections, with 0 infections as the reference. Results: The mean age at diagnosis in AYA HL cases was 30 years and the mean age at blood draw was 36 years. 57% of the cases were female. Out of the 186 cases with EBV tumor status, 78% were EBV-. Out of the 242 cases with histologic subtype, 72.5% were nodular sclerosis. The mean age of the 194 family controls at blood draw was 53 years and 63.4% were female. Evidence of past HHV6 infection was associated with an increased risk of AYA HL (OR= 1.80; 95% CI= 1.06-3.07; for nodular sclerosis only: OR= 1.92, 95% CI=1.05-3.42). Having antibodies to H. pylori was associated with a decreased risk (OR= 0.49; 95% CI= 0.25-0.98; for nodular sclerosis only: OR= 0.33, 95% CI= 0.14-0.77). An increasing number of fecal-oral infections (H. pylori, T. gondii) was associated with a decreasing risk of AYA HL (ptrend=0.015), while an increasing number of respiratory transmitted infections (Rubella virus, Parvovirus) was not significantly associated (ptrend=0.43). After adjusting for family, infection with Parvovirus was strongly and significantly associated with AYA HL (OR=3.8,1.06-13.6; for nodular sclerosis only: OR=10.5, 95% CI=1.71-65.25). Past infection with EBV was not associated with risk of overall HL, or with EBV- or EBV+ AYA HL separately, probably because of the high frequency of this infection in the overall population. Conclusions: We found continuing evidence for an inverse association between fecal-oral transmitted agents and risk of AYA HL, supporting the hypothesis that a deficit of early life fecal-oral transmitted microbes may be associated with susceptibility. HHV6 and Parvovirus were associated with an increased risk, possibly due to a subclinical immune deficiency or another unknown mechanism Disclosures No relevant conflicts of interest to declare.
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Sacca, Lea, Stephanie Craig Rushing, Christine Markham, et al. "Assessment of the Reach, Usability, and Perceived Impact of “Talking Is Power”: A Parental Sexual Health Text-Messaging Service and Web-Based Resource to Empower Sensitive Conversations with American Indian and Alaska Native Teens." International Journal of Environmental Research and Public Health 18, no. 17 (2021): 9126. http://dx.doi.org/10.3390/ijerph18179126.
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Background: Early sexual debut among American Indian and Alaska Native (AI/AN) adolescents has been associated with an increased risk of teenage pregnancies and sexually transmitted infections, along with an increased risk of having multiple lifetime sexual partners, and engaging in greater frequency of sex, substance abuse, and lack of condom use. A major protective factor against early sexual debut among AI/AN youth is the familial system. Interventions aiming to improve parent–child communication and parental warmth toward adolescent sexual health topics were reported to contribute to positive youth sexual health outcomes, specifically among minority youth. Healthy Native Youth thus developed the Talking is Power text-messaging service to guide parents and caring adults on how to initiate sensitive topics with youth and how to support them in making informed decisions regarding sex and healthy relationships. Methods: Descriptive statistics were used to demonstrate website analytics and reach per views and time spent on each page, and for displaying participants’ responses to the questions on the usability of the Talking is Power text-messaging series. To assess the perceived impact of the series, the differences in mean percentage scores of the question assessing parental comfort in engaging in sexual health topics with youth between pre- and post-intervention were calculated using two-sample t-tests of equal variances. Descriptive content analysis was adopted to highlight emerging themes from open-ended items. Results: When looking at reach, 862 entrances were recorded during the specified time period (5.8% of total entrances to HNY website), while the bounce rate was set at 73.1% (22.6% greater than the industry average), and the exit rate was 54.3% (15.2% greater than the industry average). Series usability was highly ranked on the 5-Likert scale in terms of signing up for a similar series on a different topic, quality of images, texts, and links, relating to prompts, and change in sparking sensitive conversations with youth. High likelihood of recommending the series to a friend or colleague was also reported by participants (0–10). No significant difference in parental comfort levels was reported (p = 0.78 > 0.05). Main themes provided suggestions for improving the series mode of delivery, while others included positive feedback about the material, with the possibility of expanding the series to other adolescent health topics. Conclusion: Lessons learned during the design, dissemination, and evaluation of the resource’s usability, reach, and perceived impact may be of interest to other Indigenous communities who are in the process of adapting and/or implementing similar approaches.
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Jacola, Lisa M., Kim Edelstein, Wei Liu, et al. "Cognitive, Behavior and Academic Problems in Adolescent Survivors of Childhood Acute Lymphoblastic Leukemia (ALL): A Report from the Childhood Cancer Survivor Study." Blood 126, no. 23 (2015): 877. http://dx.doi.org/10.1182/blood.v126.23.877.877.
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Abstract Introduction: Over the past 30 years, survival rates for childhood ALL have improved and neurotoxicity has been reduced by largely replacing cranial radiation therapy (CRT) with additional systemic and intrathecal therapy. However, survivors treated without CRT may still be at risk for long-term neurocognitive deficits and reduced quality of life. Neurobehavioral problems during adolescence are particularly problematic as increased environmental demands for self-direction and higher order cognition are expected. As existing studies of cognition and behavior in adolescent survivors are limited by small samples, single-site data collection, and short follow-up intervals, we examined the prevalence of and risk factors for cognitive, behavior, and academic problems in adolescent survivors of childhood ALL using the Childhood Cancer Survivors Study (CCSS) cohort. Methods: Caregiver report data were analyzed for 1426 5+ year survivors of childhood ALL who were diagnosed between 1970 and 1999 and between 12 to 17 years of age at follow-up, and 609 sibling controls. Cognitive and behavior problems were measured with the Behavior Problem Inventory (BPI). Academic problems were defined as special education placement (yes/no). Chi-Square tests were used to compare the frequency of elevated BPI scores (≥90th percentile) and special education placement in survivors versus siblings. Multivariable logistic regression was used to examine the association between CRT and chemotherapy doses (Table 1) and cognitive, behavior, and academic problems, adjusting for sex and age at diagnosis (<5 years, ≥5 years). In a subset of 736 survivors for whom longitudinal data were available, associations were examined between cognitive/behavior problems and special education placement during adolescence and self-reported educational attainment as adults (mean [range] age = 28.0 [25.0-37.3]). Results: Compared to siblings, survivors were more likely to have elevated symptoms of anxiety-depression, inattention-hyperactivity, headstrong behavior, and social withdrawal, as well as higher rates of special education placement (Table 2). Relative to no CRT, treatment that included CRT at a dose of <20 Gy increased the risk for anxiety-depression (OR=1.69, [95%CI, 1.25-2.30]), inattention-hyperactivity (OR=1.25, [1.16, 2.00]), and social withdrawal (OR=1.98, [1.51, 2.61]). Moreover, risk of special education placement was increased for survivors treated with <20 Gy CRT (OR=1.89, [1.47, 2.45]) and ≥20 Gy (OR=2.45, [1.93-3.91]). Among survivors treated without CRT, cumulative doses of intrathecal or intravenous methotrexate (MTX) were not associated with risk for cognitive, behavior, or learning problems. Survivors with cognitive or behavior problems, and those who participate in special education during adolescence were less likely to graduate from college as adults (Table 2*). Conclusion: Adolescent survivors of childhood ALL, especially those treated with CRT, are at significantly increased risk for cognitive, behavior, and academic problems that adversely impact adult outcomes. Participation in special education did not remediate this risk, as survivors receiving services were less likely to graduate college as adults. Interventions designed to improve adolescent neurobehavioral functioning should be prioritized. Table 1. % Mean ± SD Age at diagnosis < 5 years 79 3.74±1.82 ≥ 5 years 21 Sex - Male 54 Seizures or strokes after diagnosis - Yes 7 CRT None 50 <20 Gy 31 ≥ 20 Gy 12 IT MTX <230 mg 44 ≥ 230 mg 56 IV MTX None 55 <4.3 g/m2 21 ≥ 4.3 g/m2 24 Cytarabine None 29 Yes 71 Anthracyclines None 48 < 300 mg/m2 39 ≥ 300 mg/m2 13 Alkylating agents None 41 Yes 59 5716.26 ± 5424.92 Dexamethasone None 26 Yes 74 Table 2. Survivors College Graduation* Siblings p OR 95% CI Cognitive and behavior problems Antisocial 14% 11% 0.0800 2.28 1.34, 3.90 Anxiety-Depression 17% 11% 0.0003 1.55 1.02, 2.35 Headstrong 22% 14% 0.0002 1.52 1.03, 2.23 Inattention - Hyperactivity 24% 14% <0.0001 3.04 2.04, 4.54 Social Withdrawal 25% 12% <0.0001 1.31 0.92, 1.88 Academic Problems Special Education - Yes 34% 14% <0.0001 4.29 2.95, 6.22 Disclosures No relevant conflicts of interest to declare.
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Ranney, Megan L., Sarah K. Pittman, Isabelle Moseley, et al. "Cyberbullying Prevention for Adolescents: Iterative Qualitative Methods for Mobile Intervention Design." JMIR Formative Research 5, no. 8 (2021): e25900. http://dx.doi.org/10.2196/25900.
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Background Cybervictimization among adolescents is associated with multiple negative mental health consequences. Although pediatricians often screen for cyberbullying, validated and acceptable programs to reduce the frequency and impact of adolescent cybervictimization are lacking. Objective This study uses agile qualitative methods to refine and evaluate the acceptability of a mixed-modality intervention, initiated within the context of usual pediatric care, for adolescents with a history of cyberharassment and cyberbullying victimization. Methods Three groups of adolescents were successively recruited from an urban primary care clinic to participate in three consecutive iterations (1, 2, and 3) of the program, which consisted of a brief in-clinic intervention followed by 8 weeks of daily, automated SMS text messaging. After 2 weeks of messaging, iteration 1 (I1) participants completed semistructured interviews regarding intervention experiences. Participant feedback was evaluated via framework matrix analysis to guide changes to the program for iteration 2 (I2). Feedback from 2-week interviews of I2 participants was similarly used to improve the program before initiating iteration 3 (I3). Participants in all 3 iterations completed the interviews after completing the program (8 weeks). Daily response rates assessed participant engagement, and satisfaction questionnaires assessed acceptability. Results A total of 19 adolescents (aged 13-17 years) reporting past-year cybervictimization were enrolled: 7 in I1, 4 in I2, and 8 in I3. Demographic variables included the following: a mean age of 15 (SD 1.5) years; 58% (11/19) female, 42% (8/19) male, 63% (12/19) Hispanic, 37% (7/19) non-Hispanic, 79% (15/19) people of color, and 21% (4/19) White. A total of 73% (14/19) self-identified as having a low socioeconomic status, and 37% (7/19) self-identified as lesbian, gay, or bisexual. The average past 12-month cybervictimization score at baseline was 8.2 (SD 6.58; range 2-26). Participant feedback was used to iteratively refine intervention content and design. For example, participants in I1 recommended that the scope of the intervention be expanded to include web-based conflicts and drama, rather than narrowly focusing on cyberbullying prevention. On the basis of this feedback, the I2 content was shifted toward more general de-escalation skills and bystander empowerment. Overall, 88.34% (940/1064) of the daily queries sent to participants across all 3 iterations received a reply. Participant satisfaction improved considerably with each iteration; 0% (0/7) of I1 participants rated the overall quality of Intervention to Prevent Adolescent Cybervictimization with Text message as excellent, compared to 50% (2/4) of I2 participants and 86% (6/7) of I3 participants. Engagement also improved between the first and third iterations, with participants replying to 59.9% (235/392) of messages in I1, compared to 79.9% (358/488) of messages in I3. Conclusions This study shows the value of structured participant feedback gathered in an agile intervention refinement methodology for the development of a technology-based intervention targeting adolescents.
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Awada, Hassan, Carmelo Gurnari, Arda Durmaz, et al. "Comparative Genomic Analysis of Adolescents and Young Adults Versus Elderly with Acute Myeloid Leukemia." Blood 136, Supplement 1 (2020): 18. http://dx.doi.org/10.1182/blood-2020-141577.
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Prognosis and survival outcomes of acute myeloid leukemia (AML) strongly depend on age at diagnosis. In fact, long-term survival rates range from 60% in children and adolescent/young adults (AYA-AML: aged 15-39 years) to 10-15% in elderly patients (E-AML: aged >70 years). The currently available classification and prognostication models incorporate genomic features that include cytogenetics and molecular mutations based on adult AML clinical trials that mainly enroll patients outlying these two age categories. Consequently, prognostication models might still not account for the invariant genomic background of each subgroup. In this study, we aimed to dissect the genomic landscape of AYA-AML and E-AML cases in order to uncover patterns of distinct genomic features of important pathogenetic information, knowing how fundamental it is for the development of novel treatment approaches and more importantly for providing opportunities of individualization therapies. We studied the clinical and genomic characteristics of fully annotated sets of 198 AYA-AML and 414 E-AML cases from the Cleveland Clinic and publicly available data. Median age at diagnosis was 31 years for AYA-AML (range: 16-39 years) and 76 years (range: 71-100 years) for E-AML patients with a significant male preponderance noted in the latter cohort (65% vs 46%, P<0.0001). Based on the 2016 WHO classification, AML subtypes were differently distributed within the two subgroups. Low-risk AML (PML-RARA AML, core-binding factor AML, and CEBPA biallelic AML) was more prevalent among AYA cases while a higher odd of secondary AML (sAML) was found in E-AML. Compared to AYA-AML, E-AML were more typically presenting with a less proliferative disease phenotype, as outlined by a lower bone marrow blast infiltration (median: 34% vs 51%, P=0.04) and a higher frequency of leukopenia at baseline (66% vs 27%, P=0.009). In terms of cytogenetic abnormalities, when compared with AYA-AML, E-AML cases harbored more complex karyotype (32% vs 13%, P=0.002) and other cytogenetic abnormalities e.g., -5/del(5q) (14% vs 2%, P<0.0001), -7/del(7q) (14% vs 5%, P=0.001), -17/del(17p) (5% vs 1%, P=0.02), del(20q) (4% vs <1%, P=0.01) and trisomy 8 (14% vs 5%, P=0.0007) while a significantly lower odd of -9/del(9q) (<1% vs 4%, P=0.006). A total of 1092 somatic mutations were identified by next-generation sequencing of common myeloid genes. The AYA-AML cohort had a total of 249 mutations (ratio 1.25) while 843 mutations were reported in E-AML patients (ratio 2.04). Older patients, as compared to AYA-AML, had more mutations in age-related myeloid genes linked to clonal hematopoiesis, including mutations in DNMT3A (15% vs 6%, P=0.001), ASXL1 (14% vs 4%, P=0.0005), and TET2 (19% vs 7%, P=0.0002). As inferred from the cytogenetic comparisons, TP53 mutations were more frequently detected in E-AML (10% vs 2%, P=0.002) compared to AYA-AML, as they carried more chromosomal 5 and 17 abnormalities which are commonly associated with this genomic lesion. On the other hand, AYA-AML had a higher frequency of mutated WT1 gene (9% vs 2%, P=.0009). Multivariate Cox-Proportional hazard was performed to identify group-specific genomic lesions associated with survival in each cohort. In AYA-AML, normal karyotype (HR:0.59, P=0.02), t(15;17) translocation (HR:0.24, P=0.0001), inv(16)/t(8;21) (HR:0.52, P=0.02) and CEBPA biallelic (HR:0.50, P=0.02) were favorable lesions while complex karyotype had an adverse impact on survival (HR:3.0, P=0.0003). Moreover, while normal karyotype and t(15;17) translocation had a favorable impact in E-AML (HR:0.73, P=0.0001 and HR:0.28, P<0.0001, respectively), mutations in RUNX1 (HR:1.2, P=0.4), TET2 (HR:1.2, P=0.01), and TP53 (HR:1.97, P<0.0001) lead to worse outcomes. In conclusion, we demonstrated that E-AML cases are typically characterized by mutations belonging to the genomic subgroups of DNA methylation and chromatin modifiers, which have been reported to occur in age-related hematopoiesis or CHIP. Moreover, the complexity of aberrations (including cytogenetics) emphasizes that in this group of patients AML arises from a stepwise mutation acquisition model. In contrast, AYA-AML are typically characterized by favorable cytogenetic translocations and less clonal instability, dominated by the enrichment in myeloid leukemia driver gene mutations such as WT1. Disclosures No relevant conflicts of interest to declare.
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Sinno, Mohamad G., Sneha Butala, and Jignesh Dalal. "Increased Toxicity Among Adolescents and Young Adults Treated for Acute Myeloid Leukemia at US Children's Hospitals." Blood 134, Supplement_1 (2019): 332. http://dx.doi.org/10.1182/blood-2019-123796.
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Introduction Adolescents and Young Adults (AYAs) with cancer are known to experience disparities in access to care along with delays in diagnosis and treatment. Acute Myeloid leukemia (AML) represents 15-20% of childhood leukemias and 33% of adolescent leukemias. Although improvements in the survival of pediatric AML is encouraging, older age has historically been an adverse prognostic factor, and survival does not appear to be improving to the same extent in AYAs as in children. AYA patients treated on pediatric trials had better outcomes than those treated on adult trials. As a result, AYAs are increasingly being treated in children's hospitals on pediatric protocols, which generally consist of intensified regimens compared with adult protocols. However, minimal data exists regarding how well AYAs tolerate the intensity of chemotherapy at doses and regimens designed for children. Our study aims to compare toxicities between pediatric and AYA patients treated for AML in children's hospitals in the United States. Methods With IRB approval, the Pediatric Health Information Systems (PHIS) database was queried to analyze healthcare outcomes in pediatric and AYA patients with AML admitted between January 2004 and December 2018. We chose to utilize the PHIS database, as these AYA patients with AML were more likely to have been treated on pediatric protocols. AYA was defined as patients between the ages of 15 and 39 per the National Cancer Institute (NCI) definition. We extracted relevant ICD-9 and -10 diagnoses, procedure codes and medications for each patient related to toxicities as outlined by the NCI. For the descriptive statistics, demographics and clinical characteristics of patients were described using median and interquartile ranges for continuous variables, and frequency and percentages for categorical variables. Categorical variables were analyzed with the chi-square test. Continuous variables were assessed by the Mann Whitney U test. Multiple logistic regression was performed with 'discharge mortality' as the primary outcome. The age was categorized into two levels (0-14 y.o and ≥ 15 y.o). P-value of less than 0.05 or absence of 1 in the 95% confidence intervals were considered as statistically significant for the analysis. All statistical analyses were performed using SAS software, version 9.4 (SAS institute, Cary, NC). Results A total of 31,868 admissions met inclusion criteria, representing a total of 7,229 AML patients. Of these, 8,606 admissions (27%) were in the AYA group. 64% of children and 67% of AYA patients were Caucasians. AYA patients had a significantly higher incidence of ICU stay [20.1% vs 15.7%, p<0.0001] and overall mortality [23.4% vs 15.5%, p<0.0001]. Out of a total of 7,229 AML patients, 1277 (18%) passed away. Table 1 describes our findings and show statistically significant differences among the two groups, with AYA patients showing markedly increased toxicity, and requiring more supportive medications and procedural interventions. No difference in terms of need for blood and platelets products was observed among the two groups. 24.4% of children and 31.6% of AYA patients underwent stem cell transplant. We identified no significant differences in mortality between these two groups. After adjusting for other factors, diagnosis prior to 2014, public insurance, African American ethnicity in ≥ 15 y.o, ICU stay and use of antifungals other than fluconazole, were associated with inferior outcome. ICU stay remained the strongest predictor of mortality (OR 10.5, 95% CI = 8.85 - 12.47 for pediatric patients, and OR 13.3, 95% CI = 10.39 - 17.03 for AYA patients). Conclusion To our knowledge, this is the largest multicenter database study evaluating toxicity and mortality in AML patients. Compared to children, AYA patients developed disproportionately higher toxicities from chemotherapy and required more supportive medications and procedures. We found overall increased mortality in AYA patients, however the negative impact of older age lost its significance in an additional analysis focusing on transplant patients. Despite improvements in treatments and outcomes over time, there is still need for more effective strategies for preventing toxicities and mortality in AYA patients. Prospective studies are needed to assess whether dose modifications for certain chemotherapeutics may improve the toxicity profile of AYA patients with AML treated in Children's hospitals. Disclosures No relevant conflicts of interest to declare.
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Jarvis, Kirsten Brunsvig, Marissa Le Blanc, Morten Tulstrup, et al. "Single Nucleotide Polymorphisms and Thromboembolism in Acute Lymphoblastic Leukemia — a NOPHO ALL2008 Study." Blood 132, Supplement 1 (2018): 143. http://dx.doi.org/10.1182/blood-2018-99-109902.
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Abstract Introduction: Thromboembolism (TE) is a major toxicity of acute lymphoblastic leukemia (ALL) treatment and contributes to substantial morbidity and mortality. Several germline DNA variants have been associated with TE in adults without cancer. A meta-analysis of genome-wide association studies on TE by Germain et al. (Am J Hum Genet 2015) identified single nucleotide polymorphisms (SNPs) in 8 genes that contribute to increased risk of TE in adults (ABO,F2, F5,F11, FGG,PROCR,TSPAN15, and SLC44A2). De Haan et al. (Blood 2012) found that SNPs in 5 of these (F5, F2, F11, FGG, and ABO) predicted TE almost as well as a 31 SNP-based risk score. However, the impact of these SNPs in patients with cancer, particularly in children, remains uncertain. Materials and methods: The Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol for children and adults (1-45 years) included a 3-drug induction (vincristine, doxorubicin, glucocorticosteroid) followed by exposure to asparaginase (1,000 IU/m.sq. i.m.) from week 5 until week 33 (details of therapy in Toft, Leukemia 2018). We collected germline DNA and prospectively registered TE events on 1482 children and adults diagnosed with ALL and treated according to the ALL2008 protocol in seven Nordic and Baltic countries (7/2008-7/2016) (Rank, Blood 2018). Inclusion criteria for TE were i) symptomatic venous or arterial TE confirmed by imaging or by autopsy for TE diagnosed post mortem or ii) asymptomatic TE confirmed by imaging due to other non-TE symptoms and treated with systemic anticoagulation. Based on previously published data and a priori power calculations, we selected and genotyped 5 SNPs: F5 rs6025 (risk allele frequency (RAF) 0.05), F11 rs2036914 (RAF 0.52), FGG rs2066865 (RAF 0.22), and ABO SNPs rs8176719 (RAF 0.39) and rs2519093 (RAF 0.24). Three SNPs (F5 and the two ABO SNPs) were found by imputation, which was done on a subset of patients with European ancestry and included in the NOPHO ALL2008 protocol (N = 1229). We constructed genetic risk scores using a combination of the SNPs. Results: During the ALL treatment period 107 of 1482 patients developed TE (2.5-year cumulative incidence 7.3%, 95% confidence interval (CI) 5.9-8.5). In multivariate Cox regression analysis controlling for age, gender, presence of mediastinal mass and enlarged lymph nodes (N = 1192, whereof TE events 84), we found statistically significant associations with TE development for SNPs F5 rs6025 (hazard ratio (HR) 2.96, 95% CI 1.59-5.48), F11 rs2036914 (HR 1.62, 95% CI 1.18-2.24), and FGG rs2066865 (HR 1.40 95% CI 1.01-1.95), whereas there were no significant associations with ABO SNPs rs8176719 (HR 0.98, 95% CI 0.64-1.51) or rs2519093 (HR 1.06, 95% CI 0.65-1.73). An unweighted 3 SNP risk score based on SNPs F5, F11, and FGG was associated with TE development (HR 1.59, 95% CI 1.27-1.98) (Figure 1). Twenty-six of 217 patients with ≥3 risk alleles developed TE (12.0%, 95% CI 8.1-17.2), compared to 62 of 1007 patients with <3 risk alleles (6.2%, 95% CI 4.8-7.9). The association was strongest in the adolescent age group (10-18 years; HR 1.88, 95% CI 1.35-2.63). Thirteen of 43 adolescents with ≥3 risk alleles developed TE (30.2%, 95% CI 17.8-46.3), compared to 20 of 182 adolescents with <3 risk alleles (11.0%, 95% CI 7.0-16.7) (Figure 2). In adults (>18 years) the proportion who developed TE was quite high in both the group with ≥3 risk alleles (23.5%, 95% CI 7.8-50.2) and with <3 risk alleles (17.6% 95%CI 11.1-26.3). In children (1-10 years) the proportion who developed TE was low in both the group with ≥3 risk alleles (5.7%, 95% CI 2.8-10.9) and with <3 risk alleles (3.2%, 95% CI 2.1-4.8). A weighted 3 SNP genetic risk score based on estimated odds ratios from literature for SNPs F5, F11 and FGG was also associated with TE development (HR 2.84, 95% CI 1.85-4.36). Again, the association was strongest in adolescents (HR 4.20, 95% CI 2.22-7.94). Conclusion: Based on the strong association between F5 rs6025, F11 rs2036914, and FGG rs2066865 and TE development, not least for adolescents, future preventive measures for TE should target adolescents with ≥3 risk alleles as well as any adults ≥18 years. Disclosures No relevant conflicts of interest to declare.
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Anjali, Anjali, and Manisha Sabharwal. "Perceived Barriers of Young Adults for Participation in Physical Activity." Current Research in Nutrition and Food Science Journal 6, no. 2 (2018): 437–49. http://dx.doi.org/10.12944/crnfsj.6.2.18.
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This study aimed to explore the perceived barriers to physical activity among college students Study Design: Qualitative research design Eight focus group discussions on 67 college students aged 18-24 years (48 females, 19 males) was conducted on College premises. Data were analysed using inductive approach. Participants identified a number of obstacles to physical activity. Perceived barriers emerged from the analysis of the data addressed the different dimensions of the socio-ecological framework. The result indicated that the young adults perceived substantial amount of personal, social and environmental factors as barriers such as time constraint, tiredness, stress, family control, safety issues and much more. Understanding the barriers and overcoming the barriers at this stage will be valuable. Health professionals and researchers can use this information to design and implement interventions, strategies and policies to promote the participation in physical activity. This further can help the students to deal with those barriers and can help to instil the habit of regular physical activity in the later adult years.
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Osigwe, Ijeoma, Kenneth D. Gadow, Sharon Nachman, and Deborah A. G. Drabick. "Symptom Profiles of CD and ODD Among Youth With Perinatally Acquired HIV." Journal of Pediatric Psychology, October 10, 2019. http://dx.doi.org/10.1093/jpepsy/jsz074.
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Abstract Objective Youth with perinatally acquired human immunodeficiency virus (PHIV) face increased risk for conduct disorder (CD) and oppositional defiant disorder (ODD) symptoms, and heterogeneous findings indicate that there may be subgroups of youth with PHIV differing in the quality and/or frequency of symptoms. The present study examined symptom profiles of CD and ODD among youth with PHIV and whether profiles differed in terms of parent–child and family correlates. Methods Participants included 314 youth with PHIV, aged 6–17 years (M = 12.88 years, SD = 3.08; 51% male; 85% Black or Latinx), and their caregivers who were recruited from 29 clinics in the US involved in the International Maternal Pediatrics Adolescent AIDS Clinical Trials (IMPAACT) Group’s P1055 study. Caregivers reported on youth CD and ODD symptoms, parent–child interactions, and family environment. Results Latent class analysis indicated that a four-class model (i.e., moderate CD/high ODD, high ODD, moderate ODD, low CD/ODD) best fit the data. Ancillary analyses to validate these classes revealed differences for family cohesion and conflict; and child-centeredness, detachment, guilt-induced control, and consistency in parent–child interactions. The low CD/ODD class generally differed from other classes with additional differentiation between some higher risk profiles. Conclusions Findings suggest that homogeneous classes of CD/ODD symptoms can be identified among youth with PHIV, and these profiles differ in terms of family processes, consistent with previous work among chronically ill youth.
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Arránz Becker, Oliver. "The Impact of Union Dissolution and Divorce on Adolescents’ and Adults’ Relationships with their Parents." Comparative Population Studies 40, no. 3 (2015). http://dx.doi.org/10.12765/cpos-2015-09.
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Using data of the German Family Panel pairfam, this article examines whether relationship-related transitions among adolescents and adults – separations with or without subsequent new relationships and transitions from being single to a relationship – impact different aspects of their relationship with their parents (contact frequency, intimacy, and conflict). Several competing hypotheses are tested. The resource hypothesis, following a supply-side argumentation, posits that relationships generate resources (i.e. social capital) that facilitate exchange with parents; relationship breakup implies resource deprivation and produces strain, which adversely affects the parent-child relationship (spillover hypothesis). According to the demand-based compensation hypothesis, horizontal relationships and vertical intergenerational relations are substitutively associated with each other; hence, exchanges between generations should be strongest when children are not involved in romantic relationships. The analyses yield evidence in line with both the compensation hypothesis (particularly among adolescents) and the spillover hypothesis (among adults). The effects are largely gender neutral.
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Baviskar, Siddhartha. "Does child gender moderate the relationship between interparental conflict and child outcomes? Findings from the Danish Longitudinal Study of Children." Norsk Epidemiologi 20, no. 1 (2011). http://dx.doi.org/10.5324/nje.v20i1.1296.
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The hypothesis that child gender moderates the relationship between interparental conflict (IPC), conceptualized as a normative phenomenon, and child outcomes was evaluated using Danish mother data from the Danish Longitudinal Survey of Children (DALSC), which follows a nationally representative sample of children born in September-October 1995. IPC was assessed at age seven using a five-item scale measuring frequency of quarrels between parents on topics common to daily family life. Child outcomes were evaluated at age eleven using three indicators of internalizing (emotional problems, somatic symptoms, psychological symptoms) and two indicators of externalizing symptoms (conduct problems and hyperactivity). OLS regression analyses indicated, overall, that the longitudinal association between IPC and the chosen outcomes was weak and child gender weakly moderated the association between IPC and child outcomes. Specifically, gender differences were limited only to conduct problems after controlling for the child’s psycho-social adjustment and health characteristics, mother’s depressive symptoms and disciplinary behaviour and parents’ socio-economic status at age 7. Furthermore, contrary to expectations derived from the male vulnerability and differential reactivity models, the IPC-conduct problems association was stronger among girls than among boys. In general, IPC predicted a number of outcomes among girls but did not predict any among boys. These findings suggest that it is important in both academic and professional work to consider that the impact of IPC on boys and girls may vary depending on the nature of the conflict and the type of families affected by it. Furthermore, while IPC may not have a direct impact over time, its effects may continue to be felt through other elements of the family system, such as the parent-child relationship.
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Bahrami-vazir, Ellahe, Mojgan Mirghafourvand, Sakineh Mohammad-Alizadeh-Charandabi, and Mahin Kamalifard. "Predictors of sexual function in pregnant Iranian adolescents." International Journal of Adolescent Medicine and Health, February 26, 2019. http://dx.doi.org/10.1515/ijamh-2018-0069.
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Abstract Introduction Human sexual activity is one of the main aspects of life. The present study intended to determine the status of sexual function in pregnant adolescents at their second trimester of pregnancy and its predictive factors. Materials and methods This cross-sectional research studied 136 adolescents aged 15–19 years in their 24th–30th gestational weeks. All eligible pregnant adolescents in all 80 health centers of Tabriz, Iran were considered as the study samples. The data were collected using a socio-demographic questionnaire, the Female Sexual Function Index (FSFI) and the Conflict Tactics Scale (CTS2). A general linear model was used to determine the relationships between sexual function and socio-demographic characteristics and intimate partner violence (IPV). Results The frequency of sexual dysfunction in pregnant adolescents was about 65%. The mean [standard deviation (SD)] of total sexual function score was 25.3 (5.9) from the attainable score of 2–36. The pregnant adolescents obtained the lowest and the highest mean scores in the sexual desire and sexual satisfaction subscales, respectively. Shorter marital duration and IPV were sexual function predictors. Conclusion Considering the high prevalence of sexual dysfunction in pregnant adolescent, and the impact of IPV on sexual function, midwives should take the necessary actions in identifying and consulting this disorder and IPV in their prenatal visits.
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Mills, Abigail L., Gabriela A. Aquino, Sarah Hoegler, and E. Mark Cummings. "Interparental Conflict, Emotional Insecurity, and Parent–Adolescent Communication." Journal of Family Issues, December 14, 2020, 0192513X2098003. http://dx.doi.org/10.1177/0192513x20980035.
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Destructive conflict within the marital relationship has been shown to negatively impact the family system. Exposure to destructive interparental conflict may be particularly detrimental to adolescent development. Destructive interparental conflict is associated with decreased quality of parent–adolescent communication. One potential explanatory mechanism for this relationship is adolescents’ emotional insecurity in the interparental relationship. Exposure to destructive interparental conflict may decrease adolescents’ sense of emotional security. Therefore, this study examined whether emotional insecurity security mediated the relationship between destructive interparental conflict and parent–adolescent communication, based on a longitudinal study on family communication ( N = 225). Path analysis revealed that the relationship between destructive interparental conflict and father–adolescent communication, as well as mother–adolescent communication, was mediated by emotional insecurity. The results provide insight into the consequences that destructive interparental conflict may have for aspects of the parent–adolescent relationship, as well as practical implications for the development of future intervention programs.
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Campbell, MaryJane S., and Cynthia A. Berg. "Topical Review: Developmental Framework of Moderators of Family Conflict for Type 1 Diabetes Outcomes." Journal of Pediatric Psychology, May 18, 2021. http://dx.doi.org/10.1093/jpepsy/jsab081.
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Abstract Objective To present a developmental framework of family conflict in youth with type 1 diabetes (T1D) that aims to guide future research. Methods Developmental and pediatric literature are reviewed to highlight family factors that may modify the degree to which diabetes-related family conflict is related to adolescent health outcomes. Results Developmental literature suggests that family conflict is not inherently bad; rather, conflict that arises under optimal conditions (moderate frequency, warm and accepting relationships) can be adaptive for adolescents. However, family conflict is consistently associated with poor disease outcomes in youth with T1D, with few researchers examining specific moderators of these associations. In this topical review, we highlight moderators of family conflict and developmental outcomes identified in adolescents without chronic illness (e.g., cultural factors, parent–child relationship quality, conflict characteristics) and how these moderators may operate for a pediatric chronic illness such as T1D. Conclusions Incorporating conceptualizations of family conflict from mainstream developmental research has important implications for future research and intervention adaptations on family conflict in pediatric populations.
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Glass, Nancy, Anjalee Kohli, Pamela J. Surkan, Mitma Mpanano Remy, and Nancy Perrin. "The relationship between parent mental health and intimate partner violence on adolescent behavior, stigma and school attendance in families in rural Democratic Republic of Congo." Global Mental Health 5 (2018). http://dx.doi.org/10.1017/gmh.2018.10.
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Background.Prolonged conflict and economic instability challenge the existing support networks in families and society places significant stress on both adults and adolescents. Exploring individual, family and social factors that increase the likelihood of or protect adolescents from negative outcomes are important to the development of evidence-based prevention and response programing in global settings.Objective.Examine the relationship between parent mental health and experience/perpetration of intimate partner violence (IPV) and adolescent behaviors, stigma, and school attendance. The relationship is further examined for differences by gender.Methods.Secondary analysis of data from an ongoing comparative effectiveness trial of a productive asset transfer program in eastern Democratic Republic of Congo (DRC).Results.Three hundred and eighty-eight adolescent and parent dyads were included in the analysis. The analysis demonstrated that parent mental health and IPV can have a negative impact their children's well-being and the impact is different for boys and girls, likely linked to gender roles and responsibilities in the home and community. Social relationships of adolescents, as reported through experienced stigma, were negatively impacted for both boys and girls. Parent report of symptoms of PTSD and depression had a stronger negative effect on girls’ outcomes, including experienced stigma, externalizing behaviors, and missed days of school than boys. For adolescent boys, their parent's report of IPV victimization/perpetration was associated with more negative behaviors at the 8-month follow-up assessment.Conclusion.The findings reinforce the critical importance of interventions that engage parents and their children in activities that advance health and improve relationships within the family.
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Mrs. Shalini Singh. "Attachment to Parents during Adolescence and Its Impact on Their Psychological and Social Adjustment." International Journal of Indian Psychology 2, no. 4 (2015). http://dx.doi.org/10.25215/0204.010.
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The notion of attachment has been defined in different ways, but something which is identical in all definitions is that attachment is an essential ingredient for normal Human Development. From a developmental perspective, attachment theory has served as an important framework in understanding relationships throughout the lifespan. Attachment theory explains how individuals cope with conflict and assume various interpretations from the behaviors of others. From the experiences of early attachment relationships with a primary caregiver, the internal working model (IWM) becomes a mental representation of expectations and beliefs about the self in relation to others. The parent-child relationship serves as a prototype for future relationships of the child. It is this first relationship that the child uses as a template to apply to future relationship experiences. In short, the qualities of early relationships predict later relationships, and success in later relation-ships takes root in lifespan development. The present article provides a brief synopsis of the changes that occur during adolescence and describes what attachment is, why it continues to be important and how it is transformed during adolescence. It summarizes major findings on the impact of attachment on adolescent adjustment and discusses strategies for supporting healthy adolescent-parent attachment and also describes the secure and insecure attachments, patterns during adolescence towards parents and impact on their social & Psychological adjustment.