The gay adolescent: stressors, adaptations, and psychosocial interventions.

Social stigmatization hinders the ability of gay adolescents to achieve the tasks of adolescence. Because their sexual identity is denigrated by society, these youth have difficulty forming a positive identity and establishing healthy peer and intimate relationships. Family relations are often painful, and gay adolescents are susceptible to loneliness, isolation, depression, and suicide. Validation of these adolescents' affectional and erotic feelings helps to normalize their adolescence, as does providing them with a peer group of other gay youth.

Cognitive problem-solving and life event correlates of depressive symptoms in children.

This study examined the relationship between a number of cognitive problem-solving and life event variables and depressive symptoms in a sample of non-referred grade school children. The results indicated that higher levels of depressive symptoms were associated with an external locus of control, increased levels of objective and subjective life stress, and lower performance levels on an impersonal problem-solving task. Level of depressive symptoms was also found to be inversely related to socioeconomic status as measured by father's occupation. Contrary to prediction, no consistent relationship was found between depression and interpersonal problem-solving ability.

The effects of biasing information on behavioral observations and rating scales.

The effects of biasing information on behavioral observations and rating scales were studied. Forty-one undergraduate students trained in making reliable behavioral observations were given differential expectations concerning the activity level of a target child. They then viewed videotape recordings of that child and tallied frequency counts of six behavioral categories simultaneously. In addition, subjects completed postexperimental rating scales composed of specific, identifiable behaviors in regard to the target child. Results indicated that, for the most part, neither the behavioral observations nor the rating scales were significantly affected by the biasing information. It is suggested that rating scales constructed of items as discrete and readily identifiable as those of behavioral observation measures may prove resistant to biasing effects.

Posttraumatic stress disorder in children and adolescents: a review and analysis.

Only recently has the mental health community recognized the applicability of diagnostic criteria for posttraumatic stress disorder (PTSD) in children and adolescents, including a consideration of specific age-related features. This paper provides a current review of the literature on PTSD pertaining to children and adolescents. Following a discussion of issues on diagnostic criteria and assessment of this affective disorder in this population, there is an overview of the existing literature on prevalence, comorbidity, risk factors, parental and family factors, and issues of gender and age of onset. The remainder of the paper focuses on the range of traumatic stressors in children and adolescents that can result in PTSD, including natural or human disasters, war and violence, chronic or life-threatening medical conditions, community violence and the witnessing of traumatic events, and physical and/ or sexual abuse and other forms of interpersonal violence. Throughout the paper, there is an emphasis on the importance of considering developmental factors. Finally, implications of the existing literature for future areas of research are addressed.

Infection control barrier techniques. Used by physicians during routine examinations. Parental attitudes.

Parents of 316 children seen in the outpatient clinics of a large pediatric teaching hospital completed a questionnaire regarding their attitudes toward the use of infection control procedures by doctors during the routine examination and treatment of their children. Results revealed that the majority of parents held favorable attitudes toward the wearing of gloves and masks during patient care activities. Parents who agreed that gloves and masks should be worn also tended to believe that diseases could be spread through cross-infection, that protective wear would prevent such infection, and that their children generally would benefit from these precautions. Parents of preschool-aged children felt that such procedures might make their children more fearful. These data indicate that many parents are basically supportive of the use of infection control procedures with their children and that such techniques do not appear to be an obstacle to effective relationships between health-care professionals and their patients.

Adolescents' concepts of depression among their peers.

The purpose of this study was to quantify the behavioral cues adolescents use to identify their peers as depressed in order to gain a more accurate understanding of the factors associated with adolescent depressive symptomatology. Because of limited information about depression in adolescents, a questionnaire was constructed to explore the concept in this age group. Ninety-nine middle and high school students, 12 to 18 years old, completed the questionnaire which included open-ended and forced choice questions. The results indicated that social isolation was an important component of adolescents' concepts of depression among their peers. Subjects felt that there was a higher frequency of alcohol and marijuana use among depressed as compared to non-depressed peers. Eighty-six percent of the subjects believed that most depressed adolescents had suicidal thoughts, but only 35% believed that most depressed adolescents had attempted suicide. Factor analyses of the subjects' responses to the open-ended questions delineated several underlying dimensions of depressive symptomatology which adolescents appear to use in identifying their peers as depressed.

Correlates of depressive symptoms in adolescents.

The relationship between a number of social and cognitive variables and depressive symptomatology was evaluated in a sample of public middle-school and high-school students. The variables measured included stressful life events, locus of control, causal attributions, and means-ends problem-solving abilities. Higher levels of depression were found to be associated with a more external locus of control and a tendency to attribute outcomes to causes which are internal, stable, and global. Parental divorce and socioeconomic status were also found to be associated with higher levels of depression. No relationship was found to exist between either amount of life stress or problem-solving ability and depression. The implications of these results for delineating the underlying dimensions of depression in adolescents are discussed.

Preparation for childbirth and contemporary research on pain, anxiety, and stress reduction: a review and critique.

The literature on psychoprophylaxis (prepared childbirth) manifests little interface with contemporary psychosomatic research, despite the fact that psychosomatic variables are intimately involved in the treatment process. Comments are made regarding the application of research on pain and anxiety reduction to labor preparation, and the employment of this knowledge in the development of more efficacious treatment methods. In addition, an examination of studies designed to evaluate the therapeutic efficacy of psychoprophylaxis reveals that a variety of methodological errors have confounded the measurement of treatment effects. It is concluded that preparation for labor is a valid and desirable subject of inquiry for psychosomatic medicine, with particular relevance for researchers engaged in a study of the cognitive, behavioral, or psychophysiological manifestations of pain, anxiety, or stress.

Children's strategies for coping with pain.

Children's typical modes of responding to stress influence their ability to manage painful events. Coping skills mediate a child's response to pain that is associated with illness, injuries, and medical procedures. A number of factors can influence children's use of coping skills and their adaptation responding to pain, including cognitive-developmental level, previous experiences with painful events and children's belief in their ability to tolerate pain, parental support, and the extent to which the pain is acute or chronic and perceived as controllable by the child. There has been recent progress in the assessment of children's coping with distressing and/or painful experiences. Research in this area is providing a foundation upon which interventions can be tailored to a particular child's specific needs to assist him or her in the management of pain.

Behavioral and familial correlates of episodic heroin abuse among suburban adolescents.

Behavioral and familial correlates of predominantly White, suburban heroin abusers were investigated to determine whether such abuse was self-contained experimentation or suggestive of generalized personality disorders and impaired family relationships. Twenty of 296 male high school students recruited from 10 middle-class suburban schools had engaged in episodic heroin abuse. Of 29 antisocial behaviors other than heroin abuse assessed, heroin abusers engaged in 16 significantly more frequently. Heroin abusers found their fathers to be significantly less nice, honest, strong, and kind than did nonabusers, according to semantic differential technique. They found themselves to be significantly less strong than did nonabusers, suggesting failure to model themselves after adequately coping fathers. Heroin abusers also found their mothers to be significantly less fair, honest, and valuable than did nonabusers. It was concluded that episodic heroin abuse among suburban adolescents is suggestive both of generalized antisocial behavior and of impaired family relationships.

The effects of using infection-control barrier techniques on young children's behavior during dental treatment.

This report provides a review of infection-control techniques used by health-care practitioners. It is then stated that there is an increased awareness regarding the role of nonverbal influences on the communication process, especially among child patients, for whom fear and anxiety are common traits. This study evaluated whether the use of masks in the dental operatory affected anxiety behavior, based on changes in heart rate, self-reports, and uncooperative responses. The findings here suggest that wearing a mask during dental treatment represents a minimal stressor for the young child with previous dental experience.