Last rights. In sickness and in health, more people are taking life's biggest decision away from doctors and into their own hands

When dying is all that awaits them, more and more people are choosing certain death now rather than uncertain life on medical support systems. But the decision seldom comes easy, as a Newsweek reporter discovers during three weeks with the doctors, nurses, patients and families in an intensive-care ward. A best-selling guide to suicide fires debate over when it is right to let life go--and who should make that choice when the patient no longer can.     

Acculturation, Enculturation, and Symptoms of Depression in Hispanic Youth: The Roles of Gender, Hispanic Cultural Values, and Family Functioning

The risk for depression increases as Hispanic youth acculturate to U.S. society. This association is stronger for Hispanic girls than boys. To better understand the influence of culture and family on depressive symptoms, we tested a process-oriented model of acculturation, cultural values, and family functioning. The data came from Project RED, which included 1,922 Hispanic students (53?% girls; 86?% were 14?years old; and 84?% were U.S. born) from Southern California. We used data from 9th to 11th grade to test the influence of acculturation-related experiences on depressive symptoms over time. Multi-group structural equation analysis suggested that both family conflict and cohesion were linked with depressive symptoms. Hispanic cultural values were associated with family cohesion and conflict but the strength and direction of these relationships varied across cultural values and gender. For girls and boys, familismo and respeto were associated with higher family cohesion and lower family conflict. Moreover, gender roles were linked with higher family cohesion in girls but not in boys. These results indicate that improving family functioning will be beneficial for boys' and girls' psychological well-being. This may be achieved by promoting familismo and respeto for boys and girls and by promoting traditional gender roles for girls.     

Internalizing Symptoms: Effects of a Preventive Intervention on Developmental Pathways from Early Adolescence to Young Adulthood

This study examined the mediated and moderated effects of a universal family-focused preventive intervention, delivered during young adolescence, on internalizing symptoms assessed in young adulthood. Sixth grade students (N=446; 52% female; 98% White) and their families from 22 rural Midwestern school districts were randomly assigned to the experimental conditions in 1993. Self-report questionnaires were administered at seven time points (pre-test to young adulthood-age 21) to those receiving the Iowa Strengthening Families Program (ISFP) and to the control group. Results showed that growth factors of adolescent internalizing symptoms (grades 6-12) were predicted by ISFP condition and risk status (defined as early substance initiation). Moderation of the condition effect by risk status was found, with higher-risk adolescents benefitting more from the ISFP. Results also supported the hypothesis that the ISFP's effect on internalizing symptoms in young adulthood was mediated through growth factors of adolescents' internalizing symptoms; risk moderation, however, was only marginally significant in young adulthood. The relative reduction rate on clinical or subclinical levels of young adult internalizing symptoms was 28%, indicating that for every 100 young adults displaying clinical or subclinical levels of internalizing symptoms from school districts not offering an intervention, there could be as few as 72 displaying those levels of symptoms in school districts that offered middle school prevention programming. These findings highlight how the positive effects of family-focused universal interventions can extend to non-targeted outcomes and the related potential public-health impact of scaling up these interventions.     

Adolescent Daughters’ Romantic Competence: The Role of Divorce,Quality of Parenting,and Maternal Romantic History

This study examined the links between parental divorce, quality of maternal parenting, spousal relationships and middle adolescent romantic competence in 80 mother-adolescent daughter pairs (40 divorced). Mothers were asked to describe their attitudes and behaviors with regard to their daughters’ romantic behavior. In addition, mothers were interviewed about their own romantic experiences when they were at the age of their daughters. Adolescent girls (mean age = 16.98 years; range 16–18) were administered a comprehensive interview about romantic competence. Findings indicated that adolescent girls from divorced families showed lower levels of romantic competence, which were expressed in their behavior, attitudes toward relationships and skill in handling those relationships. Divorce was found to have had an adverse effect on girls’ romantic competence, whereas continued adaptive parenting and spousal relationships alleviated the effect of divorce. Mothers’ coherent representation of their own adolescent romantic experiences also alleviated the effect of divorce on daughters’ romantic behavior. Results show the important role of family relationships in fostering romantic competence among adolescent girls.     

Associations of Participation in Service Activities with Academic, Behavioral, and Civic Outcomes of Adolescents at Varying Risk Levels

Youth who participate in service activities differ from those who do not on a number of key demographic characteristics like socio-economic status and other indicators of risk; and most studies demonstrating positive outcomes among service participants employ small non-representative samples. Thus, there is little evidence as to whether the outcomes associated with service participation are similar among students with varying levels of risk. The National Household Education Survey of 1999, a large nationally representative cross-sectional data set that focused on community service, was analyzed to investigate associations between the risk status of 4,306 adolescent students (50.2% female; 63.3% European American, M age?=?15.9), their participation in community service, and their academic adjustment, behavioral problems, and civic knowledge. Because adolescents who participate in service differ from those who do not with respect to demographic characteristics, propensity score analyses were used to correct for potential selection bias in the examination of these relationships. Analyses tested competing theoretical models of service??protective versus compensatory??among students at varying levels of risk, and suggested that service acts as a compensatory factor with respect to academic, behavioral, and civic outcomes. Propensity score analyses revealed patterns suggesting that, in some cases, students with certain demographic profiles that are themselves related to the likelihood of service participation may benefit from service participation more than others. Findings are discussed in terms of their significance for adolescent development, for planning service programs, and for educational policy.