Adolescent Co-occurring Disorders Treatment: Clinicians' Attitudes,Values, and Knowledge

This study examined community-based clinicians’ (N = 294) attitudes, background/experiences, values, and knowledge relating to issues of co-occurring disorders, which occur at a high rate among adolescents involved in the juvenile justice system. Study results reveal that clinicians self-rate their clinical values and attitudes at or above the expected level of competency, but they concede that their skill and knowledge levels are not adequate. Comparison measures reveal that employment setting conditions, geographic region, hours worked per week, and strongly held convictions about the importance of integrated mental health and substance use disorders service delivery distinguish clinicians’ co-occurring disorders knowledge levels. Implications are offered.     

青少年心理问题若干个案的思维方式归因分析

思维与心理有着极为密切的关系,探讨和解决青少年心理问题,不能把思维方式的影响撇在一边。对青少年心理问题的个案进行分析,均会发现思维方式侧身其中的情况。因此,不解决思维方式问题,心理问题也不可能得到彻底的解决。思维方式教育应该作为青少年心理健康教育的重要组成部分。     

试论我国新农村卫生人才医德建设

加强农村卫生人才医德建设是社会主义新农村建设的需要。社会存在决定社会意识的哲学原理,决定了农村卫生人才医德的内涵具有继承性、时代性和地域性特征。加强医学高职高专学生的医德教育,加强乡村医生培训中的医德教育及机制建设,是新形势下农村卫生人才医德建设的路径选择。     

Factors that Influence Mental Health Stigma Among 8th Grade Adolescents

Unmet mental health need is a significant problem for adolescents. Although stigma is identified as a major barrier to the use of mental health services among youth, there is limited research on this topic. In-depth interviews (n=57) among a sample of 8th grade students in a suburban, mid-Atlantic community portray adolescent mental health attitudes and how these views are shaped. Satisfactory personal experiences with mental health services as well as accurate mental health knowledge contribute to positive mental health attitudes among teens. The anticipation of negative responses towards mental health care-seeking from family members, peers, and school staff are key factors in teens’ comfort and willingness to address mental health concerns. The research provides critical information on the factors that contribute to the development of stigma and emphasizes the need to address stigma in youth mental health education, programs, and treatment plans. Authors are affiliated with the Johns Hopkins Bloomberg School of Public Health, Department of Population and Family Health Sciences. Dr. Chandra has a background in adolescent health, and is particularly interested in improving the accessibility and appropriateness of youth mental health services and involving young people in the translation of research into practice. Dr. Minkovitz is interested in improving preventive service delivery, enhancing quality of care, and understanding maternal factors that influence children’s receipt of health care     

Maternal Acceptance as a Moderator of the Relation Between Threat to Self Appraisals and Mental Health Problems in Adolescents from Divorced Families

Appraisals about the implications of stressful events that are evaluated as involving a threat to self (negative self-evaluation, negative evaluation from others, rejection by others) have been shown to place youth at risk for the development of mental health problems. This longitudinal study tested a protective-stabilizing interactive model, in which high maternal acceptance was predicted to mitigate the prospective relation between threat to self appraisals and change in adolescents’ mental health problems six months later. Participants were 89 adolescents from divorced families ages 10–12 and residential mothers. Adolescents reported on threat to self appraisals from the most stressful event experienced in the past month. Mothers and youth reported on maternal acceptance and mental health problems. Multiple regression analyses provided support for the protective effects of maternal acceptance on adolescents’ mental health problems. Intervention implications are discussed. Ana Brown is a pre-doctoral fellow in prevention research (NIMH 2 T32 MH18387–19) and doctoral student in the Department of Psychology at Arizona State University, Tempe, AZ. Research interests include the study of children’s appraisals and responses to stressful events in the prevention of mental health problems. Sharlene Wolchik is a clinical psychologist and professor in the Department of Psychology at Arizona State University, Tempe, AZ. Her research focuses on identifying risk and protective factors for children whose parents have divorced. She also has designed and evaluated the efficacy of preventive interventions for children from divorced families and children who have experienced parental bereavement. Jenn-Yun Tein is a research associate professor and Co-Director of the Research Methodology Core of the Prevention Research Center at Arizona State University, Tempe, AZ. Her research interests include analyses of mediation and moderation of preventive interventions as well as applications of methodology and statistics in prevention research. Irwin Sandler is a Regents’ Professor in the Department of Psychology and Director of the Prevention Research Center at Arizona State University, Tempe, AZ. His research interests focus on understanding resilience for children exposed to stress and on the development, evaluation and dissemination of programs to promote resilience and prevent mental health problems for children in stress.     

Mental Health Literacy and Eating-Disordered Behavior: Beliefs of Adolescent Girls Concerning the Treatment of and Treatment-Seeking for Bulimia Nervosa

This research examined the “mental health literacy” of adolescents concerning eating-disordered behavior. A vignette describing a fictional 16-year old female meeting diagnostic criteria for bulimia nervosa was presented to 522 female high school students, followed by a series of questions concerning treatment of and treatment-seeking for the problem described. Results indicated that primary care practitioners, mothers and close female friends were most highly regarded as potential sources of help. Self-help interventions, including the use of vitamins and minerals, were also highly regarded, whereas participants were less positive about the benefits of mental health specialists and ambivalent about the use of anti-depressant medication. Most participants believed that the problem described would be difficult to treat, and that relapse was likely even given appropriate treatment. An additional finding of note was that among participants with a high level of eating disorder symptoms (n=36, 6.9%), recognition of an eating problem was poor. We conclude that beliefs likely to be conducive to low and/or inappropriate treatment-seeking for eating problems may be common among adolescent girls. In addition, the findings suggest that prevention programs for the eating disorders need to target not only at-risk individuals, but also individuals in their immediate social environment.     

恢复性行刑：和谐、健康与回归社会

恢复性行刑的最终目的是恢复正常的社会关系和社会秩序。它包括对罪犯的再社会化,对罪犯社会谋生技能的训练或修复,对罪犯健全人格的修复和教育,对罪犯社会道德与良知的恢复等。恢复性行刑所涉及的主体包括国家、社会、服刑罪犯、受害人以及社区公众。为此,恢复性行刑的价值集中体现在:尊重、和谐、安全、健康和回归社会。     

Comparison of Anonymous Versus Confidential Survey Procedures: Effects on Health Indicators in Dutch Adolescents

Self-report questionnaires are frequently used in youth research, but doubt remains whether total anonymity affects the results. This study compared the responses of 704 mainly 16–17-year-old adolescents to self-report measures of various health indicators in 2 groups: anonymous and confidential collection. For most health indicators no significant differences were found. Perceived health, use of alcohol, and aggressive behavior (for boys) were reported significantly less frequently in the confidential group (small effect size). It appeared that pupils with high scores on social desirability do not respond differently at most health indicators in the 2 conditions. For most health characteristics, epidemiologically useful outcomes may be derived from confidential self-report measures, which are also valuable for detecting individual at-risk children. Similar studies in lower grades and other types of education should confirm the results.Youth Department, Municipal Health Service Rotterdam area. Main research interests are emotional and behavioral problems of adolescents, youth health care, monitoring.Youth Department, Municipal Health Service Rotterdam area. Main research interests are emotional and behavioral problems of adolescents, youth health care, monitoring.Research Department, Municipal Health Service Rotterdam area. Major research interests include emotional and behavioral problems of adolescents, suicidal behavior, youth health care, monitoring.     

Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.