Outcome of anorexia nervosa related to treatment utilizing an adolescent medicine approach

The scientific literature suggests that outcome for adolescents with eating disorders bears little relation to the type of treatment used. Practitioners of adolescent medicine care for adolescents with eating disorders and have reported outcome in three studies, to which a fourth is added in this paper. This new sample of 34 adolescents represents consecutive admissions to an inpatient adolescent medicine unit who were then followed as outpatients by the same interdisciplinary treatment team. An average of more than 5 years after hospitalization, the group had a mean weight of 97.9% of normal and 94% were menstruating (87.5% regularly). Depending on the outcome criteria used, between one-half and two-thirds of the subjects had an excellent to good outcome, with only about 10% of subjects symptomatic at follow-up. Comparing the most recent cohort of 34 adolescents (Group II) with the older cohort of 49 subjects (Group I) reveals a trend toward behaviors associated with bulimia more commonly on entering treatment. These encouraging results suggest that adolescent medicine may offer a complementary approach to traditional methods for adolescents with eating disorders.Received M.D. from Temple University School of Medicine in Philadelphia, PA. Research interests are in bone mineral density in females with anorexia nervosa.Received M.D. from the University of Buffalo School of Medicine in Buffalo, NY. Research interests include examination of the relationship of violence and illicit substance use in adolescents and the relationship of physical abuse and bulimia nervosa.     

A comparison of adolescent inpatients with and without substance abuse using the Millon Adolescent Clinical Inventory

We compared clinical syndromes, expressed concerns, and personality styles of adolescent inpatients with substance use disorders (SUD; n=44) vs. without substance use disorders (non-SUD; n=61) using the Millon Adolescent Clinical Inventory. The two groups did not differ with regard to age, sex, ethnicity, functional severity, or the frequency of other major psychiatric disorders, and were drawn from the same overall sample population. SUD subjects showed significantly higher levels of delinquent predisposition and lower levels of anxiety. Consistent with these syndromal findings, we found that SUD subjects were characterized by higher levels of unruliness and social insensitivity and lower levels of submissiveness. Our findings suggest that, in severely disturbed adolescents who require psychiatric hospitalization, externalizing phenomena are closely associated with SUD. Our findings also suggest that internalizing problems also exist in SUD, although not at levels greater than that observed in non-SUD inpatients.Received Ph.D. in clinical psychology from the University of Pittsburgh. Research interests include eating and weight disorders, addictive behaviors, behavioral medicine, psychological assessment, and psychiatric comorbidity.Received Psy.D. in clinical psychology from the University of Hartford. Research interests include psychological assessment, adolescent psychopathology, and psychiatric comorbidity.Received B.A. in Psychology from Swarthmore College. Research interests include perception, developmental psychopathology, and psychosis proneness.Received Ph.D. in clinical psychiatry from DePaul University. Research interests include the assessment and treatment of substance abusing psychiatric populations.     

An eight-year follow-up: Outcome from adolescent compared to adult onset anorexia nervosa

Seventy-five women were traced and reassessed on average eight years after the onset of anorexia nervosa. All patients received treatment and 88% were hospitalized at least once. Comparisons between early (11–15 years; N=35), late (16–18 years; N=24) adolescent and adult (19–27 years; N=14) onset revealed no significant differences in outcome for age at onset. For 70% of adolescent and 42% of adult onset patients the outcome was good, meaning that the weight was within ± 15% of norm with regular cyclical menstruation,17% and 21% had an intermediate, and 9% and 21%, respectively, had a poor outcome, 5.3% had died. Taken together, 59% had physically recovered and were free of any eating disorder. Severity of illness reflected in a low body mass index, excessive exercise, and poor psychosocial functioning at intake were poor prognostic indicators;length of illness and food restriction or bulimia as eating patterns were unrelated to outcome. The observation that all women with chronic anorexia nervosa, and even a third of those who had physically recovered from anorexia nervosa, qualified for one or more psychiatric diagnoses suggests that the psychosocial correlates of anorexia nervosa require further study.Supported by grant MH ROI35585-01A1.Received an M.D.-Ph.D. degree from Albert-Ludwig University in Freiburg, Germany. Research interests have been depressive disorders, eating disorders, in particular anorexia nervosa, and more recently women's health.Received M.D. degree from the University of Illinois in Chicago, Illinois. Research interest is in preventive medicine.     

Ten-Year outcome in adolescent onset anorexia nervosa

The purpose of the present study was to characterize the psychopathology measured ten years posttreatment in 51 women who had an adolescent onset of anorexia nervosa. Outcome status was determined using the modified categories of Ratnasuriya et al.[1991]. Anorexia Nervosa: Outcome and Prognostic Factors After 20 Years, British Journal of Psychiatry, Vol. 158, pp. 495–502). Psychopathology was assessed using a number of self-report questionnaires: Beck Depression Inventory, Hamilton Depression Inventory, Leyton Obsessionality Inventory, Social Adjustment Scale, and Minnesota Multiphasic Personality Inventory. Within this adolescent age of onset sample of anorexia nervosa, age of onset was not, in and of itself, associated with increased psychopathology at follow-up. Rather, severity of eating disorder outcome was associated with general psychopathology, with patients in the poor outcome group displaying elevations on several of the measures of psychopathology.Received Ph.D. in psychology from Rutgers Univesity. Major research interests are in eating behavior and attitudes toward foods in anorexia and bulimia nervosa, preoccupations and rituals associated with eating disorders, and comorbidity and eating disorders.Received M.D. from the University of Medicine and Dentistry in New Jersey. Research interests are in eating disorders.Received M.D. from University of Minnesota Medical School-Minneapolis, MN. Major research interests are anorexia nervosa and other eating disorders.Received M.D. from the University of Iowa—Iowa City. Research interests are in eating disorders.     

Family influences,school behaviors,and risk for the later development of an eating disorder

Interviews were conducted with parents of 136 female and 45 male adolescents categorized into risk groups for the later development of an eating disorder. The family and school concomitants of risk status in females were demonstrated to be different from that in males. Risk group female adolescents rated family cohesion, parent-adolescent communication processes, and overall family satisfaction more negatively than the comparison group. Mothers of moderate risk group females reported lower family cohesion than the comparison group; there were no group differences for adolescent females in fathers' ratings of family measures. However, no group differences were found on any of the family measures between male risk and comparison males. For both females and males, there were no significant group differences in family history of eating and mood disorders, or alcohol dependence. Teacher ratings indicated relatively greater internalizing tendencies in the high-risk female group.This investigation was supported by NICHD Grant Number 1R01-HD24700 awarded to Gloria R. Leon.Received Ph.D. from University at Maryla. Research interests include precursors of eating disorders and stress and coping in extreme environments. To whom correspondence should be addressed.Received M.A. from San Diego State University. Research interests include precursors of eating disorders, substance abuse, and personality.Received Ph.D. from Stanford University. Research interests include psychosocial aspects of health promotion and disease prevention.Received B.A. from University of Maine. Research interests life span development and family issues.     

Outcome,psychosocial functioning,and prognostic factors in adolescent anorexia nervosa as determined by prospective follow-up assessment

The aim of this prospective longitudinal study was to examine outcome, psychosocial functioning, and prognostic factors in adolescent anorexia nervosa. Thirty-four (88%) out of a consecutive series of 39 inpatients were reinvestigated three and seven years after discharge. The patients and 34 controls matched for age, sex, and occupational status were interviewed using structured interviews on their Diagnostic Statistical Manual, third edition, revised (DSM-III-R) eating disorder diagnoses, specific eating disorder psychopathology, comorbid psychiatric disorders, and psychosocial functioning. At the seven-year follow-up 15 patients (44%) still fulfilled DSM-III-R criteria for some form of eating disorder diagnosis, 21 (62%) for some other psychiatric diagnosis. Patients with a poor outcome showed significantly more problems in most areas of psychosocial functioning than the good-outcome group, but even recovered anorectic patients had more psychosexual difficulties than healthy controls. From a large range of potential prognostic factors, only low body weight at intake and low minimum weight during course of illness proved to be of predictive value.Received M.D. from Rheinische Friedrich-Wilhelms University, Bonn. Major research interests are childhood and adolescent eating disorders including links to affective disorders.Received M.D. from Philipps University. His current interests include follow-up studies of adolescent eating disorders.Received M.D. from Philipps University. His interests are body image disturbances in eating disorders and research in neurophysiology and neuropsychology.Received M.D. from Friedrich-Alexander University, Erlangen, Germany, and Ph.D. from Rupprecht-Karls University, Tübingen. Current research interests are eating disorders, affective disorders, and early onset schizophrenia.     

A prospective follow-up of children with anorexia nervosa

We report on a prospective follow-up (mean 3.1 years) of 22 children with anorexia nervosa (mean age at onset—12.1). Adequate information was obtained for 18 children. The specific outcome was good in 10 (55.5%), intermediate in 5 (27.8%), and poor in 3 (16.7%); none had died. No prognostic factors were identified. The findings are compared with those from the long term follow-up of a previous cohort of children with anorexia nervosa, and confirm the unsatisfactory prognosis for this age group.Major research interest concerns the etiology and treatment of eating disorders in children and adolescents.Has been with the Eating Disorders Research Team since 1992. His major interest is research methodologyHas been with the eating disorders Research Team since 1989. Her major interests are in obsessional-compulsive problems and eating disorders in children.Major research interests include eating disorders in children and adolescents, cystic fibrosis, the effects of transplantation in children and adherence to treatment. Chief Editor ofClinical Child Psychology and Psychiatry. Has been collaborating with the Eating Disorders Research Team since 1985.     

Body image ideals of low-income African American mothers and their preadolescent daughters

Given the high incidence of obesity and obesity-related health problems among low-income African American women, it is both timely and significant to study factors that contribute to obesity in this population. The perception of current body size (body image) and desired body size (body image ideal) has been associated with the development of anorexia and bulimia in white adolescent girls. Body images and ideals may also be related to the development of obesity among African Americans adolescent girls. This study examined the body images and ideals of 27 low-income African American mothers and their 29 preadolescent daughters. Results suggest that there is a relationship between mothers' perceptions of their daughters bodies and their daughters' body images. Preadolescent, low-income, African American girls have normal weight ideals rather than the ultrathin ideals typically found among white girls. Normal weight girls have ideals that are heavier than their body images. This population may be less motivated than those with thinner ideals to engage in behaviors that would prevent the development of obesity during adolescence. Health promotion programs for this population should acknowledge cultural body weight standards.This study was funded by the American Heart Association of Metropolitan Chicago.Received B.A from the University of Pennsylvania. Research interests include cross-cultural studies of body image, eating disorders, health risk perceptions, and health promotion programs.Received Ph.D. from in Clinical Psychology from Long Island University. Research interests include obesity prevention, binge eating, and cultural differences in eating behavior.     

Consistency of adolescents' self-report of sexual behavior in a longitudinal study

This study examines three issues relevant to adolescent self-reported sexual behavior: the extent to which adolescents rescind reports of sexual intercourse, changes in reporting of lifetime sexual intercourse, and changes in reported age at first sexual intercourse. Data come from a three-year longitudinal study of health-compromising behaviors among a cohort a 758 rural adolescents. Students completed a self-administered questionnaire on health behaviors annually in eighth, ninth, and tenth grades. Findings show that 88.8% of students in eighth grade and 94.3% in ninth grade who reported having had sexual intercourse gave the same answer in a subsequent year. Approximately 15% of students reported fewer numbers of lifetime sexual intercourse experiences in tenth grade than they did in ninth grade. Age at first sexual intercourse was reported inconsistently by 67% of the students. Inconsistency rates differed by racial-gender groups, question sensitivity, and prior sexual experience.Received Ph.D. from Johns Hopkins University. Research interests include adolescent health and early adolescent development.Received Ph.D. from Johns Hopkins University. Research interests include personality, stress, and coping.Received Ph.D. from University of Chicago. Research interests include adolescent delinquency and substance use.Received Dr. P.H. from Johns Hopkins University. Research interests include rural adolescents and international health issues.Received Ph.D. from Johns Hopkins University. Research interests include adolescent sexuality and contraceptive decision making.     

Psychiatric Disorders Associated with the Onset and Persistence of Bulimia Nervosa and Binge Eating Disorder During Adolescence

A prospective longitudinal study was conducted to investigate whether anxiety, depressive, personality, or substance use disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Axis I and II psychiatric disorders were assessed in a primary care sample of 201 adolescents. Axis I disorders were reassessed 10 months later. Youths with dysthymic disorder were at elevated risk for the onset or recurrence of BN or BED after preexisting psychiatric disorders were controlled statistically. Problems with depression or anxiety tended to precede the onset of eating problems. In addition, youths with eating disorder symptoms were at elevated risk for the onset or recurrence of depressive disorders. These findings suggest that adolescents with chronic depressive symptoms may be at elevated risk for the development of BN or BED, and that adolescents with eating disorder symptoms may be at elevated risk for the development of depressive disorders.     

Introduction to special issue

As regards prognosis, none of these cases, however exhausted, are really hopeless whilst life exists: and, for the most part, the prognosis may be considered favourable. (Gull, 1873)Received M.D. Ph.D. from Albert-Ludwig University in Freiburg, Germany. Research Interests are depressive disorders, eating disorders, in particular anorexia nervosa, and more recently women's health.     

A comparative analysis of personality organization in juvenile anorexia nervosa

To identify distinguishing features of personality associated with anorexia nervosa in adolescence, univariate and multiple group discriminant function analyses were used to compare the Cattell High School Personality Questionnaire responses of 50 anorectics and matched groups of depressed and antisocial adolescent females. Results indicated the presence of two major sources of discriminating variance. Relative to both control groups, anorectics were characterized by significantly greater conformity, neurotic anxieties, control of emotionality, and stimulus avoidance. These findings suggest that at the level of personality functioning, the anorectic has failed to acquire the sense of individuation, mastery, and general plasticity of psychological functioning necessary to cope effectively with critical developmental tasks and progress toward identity formation. Results are discussed in terms of the extant literature on anorexia nervosa and future research needs.Received his Ph.D. from the University of Pittsburgh. Primary research interests are empirical studies of clinical psychopathology and psychosomatic disorders in adolescents.     

Manifestations of depressive affect in adolescence

This paper discusses the manifestations and correlates of depressive affect disorders in adolescents. It begins with some definitions and a discussion of the concept (from adult psychiatry) of depression and depressive disorders. The clinical picture of depressive disorders in adults is described, and the interrelationship is considered between them and the depressive disorders of adolescents and prepubertal children. Data are discussed regarding the external validity of adolescent depressive disorders (including their familial and biological correlates, their course and treatment outcome). Finally, the relevance of these data is summarized with regard to the process of establishing a diagnosis of a depressive disorder in adolescents.Received M.D. from Washington University. Research interests are the diagnosis and assessment of childhood psychopathology, especially Attention Deficit Disorder and Depressive Disorders.Received Ph. D. from UCLA. Research interests are language and learning disorders and childhood psychopathology.     

Factors related to cigarette smoking during adolescent pregnancy

Previous research suggests that maternal smoking during pregnancy remains prevalent, particularly among adolescents. However, little is known about the factors related to smoking during adolescent pregnancy. The goal of the present study is to identify intrapersonal, familial, and peer factors that are related to smoking during adolescent pregnancy, and to determine the relative degree to which they affect this behavior. Interviews were conducted with 241 unmarried pregnant adolescents who planned to carry their pregnancies to term. Consistent with previous studies, 27% of the respondents reported daily smoking during pregnancy, and whites reported higher rates of use than members of other racial groups. Smoking during adolescent pregnancy was related to intrapersonal, familial, and peer factors. The results of a regression analysis suggest that perceived parental disapproval of smoking during pregnancy, friends' cigarette use, and race play a particularly important role in this behavior. The implications of these findings for preventive programs are discussed.Research reported here and the preparation of this report were supported by Grant DA-05208 from the National Institute on Drug Abuse.Received M.A. in sociology from the University of Washington. Research interests include health behaviors, and the relationship between social stratification and health.Received Ph.D. in social welfare from the University of Washington. Research interests are in adolescent development, gender issues in adolescent development, and health promotion and problem prevention with children and adolescents. Received Ph.D. in sociology from the University of Washington. Research interests are adolescent problem behaviors, and particularly adolescent sexual decision making.Received M.S. in educational psychology from the University of Wisconsin—Madison. Research interests: adolescent substance use, pregnancy and parenthood, and peer relations.     

Adolescent depression in a school-based community sample: Preliminary findings on contributing social factors

A two wave survey carried out on a large community sample of adolescents with increased risk for problems with social functioning is described. In this paper we report the prevalence of depression in this population and social factors that contribute to it. The prevalence of depression is twice that in other studies. Stress is both a risk and causal factor in depression while relatively low social self-efficacy moderately increases risk. Being female is a risk factor for depression. The perception of parents and siblings as a source of support appears to be a key factor in protection from the onset of depression.Received M.D. from Queen's University. Research interests include developmental experiences that influence adolescent and adult social functioning, and mechanisms of mortality rates in post coronary depressed subjects.Received Ph.D. from University of Waterloo. Research interests are risk factors affecting depression in adolescents and young adults and social factors associated with chronic pain.Received Ph.D. from McMaster University. Research interests are psycho-social factors that influence adolescent well being, measurement of clinical competence, and research design.Received M.A. from McMaster University.     

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.     

Family contexts of pubertal timing

This study examined the influence of pubertal timing upon family interactions in normal and psychiatric adolescent samples. An important feature of our approach is its emphasis upon micro-analysis of family behaviors (individual speeches) and family processes (theoretically specified speech pairings). Rather than assume that global family patterns (e.g., power) shift in response to pubertal changes, we follow how types of speeches and speech sequences are associated with different pubertal timing. Using the previously constructed family coding system, the Constrainig and Enabling Coding System, we found that on-time adolescents and their parents differed from both off-time groups (early or late). These results are discussed in terms of current implications and suggestions for future research.An earlier version of this paper was presented at the SRCD Study Group on Timing of Maturation, October, 1983, at the Education Testing Service, Princeton, NJ. This research was supported by NICHD Grant 1 R01 HD18684-01, and an NIMH Research Scientist Award (Dr. Hauser).Received his Ph.D. from Harvard University. Research interest is adolescent development within the family and impact of chronic illness on adolescent development and family interaction.Received her B.A. from Wellesley College. Research interests are in humor and attractiveness.Received his M.A. from Boston University. Research interests are in methodology and statistics.Received Ed.D. from Harvard University. Research interests are in adolescent development within the family, and family coping with stress.Received M.D. from University of Chicago. Research interests are in psychosocial aspects of diabetes.Received Ed.D. from Harvard University. Research interests are in developmental psychopathology, and moral and ego development.Received Ph.D. from Ohio State University. Research interests are in assessment of ego development and family systems.Received Ph.D. from University of Miami. Research interests are in family studies and adolescent development.     

Correlates of Ideal Body Size Among Black and White Adolescents

Cultural differences have been found in body image perceptions among Black and White adolescents, however little is known about the factors associated with perceptions of an ideal body size (IBS). This study examined differences in correlates of IBS among 265 Black (116 girls and 62 boys) and White (63 girls and 24 boys) adolescents. IBS for White girls and boys was related to perceptions of how their parents wanted them to look, while IBS for Black girls was related to perception of how peers look and would like to look. IBS for Black boys was significantly related to perceptions of their current size, how peers would like to look, how parents think they look, and depressive symptoms. Findings suggest cultural differences in the factors related to body image perceptions and have implications for educational programs promoting healthy body image development among Black and White adolescents.Assistant Professor, Department of Preventive Medicine and Public Health, University of Kansas Medical Center. Received PhD in Counseling Psychology from University of Missouri-Kansas City. Research interests include environmental and cultural correlates of obesity, obesity prevention, nicotine and tobacco addiction, and health promotion interventions.Assistant Professor, Department of Pediatrics, University of Minnesota. 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.Research Associate, Department of Preventive Medicine and Public Health, University of Kansas Medical Center. Completing PhD in clinical psychology from University of Kansas and Master of Public Health from University of Kansas School of Medicine. Research interests include obesity prevention, smoking cessation, and positive psychology.Assistant Professor and Director, MPH Program, Department of Preventive Medicine and Public Health, University of Kansas Medical Center. Received MPH from Boston University and PhD in epidemiology from the University of California/San Diego State University. Research interests include behavioral epidemiology of tobacco use among adolescents and ethnic minorities.Professor of Medicine and School of Public Health, University of Illinois at Chicago, Associate Director, Midwest Center for Health Services and Policy Research, Jesse Brown VA Medical Center, Director, Section of Health Promotion Research, Department of Medicine, University of Medicine, University of Illinois at Chicago. Received PhD in clinical psychology from Long Island University. Research interests include obesity prevention, binge eating, and cultural differences in eating behavior.Medical Epidemiologist, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Received MD and MPH from Tongji Medical University, Wuhan, China and PhD from University of Southern California Keck School of Medicine. Research interests include the etiology, epidemiology, and prevention ofobesity, metabolic syndrome, and diabetes.Research Instructor, Department of Preventive Medicine and Public Health, University of Kansas Medical Center. 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.Professor Department of Medicine and Office of Clinical Research, University of Minnesota School of Medicine. 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.     

Gender/Racial Differences in Jock Identity,Dating, and Adolescent Sexual Risk

Despite recent declines in overall sexual activity, sexual risk-taking remains a substantial danger to US youth. Existing research points to athletic participation as a promising venue for reducing these risks. Linear regressions and multiple analyses of covariance were performed on a longitudinal sample of nearly 600 Western New York adolescents in order to examine gender- and race-specific relationships between jock identity and adolescent sexual risk-taking, including age of sexual onset, past-year and lifetime frequency of sexual intercourse, and number of sexual partners. After controlling for age, race, socioeconomic status, and family cohesion, male jocks reported more frequent dating than nonjocks but female jocks did not. For both genders, athletic activity was associated with lower levels of sexual risk-taking; however, jock identity was associated with higher levels of sexual risk-taking, particularly among African American adolescents. Future research should distinguish between subjective and objective dimensions of athletic involvement as factors in adolescent sexual risk.Research Scientist at the Research Institute on Addictions of the University at Buffalo. Received PhD in sociology from the University at Buffalo. Research interests include adolescent athletic involvement, gender, race, and health-risk behavior, particularly substance use.Department Chair and Professor of Sociology at the University at Buffalo. Received PhD in sociology from Yale University. Research interests include the effects of families, friendships, and organizational participation on adolescent development and substance use.Senior Research Scientist at the Research Institute on Addictions of the University at Buffalo. Received PhD in sociology from the University at Buffalo. Research interests include family influences on adolescent substance use, gambling, and other problem behaviors.Professor of Physical Education and Sport at SUNY College at Brockport. Received PhD in physical education from Ohio State University. Research interests include the sociology of sport, social psychology of sport, sport group dynamics, and sport spectatorship/fandom.Professor of Sociology at DYouville College. Received PhD in sociology from the University at Buffalo. Research interests include the sociology of sport, gender, and mens health.     

The relation of personality functions and adaptive skills to self-esteem in early adolescence

This paper examines the relation, in early adolescence, of competence in personality functions and adaptive skills to self-esteem. As part of a longitudinal study of adolescent personality development, a nonclinical group of 63 adolescents underwent a comprehensive assessment at age 13. Their personality functioning status was assessed by means of a semistructured psychiatric interview. A psychometric battery was administered to assess verbal and nonverbal adaptive skills. In addition, global self-esteem was assessed. The findings indicate that positive self-esteem was associated with competence in both personality functions and in adaptive skills. Both domains contributed to self-esteem to a similar degree.This study was supported by a grant from the Ministry of Community and Social Services of the Province of Ontario, Canada. This paper was presented at the annual meeting of the Canadian Academy of Child Psychiatry, Quebec City, Quebec, Canada, 1985.Received his Ph.D. from the State University of New York at Stony Brook. Research Interests include adolescent personality development and the effects of affective disorders on development.Received his M.D. from the University of Toronto. Research interests include mood disorders, personality development in adolescence, and preventive psychiatry.Received his M.D. from the University of Toronto. Research interests include adolescent personality development, effects of psychosis on personality, and psychophysiology of schizophrenia.Received his M.D. from the University of Toronto. Research interests include affective disorders in adolescence and individual psychotherapy.