Self-image of adolescents with cystic fibrosis

Cystic fibrosis (CF) is a lethal genetic disease, yet improved care has extended the mean age of survival into the young adult years. Many of the surviving adolescents have respiratory and digestive problems which delay growth and sexual development. It has been suggested that the specter of fatal disease interferes with adjustment to adolescence. We administered the Offer Self-Image Questionnaire to three groups with mean height less than the fifth percentile: CF males aged 12–19 (n=16); CF females aged 12–19 (n=8); and otherwise healthy males with short stature and/or delayed puberty aged 13–19 (n=34). The values obtained were compared to published normative data for a large number of normal adolescents and a smaller number of adolescents actively undergoing treatment for emotional disorders. CF males showed an abnormal pattern of adjustment that could be considered comparable to disturbed males and to growth-delayed and sexually delayed males. The CF female group was concordant with the normal population, rather than with the emotionally disturbed population. Thus CF and pubertally delayed males have a self-perception of maladjustment to the psychologic problems of adolescence. This suggests that adjustment problems of the CF male may be related to growth retardation and pubertal delay, the social stigma of which may be more easily disguised in the female. This is important in health care, since recent evidence suggests that exemplary attention to medical compliance and nutrition may ameliorate some of the growth lag both in pubertal delay and CF.Postdoctoral medical research fellow in allergy, immunology, and respiratory disease at Children's Hospital at Stanford. Received his M.D. from the University of Southern California and pediatric training at Stanford University Hospital. Main research interests are clinical nutrition and behavioral intervention in adolescents with chronic disease.Received his M.D. from Stanford University and pediatric training at Stanford University Hospital. Main research interests are growth disorders and adolescent development.Studied psychology at Dartmouth College and Oxford University before coming to Stanford University, where he is currently completing his Ph.D. in social psychology. Main research interests are the social determinants of motivation.Chief of the Allergy and Pulmonary Disease Service at Children's Hospital at Stanford and Assistant Professor of Pediatrics at Stanford University. Received his M.D. from University of Iowa; pediatric training at Yale-New Haven Hospital and Stanford University Hospital; and allergy, immunology, and respiratory postdoctoral training at Stanford University Hospital. Main research interest is cystic fibrosis.     

Self-image complexity and identity formation in adolescence: Longitudinal studies

Using a specially designed Q-sort technique, multiple self-images which were held by each of 60 adolescents were studied. Sixty normal and psychiatrically hospitalized adolescents were tested initially and then every 6 months for 12–18 months. Each subject's self-images were analyzed in terms of their complexity. Results showed that, as predicted, the patients and normals differed significantly. The patients had consistently lower complexity scores on each trial. The patients' and normals' patterns of complexity scores are discussed in terms of their reflecting the ego identity configurations described clinically by Erikson and operationally defined herein.This study was supported in part by a Research Scientist Development Award (Kl-70-178) from the National Institute of Mental Health.Received his medical training at Yale University School of Medicine and his psychiatric training at Massachusetts Mental Health Center. Currently continuing graduate training in personality and development in the Psychology and Social Relations Department at Harvard University. Present research interests are in the interplay between fantasy and nonverbal process in interracial adolescent dyads; and in the longitudinal study of adolescent identity development.     

Undivided interest and the growth of talent: A longitudinal study of adolescents

Based on theoretical considerations drawn from John Dewey and others, and using the Experience Sampling Method to longitudinally investigate a group of talented high school students,undivided interest was operationalized as times when the students felt above average spontaneous interest (i.e., excitement, openness, and involvement) while also reporting above average goal-directed interest (i.e., that their task was important to their goals). Results showed that after adjusting for the effects of family background, scholastic aptitude, and other individual differences, undivided interest while doing talent-related activities was positively correlated with independent assessments of talent area performance three years later: the level of mastery students achieved as indicated by their school records, the ratings students received from their talent area teachers, and the students' assessments of their own level of engagement. Highly engaged students reported over twice as much undivided interest in comparison to a group of disengaged students, who reported more divided interest (i.e., more of what Dewey referred to as fooling—high spontaneous involvement with no goal direction; and more drudgery—low spontaneous involvement and high goal direction). These findings held regardless of whether the teenagers were talented in math, science, music, or art. The implications of the study are discussed in terms of contemporary theories of attention and cognitive development, as well as unproductive educational philosophies that pit these important dimensions of experience against each other.Received Ph.D. in psychology from the University of Chicago. Main research interests are adolescent development within the family and the role of interest in learning and development.Received Ph.D. in human development from the University of Chicago. Main research interests are optimal experience and creativity.     

Idiopathic precocious puberty in girls: Psychosexual development

A promising model syndrome for the examination of the role of physical maturation in the development of female sexuality is idiopathic precocious puberty (IPP). In this first controlled study of psychosexual development in IPP females, 16 females between 13 and 20 years of age with a history of IPP were compared to 16 control subjects with a history of normal puberty pair-matched to the index subjects on the basis of sex, race, age, socioeconomic level, and menarcheal status. The psychosexual history and the current psychosexual status were assessed by a systematic half-structured interview. The IPP females on average passed the psychosexual milestones at an earlier age than their normal maturing peers, with a particularly early onset of masturbation. Those who were sociosexually active tended to report a higher total orgasmic outlet and a higher sex drive. There was no increase in homosexuality among IPP girls. The timing of puberty has a (modest) influence on psychosexual development in females.This work was supported by NIMH Center Grants MH 30906-01A and MH 30906-03 and by a grant from the Spencer Foundation.     

Psychological adjustment of adolescents with myelodysplasia

The psychosocial development of 20 adolescents with congenital paralysis due to myelodysplasia is compared to 20 age- and gender-matched subjects with no physical handicap. On many of the measures the myelodysplasia group showed poorer adjustment and lower self-esteem than the controls. Consistent with hypotheses regarding adjustment during adolescence the paralyzed males did show greater concern on Offer's scales of Body and Self-Image and External Mastery and showed poorer adjustment on his Sexual Attitudes Scale. The paralyzed girls, particularly those 13 years or younger, showed the poorest emotional adjustment with a significant variability in responses on many of the tests. This degree of variability may indicate a lack of integration of self-concepts and is consistent with an emotional immaturity discordant with advanced physiologic maturation of these girls.This study was supported in part by the National Foundation-March of Dimes.Received her Ph.D. from the University of Washington in 1959. Main interests are adolescent development, personality, and evaluative research.Received her M.D. from the University of Rochester, New York, in 1953 and her pediatrics training at Children's Hospital, Los Angeles. Main interests are comprehensive care of patients with birth defects; research and management of hydrocephalus.Received her M.D. from McGill University in 1968 and her pediatric training at University of Washington, Seattle. Main interest is care of children with handicapping conditions, with emphasis on communication problems of the hearing impaired.     

Social skills training with young adolescents

It is hypothesized that young adolescents with social skills difficulties can be helped by group social skills training if a school setting is used and school staff are involved in selection and treatment. An intervention using group social skills training was run in a secondary school as part of the curriculum. The results of 9 treated subjects on three measures were compared with those of an equal number of subjects who had no treatment. Scores were computed before treatment, after treatment, and at follow- up. On two of the measures significant improvement was found in the case of the treated subjects, while there was no improvement in the case of the untreated subjects.Received B.A. from Pembroke College, Oxford, in 1966 and M.A. in 1983. Completed postgraduate professional training as a psychologist at the Tavistock Centre in 1971. He has previously worked as an educational psychologist and currently works as principal clinical psychologist at Peterborough District Hospital, Peterborough, PE3 6DA, United Kingdom. He has published papers in a number of clinical areas. Currently his main research interest is in social skills.He was previously associated with the Institute of Psychiatry at the Maudsley Hospital in London. His research interest is in person-centered therapy and in testing assumptions derived from the theories of Carl Rogers. He has published extensively in this area and is currently developing research into the process of psychotherapy.     

Hallucinations in nonpsychotic children and adolescents

The case histories of ten nonpsychotic patients (nine female and one male) who had experienced hallucinations are summarized. Significant anxiety and depression were found in the majority of the patients, five of whom expressed suicidal ideas. Stress factors were primarily family and school. Eight children had combined auditory and visual hallucinations, which involved dead relatives in five cases. The aims or purposes of the hallucinations were multiple, but escape mechanisms were most common. A profile of the nonpsychotic patient most likely to experience hallucinations would be a socially immature teenage girl who is experiencing depression and anxiety due to stress within the family.     

Risk and resilience in young adolescents

This exploratory study focused on the role of risk and protective factors in 179 adolescents from a middle and lower income northeastern school district. The protective factors examined were family cohesion, locus of control, mother/father communication, and relationship with a nonparent adult. The study found that the protective factors were powerful predictors of adaptation in their own right independent of risk. Protective factors were found to be highly context specific and there was no evidence of broadly applicable protective factors. Gender was found to be an important aspect of context, and there were significant sex differences. Most strikingly, the study did not find any significant interactions between protective factors and risk for girls or boys. Thus, these results support the growing view that researchers must identify specific rather than global protective factors that provide protection in the space of specific risks for youth in specific life contexts.A grant from the Boston University Graduate School provided initial support for this project.Received Ph.D. from Yale University in clinical psychology. Research interests include effects of risk, particularly sexual and physical abuse, and resiliency.Received M.A. from Boston University. Research interests include risk and developmental factors in psychopathology.Received Ph.D. in counseling psychology from Boston University Department of Psychology. Research interests include study of adolescence and risk factors.Received Ph.D. from Boston University.Received M.A. from Eastern Nazarine College, Quincy, MA.Received B.A. from Boston University Department of Psychology, Boston, MA 02215.     

Selective attention and self-control in delinquent adolescents

Research studies are briefly reviewed to examine the hypothesis that delinquent adolescents may process information in a different manner than non-delinquents. Studies suggest that delinquents may have less control over which information they attend to, may expose themselves to more stimulation, may process information more slowly, and may selectively attend to different information than matched controls. Findings from a recent study are presented in support of the latter hypothesis. A clinical example illustrates how these attention differences may appear in the course of treatment.This work was conducted while Dr. Rosenthal was a Clinical Research Training Fellow in Adolescence in a program jointly sponsored by the Adolescent Program of the Illinois State Psychiatric Institute, the Institute for Psychosomatic and Psychiatric Research and Training at Michael Reese Hospital and Medical Center, and by the Departments of Behavioral Science (Human Development) and Psychiatry of the University of Chicago. The training program was funded by Public Health Service grant T32MH14668.A version of this paper was presented at the Conference on the Psychology of Adolescence, Chicago, June 20–21, 1980. Portions of this article are based upon the doctoral dissertation submitted by Frank Lani in partial fulfillment of the Ph.D. degree, Loyola University, Chicago, Illinois.Received his Ph.D. in clinical psychology at Vanderbilt University. Current research interests include delinquency, hyperkinesis, and evaluation of hospital treatment.Received his Ph.D. in clinical psychology at Loyola University. Current research interests include social cognition in delinquency.     

Depression and suicidal ideation in early adolescents

This study sought to determine to what extent depression in young adolescents could be predicted by a variety of demographic and personality measures. A sample of 132 adolescents enrolled in junior high school completed a biographical data sheet, short forms of the Beck Depression Inventory (BDI), a Sensation- Seeking Scale (SSS), the Family Environment Scale (FES), a social support index (SSI), and a life stress inventory (LSI). The nondepressed group differed from the depressed group on a variety of variables, and stepwise multiple regression suggested a significant relationship between depression and life stress and an inverse relationship between depression and family cohesion.Received Ph.D. from University of North Dakota. Main research interests are family coping and child psychopathology.Received M.A. from University of Washington. Main research interests are adolescent depression and future self-concept.Received M.A. from University of Washington. Main research interests are Projective assessment of Personality.     

Divergent thinking and self-esteem in preadolescents and adolescents

The purpose of this study was to explore the relationship between divergent thinking and self-esteem in preadolescents and adolescents. A second focus pertained to sex differences in the dependent variables. A total of 115 White middle class subjects ranging in age from 10–17 years responded to a personal data inventory, a self-esteem measure, and a taped auditory free-response exercise in divergent thinking. Subjects were categorized for data analysis into two age groups, preadolescents and adolescents. Scores were obtained for fluency, flexibility, and originality of thought, and for self-esteem. Adolescents were significantly more fluent and flexible than preadolescents. The two age groups did not differ significantly in orginality or self-esteem. Self-esteem correlated significantly with divergent thinking in preadolescents only. Female adolescents scored significantly higher on all dependent measures than adolescent males; there were no sex differences in preadolescents. Results are discussed from both an intra- and interstage developmental perspective on adolescence.Research assistant and doctoral canditate in human developmental and family studies at Cornell University. Major interests are adolescent and human life-span development.Received his Ph.D. from the University of Wisconsin. Major interests are the study of creativity and the educational psychology of human life-span development.     

Social support in healthy adolescents

Social support is examined in a representative sample of 141 healthy adolescents. By means of a revised version of the Mannheim Interview on Social Support, the number, type, perceived adequacy (satisfaction), and quality (importance) of the social relationships available were assessed. While peers were found to provide prime supportive functions in day-to-day matters, the social support provided by parents has a stress-buffering effect in emergency situations. The role of other family members is discussed. Differences in gender and education are moderate. The data suggests the adequacy of social support and social integration, contrary to the traditional view of adolescence as a time of crisis and conflict.This study was supported by the Swiss National Foundation (Grant Number 32.26367.89).Received M.D. from University of Berne. Has conducted research on chronic illness (cystic fibrosis), minimal brain dysfunction, and suicide prevention in children.Received Ph.D. from University of Berne. Has done research on coping in cancer and cystic fibrosis.     

Healthy and maladjusted Type A behavior in adolescents

The dimensions of Type A behavior were studied in 990 randomly selected adolescents and their conceptualization was clarified in terms of achievement striving, self-concept, and sense of control. The methods used were the AFMS to evaluate Type A behavior, the Nowicki-Strickland Locus of Control Scale, and Coopersmith's Self-Esteem Inventory. Achievement striving was assessed using the questionnaire designed for this study. It was revealed that Type A consisted of two independent dimensions, both adding an equal contribution to the total score. One was an impatient, aggressive competitiveness related to a low self-esteem, low self-set achievement standards, and external locus of control. The other Type A exhibited competitiveness related to a sense of responsibility, leadership, social activity, high achievement striving, and high self-esteem. These factors may distinguish maladjusted competitiveness from healthy ambition and suggest that it is important to distinguish risk Type A individuals from Type A's who are potential leaders in society.Received Ph.D. in Psychology from the University of Helsinki, Finland. Her major research interest is psychosomatic medicine.     

Gifted adolescents and intimacy in close same-sex friendships

As most research with gifted children has demonstrated that giftedness has a positive effect on popularity and social self-esteem, it was expected that gifted adolescents would demonstrate higher intimacy with their same-sex closest friends and would tend to evince a more secure attachment style than nongifted cohorts. A total of 56 gifted and nongifted 9th graders completed questionnaires regarding their intimacy with closest same-sex friend and attachment style. However, the hypotheses were not confirmed. Gifted adolescents of both sexes reported lower intimacy with their closest same-sex friends than nongifted adolescents, and they did not differ from the latter in the frequency of the attachment styles they exhibited. These results are discussed in light of the distinction between instrumentality and expressiveness in social relations; it is suggested that gifted adolescents have a stronger instrumental orientation than others. While this may prove conducive to close relationships at the preadolescent stage, it does not give them an advantage during adolescence.Received Ph.D. in psychology from Tel-Aviv University, Israel. Current research interests are close relationships, attachment, intimacy, and identity formation.     

A “second look” at interviews with adolescents

Interviews are widely used in adolescent study as data collection methods. This article argues that such interviews contain an additional order of data, located in the conversing, which can complement the content analysis and interpretation of answers to questions. This argument is based on treating interviews with adolescents as actual instances of adolescent adult interaction and is illustrated by transcribed passages from a series of interviews with young adolescents. The purpose of the study is to outline how researchers using an interview method can examine records of the talk for valuable supplementary data. The conversational analysis sketched here is, of course, only one possible way of taking this second look. In this area, it would also be a valuable resource for investigators to study how adolescents manage their research participation under a variety of data collection methods. Adequately recorded interviews contain such data, and can be inspected for the presence or clues to the very phenomena researchers may be interested in. All of this requires the understanding that 1) the primary order of empirical data is the talking and, 2) the interviews are instances of adolescent behavior.     

Psychological distress and alcohol use in Hispanic adolescents

Psychological distress has been increasingly implicated as an important risk factor that predisposes adolescents toward alcohol and drug use, particularly for Hispanics and other ethnic minority groups. The scant research on the relation between psychosocial stress and alcohol use has found higher levels of alcohol and drug use among Hispanic adolescents who report higher levels of psychological and emotional distress. In this study, Hispanic adolescents (N=171, with a median age of 14, completed a paper- and-pencil questionnaire, which was designed to assess levels of psychosocial stress, anxiety, and depression. Self-reported patterns of alcohol use were also assessed. In general, males reported higher levels of alcohol use and more friends who drink, compared to females. The study also found generational differences in drinking patterns. A strong association between psychosocial stress, depression, and alcohol use also was found, suggesting that Hispanic adolescents are using alcohol as a way of coping with conflicts in adapting to the norms and expectations of the dominant group and other difficult events and conditions that produce psychological distress.Received Ph.D. in 1988 from the University of California, Los Angeles, specializing in developmental psychology. Research interests include the educational attainment of Hispanic and minority children, alcohol use among adolescents, and social policy.     

Interpersonal and self-critical dysphoria and behavioral problems in adolescents

Clinical evidence suggests that various problem behaviors in adolescence can be expressions of dysphoria that have not reached threshold for the diagnosis of depressive disorders. Formulations of two major types of dysphoria distinguish between disruptions of interpersonal relatedness (e.g., feelings of loss or abandonment) and diminished self-esteem (e.g., feelings of self-criticism, failure, or guilt). Adolescents in a suburban high school were given the Achenbach Youth Self-Report, the Adolescent Depressive Experiences Questionnaire, and the Community Epidemiological Survey of Depression for Children (CES-DC). Even after level of depressive symptoms (CES-DC) was partialled out in hierarchical multiple regressions, interpersonal dysphoria significantly accounted for additional variance in predicting internalizing disorders, while self-critical dysphoria added significantly to the explained variance of both internalizing and externalizing disorders, specifically delinquency and aggression in both males and females.Ph.D., 1957, University of Chicago. Research interests: The development of mental representations, their differential impairment in various forms of psychopathology (especially depression), and their change in the therapeutic process.Ph.D., 1981, Yeshiva University. Research interests: adolescent pregnancy, depression, and ego development.Ph.D., 1968, Yale University, New Haven, Connecticut. Research interests: cognitive processes in schizophrenia, dependency and self-criticism in depression, and cognitive structural models of development and psychopathology.Ph.D., 1986, Columbia University, New York. Research interests: adolescent development.Ph.D., 1988, State University New York—Buffalo. Research interests: Language and self-representation and narcissism and borderline disorders.     

Relationship of life events and social support with psychological dysfunction among adolescents

Relationships among major life events, perceived social support, and psychological disorder were assessed in a sample of older adolescents. Negative life events and satisfaction with social support were significantly and independently related to a range of psychological symptoms. Further, the relationship between negative events and disorder was moderated by gender, the types of events experienced, and anticipated change in the psychosocial environment. The importance of the use of standardized and psychometrically sound measures of life events, social support, and psychological disorder is highlighted.Received his Ph.D. from UCLA in 1980. An assistant professor, he is currently investigating stress and coping among children and adolescents.Received her Ph.D. from the University of Vermont in 1985. An assistant professor, she is currently studying social support.Received Ed. M. from Harvard Universtiy. He is a doctoral student in clinical psychology interested in the role of social support in coping with stress during adolescence.Received her BA from the University of Vermont. She is a doctoral student in clinical psychology.