Adolescent Development and Sexting

The early identification of developmental delay in adolescents by health professionals is relevant for a good prognosis. However, the clinical indicators of development delay are unclear in nursing science. To analyze the clinical indicators of delayed development in school adolescents. A diagnostic accuracy study that investigated delayed development among 385 adolescents in public schools between July and September of 2017. The accuracy measures were analyzed using a latent class analysis based on sensitivity and specificity values. The delayed development is present in 18.26% of school adolescents. The best accuracy values were as follows: low self-esteem (0.9838), dissatisfaction with own image (0.8400), impaired daily activities (0.9815), internalization behavior (0.8304), outsourcing behavior (0.6367), eating disorders (1.0000), emotional insecurity (0.7093), dependent behavior (0.9836), and altered sexual maturation (0.6085). Thus, this set of nine clinical indicators can be used by nurse practitioners to confirm delayed development in school adolescents. This research contributes by providing accurate clinical indicators of delayed development in adolescents. Thus, nurses should recognize delayed development in adolescents through accurate clinical indicators and propose nursing interventions that have positive health results.

We describe a series of analyses that were carried out using the Constraining and Enabling Coding System (CECS). This scheme was specially constructed to identify family interactions conceptually relevant to adolescent ego development. We present results based on the application of these scales to observations of 80 families, consisting of two parents and an adolescent drawn from closely matched high school and psychiatric populations. The families are predominantly upper middle and middle class. Each family member completed the Loevinger Sentence Completion Test and then participated in a revealed-differences task, using responses to Kohlberg Moral Dilemmas as discussion stimuli. Transcripts of these audiorecorded discussions form the database for our family analyses. The family analyses were of two general types. First, we examined relations between family style and the ego development of each family member. The style analyses were based on aggregate scores for each of the enabling or constraining behaviours. After controlling for patient status, adolescent age, and family social class, adolescent and parent ego development scores contributed to explained variance in these family style behaviours. Parental style behaviours, especially of mothers, were also significantly associated with parent ego development as well as adolescent ego development. We then examined family sequences in terms of their links with adolescent ego development. Through these process-oriented analyses, we discovered that the intensity of turn taking and reciprocal enabling (mutual enabling) interactions between mothers and adolescents were significantly enhanced by the ego development of the mother. Such associations between reciprocal interactions and parental ego development were not present for mutual enabling pairings between fathers and adolescents. In our discussion we consider the importance of adding these sequence analyses to our studies, as one more way of exploring relations between family factors and adolescent development.

BackgroundThe construct “identity” was discussed to be integrated as an important criterion for diagnosing personality disorders in DSM-5. According to Kernberg, identity diffusion is one of the relevant underlying structures in terms of personality organization for developing psychopathology, especially borderline personality disorder. Therefore, it would be important to differentiate healthy from pathological development already in adolescence. With the questionnaire termed AIDA (Assessment of Identity Development in Adolescence), a reliable and valid self-rating inventory was introduced by Goth, Foelsch, Schlueter-Mueller, & Schmeck (2012) to assess pathology-related identity development in healthy and disturbed adolescents. To test the usefulness of the questionnaire in Mexico, we contributed to the development of a culture-specific Spanish translation of AIDA and tested the reliability and aspects of validity of the questionnaire in a juvenile Mexican sample.MethodsAn adapted Spanish translation of AIDA was developed by an expert panel from Chile, Mexico, and Spain in cooperation with the original authors, focusing on content equivalence and comprehensibility by considering specific idioms, life circumstances, and culture-specific aspects. The psychometric properties of the Spanish version were first tested in Mexico. Participants were 265 students from a state school (N = 110) and private school (N = 155), aged between 12 and 19 years (mean 14.15 years). Of these, 44.9% were boys and 55.1% were girls. Item characteristics were analyzed by several parameters, scale reliability by Cronbach’s Alpha, and systematic effects of gender, age, and socioeconomics by an analysis of variance (ANOVA). We evaluated aspects of criterion validity in a juvenile justice system sample (N = 41) of adolescent boys in conflict with the law who displayed various types of behavioral problems by comparing the AIDA scores of a subgroup with signs for borderline pathology (N = 14) with the scores obtained in the student sample using T-tests.ResultsThe psychometric properties of the Spanish version of AIDA proved satisfactory in the Mexican sample for items as well as scales. The reliability coefficients were α = .94 for the total scale “Identity Diffusion”, α = .85 and .92 for the two primary scales “Discontinuity” and “Incoherence”, and between α = .70 and .83 for the subscales. However, some items of the item pool in the Spanish version of AIDA did not meet all criteria for test equivalence and should thus be reformulated, taking the Mexican culture into account. Significant effects for gender and age were found. In line with our theory, the AIDA scores in the domains “Discontinuity” (high effect size) and “Incoherence” (medium effect size) were markedly higher in the delinquent boys than in the student group.ConclusionThe Spanish version of AIDA can be used in Mexico with satisfying psychometric properties, with only minor adaptions required. Our study contributes to the intercultural applicability of the AIDA instrument using the construct “identity integration vs. diffusion” as it was defined in the AIDA model for diagnostic purposes. Cultural differences, even those present in the various Spanish-speaking countries, should be modeled carefully.

This paper examines the effects of adverse childhood experiences on adolescent identity development and mental health. A sample of 200 adolescents aged 12-18 was analyzed using SPSS. The tools used to investigate this study were the ACE questionnaire, Erikson psychosocial stage inventory, Beck depression inventory, state-trait anxiety inventory, and peer relations scale. The results indicated a significant positive relationship between ACE score and depression, anxiety, and disrupted identity formation. The mediating effect of peer victimization on all these aspects was revealed, while social support functioned as a possible protective factor. These findings emphasize the importance of early interventions for adolescents with ACEs and opportunities for further study into mechanisms and protective variables. This study is essential for highlighting the lasting impact that childhood adversity has on adolescent development. By identifying and recognizing key risk factors and protective elements, this research contributes to the formation of targeted interventions that foster resilience, improve mental health outcomes, and support healthy adolescent identity formation.

The retardation of psychosexual development and its impact on man's sexual life and sexual identity: a clinical case

BackgroundIn the continuing revision of Diagnostic and Statistical Manual (DSM-V) “identity” is integrated as a central diagnostic criterion for personality disorders (self-related personality functioning). According to Kernberg, identity diffusion is one of the core elements of borderline personality organization. As there is no elaborated self-rating inventory to assess identity development in healthy and disturbed adolescents, we developed the AIDA (Assessment of Identity Development in Adolescence) questionnaire to assess this complex dimension, varying from “Identity Integration” to “Identity Diffusion”, in a broad and substructured way and evaluated its psychometric properties in a mixed school and clinical sample.MethodsTest construction was deductive, referring to psychodynamic as well as social-cognitive theories, and led to a special item pool, with consideration for clarity and ease of comprehension. Participants were 305 students aged 12–18 attending a public school and 52 adolescent psychiatric inpatients and outpatients with diagnoses of personality disorders (N = 20) or other mental disorders (N = 32). Convergent validity was evaluated by covariations with personality development (JTCI 12–18 R scales), criterion validity by differences in identity development (AIDA scales) between patients and controls.ResultsAIDA showed excellent total score (Diffusion: α = .94), scale (Discontinuity: α = .86; Incoherence: α = .92) and subscale (α = .73-.86) reliabilities. High levels of Discontinuity and Incoherence were associated with low levels in Self Directedness, an indicator of maladaptive personality functioning. Both AIDA scales were significantly different between PD-patients and controls with remarkable effect sizes (d) of 2.17 and 1.94 standard deviations.ConclusionAIDA is a reliable and valid instrument to assess normal and disturbed identity in adolescents. Studies for further validation and for obtaining population norms are in progress and may provide insight in the relevant aspects of identity development in differentiating specific psychopathology and therapeutic focus and outcome.

This module, Developmental Perspectives of Emotions and Illness, discusses the impact of development on a child's understanding and experience of illness. Cognitive developmental influences are emphasized and the concepts of “immanent justice” (the belief that a form of natural justice exists and is the consequence of misdeeds), germ theories, and contagion are illustrated via a video clip interview with a 12 year old girl. Influences on the adaptation of children and adolescents to medical conditions related to onset, etiology, diagnosis, disability/deformity, and prognosis are reviewed and the concept of risk/protective factor is introduced. Additionally, pediatric hospitalization and its influential variables and developmental considerations are highlighted via a video clip interview of two boys (ages 12 and 14) discussing the older boy's hospitalization at age 10. Strategies to maximize coping in the ill child as well as other family members are reviewed. This submission is one of six modules which can be used together as a complete course or independently by topic. Each module uses teaching tools which include learning objectives, lecture outline lecture text, clinical correlations or case vignettes, sample test questions, recent related research, after-class exercises or activities, audiovisual aids including some dedicated teaching clips or transcripts, bibliographies, and PowerPoint presentations. It is not unusual for medical learners to devalue course material deemed “soft science” even when the learner is psychologically sophisticated, particularly when taught concurrent with challenging and volume intensive courses requiring memorization of many details. Such was the case when this course was instituted at a large medical school 15 or more years ago. Because educational leaders felt the material to be essential to the learner's integration of the “biopsychosocial” approach to patient care, and also supported on of the course's tenets (that improved self-understanding and self-reflection supports physician self-care and the doctor-patient relationship), course leaders undertook a process of course examination and improvement which is ongoing. Included in this submission are assessment samples from in-house course evaluations and also from other institutions exposed to the materials that support the success of this curriculum. The authors of this submission believe that the comprehensive course format utilizing a multi-media approach, lectures as well as after-class activities, case correlations, etc. appeals to almost all learners.

This study focuses on the impact of extended family on the family environment of secondary school students. We examine to what extent extended family members (i.e. grandparents, aunts, uncles, cousins and similar relatives) contribute to academic performance, social skills and emotional/extracurricular well-being of the student. The family environment refers to both the social and emotional environment of family settings and is a strong predictor of adolescent development. The current study uses qualitative research intended as a literature review and is based on secondary data and surveys regarding extended family involvement in adolescent development. It is anticipated that extended family acts as a protective function against stress and encouragement of resource development for later academic studies and adolescent well-being development. The survey data analysis considers how the number of interactions with extended family contributes to student scores in grade point average, extracurricular participation, and self- reported happiness and contentment. Preliminary data suggests that students who have regular support from extended family have better emotional resilience, and belonging. Data from qualitative interviews shed light on possible mechanisms through which this support works, such as, intergenerational knowledge transfer, where older family members recount life experiences and their practical advice, and the provision of childcare to reduce parental stress resulting in a safer home environment. The findings also identify variances in the composition of support, based on culture and socio-economic status. This study draws attention to the important, and often underestimated, role of extended family in secondary school students' development. It also shows that to better understand a child's family, it is best to expand understanding beyond the nuclear family, and include extended family, and every person's kinship network. The findings have implications for educational policies, and family counselling, by suggesting that acknowledging and collaborating with a child's extended family systems should be integrated into all adolescent support programs.

Adolescent ego development: relationship to family cohesion and adaptability

This is a short book with a 130-page introduction that takes up almost 40% of the written material. It has brief chapters covering fetal through late adolescent growth and development. It could best be described as an overview of an incredibly vast amount of material, but not in enough detail to qualify as a practical text or a comprehensive reference. I find it to be interesting reading but mostly covering material available in other sources and lacking any originality in its style of presentation. It does contain valuable material for medical students who are rotating through general pediatrics, adolescent medicine, or developmental pediatrics, although not as a required primary text. I find the chapter on fetal development sufficiently convincing that we are dealing with indispensable humanity and not disposable amorphous tissue. In the chapter on the newborn it is fascinating to discover what an intelligent infant, with memory and preferences,

White matter and latency of visual evoked potentials during maturation: A miniature pig model of adolescent development

Experiences of early life stress are associated with long-term socioemotional, cognitive and mental health challenges. Despite the growing interest in elucidating the neurobiological consequences of early life stress, relatively little is known about its specific impacts on adolescent white matter maturation. The objective of this systematic review was to consolidate the current literature on neuroimaging studies utilizing diffusion tensor imaging to investigate white matter correlates of early life stress experiences in adolescents (10–25 years). A comprehensive search of online databases identified 546 studies, with 22 studies meeting the inclusion criteria. Early life stress was consistently associated with alterations across several white matter pathways, across Association, Projection and Commissural tracts. Compared to healthy controls, perturbed white matter integrity was observed in adolescents with early life stress exposure, as indexed by both increased and decreased fractional anisotropy. Compromised white matter integrity can have extensive impacts on adolescent development and associated functioning, including emotional dysregulation, mood instability, executive dysfunction, and sensorimotor impairments. Limitations of the current evidence base include the inconsistencies in the measurement of early life stress exposure and the lack of longitudinal research. Future investigations should track developmental trajectories of early life stress exposure and determine how this impacts adolescent neural connectivity.

IntroductionSalivary bioscience has found increased utilization within pediatric research, given the non-invasive nature of self-collecting saliva for measuring biological markers. With this growth in pediatric utility, more understanding is needed of how social-contextual factors, such as socioeconomic factors or status (SES), influence salivary bioscience in large multi-site studies. Socioeconomic factors have been shown to influence non-salivary analyte levels across childhood and adolescent development. However, less is understood about relationships between these socioeconomic factors and salivary collection methodological variables (e.g., time of saliva collection from waking, time of day of saliva collection, physical activity prior to saliva collection, and caffeine intake prior to saliva collection). Variability in salivary methodological variables between participants may impact the levels of analytes measured in a salivary sample, thus serving as a potential mechanism for non-random systematic biases in analytes.MethodsOur objective is to examine relationships between socioeconomic factors and salivary bioscience methodological variables within the Adolescent Brain Cognitive Development Study© cohort of children aged 9–10 years old (n = 10,567 participants with saliva samples).ResultsWe observed significant associations between household socioeconomic factors (poverty status, education) and salivary collection methodological variables (time since waking, time of day of sampling, physical activity, and caffeine intake). Moreover, lower levels of household poverty and education were significantly associated with more sources of potential bias in salivary collection methodological variables (e.g., longer times since waking, collections later in the day, higher odds of caffeine consumption, and lower odds of physical activity). Consistent associations were not observed with neighborhood socioeconomic factors and salivary methodological variables.DiscussionPrevious literature demonstrates associations between collection methodological variables and measurements of salivary analyte levels, particularly with analytes that are more sensitive to circadian rhythms, pH levels, or rigorous physical activity. Our novel findings suggest that unintended distortions in measured salivary analyte values, potentially resulting from the non-random systematic biases in salivary methodology, need to be intentionally incorporated into analyses and interpretation of results. This is particularly salient for future studies interested in examining underlying mechanisms of childhood socioeconomic health inequities in future analyses.

Back to table of contents Previous article Next article Letters to the EditorFull AccessASAP's Role RecognizedMark A. Wellek, M.D., Mark A. WellekSearch for more papers by this author, M.D., Past PresidentPublished Online:17 Jun 2005https://doi.org/10.1176/pn.40.12.00400038Thank you for the article in the April 5 issue on the successful fight against the juvenile death penalty in the Supreme Court case Donald Roper v. Christopher Simmons (“Court Bars Death Penalty for Youth Under Age 18”). The article noted how APA and the American Academy of Child and Adolescent Psychiatry (AACAP) signed onto a brief in the case submitted to the Supreme Court. I would like to point out the actions of a prime and early mover on the issue, the American Society for Adolescent Psychiatry (ASAP).In 1986 ASAP initiated and sponsored the original psychiatric argument in its amicus curiae brief in the case Thompson v. Oklahoma. At the time, ASAP was the only organization to sign on to an amicus brief concerning adolescent development. That brief was repeatedly referenced in the Supreme Court's decision in 1988 to strike down the death penalty for capital crimes committed by children and adolescents below the age of 16.I was also active within APA on this issue, and I was instrumental in bringing the issue to the Council on Children, Adolescents, and Their Families. In 2001 the council referred AACAP's position statement opposing the juvenile death penalty to APA's Joint Reference Committee (JRC) for possible adoption by APA. The JRC referred the statement to the Council on Psychiatry and Law, which revised it. The statement was subsequently approved by the Assembly in May 2001 and by the Board of Trustees a month later.In that same timeframe, ASAP joined with the Juvenile Death Penalty Initiative of the American Bar Association and one of its able leaders, attorney Stephen Harper. We wrote letters under the auspices of our respective organizations to the governors of Texas, Oklahoma, Missouri, and Kentucky asking them to commute the death sentences of adolescent offenders. We had some success and helped to slow and even to prevent some executions. Subsequently I testified on adolescent brain development before the South Dakota legislature. In March 2004, Gov. Michael Rounds signed a law raising the age of eligibility for the death penalty to 18.Finally, in 2003 ASAP initiated another amicus brief, and APA's Board of Trustees voted to sign on in June 2004. Dr. Robert Weinstock, the current president of ASAP and a member of APA's Committee on Judicial Action, played a key role in revising the language to improve it.A summary of the brief's arguments states, “The adolescent's mind works differently from ours.... Scientists have documented the differences along several dimensions. Adolescents as a group, even at the age of 16 or 17, are more impulsive than adults. They underestimate risks and overvalue short-term benefits. They are more susceptible to stress, more emotionally volatile, and less capable of controlling their emotions than adults.“In short, the average adolescent cannot be expected to act with the same control or foresight as a mature adult.”This brief is now history, and we in ASAP feel a strong sense of pride as part of the large coalition of professional and advocacy groups that worked together to end the execution of juvenile offenders in the United States.American Society for Adolescent Psychiatry ISSUES NewArchived

Cognitive and Neurocognitive Development in Adolescence