Coping with challenge in adolescence: a conceptual model and psycho-educational intervention

A Qualitative Assessment of Adolescent Girls' Perception of Living with Congenital Heart Disease: Focusing on Future Pregnancies and Childbirth

PURPOSE

Congenital heart disease (CHD) is the most common birth anomaly in Japan, occurring in approximately 10.6 of every 1,000 live births. Advancements in medical and surgical care have increased births by women diagnosed with CHD. The study's purpose was to examine the perceptions of pregnancy and childbirth among adolescent girls with CHD.

DESIGN AND METHODS

Twelve semi-structured interviews were conducted, and the data were analyzed using a modified grounded-theory approach.

RESULTS

Three categories and 16 subcategories were extracted. Adolescent girls with CHD reported feelings of distress and anxiety while struggling with their disease, and feared how their disease might negatively influence their future pregnancy. These concerns were related to a desire to become familiar with CHD. The girls also explored how their disease would be managed during pregnancy and childbirth. Overall, these perceptions were influenced by the girls' acceptance of their disease, and support from family, friends, and healthcare professionals.

CONCLUSIONS

Healthcare professionals might assess adolescent girls' awareness of their disease before discussing pregnancy and childbirth risks. To encourage them to understand and cope with their disease, healthcare professionals might provide interventions tailored to the timing, stage, and degree of pregnancy and childbirth awareness. This could allow safer life planning, especially concerning pregnancy and childbirth decisions.

PRACTICE IMPLICATIONS

To address adolescent girls' needs, healthcare professionals should continuously assess their awareness of pregnancy and childbirth as well as their psychological status, alongside CHD issues.

Exposure to Childhood Poverty and Mental Health Symptomatology in Adolescence: A Role of Coping Strategies

Childhood poverty is associated with stress dysregulation which contributes to psychological illness in later ages. The adverse effects of childhood poverty on stress regulation may be mediated in part by the use of disengaging strategies to cope with stress. However, the relations among childhood poverty, coping strategies and psychopathology throughout childhood to adolescence have not been explored. This prospective, longitudinal study included 185 low- and middle-income adolescents at age 17. Chronic exposure to poverty from birth to early adolescence (age 13) was prospectively associated with increases in the use of disengagement versus engagement coping four years later. Increased use of disengagement coping between the ages of 13 and 17 explained the indirect link between poverty exposure since birth and both externalizing and internalizing symptoms at age 17. The findings provide evidence for a coping pathway underlying the link between prolonged exposure to childhood poverty and mental health sequelae. Copyright © 2015 John Wiley & Sons, Ltd.

Stress, Coping, and Social Support among Homeless Youth

Evaluated in this study was the extent to which stress, coping strategies, and social support were associated with depressive symptoms, poor physical health, and substance use in homeless youth. Data were obtained from a stratified random sample of 432 homeless youth recruited.from service sites and street sites in Los Angeles, California. Stres,sful life events were associated positively with symptoms of depression, poor physical health, and substance use. Use of emotion-focused coping strategies increased the risk of symptoms of depression, poor health, and substance-use disorders, whereas use of problem-focused coping strategies decreased the risk of alcohol use disorder and poorhealth. Social support decreased the risk of symptoms of depression and poor health but was not related to the risk of substance use. Results indicate that effective coping skills and social support may counteract the negative efficts of stressful life events on physical and psychological health in homeless youth.

A Descriptive Study of Urban Mexican American Adolescents’ Perceived Stress and Coping

In this descriptive study, the perceived stress, coping, and coping effectiveness of 158 low-income, urban, Mexican American 10th graders were assessed using open-ended and structured interview procedures. A total of 95% of participants were able to identify a difficult life event stressor and at least one way they coped with this event. Participants, particularly females, most frequently identified family-related events as being the most difficult recent life event stressor. To manage stress, participants most commonly reported using active coping strategies, followed by family social support, self-reliance, and behavioral avoidance. Females were more likely than males to seek family support and to vent emotions when coping with stress. Participants were most likely to use active, problem-focused strategies when confronting school-and personal-related stressors, and to find coping most helpful when dealing with stressful school events. Findings are discussed in terms of the urban, ethnic-minority backgrounds of participants and directions for further research.

Latino Students in North Carolina

This study describes results from an investigation of Latino students attending a Hispanic Education Summit (HES) in North Carolina. Findings from data gleaned from 275 middle and high school students' perceptions are presented. Self-report data assessed level of acculturation, as well as students' perceptions with regard to a variety of issues, including school programs, barriers to participation in programs, problems in the school environment, and academic aspirations. Results revealed that students reported few perceived barriers to school and aspirations. However, there was a significant relationship between acculturation level and the frequency with which students reported selected barriers and future life goals. Gender differences were found with regard to acculturation level, perception of barriers, and academic aspirations. Directions for further research are discussed.

Interprofessional Collaboration for Children and Families:

As societal forces affect the well-being of children, youth, and families, professionals are changing the ways they practice and the settings in which they work In this article, the authors point toward interprofessional collaborations and integrated service systems as promising reform efforts that present opportunities and challenges for counseling psychologists. The authors describe the history and commitments of counseling psychology that position the profession to meet these challenges and the changes in focus and roles necessary to do so. Finally, efforts underway at Boston College are described as one exanlple of counseling psychologists engaged in interprofessional collaboration within schools.

Attachment to Parents and Adjustment in Late Adolescent College Students

The attachment model holds considerable promise for understanding the challenges and adjustment vicissitudes of late adolescent college students. The model is potentially valuable for counseling psychologists, further more, in linking knowledge of developmental theory with counseling intervention and prevention. Existing research supports an association between secure parental attachment and adjustment for first-year college students. A variety of methodological challenges, however, need to be addressed in order to fully assess the validity of attachment-based developmental and intervention models, especially for women and culturally and racially diverse college students.

Coping skills training for adolescents at school

This study investigates the effect of a coping skills program “The Best of Coping” on adolescents’ coping style and self-efficacy and highlights a model of program delivery through the collaboration of school staff and a school psychologist Eighty-eight adolescents were recruited from a Melbourne suburb and divided into treatment and control groups, with the treatment group receiving the program. All participants completed the Adolescent Coping Scale and Perceived Control of Internal States questionnaires prior to and after the program was conducted. Results showed significant decreases in nonproductive coping and increases in self-efficacy for the treatment group postprogram and a trend indicating increases in productive coping. The findings are discussed with regard to the need to implement programs that can teach adolescents optimism and problem-solving skills so that they may handle problems and stressors more effectively. With the increase in depression and suicide rates, the need to provide school based programs is discussed, with particular emphasis placed on program implementation by collaboration of the school psychologist with teachers.

A prospective study of religiousness and psychological distress among female survivors of Hurricanes Katrina and Rita

This prospective study examined the pathways by which religious involvement affected the post-disaster psychological functioning of women who survived Hurricanes Katrina and Rita. The participants were 386 low-income, predominantly Black, single mothers. The women were enrolled in the study before the hurricane, providing a rare opportunity to document changes in mental health from before to after the storm, and to assess the protective role of religious involvement over time. Results of structural equation modeling indicated that, controlling for level of exposure to the hurricanes, pre-disaster physical health, age, and number of children, pre-disaster religiousness predicted higher levels of post-disaster (1) social resources and (2) optimism and sense of purpose. The latter, but not the former, was associated with better post-disaster psychological outcome. Mediation analysis confirmed the mediating role of optimism and sense of purpose.

The relationship between the age of onset of type 1 diabetes and the subsequent development of a severe eating disorder by female patients

OBJECTIVES

To determine the age of onset of type 1 diabetes that is most closely related to the subsequent development of a severe eating disorder such as anorexia nervosa (AN) or bulimia nervosa (BN).

METHODS

Participants were 53 female type 1 diabetes patients with AN or BN referred to our outpatient clinic from the Diabetes Center of Tokyo Women's Medical University. Forty-nine female type 1 diabetes patients who regularly visited the Diabetes Center and had no eating disorder-related problems constituted the 'direct control' group, whereas 941 female patients who for the first time visited the Diabetes Center constituted the 'historical control' group. The kernel function method was used to generate a density estimation of the onset age of each group and the chi-square test was used to compare the distribution.

RESULTS

The control groups had similar density shapes for the onset age of type 1 diabetes, but both differed from the 'eating disorder' group. For onset age 7-18 yr, the density of the 'eating disorder' group was higher than those of the control groups, but for the younger and older onset ages the densities were lower. The 'eating disorder' group developed type 1 diabetes significantly more frequently than the 'historical control' group between 7 and 18 yr of age (χ2 = 9.066, p < 0.011).

CONCLUSION

The development of type 1 diabetes in preadolescence or adolescence seems to place girls at risk for the subsequent development of AN or BN. Careful attention should be paid to these high-risk patients.

Contextual stress and health risk behaviors among African American adolescents

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

Contextual stress and health risk behaviors among African American adolescents

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.

Coping With Daily Stressors

Using daily diary methodology, 67 Mexican American adolescents completed measures assessing daily stressors experienced, specific coping strategies employed with reference to these stressors, and indices of psychological health over 5 consecutive days. With respect to coping usage, adolescents reported they most often used planning and least often used humor to cope with stress. Significant intraindividual and interindividual variability was found for each coping strategy and psychological health. When this variability was modeled, adolescents who reported using more direct problem solving, positive thinking, acceptance, and humor reported more positive affect. Adolescents who reported using more religious coping, distancing, and acceptance reported more negative affect. These findings indicate that intraethnic variability exists at the daily stressor level in Mexican American adolescents and that this variability in coping is predictive of daily psychological health. Discussion focuses on the developmental importance of flexible coping repertories in Mexican American adolescents and the (mal)adaptive nature of specific coping strategies.

Rural adolescents experiencing an urban transition

OBJECTIVE

To determine the distress levels of adolescents leaving rural Queensland towns for urban boarding schools.

DESIGN

A questionnaire study and focus groups were used to collect data from students who made the transition and those who did not.

PARTICIPANTS

Two hundred and fifty-five rural students completed the questionnaire and of these 36 left home to attend an urban boarding school. Twenty-eight students participated in one of five focus groups.

MEASURES

Self-report scales administered were Life Events Scale and the Depression, Anxiety, Stress Scale. A semistructured set of prompts was used in the focus groups.

RESULTS

Both methodologies revealed adolescents reported coping well with the transition from rural and remote family homes and schools to boarding school in the city. Reported distress levels of those who moved were no higher than those who did not and homesickness, while common, was rarely high or enduring. Adolescents who moved offered useful insights in the focus groups into the best and worst aspects of the transition; how best to cope, and how families and schools can ease their path.

CONCLUSIONS

In general, adolescents who leave isolated homes and schools to board in the city manage the transition surprisingly well and regard the transition as having a number of advantages. Being prepared for the move emerged as important.

Towards a model of suicidal ideation for Hong Kong Chinese adolescents

This study tested a model of suicidal ideation with family cohesion, expressiveness, conflicts, teacher support, teacher-student relationships and peer support as antecedents, and self-esteem and depression as mediators. Data was collected from survey questionnaires with 433 Hong Kong Chinese adolescents. The results showed that only family cohesion, conflicts, teacher support and peer support significantly predicted self-esteem and depression, with depression being a strong mediator of suicidal ideation. Implications of the findings for future research were discussed.

Coping responses and problem appraisal in Spanish adolescents

This study uses Moos's Coping Responses Inventory (Youth Form, 1993) to examine coping behavior in Spanish adolescents. 1362 adolescents were recruited from the metropolitan area of Barcelona, Spain. All subjects were in high school and ages 12 to 16 years. The socio-economic status was primarily middle class. Adolescents' coping behaviors were examined by sex and age, and the relationship between problem appraisal and choice of coping strategy was analyzed. Girls used more approach, avoidance, and behavioral responses than boys, especially Logical Analysis, Seeking Guidance and Support, and Emotional Discharge strategies. At older ages, Logical Analysis and Emotional Discharge became more frequent in girls and Cognitive Avoidance less frequent in boys. The results also suggest that problem appraisal has only a limited effect on the selection of coping strategies and that only few strategies are related to the problems' outcomes.

Violence, coping, and mental health in a community sample of adolescents

The current study examined the coping strategies, exposure to violence and psychological trauma symptoms of violent adolescents compared to less violent and nonviolent adolescents in a community sample. An anonymous self-report questionnaire was administered to students in six public high schools (grades 9-12). The 10% most violent adolescents were identified and compared to their less violent and nonviolent peers. A total of 3724 students represented 68% of adolescents in all targeted schools. Ages ranged from 14 to 19 years; 52% were female; and 35% were African-American, 34% Caucasian and 23% Hispanic. Analyses revealed that violent adolescents compared to their less violent and nonviolent peers employed more maladaptive coping strategies, were exposed to higher levels of violence and reported higher clinical levels of psychological trauma symptoms. Maladaptive coping was also significantly associated with psychological trauma symptoms and violent behavior, even after controlling for the influence of demographic factors. The findings support the importance of appropriate identification, assessment and referral services for adolescents in nonclinical settings, and the role that coping strategies play in contributing to adolescent mental health and well-being.

Können Unterschiede in Stresswahrnehmung und -bewältigung Geschlechtsunterschiede in der depressiven Symptombelastung bei Jugendlichen erklären?

Zusammenfassung: Die vorliegende Längsschnittstudie untersucht den differentiellen Beitrag von Belastung, Bewältigung und sozialen Beziehungen zur Erklärung depressiver Symptombelastung im Jugendalter. 101 weibliche und 89 männliche Jugendliche nahmen an vier jährlichen Erhebungswellen teil, in denen depressive Symptome, Alltagsbelastungen, Konflikte mit Eltern und Freunden, der Copingstil sowie das Selbstkonzept untersucht wurden. Im Alter von 14 Jahren wurden bei weiblichen im Vergleich zu männlichen Jugendlichen ein höheres Ausmaß an Alltagsstressoren, mehr Konflikte in der Beziehung zur Mutter sowie mehr vermeidendes Coping festgestellt; männliche Jugendliche wiesen zu allen Messzeitpunkten weniger depressive Symptome und ein positiveres Selbstkonzept auf. Regressionsanalysen ergaben, dass depressive Symptombelastung bei weiblichen Jugendlichen in der späten Adoleszenz konsistent durch alltägliche Belastungen und vermeidendes Coping in der frühen und mittleren Adoleszenz vorhergesagt werden konnte. Bei männlichen Jugendlichen hingegen trug lediglich das Ausmaß an Konflikten in der Beziehung zu Freunden in der frühen Adoleszenz zur Erklärung der depressiven Symptombelastung in der späten Adoleszenz bei.

Social relationships and health: the meaning of social "connectedness" and how it relates to health concerns for rural Scottish adolescents

Adolescence has been posited as an important period for the onset of mental health problems and for the need to adapt successfully to many psychosocial changes. The assumption has been made that social belonging is both a health-related goal and an antidote for other sorts of emotional crises, but there is little research on how normal adolescents themselves view connections between social relationships and their physical and mental health. This qualitative study examines how social connectedness represents both a content and process variable in northern Scottish young people's discussion of their health concerns, that is, it was both a source of distress and implicated as a helpful or harmful factor in relation to other health concerns. Analyses revealed both the potency of all of these concerns and participants' belief that skills acquired now could affect their future life goals and health. Suggestions are given for building new approaches for conceptualizing rural young people's health problems and helping them cope with the social contexts involved within and around them.

Teenagers: mental health and psychological issues

Adolescence is a developmental period marked by multiple challenges and demands which create a heightened vulnerability to the development of emotional disorders. Primary care physicians are in an ideal position to intervene in the early stages and prevent the tragic consequences which can occur with an untreated mental health disorder. This article reviews the assessment and treatment of adolescent mental health in the primary care medical setting. Knowledge of these disorders and their manifestations in the primary care environment will enable clinicians to provide higher quality medical care and will reduce the potential for continual life disruptions into the adult years.