Serious safety concerns have been raised recently about the use of second generation antipsychotics (SGAs), in young patients. In this population based study, utilization of antipsychotics use in the youth population of Manitoba between 1996 and 2011 was determined. Rates of adverse events (diabetes, hypertension, EPS) were compared among the users of SGAs. School enrolment and high school completion rates were evaluated for young users. Databases from the Population Health Research Data Repository, housed at the Manitoba Centre of Health Policy were accessed. Increased utilization (prevalence: 2.3 to 9 per 1,000 persons; incidence: 1.2 to 2.7 per 1,000 between 2001 and 2011) of SGAs was observed in the youth population of MB. The most common diagnosis recorded were Attention Deficit Hyperactivity Disorder (56.8%), Conduct Disorders (38%) and Mood Disorders (22.7%). Olanzapine therapy seemed to be associated with a higher risk of hypertension compared to risperidone users (HR: 2.52, 95% CI: 1.20 – 5.29). Risperidone users seemed to be at higher risk of EPS than quetiapine users (HR: 0.46, 95% CI: 0.26 – 0.82). School enrolment of SGAs users appeared to be comparable to those reported for the general population. High school completion rates may be lower than those of the general population.

ADHD medication use has grown substantially, yet, little is known about treatment-seeking and prescription practices in the absence of ADHD diagnoses. This project utilized data from the National Comorbidity Survey-Adolescent Supplement, a survey of adolescent psychiatric disorders in the U.S. Rates of medication use, and the influence of prescriber specialty and treatment encouragement, on medication use were investigated among adolescents with ADHD, sub-threshold ADHD, and without ADHD. Findings showed that a small but notable proportion of adolescents in the sub-threshold and no ADHD groups took medication for ADHD. Encouragement from psychiatrists but prescriptions from family doctors were associated with medication use. These findings suggest that adolescents with minimal symptoms may be medicated for behaviour within the range of normal, whereas those with numerous symptoms may not be receiving adequate treatment. Second opinions may assist in proper dosage and treatment. The influence of encouragement from psychiatrists and prescribing physicians is discussed.

In this thesis, an exploration of the factors that prohibit and/or contribute to counsellors incorporating spiritual conversations in their practice with adolescent (10-15yrs) clients takes place. Through a narrative inquiry method participants from the University of Victoria in a masters level program in Child and Youth Care or Educational Psychology and Leadership Studies describe personal and professional reasons to support the inclusion or exclusion of spirituality in counselling practices with adolescents. Results indicated that practitioners’ personal experiences of grappling with spirituality and religion, professional policies outlining if a practitioner can or cannot converse with their client regarding spirituality, and the lack of educational training to incorporate spirituality for soon-to-be practitioners all strongly played into a practitioners’ reasoning to refrain from or engage in spiritual conversations with their clients. In order to move forward it is vital that practitioners begin to recognize that children and youth are spiritual beings, that educational programs within the helping professions include spiritual training, that practitioners are supported by supervisors when they feel that the inclusion of spiritual conversations is vital in their practice, and that organizational policies are adapted to allow practitioners the necessary time and space to engage in spiritual conversations with adolescent clients. / Graduate

This longitudinal study investigated the course and changes in the time-varying covariation between peer victimization and internalizing problems among adolescents who were transitioning into young adulthood, and proposed that initial levels of emotional support from fathers, mothers, and friends diminished the relation between peer victimization and internalizing problems over a four-year period. Sex and developmental transition group differences (for mid-adolescent transition group aged 12-15 years and late adolescent transition group aged 16-19 years) were explored. Participants included 639 adolescents aged 12 to 19 years at baseline testing. Physical and relational victimization, emotional support, and internalizing problems were assessed from adolescent‟s self-reports. Overall, findings revealed that on average internalizing problems increased over time, but also differed by developmental transition group. For the mid-adolescent transition group, increases in physical and relational victimization were significantly associated with increases in internalizing problems. For the late adolescent group, increases in relational victimization (and not in physical victimization) were significantly associated with increases in internalizing problems. Emotional support from fathers, mothers, and friends significantly impacted the time-varying covariation between peer victimization and internalizing problems, and findings differed by sex and transition group. For the mid-adolescent transition group, high levels of mother and father emotional support were associated with decreases in the association between peer victimization and internalizing problems for girls. High levels of friend emotional support were protective for boys, but were associated with increases in the association between peer victimization and internalizing problems for girls. For the late adolescent transition group, high levels of mother emotional support remained protective for girls, but high levels of father and friend emotional support were associated with increases in the association between relational victimization and internalizing problems. High levels of friend emotional support remained protective for boys. / Graduate / 0620

Recent statistic shows that about 28% of adolescents living in Stockholm drink alcohol at such a high level that their consumption counts as risky drinking. The correct term to use in this matter would be binge drinking adolescents.  In the more wealthy areas of Stockholm this group of binge drinking adolescents counts for as much as a third of the population. In contrast, the adolescents living in exposed areas do not drink nearly as much. Binge drinking adolescents in these areas only counts for 15%, nearly half as much as in the wealthy areas. In light of this the intentions of this study is to investigate which explanatory factors that can clarify the range-rated differences in binge drinking between adolescents in Stockholm. The basis for the analysis is the theory of social capital. In this study specifically, social capital defines as capital inherited from the adolescents’ immediate network.  These networks are their neighborhood, family, school and also the network-belonging that gains from leisure-participation. The analysis also includes control for the effects of parents’ attitudes toward alcohol, parental education and how friends’ drinking habits affect the probability of being risk consumer of alcohol. Furthermore all results are controlled for gender, age, provenance and the adolescences monthly allowance. The empirical material of this study consists of selected parts from the survey “Stockholmsenkäten 2012”. This survey is a cross-sectional study and comprehensive survey which is biennial answered by all Stockholm's public schools 9-th graders and year 2 in high school in.The correlation analyzes in this study is presented in the form of Logistic regression analysis in the statistical program “Statistical Package for the Social Sciences” (SPSS) The results in this study shows that the area-related differences in alcohol consumption cannot be explained by social capital. The young people's drinking habits is rather explained by parental attitudes towards alcohol and also by their friends' drinking habits. The absolute strongest correlation to belong to the group risk consumers of alcohol is when the adolescents have friends who consume alcohol. This statistical correlation persists regardless of geographical area belonging.

This research explores the concept of stress as it is perceived by children and builds a paradigm of this perception. The thesis argues that a cognitive paradigm is useful in understanding the stress process but seems incomplete without an acknowledgement of the role of unconscious cognition and phenomenology. This research extends this model to include these elements. A review of the literature includes an exploration of the definitions of the concept of stress and an examination and evaluation of the usefulness of the models of stress from which these definitions arise. From an initial literature review, a starting point in terms of an examination of "stressors" was identified and lead to a survey in this area. This led, in turn, to five subsequent investigations being undertaken for this thesis, each driven by questions and issues which emerged from the previous one. The methodology used in each study was different and driven by the questions that were under exploration. However, all had a qualitative philosophical base. The samples are described study by study and encompassed children from the age of eleven to adults. Results from this research confirm that triggers of and responses to stress are many and various. The individuals' perception of the stress appears to rest upon factors which include learned responses, social support and personality. Coping strategies are also many and various and likewise appear to rest upon the same mediating factors, as well as the individuals perceived control over the stressors. Suggestions are also offered for interventions that could be used in schools to help children to cope more successfully with stress. These suggestions look at the psychological environment of schools as well as the individual adolescents and events which may be stressful.

No description available.

Early-onset major depressive disorder (MDD) is associated with significant morbidity in adolescence. The interview-dependent diagnostic process used in psychiatry leaves a subset of adolescents with MDD undiagnosed. Sleep disturbances are a central feature of depression and adolescence is a period of rapid change in sleep physiology. The aim of this study was to test physiological features of sleep and circadian rhythms as markers of adolescent MDD. Adolescents completed a two-week protocol that included a formal psychiatric interview, polysomnographic (PSG) assessment, actigraphy, salivary melatonin sampling, and holter monitoring. Depressed adolescents (n = 18) differed from controls (n = 15) on features of sleep macroarchitecture measured by PSG, and on autonomic nervous system functioning measured by 24-hour heart rate variability. Depressed adolescents had shorter REM latency and decreased stage 4 sleep. Adolescents with MDD also showed decreased parasympathetic activity over 24-hours and during the day, and decreased sympathetic activity during the night.

Technological advances for treatment of congenital heart disease (CHD) have led to decreases in mortality over the past thirty years. Persistent morbidity into adolescence and adulthood necessitates regular medical follow-up and the influence of ongoing physical health issues on the teens emotional health merits clinician and researcher attention. Employing interpretive description research methodology, 22 interviews with teens aged 13-17 years were analyzed to understand how adolescents with CHD describe everyday life and relate to questions about quality of life (QOL). Although the majority of these teens viewed themselves as normal, CHD was a part of their everyday life that they situated into the foreground or background of their lives, as it suited their needs. These teens spoke of QOL issues in a concrete manner focusing on physical activity limitations and their need to fit in. Further discussion of these issues must be undertaken as adolescents with CHD transition to adulthood.

Assessments of quality of life (QOL) for adolescents have received relatively little attention in the literature. Although there is no consensus on the definition of adolescent QOL and what aspects should be measured, it is generally accepted that QOL is a multidimensional construct. Issues related to adolescent QOL bear special considerations since experiences of adolescents are substantially different from those of adults. The aim of this study is to provide a better understanding of adolescent QOL by assessing the impact of determinants of QOL over a six-month period. The study will also evaluate the measurement properties of the latent factors underlying adolescent OL based on a second-order confirmatory factor analysis. A recursive structural equation model is then proposed to determine the direction and magnitude of the interdependent effects among the latent factors. The Quality of Life Profile Adolescent Version (QOLPAV), a generic 54-item questionnaire was utilised. It was administered to 251 adolescents without a chronic condition and 112 adolescents with a chronic condition at baseline and the cohort of 204 adolescent without a chronic condition and 96 adolescents with a chronic condition a six months. Stratified sampling was used to recruit the adolescents from high schools in the Perth metropolitan area. Subjects were aged 10 to 19. A non-categorical approach was utilised to recruit adolescents with a chronic condition. To account for the hierarchical effects of the adolescents nested within schools multilevel modelling was undertaken to explore the potential determinants of adolescent QOL perceived in his/her life and the opportunities available were found to be significant predictors for adolescent QOL. However, as expected, health was rated poorer, with more sick days reported by chronically ill adolescents. / The results of the second-order confirmatory factor analysis suggested that adolescent QOL may be measured by five underlying constructs namely social, environment, psychological, physical health, and opportunities for growth and development. interdependent relations among these constructs identified the environment factor as primary, exerting both direct and indirect effects on the other four factors. A multivariate analysis of variance (MANOVA) also revealed no difference between chronically ill and healthy adolescents in their perceptions of the five constructs. Multilevel longitudinal analysis was performed to explore and quantify the variations in QOL over the six-month period. Although a large proportion of the variation can be accounted for by the covariates perceptions of physical health, age, control and opportunities, 38% of the variability in QOL scores was actually due to time. Similar to the baseline results, there was again no significant difference in the overall QOL scores between chronic and non-chronic adolescents at six months. Health was again rated poorer, with more sick days reported by chronically ill adolescents. The majority of both groups reported a positive QOL. Only 1% of the adolescents (non-chronic) reported a problematic QOL at baseline, which increased to 2.5% (non-chronic) at six months. There was also no significant change between the baseline QOL scores and those at six months. However, the social, physical health and opportunities for growth and development composite factor scores showed a decrease for both groups over the six months. The findings indicated that adolescents with a chronic condition do not view themselves different from their healthy counterparts in terms of QOL. The study enhanced our understanding of the effects of the broader determinants of adolescent health through a QOL perspective. / The perceptions that teachers, parents and health professionals have on the relative importance of different aspects of QOL for the adolescent with a chronic illness were separately explored using a three round Delphi study. The first round questionnaire identified the level of importance each of the three panels attached to sixteen aspects relating to QOL. Panelists were also encouraged to provide additional comments on why they felt a particular item was important to the chronically ill adolescent's QOL. In round two, panelists were asked to prioritise the items in order of importance whereas round three attempted to achieve consensus within each of the panels. Differences between and within each of the panels in the prioritisation of item importance in round one and round two were evident. However, consensus was achieved in round three for the prioritisation of very important items by the panel of teachers. Items identified by by all three panels as extremely important included the adolescent's attitude, and friendships with the same age group. Themes to emerge from the qualitative responses to the open-ended questions included the adolescent "not Wanting to be different" and the importance of a "positive attitude". The majority of the three panels also perceived the QOL for the adolescent with a chronic illness to be worse than their healthy counterparts. / Panelists were also encouraged to provide additional comments on why they felt a particular item was important to the chronically ill adolescent's QOL. In round two, panelists were asked to prioritise the items in order of importance whereas round three attempted to achieve consensus within each of the panels. Differences between and within each of the panels in the prioritisation of item importance in round one and round two were evident. However, consensus was achieved in round three for the prioritisation of very important items by the panel of teachers. Items identified by by all three panels as extremely important included the adolescent's attitude, and friendships with the same age group. Themes to emerge from the qualitative responses to the open-ended questions included the adolescent "not Wanting to be different" and the importance of a "positive attitude". The majority of the three panels also perceived the QOL for the adolescent with a chronic illness to be worse than their healthy counterparts.