Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2005.

Although a history of childhood maltreatment is widely considered to be a risk factor for the perpetration of abuse or neglect in successive generations, the intergenerational transmission theory of child maltreatment has demonstrated mixed support over more than three decades of research. Using a prospective, longitudinal design, this study sought to investigate adolescent, young adult, and reproductive risk factors for the intergenerational continuity of child maltreatment, analyzing data from a sample of 147 women with a history of childhood maltreatment and child welfare services involvement (CWS), juvenile justice system (JJS) involvement, and out-of-home placements. The participants were originally recruited in adolescence for a randomized control trial (RCT) assessing the impact of the Treatment Foster Care Oregon (TFCO) intervention. Maltreatment continuity was measured using both official CWS records and participant self-report of contact with CWS. More than half the sample (n = 79, 53.7%) demonstrated maltreatment discontinuity (MD), indicating no evidence of maltreatment of offspring, and under half demonstrated maltreatment continuity (MC; n = 68, 46.3%). Using separate logistic regression analyses to test three models, results indicated that higher levels of hard drug use in adolescence increased the likelihood of maltreatment continuity at young adult follow-up by 47%. Partner risk in young adulthood was a strong predictor of maltreatment continuity, increasing the likelihood of maltreatment of offspring by over 2 times, or 103%. Marijuana use in young adulthood also emerged as strong predictor of MC, but not in the expected direction: higher levels of marijuana use were associated with a 56% decreased likelihood of MC. An older age at first birth significantly predicted a 52% decreased likelihood of maltreating offspring. Study limitations, future directions, and implications for interventions are discussed.

Multi-problem youth undergoing treatment for substance use problems are at high behavioral risk for exposure to sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Specific risk factors include childhood adversities such as maltreatment experiences and subsequent forms of psychopathology. The current study used a person-centered analytical approach to examine how childhood maltreatment experiences were related to patterns of psychiatric symptoms and HIV/STI risk behaviors in a sample of adolescents (N = 408) receiving treatment services. Data were collected in face-to-face interviews at two community-based facilities. Descriptive statistics and Latent Profile Analysis (LPA) were used to (a) classify adolescents into groups based on past year psychiatric symptoms, and (b) examine relations between class membership and forms of childhood maltreatment experiences, as well as past year sexual risk behavior (SRB). LPA results indicated significant heterogeneity in psychiatric symptoms among the participants. The three classes generated via the optimal LPA solution included: (a) a low psychiatric symptoms class, (b) a high alcohol symptoms class and (c) a high internalizing symptoms class. Class membership was associated significantly with adolescents’ self-reported scores for childhood sexual abuse and emotional neglect. ANOVAs documented significant differences in mean scores for multiple indices of SRB indices by class membership, demonstrating differential risk for HIV/STI exposure across classes. The two classes characterized by elevated psychiatric symptom profiles and more severe maltreatment histories were at increased behavioral risk for HIV/STI exposure, compared to the low psychiatric symptoms class. The high internalizing symptoms class reported the highest scores for most of the indices of SRB assessed. The heterogeneity of psychiatric symptom patterns documented in the current study has important implications for HIV/STI prevention programs implemented with multi-problem youth. The results highlight complex relations between childhood maltreatment experiences, psychopathology and multiple forms of health risk behavior among adolescents. The results underscore the importance of further integration between substance abuse treatment and HIV/STI risk reduction efforts to improve morbidity and mortality among vulnerable youth.

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Adolescents evince a more heightened propensity for risk taking than children and adults. This propensity can be directed toward negative (e.g., illegal or health-compromising) or positive (e.g., socially acceptable and beneficial) risk behaviors. Much existing research on adolescent risk behavior focuses on negative risk taking due to the public health implications of engaging in these behaviors. However, it is also important for society to promote youth engagement in positive risk behaviors that may benefit the well-being of adolescents and those around them. The present study explored positive risk taking in a sample of 164 American adolescents (45% female) ages 16-20 (M = 17.9; SD = .72). There were three central aims: (1) develop a reliable self-report measure of positive risk taking and examine its association with self-reports of negative risk taking and several behavioral measures of risk taking; (2) explore the extent to which previously established psychological correlates of negative risk taking are also associated with positive risk taking; (3) determine whether positive risk taking is associated with indicators of positive functioning, such as academic orientation, grit, and mental health. Results indicated that positive risk taking was associated with greater self-reported negative risk taking, and greater risk taking, feedback learning, and punishment sensitivity on experimental risk taking tasks. Although positive risk taking was not associated with grit or internalizing symptoms, positive risk taking was positively associated with stronger school engagement and better school performance. Future directions and applications to positive youth development programming are discussed. / Psychology

Peer and dating violence perpetration and victimization are common experiences placing adolescents at-risk for maladaptive outcomes, yet little research has focused on specific problematic situations associated with these types of violence and other related risk-taking behaviors. Further, prevention programs have typically focused on changing beliefs, attitudes, and skill-deficits, with little attention to adolescents’ motivations or perceptions of costs and benefits associated with risky situations, despite support for this type of research in other health-related fields (e.g., substance abuse, behavioral medicine). The current study assessed adolescents’ perceptions of potential positive and negative outcomes associated with risky dating and peer situations, many of which may increase youths’ risks for violence perpetration or victimization. Interviews were conducted with 82 predominantly African American adolescents living in an urban setting. At the conclusion of qualitative coding, 17 and 13 themes were identified for risky dating and peer situations, respectively. Content within these themes included potential positive and negative outcomes and associated processes and contextual factors identified by youth, across topics such as aggression, victimization, and other risks for physical or psychological harm; interpersonal and intrapersonal processes associated with dating and peer relationships (e.g., communication, emotion, respect, pressure); and more concrete costs and benefits for youth (e.g., gain or loss of financial or material goods, opportunities for fun things to do). This research has important implications for improving the ecological relevance and credibility of youth violence prevention programs, and the discussion of decisional balances of potential costs and benefits may represent important targets for prevention programs.

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No description available.