Victimization is a relatively common, yet serious problem, with potentially severe consequences for children's psychosocial and academic functioning. Children who are Deaf or Hard of Hearing (DHH) may be at a higher risk for victimization than hearing children. The aims of the present study were to compare DHH and hearing children on i) self-reported experiences of victimization and ii) associations between victimization, parental- and child variables. In total 188 children (mean age 11;11 years) from the Netherlands and Dutch-speaking part of Belgium participated in the study. No difference between DHH and hearing children were found on general experiences of victimization. However, differences between the groups were found on specific forms of experienced victimization and on the associations between victimization and parental variables. For DHH children, parental sensitivity and parents who challenge their DHH children to become competent in the practical, emotional, cognitive and social domain is associated with them being less victimized. For hearing children at this age these relations were reversed, absent or more complex. Finally, DHH children in special schools were more victimized than DHH children in regular schools. It can be concluded that parents can play an important role in reducing social problems experienced by DHH children and young adolescents.
Objective To conduct a meta-analytic review of psychosocial adjustment of youth with inflammatory bowel disease (IBD). Methods Nineteen studies with a total of 1167 youth with IBD (M age = 14.33, 50% female) were included. Effect size (ES) estimates were calculated for anxiety symptoms & disorders, depressive symptoms & disorders, internalizing symptoms & disorders, externalizing symptoms, quality of life (QOL), social functioning, and self-esteem. Separate ESs were calculated for comparisons between IBD and youth with chronic illnesses versus healthy youth. Results Youth with IBD had higher rates of depressive disorders and internalizing disorders than youth with other chronic conditions. Youth with IBD had higher parent-reported internalizing symptoms, lower parent- and youth-reported QOL, and lower youth-reported social functioning compared to healthy youth. Conclusions Clinical attention to depressive disorders, QOL, and social functioning may be particularly salient in the context of pediatric IBD.
inflammatory bowel disease; meta-analysis; psychosocial functioning; quality of life
Around 96 percent of children with hearing loss are born to parents with intact hearing,1 who may initially know little about deafness or sign language. Therefore, such parents will need information and support in making decisions about the medical, linguistic, and educational management of their child. Some of these decisions are time-sensitive and irreversible and come at a moment of emotional turmoil and vulnerability (when some parents grieve the toss of a normally hearing child).2 Clinical research indicates that a deaf child’s poor communication skills can be made worse by increased level of parental depression.3 Given this, the importance of reliable and up-to-date support for parents’ decisions is critical to the overall well-being of their child.4 In raising and educating a child, parents are often offered an exclusive choice between an oral environment (including assistive technology, speech reading, and voicing) and a signing environment. A heated controversy surrounds this choice, and has since at least the late 19th century, beginning with the International Congress on the Education of the Deaf in Milan, held in 1880.5 While families seek advice from many sources, including, increasingly, the internet,6 the primary care physician (PCP) is the professional medical figure the family interacts with repeatedly.7
The present article aims to help family advisors, particularly the PCP and other medical advisors in this regard. We argue that deaf children need to be exposed regularly and frequently to good language models in both visual and auditory modalities from the time hearing loss is detected and continued throughout their education to ensure proper cognitive, psychological, and educational development. Since there is, unfortunately, a dearth of empirical studies on many of the issues families must confront, professional opinions, backed by what studies do exist, are the only option. We here give our strongly held professional opinions and stress the need for improved research studies in these areas.
The high prevalence of depression among incarcerated youth indicates a need to better understand factors that contribute to depression within this vulnerable subgroup. Previous research in general community samples has suggested that high levels of stress and low levels of parental support are associated with depression in young people, but it is unclear whether or how they might be associated with depression among incarcerated youth who are already vulnerable. Using a sample of 228 adolescents (aged 13–18 years) who were detained in the juvenile justice system, stress and support were modeled as independent main effects and as interactive risk factors in relation to depressive symptoms. More stressful life events and less caregiver support were each independently associated with depressive symptoms, but no evidence was found for the buffering hypothesis in this sample. Stressful life events were more strongly associated with depressive symptoms among boys compared to girls.
depression; stress; support; incarcerated youth
This community-based study examined differences in parenting quality and parent symptoms for youth in four categories: anxious (elevated anxiety symptoms), depressed (elevated depressive symptoms), comorbid (elevated anxiety and depressive symptoms), and nonelevated (elevations of neither type). Respondents were 976 young adolescents (mean age = 11.3) and their parents (912 mothers, 647 fathers) randomly selected from 28 rural/small town communities. Results indicated that depressed and comorbid groups were associated with significantly lower parenting quality and higher parent psychopathology compared to the nonelevated and anxious groups. This pattern was generally consistent across reporters (youth, mother, and father) and four domains of or related to parenting (support/warmth, conflict/anger, general child management (GCM), and parent psychopathology). Results highlight the importance of accounting for comorbidity when examining relationships between psychopathology symptoms and related variables such as parenting. Implications include the need to address relationships with parents when intervening with youth at risk for or experiencing elevated depressive symptoms.
parenting; early adolescence; anxiety; depression; comorbidity
The hard of hearing communicate mainly by speech, the deaf by sign language. Services differ, but some hearing-impaired persons need non-medical services provided for both groups. These services are important in Newfoundland because there are few hearing-health professionals to serve a small population distributed over a wide area. This article outlines problems faced by the hard of hearing and describes the services provided by the Newfoundland Hearing Association, the Newfoundland School for the Deaf, the Parents' Association of the Deaf, and the Counselling/Interpreting services of the Newfoundland Co-ordinating Council on Deafness. Programs need to be expanded, but are suggested as an appropriate model for any area of the country.
hearing impairment; services for the deaf
Of the many forms of psychotherapy offered to treat depression in youth, Cognitive Behavioural Therapy (CBT) has been shown to be efficacious. Nonetheless, a high degree of apparent non-responsiveness, failure to remit post-treatment, and lack of long term benefit are all problematic. Given that regular participation is critical to treatment success, child and family predictors of attendance were researched.
Twenty-nine depressed Canadian youth (aged 10–17) participated in a youth only or youth plus parent CBT group. Child and parent predictors of attendance were examined.
Youth who were younger, less anxious (by maternal report), and had more formally educated parents attended CBT more consistently. Further, mothers who perceived their children’s depressive symptoms as more severe, whose children reported more depressive and anxious symptoms, and who reported more life stressors attended more parent sessions.
This study identifies key factors influencing youth and parent attendance in group CBT for depressed youth. Addressing these factors at the outset of treatment may decrease attrition in this form of psychotherapy.
cognitive behavioural therapy; depression; youth; attendance; thérapie cognitivo-comportementale; dépression; adolescents; présence
This pilot study assessed the quality of life and psychosocial functioning of pediatric patients with Barth Syndrome. Thirty-four boys with Barth Syndrome and 22 healthy male controls were administered a measure of verbal ability and completed measures of quality of life, loneliness, perceived peer support, and sibling relationship quality. Parents completed measures of parental distress, parenting stress, child academic functioning, child adaptive behavior, and child emotional and behavioral functioning. Quality of life ratings were consistently lower in youth with Barth Syndrome relative to both healthy controls and a previously reported sample of youth with cardiac disease. Compared to healthy controls, children with Barth Syndrome were rated as having more internalizing and externalizing symptoms, social problems, loneliness, and lower independent functioning. Parents of boys with Barth Syndrome reported greater distress and parenting stress relative to healthy controls. In addition, parents reported a significant need for academic accommodations, given their son’s illness and associated impairments. Boys with Barth Syndrome and their parents appear to be affected by the presence of the illness in numerous ways. Results suggest the need for interventions aimed at helping children and families cope with illness-related stressors to enhance quality of life and overall functioning.
Barth Syndrome; Children; Chronic Illness; Quality of life; Psychosocial functioning
Stigma toward people living with HIV is pervasive in China and related to poor service utilization, psychosocial distress, and diminished quality of life. In an effort to identify mechanisms to reduce HIV stigma and its negative consequences, we examined whether social support mediates the relation between enacted stigma and both depressive symptoms and quality of life among 120 HIV outpatients in Beijing, China. Generally, perceived social support was associated with less stigma, less depressive symptomatology, and better quality of life. Using multivariable regression models, we found that social support was a full mediator of the impact of stigma on both depressive symptomatology and quality of life. The findings suggest social support may be an important target of interventions to reduce the impact of stigma on poor psychosocial health outcomes.
The present study examined discrimination attributions in the psychological well-being of Black adolescents. Findings are based on a representative sample of 810 African American and 360 Caribbean Black youth, aged 13 to 17, who participated in the National Survey of American Life (NSAL). Youth completed measures of perceived discrimination, discrimination attributions, depressive symptoms, self-esteem and life satisfaction. Approximately half the youth attributed discrimination to race/ethnicity (43%), followed by age (17%), physical appearance (16.5%) and gender (7.5%) and there were no ethnic, gender or age differences regarding discrimination attributions. Key findings suggest that the association between perceived discrimination and psychological did not vary according to discrimination attribution, which implies that discrimination is harmful for Black youth regardless of the attribution.
Blacks; Adolescents; Perceived Discrimination; Discrimination Attributions; Psychological Well-being
This cross-sectional study explored differences in the impact of self-reported coping style, self-esteem and perceived support on the psychological adjustment of homeless and housed female youth.
Data were obtained from homeless female youth (n = 72, M = 17.5 years) accessing an emergency shelter in a large Canadian urban centre and a comparison group of housed females (n = 102 ; M = 17.2 years) from local high schools who had never resided in a shelter.
Homeless youth reported lower self-worth, increased suicidal behaviour, less perceived parental support and higher levels of depressive symptoms and both internalizing and externalizing behaviour problems than housed youth. Hierarchical regression analyses indicated that disengagement coping was a significant predictor of depressive symptoms and both internalizing and externalizing behaviour problems in homeless and housed youth.
Findings reflect the merit of considering coping style, parental support and self-worth in the presentation of depressive symptoms and behaviour problems in homeless and housed female youth.
homeless youth; females; coping; self-worth; psychological adjustment; adolescentes sans domicile; femmes; adaptation; estime de soi; ajustement psychologique
Some evidence suggests that close friends may be knowledgeable of youth’s psychological adjustment. However, friends are understudied as reporters of adjustment. The current study examines associations between self- and friend-reports of internalizing and externalizing adjustment in a community sample of fifth-, eighth-, and eleventh-grade youth. The study extends prior work by considering the degree to which friends’ reports of youth adjustment are accurate (i.e., predicted by youths’ actual adjustment) versus biased (i.e., predicted by the friend reporters’ own adjustment). Findings indicated stronger bias effects than accuracy effects, but the accuracy effects were significant for both internalizing and externalizing adjustment. Additionally, friends who perceived their relationships as high in positive quality, friends in relationships high in disclosure, and girls perceived youths’ internalizing symptoms most accurately. Knowledge of externalizing adjustment was not influenced by gender, grade, relationship quality, or self-disclosure. Findings suggest that friends could play an important role in prevention efforts.
Friends’ knowledge; Friendship quality; Self-disclosure; Gender
Health-related quality of life (HRQoL) is reduced in obese children and adolescents, especially in clinical samples. However, little is known regarding the HRQoL of moderately overweight youth. Moreover, several studies have indicated perceived overweight as a critical factor associated with lower HRQoL. Our main objective was to compare HRQoL between treatment-seeking overweight youth and the general adolescent population, whilst separating the effects of treatment-seeking status and perceived weight from those of objective weight status.
We compared the HRQoL of a clinical sample of overweight youth (N=137 patients, mean age±s.e.=11.24±0.15 years) with that of a representative population sample (N=6354, mean age=12.75±0.03 years). The population sample was subdivided into groups based on measured and perceived weight status. We used hierarchical linear models to compare HRQoL subscale scores (self- and parent-reported) between patients and population groups, adjusted for sociodemographic characteristics and taking into account clustering of the population sample.
The parent-reported HRQoL of the treatment sample was significantly lower than that of other overweight youth perceived as ‘too fat’ on two subscales: ‘self-esteem’ and ‘friends’ (effect sizes: d=0.31 and 0.34, respectively). On other subscales, patients scored lower than adolescents perceived as having a ‘proper weight’ by their parents. The patterns for self-reported HRQoL in adolescents were different: patients reported higher self-esteem than other overweight youth feeling ‘too fat’ (d=-0.39). Female patients also reported higher physical well-being (d=-0.48), whereas males scored lowest among all compared groups (d=0.42-0.95). Patients did not differ from other overweight youth who felt ‘too fat’ with respect to other HRQoL dimensions. In general, lower HRQoL was primarily associated with a perceived, rather than actual, overweight status.
The treatment-seeking status of overweight youth was notably associated with low social well-being, which may therefore be the main motive for seeking treatment. Other HRQoL domains were not consistently reduced in treatment-seekers. Our results further indicate that perceived overweight rather than actual overweight impacts HRQoL in youth with a modest excess weight. These results have implications for interventions in overweight youth and in individuals who are dissatisfied with their weight.
‘Obeldicks light’ is registered at clinicaltrials.gov (NCT00422916).
Health-related quality of life; Overweight; Obesity; Weight perception; Body image; Children and adolescents; Treatment-seeking status
Individual's hearing performance after cochlear implant (CI) is variable and depends on different factors such as etiology of deafness, age at implantation, and social/family hearing environment. Here we report the case of dizygotic twins, boy and girl, presenting with neurosensorial profound deafness prior CI (age of implantation = 3.5 years old). Both parents have severe/profound deafness, since childhood, and use sign language as primary mode of communication. Clinical and genetic characterization was performed, as well as the assessment of the auditory and oral (re)habilitation after CI, applying a battery of audiological, speech, and language tests.
The twin girl and the father were homozygous for the c.35delG mutation in the GJB2 gene, while the twin boy and the mother were compound heterozygotes, both monoallelic for c.35delG and for the deletion del(GJB6-D13S1830) in the GJB6 gene. The remaining hearing impaired relatives were c.35delG homozygotes. The genetic cause of deafness was thus identified in this family. Some noteworthy differences were observed regarding twins' auditory and oral performance after CI. Subsequent follow-up of these children allowed us to conclude that those differences were most likely due to the different environment in which the twins have been living than to their different GJB2/GJB6 genotypes.
The present study examined ethnic, gender and age differences in perceived discrimination, and the association between perceived discrimination and psychological well-being in a nationally representative sample of Black adolescents. Data are from the National Survey of African Life (NSAL), which includes 810 African American and 360 Caribbean Black youth. Results indicate that the majority of Black youth perceived at least one discriminatory incident in the previous year. Adolescents at later stages of development perceived more discrimination than those at earlier stages, and African American and Caribbean Black males perceived more discrimination than their female counterparts. Perceptions of discrimination were positively linked to depressive symptoms and negatively linked to self-esteem and life satisfaction, regardless of ethnicity. However, Caribbean Black youth appear to be more vulnerable when they perceive high levels of discrimination.
African Americans; Caribbean Blacks; Adolescents; Perceived Discrimination; Psychological Well-being
Hispanic youth are at risk for experiencing depressive symptoms and smoking cigarettes, and risk for depressive symptoms and cigarette use increase as Hispanic youth acculturate to U.S. culture. The mechanism by which acculturation leads to symptoms of depression and cigarette smoking is not well understood. The present study examined whether perceived discrimination explained the associations of acculturation with depressive symptoms and cigarette smoking among 1,124 Hispanic youth (54% female). Youth in Southern California completed surveys in 9th–11th grade. Separate analyses by gender showed that perceived discrimination explained the relationship between acculturation and depressive symptoms for girls only. There was also evidence that discrimination explained the relationship between acculturation and cigarette smoking among girls, but the effect was only marginally significant. Acculturation was associated with depressive symptoms and smoking among girls only. Perceived discrimination predicted depressive symptoms in both genders, and discrimination was positively associated with cigarette smoking for girls but not boys. These results support the notion that, although Hispanic boys and girls experience acculturation and discrimination, their mental health and smoking behaviors are differentially affected by these experiences. Moreover, the results indicate that acculturation, gender, and discrimination are important factors to consider when addressing Hispanic youth’s mental health and substance use behaviors.
Acculturation; Gender; Perceived discrimination; Depression; Cigarette smoking; Hispanic youth
Irritability is a widely occurring DSM-IV symptom in youths. However, little is known about the relationship between irritability in early life and its outcomes in mid-adulthood. This study examines the extent to which youth irritability is related to adult psychiatric outcomes by testing the hypothesis that it predicts depressive and generalized anxiety disorders.
The authors conducted a longitudinal community-based study of 631 participants whose parents were interviewed when participants were in early adolescence (mean age=13.8 years [SD=2.6]) and who were themselves interviewed 20 years later (mean age=33.2 years [SD=2.9]). Parent-reported irritability in adolescence was used to predict self-reported psychopathology, assessed by standardized diagnostic interview at 20-year follow-up.
Cross-sectionally, irritability in adolescence was widely associated with other psychiatric disorders. After adjustment for baseline emotional and behavioral disorders, irritability in adolescence predicted major depressive disorder (odds ratio=1.33, 95% confidence interval [CI]=1.00–1.78]), generalized anxiety disorder (odds ratio=1.72, 95% CI=1.04–2.87), and dysthymia (odds ratio=1.81, 95% CI=1.06–3.12) at 20-year follow-up. Youth irritability did not predict bipolar disorder or axis II disorders at follow-up.
Youth irritability as reported by parents is a specific predictor of self-reported depressive and anxiety disorders 20 years later. The role of irritability in developmental psychiatry, and in the pathophysiology of mood and anxiety disorders specifically, should receive further study.
Objective To examine the association of youth and caregiver HIV status, and other contextual and social regulation factors with youth mental health. Method Data were from two longitudinal studies of urban youth perinatally infected, affected, and unaffected by HIV (N = 545; 36% PHIV+ youth; 45.7% HIV+ caregivers). Youth mental health was measured using the Child Behavior Checklist, the Child Depression Inventory, and the State–Trait Anxiety Inventory for Children. Results HIV+ youth reported elevated scores on the CDI compared with HIV− youth. HIV+ caregivers reported fewer symptoms and were less likely to report scores in the clinical range for their children on the CBCL compared with HIV− caregivers. Caregiver mental health and parent–child communication and involvement were also associated with youth mental health. Conclusions Youth who resided with HIV+ caregivers had better mental health. Future research needs to further explore the role of caregiver HIV infection in youth mental health. Understanding and building upon strengths of HIV-affected families may be an effective focus of interventions for this population.
at-risk youth; HIV/AIDS; mental health
Client satisfaction with mental health services is used commonly as an indicator of the quality of care, but there is minimal research on the construct of client satisfaction in youth services, and the extent to which satisfaction is related to improvements in clinical functioning versus other determinants. We examined the relationship between parent and youth satisfaction with youth services, and tested for significant determinants of satisfaction across three major domains: (1) change in youth clinical functioning; (2) youth/family service entry characteristics; (3) treatment/therapist characteristics.
The participants were 143 youths receiving community-based out-patient care. Youths and parents were interviewed at service entry and six months later using well-established measures of clinical functioning and service satisfaction.
Youths and parents reported generally high satisfaction, but the correlation between them was low. Despite testing for many potential predictors of satisfaction, very few significant effects were found. In regression analyses of significant predictors of satisfaction, higher youth satisfaction was significantly associated with Caucasian ethnicity and more positive youth expectations about treatment. Higher parent satisfaction was associated with lower caregiver strain at service entry, increased number of sessions, and improvement in youth-reported functional impairment.
Client satisfaction; youth psychotherapy; outcomes
In Contrast with the nearly 30 years of HIV/AIDS research with the hearing community, data on HIV infection among persons who are deaf and hard of hearing is primarily anecdotal. Although the few available estimates suggest that deaf and hard of hearing persons are disproportionately affected by HIV infection, no surveillance systems are in place to Identify either frequency or mode of HIV infection within this population. Moreover, to date, all empirically validated HIV prevention interventions have relied on communication strategies developed for persons who hear. Therefore, understanding and developing-effective prevention methods is crucial for persons who are deaf or hard of hearing. The authors explore (a) factors among this population that may contribute to HIV-related behaviors, (b) four key concepts consistently included in successful interventions, and (c) practical ways in which to use this information to tailor effective intervention strategies for this population.
To examine the mediating role of youth depressive symptoms in the relationship between parent distress and youth health-related quality of life (HRQOL) in a sample of adolescents with inflammatory bowel disease (IBD).
Sixty-two adolescents, aged 13-17 years, with a confirmed diagnosis of IBD completed assessments of depressive symptoms and HRQOL. Each adolescent’s primary caregiver completed a measure of parent stress related to their child’s illness. Pediatric gastroenterologists provided data for disease severity assessments.
Multiple regression analyses revealed that adolescent depressive symptoms fully mediated the relationship between parent distress and several dimensions of HRQOL (i.e., General Well-Being, Emotional Functioning, Social Functioning, and Total HRQOL). Moreover, mediation was observed after statistically controlling for the impact of disease severity, IBD diagnosis, and significant demographic parameters on HRQOL.
Findings suggests that adolescent depressive symptoms may serve as the mechanism through which parent distress is linked to poorer HRQOL in adolescents with IBD. Close monitoring of parent illness-related distress and adolescent depressive symptoms as well as clinical interventions targeting these factors, are needed to promote optimal outcomes in adolescents with IBD.
Inflammatory Bowel Disease; Adolescents; Quality of Life; Parent Distress; Depression
One aspect of establishing effective communication between physicians and patients has not received adequate attention: the special needs and challenges presented by patients with impaired hearing. In this article the term “hearing impaired” is generic and is applied to both those persons who are commonly labeled “deaf” and those labeled “hard of hearing” as a result of a bilateral hearing loss. The general skills, both verbal and nonverbal, that a physician must have in order to communicate successfully with a hearing-impaired patient are in essence the same as those required for a hearing patient. Where the divergence occurs is not in the basic skills (empathy, probing and the like) but rather in the means of applying them. Communicating with a hearing-impaired patient makes the use of some combination of the following necessary: speech, hearing, speechreading (lipreading), writing, visual aids, visual language systems and the assistance of an interpreter.
The present study examined whether combinations of ethnicity, gender and age moderated the association between perceived discrimination and psychological well-being indicators (depressive symptoms, self-esteem and life satisfaction) in a nationally representative sample of Black youth. The data were from the National Survey of African Life (NSAL), which includes 810 African American and 360 Caribbean Black adolescents. The results indicated main effects such that perceived discrimination was linked to increased depressive symptoms, and decreased self-esteem and life satisfaction. Additionally, there were significant interactions for ethnicity, gender and race. Specifically, older Caribbean Black females exhibited higher depressive symptoms and lower life satisfaction in the context of high levels of perceived discrimination compared to older African American males.
African Americans; Caribbean Blacks; Adolescents; Perceived Discrimination; Psychological Well-being
Youth’s reactions to disasters include stress reactions, posttraumatic stress disorder (PTSD), and comorbid conditions. A number of factors contribute to outcome including characteristics of the event; the nature of the youth’s exposure; and individual, family, and social predictors. Demographic features may be less important than exposure and other individual variables like preexisting conditions and exposure to other trauma. While youth’s disaster reactions reflect their developmental status and thus may differ from those of adults, their reactions generally parallel those of their parents in degree. Family factors that appear to influence youth’s reactions include parental reactions and the quality of interactions within the family. Social factors have not been well examined. We describe these outcomes and predictors to prepare professionals who may work with youth in post-disaster situations.
To describe self-reported health status and quality of life (QOL) of ambulatory youths with cerebral palsy (CP) compared with sex- and age-matched typically developing youth (TDY).
Prospective cross-sectional cohort comparison.
A convenience sample of 81 youth with CP (age range, 10–13y) with Gross Motor Function Classification System (GMFCS) levels I through III and 30 TDY participated. They were recruited from 2 regional children’s hospitals and 1 regional military medical center.
Main Outcome Measures
Participants completed the Child Health Questionnaire–Child Form (CHQ-CF87) for health status and the Youth Quality of Life for QOL.
Youth with CP reported significantly lower health status than age- and sex-matched TDY in the following CHQ-CF87 subscales: role/social behavioral physical, bodily pain, physical function, and general health (CP mean rank, 46.8–55.2; TDY mean rank, 62.2–80.9). There were significant differences across GMFCS levels. There were no significant differences in self-reported QOL.
Self-reported health status, but not QOL, appears sensitive to the functional health issues experienced by ambulatory youth with CP. Pain management and psychosocial support may be indicated for them.
Cerebral palsy; Health status; Quality of life; Rehabilitation