Lynn E. Ponton

Adolescents at Risk

Adolescence is a developmental period of rapid physical, psychological, sociocultural, and cognitive changes characterized by efforts to confront and surmount challenges and to establish a sense of identity and autonomy. While many adolescents navigate the sometimes turbulent course from childhood to adulthood to become productive and healthy adults, there is growing concern that far too many others may not achieve their full potential as workers, parents, and individuals. Unfortunately, adolescence is also a period fraught with many threats to the health and well-being of adolescents, many of whom suffer substantial impairment and disability. Much of the adverse health consequences experienced by adolescents are, to a large extent, the result of risk behaviors (Ginzberg, 1991). As such, they are preventable.

Prevalence and correlates of cutting behavior: Risk for HIV transmission

The prevalence of cutting behavior among a population of 76 psychiatrically hospitalized adolescents was found to be 61.2%. The frequency ranged from a single occasion to over 50 instances, with a mean of 9.9 occasions. Increased self-mutilation was not found to be associated with gender, age, ethnicity, or primary psychiatric diagnosis. A significant association was identified between adolescents who report forced sex and those who report cutting behavior. Approximately 26.7% of those reporting this behavior also report sharing cutting implements with other adolescents. This article raises concern about this behavior as it relates to the transmission of human immunodeficiency virus and makes recommendations for clinicians treating this population.

Adolescents with psychiatric disorders and the risk of HIV

OBJECTIVE To review literature relevant to human immunodeficiency virus (HIV)-associated risk behaviors among adolescents with psychiatric disorders and psychological influences on risk behaviors. METHOD This report is based on review of 66 articles, which comprise all of the relevant literature in the English language. RESULTS Although the seroprevalence of HIV in adolescents with psychiatric disorders is unknown, studies indicate that adolescents with psychiatric disorders are at greater risk than their peers because of increased rates of unsafe sexual practices, impulsivity, self-destructive attitudes, cognitive immaturity, high rates of substance use, self-cutting behavior, and the sequelae of sexual abuse. CONCLUSION Directions are proposed for the design of developmentally appropriate, clinically oriented HIV prevention interventions based on the relationships between psychological dysfunction, social stressors, and HIV risk behaviors.

Child sexual abuse of Asians compared with other populations

This retrospective chart review study of a child sexual abuse clinic compared a consecutive sample of substantiated sexual abuse cases of Asian victims with random samples of black, white, and Hispanic victims. The findings suggest that there are clinically relevant differences between Asians and the other three populations. Asian victims showed a distinct demographic profile, suffered less physically invasive forms of abuse, were more likely to express suicidality, less likely to display anger and sexual acting out, and had less supportive primary caretakers than non-Asians. Awareness of such ethnic differences will help clinicians better evaluate and treat minority victims.

The developmental implications of prenatal and/or postnatal crack cocaine exposure in preschool children : a preliminary report

Previous studies examining the development of prenatally cocaine-exposed children through 3 years of age have found no significant differences between exposed and control groups. This study explored the developmental correlates of prenatal and/or postnatal crack cocaine exposure in children between 4 and 6 years of age. Three groups were studied: Group 1, 18 prenatally-exposed children whose mothers continue to use crack; Group II, 28 children without prenatal exposure whose mothers presently use crack; and Group III, 28 children whose mothers never used crack. Mothers were street-recruited and were comparable in race and socioeconomic status. The three groups of children did not differ on neurological gross motor and expressive language measures. However, prenatally exposed children performed significantly worse than others on receptive language and visual motor drawing tests. Prenatal crack exposure predicted poor visual motor performance even after control for intrauterine alcohol and marijuana exposure, age, birth weight, and duration of maternal crack use.

New Directions for Adolescent Risk Prevention and Health Promotion Research and Interventions

The lessons learned from research on individual adolescent health risk behaviors show that all of these behaviors have similar patterns of development and etiologic roots, and may respond to similar prevention and treatment programs. Surprisingly, research on each of these areas has proceeded relatively independently, yet similar findings are emerging. There are, of course, important differences across risk behaviors as well. Understanding the similarities and differences across risk behaviors expands the options for prevention and treatment.

Risks of road injuries in patients with bipolar disorder and associations with drug treatments: A population-based matched cohort study

OBJECTIVE Using a nation-wide, population-based dataset, we aimed to investigate the risk of road injury among individuals with bipolar disorder (BD) compared to individuals without BD. In addition, we investigated the putative moderating effects of prescription for lithium, anticonvulsants, antidepressants, and/or first- or second-generation antipsychotic agents on the association between BD and risk of road injury. METHOD As part of an16-year longitudinal cohort study, we compared the risk of road injuries among study subjects aged 16 and above with a diagnosis of BD, with ten age- and sex-matched sample of individuals without BD. Individuals were compared on measures of incidence on road injuries using medical claims data based on the ICD-9-CM codes: E800~807, E810~817, E819~830, E840~848. Time dependent Cox regression models were used to adjust for time-varying covariates such as age, and medication uses. Hazard ratios before and after adjusting for age, sex, other comorbidities, and drug use were calculated. RESULTS 3953 people with BD were matched with 39,530 controls from general population. Adjusted hazard ratios revealed a 1.66-fold (95% CI 1.40-1.97) increase in risk of road injuries among bipolar subjects when compared to controls. Female gender, older age (i.e. over 80), residence in areas of highest levels of urbanization, and use of antidepressants were associated with a lower risk of road injuries. CONCLUSIONS In this large, national, population-based cohort, BD was associated with an elevated risk of road injuries. However, prescriptions of antidepressants might help mitigate the foregoing risk.

Adolescence and Psychoanalysis: The Story and the History

Journal of the American Academy of Child & Adolescent Psychiatry - Vol. 38 - N° 12 - p. 1601-1602