Handbook of Adolescent Health Risk Behavior

440 Pages·1996·11.04 MB·English

by  Ralph J. DiClemente

Handbook of Adolescent
Health Risk Behavior
Issues in Clinical Child Psychology
Series Editors: Michael C. Roberts, University of Kansas-Lawrence, Kansas
Lizette Peterson, University of Missouri-Columbia, Missouri
BEHAVIORAL ASPECTS OF PEDIATRIC BURNS
Edited by Kenneth J. Tarnowski
CHILDREN AND DISASTERS
Edited by Conway F. Saylor
CONSULTING WITH PEDIATRICIANS: Psychological Perspectives
Dennis Drotar
HANDBOOK OF ADOLESCENT HEALTH RISK BEHAVIOR
Edited by Ralph J. DiClemente, William B. Hansen,
and Lynn E. Ponton
HANDBOOK OF DEPRESSION IN CHILDREN AND
ADOLESCENTS
Edited by William M. Reynolds and Hugh F. Johnston
INTERNATIONAL HANDBOOK OF PHOBIC AND ANXIETY
DISORDERS IN CHILDREN AND ADOLESCENTS
Edited by Thomas H. Ollendick, Neville J. King, and William Yule
MENTAL HEALTH INTERVENTIONS WITH PRESCHOOL
CHILDREN
Robert D. Lyman and Toni L. Hembree-Kigin
A Continuation Order Plan is available for this series. A continuation order will bring
delivery of each new volume immediately upon publication. Volumes are billed only
upon actual shipment. For further information please contact the publisher.
Handbook of Adolescent
Health Risk Behavior
Edited by
RALPH J. DICLEMENTE
University ofA labama at Birmingham
Birmingham, Alabama
WILLIAM B. HANSEN
Bowman Gray School of Medicine
Winston-Salem, North Carolina
and
LYNN E. PONTON
University of California, San Francisco
San Francisco, California
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging in Publication Data
Handbook of adolescent health risk behavior / edited by Ralph J. DiClemente, William B.
Hansen, and Lynn E. Ponton.
p. cm.—(Issues in clinical child psychology)
Includes bibliographical references and index.
ISBN 978-1-4899-0205-4
1. Health behavior in adolescence. 2. Risk-taking in adolescence. 3. Health promotion. 4.
Health behavior in adolescence—United States. 5. Risk-taking in adolescence—United
States. I. DiClemente, Ralph J. II. Hansen, William B. (William Bunker), 1949- . III.
Ponton, Lynn E. IV. Series.
RJ47.53.H36 1995 95-43464
616.89'022-dc20 CIP
ISBN 978-1-4899-0205-4 ISBN 978-1-4899-0203-0 (eBook)
DOI 10.1007/978-1-4899-0203-0
© Springer Science+Business Media New York 1996
Originally published by Plenum Press, New York in 1996
Softcover reprint of the hardcover 1st edition 1996
1098765432
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written
permission from the Publisher
Contributors
Robert Wm. Blum, M.D., Ph.D., Department of Pediatrics, University of Minnesota,
Minneapolis, Minnesota
Larry K. Brown, M.D., Brown University School of Medicine and Department of Child
and Family Psychiatry, Rhode Island Hospital, Providence, Rhode Island
Oscar Bukstein, M.P.H., M.D., University of Pittsburgh Medical Center, Western
Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
Coleen Cantwell, Division of Social and Community Psychiatry, Department of Psychia
try, University of California, Los Angeles, Los Angeles, California
Yifat Cohen, M.D., Brown University School of Medicine and Department of Child and
Family Psychiatry, Rhode Island Hospital, Providence, Rhode Island
Renee Cunningham, Ph.D., George Warren Brown School of Social Work, Washington
University, St. Louis, Missouri
Lawrence J. D'Angelo, M.D., Department of Pediatrics, Adolescent/Y oung Adult Med
icine, Children's National Medical Center, Washington, D.C.
Ralph J. DiClemente, Ph.D., Departments of Health Behavior and Pediatrics, Univer
sity of Alabama, Birmingham, Alabama
Peter Dore, M.A., George Warren Brown School of Social Work, Washington Univer
sity, St. Louis, Missouri
Felton Earls, M.D., Department of Behavioral Science, Harvard University School of
Public Health, Boston, Massachusetts
Sharon Farber, M.S.W., George Warren Brown School of Social Work, Washington
University, St. Louis, Missouri
v
vi CONTRWUTORS
Susan Scavo Gallagher, Children's Safety Network, Education Development Center,
Inc., Newton, Massachusetts
Denise C. Gottfredson, Ph.D., Department of Criminal Justice and Criminology, The
University of Maryland, College Park, Maryland
Marya Gwadz, M.A., Division of Social and Community Psychiatry, Department of
Psychiatry, University of California, Los Angeles, Los Angeles, California
Wiltiam B. Hansen, Ph.D., Department of Public Health Sciences, Bowman Gray
School of Medicine, Winston-Salem, North Carolina
Vivien Igra, M.D., Department of Pediatrics, University of California, San Francisco,
San Francisco, California
Charles E. Irwin, Jr., M.D., Department of Pediatrics, University of California, San
Francisco, San Francisco, California
Christopher S. Koper, Ph.D., Department of Criminal Justice and Criminology, The
University of Maryland, College Park, Maryland; present address: Crime Control Insti
tute, Washington, D.C.
Dana Lescohier, Ph.D., Injury Control Center, Harvard School of Public Health, Bos
ton, Massachusetts
Elizabeth R. McAnarney, M.D., Department of Pediatrics, University of Rochester
Medical Center, Rochester, New York
Debra A. Murphy, Ph.D., Division of Social and Community Psychiatry, Department
of Psychiatry, University of California, Los Angeles, Los Angeles, California
Patrick M. O'Malley, Ph.D., Survey Research Center, Institute for Social Research,
The University of Michigan, Ann Arbor, Michigan
Michelle Parra, B.A., Division of Social and Community Psychiatry, Department of
Psychiatry, University of California, Los Angeles, Los Angeles, California
Cheryl L. Perry, Ph.D., Division of Epidemiology, University of Minnesota School of
Public Health, Minneapolis, Minnesota
Lynn E. Ponton, M.D., Langley Porter Psychiatric Institute, Division of Child and
Adolescent Psychiatry, University of California, San Francisco, San Francisco, California
Mary Jane Rotheram-Borus, Ph.D., Division of Social and Community Psychiatry, De
partment of Psychiatry, University of California, Los Angeles, Los Angeles, California
CONTRIBUTORS vii
Miriam D. Sealock, M.A., Department of Criminal Justice and Criminology, The Uni
versity of Maryland, College Park, Maryland
C. Wayne Sells, M.D., M.P.H., Department of Pediatrics, University of Minnesota,
Minneapolis, Minnesota
Jean Thatcher Shope, M.S.P.H., Ph.D., University of Michigan Transportation Re
search Institute, Ann Arbor, Michigan
John B. Sikorski, M.D., Child and Adolescent Psychiatry, University of California, San
Francisco, San Francisco, California
Anthony Spirito, Ph.D., Brown University School of Medicine and Department of Child
and Family Psychiatry, Rhode Island Hospital, Providence, Rhode Island
Michael J. Staufacker, M.P.H., Division of Epidemiology, University of Minnesota
School of Public Health, Minneapolis, Minnesota; current address: StayWell Health
Management Systems, Inc., St. Paul, Minnesota
Catherine Stevens.Simon, M.D., Division of Adolescent Medicine, University of Colo
rado Health Science Center, The Children's Hospital, Denver, Colorado
Arlene Rubin StitTman, Ph.D., George Warren Brown School of Social Work, Wash
ington University, St. Louis, Missouri
Michael Windle, Ph.D., Research Institute on Addictions, Buffalo, New York
Preface
Adolescence is a developmental period of accelerating physical, psychological, social!
cultural, and cognitive development, often characterized by confronting and surmounting
a myriad of challenges and establishing a sense of self-identity and autonomy. It is also,
unfortunately, a period fraught with many threats to the health and well-being of adoles
cents and with substantial consequent impairment and disability. Many of the adverse
health consequences experienced by adolescents are, to a large extent, the result of their
risk behaviors.
Many adolescents today, and perhaps an increasing number in the future, are at risk
for death, disease, and other adverse health outcomes that are not primarily biomedical
in origin. In general, there has been a marked change in the causes of morbidity
and mortality among adolescents. Previously, infectious diseases accounted for a dispro
portionate share of adolescent morbidity and mortality. At present, however, the over
whelming toll of adolescent morbidity and mortality is the result of lifestyle practices.
Contemporary threats to adolescent health are primarily the consequence of social, envi
ronmental, and behavioral factors, the so-called "social morbidities."
Social morbidities include a broad spectrum of behaviors and related outcomes such
as substance use and abuse, violence, suicide, unintentional injury, eating disorders,
teenage pregnancy, and sexually transmitted diseases, to name but a few. More recently,
the emergence of human immunodeficiency virus infection and its related outcome,
AIDS, poses yet another serious health threat for adolescents. In addition to the morbidity
and mortality associated with adolescent risk-taking, often underemphasized is the high
proportion of adolescents who are school dropouts or homeless. As a consequence, many
youth do not attain their full potential and do not become productive members of society.
Clearly, the cost to adolescents and society, in general, is staggering, in terms of disease,
premature mortality, wasted human potential, and economic expenditures for health care,
rehabilitation, and incarceration in juvenile detention facilities.
This Handbook ofA dolescent Health Risk Behavior attempts to describe the epidemi
ologic trends associated with specific risk behaviors, assess a broad array of preventive
strategies, and evaluate the efficacy of treatment modalities. To accomplish this goal, a
multidisciplinary group of researchers and clinicians, all with extensive experience work
ing with adolescents, offer a variety of perspectives with direct relevance, implications,
and practical strategies for promoting the health and well-being of adolescents. Specifi-
ix
x PREFACE
cally, this volume serves to highlight the epidemiologic data describing the socio
demographic correlates and trends in adolescent risk behavior. Further, it examines a
variety of prevention strategies and evaluates their effectiveness. And, finally, treatment
modalities are evaluated and recommendations offered regarding their efficacy for spe
cific adolescent subpopulations.
In the introductory chapter, DiClemente, Hansen, and Ponton provide an overview
of the impact of adolescent risk behaviors on health and well-being and assess the role of
prevention and treatment interventions for reducing these behaviors. Sells and Blum
follow with a careful analysis of temporal trends in adolescent morbidity and mortality. In
the next chapter, Igra and Irwin describe a biopsychosocial model for understanding the
factors influencing adolescent risk-taking behaviors.
The next group of chapters address specific adolescent risk behaviors. Each chapter
follows a similar template; that is, they describe the scope of the problem, the epidemiol
ogy associated with a particular risk behavior, assess prevention strategies, and describe
and evaluate treatment modalities. First, Perry and Staufacker address tobacco use, a
critical risk factor for a host of subsequent disease conditions. Ponton follows with a
discussion of disordered eating. Next, Windle, Shope, and Bukstein describe the epidem
iology of alcohol use among adolescents and evaluate prevention and treatment ap
proaches. In a related chapter, Hansen and O'Malley examine drug use as a risk behavior
associated with a myriad of adverse health and social outcomes. Cohen, Spirito, and
Brown examine suicide and suicidal behavior among adolescents, what influences these
self-destructive thoughts and behaviors, and how best to prevent and treat them. Lescohier
and Gallagher describe factors associated with unintentional injury among adolescents.
Gottfredson, Sealock, and Koper describe the causes and consequences of delinquency
among adolescents. Stiffman, Earls, Dore, Cunningham, and Farber address an issue that
has emerged as critically important for adolescents, particularly inner-city youth: violence
among adolescents. Switching to sexual risk-taking, Stevens-Simon and McAnarney
address the continuing problem of teen pregnancy. In a similar vein, D'Angelo and
DiClemente describe the epidemic of sexually transmitted diseases, including HIV infec
tion, as an emerging health threat for adolescents and offer prevention and treatment
recommendations. Rotheram-Borus, Parra, Cantwell, Gwadz, and Murphy address home
lessness as a risk behavior among adolescents and its association with other risk behaviors
and adverse health outcomes. Finally, Sikorski addresses the problem of academic under
achievement and school refusal among adolescents and how this translates into risk
behavior and poor health outcomes. The closing chapter by DiClemente, Hansen, and
Ponton provides an overarching synthesis of key findings from risk behavior-specific
chapters and offers recommendations for the design of future adolescent risk prevention
and health promotion research and interventions.
The chapters in this handbook provide a wealth of information about the epidemiol
ogy, prevention, and treatment of adolescent risk behaviors. Only by understanding the
myriad of psychological, sociological, and cultural influences on adolescent risk behavior
can we begin to meet the challenges posed by these risk behaviors and design the
necessary programs to prevent and reduce risk behaviors and, consequently, their adverse
social and health sequelae. The issues confronting us are complex, however, and simple
answers will only yield illusory solutions. Real progress will come grudgingly, through