Adolescent Ward Research Articles

Psychosocial correlates of child abuse potential in multiply disadvantaged adolescent mothers

Objective: This study had two aims: First to examine psychosocial correlates of child maltreatment risk, and second to assess the validity of the CAP Inventory (Milner, 1986) with multiply disadvantaged teenage mothers. Method: Participants were 75 adolescent mothers who were wards of the Illinois child protection system. Mothers (aged 14–18) and infants participated in home-based psychosocial assessment of personal and parenting functioning. Group comparisons examined differences for mothers with elevated versus normal versus invalid CAP scores due to faking good. Results: Findings indicated that abuse risk groups differed on emotional distress, social support satisfaction, reading achievement, and years of education, but not on parenting beliefs or quality of child stimulation. Differences favored the normal over the elevated risk group in all significant comparisons, whereas mothers with elevated faking good differed from normals only in lower reading achievement. Multiple regression analysis highlighted emotional distress, support dissatisfaction, and low achievement as significant predictors of greater abuse risk. Conclusions: Despite sharing multiple disadvantages, adolescent wards are a heterogeneous group who show different levels of psychosocial functioning corresponding to levels of child maltreatment risk. The findings provide support for the concurrent validity and clinical applicability of the CAP Inventory with disadvantaged teenage mothers.

Suites judiciaires et administratives du signalement d'adolescents en'danger

Adolescent victims of abuse or neglect are regularly reported to social agencies and legal authorities. However, decisions following reports often remain unknown, leaving the question of the reporting's relevance open. Population and methods. — Forty-one consecutive written reports sent to child protective services were reviewed, and their content analysed. These services were then contacted by telephone, in order to gather information on outcome. Results. — Forty-one reports concerned 40 adolescents (32 girls, 8 boys); 36 of whom had been admitted to our adolescent medicine ward. The most common reason for admission was a suicide attempt (20 cases). Thirty-nine reports were destined to legal authorities, while two to social agencies. The reason for reporting was physical or sexual abuse in more than half of the cases. In twenty-five cases, the main request was a separation from the family. Eighteen adolescents were lost from our medical follow-up after reporting. Thirty-two reports to legal authorities had led to a hearing by a juvenile and family court judge. When our main request was a separation from the family, the judge answered favorably in two-thirds of the cases, after a mean period of 26 days. All the subjects for whom a separation from the family was not requested in the report remained at home. Conclusion. — A simple telephone call is enough to gather information about the following of reports and enables an evaluation of the relevancy of its requests. The interface between the health care and legal systems needs improving through better coordination. Pediatricians should be leaders in this field.

Antipsychotic drugs and tardive dyskinesia: preliminary results in an adolescent psychiatric ward.

The systematic study of antipsychotic-induced movement disorders in young psychiatric patients is very sparse. We assessed the presence of tardive dyskinesia in an adolescent in-patient psychiatric ward. Eighteen per cent (3/17) exhibited either pronounced or subtle signs of tardive dyskinesia. Our study suggests that young psychiatric patients may develop signs of tardive dyskinesia even though they are exposed to relatively short-term neuroleptic treatment and at dosages that are relatively low. We advocate frequent and systematic monitoring of adolescent patients taking antipsychotic drugs in order to minimize the emergence of this long-term, troublesome complication of neuroleptic drugs.

Knowledge of AIDS and sexually transmitted diseases among foster adolescents

This study reports on knowledge about AIDS and sexually transmitted diseases among foster adolescents. The sample consisted of 533 older adolescent state wards in out-of-home placements in Illinois, Indiana, and Ohio. Knowledge levels were classified by sex and race. Foster adolescent scores were compared with the results of the National Adolescent Student Health Survey. The older foster adolescent sample scored slightly higher than the 10th grade NASHS sample. Within the foster youth sample, females scored higher than males, and Whites scored higher than non-Whites. Overall, White females scored highest, and minority males scored lowest. Variations in knowledge levels and implications for AIDS prevention education are discussed. Special attention in AIDS education should be directed toward male minority foster adolescents.

Preparing foster youth for adulthood: A knowledge-building perspective

The task of preparing foster youths for the transition to adulthood is receiving increased attention. The independent-living movement within the child welfare system is relatively new. State and local programs are in the developmental stage, and research in all areas is sorely needed. The aim of this special issue is to cut across a segment of current research activity in the area of foster youth independence and to lend perspective to a future research agenda. The child welfare practice community has, for many years, been aware that significant numbers of young people in outof-home placement are teenagers. Nearly a decade ago, Homby and Collins (1981) estimated that fewer than 5% of the adolescents in placement were likely to be placed for adoption, that the odds of reunification with own parents were less than 1 in 5, and that each year thousands of adolescent wards simply age-out of the placement system on or about age 18. Many are discharged without a plan, without resources, and lack preparation for making it on their own. At the present time, most independent living programs, services, and interventions remain untested and the child welfare system is uncertain about how to best prepare foster wards for self-support and responsible adulthood. Fortunately, the child welfare community now has an ally in the form of federal legislation which established a national level independent living program to help foster youths to emancipate from the placement system. In 1986, Title IVE Section 477 of the Social Security Act was enacted under the leadership of Senator Daniel Patrick Moynihan (DN.Y.) and Representative Robert Matsui (D-CA.) and colleagues in the House of Representatives. Congress authorized $45 million to provide independent living services to foster adolescents ages 16 to 18. In 1993 the federal independent living program attained permanent status as an entitlement. The current funding level for this program is $70 million. An identifiable nucleus of national and state level leadership is emerging in

Adaptation in Adolescence: The Influence of Time and Severe Psychiatric Disorder

This study reports the development of adaptive processes in two groups of adolescents assessed initially and 2 years later with clinical research interviews. Students from a public high school (N = 44) and inpatients on an adolescent psychiatric ward (N = 51) formed the two subject groups. The psychiatrically hospitalized group had significantly improved scores after a 2-year interval on four of six adaptive process Summary Scales: Task Orientation, Relatedness, Self Knowledge, and Inner Synthetic Functions. However, these higher scores did not reach the levels of the high school group at either point of assessment. The scores in the high school group remained stable over time except for an increase in the area of Self Knowledge. The value of this interview-derived assessment, in comparison to other forms of measurement, is discussed, and consideration is given to factors which contribute to the differences between groups.

Pseudoadolescent Munchausen syndrome

Munchausen syndrome has not been reported in adolescents. We report two cases in young adults who, because they feigned adolescence, were first seen by pediatricians and then treated on a locked adolescent psychiatric ward. Their presentations resembled Munchausen syndrome, but included prominent factitious psychological symptoms as well as factitious physical symptoms. These cases are discussed in relation to the syndrome's classification, natural history, and associated character pathology.

Growing up on Ward Twenty: the everyday life of teenagers in a mental handicap hospital

Abstract Among closed institutions surviving in contemporary Britain, mental handicap hospitals are virtually unique in assuming responsibility both for the primary socialization, and the long‐ term adult care of a resident population. This paper uses ethnographic data on an adolescent ward to consider the process of growing up in hospital. It examines the extent of cultural patterning in ward life, sources of cultural knowledge open to patients, and the major preoccupations and concerns of the two staff groups — nurses and teachers— having major responsibility for patient management.

Psychological vulnerability to alcoholism: studies in internal scanning deficit.

Three studies considered the predispositional role of impaired internal scanning in alcoholism. Scanning represents the person's sensitivity to internal stimulation and the extent to which the person utilizes internally generated information. The first study found that more acute alcoholic patients displayed poorer scanning than more chronic alcoholics. This finding contra-indicates deficit scanning as an effect of alcoholism and suggests that this impairment antecedes the alcoholic disorder. Two further studies tested the possible antecedent status of deficit scanning. Adolescent wards of the juvenile court, judged to be more at risk for alcoholism, were poorer scanners than their counterparts with fewer drinking-related problems. Male college students with a greater number of alcohol-related problems also proved to be poorer scanners. It is proposed that limited scanning contributes to alcoholic vulnerability by depriving the person of information vital to the control of drinking behaviour.

Disney and Freud: Walt Meets the Id

The Journal of Popular CultureVolume XV, Issue 4 p. 93-104 Disney and Freud: Walt Meets the Id David I. Berland M.D., David I. Berland M.D. Dr. Berland is a child psychiatrist on the staff of the Menninger Foundation. He directs a ten-bed ward for adolescents with emotional problems. He has had specialized training in psychodynamic and psychosocial principles involved in child developmentSearch for more papers by this author David I. Berland M.D., David I. Berland M.D. Dr. Berland is a child psychiatrist on the staff of the Menninger Foundation. He directs a ten-bed ward for adolescents with emotional problems. He has had specialized training in psychodynamic and psychosocial principles involved in child developmentSearch for more papers by this author First published: Spring 1982 https://doi.org/10.1111/j.0022-3840.1982.1504_93.xCitations: 8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature VolumeXV, Issue4Spring 1982Pages 93-104 RelatedInformation

Limited psychiatric consultation to an adolescent medicine unit.

Six years of association with an “adolescent care team” is described. The first three years were spent planning an adolescent medicine ward, and the second three years providing limited consultation on this ward. The ward population with predominantly orthopedic problems provided an opportunity for teaching pediatric residents and nursing staff about the psychosocial factors in hospitalization and illness. Important aspects of consultation are protecting times for staff development seminars and transmitting an optimistic attitude about potential improvement of some maladaptive adolescent behavior with appropriate intervention.

RORSCHACHTESTNING af grænsepsykotiske unge

SUMMARY The present paper is a result of almost 10 years' work with adolescent psychiatric patients in the adolescent ward of Bispebjerg Hospital, Copenhagen. The author considers the Rorschach-test particularly suitable for the diagnosis of borderline states in adolescence. First, however, clinicians are cautioned not to underestimate the extent of psychiatric disease in adolescence, and, in particular, not to overestimate the role of puberty itself. Contact-disturbances and defects in reality- testing are serious symptoms in adolescence as well as in all other age groups. In order to be able to use the Rorschach-test in an adolescent psychiatric clientele, it is, of course, necessary to be well acquainted with the norms of this age group. A description is therefore given of the differences in normal Rorschach-responses between adolescents and adults. The adolescent test-records are usually shorter, with relatively more W-responses, somewhat more coarctated, with fewer M-responses and particularly fewer ...

The hospitalized adolescent interaction scale: An instrument to measure patient behavior on an adolescent medicine ward

The Hospitalized Adolescent Interaction Scale was developed to assess the behavior of adolescents on an adolescent unit. This 30-item checklist was utilized to measure the behavior of patients hospitalized on adolescent units in two hospitals. The type and level of behavior of the adolescents were similar at the two hospitals. Adolescents spent only a small percentage of their time interacting with each other (3-8%), while over half their time was spent in solitary activities (33-37%) or doing nothing at all (21-17%). In rank order, the four most frequent activities at both institutions were: (1) television on, (2) visitor in room, (3) patient watching TV, and (4) visitor and patient talking.

School follow-up of adolescents treated in a psychiatric hospital.

Parents of 25 patients discharged from an adolescent psychiatric ward over a one-year period were interviewed to determine their child's school adjustment. Satisfactory or excellent adjustment was reported in 84 percent of the cases. Findings were discussed in terms of the role of hospital school staff in assisting adolescents to make the transition to community school settings.

A method for small group training of psychiatric ward staff.

On a psychiatric ward for adolescents a change in organizational structure provided more autonomy and responsibility to the ward staff. As part of a program to help staff meet these new responsibilities, training groups were instituted to teach staff how to use their work groups more effectively. A method for staff training was used which promoted the development of group cohesiveness in the work groups and the transfer of insights made in training to job performance. In order to articulate clearly the conceptual rationale for the method, it is analyzed here in three parts: the goals of training and their impediments; the conditions under which learning will occur; and the processes through which learning takes place. In the description of the learning processes, "work" is conceived of as a group problem-solving process, involving the balancing and synthesizing of formal task demands and interpersonal pressures. Ward staff resistance to this form of training is discussed, and examples of improved performance on the job are presented. The training groups are defined in comparison to other types of groups and to more traditional didactic teaching.

An Approach to the Analysis of Faculty-Student Interactions in Small Groups

The adolescent's experience in groups and institutions is determined in important ways by the nature of the authority in these settings. To study adolescent relationships with those in authority positions we have used methods of participant observation in small groups. In two different settings we served as consultants for regularly meeting groups of adolescents and adults. On an adolescent psychiatric ward, these groups included patients, the ward administrator, and the head nurse. In a comparison setting from a private day school the groups comprised students, a school administrator, and a teacher. In this paper we report findings from the school study, where one of us (STH) met as a consultant with three groups over a total of 1/2 years. The observations we discuss primarily concern the various coping strategies used by the groups'faculty members. Attempts to abandon school role behaviors were common among the faculty members of the groups. Our observations suggest that these repeated efforts to either abandon or blur their roles represented modes of coping with a highly stressful situation. Examples of these stresses and the coping strategies are detailed within the paper, together with illustration of how the consultant unwittingly participated in such role shifts.

The Formation of a Milieu on an Adolescent Inpatient Ward: Staff Attitudes and Issues

The Formation of a Milieu on an Adolescent Inpatient Ward: Staff Attitudes and Issues

A token reinforcement system for large wards of institutionalized adolescents

Problems associated with the application of token systems to large public institutions for male and female adolescents are discussed. The present experiments demonstrate that two specific behavior problems on an adolescent ward of a state hospital could be controlled through the use of contingent points via a rapid-delivery token procedure and backed up by reinforcers already available in the hospital setting. Sixty male and female patients were maintained by a staff of five aides. Experiment I examined the effects of verbal demands and contingent points on room maintenance behavior. Experiment II examined the effects of verbal demands and contingent points on ward maintenance behavior. Contingent points produced substantial effects on both types of behavior. Several design criteria are elaborated which facilitate working within the limitations of a setting with low priorities on research.

A follow-up study of hospitalized adolescents

An effort was made to assess 138 patients previossly hospitalized as adolescents by a two-stage longitudinal study extending up to 9 yr following discharge from an adolescent ward. The psychotic patients did poorly over time, with significant improvement rare in more than a third of the cases. In contrast, those patients having neurotic disorders, those patients with adjustment reactions, and those patients having personality disorders did quite well over time in spite of their hospitalizations. Also, between the first and the second stages we tended to lose those patients who were functioning in a lower behavioral levels.

Is a separate adolescent ward worthwhile?

In an attempt to ascertain whether a separate ward for adolescents in a hospital is worthwhile, detailed questionnaires were sent to the medical and nursing staff of hospitals with adolescent programs previously surveyed by the authors. Some of these hospitals had separate adolescent wards and some did not. Sixteen of them were then visited personally by us. We examined the facilities and interviewed both staff and patients. For comparative purposes adolescents in four hospitals without adolescent programs were also interviewed. The consensus of the medical and nursing staff, and the patients, was that a separate adolescent ward is worthwhile.