Irish Adolescents Research Articles

Sexual Behaviour among Adolescents in Ireland: Findings from the Health Behaviour in School Aged Children (HBSC) Study

Objective: Tackling adolescent sexual health problems and promoting positive sexual health has been widely acknowledged in health policies across Ireland. Increasingly emphasis is placed on integrating empirical evidence at policy and practice level, however limited data on Irish adolescents’ sexual behaviour are available. This study presents the first nationally representative and internationally comparable data on adolescent sexual behaviour in Ireland. Design and Method: Questionnaire data were collected from a stratified national sample of 4494 schoolchildren aged 15-18 as part of the Health Behaviour in School aged Children study. Results: Overall, 28.8% of boys and 22.8% of girls were sexually initiated, with clear age and social class gradients. Substance use and living in poorer neighborhoods were predictive of sexual initiation. While there were no systematic urban/rural differences, living with both parents was protective. Very early sexual initiation (<14 years) was associated with male gender and rural dwelling, and for girls with smoking and cannabis use. Non-use of contraception at last intercourse was reported by 10.5% of boys and 6.8% of girls; with age and social class gradients. Condom use was predicted by self-care behaviours such as physical activity and seat-belt use, but not by substance use. Conclusions: For the first time, data have been collected which improve our understanding of adolescent sexual behaviour in Ireland. The findings highlight the importance of focusing on adolescents as a distinct population subgroup with unique influences on their sexual health requiring specifically targeted policy and interventions.

A shift from offline to online: Adolescence, the internet and social participation

ABSTRACTAdolescents’ social participation is increasingly taking place in virtual settings, including social media, but there is no longer a distinct boundary between online and offline social participation. Furthermore, online social participation is becoming a societal concern, with internet use identified as impacting social and emotional well-being. This qualitative descriptive study explored the occupational nature of online social participation amongst Irish adolescents aged 9-16 years old. Data were collected through three focus groups. Four themes that captured the nature of the Internet as a setting for social participation were identified: a) building relationships and connections, b) identity experimentation and construction, c) cyber culture and virtual norms, and d) overuse and unsociable behaviour. The study provides insights into how adolescents experience and organise their social occupations in online settings and how these unfold into offline ‘reality’. While online social participation expands social experiences and connections, face-to-face experiences were more valued. There is an imperative to research online-offline social participation to develop a broader understanding of this evolving, contemporary occupation.

The Development and Validation of the Gender Role Conflict Scale for Irish Adolescent Boys

Ó Beaglaoich and associates (2013, 2015a, 2015b) report that the Gender Role Conflict Scale for Adolescents (GRCS-A, Blazina et al. 2005) may not be suitable for use with Irish boys. Therefore, the purpose of the current study was to develop a culturally appropriate measure of gender role conflict (GRC). The resultant 26-item scale was entitled the Gender Role Conflict Scale for Irish Adolescents (GRCS-IA). It had satisfactory scale score reliability and a unidimensional factor structure. Evidence of convergent validity was adduced through statistically significant correlations between participants’ gender role conflict and indices of psychological functioning (i.e., self-esteem and state as well as trait anxiety). The divergent validity of the GRCS-IA also was demonstrated (i.e., participants’ gender role conflict did not correlate significantly with their endorsement of masculine norms). Limitations of the current study are outlined and directions for future research are discussed.

Alcohol Behaviors across Perceived Parental Security Profiles in Adolescents

Background: Previous research has suggested a bivariate or correlational relationship between attachment scores and alcohol use behaviors among adolescents. Methods: The present study is a person-oriented analysis of the association between perceived parental security and alcohol behaviors in Northern Irish adolescents (N=1,126, 61% male, school grades 8 to 12; aged 12 to 16 years). Results: Model-based clustering of Inventory of Parent and Peer Attachment-Revised (IPPA-R) scores yielded five profiles: (a) High Security (n=146, 13%), (b) Moderately High Security (n=371, 33%), (c) Ambivalent Security (n=344, 31%), (d) Moderately Low Security (n=198, 18%), and (e) Low Security (n=67, 6%). High Security adolescents perceived high levels of communication and trust with, and low levels of alienation from, parents. Alcohol use ranked from least to highest in the order provided above. Conclusions: When compared to peers with High Security profiles, adolescents with Low Security profiles were almost 8 times more likely to be moderate drinkers and 55 times more likely to be problematic drinkers than abstainers.

An Evaluation of the Measurement Properties of the Five Cs Model of Positive Youth Development.

There is growing recognition of the need to develop acceptable measures of adolescent's positive attributes in diverse contexts. The current study evaluated the measurement properties of the Five Cs model of Positive Youth Development (PYD) scale (Lerner et al., 2005) using a sample of 672 Irish adolescents. Confirmatory factor analyses indicated that a five-factor model provided a good fit to the data. The internal reliability and construct validity of the Five Cs model were supported, with character the strongest predictor of contribution, while connection was the strongest predictor of risky-behaviors. Notably, confidence was significantly negatively related to contribution, and positively related to risky-behaviors. Multi-group hierarchical nested models supported measurement invariance across early- (11–14 years) and late- (15–19 years) adolescent age groups, with partial invariance found across gender. Younger adolescents evinced higher PYD, while PYD was associated with higher contribution and lower depression and risk-behaviors across all groups. The application of the PYD framework as a measure of positive functioning across adolescence is discussed.

Epidemiology of injury in male Irish secondary school adolescents in one academic year

BACKGROUND:Establishing the incidence of injury is the first step in initiating injury prevention strategies. There is a lack of research on injury in Irish adolescents and this study paves the way for further injury prevention research, by implementing a prospective cohort study. PURPOSE:To establish the epidemiology of injury in male adolescents in Irish secondary schools in one academic year. METHODS:452 male 4th and 5th year adolescents (aged 15.62±0.70 years) took part in a prospective epidemiology study for one academic year. Any injury sustained during training or competition resulting in restricted performance or time lost from play was assessed weekly by an athletic rehabilitation therapist. An injury report form was completed to ensure standardisation of the injury description. RESULTS:5.16 injuries per 1,000 hours were noted, with 35.6% at risk of injury and 27.9% of injured participants at risk of sustaining another injury that school year. Competition injuries (16.91 injuries per 1,000 hours) were more common than training injuries (2.63 injuries per 1,000 hours). Lower limb injuries predominated (73.1%) with knee (17.9%), ankle (13.5%) and hamstring (11.7%) injuries most common. Strains (29.4%), sprains (20.8%), fatigue-induced muscle disorder (14.5%) and contusions (13.1%) were frequent. Injuries were primarily minor (0–7 days) (41.6%), followed by severe (>22 days) (39.7%) and moderate (8–21 days) (18.7%). CONCLUSION:Injuries are common in adolescents in Irish secondary schools and the development and implementation of injury prevention strategies are required.

Personality and substance use: psychometric evaluation and validation of the Substance Use Risk Profile Scale (SURPS) in English, Irish, French, and German adolescents.

The aim of the present longitudinal study was the psychometric evaluation of the Substance Use Risk Profile Scale (SURPS). We analyzed data from N = 2,022 adolescents aged 13 to 15 at baseline assessment and 2 years later (mean interval 2.11 years). Missing data at follow-up were imputed (N = 522). Psychometric properties of the SURPS were analyzed using confirmatory factor analysis. We examined structural as well as convergent validity with other personality measurements and drinking motives, and predictive validity for substance use at follow-up. The hypothesized 4-factorial structure (i.e., anxiety sensitivity, hopelessness, impulsivity [IMP], and sensation seeking [SS]) based on all 23 items resulted in acceptable fit to empirical data, acceptable internal consistencies, low to moderate test-retest reliability coefficients, as well as evidence for factorial and convergent validity. The proposed factor structure was stable for both males and females and, to lesser degree, across languages. However, only the SS and the IMP subscales of the SURPS predicted substance use outcomes at 16 years of age. The SURPS is unique in its specific assessment of traits related to substance use disorders as well as the resulting shortened administration time. Test-retest reliability was low to moderate and comparable to other personality scales. However, its relation to future substance use was limited to the SS and IMP subscales, which may be due to the relatively low-risk substance use pattern in the present sample.

Psychostimulant prescribing trends in a paediatric population in Ireland: a national cohort study

BackgroundPsychotropic paediatric prescribing trends are increasing internationally. The aim of this study is to examine the prevalence and secular trends in psychotropic prescribing in Irish children and adolescents between 2002 and 2011.MethodsData was obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive Primary Care Reimbursement Services (HSE-PCRS). Prescribing rates per 1000 eligible population and associated 95 % confidence intervals (CIs) were calculated across years (2002–2011), age groups (0–4, 5–11, 12–15 years) and gender. Rates of concomitant prescriptions for psycholeptics and antidepressants were also examined. The total expenditure costs were calculated and expressed as a percentage of the cost of all prescriptions for this age group (≤15 years).ResultsIn 2002, 3.77/1000 GMS population (95 % CI: 3.53–4.01) received at least one psychostimulant prescription and this rate increased to 8.63/1000 GMS population (95 % CI: 8.34–8.92) in 2011. Methylphenidate was the most frequently prescribed psychostimulant. For both males and females the prevalence of medication use was highest among the 12–15 year old group. On average, a psycholeptic medication was prescribed to 8 % of all psychostimulant users and an antidepressant was concomitantly prescribed on average to 2 %. Total expenditure rose from €89,254 in 2002 to €1,532,016 in 2011.ConclusionsThe rate and cost of psychostimulant prescribing among GMS children and adolescents in Ireland increased significantly between 2002 and 2011. Further research is necessary to assess the safety, efficacy and economic impact of concomitant psychotropic prescribing in this population.

Reliability and factorial validity of Adolescent Time Inventory–Time Attitude (ATI-TA) Scores in Scottish and Northern Irish adolescents

The contemporary literature investigating the construct broadly known as time perspective is replete with methodological and conceptual concerns. These concerns focus on the reliability and factorial validity of measurement tools, and the sample-specific modification of scales. These issues continue to hamper the development of this potentially useful psychological construct. An emerging body of evidence has supported the six-factor structure of scores on the Adolescent Time Inventory–Time Attitudes Scale, as well as their reliability. The present study utilized data from the first wave of a longitudinal study in the United Kingdom to examine the reliability, validity, and cross-cultural invariance of the scale. Results showed that the hypothesized six-factor model provided the best fit for the data; all alpha and omega estimates were >.70; scores on ATI-TA factors related meaningfully to self-efficacy scores; and the factor structure was invariant across both research sites. Results are discussed in the context of the extant temporal literature.

Attitudes and perceived risk of cannabis use in Irish adolescents.

Cannabis is the most widely used illicit drug in the developed world and its use is associated with several adverse physical and mental health effects and negative social outcomes. Earlier use of cannabis increases the risk of adverse effects. Attitudes and perceived risk towards drugs are regarded as strong influences in determining whether or not a person uses cannabis, but there is little existing research on Irish teenagers' attitudes to the risks of this drug. This was a descriptive, cross-sectional study using a structured, anonymous questionnaire. The study was undertaken in nine public and private secondary schools in Cork City and suburbs. Students aged 15-18 and in fourth, fifth or sixth year of school were included. Of the 507 participating students, 39.3% (n=199) reported previous cannabis use. There were significantly lower levels of perceived risk of cannabis among those who had used the drug compared with those who had not, for all categories of risk (p<0.01). Attitudes towards cannabis were more liberal among males and those with previous use of the drug. A minority of students (n=92; 18.2%) support legalisation of cannabis. The majority of teenagers (n=382; 75.8%) believe that they are not given enough information about the drug. Cannabis use is very widespread among teenagers in Cork. There are relatively low levels of perceived risk of mental and physical health problems with use of the drug. Attitudes towards cannabisare associated with personal use of the drug and gender.

Psychometric properties of the Posttraumatic Cognition Inventory within a Northern Ireland adolescent sample.

This study sought to investigate the psychometric properties of the Posttraumatic Cognitions Inventory (PTCI; Foa etal., 1999, Psychol. Assess., 11, 303) among a cohort of older adolescents and to determine the relationship between post-traumatic cognitions and a variety of psychological outcomes including depression, anxiety, stress, and loneliness. The PTCI was investigated among a large sample (N=785) of Northern Irish adolescents. Confirmatory factor analysis and composite reliability analysis were conducted to assess the psychometric properties of the scale. The familiar three-factor solution of negative cognitions of self, negative cognitions of the world and others, and self-blame was supported; however, it was necessary to remove eight items from the original 33-item scale. The three-factor structure was subsequently demonstrated to be factorially invariant across gender and to possess satisfactory internal reliability. The three PTCI factors were found to correlate with depression, anxiety, stress, and three dimensions of loneliness. These results provide the first piece of evidence that older adolescents cognitively respond to trauma in a similar manner to adults, that the PTCI is factorially invariant between genders, and that trauma cognitions are correlated with feelings of loneliness. The contextual dependent nature of the structure of the PTCI factors is discussed in relation to future research efforts. The PTCI is a valid and reliable measure of trauma-related cognitions among adolescents and works equally well for male adolescents and female adolescents. Trauma cognitions are associated with a range of mental health problems beyond post-traumatic stress disorder including depression, anxiety, stress, and various aspects of loneliness. Reductions in trauma cognitions in survivors of trauma will have wide-scale clinical benefits to patient well-being. The exact structure and make-up of items in the PTCI may well be dependent on culture, context, and the nature of the trauma. The study is limited due to the fact that the authors could not assess the severity of the trauma experienced by the adolescent sample.

Mental Health Literacy and Help-Giving Responses in Irish Adolescents

This study assessed mental health literacy in Irish adolescents ( N = 187), and explored participants’ help-giving responses toward hypothetical depressed peers. Participants read five vignettes, each describing an adolescent experiencing a life difficulty; two of the characters met Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) criteria for depression. The majority of participants could not identify depression or potential suicidality, but felt concerned for the depressed characters’ well-being. Most participants stated they would provide help if they were the depressed characters’ friends. Correct identification of depression did not influence the type of help offered. A significant proportion of participants did not mention engaging an adult’s assistance, and assessing for suicidality was not mentioned by any participant. Gender differences were found in mental health literacy and the type of responses offered. Education that emphasizes the importance of informing an adult and assessing for suicidal risk is recommended.

The risk and protective factors associated with depression and anxiety in a national sample of Irish adolescents.

The aim of this study is to examine the risk and protective factors associated with anxiety and depression in a representative sample of Irish adolescents. Data used in this study were drawn from a subset of the My World Survey (MWS). The MWS-Second Level (MWS-SL) subset consists of a randomised sample of 72 schools, with a final sample of 6085 students. Outcome measures were depression and anxiety. Risk and protective factors included measures within the socio-demographic, psychosocial and risk-taking domains. One in three adolescents experienced elevated levels of depression and anxiety. Age, gender, maternal education, family composition, parental mental health as well as the experience of racism and bereavement were associated with elevated distress. Psychosocial factors associated with depression and anxiety included optimism, personal competence, life-satisfaction, self-esteem, anger, body dissatisfaction, family competence, maternal and paternal criticism, experiencing the break-up of a romantic relationship, school and peer connectedness as well as the availability of one good adult. Finally, engaging in substance misuse was found to increase the likelihood of anxiety and depression. Since factors protecting and putting adolescents at risk of anxiety and depression exist at every level of the adolescent's ecological system, the study supports a community-based approach to youth mental health.

Exploring traditional and cyberbullying among Irish adolescents

This study aimed to explore the associations of traditional and cyberbullying victimisation with self-reported health and life satisfaction, and to examine whether involvement in risk behaviours contributes to these health outcomes. We asked questions on involvement in traditional and cyberbullying, risk behaviours, self-reported health and life satisfaction to school children. In total, 318 students aged from 15 to 18years old in 8 post-primary schools in Ireland completed the survey. Children who were victims of bullying were more likely to report poor health, low life satisfaction and engaging in risky behaviours. Although not statistically significant, we found that cyber victimisation was positively associated with increased reporting of poor health and low life satisfaction. Traditional bullying is the most common type of bullying among school children in Ireland, and overall, seems to have a stronger association with poor health. However, a sizable proportion of children are victims of cyberbullying or of both cyberbullying and traditional bullying. It is, therefore, important to acknowledge, identify and address all types of bullying to improve the health outcomes of children.

Adolescents’ Explanations for the Exclusion of Peers With Mental Health Problems

Young people with mental health problems are often excluded from their peer group; however, research has not specifically explored their peers’ explanations for this exclusion. Drawing on data from group interviews with Irish adolescents ( N = 148), this study explores the reasons offered for rejecting young people with mental health problems. Such reasons include perceived violation of expectations of friendships, and perceived social and personal risks to members of the peer group. The implications of these findings for the development of interventions to combat the stigma of mental health problems are discussed.

Food portion sizes and dietary quality in Irish children and adolescents.

To describe relationships between the portion sizes of a range of foods commonly consumed by Irish children and adolescents and key indicators of dietary quality on the days they were consumed. Cross-sectional data from the Irish National Children's Food Survey (2003-2004; 7 d weighed record) and National Teens' Food Survey (2005-2006; 7 d semi-weighed record) were used to compare mean values for a number of dietary quality indicators (e.g. energy-adjusted intakes of saturated fat, dietary fibre and Na) across portion size tertiles for a range of foods, on the days the foods were consumed. The Republic of Ireland. Nationally representative samples of children aged 5-12 years (n 594) and adolescents aged 13-17 years (n 441). Relationships between food portion sizes and indicators of dietary quality on the days the foods were consumed were similar in both children and adolescents. Lower dietary energy density and saturated fat intakes, and higher dietary fibre intakes, were observed on the days larger portions of fruit and boiled potatoes were consumed. Higher dietary energy density and lower micronutrient intakes were observed on the days larger portions of sugar-sweetened beverages were consumed. Higher Na intakes were observed on the days larger portions of frying meats were consumed. The current work identifies foods for which larger portion sizes may be associated with positive dietary attributes, as well as the opposite. Findings will form an evidence base from which more specific dietary guidance relating to portion size may be developed for Irish children and adolescents.

Differences in the factor structure of the Strengths and Difficulties Questionnaire in Northern Irish children.

This study presents the psychometric properties of the Strengths and Difficulties Questionnaire (SDQ) in a sample of 386 Northern Irish adolescents. Structural validity was evaluated by exploratory and confirmatory factor analysis. Agreement was found with 3 of the 5 original factor structures: Emotional Problems, Prosocial, and Hyperactivity. However, unlike in the original SDQ, there appeared to be 2 distinct and separate Conduct factors, an Aggressive Conduct and an Antisocial Conduct factor. Furthermore, there appeared to be a Good Behavior factor, which is not present in the original factor structure. The findings imply that when using the SDQ with children and adolescents exposed to community and political conflict, results should be interpreted with caution. Further research is warranted to explore the reliability of the original factor structure with these young people who experience unique developmental trajectories compared with their peers who do not grow up in such an environment.

Vitamin D status in Irish children and adolescents: value of fortification and supplementation.

Vitamin D has important skeletal and extraskeletal roles but those living at northerly latitudes are at risk of suboptimal levels because of reduced sunlight exposure. To describe the vitamin D status of Irish children and identify factors predictive of vitamin D status. A prospective cross sectional study was undertaken over a 12 month period. Two hundred and fifty two healthy children attending for minor medical or surgical procedures were recruited. All had 25-hydroxyvitamin D (25OHD), parathyroid hormone and bone profiles measured. The mean (standard deviation) for 25OHD was 51(25) nmol/L (20.4 (10) ng/mL). Forty-five percent had levels >50 nmol/L (20 ng/mL). The following variables were significantly associated with 25OHD levels >50 nmol/L (20 ng/mL): sample drawn in April-September, use of vitamin D supplements, consumption of formula milk, and non-African ethnicity. More than half of the children in this study had 25OHD levels less than 50 nmol/L (20 ng/mL). Vitamin D status was significantly improved by augmented oral vitamin D intake.

The iceberg of suicide and self-harm in Irish adolescents: a population-based study

Suicide is a leading cause of death among adolescents. Self-harm is the most important risk factor for suicide, yet the majority of self-harm does not come to the attention of health services. The purpose of this study was to establish the relative incidence of adolescent suicide, hospital-treated self-harm and self-harm in the community. Annual suicide rates were calculated for 15-17 year-old in the Cork and Kerry region in Ireland based on data from the Central Statistics Office. Rates of hospital-treated self-harm were collected by the Irish National Registry of Deliberate Self-Harm. Rates of self-harm in the community were assessed using a survey of 3,881 adolescents, the Child and Adolescent Self-harm in Europe study. The annual suicide rate was 10/100,000. Suicide was six times more common among boys than girls. The annual incidence rate of hospital-treated self-harm was approximately 344/100,000, with the female rate almost twice the male rate. The rate of self-harm in the community was 5,551/100,000, and girls were almost four times more likely to report self-harm. For every boy who died by suicide, 16 presented to hospital with self-harm and 146 reported self-harm in the community. For every female suicide, 162 girls presented to hospital with self-harm and 3,296 reported self-harm. Gender differences in relative rates of self-harm and suicide are very large, with boys who have harmed themselves at particularly high risk of suicide. Knowledge of the relative incidence of self-harm and suicide in adolescents can inform prevention programmes and services.

Prevalence rates and risk factors for mental health difficulties in adolescents aged 16 and 17 years living in rural Ireland.

This study sought to ascertain the prevalence rates and risk factors for a range of mental health difficulties, including suicidal ideation/self-harm among 16 and 17-year-old rural Irish adolescents, a vulnerable group in transition from childhood to adulthood. Adolescents (n=237) took part in this cross-sectional study. Participants completed a questionnaire compendium consisting of generic questions on demographic information, use of mental health services and four normed questionnaires: The Youth Self-Report, the Children's Depression Inventory, the Coping Inventory for Stressful Situations-Adolescent and The Family Assessment Device. We found that 16.9% of adolescents reported clinically significant mental health difficulties. Significant gender differences were found on internalising and externalising difficulties. There were no gender differences in suicidal ideation or self-harm. Only 3.4% of adolescents were receiving professional help for mental health difficulties. Multiple regression analyses revealed that family dysfunction, emotion-focussed coping and poor academic competence were significant predictors of poorer mental health difficulties in both genders. Family dysfunction was the strongest predictor of mental health difficulties in males. Among females, emotion-focussed coping was the strongest predictor of internalising difficulties and depression. Social diversion (social support) was predictive of less internalising difficulties and depression for females. The study shows that a significant number of Irish 16 and 17 year olds have mental health difficulties, yet very few are receiving treatment. Emotion-focussed coping, family dysfunction, poor academic competence and less social support were important predictors of mental health difficulties. A new finding is the stronger association that family dysfunction has with poorer mental health in males than females, when controlling for academic competence and coping skills. The findings may have implications for psychological interventions.