Dating,Sexual Activity,and Well-Being in Italian Adolescents

Associations among dating, sexual activity, gender, and adjustment were investigated in 2,273 Italian adolescents (54% female, ages 14 to 19 years) attending public high schools. After controlling for age and type of school attended, both being in a dating relationship and being male were associated with less alienation, more positive views of the self, and higher general expectations for success. Sexual activity interacted with both gender and dating status in predicting feelings of depression. For boys, there were no differences between youth who were sexually active and youth who were not; however, sexually active girls had higher levels of depressive symptoms than girls who were not sexually active. Among youth who were not sexually active, there were small differences between daters and nondaters; among sexually active youth, daters had lower levels of depression than nondaters. Gender differences in adolescents' experience of dating and sexual relationships and implications for adjustment are discussed.     

青少年的生命意义感与幸福感

目的:探讨当代青少年生命意义感与幸福感的特征及关系,为进一步开展青少年生命教育提供依据.方法:选取温州、湖州两地区初一至初二、高一至高二、大一至大四青少年1141名.采用生命态度剖面图量表(LAPS)、心理幸福感量表(PWBS)、学生总体生活满意度量表(SLSS)和积极-消极情感量表(PANA)进行调查.将PWBS得分最高和最低的各27％抽出作为高分组和低分组,其余为中间组.结果:高中生LAPS、PWBS、SLSS及积极情感和消极情感得分均低于初中生和大学生[如,LAPS得分,(3.5±4.2)vs.(3.8±4.7),(3.7±4.0);均P＜0.001];性别与年级在生命意义感的意义意志和生命控制两个维度及积极情感上有交互作用(F=3.67、7.20、4.92;均P＜0.05).高生命意义感水平青少年的PWBS、SLSS和PANA的积极情感得分均高于低生命意义感青少年[(4.5±7.6)vs.(3.5±7.0)、(3.3±4.0)vs.(2.7±4.1)、(3.6±2.5)vs.(2.8±3.8);均P＜0.01].LAPS的存在充盈、意义意志、生命控制、死亡接纳及生命目的因子得分与PWBS总分呈正相关(0.11～0.39,均P＜0.001),LAPS的存在充盈、生命目的、苦难接纳因子得分与SLSS总分呈正相关(0.38、0.12、0.11,均P＜0.001),LAPS的存在充盈、意义意志、生命控制因子得分与积极情感总分呈正相关(0.25、0.31、0.18,均P＜0.001).结论:青少年中高中生的幸福感水平较低,生命意义感对个体的幸福感可能有促进作用.     

Emotional well-being, sexual behaviour and hormone replacement therapy

Improvements in the design of epidemiological studies of the climacteric and postmenopause have been made in the past 25 years. But more complex theoretical models are necessary if we are to give due emphasis to the influence of psychological, social, cultural and hormonal factors and their interactions. The majority of studies show that emotional problems are not more prevalent during the climacteric and postmenopause and that psychosocial factors, such as stressful life-events, are more likely causes of emotional distress during mid-life. Vaginal dryness increases in postmenopausal women but there are varied reasons for changes in other aspects of sexual behaviour which require further research. While estrogen may have a "mental tonic" effect when prescribed in high doses, HRT does not appear to have a significant effect upon mood or sexual behaviour over and above placebo effects and the relief from vasomotor and vaginal symptoms.     

Subjective well-being and 'male depression' in male adolescents

BACKGROUND: The concept of male depression is based on the hypothesis that typical symptoms of depression in men often seem to be masked by non-typical male distress symptoms not considered in common depression inventories. Although there is a large amount of clinical evidence, scientific evidence is still lacking. The study aims at further validating the concept of male depression, by obtaining information on symptoms reported by males, and analyzing the dimensional structure of the Gotland Scale of Male Depression [Rutz, W., 1999. Improvement of care for people suffering from depression: The need for comprehensive education. International Clinical Psychopharmacology 14, 27-33.]. METHODS: A community sample of male adolescents aged 18 (n=1004) was asked to complete the WHO-5 Well-being Index [Bech, P., 1998. Quality of life in the psychiatric patient. London: Mosby-Wolfe.] and the Gotland Scale of Male Depression [Rutz, W., 1999. Improvement of care for people suffering from depression: The need for comprehensive education. International Clinical Psychopharmacology 14, 27-33.]. Principal component analysis with promax rotation was calculated to analyze the dimensional structure of the Gotland Scale. Cluster center analyses were used to classify the sample according to the symptoms' characteristics. RESULTS: General well-being was rather reduced, and 22% of the respondents were seen to be at risk of male depression. There was no evidence for the hypothesis that young males tend to mask their depressive symptoms with distress symptoms. Depressive and male distress symptoms appeared to be mixed in a dominant factor, while male distress symptoms constitute an additional minor factor. A cluster of 38% of those at risk for depression could be identified who reported significantly elevated male distress symptoms. Irritability turned out to be the single item of the Gotland Scale with the highest item-total correlation. LIMITATIONS: Risk of depression was not assessed by an additional depression scale or evaluated by a clinical rating. CONCLUSIONS: Male distress symptoms should be considered when diagnosing depression in men. Further research is needed with respect to comorbidity and differential diagnoses, which should also include bipolar depression.     

Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women

OBJECTIVE: Circulating testosterone in women declines during the late reproductive years such that otherwise healthy women in their 40s have approximately half the testosterone level as women in their 20s. Despite this, research showing the benefits of androgen replacement has been limited to the postmenopausal years. In view of the known premenopausal physiological decline in testosterone, we have evaluated the efficacy of transdermal testosterone therapy on mood, well-being, and sexual function in eugonadal, premenopausal women presenting with low libido. DESIGN: Premenopausal women with low libido participated in a randomized, placebo-controlled, crossover, efficacy study of testosterone cream (10 mg/day) with two double-blind, 12-week, treatment periods separated by a single-blind, 4-week, washout period. RESULTS: Thirty-four women completed the study per protocol, with 31 women (mean age 39.7 +/- 4.2 years; serum testosterone 1.07 + 0.50 nmol/L) providing complete data. Testosterone therapy resulted in statistically significant improvements in the composite scores of the Psychological General Well-Being Index [+12.9 (95% CI, +4.6 to +21.2), P = 0.003] and the Sabbatsberg Sexual Self-Rating Scale [+15.7 (95% CI, +6.5 to +25.0), P = 0.001] compared with placebo. A mean decrease in the Beck Depression Inventory score approached significance [-2.8 (95% CI, -5.7 to +0.1), P = 0.06]. Mean total testosterone levels during treatment were at the high end of the normal range, and estradiol was unchanged. No adverse effects were reported. CONCLUSIONS: Testosterone therapy improves well-being, mood, and sexual function in premenopausal women with low libido and low testosterone. As a substantial number of women experience diminished sexual interest and well-being during their late reproductive years, further research is warranted to evaluate the benefits and safety of longer-term intervention.     

Mental distress and sexual harassment in Italian university students

Only a few studies have analyzed the association between sexual harassment (SH) and mental health controlling for other types of violence. The aim of this study was to describe SH among male and female university students and analyze the association between harassment and mental distress controlling for sexual violence. An observational survey was conducted at Trieste University (Italy). Students answered an anonymous questionnaire about harassment that included three domains—sexual harassment, gender harassment, cyber harassment—and three psychological health indicators. The global harassment index was computed, with three levels: 0, no harassment; level 1, harassment in at least one of the three domains; and level 2, harassment in two or three domains. The symptoms of mental distress were measured by the 12-item General Health Questionnaire (GHQ) for depressive symptoms; a question about panic symptoms; and a question about general health. The sample included 759 students (412 women; 18 to 29 years old). After adjustment for age, birth country, couple relationship, employment status, mother’s education, and previous sexual violence, the risk of mental distress was increased with harassment exposure. Men were affected in perceived health and depressive symptoms (GHQ score ≥ 6); women were affected in panic symptoms. Harassment has a strong negative impact on the mental health of victims; in some cases, men may be more affected than women. Clinicians should be aware of the negative impact of SH also on men.

     

Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents

In the present study, the researchers examined factors related to depression, hopelessness, and suicidality in gay, lesbian, and bisexual adolescents, compared with demographically similar heterosexual adolescents. Sexual minority adolescents reported greater depression, hopelessness, and past and present suicidality than did heterosexual adolescents. However, when controlling for other psychosocial predictors of present distress, significant differences between the 2 samples disappeared. For past suicidality scores, the effects of sexual orientation were reduced, but still significant, when accounting for the other predictor variables. These results suggest that environmental factors associated with sexual orientation, which can be targeted and changed through prevention and intervention efforts, play a major role in predicting distress in this population.     

Sleep habits and circadian preference in Italian children and adolescents

Sleep habits and circadian preference (morningness/eveningness, M/E) have been extensively analyzed in adolescents and young adults, while few studies were conducted on children and early adolescents. Aim of the present study was to investigate the developmental changes of circadian preference and to analyze its relationship with sleep habits, sleep problems and circadian preference in a large sample by means of a school-based survey. One thousand seventy-three participants (50.8% boys and 49.2% girls; mean age = 10.6; range = 8-14 years), recruited from four schools randomly extracted within the district of Rome, completed a modified version of School Sleep Habits Survey developed by Carskadon et al. The questionnaire included items about sleep habits during schooldays and weekends; a Sleepiness Scale; a Sleep-Wake Problems Behaviour Scale; a Morningness/Eveningness scale. The results show a consistent age-related change in sleep habits, particularly in the weekends. The difference in sleep duration between schooldays and weekends increases linearly with age. No gender difference was observed in morningness/eveningness, while a significant linear increase in evening preference was found with increasing ages. M/E total scores correlated significantly with both self-reported sleep/wake problems and daytime sleepiness indicating a higher prevalence of sleep complaints in evening-type subjects. Overall, the present results support the existence of consistent age-related changes in sleep habits and M/E dimension in the 8- to 14-year age range.     

Family functioning and binge drinking among Italian adolescents

Limited studies have sought to describe binge drinking among adolescents and even fewer studies have attempted to examine whether family functioning, family communication and satisfaction could be associated with alcohol abuse. Our sample was made up of 726 Italian adolescents between the ages of 16 and 18. According to previous research, adolescents were categorized into non-drinkers, social, binge and heavy drinkers. Results showed that social, binge and heavy drinkers differ in terms of some drinking variables, family functioning, family communication and satisfaction.     

FELS,Greulich-Pyle,and Tanner-Whitehouse bone age assessments in a group of Italian children and adolescents

Assessments of skeletal maturity are usually made from handwrist radiographs, using either the method of Greulich-Pyle (GP) or Tanner-Whitehouse (TW). Recently the FELS method has been developed, and it represents a potentially valuable approach to skeletal age assessment. The present study evaluates the accuracy and precision of FELS skeletal age assessments compared with ratings by the GP and TW methods in a group of Italian children and adolescents. The hand-wrist radiographs of subjects (171 males and 156 females 1 to 17 years) referred to the “Istituto di Puericultura e Medicina Neonatale” of the University of Genoa in Italy between 1985 and 1990 were assessed according to each method. Two independent observers rated the radiographs and one observer reassessed them after 6 months or more. GP estimates rather closely match chronological age; TW ratings tend to overestimate chronological age by 7–9 months around puberty, mainly in boys; and the FELS method tends to overestimate chronological age by amounts that increase with chronological age. The degree of precision of skeletal age assessments is within the usually accepted limits. Higher levels of repeatability and reproducibility are apparent for the FELS estimates than for GP and TW assessments. Thus, skeletal maturity is likely to be adequately interpreted by the FELS method as well as by the more commonly used GP and TW systems in Italian children and adolescents. © 1992 Wiley-Liss, Inc.     

HIV/AIDS among adolescents in Eastern Europe: knowledge of HIV/AIDS, social representations of risk and sexual activity among school children and homeless adolescents in Russia, Georgia and the Ukraine

The two studies reported here focus on knowledge and representations of HIV/AIDS (study 1) plus sexual behaviour and hedonistic values (study 2) among 14-17-year-old school children and similar aged shelter children. Results indicate that shelter children are more sexually active, less knowledgeable about means of HIV transmission and are more likely to hold stereotyped representations of those most at risk of infection. Russian respondents were the most sexually active, a finding which could at least be partly explained by their higher levels of hedonistic values. These findings are discussed in the context of a climate of continuing social change in this region.     

African-American sexual minority adolescents and sexual health disparities: An exploratory cross-sectional study

PurposeTo better understand sexual health disparities among African-American sexual minority adolescents.MethodsAfrican-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history.ResultsCompared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV.ConclusionsAfrican-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents.     

Assessment of sexual function, interest and activity in depressed men

Sexual function, interest, and activity were assessed in drug-free outpatient depressed men (n = 26) and in age-matched healthy control men (n = 20) by means of the Derogatis Sexual Functioning Inventory (DSFI), a retrospective sexual function questionnaire (SFQ), and a prospective daily sexual function log. Good test-retest reliability over 1 month was demonstrated for the DSFI and the SFQ in depressives and controls. Compared to healthy controls, depressed men reported significantly lower sexual interest and satisfaction, but no less sexual activity, on both retrospective questionnaires and prospective daily logs. Depressed men also showed significantly more negative body image and less 'manly' sexual role function as measured by the DSFI. Significant partial correlations (controlling for the effects of anxiety) were found between severity of depression and sexual interest, satisfaction, and role.     

Illness centrality and well-being among male and female early adolescents with diabetes

OBJECTIVE: We examined the implications of illness centrality for psychological and physical health among male and female early adolescents with type 1 diabetes. METHODS: We interviewed 132 adolescents before or after a routine clinic appointment. We measured the extent to which they defined themselves in terms of their illness, their views of the illness, psychological well-being, self-care behavior, and metabolic control. RESULTS: Females scored higher on illness centrality than males. Illness centrality was related to poor psychological well-being when the illness was perceived in negative terms, but only for females. For males, illness centrality was unrelated to psychological well-being. Illness centrality was related to poor metabolic control. CONCLUSIONS: The extent to which adolescent females define themselves in terms of their illness is most problematic when the illness is perceived in highly negative terms. Future research should examine how illness centrality and views of illness change over the course of adolescence.     

Characterisation of invasive meningococcal isolates from Italian children and adolescents

Meningococcal invasive disease is a life-threatening infection that affects mostly children and adolescents. The present study was performed during 2003-2005 to compare the phenotypic characteristics of meningococcal isolates from these two main groups at risk with those of isolates from other age groups to assess whether strategies for treatment and prevention implemented elsewhere can also be applied in Italy. The results showed that serogroup C meningococci were predominant, and that a dramatic increase in the circulation of strains with decreased susceptibility to penicillin was associated mainly with a prevalent phenotype C:2b:P1.5,2, which belongs to the hyper-virulent ST8/A4 cluster.     

Relationships between physical activity, obesity and meal frequency in adolescents

OBJECTIVE: The purpose of this study was to assess the associations and impact of increased meal frequency, physical activity and 'skipping' breakfast on obesity levels in a sample of urban adolescents, aged 13-17 years old, from Porto, Portugal. METHODS: Overweight and obesity were defined according to age- and sex-specific BMI cut-points. Daily meal frequency was assessed by questionnaire. Self-reported physical activity was recalled. Results: The proportion of overweight/obese girls (p < or = 0.05) and boys (p < or = 0.001) that consumed fewer than three meals was significantly higher than those reported from normal-weight counterparts. While no statistically significant differences were reported in girls, obese boys skipped breakfast significantly more (13% vs 5.6%; p < or = 0.05) than normal-weight counterparts did. Normal-weight boys but not girls were significantly more active (p < or = 0.01) than obese peers. An additional meal in boys (OR: 2.75; p < or = 0.05) and girls (OR: 1.97; p < or = 0.05) reduced the risk of being overweight/obese. Regardless of gender, breakfast skipping is not seen as a predictor of being overweight/obese. However, boys (OR: 2.10; p < 0.003), but not girls, who were moderately active were more likely to be of normal weight. CONCLUSION: The data indicate that increased meal frequency may have a beneficial effect on a reduced BMI. Physical activity and breakfast skipping may be candidate targets for prevention programmes aimed at reducing overweight/obesity among adolescents.