Ecological factors predicting adolescent contraceptive use: implications for intervention.

Questionnaires addressing areas expected to relate to contraceptive use were completed by 230 female adolescents. Contraceptive use among the 130 sexually active subjects were predicted by a model composed of 12 scales assessing social permissiveness, costs and benefits of contraception, parent communication, boyfriend support, sex education and knowledge, attitudes about pregnancy and contraception, and access to contraception services. Scales from the predictive model which raise ideas for potential intervention strategies assessed parent communication, boyfriend support, and perceived costs and benefits related to contraception. Since there has been public concern that intervention programs for enhancing adolescent contraceptive use might also stimulate sexual activity, correlations were computed between the predictive scales and the measure of sexual experience among all 230 subjects. These data indicated that positive parent communication about sexuality and a perception of high benefits and low costs associated with contraceptive use were not positively correlated with sexual experience. Implications for the prevention of adolescent pregnancy are discussed with an emphasis on designing innovative sex education, improving parent-child communication, resolving conflicts in contraceptive decisionmaking, and supporting the role of boyfriends in contraceptive use.

PIP: Questionaires addressing areas expected to relate to contraceptive use were completed by 230 female adolescents. Contraceptive use among the 130 sexually active subjects was predicted by a model composed of 12 scales assessing social permissiveness, costs and benefits of contraception, parent communication, boyfriend support, sex education and knowledge, attitudes about pregnancy and contraception, and access to contraception services. Scales from the predictive model which raise ideas for potential intervention strategies assessed parent communication, boyfriend support, and perceived costs and benefits related to contraception. Since there has been public concern that intervention programs for enhancing adolescent contraceptive use might also stimulate sexual activity, correlations were computed between the predictive scales and the measure of sexual experience among all 230 subjects. These data indicate that positive parent communication about sexuality and a perception of high benefits and low costs associated with contraceptive use were not positively correlated with sexual experience. Implications for the prevention of adolescent pregnancy are discussed with an emphasis on designing innovative sex education, improving parent-child communication, resolving conflicts in contraceptive decision-making, and supporting the role of boyfriends in contraceptive use. Sex education had relatively weak individual relationships with contraceptive regularity. Objective knowledge about contraception was the strongest predictor of contraception. One of the most striking findings is that positive and open parent communication about sexuality is a strong predictor of regular contraceptive usage. Communication with parents may be important in helping female adolescents accept their sexuality and avoid the denial and conflicts which may deter or delay contraceptive use. Personal conflicts and ambivalence about acquiring and using contraceptives needs more investigation. Typically, there is a 6-month delay between initiation of sexual activity and contraceptive use among adolescents. Several researchers have suggested that a period of sexual activity is necessary before female adolescents accept and take responsibility for their sexuality. Boyfriend support was also a strong predictor of contraceptive use. Males may play an important role in helping and supporting girlfriends in contraceptive decision-making. Just as there is a valuable and growing tendency to place more responsibility on males to use contraception, there should be greater acknowledgment for their role in helping females with contraception.

Persistent neuropsychological sequelae of toxic shock syndrome.

Twelve women, aged 16 to 29 years, were interviewed and examined for possible neuropsychological sequelae 2 to 12 months after they recovered from toxic shock syndrome. Six of the 12 women had symptoms such as difficulty concentrating, headache, recent memory lapses, inability to compute, and loss of other higher integrative functions. Eight patients were found to have electroencephalographic abnormalities. All six symptomatic patients but no asymptomatic patients had abnormal neurologic findings. Abnormalities such as impaired memory and calculation and poorly sustained concentration were found in five of six symptomatic patients but in no asymptomatic patient. Six control subjects, all asymptomatic women aged 17 to 29 years, were interviewed and examined 2 to 12 months after they recovered from postpartum endometritis; these subjects were normal in all parameters tested. A direct effect of the staphylococcal toxin on the central nervous system may be the cause of these sequelae.

Assessing community attitudes toward mentally retarded persons.

Although many researchers have found evidence of discrimination toward retarded individuals in employment, education, and housing, attitude-survey researchers generally report acceptance of retarded people in the community (Gallup, 1976; Gottwald, 1967). To examine this discrepancy, we compared responses on a survey concerning retarded people of a "threat" group, who lived near a house for sale that was described as "having the necessary characteristics" for a potential group home, and a "nonthreat" control group. Analysis between and across groups yielded differences that have implications for public education efforts and the validity of the survey method for research on mental retardation.

Chronically ill children. A psychologically and emotionally deviant population?

The study evaluated the psychosocial functioning levels of a group of chronically ill (diabetic, asthmatic, cystic fibrotic, and hearing-impaired) children across a battery of standardized personality instruments. The assessments were performed to provide a rigorous test of the popular hypothesis that chronically ill children are especially vulnerable to psychopatholgy. In contrast to this sterotype, results across measures demonstrated the normalcy rather than the deviance of these children. Although exceptions were noted, the children's functional strengths and coping abilities noticeably outweighed their weaknesses.