A review on eating disorders and adolescence.

Eating disorders in adolescence are a public health concern with both personal costs and a financial burden for the community health services. This paper is a review of incidence and gender differences of eating disorders; comorbid psychopathology, including substance abuse, mood disorders, anxiety disorders and personality disorders; developmental and intellectual factors; family, socio-cultural functioning and birth order; self-injury and suicidal behaviour with health outcome and therapy success rate. We have also asked several questions from our clinical experience and tried to answer them with our clinical knowledge and based on literature review. Overall, there is an indication that therapy success is significantly correlated with (low) manifestation, specifically for social problems and aggressivity. Due to the complexity of factors involved in the manifestation of eating disorders, the inclusion of cognitive-behavioural therapy as well as family-oriented therapeutic concepts coupled with medical treatment would appear to offer an intervention inventory, which would be most effective in offering adolescents optimal treatment programmes. The implications of our review is discussed in terms of psychotherapeutic treatment plans for adolescents in clinical care.

Risk factors for suicidal behavior in adolescents.

Adolescent suicide is today a public health problem among the leading cause of mortality among adolescents and young adults. There seems to be many reasons for this increase (which has different trends in different populations), but associations have been found with increased substance abuse, television and video violence, socio-economic status and easy access to firearms. Gender differences have also been observed with crime, suicide and substance abuse higher among males, while eating disorder, depression and suicidal behavior more prevalent among females. This paper will review prevalence and incidence of adolescent suicidal behavior, socio-demographic and psychological risk factors, associated cognitive factors and socio-economic factors. Risk factors include previous suicide attempts, a history of others in the family who have been suicidal, mental illness, alcohol and drug use, and other self-destructive behaviors as well as consideration being given to hopelessness, hostility, negative self-concept and isolation. At the individual difference level, factors such as trait depression, anger and hostility, perfectionism and social sensitivity would seem critical variables, as would age, gender and intellectual functioning. Sociological and family-related factors may also be implicated including dysfunctional family organizations, a history of physical or psychological abuse (sexual abuse) and limited extent of social support networks. A frequently reported precipitating event of suicidal behavior is family adversity including rejection, separation and interpersonal conflict. At a socio-economic level it would seem essential to provide comprehensive document about the social and economic conditions from which the adolescent comes.

[Health and migration. Psychosocial determinants]. / Migration und Gesundheit. Psychosoziale Determinanten.

The article provides an overview of the contemporary literature on the social and psychological factors which are associated with migration. Derived from the operationalisation of "migration" and an examination of the methodological peculiarities of migration research, a (transactional) stress model of migration is proposed incorporating potentially stress-eliciting influences of migration including occupational pressures, social isolation and/or family-related problems and their impact on psychological and physical health. There are inconsistencies in the findings regarding psychological health, which can in part be explained through the phenomena of the "healthy migrant effect", duration of stay in the host culture or the culture-specificity. Moreover, a discussion is provided of the extent that disorders associated with differentially stressed migrants will be manifested in the health care system. Finally, concluding remarks are offered together with a short discussion of the implication of these findings for future research and social and health policy decision-making.

The relationship between physical activity and self-image and problem behaviour among adolescents.

BACKGROUND: Although there are a vast array of studies which have demonstrated the psychological and physical health benefits of regular aerobic exercise for adults, few studies have focussed on children and adolescents. The current study examined associations between the extent of participation in endurance sport, and self-report data on self-image, physical and psychological health and overall lifestyle in a large representative sample of German high-school students. METHOD: Almost 1000 German adolescents (aged 14-18 years) were administered a comprehensive series of questionnaires aimed at assessing anxiety-depression, trait addiction, smoking and drinking behaviour, physical ill-health reports, and self-perception of self-image, parental acceptance and educational attainment. RESULTS: Regular practice of endurance exercise was related to a more favourable self-image. There was a strong association between participation in sports and the type of personality that tends to be resistant to drug and alcohol addiction. Physical exercise was further significantly related to scores for physical and psychological well-being. Adolescents who engaged regularly in physical activity were characterised by lower anxiety-depression scores, and displayed much less social behavioural inhibition than their less active counterparts. CONCLUSION: It is likely that discussion of recreational or exercise involvement may provide a useful point of entry for facilitating dialogue among adolescents about concerns relating to body image and self-esteem. In terms of psychotherapeutic applications, physical activity has many additional rewards for adolescents. It is probable that by promoting physical fitness, increased physical performance, lessening body mass and promoting a more favourable body shape and structure, exercise will provide more positive social feedback and recognition from peer groups, and this will subsequently lead to improvement in an individual's self-image.

Age and sex differences in health beliefs and behaviours.

200 adults completed various questionnaires about their general health awareness, health locus of control, and the perceived causes of illness. Whereas there were fewer age differences than expected, a number of consistent sex differences appeared. For example, the women relied less on "provider control" of health (doctors being in charge), expressed greater "nutritional consciousness," and believed more than men that psychological factors play an important part in the aetiology of illness.

The self-image of Greek, Greek-migrant and German adolescents.

This paper provides an empirical perspective on the relationship between immigration and self-image in a sample of German and Greek adolescents. The subjects were Greeks (non-migrants, n = 128), Germans (n = 103) and Greek migrants living in West Germany (n = 103). The Offer Self-image Questionnaire (OISQ) was used as a multidimensional measure of psychological, social and sexual self, and family relations. Comparisons were made between the mean scores of the three national groups on subscales of the OSIQ. Greek migrants had quite distinct self-image profiles that were intermediate between non-migrating Greeks and native Germans. Gender and age differences in self-image were pronounced in sub-scales of the OSIQ. Migrants were more emotional than non-migrants, less introverted, more liberal in their sexual attitudes and displayed superior adjustment. Compared with their German counterparts, migrants emerged as more impulsive and emotional, with an inferior body image, higher achievement motivation, lower mental ill-health but with higher adjustment. The results showed that when both Greek samples (non-migrants and migrants) were taken together and compared to Germans then differences emerged and indicated small but significant cross-cultural differences in personality.

The health beliefs and behaviours of orthodox and complementary medicine clients.

This study examined different attitudes towards health and illness among an adult, working, German population. Two hundred and two subjects completed a questionnaire which assessed such beliefs as control over one's health; preventative and restorative measures in staying healthy; perceived efficacy of orthodox vs. complementary medical treatment; the underlying physiological or psychological bases of illnesses, and health consciousness. There was some evidence that females were more inclined to attend complementary forms of treatment, and that younger persons were more likely to consult an orthodox general practitioner, otherwise demographic variables were unrelated to preference for orthodox or complementary forms of treatment. Overall, the complementary medicine (CM) group compared to the general practitioner (GP) group were more critical and sceptical of the effectiveness of orthodox medicine; they felt their health could be improved; they were more loyal to their practitioner, and appeared to display more ecologically aware life-styles. Thus clients who select complementary forms of treatment may do so less from disenchantment with, and bad experience of, orthodox medical techniques rather than from a deep-seated belief in the effectiveness of complementary medicine.

Occupational stress among senior police officers.

From a survey of over 500 senior UK police officers completing the occupational stress inventory, it was observed that those serving in England and Wales exhibited the highest job stress related to structure and climate, co-worker relationships and their managerial role. There were no inter-regional differences on the individual difference variables, Type A behaviour, locus of control, or on physical health measures. Superintendents in Scotland used coping methods least frequently including domestic/home support, time management and social support, the latter strategy being most used by Northern Ireland officers. Findings relating job stress to job satisfaction were inconsistent with other police populations. Results are discussed in the context of organizational reform in the police service.

Work stress and health in a sample of U.S. police.

This study assessed responses to the Occupational Stress Indicator in the Naperville Police Department. This 40% sample of 49 police officers were compared against population norms for employed workers in a range of occupations. Although the police officers perceived less stress from "factors intrinsic to the job", they expressed greater job-related pressure from "organizational structure and climate". They also rated greater the competitiveness and assertiveness in their work behavior.

Sociogrid analysis of a child and adolescent psychiatric clinic.

The diverse roles of medical health professionals working in a child psychiatry clinic were examined using sociogrid analysis allowing for idiographic and nomothetic analyses, the latter enabling assessment of larger numbers of individuals. Role repertory grid analysis was further used to explore the cognitive structure of the doctor and the nurse. As a result, insight was offered regarding the configuration of the clinic organisation, with detailed evaluation of occupational boundaries and interaction between roles. Central figures in the social network were those of the physician and the parents of the patient. The social worker and the psychologist appeared isolated from the rest of the treatment group and seemed to work independently with the parents, in contrast to the physician who did not relate to either the parent or the patient. Administrators occupied a unique pivotal position between these two core occupational clusters (parents, social worker, patient and psychologist; physician, nursing and care, occupational therapist and physiotherapist).

MMPI profiles of male and female migraine sufferers.

Among a sample of 40 severe migraine sufferers, males and females displayed common personality profiles. Both sexes exhibit heightened scores on those MMPI clinical scales associated with neuroticism (hypochondriasis, depression and hysteria). Female migraine sufferers were further characterised by elevated scores on the primary scales constituting the psychotic tetrad (paranoia, psychaesthenia, schizophrenia, and hypomania). Migraine females appeared to differ from male patients with respect to a dimension associated with sex-role conformity (loaded on the L-scale and masculinity-femininity). The implication of these results are considered.

Job stress and satisfaction: international police officers.

Scores of 30 police officers on the Occupational Stress Indicator differed from British norms on organisational structure and climate, home and work interface, and relations with others. Officers showed internal control and individual influence. Through managed time and home support, officers coped with stress. Scale scores were intercorrelated.

Personality correlates of intelligence in a clinical group.

The relationship between personality and intelligence test performance among 84 psychiatric patients was examined using a reduced version of the Wechsler Adult Intelligence Scale together with the Eysenck Personality Questionnaire. Introverts were inclined to do better than extraverts on all WAIS scales, the difference being statistically significant for the verbal subtests of Information and Similarities only. A 2-way multivariate analysis of variance gave a significant main effect for Social Conformity, in which low Lie scorers obtained higher scores on all subscales, particularly Verbal IQ. There was no main effect for Psychoticism but there were two interactions (Psychoticism x Lie) for the verbal subscales. For individuals characterized by high social conformity, the high Psychoticism scorers displayed lower scores on those scales associated with sensory associative intelligence (Information, Similarities, and Picture Completion). The results were discussed with particular reference to two competing theories relating personality and intelligence.

Occupational stress among mental health professionals. The relationship between work and recreational pursuits.

A sample of 111 medical and allied staff in a large child and adolescent psychiatric hospital responded to a survey assessing work- and leisure-related attitudes. Gender, marital status, parenthood, and length of employment were among the demographic variables found to be associated with various facets of occupational stress and job satisfaction. Men were somewhat more stressed, complained more about their relationships with coworkers and displayed greater 'negative spill' than women; Married employees were particularly susceptible to the adverse effects of work; Parenthood had little effect on work-related stress, although there is some indication that being a mother prevented one recuperating as effectively as desired during leisure-time; and tenure of employment at the hospital was related to increased feelings job pressure without affecting job satisfaction levels, and to lower levels of career motivation. The implications of these findings are discussed: Suggestions are provided for improving working climate and job satisfaction amongst mental health professionals.

Psychological characteristics of breast cancer patients.

Two breast cancer groups (mastectomised or chemotherapeutic intervention) and a control group of healthy female nurses were given a demographic questionnaire and the Minnesota Multiphasic Personality Inventory. The personality profiles of all three groups emerged as significantly different from each other on all scales with the exception of social introversion and psychopathic deviance. Both cancer groups displayed inflated scores on the clinical scale Depression. A separate series of univariate F tests revealed that the mastectomised patients were characterised by elevated scores on the clinical scales Hypochondriasis, Depression, Hysteria, Masculinity-Femininity and Schizophrenia compared to normals. The discriminant analysis confirmed that between the clinical groups the mastectomised patients exhibited higher scores (compared to those receiving chemotherapy) along the scales Hypochondriasis, Paranoia, Psychaesthenia, Schizophrenia and Hypomania, the latter 4 scales constituting the psychotic tetrad.

Performance and circadian rhythms.

Physiological studies frequently neglect effects due to individual differences, thus inflating the error variance term. Psychological determinants of endogenous arousal are examined in association with somatic functioning and circadian rhythms. Frontalis EMG and heart rate did not appear to display clear phasic circadian rhythms. The subjective perception of activation displayed a cubic trend, independent of sex, exhibiting two peaks, at 08.00-11.00 and 17.00-20.00. Peak performance on a choice reaction time task depended very much on whether it was executed in a free response or experimenter determined tempo condition, indicating the importance of stipulating the task demand characteristics. There was a certain stability in extraverts (cortically less aroused) across periods throughout the day with respect to physiological measures; the same was not true for introverts, who exhibited a complex interaction with time of day - stable introverts possessing higher cardiac rates than unstables in the earlier part of the day, the position reversing itself in the late evening. Personality variables can exercise moderating influences on physiological activity associated with performance.