Helping mothers discuss sexuality and AIDS with adolescents.

The current study was designed to alter experimentally mothers' style when discussing sexuality and AIDS with their adolescent children. Mothers of 11- to 15-year-olds (N = 50) were assigned to an intervention or control group, resulting in 20 dyads in each group. All dyads were assessed twice, on self-reported and observed communication, AIDS knowledge, and perceived vulnerability to AIDS. Intervention group mothers received two training sessions. Observational data revealed that intervention group mothers reduced their amount of speaking, asked more open-ended questions, acted less judgmental, and discussed dating and sexuality more than did control group mothers. Intervention group adolescents reported increased discussions of birth control and increased daily comfort talking to their mothers. There was some evidence that intervention group girls increased in AIDS knowledge. There was no change in AIDS-related beliefs.

How Latino American and European American adolescents discuss conflicts, sexuality, and AIDS with their mothers.

The authors examined how the structure of mother-adolescent conversations differs by ethnic group, age, and dyadic and individual factors. Mother-adolescent dyads of European or Latino descent participated in conversations and reported on their relationship and AIDS knowledge. Latina American mothers dominated conversations more than European American mothers, independent of socioeconomic status. Mothers dominated conversations about sexuality and AIDS more than conversations about conflicts. Mothers of older adolescents reacted more negatively, and older adolescents reported less satisfaction, less openness, and more sexual discussions with persons other than their mothers. Latino American adolescents whose mothers dominated conversations more reported fewer sexual discussions. Latina American mothers who dominated conversations more reported more openness and satisfaction. When mothers dominated conversations more, adolescents had lower AIDS knowledge.

Risk factors for depressive symptoms in late adolescence: a longitudinal community study.

In a longitudinal study, following a community sample (N = 386) from age 5, early risk factors for depressive symptomatology at age 18 were examined separately for females and males. For females, predictors included low birthweight and death of a parent; for males, they included emotional dependency and internalizing behavior problems. Depressive symptomatology at age 15 emerged as an important risk factor for both genders. Clinical implications are discussed, and areas for further research are proposed.

A longitudinal study of AIDS conversations between mothers and adolescents.

The current study examined the stability of mother-adolescent AIDS conversations. Twenty-four mother-adolescent dyads (9 boys, 15 girls) participated at Time 1 (adolescents aged 10-14 years), and again 2 years later. Mothers and adolescents engaged in a videotaped conversation about AIDS and completed AIDS questionnaires. Conversations were coded for content and the extent to which mothers dominated conversations. Conversational dominance remained stable over time. AIDS knowledge was greater for mothers than adolescents, but it improved over time for adolescents while remaining stable for mothers. Mothers who reported discussing AIDS-related topics with their adolescents had less discrepancy between their own and their children's AIDS knowledge. Conversational dominance at Time 1 predicted discrepancy in AIDS knowledge 2 years later, whereas discrepancy in AIDS knowledge at Time 1 did not predict conversational dominance two years later. These results suggest the importance of interactive conversations as a more effective way of teaching than didactic conversations.

The effect of passive smoking and tobacco exposure through breast milk on sudden infant death syndrome.

OBJECTIVE: To examine the relationship between sudden infant death syndrome (SIDS) and smoking during pregnancy; postnatal tobacco smoke exposure from the mother, father, live-in-adults, and day care providers; and postnatal smoke exposure from breast-feeding. DESIGN: Case-control study. SETTING: Five counties in Southern California. PARTICIPANTS: A total of 200 white, African-American, Hispanic, and Asian parents of infants who died of SIDS between 1989 and 1992 were compared with 200 control parents who delivered healthy infants. Case infants were matched to control infants on the basis of birth hospital, birth date, gender, and race. All information was obtained from a detailed telephone interview and validated with medical records. MAIN OUTCOME MEASURES: Risk of SIDS associated with passive smoking by the mother, father, live-in adults, and day care providers; smoking in the same room as the infant; total number of cigarettes smoked by all adults; and maternal smoking during the time period of breast-feeding. RESULTS: Conditional logistic regression resulted in overall adjusted odds ratios (ORs) for SIDS associated with passive smoke from the mother of 2.28, the father of 3.46, other live-in adults of 2.18, and all sources of 3.50 (95% confidence interval, 1.81 to 6.75), while simultaneously adjusting for birth weight, sleep position, prenatal care, medical conditions at birth, breast-feeding, and maternal smoking during pregnancy. A dose-response effect was noted for SIDS associated with increasing numbers of cigarettes, as well as total number of smokers. Breast-feeding was protective for SIDS among nonsmokers (OR = 0.37) but not smokers (OR = 1.38), when adjusting for potential confounders. CONCLUSIONS: Passive smoking in the same room as the infant increases the risk for SIDS. Physicians should educate new and prospective parents about the risk of tobacco smoke exposure during pregnancy and the first year of the infant's life.

Sunlight, vitamin D, and ovarian cancer mortality rates in US women.

BACKGROUND: In general, ovarian cancer incidence and mortality is higher in northern than southern latitudes. This ecologic study tests the hypothesis that vitamin D produced in the skin from sunlight exposure may be associated with a protective action in ovarian cancer mortality. METHODS: The association between average annual sunlight energy and age-specific ovarian cancer mortality rates in counties containing the 100 largest US cities was evaluated for 1979-1988. Simple linear regression was performed by decade using sunlight and ozone as independent variables and ovarian cancer rates as the dependent variable. Multiple regression was used to adjust for ozone and sulphur dioxide, since these atmospheric components may absorb ultraviolet light. RESULTS: Fatal ovarian cancer in these areas was inversely proportional to mean annual intensity of local sunlight in a univariate analysis (P = 0.0001), and in a regression adjusted for air pollution (P = 0.04). The association was also seen when restricted to 27 major urban areas of the US; however, probably due to a small sample size, this statistic did not reach significance. CONCLUSIONS: This ecologic study supports the hypothesis that sunlight may be a protective factor for ovarian cancer mortality.

Psychosocial risks for major depression in late adolescence: a longitudinal community study.

OBJECTIVE: An ongoing 14-year longitudinal study examined psychosocial antecedents of major depression in late adolescence in a community population. METHOD: Subjects were 385 adolescents followed between the ages of 5 and 18 years. Early health, familial, behavior, academic, and environmental risks for major depression were identified using data collected at ages 5, 9, 15, and 18 years. At age 18, a lifetime diagnosis of major depression was assessed using the NIMH Diagnostic Interview Schedule (DIS-III-R). RESULTS: For males, neonatal health problems, dependence problems at age 5 years, perceived unpopularity and poorer perceptions of their role in the family at age 9 years, remarriage of a parent, early family discord, and anxiety at age 15 years significantly increased the risk of developing major depression. Females with major depression, compared with nondepressed females, had older parents and came from larger families, and at age 9 years had greater perceived unpopularity and anxiety, lower self-esteem, and poorer perceptions of their role in the family. Depressed females also reported more stressful life events, including death of parent and pregnancy. CONCLUSIONS: Underscoring the importance of early psychosocial factors in the later development of major depression and pointing to specific risks, our findings can aid in developing strategies for prevention and early intervention.

Prevalence of psychiatric disorders in a community population of older adolescents.

In a community study of 386 Caucasian working-class older adolescents, a sizeable proportion met lifetime criteria for selected DSM-III-R diagnoses. Alcohol abuse/dependence had the highest lifetime prevalence rate (32.4%), followed by phobias (22.8%), drug abuse/dependence (9.8%), major depression (9.4%), and, least commonly, post-traumatic stress disorder (6.3%) and obsessive compulsive disorder (2.1%). Significant gender differences were found for major depression, post-traumatic stress disorder, and alcohol abuse/dependence, whereas socioeconomic differences occurred in major depression, phobias, and drug abuse/dependence. Adolescents with specific psychiatric disorders had significantly poorer functioning on measures of behavioral problems, interpersonal problems, self-esteem, and school performance. Results suggest the importance of identifying psychiatric disorder in adolescence, and the need for preventive strategies and prompt treatment.