Risk and protective factors associated with youth violence among secondary school students in a nationally representative sample in Puerto Rico

During the past decade, youth violence has received increasing attention as a major public health issue in Puerto Rico as well as in the United States. This study sought to identify risk and protective factors of youth violence in a representative sample of school adolescents in Puerto Rico. Risk and protective factors were grouped into five domains: individual, family, peer group, school and community. From a total of 2,385 participants, 10.7 reported at least one violent behavior and 3.4 reported two or more violent behaviors. In multiple regression analysis the risk factors identified were male gender, junior grade students, having a favorable attitude towards antisocial behavior, use of ecstasy, involvement with antisocial peers and reporting antisocial parents. Participation in family decisions was the only protective factor associated with violence. Findings from this study could have important implications for the development of preventive programs for the adolescent population in Puerto Rico

Risk and protective factors associated with youth violence among secondary school students in a nationally representative sample in Puerto Rico.

During the past decade, youth violence has received increasing attention as a major public health issue in Puerto Rico as well as in the United States. This study sought to identify risk and protective factors of youth violence in a representative sample of school adolescents in Puerto Rico. Risk and protective factors were grouped into five domains: individual, family, peer group, school and community. From a total of 2,385 participants, 10.7% reported at least one violent behavior and 3.4% reported two or more violent behaviors. In multiple regression analysis the risk factors identified were male gender, junior grade students, having a favorable attitude towards antisocial behavior, use of ecstasy, involvement with antisocial peers and reporting antisocial parents. Participation in family decisions was the only protective factor associated with violence. Findings from this study could have important implications for the development of preventive programs for the adolescent population in Puerto Rico.

An overview of reported youth violence in Puerto Rico

OBJECTIVES: The purpose of this paper is to describe the prevalence of school and youth violence in Puerto Rico based on several representative samples surveyed in the Island during the 1990's. BACKGROUND: Reviewing the available data on youth violence is necessary in order to decide the best strategies to follow in developing new ways to prevent and monitor it. METHODS: Three surveys were reviewed in this paper: The Youth Risk Behavior Survey conducted by the Center for Disease Control (1991, 1995, 1997); The Methods for the Epidemiology of Child and Adolescent Mental Disorders Study (1991); and the Youth Survey (1997-98). RESULTS: It was found that the prevalence of reported school violence in Puerto Rico tends to be somewhat lower than the prevalence reported in other sites of the U.S.A. Age and gender has a dramatic influence in the reports of youth violence in Puerto Rico. Male students are three times as likely to carry weapons than females and almost twice as likely to report hurting someone than females. Less than 10 per cent of the male students ages 12-13 report carrying a weapon while fully 30 per cent of those 18 year olds reported carrying a weapon. Being arrested also increases from only 3 per cent in the youngest students surveyed to 10 per cent on the oldest group (18 or older). CONCLUSION: The CDC has recently reported that since the early 90's there has been a decrease in reported school violence in the U.S.A. This analysis of youth surveys replicated a similar tendency for Puerto Rican youngsters. Implications for prevention programs are discussed.

Sexual behavior among Puerto Rican adolescents.

OBJECTIVE: The objective of this study is to compare the prevalence of several types of sexual behaviors among Puerto Rican adolescents living in New York City and in the Greater San Juan Metropolitan Area of Puerto Rico. BACKGROUND: There is a scarcity of literature about sexual behaviors among Hispanic adolescents. The available literature has several limitations. METHODS: The data for the analysis was collected through personal interviews in two high schools, one in Puerto Rico and the other in New York City as part of multi-site Centers for Disease Control (CDC) study. RESULTS: To test whether the adolescent sexual behavior varied by site and more specifically to determine whether the Puerto Rican youngsters surveyed in New York are more sexually experienced, as measured by a sexual involvement scale, a set-wise hierarchical multiple regression/correlation (MRC) analysis was done. It showed that the sexual involvement behavior of Puerto Rican students in N.Y. was higher that the involvement of students surveyed in Puerto Rico even when controlling by gender, age, mother's education and household composition. CONCLUSION: Variations in the sexual behavior of Puerto Rican adolescents living in two socio-cultural environments (New York City and Greater San Juan in Puerto Rico) were documented. Differences were observed both in the patterns of sexual experiences reported in the two sites in the higher levels of sexual experience reported in the New York sample. The documented differences have important implications for the development of interventions for HIV/STD prevention strategies.

Intention to postpone sexual initiation among Puerto Rican female adolescents.

The purpose of this analysis is to examine the factors associated with intentions to initiate sexual intercourse among a group of female high school students in Puerto Rico. A large metropolitan high school was purposively selected for the study. The mean age of the girls who participated in the study (N = 133) was 16. 13% of the surveyed girls reported having had intercourse at some point in their lives. 45% indicated when answered that they were sure they would not initiate sex during the next year; 18% answered that it probably would not happen; and the others (28%) responded with an even 50-50 chance or more that it will probably happen. A multiple regression/correlation analysis showed that the mother's traditional sexual values along with the teen's own conventional behavior, traditional sexual values as well as a perception of conventional behavior by their peers were related to a lower expectation of sex initiation.

Puerto Rican youth in drug treatment facilities: who volunteers for HIV testing?

This paper examines the characteristics of youngsters in drug treatment who volunteer for AIDS testing in comparison to those who do not. HIV Antibodies testing was offered on a voluntary basis to a sample of 250 Puerto Rican youngsters enrolled in three ambulatory drug treatment centers in 1991. Sixty-six percent of the youngsters agreed to take the test. Male adolescents who volunteered reported fewer years of education and were more likely to have dropped-out of school. Consistent with research findings among adults, those adolescents at greater risk of HIV infection as measured by drug use and sexual behaviors were more likely to volunteer for on-site testing for HIV infection. Higher rates of alcohol use and marijuana use differentiated volunteers from those who did not. Among the sexual behaviors investigated, number of partners, engaging in less risk reduction practices, having a sexual partner who had used illicit drugs and using condoms to avoid STD's were found to be significantly higher in volunteers.

Adolescent heterosexual experience: a new typology.

PURPOSE: The purpose of this paper is to define a typology that encompasses the full range of adolescent heterosexual behavior; to compare the usefulness of the new typology with that of the traditional dichotomy of "sexually active"/"sexually inactive" for understanding sexual behavior among adolescents; and to determine the implications of the new typology for the design and implementation of HIV prevention programs targeting adolescents. METHODS: Detailed face-to-face interviews were conducted with a cross-sectional sample of 907 mothers and their adolescents, ages 14-17 years, recruited from public high schools in Alabama, New York, and Puerto Rico. Information from the adolescent survey on precoital sexual behaviors and STD/HIV sexual risk and risk reduction behaviors was examined. A typology of adolescent heterosexual experiences was constructed using four behavioral dimensions. RESULTS: Ninety-nine percent (n = 894) of the sample was classified into one of the five patterns of sexual experience: Delayers, Anticipators, One-timers, Steadies, and Multiples. Among the participants who were not sexually active, precoital behaviors differed significantly between the 22% who anticipated initiating sexual intercourse in the next year (Anticipators) and those who did not (Delayers). Among those traditionally classified as "sexually active", One-timers and Steadies were significantly older when they first had penile-vaginal intercourse than those who had multiple partners. One-timers were more likely to use condoms than Steadies or Multiples, and only Multiples reported previous STDs. CONCLUSION: A typology that defines a range of adolescent heterosexual experiences was developed, and it was possible to classify 99% of our sample. The traditional dichotomy between "sexually active" vs. "not active" hides important behavioral intentions and sexual practices. These differences must be taken into account in the development and implementation of HIV prevention programs that target adolescents.

Puerto Rican youth in drug treatment facilities: who volunteers for HIV testing?

This paper examines the characteristics of youngsters in drug treatment who volunteer for AIDS testing in comparison to those who do not. HIV Antibodies testing was offered on a voluntary basis to a sample of 250 Puerto Rican youngsters enrolled in three ambulatory drug treatment centers in 1991. Sixty-six percent of the youngsters agreed to take the test. Male adolescents who volunteered reported fewer years of education and were more likely to have dropped-out of school. Consistent with research findings among adults, those adolescents at greater risk of HIV infection as measured by drug use and sexual behaviors were more likely to volunteer for on-site testing for HIV infection. Higher rates of alcohol use and marijuana use differentiated volunteers from those who did not. Among the sexual behaviors investigated, number of partners, engaging in less risk reduction practices, having a sexual partner who had used illicit drugs and using condoms to avoid STD's were found to be significantly higher in volunteers

Sensitized liposomes as an antigen delivery system for the stimulation of mucosal immunity.

This study was designed to exploit the ability of Peyer's patch M cells to recognize antigen-antibody complexes in the targeted delivery of a model antigen for the induction of mucosal immunity. Sensitized liposomes consisted of an entrapped model antigen, ovalbumin (OVA), and coated with unrelated antigen-antibody complexes. Sensitized liposomes were administered intrajejunally to mice either with or without monophosphoryl lipid A (MLA). Humoral immune responses were monitored in saliva, feces, serum, and bile. Mice which received sensitized liposomes showed up to 4-fold amounts of specific IgA in saliva, feces, and bile compared to controls. Transient increases in anti-OVA IgA and IgG were observed in serum. Formulations including MLA generated positive anti-OVA IgG responses in both serum and bile. In separate experiments, cell proliferation studies were performed with Peyer's patch lymphocytes harvested from mice immunized with OVA in either standard or sensitized liposomes. Lymphocytes from test mice receiving only sensitized liposomes proliferated in the presence of OVA, but not an unrelated antigen. Taken together, these results support the potential application of antigen-antibody complexes in the stimulation of mucosal immune responses and that MLA may play an important role in overcoming OVA tolerogenicity.

Psychosocial correlates of drug use among Puerto Rican youth: generational status differences.

This study investigates the role of several social psychological variables which could help explain the process by which Puerto Rican adolescents become vulnerable to drug use involvement with exposure to a host society, New York City, where the prevalence of drug use is higher than in the society of origin. Puerto Rico. To study how acculturation affects the psychosocial factors associated with adolescent drug use, four generational status groups of Puerto Rican students living in two settings--New York City and San Juan, Puerto Rico--were surveyed: New York Ricans (New York City-born Puerto Ricans); New York migrants (island-born Puerto Ricans living in New York); Puerto Rican islanders (adolescents who had never lived outside of Puerto Rico); and Puerto Rican immigrants (New York City-born youngsters of Puerto Rican parentage whose families had returned to live on the Island). A theoretical model developed to explain adolescent problem behavior, which posits a continuum of antecedent, intrapersonal, interpersonal and perceived environment dimensions theoretically conducive to adolescent drug use, guided the analysis. Analysis of variance was used to test for generational status group differences in each of the psychosocial risk factors. The relationship between generational status, the intervening psychosocial variables, and drug use were explored through multiple regression analyses. The data showed that Puerto Rican youth's generational status was systematically related to differences in the occurrences of the social psychological risk factors for adolescent drug use involvement. With greater exposure to the New York City environment, Puerto Rican youngsters were more likely to report problems in parental socialization, personal control and perceived environment domains. Each of the psychosocial characteristics was associated with the students' drug use involvement, and these relationships were conditioned by generational status. New York Ricans exhibited the greatest susceptibility to drug use involvement in the presence of weakening of parental controls, increased tolerance of deviance and drug use, increased unconventionality with respect to school and church, and peer use of legal and illegal drugs. Sociodemographic and psychosocial variables together explained 47% of the variance in the drug use involvement of Puerto Rican adolescents.

HIV risk factors among Puerto Rican youth in drug treatment.

A cross-section of 250 youngsters enrolled in drug treatment programs in Puerto Rico were surveyed in 1991. Even though the surveyed youngsters are not intravenous drug users it was found that they have a high prevalence of behaviors considered by the Centers for Diseases Control as increasing the risk of HIV infection in youth. These behaviors include frequent experimentation with non-IV drugs, early onset of sexual behaviors (mean = 13.5 years) and drug use (mean = 13.8 years), and a high number of sexual partners (mean = 3.13) reported for the year preceding the interview. Infrequent use of contraceptives and condoms and ineffective practices to prevent STD/HIV were also reported. This subgroup of youngsters in drug treatment centers can be defined as a high risk group in need of HIV infection prevention services.

An epidemiological study of disorders in late childhood and adolescence--I. Age- and gender-specific prevalence.

Developmental aspects of psychiatric disorders may be inferred from patterns of age differences in prevalence. Age-specific prevalences are provided for nine disorders in a general population sample of ages 10-20. Age and gender patterns for several disorders suggest developmental stage-associated risks. These include oppositional disorder in both genders and conduct disorder and major depression in girls. Major depression shows a pattern suggestive of a role for the onset of puberty. The prevalence of one or more disorders did not differ by age or gender. However, the pattern of specific diagnoses varied greatly by both age and gender.

Prevalence and stability of the DSM-III-R personality disorders in a community-based survey of adolescents.

OBJECTIVE: The purpose of this study was to estimate the prevalence, concurrent validity, and stability of DSM-III-R personality disorders in a large community-based sample of adolescents. METHOD: A randomly selected community sample of 733 youths ranging in age from 9 to 19 years was followed over a 2-year period. The protocol consisted of structured interviews with the adolescents and their mothers and self-report questionnaires. Algorithms for 10 DSM-III-R axis II disorders were developed to produce diagnoses at two levels of severity; these were validated against multiple indicators of distress and functional impairment. RESULTS: The overall prevalence of personality disorders peaked at age 12 in boys and at age 13 in girls and declined thereafter. Obsessive-compulsive personality disorder was the most prevalent moderate axis II disorder, narcissistic personality disorder the most prevalent severe disorder, and schizotypal personality disorder the least prevalent axis II disorder, based on both moderate and severe diagnostic thresholds. All moderate axis II disorders were associated with significantly greater odds for at least five of 12 diagnostic validators. Longitudinal follow-up revealed that although most axis II disorders did not persist over a 2-year period, subjects with disorders identified earlier remained at elevated risk for receiving a diagnosis again at follow-up. CONCLUSIONS: These findings suggest that a substantial minority of adolescents who are not in treatment qualify for DSM-III-R personality disorder diagnoses and that these diagnoses are associated with increased risk of psychological distress and functional impairment.

A longitudinal analysis of selected risk factors for childhood psychopathology.

Eight-year and two-year longitudinal analyses of prevalence and risk factors for adult and adolescent psychopathology were carried out for a random sample of 776 children drawn from households in New York State. A 17.7% prevalence rate for one or more DSM-III disorders was estimated. In general, the risk factors studied were more related to externalizing than internalizing diagnoses. Risk factors assessed over 8-year and 2-year intervals were very similar.

Mechanisms of the relation between perinatal problems, early childhood illness, and psychopathology in late childhood and adolescence.

Data on perinatal and early childhood somatic and psychological risk factors of a random sample of children were gathered in early to middle childhood and employed to examine the long-term risk of emotional and behavioral problems of late childhood and adolescence. 3 issues were addressed: First, can syndromic specificity of such effects be identified on scaled and diagnostic measures of syndromes? Second, are these effects attributable to excess risk of low-income children for both perinatal and later childhood problems? Third, are the intervening mechanisms identifiable as intellectual impairment, vulnerability to poor health, poor maternal caretaking, maternal rejection, or maternal stress associated with marital problems? Findings indicated that elevated risk was present for all syndromes, both at the scale level and at the diagnostic level. None of the examined intervening mechanisms fully accounted for the effects of early risks.

Drug use among Puerto Rican youth: an exploration of generational status differences.

An analysis of the relationship between generational status, or a migrational experience, and adolescent drug use takes advantage of a natural experiment--the migration of Puerto Ricans to the continental United States and their immigration back to the island. Although researchers have studied different sources of variation in adolescent drug use behavior, few have examined the drug use experience of the same ethnic group in varying sociocultural settings. The present study focused on the drug use involvement of four generational status groups of Puerto Rican adolescents in two different settings--New York City and San Juan, Puerto Rico. The groups surveyed in New York City were: New York Ricans (New York City-born Puerto Ricans) and New York migrants (island-born Puerto Rican adolescents). The two groups identified in Puerto Rico were: Puerto Rican islanders (adolescents who had never lived outside of Puerto Rico) and Puerto Rican immigrants (New York City-born youngsters of Puerto Rican parentage whose families had returned to live on the island). In this study, it was hypothesized that the more the perceived environment dimensions of the different generational status groups have characteristics conducive to drug use, the greater the drug use involvement of the groups will be. The analysis confirmed that the drug use involvement of the four groups of Puerto Rican adolescents paralleled the exposure of the groups to a host society, New York City, which has a higher prevalence of adolescent drug use than the culture of origin, Puerto Rico. In addition, it was found that the longer New York migrants lived in New York City, the greater was their drug use involvement. The roles of various other sociodemographic factors (i.e. gender, grade level, family structure and socioeconomic status) in relation to adolescent drug use were also investigated. Two important conditional relationships were documented. First, the impact of length of time living in New York City varied with the adolescent's gender, with higher risk of drug involvement observed for female migrants. Second, socioeconomic status was associated with Puerto Rican adolescents' drug use involvement in the New York City subgroups, but not among the students in Puerto Rico.

Attempted suicide in youth: its relationship to school achievement, educational goals, and socioeconomic status.

Twenty-six suicide attempters, 9 to 18 years of age, were compared with 725 nonattempters on measures of school achievement, educational goals, socioeconomic status, and depression. As has been found in studies using clinical samples, suicide attempters in our community-based sample had significantly lower school achievement than nonattempters. The relationship between attempted suicide and low school achievement seemed to be explained by the effects of depression. Lower-SES youth tended to be more likely to attempt suicide than higher-SES youths. However, SES appeared to have little effect on the relationship between attempted suicide and school achievement. Results also suggest that children of mothers with low educational goals for them may be more at risk for attempted suicide than youths whose mothers have higher educational goals for their children.