Search results for: immigrant deaf adolescents

Authors: Dora Bianchi, Anthony Schinelli, Laura Maria Fatta, Antonia Lonigro, Fabio Lucidi, Fiorenzo Laghi

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Purpose: The role of body image in adolescent binge eating is widely confirmed, albeit the various facets of this relationship are still mostly unexplored. Within the multidimensional body image framework, this study hypothesized the indirect effects of three body image coping strategies (positive rational acceptance, appearance fixing, avoidance) in the expected relationship between the perceived impact of body image on individuals’ quality of life and binge eating symptoms. Methods: Participants were 715 adolescents aged 15-21 years (49.1% girls) recruited in Italian schools. An anonymous self-report online survey was administered. A multiple mediation model was tested. Results: A more positive perceived impact of body image on quality of life was a negative predictor of adolescents’ binge eating, controlling for individual levels of body satisfaction. Three indirect effects were found in this relationship: on one hand, the positive body image impact reduced binge eating via increasing positive rational acceptance (M1), and via reducing avoidance (M2); on the contrary, the positive body image impact also enhanced binge eating via increasing appearance fixing (M3). Conclusions: The body image impact on quality of life can be alternatively protective—when adaptive coping is solicited, and maladaptive strategies are reduced—or a risk factor, which may increase binge eating by soliciting appearance fixing.

Keywords: binge eating, body image satisfaction, quality of life, coping strategies, adolescents

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Authors: Ifeanyi Adigwe

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The influence of television on adolescents is prevalent and widespread because television is a powerful sex educator for adolescents. This study examined the relationship between viewing sexual content on television and sexual behaviour of adolescents in public senior secondary schools in Lagos, Nigeria. The study employed a survey research design with a structured questionnaire as instrument. The multi-stage sampling technique was adopted. Firstly, purposive sampling was adopted in selecting 3 educational districts namely: Agege, Maryland, and Agboju. These educational districts were chosen for convenience and its wide coverage area of public senior secondary schools in Lagos State. Secondly, the researcher adopted systematic sampling to select the schools. The schools were listed in alphabetical order in each district and every 10th school were selected, yielding 13 schools altogether. A total of 501 copies of questionnaire were administered to the students and a total 491 copies of the questionnaire were retrieved. Only 453 copies of the questionnaire met the inclusion criteria and were used for analysis. Data were analyzed using descriptive statistics, Pearson Correlation, Principal components analysis, and regression analysis. Results of correlation analysis showed a positive and significant relationship between adolescent sexual belief and their preference for sexual content in television (r =0.117, N =453, p=0.13), viewing sexual content on television and adolescent sexual behavior, (r =-0.112, N =453, p<0.05), adolescent television preference and their preference for sexual content in television (r =0.328, N =453, p<0.05), adolescent television preference and adolescent’s sexual behavior (r=0.093, N =453, p<0.05). However, a negative but significant relationship exists between adolescent’s sexual knowledge and their sexual behavior (r=-122, N=453, p=0.0009). Pearson’s correlation between adolescents’ sexual knowledge and sexual behavior shows that there is a positive significant but strong relationship between adolescent’s sexual knowledge and their sexual behavior (r=0.967, N=453, p<0.05). The results also show that adolescent’s preference for sexual content in television informs them about their sexuality, development and sexual health. The descriptive and inferential analysis of data revealed that the interaction among adolescent sexual belief, knowledge and adolescents’ preference of sexual in television and its resultant effect on adolescent sexual behavior is apparent because sexual belief and norms about sex of an adolescent can induce his television preference of sexual content on television. The study concludes that exposure to sexual content in television can impact on adolescent sexual behaviour. There is no doubt that the actual outcome of television viewing and adolescent sexual behavior remains controversial because adolescent sexual behavior is multifaceted and multi-dimensional. Since behavior is learned overtime, the frequency of exposure and nature of sexual content viewed overtime induces and hastens sexual activity.

Keywords: adolescent sexual behavior, Nigeria, sexual belief, sexual content, sexual knowledge, television preference

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: Laleh Golamrej Eliasi

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Finland is the second most violent country for women in the European Union (EU). 47% of women in Finland claimed to have experienced domestic violence against women (DVAW), compared to an average of 33% in the EU. Although the statistics in Finland are transparent, to the author’s best knowledge, there are no statisticsonDV by nationality in Finland. On the other hand, being a Muslim woman in a non-Muslim-majority country represents a position of double vulnerability to violence. There are 10404 Afghan refugees in Finland who are Muslim. Barriers such as unfamiliarity with support services, fear of the police, racism, language, economic and practical dependence, social isolation, and family commitments all lead to a lack of reporting of DVAW among migrants. Although witnessing and experiencing DV have devastating effects on women’s and children’s health and well-being, there is a lack of studies about DVAW among Afghan families in Finland. To fill this knowledge gap, Afghan women living in Finland are selected as the target group to assess their views on DVAW and child protection. This study is implemented in the socio-ecological approach framework to assess the impacts of individual characteristics, interpersonal relationships, community, and society components on DVAW in Afghan families. Interviews with Afghan women and content analysis are used to find out participants' views on DVAW, its risk factors, and approaches and methods to improve protection for women and children. Main purpose is to obtain information about participants' views on the subject. The findings can be used to improve culturally safe social work knowledge and practices with a bottom-up approach to reduce DV and increase child protection. Therefore, this research can have important effects on the sustainable development of services and supports the welfare and inclusion of immigrant families. The expected results will contribute to sustainable gender equality, which is in line with the fifth goal of the Sustainable Development Goals.

Keywords: domestic violence, immigrant women, immigrant child protection, social work

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Authors: Ifeanyi Adigwe, Thomas Van der Walt

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Digital media has been integrated into the social and entertainment life of young children, and as such, the impact of digital media appears to affect young people of all ages and it is believed that this will continue to shape the world of young children. Since, technological advancement of digital media presents adolescents with diverse contexts, platforms and avenues to engage with digital media outside the home environment and from parents' supervision, a wide range of new challenges has further complicated the already difficult tasks for parents and altered the landscape of parenting. Despite the fact that adolescents now have access to a wide range of digital media technologies both at home and in the learning environment, parenting practices such as active, restrictive, co-use, participatory and technical mediations are important in mitigating of online risks adolescents may encounter as a result of digital media use. However, these mediation practices only focus on the home environment including digital media present in the home and may not necessarily transcend outside the home and other learning environments where adolescents use digital media for school work and other activities. This poses the question of who mediates adolescent's digital media use outside the home environment. The learning environment could be a ''loose platform'' where an adolescent can maximise digital media use considering the fact that there is no restriction in terms of content and time allotted to using digital media during school hours. That is to say that an adolescent can play the ''bad boy'' online in school because there is little or no restriction of digital media use and be exposed to online risks and play the ''good boy'' at home because of ''heavy'' parental mediation. This is the reason why parent mediation practices have been ineffective because a parent may not be able to track adolescents digital media use considering the diversity of contexts, platforms and avenues adolescents use digital media. This study argues that due to the diverse nature of digital media technology, parents may not be able to monitor the 'whereabouts' of their children in the digital space. This is because adolescent digital media usage may not only be confined to the home environment but other learning environments like schools. This calls for urgent attention on the part of teachers to understand the intricacies of how digital media continue to shape the world in which young children are developing and learning. It is, therefore, imperative for parents to liaise with the schools of their children to mediate digital media use during school hours. The implication of parents- teachers mediation practices are discussed. The article concludes by suggesting that third party mediation by teachers in schools and other learning environments should be encouraged and future research needs to consider the emergent strategy of teacher-children mediation approach and the implication for policy for both the home and learning environments.

Keywords: digital media, digital age, parent mediation, third party mediation

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Authors: Andra Vidyarini

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Adolescence is a transition period in which various changes occur, both biologically, intellectually and psychosocially. Changes in adolescents, one of which is a change in food consumption patterns that make adolescents vulnerable to nutritional problems that can affect their growth and health in the future. Nutritional problems in adolescents have increased from year to year and one of the causes is the low diversity and quality of consumption. The diversity and quality of consumption can be seen through the Individual Dietary Diversity Score and the Healthy Eating Index. Currently, in Indonesia, data on the diversity and quality of food consumption, especially among adolescents, are still scarce. In general, the purpose of this study is to describe the diversity and quality of adolescent food consumption and the relationship between the diversity and quality of food consumption with nutritional status. This study is a cross-sectional study by looking at the diversity and quality of consumption of adolescents aged 15-17 years. The total number of subjects in this study amounted to 70 teenagers. This research was conducted online via a google form. Data analysis in this study was univariate and bivariate. The results showed that the diversity of the subject's food consumption was in the diverse and very diverse category with an average of 6. However, the quality was still not good, whereas it was still in the bad and moderate categories with an average of 12.93. The nutritional status of the majority of the subjects was in the normal category and overweight to obese. The implementation of blended learning where there are still limited face-to-face meetings at school can be the reason why teenagers' food consumption is more diverse than when they are face-to-face schools. In addition, changes in people's diet during the pandemic also influenced the results of the study. The change in pattern is a change in eating habits to three times a day with menu choices ranging from rice, meat, fish, bean and vegetables. Analysis of the relationship between the diversity and quality of food consumption shows that the diversity of consumption has a significant relationship with the quality of food consumption with a p-value of 0.002 (p<0.05). Meanwhile, the diversity and quality of food consumption have no significant relationship with nutritional status, with p values 0.777 and 0.251 (>0.05), respectively. This shows that the diversity of food consumption is directly proportional to the quality of consumption, where if you have a variety of food consumption, the quality or in terms of portions and weight are also sufficient in accordance with the recommendations of PGRS.

Keywords: healthy eating index (HEI), food diversity, quality of consumption, adolescent

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Authors: Nur H. Ahmad, Silvia S. Inge, Vanessa A. Julliete, A. Veraditias, Laila F. Febinda

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Abdominal obesity is a risk factor for metabolic syndrome and mostly found in adolescents. Waist circumference is related to abdominal obesity which has a significant effect on the increase of blood pressure. Inulin is one of prebiotic, that has health benefits by offering the potential for lipid management, that can be useful to decrease the risk factor of metabolic syndrome. The aim of the research is to evaluate the effect of 10 gram inulin-substituted ice cream in waist circumference and blood pressure of abdominal obesity adolescents. Inulin had the ability to produce Short Chain Fatty Acid which can improve blood pressure and waist circumference. Systolic blood pressure was significantly decreased in the treatment group (p=0.028) with the mean of reduction 7.35 ± 11.59 mmHg. However, diastolic blood pressure and waist circumference showed no significant effect. Waist circumference, systolic blood pressure and diastolic blood pressure was decreased in control group. These results suggest that inulin-substituted ice cream used as therapeutics and prevention for the early onset of metabolic syndrome.

Keywords: blood pressure, inulin, metabolic syndrome, waist circumference

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Authors: Israel Ekanade, Richard Molapo, Patrick Dzimiri, Isaac Ndlovu

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This study aims to unravel the myth behind animosity towards foreign nationals in South Africa. Systemic violence against foreign African nationals since 2008 to date necessitates critical research with regards to migration issues connected to social upheavals. Extensive research ubiquitously tagged black-on-black violence as xenophobia or Afrophobia. In all, escalation of violence indicates a connotation of belonging. With unemployment rates approaching a crescendo, other vices have also soared in the same regard. As a result, this present generation seems cynical as the South African state has not fulfilled her obligations towards the indigent population; a situation pitching locals against foreigners. Locals have repeatedly blamed African foreign nationals for the economic downturn, using service delivery strikes to express their grievances. These strikes have continued unabatedly over the years but February 2017 marked a turning point in ‘insider-outsider’ relations as the strike was now turned to an anti-immigrant march resulting into widespread violence as the police failed to restore normalcy at some point. Over time, migration has been a harbinger of violence against the foreign black population in South Africa. Our paper encourages the state and civil society to invent new peace-building mechanisms to reduce xenophobic orchestrated violence. Our paper also contends that since the political class has hijacked the situation by using the youths for political propaganda during crises periods, a re-education of the political class and a culture of tolerance is inevitable for peace and harmony between locals and foreigners in post-apartheid South Africa.

Keywords: anti-immigrant march, politics of belonging, service delivery strikes, South Africa

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Authors: Libia Yanelli Yanez-Penunuri, Carlos Alejandro Hidalgo-Rasmussen, Cesar Armando Rey-Anacona

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Cultural and social norms have a great influence on individual behavior, including the use of violence. In this way, culture can protect against violence, but it can also support and encourage the use of violence. The aim of this study was to analyze differences in cultural acceptance and dating violence among Mexican high school students. A Cross-sectional study was carried out with 867 adolescent Mexican students of high school aged 14 to 18 years old in a dating relationship for at least a month in Guzman City, Mexico. To measure cultural acceptance and dating violence, the questionnaire abuse in dating (CMO) was applied. Informed consent to parents and students was requested. Analyses of descriptive and inferential statistics were performed. Participants were adolescent girls (61.4%) and adolescent boys (38.6%). About 63.7% of adolescents reported cultural acceptance of dating violence in their dating relationships. Associations between physical, sexual, economical dating violence and cultural acceptance were found. No association was found between psychological dating violence and cultural acceptance. The effect size in all dimensions was small. For future research, it is very important to take into consideration the change and evaluation of culture norms to prevent dating violence among adolescents.

Keywords: adolescents, culture, social norms, dating violence, students

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Authors: Anshu Gupta, Charu Gupta

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Background: Adolescence is the transitional period between puberty and adulthood. It is marked by immense turmoil in emotional and behavioral spheres. Adolescents are at risk of an array of behavioral and emotional problems, resulting in social, academic and vocational function impairments. Conflicts in the family and inability of the parents to cope with the changing demands of an adolescent have a negative impact on the overall development of the child. This augers ill for the individual’s future, resulting in depression, delinquency and suicides among other problems. Aim: The aim of the study was to compare the prevalence of behavioral and emotional problems in school going adolescents aged 13 to 15 years residing in Ludhiana city. Method: A total of 1380 school children in the age group of 13 to 15 years were assessed by the adolescent health screening questionnaire (FAPS) and Youth Self-Report (2001) questionnaire. Statistical significance was ascertained by t-test, chi-square test (x²) and ANOVA, as appropriate. Results: A considerably high prevalence of behavioral and emotional problems was found in school going adolescents (26.5%), more in girls (31.7%) than in boys (24.4%). In case of boys, the maximum problem was in the 13 year age group, i.e., 28.2%, followed by a significant decline by the age of 14 years, i.e., 24.2% and 15 years, i.e., 19.6%. In case of girls also, the maximum problem was in the 13 year age group, i.e., 32.4% followed by a marginal decline in the 14 years i.e., 31.8% and 15 year age group, i.e., 30.2%. Demographic factors were non contributory. Internalizing syndrome (22.4%) was the most common problem followed by the neither internalizing nor externalizing (17.6%) group. In internalizing group, most (26.5%) of the students were observed to be anxious/ depressed. Social problem was observed to be the most frequent (10.6%) among neither internalizing nor externalizing group. Aggressive behavior was the commonest (8.4%) among externalizing group. Internalizing problems, mainly anxiety and depression, were commoner in females (30.6%) than males (24.6%). More boys (16%) than girls (13.4%) were reported to suffer from externalizing disorders. A critical review of the data showed that most of the adolescents had poor knowledge about reproductive health. Almost 36% reported that the source of their information on sexual and reproductive health being friends and the electronic media. There was a high percentage of adolescents who reported being worried about sexual abuse (20.2%) with majority of them being girls (93.6%) reflecting poorly on the social setup in the country. About 41% of adolescents reported being concerned about body weight and most of them being girls (92.4%). Up to 14.5% reported having thoughts of using alcohol or drugs perhaps due to the easy availability of substances of abuse in this part of the country. 12.8% (mostly girls) reported suicidal thoughts. Summary/conclusion: There is a high prevalence of emotional and behavioral problems among school-going adolescents. Resolution of these problems during adolescence is essential for attaining a healthy adulthood. The need of the hour is to spread awareness among caregivers and formulation of effective management strategies including school mental health programme.

Keywords: adolescence, behavioral, emotional, internalizing problem

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Authors: Rodlyn Remina Hines

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Males and Females respond differently to life situations, including transnational living. Being in a transnational marriage relationship may put a strain on the relationship requiring partners to adjust their behaviors and expectancies of the other partner to accommodate the disruptions in the relationship. More so, when one partner is an immigrant to a new geographic location with the other in the native country, these disruptions may be intensive. This qualitative study examined gender differences in how married Ghanaian couples respond to making a life together as a couple while living across international borders. The study asked two questions: (1) What are the perceptions of males and females on transnational living? and (2) how do married males and females respond to transnational living situations? To answer these questions, semi-structured interviews were conducted with 24 married couples- with one partner living in the United States (U.S.) and the other spouse in Ghana via purposive and snowball sampling techniques. Participants were aged 26 to 59 years with an average age of 40; the average age of relationship: 10.41; and average years of living apart: 6.7. Induction and deduction hybrid analysis strategies were used to derive emerging themes. The results highlight significant gender differences in response to transnational living status and practices. The data indicate that transnational couples with the male spouse residing in the U.S. experience more relationship strains than is the case when the female partner is the immigrant. Three couples who were in divorce proceedings at the time of the interview had the male partner residing in the U.S. and the female spouse in Ghana. These gender differences also reflected spousal visitation frequency, duration of spousal reunification, amount of and frequency of spousal remittance(s), and immigration processing procedures. Finally, the data show female immigrant partners as better managers of transnational living stresses and strains than their male counterparts. Findings from this study have implications for marriage and family practitioners and immigration policy makers.

Keywords: gender differences, , ghanaian couples, ghanaian immigrants, transnational living

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Authors: Ellen Lagast, Melissa Ceuterick, Mark Leys

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Although adolescence is a stressful period with an increased risk for mental illnesses such as anxiety and depression, little in-depth knowledge is available on the determinants of the use of psychotropic drugs (BZD/SSRIs) and the effects. A qualitative research with adolescents in Flanders was performed. Based on indepth interviews, the interviewees indicate feelings of ambiguity towards their medication use because on the one hand the medication helps to manage their mental vulnerability and disrupted lives, but on the other hand they experience a loss of control of their self and their environment. Undesired side-effects and stigma led to a negative pharmaceutical self. The interviewed youngsters also express dissatisfaction about the prescription behavior with regard to psychotropic drugs of their general practitioner (GP). They wished to have received more information about alternative non-pharmaceutical treatment options. Notwithstanding these comments, the majority of the interviewees maintained trust in their GP to act in their best interest. This paper will relate the prescription behavior in primary care to the organization of mental health care to better understand the “phamaceuticalization” and medicalization of mental health problems in Belgium. Belgium implemented fundamental mental health care reforms to collaborate, to integrate care and to optimize continuity of care. Children and adolescents still are confronted with long waiting lists to access (non-medicalized) mental health services. This access to mental health care partly explains general practitioners’ prescription behavior of psychotropics. Moreover, multidisciplinary practices have not pervaded primary health care yet. Medicalization and pharmaceuticalization of mental health vulnerabilities of youth are both a structural and cultural problem.

Keywords: adolescents, antidepressants, benzodiazepines, mental health system, psychotropic drugs

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Authors: Mukhamad Fatkhullah, Arfan Fadli, Marini Kristina Situmeang, Siti Hazar Sitorus

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The emergence of a community of people with disabilities along with the various works produced has made great progress to open the public eye to their existence in society. This study focuses attention on a community that is suspected to be one of the pioneers in pursuing the movement. It is Deaf Art Community (DAC), a community of persons with disabilities based in Yogyakarta, with deaf and speech-impaired members who use sign language in everyday communication. Knowing the movement of disabled communities is a good thing, the description of the things behind it then important to know as the basis for initiating similar movements. This research focuses on the question of how community of people with disabilities begin to take shape in different regions and interact with collaborative events. Qualitative method with in-depth interview as data collection techniques was used to describe the process of formation and the emergence of community. The analytical unit in the study initially focuses on the subject in the community, but in the process, it develops to institutional analysis. Therefore some informants were determined purposively and expanded using the snowball technique. The theory used in this research is Phenomenology of Alfred Schutz to be able to see reality from the subject and institutional point of view. The results of this study found that the community is formed because the existing educational institutions (both SLB and inclusion) are less able to empower and make children with disabilities become equal with the society. Through the SLB, the presence of children with disabilities becomes isolated from the society, especially in children of his or her age. Therefore, discrimination and labeling will never be separated from society's view. Meanwhile, facilities for the basic needs of children with disabilities can not be fully provided. Besides that, the guarantee of discrimination, glances, and unpleasant behavior from children without disability does not exist, which then indicates that the existing inclusion schools offer only symbolic acceptance. Thus, both in SLB and Inclusive Schools can not empower children with disabilities. Community-based assistance, in this case, has become an alternative to actually empowering children with disabilities. Not only giving them a place to interact, through the same community, children with disabilities will be guided to discover their talents and develop their potential to be self-reliant in the future.

Keywords: children with disabilities, community-based assessment, community empowerment, social equity

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Authors: Dorit Olenik-Shemesh, Tali Heiman

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Aggressive peer behaviors, particularly bullying and cyberbullying (CB) victimization during adolescence, are strongly and consistently linked to decreased levels of subjective well-being, potentially hindering a healthy and consistent developmental process. These negative effects might be expressed in emotional, physical, and behavioral difficulties. Adolescents victims of bullying/CB present more depressive moods, more loneliness, and more suicidal thoughts, while adolescents who had never been victims of bullying and CB acts present higher levels of well-being. These difficulties in their lives may be both a consequence of and a partial explanation for bullying/CB victimization. Interpersonal behavior styles and psychosocial factors may interact to create a vicious cycle in which adolescents place themselves at risk, which might explain the reduced well-being reported among victims. Yet, to the best of our knowledge, almost no study has examined the effect of two key variables in adolescents' lives, resilience and self-concept, in the relationship between bullying/CB victimization and low levels of psychological well-being among adolescents. Resilience is defined as the individual's capacity of maintaining stable functioning and make adjustments in the face of adversity; a capacity that promotes efficiently coping with environmental stressors and protects from psycho-social difficulties when facing various challenges. Self-concept relates to the way we perceive ourselves, influenced by many forces, including our interactions with the surroundings; a collection of beliefs about oneself. Accordingly, the current study has examined the possible mediating effect of these two main positive personal variables, resilience, and self-concept, through a mediation model analysis. 507 middle school students aged 11–16 (53% boys, 47% girls) completed questionnaires regarding bullying and CB behaviors, psychological well-being, resilience, and self-concept. A mediation model analysis was performed, whereas the hypothesized mediation model was accepted in full. More specifically, it was found that both self-concept and resilience mediated the relationship between bullying/CB victimization and a sense of well-being. High levels of both variables might buffer against a potential decrease in well-being associated with youth bullying/CB victimization. No gender differences were found, except a small stronger effect of resilience on well-being for boys. The study results suggest focusing on specific personal positive variables when developing youth intervention programs, creating an infrastructure for new programs that address increasing resilience and self-concept in schools and family-school contexts. Such revamped programs could diminish bullying/CB acts and the harmful negative implications for youth well-being. Future studies that will incorporate longitudinal data may further deepen the understanding of these examined relationships.

Keywords: adolescents, well being, bullying/CB victimization, resilience, self-concept

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Authors: Netta Horesh Reinman

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The inability to communicate feelings and thoughts to people close to oneself may be an important risk factor for suicidal behavior. This inability has been operationalized in the concept of “self-disclosure.” The purpose of this paper was to evaluate the correlation of self-disclosure with suicidal behavior in adolescents. Eighty consecutive admissions to an adolescent psychiatric inpatient unit were evaluated. Thirty-four were suicide attempters, 18 were suicidal ideators, and 18 were non-suicidal. Assessment measures included the Child Suicide Potential Scale, the Suicide Intent Scale, the Suicide Ideation Scale, and the Self-Disclosure Scale. The results show that low self-disclosure levels are associated with suicidal thinking, suicide attempts and suicidal attitudes. Thus, low self-disclosure may well be a risk factor worthy of further evaluation in the attempt to understand adolescent suicidal behavior.

Keywords: self disclosure, suicide, adolescents, treatment

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Authors: Narash Narasimman, Calvin Leong Jia Jun, Raksha Karthik, Paul Englert

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Background: Project Grit, a 12-week youth resilience program implemented by Impart and Spartans Boxing Club, aimed to help at-risk adolescents develop resilience through psychoeducation and mental health techniques for dealing with everyday stressors and adversity. The programme consists of two parts-1.5 hours of group therapy followed by 1 hour of boxing. Due to the novelty of the study, 6 male participants, aged 13 to 18, were recruited to participate in the study. Aim: This case study aims to examine the effectiveness of Project Grit in building resilience among at-risk adolescents. Methods: A case study design was employed to capture the complexity and uniqueness of the intervention, without oversimplifying or generalizing it. A 15-year-old male participant with a history of behavioural challenges, delinquency and gang involvement was selected for the study. Teacher, parent and child versions of the Strengths and Difficulties Questionnaire (SDQ) were administered to the facilitators, parents and participants respectively before and after the programme. Relevant themes from the qualitative interviews will be discussed. Results: Scores from all raters revealed improvements in most domains of the SDQ. Total difficulties scores across all raters improved from “very high” to “close to average”. High interrater reliability was observed (κ= .81). The participant reported learning methods to effectively deal with his everyday concerns using healthy coping strategies, developing a supportive social network, and building on his self efficacy. Themes from the subject’s report concurred with the improvement in SDQ scores. Conclusions: The findings suggest that Project Grit is a promising intervention for promoting resilience among at-risk adolescents. The teleological behaviourism framework and the combination of sports engagement and future orientation may be particularly effective in fostering resilience among this population. Further studies need to be conducted with a larger sample size to further validate the effectiveness of Project Grit.

Keywords: resilience, project grit, adolescents, at-risk, boxing, future orientation

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Authors: V. Argyropoulos, M. Nikolaraizi, K. Tanou

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There is little available information concerning the cognitive and communicative abilities of the people who are deaf-blind. This mainly stems from the general inadequacy of existing assessment instruments employed with deafblind individuals. Although considerable variability exists with regard to cognitive capacities of the deaf-blind, careful examination of the literature reveals that the majority of these persons suffer from significant deficits in cognitive and adaptive functioning. The few reports available primarily are case studies, narrative program descriptions, or position papers by workers in the field. Without the objective verification afforded by controlled research, specialists in psychology, education, and other rehabilitation services must rely on personal speculations or biases to guide their decisions in the planning, implementation, and evaluation of services to deaf-blind children and adults. This paper highlights the framework and discusses the results of an action research network. The aim of this study was twofold: a) to describe and analyse the different ways in which a student with deafblindness approached a number of developmental issues such as novel tasks, exploration and manipulation of objects, reactions to social stimuli, motor coordination, and quality of play and b) to map the appropriate functional approach for the specific student that could be used to develop strategies for classroom participation and socialization. The persons involved in this collaborative action research scheme were general teachers, a school counsellor, academic staff and student teachers. Rating scales and checklists were used to gather information in natural activities and settings, and additional data were also obtained through interviews with the educators of the student. The findings of this case study indicated that there is a great need to focus on the development of effective intervention strategies. The results showed that the identification of positive reinforcers for this population might represent an important and challenging aspect of behaviour programmes. Finally, the findings suggest that additional empirical work is needed to increase attention to methodological and social validity issues.

Keywords: action research, cognitive and communicative abilities, deafblindness, effective strategies

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Authors: Jeffrey L. Hurst, Sarah M. Coyne

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With the growth of technology and media, teens are increasingly exposed to media such as pornography and engaging in risky media use such as sexting. Parental media mediation strategies including controlling or autonomy supporting strategies can be an important protective factor against risky media uses. The purpose of this study is to examine how parental media mediation around media, influence adolescents’ behaviors including frequency of pornography use and sexting. We also examine the effects of parental media mediation on adolescents disclosing pornography use to parents and the amount of secrets that adolescents keep about pornography use. We hypothesize that controlling media mediation will result in more sexting, more frequency pornography use, more secrets about pornography and less disclosure to parents. We also predict that autonomy supportive media mediation will show the opposite pattern. Data for this study came from a nationally representative research project, Project M.E.D.I.A. Participants included 783 adolescents. 49% of the participants were male, and the mean age for boys was 15.44 years (SD= 3.34) and for girls was 15.3 years (SD=2.93). Parental media mediation was assessed using an eight-item measure with subscales of controlling and autonomy supporting media mediation. Participants were also asked if they have ever viewed pornography. If they answered yes, they were asked about the frequency of pornography use as well as if they have ever kept secrets from their parents about it and if they had ever disclosed their pornography use to their parents. The data analysis strategy for this study was a multiple group path analysis. Frequency of pornography use, sexting, secrets from parents and disclosure to parents were predicted by controlling and autonomy supporting parental media mediation, frequency of parents warning against pornography use, income and ethnicity. Groups were distinguished by boys and girls, allowing for sex differences. After running the model in MPLUS, we found partial support for our hypotheses. Autonomy supportive media mediation resulted in less sexting for boys (β= -.15, p < .05) and girls ( β= -.13, p < .05). Autonomy supportive media mediation also predicted keeping fewer secrets for girls (β=-.27, p < .01) but had no effect for boys. Controlling media mediation predicted more disclosure about pornography to parents for boys (β=.16, p < .05) and less disclosure to parents about pornography for girls (β=-.14, p < .05). Frequency of pornography was not predicted by any of the predictors in the model. Autonomy supportive media mediation was a very strong predictor of less sexting for both boys and girls. Parents should approach media mediation with this supportive and understanding mindset. Parental autonomy support allows adolescents to explore and develop their own moral beliefs without feeling guilt or shame from their parents. This need to have autonomy is also shown by girls disclosing less pornography use to their parents when parents are really controlling about media use. Interestingly, boys disclosed more to their parents when their parents were controlling. Further research is needed on why this is. Further research should also look at the effects that disclosing pornography use to parents has on future pornography use.

Keywords: media, moral development, parental mediation, pornography, sexting

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Authors: Saeid Doaei

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Background: Obesity in adolescence is a primary risk factor for obesity in adulthood. The objective of this study was the assessment of the effect of a comprehensive lifestyle intervention on different anthropometric indices in 12 to 16 years old boy adolescents. Methods: 96 adolescent boys of two schools of District 5 of Tehran have participated in this study. The schools were randomly assigned as intervention school (n=53) and control school (n=43). The height and weight of students were measured with a calibrated tape line and digital scale respectively and their BMI were calculated. The amounts of body fat percent (BF) and body muscle (BM) percent were determined by Bio Impedance Analyzer (BIA) considering the age, gender and height of students at baseline and after intervention. The intervention was implemented in the intervention school, according to the Ottawa charter principles. Results: 12 weeks of intervention decreased body fat percent in the intervention group in comparison with the control group (decreased by 1.81 % in the intervention group and increased by .39 % in the control group, P < .01). However, weight, BMI and BM did not change significantly. Conclusion: The result of this study showed that the implementation of comprehensive intervention in obese adolescents may improve the body composition, although these changes may not be reflected in BMI. It is possible that BMI is not a good indicator in assessment of the success of obesity management intervention.

Keywords: obesity, childhood, BMI, nutrition

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Authors: Lunthita M. Duthely, John T. Avella, John Ganapati Coleman

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For as many as one in three adolescents living in the United States, the adolescent years is a period of low well-being and mental health challenges—from depressive symptoms to mild to moderate psychological diagnoses. Longitudinal population health studies demonstrated that these challenges persist in young adulthood, and beyond. The positive psychology (PS) approach is a more preventative approach to well-being, which contrasts the traditional, deficits approach to curing mental illness. The research among adult populations formed the basis for PS studies among adolescents. The empirical evidence for the effectiveness of PS interventions exists for both adult and youth populations. Positive Psychology interventions target individuals’ strengths, such as hope and optimism, and positive emotions, such as gratitude. Positive psychology interventions such as increasing gratitude, proved effective in many outcomes among youth, including psychological, social, and academically-related outcomes. Although gratitude-inducing studies have been conducted for the past decade in the United States, few studies have been conducted among samples of urban youth, particularly youth of diverse cultural backgrounds. For nearly two decades, the secular practice of meditation has been tested among adults and more recently among youth, focused mostly among clinical samples. The field of Contemplative Sciences explores practices such as Hatha Yoga, Tai Chi, and Meditation, as preventative practices among children and adolescents. A more recent initiative is to explore Contemplative Practices in the school environment. Contemplative Practices yield a variety of positive outcomes, including academic, social, psychological, physiological, and neurological changes among children and adolescents. Again, few studies were conducted among adolescents of diverse cultural backgrounds. The purpose of this doctoral dissertation research study was to test a gratitude-meditation intervention among middle school students attending a public charter school, located in an urban region of Metropolitan Miami. The objective of this presentation is to summarize the challenges and success of bringing a positive psychology and meditation intervention into an urban middle school. Also, the most recent findings on positive psychology and meditation interventions conducted in school environments will be presented as well.

Keywords: adolescents, contemplative intervention, gratitude, secular meditation, positive psychology, school engagement, Sri Chinmoy

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Authors: Sandra Soca Lozano, Teresa Isabel Lozano Pérez, Germain Weber

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Cancer is a chronic disease of high prevalence in children and adolescents. Medical care in Cuba is carried out by a multidisciplinary team and family is the mediator between this team and the patient. Around this disease, there are interwoven many stereotypes and taboos by its relation to death. In this research report, we describe the work paradigm of psychological care to patients suffering from these diseases in the University Pediatric Hospital Juan Manuel Márquez of Havana, Cuba. We present the psychosocial factors that must be taken into account to provide comprehensive care and ensuring the quality of life of patients and their families. We also present the factors related to the health team and the management of information done with the patient. This is a descriptive proposal from the working experience accumulated in the named institution and in the review of the literature. As a result of this report we make a proposal of teamwork and the aspects in which psychological intervention should be continue performing in terms of increasing the quality of the care made by the health team. We conclude that it is necessary to continue improving the information management of children and adolescents with theses health problems and took into account their right to autonomy.

Keywords: comprehensive care, management of information, psychosocial factors, right to autonomy

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Authors: Leen Al Kassab, Sarah Johns, Helen Noble, Nawal Nour, Elizabeth Janiak, Sarrah Shahawy

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Introduction: Immigrant and refugee women experience disparities in sexual and reproductive health (SRH) outcomes, partially as a result of barriers to SRH literacy and to regular healthcare access and engagement. Despite the existing data highlighting growing needs for culturally relevant and structurally competent care, interventions are scarce and not well-documented. Methods: In this IRB-approved study, we used a community-based participatory research approach, with the assistance of a community advisory board, to conduct a qualitative needs assessment of SRH knowledge and service engagement with immigrant and refugee women from Africa or the Middle East and currently residing in Boston. We conducted a total of nine focus group discussions (FGDs) in partnership with medical, community, and religious centers, in six languages: Arabic, English, French, Somali, Pashtu, and Dari. A total of 44 individuals participated. We explored migrant and refugee women’s current and evolving SRH care needs and gaps, specifically related to the development of interventions and clinical best practices targeting SRH literacy, healthcare engagement, and informed decision-making. Recordings of the FGDs were transcribed verbatim and translated by interpreter services. We used open coding with multiple coders who resolved discrepancies through consensus and iteratively refined our codebook while coding data in batches using Dedoose software. Results: Participants reported immigrant adaptation experiences, discrimination, and feelings of trust, autonomy, privacy, and connectedness to family, community, and the healthcare system as factors surrounding SRH knowledge and needs. The context of previously learned SRH knowledge was commonly noted to be in schools, at menstruation, before marriage, from family members, partners, friends, and online search engines. Common themes included empowering strength drawn from religious and cultural communities, difficulties bridging educational gaps with their US- born daughters, and a desire for more SRH education from multiple sources, including family, health care providers, and religious experts & communities. Regarding further SRH education, participants’ preferences varied regarding ideal platform (virtual vs. in-person), location (in religious and community centers or not), smaller group sizes, and the involvement of men. Conclusions: Based on these results, empowering SRH initiatives should include both community and religious center-based, as well as clinic-based, interventions. Interventions should be composed of frequent educational workshops in small groups involving age-grouped women, daughters, and (sometimes) men, tailored SRH messaging, and the promotion of culturally, religiously, and linguistically competent care.

Keywords: community, immigrant, religion, sexual & reproductive health, women's health

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Authors: Farhana Alam Bhuiyan, Saad Khan, Tanveer Hassan, Jhalok Ranjon Talukder, Syeda Farjana Ahmed, Rahil Roodsaz, Els Rommes, Sabina Faiz Rashid

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Breaking the shame’ is a 3 year (2015-2018) qualitative implementation research project which investigates several aspects of sexual and reproductive health and rights (SRHR) issues for adolescents living in Bangladesh. Scope of learning SRHR issues for adolescents is limited here due to cultural and religious taboos. This study adds to the ongoing discussions around adolescent’s SRHR needs and aims to, 1) understand the overall SRHR needs of urban and rural unmarried female and male adolescents and the challenges they face, 2) explore existing gaps in the content of SRHR curriculum and 3) finally, addresses some critical knowledge gaps by developing and implementing innovative SRHR educational materials. 18 in-depth interviews (IDIs) and 10 focus-group discussions (FGDs) with boys and 21 IDIs and 14 FGDs with girls of ages 13-19, from both urban and rural setting took place. Curriculum materials from two leading organizations, Unite for Body Rights (UBR) Alliance Bangladesh and BRAC Adolescent Development Program (ADP) were also reviewed, with discussions with 12 key program staff. This paper critically analyses the relevance of some of the SRHR topics that are covered, the challenges with existing pedagogic approaches and key sexuality issues that are not covered in the content, but are important for adolescents. Adolescents asked for content and guidance on a number of topics which remain missing from the core curriculum, such as emotional coping mechanisms particularly in relationships, bullying, impact of exposure to porn, and sexual performance anxiety. Other core areas of concern were effects of masturbation, condom use, sexual desire and orientation, which are mentioned in the content, but never discussed properly, resulting in confusion. Due to lack of open discussion around sexuality, porn becomes a source of information for the adolescents. For these reasons, several myths and misconceptions regarding SRHR issues like body, sexuality, agency, and gender roles still persist. The pedagogical approach is very didactic, and teachers felt uncomfortable to have discussions on certain SRHR topics due to cultural taboos or shame and stigma. Certain topics are favored- such as family planning, menstruation- and presented with an emphasis on biology and risk. Rigid formal teaching style, hierarchical power relations between students and most teachers discourage questions and frank conversations. Pedagogy approaches within classrooms play a critical role in the sharing of knowledge. The paper also describes the pilot approaches to implementing new content in SRHR curriculum. After a review of findings, three areas were selected as critically important, 1) myths and misconceptions 2) emotional management challenges, and 3) how to use condom, that have come up from adolescents. Technology centric educational materials such as web page based information platform and you tube videos are opted for which allow adolescents to bypass gatekeepers and learn facts and information from a legitimate educational site. In the era of social media, when information is always a click away, adolescents need sources that are reliable and not overwhelming. The research aims to ensure that adolescents learn and apply knowledge effectively, through creating the new materials and making it accessible to adolescents.

Keywords: adolescents, Bangladesh, media, sexuality education, unmet needs

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Authors: Megan E. Davies

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As substance use become an increasing prevalent occurrence amongst young people, prevention programs designed specifically for children and adolescents are required to protect against associated cognitive, psychological, and behavioural issues. Further, young people from marginalized backgrounds would highly benefit from culturally adapted substance use prevention programs. The first and second phase of the Life Skills Training (LST) program, the Maskwacis Life Skills Training (MLST) program, the Bii-Zin-Da-De-Da (BZDDD; “Listening to One Another”), and a culturally sensitive smoking prevention program, all of which have been adapted to Canadian Indigenous cultures and are applied within the school and family settings, are discussed. Additionally, comorbid disorders, at-risk personality types, and motivating factors associated with substance use amongst Canadian children and adolescents, specifically Indigenous youth, are explored through the application of a biopsychosocial model. Requital efforts being made in Canada towards Indigenous communities are described within a historical context, and substance use prevention programs targeting Indigenous children and adolescents are compared. Through this lens, suggestions are presented for future research on preventative interventions directed towards substance use within minority groups.

Keywords: early intervention, cultural appropriateness, life skills training, smoking prevention, drug and alcohol prevention

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Authors: Christi Conde, Claudia Macias, Bianca Sornillo

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The effects of having a child with Autism Spectrum Disorder (ASD) extends to the family specifically, to the typically developing siblings. Provided that Filipino values involve close family-ties and family-centeredness, this study is interested in exploring the experiences of Filipino adolescents as a sibling of those diagnosed with ASD. A total of eleven (11) Filipino individuals, 3 males and 8 females, ages 11-24 years old, participated in the study – 6 of them were interviewed while the rest partook in a ginabayang talakayan (a variation of a focus group discussion). The data were analyzed using thematic analysis. Results showed 5 major themes: (1) the individual has mixed emotions and perceptions towards sibling, (2) the individual experiences differential treatment from parents, (3) the individual has responsibilities towards sibling, (4) the individual experiences personal growth, and (5) the individual is adjusting to the unfavorable effects of having sibling with ASD. Another emerging theme is an interplay between acceptance of one’s sibling, and one’s emotions and perceptions. It was also observed that there were more positive changes than negative within the individual. Having a lifetime responsibility towards sibling was also evident. Differences across ages involve the depth of awareness of the sibling’s condition and its implications. Acknowledgement of future responsibilities was evident regardless of age.

Keywords: adolescents, emotions, experiences, perceptions, qualitative research, siblings with ASD

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Authors: Chirine Aouichaoui, Mohamed Tounsi, Ines Mrizak, Zouhair Tabka, Yassine Trabelsi

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The aim of this study was to provide percentile values for vertical jumping performances and anthropometric characteristics for athletic Tunisian children. One thousand and fifty-five athletic Tunisian children and adolescents (643 boys and 412 girls) aged 7-18 years were randomly selected to participate in our study. They were asked to perform squat jumps and countermovement jumps. For each measurement, a least square regression model with high order polynomials was fitted to predict mean and standard deviation of vertical jumping parameters and anthropometric variables. Smoothed percentile curves and percentile values for the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles are presented for boys and girls. In conclusion, percentiles values of vertical jumping performances and anthropometric characteristics are provided. The new Tunisian reference charts obtained can be used as a screening tool to determine growth disorders and to estimate the proportion of adolescents with high or low muscular strength levels. This study may help in verifying the effectiveness of a specific training program and detecting highly talented athletes.

Keywords: percentile values, jump height, leg muscle power, athletes, anthropometry

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Authors: Esther Moraleda Sepúlveda, Soraya Delgado Matute, Paula Salido Escudero, Raquel Mimoso García, M Cristina Alcón Lancho

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Although there is some consensus when it comes to establishing the lexicon as one of the strengths of language in people with Down Syndrome (DS), little is known about its evolution throughout development and changes based on age. The objective of this study was to find out if there are differences in receptive vocabulary between adolescence and adulthood. In this research, 30 people with DS between 11 and 40 years old, divided into two age ranges (11-18; 19 - 30) and matched in mental age, were evaluated through the Peabody Vocabulary Test. The results show significant differences between both groups in favor of the group with the oldest chronological age and a direct correlation between chronological age and receptive vocabulary development, regardless of mental age. These data support the natural evolution of the passive lexicon in people with DS.

Keywords: down syndrome, language, receptive vocabulary, adolescents, adults

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Authors: Macarena-Paz Celume, Sylvie Tordjman

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There is still no consensus regarding the differences between gifted and non-gifted students in relationship to their self-esteem and the impact that this might have on behavioral and emotional troubles. In fact, some studies present no difference between both groups or present gifted population having higher scores in self-esteem, while others indicate all the opposite, presenting lower self-esteem in gifted population, suggesting that self-esteem issues are probably due to the fact that gifted children who present low self-esteem might not consider their high Intellectual Quotient (IQ) as a positive characteristic, thus leading to behavioral or emotional troubles. According to the author's knowledge, there is poor evidence trying to understand self-esteem issues in troubled gifted and non-gifted students in France, also finding an important lack regarding the possible moderators that might influence self-esteem. This study aimed to validate the results of these samples, looking for age and sex moderators in order to present recent evidence for the study of self-esteem in troubled gifted students in France. This study analysed the data gathered in the past 12 years for troubled students attending to the National Centre for Assistance to High Potential of Children and Adolescents (CNAHP) in France comparing the results of gifted versus non-gifted population. Primary results showed no significant differences between the groups in global self-esteem (t=1,15 p < .25), consistent with correlation analysis that found no correlation between global self-esteem and total IQ for each of the groups (rgifted=.04, rnon-gifted=.-08). Nevertheless, an ANOVA analysis showed an important effect of giftedness over academic self-esteem even though no significant differences were found (t=1,8 p < .06). No significant differences between sex regarding global self-esteem in any of the groups were found. Nevertheless, non-gifted population showed a significant difference in physical self-esteem, being higher for boys than for girls (t=2.65 p < .01). Sex and age moderator analyses for self-esteem will be presented and discussed.

Keywords: children and adolescents, giftedness, self-esteem, troubled children and adolescents

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Authors: Sipu Guo, Silin Huang

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Background: Most studies investigate the link between executive function and allostatic load (AL) among adults aged 18 years and older. Studies differed regarding the specific biological indicators studied and executive functions accounted for. Specific executive functions may be differentially related to allostatic load. We investigated the comorbidities of executive functions and allostatic load via network analysis. Methods: We included 603 adolescents (49.84% girls; Mean age = 12.38, SD age = 1.79) from junior high school in rural China. Eight biological markers at T1 and four executive function tasks at T2 were used to evaluate networks. Network analysis was used to determine the network structure, core symptoms, and bridge symptoms in the AL-executive function network among rural adolescents. Results: The executive functions were related to 6 AL biological markers, not to cortisol and epinephrine. The most influential symptoms were inhibition control, cognitive flexibility, processing speed, and systolic blood pressure (SBP). SBP, dehydroepiandrosterone, and processing speed were the bridges through which AL was related to executive functions. dehydroepiandrosterone strongly predicted processing speed. The SBP was the biggest influencer in the entire network. Conclusions: We found evidence for differential relations between markers and executive functions. SBP was a driver in the network; dehydroepiandrosterone showed strong relations with executive function.

Keywords: allostatic load, executive function, network analysis, rural adolescent

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Authors: Youngsub Oh, Youngsoon Kim

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As the second largest group among international marriages in Korea, Vietnamese married immigrant women have been exposed to psychological crisis like divorce and family violence. The purpose of this study is to understand how to counsel those women from the perspective of indigenous healing as their own psychological problem-solving way. To this end, this study reviewed Vietnamese cultural literatures on their mentality as well as Vietnamese medical literatures on indigenous healing. The research results are as follows: First, cultural foundations that have formed Vietnamese mentality are Confucian value system, reserved communication, and religious pluralism. These cultural backgrounds play an important role in understanding their own therapeutic tradition. Second, Vietnamese indigenous healing considers cause of mental disease as a collapse of balance between mind and body and environment. Thus, indigenous treatment deals with psychological problems through a recovery of the balance from the holistic perspective. In fact, indigenous healing has been actively practiced in everyday place as well as hospital until today. The implications of Vietnamese indigenous healing for multicultural counseling in Korea are as follows: First, Korean counselors need to interactively understand their own assumptions on indigenous healing as well as counselees’ own assumptions. Second, a variety of psychological intervention strategies can be drawn from Vietnamese indigenous healing. Third, indigenous healing needs to be integrated with modern techniques of counseling and psychotherapy, as both treatments are not mutually exclusive but complementary.

Keywords: indigenous healing, Korea, multicultural counseling, Vietnamese married immigrant women

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