Relationships between adults and parents are characterized by positive and negative qualities. Existing measures of relationship qualities and ambivalence. The study uses data from the National Longitudinal Survey of Youth, cohort quality of parent-adolescent relationships (i.e., mother-adolescent and. Purpose: Understand the parent-adolescent relationship Age: years Administration: Self-report; Individual and/or group Time: minutes T.
In line with previous findings, we hypothesize that a favourable parent-adolescent attachment i. The goals of this study were 1 to examine the association of negative life events and parent-adolescent attachment relationship quality with mental health problems and 2 to investigate if there is an interaction between the parent-adolescent attachment relationship and one or multiple negative life events on the mental health of adolescents.
Methods Design and participants A prospective study with a two-year follow-up was conducted as part of the Rotterdam Youth Monitor RYMa longitudinal youth health surveillance system. The RYM monitors the general health, well-being, behaviour and related factors of youth aged 0 to 19 years living in Rotterdam and the surrounding region in the Netherlands.
The RYM is incorporated into the preventive care regular health examinations of the preventive youth healthcare system; the RYM is used to detect potential individual health risks and problems in order to take necessary preventive measures including referrals for treatment. The current study used RYM data from students at secondary schools. Data were collected throughout the school year, except in the months of July and August Dutch summer holidays.
The students completed a baseline questionnaire between September and July and a follow-up questionnaire between September and July The main reason for non-response at follow-up was that schools were not willing to participate at follow-up.
Ethics statement All data were gathered within and as part of the government approved routine health examinations of preventive youth health care; the RYM was completed on a voluntary basis; anonymous data were used in this study; separate informed consent was therefore not requested. Adolescents received verbal information on the RYM, each time it was applied; their parents received written information on the RYM, each time it was applied; both adolescents and their parents were free to object to participation.
Measures Mental health problems. Mental health was assessed at follow-up by the Dutch self-report version of the Strengths and Difficulties Questionnaire SDQ  — . The SDQ consists of 25 items for describing positive and negative attributes of adolescents that can be allocated to five subscales of five items each. Two groups were created based on the total SDQ score: Adolescents were asked about 11 negative life events, which were measured using three different types of response categories.
Each life event was assessed at baseline with one item. For six of the life events i. For analysis, these items were dichotomized into: For two life events i. For analysis, regular conflicts between parents was dichotomized into: Parental divorce, as well as three other life events i. A total life event score was calculated by adding up the dichotomized item scores. Subsequently, three groups were created based on the total life event scores: This scale consists of six items: The items were scored on the four-point scale using: This scale was dichotomized based on the sample distribution in this study: Age, gender, ethnicity, and education level of the adolescent were measured at baseline and are incorporated in this study as potential confounders.
For analysis purposes, confounders were dichotomized. Age was dichotomized into the categories below 13 years and 13 years or older. Education was categorized into two groups: Ethnicity was classified as Dutch or non-Dutch. In accordance with the definitions of Statistics Netherlands adolescents with at least one parent born outside the Netherlands were classified as non-Dutch.
Statistical analysis Descriptive statistics were calculated for general characteristics of the study population Table 1. Differences in gender, age, ethnicity, education, life events and parent-adolescent attachment among adolescents with and without mental health problems were evaluated by chi-square test Table 1. Mental health at follow-up. The purpose of the booster sessions was to bring the parents and adolescents together and explore their successful and unsuccessful experiences with their peer and familial relationships over the previous months.
Booster, or maintenance, sessions are provided after the initial intervention class series to review content and skills, to reinforce prevention messages to reduce and manage risk, and to foster continued parent—teen communication and interaction.
The curriculum is targeted to middle-school-aged youths because sexual activities often are initiated in the early teen and preteen years and because sexual initiation is occurring at increasingly younger ages, especially among urban minority youths. Self controls can be cognitive eg, knowledge about risks and protectionsemotional eg, feeling confident about one's capabilities for obtaining protective devicesand behavioral eg, having a broad repertoire of appropriate response alternatives for coping with pressures to have sex.
Social controls addressed in the PARE curriculum include communication about sex, values assigned to parents' and friends' opinions, parental rules about adolescent behavior, and parental monitoring through involvement in youths' activities. The PARE curriculum was delivered either as an Interactive Program IP with role-play, practice exercises, and parent—child discussions or as an Attention Control Program ACP that contained the same content but was delivered in traditional didactic format.
The IP differed from the ACP in its inclusion of the following behavioral, cognitive, and social learning modalities: Teacher and peer modeling of communication and assertiveness behaviors, and the practice of these behaviors through role-playing. We hypothesized that the social interactive activities and parent—child discussions designed into the IP approach for curriculum implementation would prove more effective than the ACP in maintaining and strengthening social and self controls on adolescent sexual behavior.
The difference in the numbers assigned to the 2 conditions was due to parents with more than 1 child participating in the program. The data source for this investigation was a curriculum-content-specific questionnaire administered to the child at the first and final meetings of the initial series of 4 prevention education sessions and at the close of each booster session. Recruitment Participants were recruited in 4 steps. First, invitations were sent through the mail and through presentations at professional conferences to all urban school districts located in and near the southeast Texas city where the research institution is located.
Administrators in 2 school districts indicated a willingness to participate in the PARE program project. Step 2 consisted of orientation meetings with principals and counselors at the middle schools in the consenting districts. Two of 3 middle schools in 1 district and 3 of 4 middle schools in the second district agreed to participate. Step 3 consisted of developing partnerships with the consenting schools and inviting families to participate.
Cover letters, consent forms, and informational flyers were sent to parents via the students and through the mail informing them about the program and providing details regarding the research protocol. The school principals at each of the participating schools endorsed the program and signed the letters to parents, which were written in both English and Spanish. Step 4 was to contact and invite parents and children by phone to participate in the experimental and control program groups.
The Institutional Review Board for the research institution approved the research protocol. We documented active informed consent for all participating parents and children.
The participating schools were diverse in size, ethnic heritage of the student body, and performance characteristics. Two of the schools had approximately students, 2 had between and 1, students, and 1 had more than 1, students. Across the 5 schools, the percent of students of different heritage ranged from 0. Three of the schools identified more than two-thirds of the student body as economically disadvantaged. The percentage of students with special circumstances ranged from 3.
Total enrollment across the 5 schools was 3, Program Implementation All sessions were conducted on middle-school campuses in the evening, and professionally trained counselors and health educators facilitated these sessions. Parents and students received small incentives ie, gift certificates and telephone and mail correspondence to encourage their full and continued participation.
Four to 8 parent—child dyads attended each 2.
During the first 4 sessions, male students met separately from female students. Male and female students attended classes together during the booster sessions. Session I focused on pubertal development and barriers to parent—child communication. Session III provided students and parents with an overview of risky sexual behaviors and the situational or environmental conditions that predispose teens to risky behavior.
Session IV explored strategies for coping with difficult situations. Booster I explored successful and unsuccessful experiences within peer and familial relationships.
Booster II addressed values, beliefs, attitudes, and communication about relationships and risky behavior. Booster III focused on dating, including what it means to date, what can happen on a date, and how parents can help youths prepare for dating.
Students typically completed the questionnaire in 15 to 20 min. Unique identifying codes were marked on the questionnaire so that we could match records from semester to semester without disclosing individual identifying information. The questionnaire, with either Likert or dichotomous response options, included scales on the following domains. We scored the items to measure a repertoire of resistance responses, regardless of the apparent social appropriateness of the particular response option, because different social pressure situations and contexts may require different responses.
We applied linear mixed models with first order autoregressive correlation structure, a strategy recommended for analyses of longitudinal data with repeated measurements over time. In this study, the first 2 administrations of the questionnaire were 4 weeks apart, whereas the next 3 occurred in intervals of 4 to 6 months.
Using linear mixed models also allows for imbalanced data structure caused by missing responses. Instead of tracing changes of each observation over time, the analytic procedures trace changes of each participant's observations. This advantage is important in a prospective study that requires the joint participation of parent and child across a 2-year project period.
We report results as beta statistic, which is the estimated effect size for the given independent variable. Because we were concerned that self-selection bias could constrain our confidence in generalizability of the study results, we prefaced the analyses of outcomes from questionnaire results with an analysis of data from a school-wide survey to compare characteristics of students who participated in the parent—child program with those of nonparticipants.
These proportions are consistent with census data on living arrangements of school-age children in Texas. In 1 case, the adult member of the dyad was a family member other than the parent. Parental Rules Compared with ACP, the IP yielded increases in the extent to which parents were reported to have definite rules about the students' behaviors. The students' self-report of the relative importance of parents' and friends' influence on decisions about drinking alcohol, having sex, and choosing friends remained approximately the same throughout the study.
There were no differences between programs or across time in youths' self-efficacy for prevention. Comment The results of this study support the hypothesis that social interactive activities and parent—child discussions designed into curriculum-guided prevention education are more effective than a traditional didactic delivery of PARE for strengthening social and self controls to reduce risks for adolescent pregnancy and STDs.
Compared with the didactic approach for delivering the curriculum content, the social interactive implementation achieved increases in social control through parental rules and enhanced self-control for youths through increased knowledge about prevention and maintenance of a broader repertoire of resistance responses when pressured to have sex.
Contrary to expectations, the social interactive methodology for parent—child prevention education did not have a measurable positive effect on the extent to which youth said they talk with or feel comfortable talking with their parents about sex and other risky behaviors.