Cultural, Historical, and Subcultural Contexts of Adolescence: Implications for Health and Development

Although clearly influenced by biological and psychological growth, adolescent development is also molded by the social and cultural context in which it occurs. As the transition from childhood to adulthood, adolescence is closely tied to the structure of adult society, and the expectations for youth during this period reflect, in important ways, the skills and qualities deemed important for success in adult roles (Benedict, 1937; Havighurst, 194811972). Furthermore, prevailing demographic, economic, and political conditions determine the adult occupational and social roles to which young people can aspire, as well as the access to and competition for those roles (Elder, 1975). The integral connection between adolescence and the societal context means that, despite universals such as puberty and cognitive development, adolescents\u27 experiences will vary across cultures and over history. The settings in which young people develop, the skills they are expected to acquire, and the ways in which their progress toward adulthood is marked and celebrated depend on the cultural and historical contexts. Within stratified, heterogeneous societies, the experience of adolescence also differs among subgroups of youth. Economic and social resources, as well as access to valued adult roles, may differ for youth from distinct racial-ethnic groups, social classes, and geographic regions. Lack of resources and opportunities in some settings may profoundly shape the course of adolescent development by influencing the timing of key developmental transitions and the supports available for coping with these transitions. Moreover, to the extent that anticipated adult lives differ for youth from distinct social subgroups, differences in socialization patterns and goals would be expected (Ogbu, 1985). In heterogeneous societies, therefore, local ecological conditions may alter considerably the normative template of adolescent development, with important implications for adolescents\u27 current health and future life course. Thus, both macrolevel, societal arrangements and local conditions help shape adolescents\u27 experiences and the course of their development. Both kinds of influences may also have consequences for adolescent health. In particular, they affect the health risks to which young people are exposed before and during adolescence, as well as the protective factors that may shield them from these risks. In this chapter, I examine the impact of both societal and local contexts, highlighting some of their implications for adolescent health. Essentially, the chapter addresses two questions: First, how has adolescent health and development been affected by changing social and economic conditions in the United States? Second, how does the health and development of adolescents in the contemporary United States vary as a function of the local ecology? Before turning to these issues, however, an overview of sociocultural influences on adolescent development will be presented

Agency in the Life Course: Concepts and Processes

The capacity of humans to influence their lives has long been a theme within Western literature, philosophy, and psychology. In recent years, the theme of human agency has crystallized in the psychological literature in the concepts of control, self-regulation, and self-efficacy. As a result, considerable attention has been devoted to the psychological processes through which control is exerted, such as cognitive appraisals, goal setting, and planning, as well as control beliefs and the potentially debilitating effects of loss of control (e.g., Bandura, 1997; Boekaerts, Pintrich, & Zeidner, 2000; Carver & Scheier, 1998; Seligman, 1975). Although this body of work has yielded pivotal insights into the mental processes underlying human agency, it has tended to focus on the person, with scant attention to the environmental exigencies over which the person seeks to exert control. An environment is assumed, but it is the individual\u27s perception of and response to that environment that is considered central, rather than the environment per se. Accordingly, there has been little attempt to delineate the facets of the environment that may be influential in shaping the expression of self-determination

Sexual Risk Taking in Adolescence: The Role of Self-Regulation and Attraction to Risk

Precursors of adolescent sexual risk taking were examined in a multiethnic sample consisting of 443 children (51% girls) of National Longitudinal Survey of Youth participants. Respondents were 12–13 years old in 1994 and 16–17 in 1998. Controlling for demographic and contextual factors, self-regulation—but not risk proneness—was significantly (modestly) associated with overall sexual risk taking 4 years later, Analyses of individual sexual behaviors indicated that self-regulation may affect choices made after becoming sexually active (e.g. number of partners) rather than the initiation of sexual activity. Measures of parent and peer influence had independent effects on sexual risk taking but did not moderate the effects of self-regulation and risk proneness, Findings add to the growing literature on implications of self-regulation for individual development

Sexual Risk Taking in Adolescence: The Role of Self-Regulation and Attraction to Risk

Precursors of adolescent sexual risk taking were examined in a multiethnic sample consisting of 443 children (51% girls) of National Longitudinal Survey of Youth participants. Respondents were 12–13 years old in 1994 and 16–17 in 1998. Controlling for demographic and contextual factors, self-regulation—but not risk proneness—was significantly (modestly) associated with overall sexual risk taking 4 years later, Analyses of individual sexual behaviors indicated that self-regulation may affect choices made after becoming sexually active (e.g. number of partners) rather than the initiation of sexual activity. Measures of parent and peer influence had independent effects on sexual risk taking but did not moderate the effects of self-regulation and risk proneness, Findings add to the growing literature on implications of self-regulation for individual development

Consistency and Recanting of Ever-Smoking Status Reported by Self and Proxy Respondents One Year Apart

The study examined consistency of reports concerning current and prior smoking behaviors. Data came from the 2002–2003 Tobacco Use Supplement to the Current Population Survey, where the current smoking behaviors and smoking history were reported by self- and proxy-respondents on two occasions, one year apart. The ever-smoking status is reported consistently, overall: Kappa coefficient is 0.78 with the corresponding 95% confidence interval given by (0.77, 0.78). One specific type of inconsistency of prior reports was assessed for respondents who were identified as never smokers at the latter assessment and former or current smokers at the earlier assessment. Based on the survey logistic regression that controls for multiple respondent characteristics and survey administration method, the estimated prevalence of such inconsistent self-reports is 9.0%, and prevalence of inconsistent proxy-reports is 5.4%. In addition, prevalence of recanting, i.e., future reporting never smoking for respondents who previously claimed to be a former or a current smoker was assessed. The recanting was shown to be most prevalent with respect to proxy-reports and former smokers: overall prevalence of recanting was estimated to be in the range 13% – 19% for current smokers, and 27% – 46% for former smokers. Our findings indicate that while, unexpectedly, proxy-respondents are more likely to report the ever-smoking status consistently than do self-respondents, the proxies are also more likely to incorrectly report never smoking in the future for smokers especially regarding adolescents and young adults. Therefore, the observed higher level of consistency for proxy-respondents may be due to proxies’ incorrect knowledge which leads to consistent yet ambiguous responses

Adolescents Occupational and Educational Goals: A Test of Reciprocal Relations

During adolescence, young people’s future aspirations and expectations begin to crystallize, especially in the domains of education and occupation. Much of the research in this area has emphasized development within a particular domain (e.g., education) and relations between aspirations and expectations across domains remain largely unexplored, resulting in a lack of information on how goals develop in tandem and affect each other. It is also unclear whether these developmental processes differ by gender and socioeconomic status. We tested reciprocal effects between occupational and educational goals using a longitudinal sample of 636 adolescents (52% boys). Results from dynamic systems models indicated change in occupational and educational goals across high school. For all youth, occupational aspirations predicted change in occupational expectations. Educational expectations predicted change in occupational aspirations for youth in high but not low parent education groups, and occupational expectations predicted change in educational expectations for girls but not boys

Anticipating Adulthood: Expected Timing of Work and Family Transitions Among Rural youth

This study examined family and individual processes influencing the future expectancies of adolescents (N = 345) from an economically stressed rural community. The anticipated timing and sequencing of key role transitions (school completion, job entry, marriage, and parenthood) were examined for each gender. In addition, factors contributing to individual differences in expected timing were examined, and gender differences in predictors were tested. Results indicated that rural adolescents\u27 expectancies about adult role transitions diverged somewhat from societal norms with respect to timing. Family background and relationships, adolescents\u27 attitudes and behaviors, and educational aspirations all contributed to individual differences in expected timing, with somewhat different factors being salient for boys and girls. These findings provide clues to the psychological processes linking adolescent experiences to the construction of the adult life course

Parenting Styles and Youth Well-Being Across Immigrant Generations

This study examines generational patterns of parenting styles, the relationships between parenting styles and adolescent well-being among youth of Mexican origin, and the role of generational parenting style patterns in explaining generational patterns in youth behavior (delinquency and alcohol problems) and psychological well-being (depression and self-esteem). This study uses two waves of data from the National Longitudinal Study of Adolescent Health (Add Health). The proportion of teens with permissive parents increased with generation; other parenting styles declined. The rate of youth with behavioral problems increased with generation. Self-esteem improved with generation; depression scores did not. Bivariate generational patterns of behavioral and psychological outcomes are a function of the patterns seen for youth with permissive parents, coupled with the increase in the proportion of permissive parents with each successive generation. In contrast, these outcomes did not worsen with generation for youth with authoritative parents

Palliative care needs of pediatric patients & their families: a phenomenological study of multidisciplinary pediatric palliative care team experiences

In the United States, more than 1 million children may be suffering from a life-limiting condition (Ruston and Catlin, 2002, p. 57) for which there is no reasonable hope for cure or long-term survival (Fraser et al, 2012, p. 923). However, less than one percent of these children and their families benefit from the provision of pediatric palliative care (Stayer, 2012, p. 350), which is an innovative health care model designed to address their physical, emotional, psychosocial and spiritual needs from diagnosis through end-of-life. During the last decade, pediatric palliative care has begun to secure a foothold as an emerging health care specialty (Crozier and Hancock, 2012, p. 198), but a dearth of literature has left the lived experience of children and their families poorly understood. Therefore, the Pediatric Palliative Care Study is a qualitative research study that utilizes interpretative phenomenological analysis to address two objectives: (1) understand and articulate the comprehensive lived experience of caring for children with life-limiting conditions and their families and (2) delineate how the collective experiences provide insights into needs that can be addressed by pediatric palliative care. The study was conducted at four research sites within Providence Health & Services. In total, nine major themes emerged from the experiences of 27 multidisciplinary care team providers who participated in the study. The themes have been framed from the perspective of the child and family: 1) Develop an innovative approach to caring for me, (2) Place me at the center of care, (3) Care for me as a whole person, (4) Be my guide, (5) Educate and prepare me for what I need to know, (6) Come alongside me, (7) Cultivate the plan and purpose for my life, (8) Be my voice and help me find my own and (9) Help me thrive. The analysis also contributed to an overarching statement about the experience that articulates the interconnectedness between the themes and creates a story of the phenomenon. The study presents seven implications for future practice related to (1) balancing matters of health care design with the human experience, (2) addressing the aims of health care reform legislation, (3) developing care models for home-based settings, (4) customizing care and developing solutions from the perspective of families, (5) educating about palliative care, (6) understanding the skills needed for palliative care providers and (7) improving data reporting for palliative care. Moreover, the study offers three contributions to extant literature, including: (1) validating and refining the WHO definition of palliative care, (2) completing an assessment of the adult versus pediatric palliative care literature from 2011-2014 and (3) addressing a known gap in the literature by offering the first IPA study to articulate the comprehensive lived experience. Limitations of the study and implications for future research are delineated as a research agenda for those seeking to build upon the study findings