Within bioethics as well as in broader clinical practice, support for transgender and gender‐questioning adolescent access to pubertal suppression has often relied heavily on the desire to prevent risky, self‐destructive, and suicidal behavior. We argue that framing justifications for access to puberty suppression in this way can actually be harmful to both individual patients as well as to the broader trans population. This justification for access to care makes such access precarious, limits its scope, and introduces perverse incentives to (...) the patient population that is being served. We go on to offer an alternative, positive defense of access to puberty‐blocking treatment for transgender youth grounded in the child's right to an open future. We argue that decisions related to pubertal suppression are both importantly weighty and potentially irreversible, and show why this justification is preferable to so‐called “informed consent” approaches. (shrink)

While social media has become an important medium for adolescents in terms of identity development, belonging, news consumption and public participation, the recommendation algorithms and attention-economy-based design features of platforms can shape adolescents’ preferences and weaken their autonomous decision-making processes. This study provides a principle-based bioethical analysis of Australia’s regulation (Online Safety Amendment [Social Media Minimum Age] Act 2024; effective: 10 December 2025), which aims to prevent users under the age of 16 from creating accounts on certain social media platforms (...) and maintaining existing accounts, within the framework of digital paternalism and adolescent autonomy. Beauchamp and Childress’ principle-based bioethical approach was adopted as the methodology; the regulation was discussed in terms of the principles of respect for autonomy, non-maleficence, beneficence, and justice. The analysis suggests that while the ban can be ethically justified as a protective public health intervention in the context of mental health risks and potential harms of usage, there are debates that the age-based categorical limit does not sufficiently consider the principle of evolving capacities and adolescents’ rights to expression/participation. Furthermore, the absolute age ban may generate secondary and unintended harms, such as weakening social support and help-seeking channels, increasing digital inequalities, and directing users towards less secure online environments. The evaluation conducted in this article concludes that, instead of absolute age-based bans, it is recommended to adopt gradual autonomy models, guide companies towards protective and safe design approaches for children, impose a duty of care specific to children on platforms, ensure algorithmic transparency, and adopt a rights-based approach to child protection. (shrink)

Despite their vulnerability, adolescents are often excluded from health research due to ethical concerns about research with minors, especially in low-income regions like Sub-Saharan Africa. We enrolled adolescent girls aged 15–17 years and caregivers of girls of the same age. Using a 25-question Comprehension Score Sheet, we applied a quantitative approach to compare the comprehension of informed consent of 33 adolescent girls and 41 caregivers of adolescent girls aged 15–17 years. The assessments were audio-recorded and reviewed for (...) quality check. The results showed that adolescent girls were significantly better than caregivers in comprehending informed consent information overall and specifically on study procedures, voluntarism and study purpose. This suggests that adolescents can understand informed consent information at the same level as or better than caregivers who are entrusted with providing permission for adolescents to participate in research. (shrink)

Navigating limits to confidentiality with adolescent clients can be ethically and professionally challenging. This study follows on from a previous quantitative survey of psychologists about confidentiality dilemmas with adolescents. The current study used qualitative methods to explore such dilemmas in greater depth. Twenty Australian psychologists were interviewed and asked to describe an ethically challenging past case. Cases were then used to facilitate discussion about the decision-making process and outcomes. Interviews were transcribed and analyzed using interpretive content and thematic analysis. (...) Three key findings are discussed. First, it is of little use to perceive confidentiality dilemmas as binary choices because psychologists described 5 distinct options. These can be conceptualized on a spectrum of varying degrees of client autonomy, ranging from “no disclosure” to “disclosure without the client’s knowledge or consent”. Second, confidentiality dilemmas often involve balancing multiple and conflicting risks regarding both immediate and future harm. Third, a range of strategies are employed by psychologists to minimize potential harms when disclosing information. These are primarily aimed at maintaining the therapeutic relationship and empowering clients. These findings and the case studies described provide a valuable resource for teaching and professional development. (shrink)

This commentary reflects on 12 narratives from parents and adolescent children on the topic of access to adolescent electronic health information (EHI). The storytellers highlight the value of EHI in improving care coordination, decision-making, and communication. However, access to adolescent EHI raises ethical dilemmas regarding autonomy, privacy, and parental involvement. While most parents and adolescents support some level of parental access, the narratives reveal nuanced views on how and when this access should be restricted. Barriers faced by (...) parents of children with complex healthcare needs are also discussed, alongside recommendations for improving EHI policies. These include reducing logistical burdens and fostering open communication between families and healthcare providers. (shrink)

The purpose of this study is to explore the application and effectiveness of a mobile technology-based emotional support system in adolescent mental health intervention in low-income communities. With the increasing severity of adolescent mental health problems, especially in low-income communities, it is difficult for traditional psychological interventions to cover all the needs due to the lack of resources. By designing a mobile emotional support system specifically for adolescents in low-income communities, this study hopes to provide emotional support, mental (...) health education, and stress management functions through an online platform, and to evaluate its effectiveness in enhancing adolescents' emotional regulation, improving mental health, and improving academic performance. The study used mixed methods, including qualitative interviews, focus group discussions, and a pre- and post-test experimental design, with the aim of providing a more effective mental health intervention model for adolescents in low-income neighborhoods and exploring the sustainability and social adaptability of the model. (shrink)

In many jurisdictions, adolescents acquire the right to consent to treatment; but in some cases their refusals – e.g. of life-saving treatment – may not be respected. This asymmetry of adolescent consent and refusal seems puzzling, even incoherent. The aim here is to offer an original explanation, and a justification, of this asymmetry. Rather than trying to explain the asymmetry in terms of a variable standard of competence – where the adolescent is competent to consent to, but not (...) refuse, certain interventions – the account offered here focuses more closely on the normative power to render actions permissible. Where normative powers are shared they can readily give rise to an asymmetry between consent and refusal. We then turn to why it is justifiable that normative powers be shared in adolescence. Transitional paternalism holds that the acquisition of normative powers by competent adolescents should not be an instant one, achieved in a single step, but that there should be a transitional period where paternalistic protection is rolled back, but not entirely withdrawn until a later date. Transitional paternalism could be implemented without generating the asymmetry between consent and refusal but, it is argued, the asymmetric version of transitional paternalism is to be preferred insofar as it offers a greater respect for the adolescent's decisions than the symmetrical alternative. (shrink)

This article argues that the Community of Philosophical Inquiry (CPI) can productively use tragedy as a stimulus. We do this by following Ann Margaret Sharp’s interest in Simone Weil and supplementing it with Iris Murdoch’s writing on art and literature. Weil and Murdoch provide accounts of the moral value of attention that are both timely and enriching for the practice of philosophy for and with young people. This approach hinges on (i) an understanding of the particular affordances of tragedy as (...) attention-based literature and (ii) an attentive approach to stimulus presentation and exploration. Thus, we propose reading tragedies for neither their philosophical nor their cultural authority but rather because of the genre's unique affordances in relation to adolescents. Beginning by tracing Weil’s own educational practises (as a philosophy teacher in schools, and when instructing fellow workers), where she made extensive use of this genre, we move on to a broader exploration of the potential for attention Weil and Murdoch recognised in literature’s stimulation of imaginative exploration. With this in mind, we advocate for the pedagogical use of tragedies as a medium instructive in the limits of individual agency and the richness of reality. For to be moral, for Weil and Murdoch, means to be open to reality, and so to approach other people with attention. In our view, the moral values that inhabit tragedies are best explored through the community of philosophical inquiry, which can facilitate attention to the structure of adolescent experience; in particular, the conditions of adolescents who are in a moment of inheritance of a world beyond their control but in need of their care, experiencing a moment phenomenologically akin to Aristotle’s reversal and recognition. Therefore, tragedies, rather than speaking to us about the ancient past, can, in the CPI, meaningfully orient young people and those who work with them towards their present. (shrink)

In consideration of family system theory, the vulnerability model of depression, and the stress buffering model of social support, the current study examined the effect of family functioning on adolescent depression, the mediating effect of self-esteem, and the moderating effect of peer relationships. A sample of Chinese adolescents completed questionnaires regarding family functioning, depression, self-esteem, and peer relationships. The results showed that: family functioning had a significant negative predictive effect on adolescent depression; self-esteem plays a mediating role between (...) family functioning and adolescent depression; and peer relationships have a moderating effect on the relationship between self-esteem and adolescent depression, supporting the moderated mediation model. These results reveal the influence mechanism of family functioning on adolescent depression and have implications for adolescent depression intervention. (shrink)

Adolescent young carers (AYCs) are a sub-group of young carers who carry out significant or substantial caring tasks and assume a level of responsibility which would usually be associated with an adult. They are a potentially vulnerable group of minors because of the risk factors associated with their caring role. AYCs face a critical transition phase from adolescence to adulthood often with a lack of tailored support from service providers. The recently completed European funded ‘ME-WE’ project, which forms the (...) focus of this paper, aimed to change the ‘status quo’ by advancing the situation of AYCs in Europe, via responsive research and knowledge translation actions. This paper outlines the participatory, co-creation approach employed in the project to optimise AYC’s involvement. It describes the ethical framework adopted by the project consortium to ensure the wellbeing of AYCs within all project activities. Ethical issues that arose in the field study work in all six countries are presented, followed by a discussion of the level of success or otherwise of the consortium to address these issues. The paper concludes with lessons learned regarding ethically responsible research with and for AYCs that are likely transferable to other vulnerable research groups and pan-European projects. (shrink)

Academic performance is among the several components of academic success. Many factors, including socioeconomic status, student temperament and motivation, peer and parental support influence academic performance. Our study aims to investigate the determinants of academic performance with emphasis on the role of parental styles in adolescent students in Peshawar Pakistan. A total of 456 students from 4 public and 4 private schools were interviewed. Academic performance was assessed based on self-reported grades in the latest internal examinations. Parenting styles were (...) assessed through the administration of the Parental bonding instrument. Regression analysis was conducted to assess the influence of socio-demographic factors and parenting styles on academic performance. Factors associated with and differences between “care” and “overprotection” scores of fathers and mothers were analyzed. Higher socio-economic status, father’s education level and higher care scores were independently associated with better academic performance in adolescent students. Affectionless control was the most common parenting style for fathers and mothers. When adapted by the father, it was also the only parenting style independently improving academic performance. Overall, mean “care” scores were higher for mothers and mean “overprotection” scores were higher for fathers. Parenting workshops and school activities emphasizing the involvement of mothers and fathers in the parenting of adolescent students might have a positive influence on their academic performance. Affectionless control may be associated with improved academics but the emotional and psychosocial effects of this style of parenting need to be investigated before recommendations are made. (shrink)

Advance care planning (ACP) is a process that seeks to elicit patients’ goals, values, and preferences for future medical care. While most commonly employed in adult patients, pediatric ACP is becoming a standard of practice for adolescent and young adult patients with potentially life-limiting illnesses. The majority of research has focused on patients and their families; little attention has been paid to the perspectives of healthcare providers (HCPs) regarding their perspectives on the process and its potential benefits and limitations. (...) Focus groups were conducted with 15 physicians as part of a larger study of adolescent and young adult ACP in hematopoietic stem cell transplant (HSCT) patients. This study identified two categories important to the utility of ACP in pediatric HSCT patients; (1) the temporal context of ACP and decision making and (2) the limitations of pediatric ACP, with subcategories identified as (a) embodied and witnessed knowing, (b) the impact of clinical cascades—when the treatment of one organ system creates complications in another system that needs to be treated—and a creation of a “new normal” following complications of illness and its treatment in the pediatric intensive care unit (PICU), (c) the balancing of adolescents’ autonomy with their capacity to make informed medical decisions, and (d) the epistemological frames that differ between HCP and patients and their families. These findings support ACP in adolescent and young adult HSCT patients, with a number of implications for practice as this process becomes more common. (shrink)

Background The South African legal framework requires mandatory parental/legal guardian consent for all research with children. Ethics guidelines provide some reprieve by allowing RECs to grant waivers of parental or guardianship consent in certain defined circumstances. In the first instance, consent may be provided by a proxy when parents or guardians are unavailable, for example with orphaned children. In the second instance, guidelines permit adolescent self-consent when the nature of the study justifies this approach, for example, research on sensitive (...) issues like sexual behaviour or substance use. Discussion South African guidelines set several conditions that must be met for waivers to be granted. These norms overlap with those in international guidelines. However, the ethical norms, especially related to self-consent are sometimes vague. This article critically evaluates the consent norms in the national ethics guidelines and makes recommendations for reform to ethics guidelines in a way that recognises the value of child participation in research, their evolving decision-making capacity and their best interests. Conclusion Recommendations are made to harmonise ethics guidelines and law in a way that promotes child participation in research, to ensure additional protections for adolescents when self-consent is allowed, and to withdraw procedural requirements for the community endorsement of self-consent strategies. (shrink)

In many regions around the world, those at highest risk for acquiring HIV are young adults and adolescents. Young men who have sex with men (young MSM) in the USA are the group at greatest risk for HIV acquisition, particularly if they are part of a racial or ethnic minority group.1 Adolescent girls and young women have the highest incidence rates of any demographic subgroup in sub-Saharan Africa.2 To reverse the global AIDS pandemic’s toll on these high-risk groups, it (...) is important to deploy the most effective HIV prevention tools to young MSM in the USA, to adolescent girls and young women in sub-Saharan Africa, and to any other adolescents and young adults at high risk for HIV as products are proven to be safe and efficacious. Although prevention interventions with proven efficacy, such as oral pre-exposure prophylaxis (PrEP), are available,3–8 they have not been sufficient to stem the tide and an expanded prevention toolkit is urgently needed to serve these populations. The field of HIV prevention continues to identify promising leads in the development of new biomedical prevention products, either delivering antiviral drug topically (eg, the dapivirine vaginal ring) or systemically (eg, injectable cabotegravir). The dapivirine ring has been shown to provide modest protection and is currently being tested in open label studies while injectable cabotegravir is being tested in a large efficacy trial for preventing HIV acquisition. Advances in the field of HIV prevention mean that scientists and regulators must plan for how they will bring prevention tools to populations at high risk for HIV as they conduct efficacy and effectiveness trials. For instance, safety data from younger age groups can also be used in combination with efficacy data from adult studies, where appropriate, as bridging studies to expand labelling to younger ages. If these …. (shrink)

Mental health problems start early in life. However, the majority of adolescents fulfilling the criteria for mental health disorders do not receive treatment, and half of those who do get treatment drop out. This begs the question of what differentiates helpful from unhelpful treatment processes from the perspective of young clients. In this study, we interviewed 12 young people who entered mental health care reluctantly at the initiative of others before the age of 18. Their journeys through mental health care (...) varied significantly despite sharing the same starting point. Our analyses resulted in a model of three trajectories. We describe relational and structural facilitators and obstacles within each trajectory and have formulated narratives highlighting core experiences differentiating them. Trajectory 1 was characterized by a rapid loss of hope, leading the adolescents to conclude that mental health care was not worth the investment. Trajectory 2 was characterized by a lingering hope that never materialized into a constructive therapeutic process despite prevailing efforts by both therapists and adolescents. Trajectory 3 was characterized by genuine meetings, allowing the therapist to transform from an unsafe stranger into a safe, competent, and benevolent adult. We discuss how our results have implications for understanding agency displayed by adolescent clients in therapy, therapist flexibility and authenticity, service organization, and attributional processes influencing clinical judgment and therapeutic processes when adolescent psychotherapy has a difficult starting point. (shrink)

Although previous research has demonstrated that parent–adolescent relationships have a significant effect on adolescent Internet Addiction, the mechanisms underlying these associations and parental differences in these effects have received insufficient attention. We investigated the mediating role of Perceived Social Support and Dual System of Self-Control in the relationship between Father-Adolescent Relationships/Mother-Adolescent Relationships and adolescent IA, as well as the differences in the effects of FAR and MAR. A cross-sectional survey of 732 Chinese adolescents was conducted (...) using the Adolescent Pathological Internet Use Scale, Parent–Adolescent Relationship Scale, Multidimensional Scale of Perceived Social Support, and Dual System of Self-Control Scale. Multiple linear regression analysis, Pearson correlation analysis and structural equation modeling were used. The results of structural modeling analysis showed that neither FAR nor MAR directly predicted adolescent IA. In contrast, FAR/MAR had an impact on adolescent IA mainly through the mediating effects of Perceived Social Support and Impulsive System. Furthermore, in the relationship between FAR/MAR and adolescent IA, the Impulsive System and Perceived Social Support both served as chain mediators, as did Perceived Social Support and the Reflective System. And more importantly, unlike FAR, MAR affects adolescent IA through the mediating effect of the Reflective System. Multiple linear regression showed that the regression coefficient of MAR on adolescent IA had stronger significance compared to FAR, MAR is deserving of more attention than FAR. These findings contribute to our understanding of the mechanisms underlying the association between FAR/MAR and adolescent IA and suggest that family relationship-focused training approaches are critical for suppressing adolescent IA. These interventions should be tailored to the unique circumstances of each family. (shrink)

The present study examined the attitudes of Filipino middle school students toward physical education and the associations between PE attitude and various personal and external correlates of PE. In total, 659 middle school students, aged between 12 and 19 years, participated in the study. The Physical Education Attitude Scale was used to measure affective, cognitive, and motivational/behavioral attitudes of adolescent students toward PE. Results showed that middle school students had moderate general attitudes toward PE. Female students had more favorable (...) attitudes toward PE when their teacher was male than female. When the teacher was female, male students were more satisfied with the PE curriculum than female students. When the teacher was male, female students were more comfortable with the PE curriculum than male students. Finally, students' PE attitude did not decrease as they got older, regardless of student sex. The findings provide a different perspective for the field and underscore the importance of not only the PE curriculum but also the student–teacher relationship. To prevent the decline in students' positive attitude and encourage positive behaviors toward PE and activities, teachers should be very considerate about their interactions with students of the same sex; school administrators, meanwhile, should focus at providing PE teachers with special training courses to enhance both their teaching and communication capabilities. (shrink)

Early exposure to stressful life events is associated with greater risk of chronic diseases and mental health problems, including anxiety. However, there is significant variation in how individuals respond to environmental adversity, perhaps due to individual differences in processing and regulating emotional information. Differences in cognitive control – processes necessary for implementing goal directed behavior – have been linked to both stress exposure and anxiety, but the directionality of these links is unclear. The present study investigated the longitudinal pathway of (...) environmental stress exposure during early adolescence on later adolescent anxiety, and the possible mediating mechanism of cognitive control. Participants were 674 Mexican-origin adolescents (mean age = 10.8 years, 50% male) enrolled in the California Families Project, an ongoing longitudinal study of Mexican-origin families. In the current analysis, we examined self-reports of environmental stressors at age 14 (Time 1), cognitive control at age 16 (Time 2), and anxiety at age 18 (Time 3). Structural equation modeling revealed that environmental stressors (Time 1) had both direct and indirect effects on later anxiety (Time 3) through their effects on cognitive control (Time 2), even when accounting for prior levels of anxiety (Time 2). Cognitive control accounted for 18% of the association between environmental stressors and adolescent anxiety: an increase in stressors decreased cognitive control (β = −0.20, p p = 0.004). These findings deepen our understanding of the mechanisms underlying the development of anxiety and highlight the importance of cognitive control as a potential protective factor. (shrink)

The problem of class type in the pedology of the transitional age—Features of the unfolding crisisCrisisof sexual maturationSexual maturation in the working adolescent—The structure of the basic life needs of a working adolescent as the basis for his unique class type—Comparative characteristics of three class types of adolescent—Spranger’s typology of the adolescent and the new form of life presented by the development of the working adolescent—Two basic variants in the form of life—The formation of a (...) new type of working adolescent in the context of the social revolutionEvolution. (shrink)

The lifetime prevalence of major depressive disorder in adolescents is reported to be as high as 20%; thus, MDD constitutes a significant social and public health burden. MDD is often associated with nonsuicidal self-injury behavior, but the contributing factors including cognitive function have not been investigated in detail. To this end, the present study evaluated cognitive impairment and psychosocial factors in associated with MDD with NSSI behavior. Eighteen and 21 drug-naïve patients with first-episode MDD with or without NSSI and 24 (...) healthy control subjects were enrolled in the study. The Hamilton Anxiety Scale, Hamilton Depression Scale, Adolescent Self-injury Questionnaire, Beck Scale for Suicide Ideation–Chinese Version, Shame Scale for Middle School Students, Sensation Seeking Scale and Childhood Trauma Questionnaire were used to assess depression-related behaviors, and event-related potentials were recorded as a measure of cognitive function. The latency of the N1, N2, P3a, P3b, and P50 components of ERPs at the Cz electrode point; P50 amplitude and P50 inhibition showed significant differences between the 3 groups. CTQ scores also differed across three groups, and the NSSI– and NSSI+ groups showed significant differences in scores on the Shame Scale for Middle School Students. Thus, cognitive function was impaired in adolescents with MDD with NSSI behavior, which was mainly manifested as memory decline, attention and executive function deficits, and low anti-interference ability. We also found that childhood abuse, lack of social support, and a sense of shame contributed to NSSI behavior. These findings provide insight into the risk factors for MDD with NSSI behavior, which can help mental health workers more effectively diagnose and treat these patients. (shrink)

In this paper I examine the debate between ‘protectionists’ and ‘liberationists’ concerning the appropriate role of minors in decision-making about their health care, focusing particularly on disagreements between the two sides regarding adolescents. Protectionists advocate a more traditional, paternalistic approach in which minors have relatively little input into the healthcare decision-making process, and decisions are made for them by parents or other adults, guided by a commitment to the patient's best interests. Liberationists, on the other hand, argue in favour of (...) expanded participation by minors in treatment decisions, and decision-making authority for at least some adolescents. My examination of the debate includes discussion of liberationist shifts that have taken place in the medical community as well as in legal policy and practice, and consideration of recent research on adolescent development. In the final section of the paper, I propose a moderate position that addresses both liberationist and protectionist concerns. (shrink)

This paper uses the perspective of Islamic psychotherapy examine the development of science and technology in its influence on the changes in adolescent life based on the values of the Qur’an and the Hadith. This research was conducted at MTs Negeri 4 Tulungagung by making student learning activities as the object of research studies. Islamic education is carried out with a spirituality approach through pray, exemplary, patience and sincerity, motivating advice and supervision. Islamic psychotherapy teaches ways to manage mind, (...) verbal, heart and morals of adolescents from physical and spiritual illnesses thatcan be detrimental. First, read the Qur’an as an obligatory routine. Second, prayers in congregation and sunnah prayers. Third, creating a religious and knowledgeable environment. Fourth, fasting Monday and Thursday. This method can develop adolescents to be devoted and knowledgeable man beings, so that adolescents are able to maintain self-integrity, integrity of the soul and achieve self-actualization well. (shrink)

Research on adolescent-to-parent violence (APV) associates specific psychosocial characteristics with adolescents who assault their parents, whether they are within or outside the juvenile justice system, or whether these characteristics are shared by other adolescents convicted of other crimes. The aim of this paper is to compare three groups of adolescents. Those who have been sentenced for APV are compared with adolescents who have committed other crimes, and with a group who have not been involved in the justice system. The (...) sample used consists of 148 male participants between the ages of 14 and 21. A comparison is made regarding type of self-reported behavior, frequency of drug use, academic performance, exposure to violence, self-concept, and parents’ conflict resolution tactics. The results obtained indicate that adolescents with judicial measures, regardless of the crime committed, differ from those who have not been in trouble with the justice system in terms of them having suffered violence in the street, the frequency with which they use drugs and in their academic achievement. Likewise, adolescents convicted of APV differ from the other two groups in the frequency with which they are victims of violence at home, in that their mothers use the tactic of asking somebody else for help as a way of solving marital conflicts, and in having a more negative family self-concept. The results are discussed highlighting the importance of taking into account whether a sample is judicial, clinical, or community, and the specific APV behaviors which are measured. (shrink)

ABSTRACT For researchers interested in how pedagogy within schools can be used as a catalyst for adolescent moral development, investigating practitioner-based studies of classroom practices that support the growth of prosocial behaviors is crucial. This paper delineates a qualitative study conducted in an ethnically diverse high school language arts classroom where texts were being utilized to promote moral development across multiple domains. Authors describe how the critical reading and discussion of the comic Yummy led students to express emotional responses (...) to the text centered in feelings of empathy, gratitude, and community awareness. Findings suggest that these specific emotional reactions demonstrate potential for critical, social consciousness and the development of empathic and prosocial behaviors. Fundamentally, this paper seeks to enrich scholarship in the field of adolescent moral development by arguing that pedagogy within schools can be utilized to promote emotions and cognitions that lead to community action. (shrink)

Various human rights issues arise from the intersection of adolescent motherhood and HIV. While health rights may be the most obvious means by which to address such issues through policy development and legislative means, the right to health is not the only human right that may provide recourse or relief in this regard. This article considers an unexplored avenue of approaching such issues through reliance on the right to enjoy the benefits of scientific progress. The International Covenant on Economic, (...) Social and Cultural Rights provides for the ‘right to science’ in article 15(1)(b) and more recently, as elaborated on in General Comment no. 25 of 2020. This article considers how this right can be relied upon to address issues pertaining to adolescent motherhood and HIV. Precedent from a Venezuelan Supreme Court decision is considered, as well as the normative content of the right to enjoy the benefits of scientific progress. This may be another legal means by which to hold states accountable for the health of young mothers and their children, especially as new practices, medicines and treatments emerge regarding HIV. (shrink)

The ability to predict the risk of severe mental disorders holds considerable promise for individuals at risk, potentially enabling prevention and early intervention. Although the clinical application of such predictive models in child and adolescent psychiatry remains a future prospect, it is essential to consider their social and ethical implications that their use may entail. This study explores child and adolescent psychiatrists' views on these issues through a cross-sectional online survey distributed to members of the European Society for (...) Child and Adolescent Psychiatry. Of the 81 respondents, the majority identified the most significant benefits of using prediction tools as enabling earlier intervention by healthcare professionals (81.5%), improving the quality of care (77.8%), and helping families enhance their resilience (63%). Participants also expressed concern about potential harms, particularly violations of privacy (74.1%), discrimination (92.6%), and the lack of explainability in Artificial Intelligence algorithms (74.1%). While most participants recognise potential medical benefits in the clinical use of predictive tools, numerous concerns must be addressed before such technologies can be considered viable. These include unresolved ethical challenges, such as risks related to privacy, potential of stigmatisation and discrimination, and algorithmic opacity, as well as limitations of healthcare systems. (shrink)

In some jurisdictions there is a puzzling asymmetry between consent and refusal, where, for some kinds of treatment, the adolescent patient has the power to permit her own treatment but her refusal does not have the same kind of normative significance as refusal of treatment by a competent adult. In this journal I recently offered a clarification and defence of this asymmetry in terms of a paternalistic justification of the sharing of normative powers between adolescents and other parties. Lawlor (...) (2016) offers a number of objections to this account. Three of his objections can be dealt with quickly. But one of them is much more challenging: the asymmetry of consent and refusal entails a practice of making sham offers (offers that purport to be responsive to the patient's choices, but which, in fact, are not). They do not really offer a choice at all. Genuine offers seem to require a commitment to be symmetrically responsive to whatever decision outcome is reached by the recipient of the offer. When we reflect upon the way that offers can be made in complex social contexts, where different parties have a ‘say’ in what ought to be done, the symmetry of responsiveness need not apply. Offers can be genuine, without being symmetrically responsive. Contrary to the seemingly plausible objection, the asymmetry of consent and refusal does not entail sham offers, or the offer of ‘sham choices’. (shrink)

This study investigates the characteristics of posttraumatic growth (PTG) and academic burnout among adolescents in an ethnic minority area in China during the COVID-19 pandemic, and examines the moderating role of core belief challenge on the association between PTG and academic burnout. This study surveyed 941 secondary school students in Wenchuan using the posttraumatic growth inventory, adolescent academic burnout inventory, core beliefs inventory, and a self-designed demographic questionnaire. The results showed that: (1) Five months after the COVID-19 outbreak in (...) China, the level of PTG among adolescents in the Wenchuan area was high and its prevalence was 32.3%. Among them, the dimension of perceived changes in self was the highest, and the PTG level of junior high school students was higher than that of high school students. The academic burnout level of adolescents, particularly emotional exhaustion, was also high. The academic burnout level of the high school students was higher than that of junior high school students. (2) There was a significant negative correlation between PTG and academic burnout among adolescents. (3) Core belief challenge moderated the relationship between PTG and academic burnout. PTG had a significant negative predictive effect on adolescents’ academic burnout only when the core belief challenge was above a moderate level. These results showed the uniqueness of PTG and psychological behavioral problems of adolescents in ethnic minority areas during the COVID-19 pandemic. They also emphasized the key role of core belief challenge in the process of PTG in reducing adolescents’ academic burnout. Based on these results, recommendations are provided to alleviate academic burnout among adolescents in Wenchuan against the background of the COVID-19 pandemic. While providing full play to ethnic minority cultural characteristics to promote posttraumatic growth, guiding adolescents’ value reflection and cognitive reconstruction should be focused on. (shrink)

Résumé Si l’adolescence enjoint le sujet à l’intégration de nouvelles données perceptives, le dessin constitue un bon support à l’exploration du processus de croissance psychique. L’article examine l’utilisation du dessin pour un adolescent en thérapie selon trois axes : un mouvement régrédient de reprise de modalités subjectives précoces, sensori-rythmiques, l’expérimentation transitionnelle du squiggle et enfin l’ouverture vers une pensée figurative. La coconstruction créative des enveloppes psychiques, l’introjection d’un objet contenant seront le fil rouge de l’étude de ce processus.

As a social issue of widespread concern, work-to-family conflict has been found to adversely affect employees’ work and family lives. The current research linked employees’ work-to-family conflict to disruptions in parenting and in turn to adolescents’ materialism. In Study 1, two-wave data from 207 Chinese dual-career families that included an adolescent in junior high school showed that both men’s and women’s work-to-family conflict was positively correlated with material rewards parenting, and this positive relationship was stronger when parenting daughters than (...) sons. Study 2 replicated the results of Study 1 in a sample of 284 Chinese dual-career families that included an adolescent of the same age group. Furthermore, Study 2 showed that employees’ work-to-family conflict was indirectly related to their adolescent offspring’s materialism through increased material rewards parenting, and this mediating effect was stronger for daughters. The results are discussed in terms of the spillover and crossover processes that affect employees and their families in the context of work-to-family conflict. (shrink)

Many published instruments for assessing adolescent adjustment can be implemented in the school context. However, most of them fail to include a comprehensive and positive theoretical perspective of adolescent development and, even when they do, priority is often given to the clinical perspective, or problems with ecological validity and cost-effectiveness emerge. The Magallanes Adaptation Scale is a 90-item Likert-instrument designed for Spanish-speaking adolescents in order to screen several adjustment areas from a holistic and positive perspective of development. Although (...) some evidence of its psychometric robustness has been tested, no confirmatory analysis of its structure has been published. This paper analyzes the items and the factor structure (exploratory factor analysis and confirmatory factor analysis, using the split-half method) of the scales. Participants were 948 Spanish adolescents (49.84% girls) aged between 11 and 17 and stratified sampled. Thirty-six items were removed from the item analysis. The results of the exploratory factor analysis revealed five factors, excluding mother’s adaptation. Several models were tested during the confirmatory factor analyses, with a 24-item second-order four-factor solution being found to have the best adjustment indicators. The short version proposed in this paper can constitute a helpful tool with screening purposes to help school teachers to assess students’ overall development beyond mere academic performance, although further validity research is needed. (shrink)

Adolescent populations have become increasingly accessible through online data collection methods. Online surveys are advantageous in recruiting adolescent participants and can be designed for adol...

Whether adolescents should be allowed to make their own medical decisions has been a topic of discussion in bioethics for at least two decades now. Are adolescents sufficiently capacitated to make their own medical decisions? Is the mature-minor doctrine, an uncommon legal exception to the rule of parental decision-making authority, something we should expand or eliminate? Bioethicists have dealt with the curious liminality of adolescents—their being neither children nor adults—in a variety of ways. However, recently there has been a trend (...) to rely heavily, and often exclusively, on emerging neuroscientific and psychological data to answer these questions. Using data from magnetic resonance imaging and functional MRI studies on the adolescent brain, authors have argued both that the adolescent brain isn't sufficiently mature to broadly confer capacity on this population and that the adolescent brain is sufficiently mature to assume adolescent capacity. Scholars then accept these data as sufficient for concluding that adolescents should or should not have decision-making authority. Two critical mistakes are being made here. The first is the expectation that neuroscience or psychology is or will be able to answer all our questions about capacity. The second, and more concerning, mistake is the conflation of decision-making capacity with decision-making authority. (shrink)

The concept of minimal risk has been used to regulate and limit participation by adolescents in clinical trials. It can be understood as setting an absolute standard of what risks are considered minimal or it can be interpreted as relative to the actual risks faced by members of the host community for the trial. While commentators have almost universally opposed a relative interpretation of the environmental risks faced by potential adolescent trial participants, we argue that the ethical concerns against (...) the relative standard may not be as convincing as these commentators believe. Our aim is to present the case for a relative standard of environmental risk in order to open a debate on this subject. We conclude by discussing how a relative standard of environmental risk could be defended in the specific case of an HIV vaccine trial among adolescents in South Africa. (shrink)

Bioethics, Volume 36, Issue 5, Page 576-586, June 2022.

BackgroundStreet-connected children and youth in low- and middle-income countries have multiple vulnerabilities in relation to participation in research. These require additional considerations that are responsive to their needs and the social, cultural, and economic context, while upholding core ethical principles of respect for persons, beneficence, and justice. The objective of this paper is to describe processes and outcomes of adapting ethical guidelines for SCCY’s specific vulnerabilities in LMIC.MethodsAs part of three interrelated research projects in western Kenya, we created procedures to (...) address SCCY’s vulnerabilities related to research participation within the local context. These consisted of identifying ethical considerations and solutions in relation to community engagement, equitable recruitment, informed consent, vulnerability to coercion, and responsibility to report.ResultsSubstantial community engagement provided input on SCCY’s participation in research, recruitment, and consent processes. We designed an assent process to support SCCY to make an informed decision regarding their participation in the research that respected their autonomy and their right to dissent, while safeguarding them in situations where their capacity to make an informed decision was diminished. To address issues related to coercion and access to care, we worked to reduce the unequal power dynamic through street outreach, and provided access to care regardless of research participation.ConclusionsAlthough a vulnerable population, the specific vulnerabilities of SCCY can to some extent be managed using innovative procedures. Engaging SCCY in ethical research is a matter of justice and will assist in reducing inequities and advancing their health and human dignity. (shrink)

Adolescent drug abuse is a social issue of global concern, causing a serious burden of diseases for individuals, families and society. To design effective prevention and intervention strategies for adolescent drug abusers, the predictive factors associated with drug abuse must be quantified and assessed. This study explores the similarities and differences between the parenting styles of adolescent drug abusers and non-drug abusers and applies a structural equation model to analyze the mechanisms involved between parenting styles, social support (...) and adolescent drug abuse identification. Data were derived from adolescent drug abusers and non-drug abusers between the ages of 18 and 35 in China, and the data were collected and analyzed by SPSS 26 and AMOS 24. The results show that parenting styles significantly predict adolescent drug abuse identification, and different parenting styles have different influencing mechanisms, which further indicates that poor parenting styles are a risk factor for adolescent drug abuse. Additionally, social support plays a mediating role between parenting styles and drug abuse identification. The specific pathways involved are as follows: Paternal parenting style → Social support → Drug abuse identification and Maternal parenting style → Social support → Drug abuse identification. However, beyond this, the mediation model of social support shows good adaptability and stability between adolescent drug abusers and non-drug abusers. Since parenting styles and social support are important predictors of adolescent drug abuse, the importance of integrating family-social support antidrug programs into adolescent prevention and intervention strategies should be considered. (shrink)

Adolescent mothers experience poorer sleep than adult mothers, and Latina adolescent mothers are at greater risk of postpartum depression compared with other racial/ethnic groups. However, social support may be protective against the negative effects of poor sleep in this population. The current study examined associations between the quality and quantity of Latina adolescent mothers’ sleep and mental health, and whether social support buffered the effects of poor sleep on mental health. A sample of Latina adolescent mothers (...) from an agricultural region in the United States reported on their sleep duration/quality, social support from family, friends, and significant others, and their depressive and anxiety symptoms. Results showed that adolescent mothers reported poorer sleep than pediatric recommendations, and poorer sleep quality was associated with greater depressive and anxiety symptoms. Interestingly, when adolescent mothers reported better sleep, they had fewer depressive symptoms in the context of high support from friends compared with low support from friends. Sleep is important for mental health in Latina adolescent mothers, and better sleep combined with strong social support has positive associations with mental health in this population. Findings hold implications for improving mental health in adolescent mothers. (shrink)

Within child and adolescent psychiatry, there are a number of potential dilemmas pertaining to diagnosis, treatment, the protection of the child, as well as the child's own developing intelligence and moral judgement. Diagnostic Dilemmas in Child and Adolescent Psychiatry is the first in the IPPP series to explore this highly complex topic.

Adolescents are routinely treated differently to adults, even when they possess similar capacities. In this article, we explore the justification for one case of differential treatment of adolescents. We attempt to make philosophical sense of the concurrent consents doctrine in law: adolescents found to have decision-making capacity have the power to consent to—and thereby, all else being equal, permit—their own medical treatment, but they lack the power always to refuse treatment and so render it impermissible. Other parties, that is, individuals (...) who exercise parental responsibility or a court, retain the authority to consent on an adolescent’s behalf. We explore four defences of the doctrine. We reject two attempts to defend the asymmetry in the power to consent to and refuse medical treatment by reference to transitional paternalism. We then consider and reject a stage of life justification. Finally, we articulate a justification based on the distinctiveness of adolescent well-being. (shrink)

Studies of adolescent conduct have found that both exemplary and antisocial behaviour can be predicted by the manner in which adolescents integrate moral concerns into their theories and descriptions of self. These findings have led many developmentalists to conclude that moral identity‐‐in contrast to moral judgement or reflection alone‐‐plays a powerful role in mediating social conduct. Moreover, developmental theory and research have shown that identity formation during adolescence is a process of forging a coherent and systematic sense of self. (...) Despite these well‐founded conclusions, many moral education programmes fail to engage a young person's sense of self, focus exclusively on judgement and reflection and make little or no attempt to establish coherence with other formative influences in a young person's life. The authors propose a new method, called “the youth charter”, for promoting adolescent self‐identification with a coherent set of moral standards. (shrink)

Drawing on a conception of scientists and community members as partners in the construction of ethically responsible research practices, this article urges investigators to seek the perspectives of teenagers and parents in evaluating the personal and political costs and benefits of research on adolescent risk behaviors. Content analysis of focus group discussions involving over 100 parents and teenagers from diverse ethnic and socioeconomic backgrounds revealed community opinions regarding the scientific merit, social value, racial bias, and participant and group harms (...) and benefits associated with surveys, informant reports, intervention studies, blood sampling, and genetic research on youth problems. Participant comments highlight new directions for socially responsible research. (shrink)