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This Month in Archives of Pediatrics and Adolescent Medicine
May 2008

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2008;162(5):399. doi:10.1001/archpedi.162.5.399

The Mental Health of US Adolescents Adopted in Infancy

In the United States, more than 120 000 children are adopted annually, a large portion of whom come from foreign countries. This study compared the mental health outcomes of 514 international adoptees and 178 domestic adoptees with those of 540 nonadopted children. The vast majority of adolescents adopted as infants were well adjusted and psychologically healthy. However, being adopted approximately doubled the odds of having contact with a mental health professional and displaying a disruptive behavior disorder. Domestically adopted children were 2.6-fold more likely to have an externalizing disorder than internationally adopted children.

See page 419

Infant Television and Video Exposure Associated With Limited Parent-Child Verbal Interactions

There is increasing evidence of the potential adverse effects of television exposure on young children. In this study of lower income families, 96.8% of mothers reported that their infants were exposed to television daily, with a median of 2 hours of exposure per day. Half of the exposures were to unintended media content. Mothers perceived that their infants actually watched two-thirds of the television programs to which they had been exposed. While two-thirds of mothers reported viewing the programs with their infants, they reported talking to their infants about the programs only one-quarter of the time. The study suggests that potential benefits from educational media may be limited in the absence of strategies to increase coviewing.

See page 411

Local Restaurant Smoking Regulations and Adolescent Smoking Initiation

More than 400 000 people die each year in the United States from smoking, making it the leading underlying cause of death. Most adults who smoke began to do so during adolescence. Siegel and colleagues examined the effect of local restaurant smoking regulations on smoking initiation in adolescents. Overall, about 9% of youth aged 12 to 17 years at baseline started smoking during the subsequent 4 years. There was no association between medium smoking regulations and progression to smoking, but youth living in towns with strong restaurant smoking regulations had a 40% lower odds of starting to smoke compared with youth living in towns with weak regulations. This effect was seen in adolescents aged 12 to 17 years at baseline but not for youth aged 18 to 21 years. Restaurant smoking bans appear to affect youth smoking initiation by lowering their perception of the prevalence of smoking as well as changing its perceived social acceptability. This study suggests that bans on smoking in public places like restaurants may be one of the most effective strategies to prevent adolescents from initiating smoking.

See page 477

Sequelae of Sudden Parental Death in Offspring and Surviving Caregivers

Parental death is one of the most stressful life events, yet our knowledge of the range and course of psychiatric outcomes in bereaved children is limited. This study examined 140 families in which a parent died suddenly of homicide, suicide, or natural death. Children in these families had a higher incidence of new onset of any psychiatric disorder, depression, or posttraumatic stress disorder (PTSD) compared with nonbereaved controls. The rates of complicated grief were similar among the 3 bereaved groups. The type of death was not predictive of depression within the bereaved group, but the parent having a last confiding conversation with the child before death increased the odds of new-onset depression 4.5-fold. A history of any psychiatric disorder in the offspring increased the likelihood of PTSD nearly 10-fold. This study has important implications for the care of children and families after the loss of a parent.

See page 403