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Simple Screening spots Teens' Risky Behaviors
Friday, May 11, 2007
By Amy Norton

NEW YORK (Reuters Health) - A short questionnaire may help spot a broad range of risky behaviors in teenagers -- from unprotected sex to substance abuse to suicidal thoughts -- a new study suggests.

It's well-known that adolescence is a time of experimentation, the authors point out. An estimated 80 percent of teens have used alcohol by the 12th grade, while half have tried marijuana and 60 percent have had sex, often unprotected.

Teenagers who try one risky behavior are prone to experimenting with others. Yet when teenagers see their doctors, even for mental health issues, there may be little discussion of drug abuse, unsafe sex and other behaviors that jeopardize their health.

Anecdotally, said Dr. Celia M. Lescano, the lead author of the new study, it seems family doctors and other health providers do not regularly ask teenagers about risky behaviors.

"Even as adults, think about what your doctor asks you," she told Reuters Health.

"How much time do you spend talking about sexual partners and what you are using to protect yourself from HIV? How many times has your physician asked you whether your partner physically, sexually or emotionally abuses you?" said Lescano, of Brown Medical School and the Bradley/Hasbro Children's Research Center in Providence, Rhode Island.

What's needed, according to Lescano and her colleagues, is a brief but comprehensive screening tool that picks up on teenagers' risk-taking.

For their study, the researchers used a short questionnaire they call the Adolescent Risk Inventory (ARI) to assess sexual behavior and emotional and behavioral issues among 134 teenagers being treated for psychiatric disorders.

The questionnaire touches on topics ranging from condom use to fighting to "self-harm" -- which includes severe problems like suicide attempts and starving or vomiting to lose weight.

The researchers found that the ARI reliably detected a range of risky behaviors, and also picked up on certain patterns. In particular, teenagers who had ever been abused or who admitted to self-harm were at heightened risk of unsafe sexual behaviors and sexually transmitted diseases.

Lescano and her colleagues report the findings in the journal Child Psychiatry & Human Development.

Although this study involved teenagers with psychiatric disorders, Lescano said the hope is that the ARI could be used by primary care doctors and mental health professionals to catch risky behaviors in all teenagers.

While some health professionals may already screen for these problems, she noted, it needs to be done more consistently and more frequently to be most effective.

SOURCE: Child Psychiatry & Human Development, April 2007
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