Adolescent Health Psychology (original) (raw)
In this article, a biopsychosocial model of adolescent development is used as an organizing framework for a review of primary, secondary, and tertiary prevention research with adolescent populations. During adolescence many critical health behaviors emerge, affecting future disease outcomes in adulthood. In addition, most of the predominant causes of morbidity and mortality in adolescence are unique to this period of development, indicating that health-focused interventions must be tailored specifically to adolescents. Moreover, it is during adolescence that lifelong patterns of self-management of and adjustment to chronic health conditions are established. Thus, an increased focus on adolescence in health psychology research is important both to improve the health of adolescents per se and to optimize health trajectories into adulthood. Adolescence has historically been a developmental period of relative neglect with respect to research on both mental and physical health intervention and outcome. Perhaps such neglect has occurred because, from a health perspective, morbidity and mortality rates are quite low during adolescence compared with other developmental periods (Holden & Nitz, 1995). However, as we argue in this article, adolescence is a pivotal period of development with respect to health and illness. First, it is during adolescence that many positive health behaviors (e.g., diet and exercise) are consolidated and important health risk behaviors (e.g., smoking, alcohol and drug use, and unsafe sexual practices) are first evident; thus, adolescence is a logical time period for primary prevention intervention. Second, the predominant causes of morbidity and mortality in adolescence are quite different from adults, indicating that early identification and treatment of adolescent health problems must be directed toward a unique set of targets in this age group. Moreover, because of the particular developmental issues that characterize adolescence, intervention efforts designed for adults are often inappropriate or ineffective in an adolescent population. Finally, even when chronic illnesses are congenital or begin in childhood (e.g., spina bifida, Type 1 diabetes), the manner in which the transition from childhood to adolescence to young adulthood is negotiated has important implications for disease outcomes throughout the remainder of the life span. Given the unique developmental challenges of adolescence, we argue that an effective and theoretically sound approach to adolescent health psychology research and treatment must be firmly grounded in a developmental framework. We present a biopsychosocial model of adolescent development as one such framework that can inform primary, secondary, and tertiary prevention research and interventions targeting adolescents. This article is organized around the three levels of health-related prevention as they apply to adolescence. Within these levels, we include discussion of the adolescent-focused aspects of what Smith and Ruiz (1999) characterize as the predominant research areas of health psychology: health behavior and risk reduction , psychosomatics, and management of medical illness. In the section on primary prevention, we discuss the health behaviors that initiate in adolescence, outline current research regarding the etiology of these behaviors, and highlight intervention efforts that have sought to prevent the onset of negative health behaviors. In discussing secondary prevention (i.e., actions taken toward early identification and treatment of morbidity), we focus on the relation between psychopa-thology and health among adolescents, examine research related to psychosocial risk factors for stress-related medical conditions in adolescents , and present successful secondary prevention interventions. With respect to tertiary prevention, we outline current research on the assessment and treatment of health problems that have progressed beyond the early stages, with a particular focus on chronic illness. Despite its relative youth, the field of adolescent health psychology is vast, and an exhaustive review of the relevant literature is beyond the scope of this article. Rather, our intent is to outline what we believe to be some of the key theoretical issues in clinical health psychology focused on adolescence and to highlight state-of-the-art, empirically based research.