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June 1989, Vol 143, No. 6 >
Article | June 1989

Adolescence: Title and subTitle BreakWhat Is Normal? FREE

Daniel Offer, MD; Eric Ostrov, JD, PhD; Kenneth I. Howard, PhD
[+] Author Affiliations

Accepted for publication January 19, 1989.

Presented at the AMA/Duke University Conference on Adolescent Health, Durham, NC, June 9, 1988.

Reprint requests to the Center for Study of Adolescence, Michael Reese Hospital and Medical Center, Lake Shore Drive at 31st Street, Chicago, IL 60616 (Dr Offer).


Arch Pediatr Adolesc Med. 1989;143(6):731-736. doi:10.1001/archpedi.1989.02150180113031
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• We present in some detail what constitutes normal behavior, or mental health, among teenagers. Our data are based on the results of a specially devised psychological questionnaire by one of us (D.O.). This questionnaire has been shown to reliably distinguish mentally healthy from psychiatrically disturbed populations. Results are presented across three decades (1960s, 1970s, and 1980s), across genders, and across the high school years. A conceptual framework is presented to help the clinician working with adolescents to understand the fluctuation in psychopathology among youth. Adolescent density in the total population is shown to be a significant factor in determining the rate of disturbance among teenagers. Our research findings demonstrate that the rate of behavioral disturbance among adolescents is the same as in other parts of the life cycle. The clinician working with adolescents tends to underestimate the severity of adolescent problems because of the near-universal belief that all adolescents undergo "adolescent turmoil." We have found that adolescents who are experiencing turmoil need professional help.

(AJDC. 1989;143:731-736)

REFERENCES

1 +
Bios P. On Adolescence . New York, NY: Free Press; 1961;.
2 +
Freud A.  Adolescence . Psychoanal Study Child . 1958;;13:255-278.
3 +
Hall GS. Adolescence: Its Psychology and Its Relation to Physiology, Anthropology, Sociology, Sex, Crime, Religion and Education . New York, NY: D Appleton Co; 1904;.
4 +
Rabichow HG, Sklansky MA. Effective Counseling of Adolescents . Chicago, Ill: Follett; 1980;.
5 +
Hechinger F, Hechinger G. Teenage Tyranny . New York, NY: William Morrow & Co; 1963;.
6 +
Offer D, Ostrov E, Howard KI.  Epidemiology of mental health and mental illness among adolescents . In: Call JD, Cohen RL, Harrison SI, Berlin IN, Stone LA, eds. Basic Handbook of Child Psychiatry . New York, NY: Basic Books Inc Publishers; 1987;:chap 9.
7 +
Burnam NA, Hough RL, Escobar JI, et al.  Six-month prevalence of specific psychiatric disorders among Mexican-American and non-Hispanic whites in Los Angeles . Arch Gen Psychiatry . 1987;;44:687-694.
8 +
Canino GJ, Bird HR, Shrout PE, et al.  The prevalence of specific psychiatric disorders in Puerto Rico . Arch Gen Psychiatry . 1987;;44:727-735.
9 +
Karno M, Hough RL, Burnam A, et al.  Lifetime prevalence of specific psychiatric disorders among Mexican-American and non-Hispanic whites in Los Angeles . Arch Gen Psychiatry . 1987;;44:695-701.
10 +
Klerman GL, Weissman MM.  An epidemiologic view of mental illness, mental health, and normality . In: Offer D, Sabshin M, eds. Normality and the Life Cycle . New York, NY: Basic Books Inc Publishers; 1984;:315-344.
11 +
Uhlenhuth EH, Balter MB, Mellinger GD, Cisin IH, Clinthorne J.  Symptom checklist syndromes in the general population: correlations with psychotherapeutic drug use . Arch Gen Psychiatry . 1983;;40:1167-1173.
12 +
Holinger PC, Offer D, Ostrov E.  Suicide and homicide in the United States: an epidemiological study of violent death, population change, and the potential for prediction . Am J Psychiatry . 1987;;144:215-219.
13 +
Johnston LD, O'Malley PM, Bachman JG. Drug Use Among American High School Students, College Students, and Other Young Adults: National Trends Through 1985 . Washington, DC: National Institute on Drug Abuse; 1986;. US Dept of Health and Human Services publication ADM 861450.
14 +
Enright RD, Levy VM Jr, Harris D, Lapsley DK.  Do economic conditions influence how theorists view adolescents? J Youth Adolesc . 1987;;16:541-559.
15 +
Easterlin RA. Birth and Fortune . New York, NY: Basic Books Inc Publishers; 1980;.
16 +
Holinger PC, Offer D, Zola M.  A prediction model of suicide among youth . J Nerv Ment Dis . 1988;;176:275-279.
17 +
Offer D, Ostrov E, Howard KI. The Adolescent: A Psychological Self-Portrait . New York, NY: Basic Books Inc Publishers, 1981;.
18 +
Offer D, Ostrov E, Howard KI, Atkinson R. The Teenage World: Adolescents' Self-Image in Ten Countries . New York, NY: Plenum Press; 1988;.
19 +
National Center for Health Statistics: Advance Report, Final Mortality Statistics, 1982, Monthly Vital Statistics Report . Hyattsville, Md: US Dept of Health and Human Services; 1984;;33:9. Public Health Service publication 85-1120.
20 +
Brenner MH. Time Series of Relationships Between Selected Economic and Social Indicators . Springfield, Va: National Technical Information Service; 1971;.
21 +
Brenner MH.  Mortality and the national economy: a review, and the experience of England and Wales, 1936-76 . Lancet . 1979;;2:568-573.
22 +
Offer D, Ostrov E, Howard KI.  The mental health professional's concept of the normal adolescent . Arch Gen Psychiatry . 1981;;38:149-152.

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1 +
Bios P. On Adolescence . New York, NY: Free Press; 1961;.
2 +
Freud A.  Adolescence . Psychoanal Study Child . 1958;;13:255-278.
3 +
Hall GS. Adolescence: Its Psychology and Its Relation to Physiology, Anthropology, Sociology, Sex, Crime, Religion and Education . New York, NY: D Appleton Co; 1904;.
4 +
Rabichow HG, Sklansky MA. Effective Counseling of Adolescents . Chicago, Ill: Follett; 1980;.
5 +
Hechinger F, Hechinger G. Teenage Tyranny . New York, NY: William Morrow & Co; 1963;.
6 +
Offer D, Ostrov E, Howard KI.  Epidemiology of mental health and mental illness among adolescents . In: Call JD, Cohen RL, Harrison SI, Berlin IN, Stone LA, eds. Basic Handbook of Child Psychiatry . New York, NY: Basic Books Inc Publishers; 1987;:chap 9.
7 +
Burnam NA, Hough RL, Escobar JI, et al.  Six-month prevalence of specific psychiatric disorders among Mexican-American and non-Hispanic whites in Los Angeles . Arch Gen Psychiatry . 1987;;44:687-694.
8 +
Canino GJ, Bird HR, Shrout PE, et al.  The prevalence of specific psychiatric disorders in Puerto Rico . Arch Gen Psychiatry . 1987;;44:727-735.
9 +
Karno M, Hough RL, Burnam A, et al.  Lifetime prevalence of specific psychiatric disorders among Mexican-American and non-Hispanic whites in Los Angeles . Arch Gen Psychiatry . 1987;;44:695-701.
10 +
Klerman GL, Weissman MM.  An epidemiologic view of mental illness, mental health, and normality . In: Offer D, Sabshin M, eds. Normality and the Life Cycle . New York, NY: Basic Books Inc Publishers; 1984;:315-344.
11 +
Uhlenhuth EH, Balter MB, Mellinger GD, Cisin IH, Clinthorne J.  Symptom checklist syndromes in the general population: correlations with psychotherapeutic drug use . Arch Gen Psychiatry . 1983;;40:1167-1173.
12 +
Holinger PC, Offer D, Ostrov E.  Suicide and homicide in the United States: an epidemiological study of violent death, population change, and the potential for prediction . Am J Psychiatry . 1987;;144:215-219.
13 +
Johnston LD, O'Malley PM, Bachman JG. Drug Use Among American High School Students, College Students, and Other Young Adults: National Trends Through 1985 . Washington, DC: National Institute on Drug Abuse; 1986;. US Dept of Health and Human Services publication ADM 861450.
14 +
Enright RD, Levy VM Jr, Harris D, Lapsley DK.  Do economic conditions influence how theorists view adolescents? J Youth Adolesc . 1987;;16:541-559.
15 +
Easterlin RA. Birth and Fortune . New York, NY: Basic Books Inc Publishers; 1980;.
16 +
Holinger PC, Offer D, Zola M.  A prediction model of suicide among youth . J Nerv Ment Dis . 1988;;176:275-279.
17 +
Offer D, Ostrov E, Howard KI. The Adolescent: A Psychological Self-Portrait . New York, NY: Basic Books Inc Publishers, 1981;.
18 +
Offer D, Ostrov E, Howard KI, Atkinson R. The Teenage World: Adolescents' Self-Image in Ten Countries . New York, NY: Plenum Press; 1988;.
19 +
National Center for Health Statistics: Advance Report, Final Mortality Statistics, 1982, Monthly Vital Statistics Report . Hyattsville, Md: US Dept of Health and Human Services; 1984;;33:9. Public Health Service publication 85-1120.
20 +
Brenner MH. Time Series of Relationships Between Selected Economic and Social Indicators . Springfield, Va: National Technical Information Service; 1971;.
21 +
Brenner MH.  Mortality and the national economy: a review, and the experience of England and Wales, 1936-76 . Lancet . 1979;;2:568-573.
22 +
Offer D, Ostrov E, Howard KI.  The mental health professional's concept of the normal adolescent . Arch Gen Psychiatry . 1981;;38:149-152.

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