The present study was designed to examine the extent to which (a) family and school functioning and (b) personal and ethnic identity is associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion were related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning were related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-à-vis conduct problems, substance use, and sexual risk taking.Correspondence and reprint requests should be sent to Seth J. Schwartz Adolescence is a time of great opportunity and great risk. Adolescents may develop the ability to contribute positively to their own lives and to those of their families and communities (Lerner, Dowling, & Anderson, 2003). At the same time, however, adolescence is also a time of increases in socially destructive outcomes such as delinquent behavior (Broidy et al., 2003), drug use (Johnston, O'Malley, Bachman, & Schulenberg, 2007), and sexual risk taking 1 (Centers for Disease Control and Prevention, 2007). These adolescent problems are worrisome not only because they are dangerous to society, but also because they interfere with adult roles such as marriage, gainful employment, and parenting (King, Meehan, Trim, & Chassin, 2006).There is evidence that substance use and sexual risk taking are often preceded by conduct problems such as aggression and rule-breaking (Tubman, Windle, & Windle, 1996). Conduct problems, substance use, and sexual risk taking are part of a constellation of negative outcomes known as the problem behavior syndrome (Jessor et al., 2003). Adolescents who engage in any of these behaviors are likely to engage in others, especially if their engagement in any of them is severe (Wanner, Vitaro, LaDouceur, Brendgen, & Tremblay, 2006). Moreover, early involvement in aggression, drug use, and sexual risk taking is prognostic of continued problematic behavior later in adolescence and in adulthood (Windle, Mun, & Windle, 2005).There is a robust literature regarding intrapersonal and contextual factors and processes that may protect against the problem behavior syndrome. Intrapersonal protective factors include a coherent and less confused sense of personal identity (Schwartz, Mason, Pantin, & Szapocznik, in press), a positive self-concept (Rodriguez & Audrain-McGovern, 2005), and a strong sense of ethnic iden...

Recent technological advancements have facilitated the study of adolescent neurological development and its implications for adolescent decision-making and behavior. This article reviews findings from the adolescent neurodevelopment and substance use prevention literatures. It also discusses how findings from these two distinct areas of adolescent development can complement each other and be used to build more developmentally appropriate interventions for preventing adolescent substance use. Specifically, a combination of child-centered and family-based strategies is advocated based on extant neurological and prevention literature. EDITORS' STRATEGIC IMPLICATIONS: Researchers are encouraged to take up the authors' challenge and study the links between adolescent neurological development/decision making ability and the long term efficacy of comprehensive interventions for preventing adolescent substance use.

The relationship between the quality of clinical decision-making and personality characteristics was confirmed. The potential to modify this relationship using a brief cognitive behavior intervention suggests that such interventions should be an essential component of medical education.

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Organogenesis throughout childhood affects almost every aspect of pediatric pharmacotherapy. The antiepileptic drugs (AEDs) are particularly impacted since most elimination rates are diminished for the first 6 months of infancy, but quickly attain and supersede adult values. When children enter a hypermetabolic stage, large doses of AEDs may be necessary to maintain effective serum concentrations. Medication noncompliance is frequently confused as hypermetabolism, since both present with low serum drug concentrations. Amazingly, noncompliance among children with chronic illness approaches a similar incidence to that reported in the adult population. It is obviously important to include this in the differential diagnosis of the etiology of subtherapeutic serum AED concentrations. Maturational differences also affect gastrointestinal drug absorption. Intestinal transit time and absorptive surface area are both diminished in young children. Drug delivery systems suitable in adults may not deliver the total dosage in children. Differences in the composition of body compartments and protein binding can alter the volume of drug distribution and, consequently, serum concentrations. In addition to pathophysiologic changes, there is evidence to suggest differences between a mature and immature brain. These differences include quantitative and qualitative responses to neurotransmitters. Hence, it is understandable why seizure semiology is different in children compared with adults. This constellation of factors contributes to the challenges of caring for children with epilepsy.