The pediatrician's concept of the normal adolescent

Complete medical assessment of an adolescent requires understanding of the normal psychological state, including self-image. To determine the pediatrician's knowledge about the self-image of normal adolescents, 33 house staff and 36 attending pediatricians in a major teaching center completed the Offer Physician-Adolescent Questionnaire (OPAQ), a scale that measures adult perceptions of adolescent self-image. Forty-one male and 28 female pediatricians completed the 50-item questionnaire as they believed a "mentally healthy, well-adjusted adolescent" would. Pediatricians' responses did not differ by sex, age, or status as resident or attending. Percentage endorsements for each item were converted to standard scores for 11 scales. The scale scores were then compared with previously established norms for healthy adolescents and adolescents with cystic fibrosis. Pediatricians accurately predicted the normal adolescent responses for only two scales: vocational and educational goals and superior adjustment. Pediatricians responded more positively than the adolescents to items on the idealism scale. For the remaining eight scales, the pediatricians responded more negatively than did normal adolescents and teens with cystic fibrosis. The pediatricians' view of normal adolescent self-image seems to be more pessimistic than what adolescents report.