Wishful thinking: Asking adolescents about their hopes and dreams proves insightful

Trying to figure out what's going on inside the mind of an adolescent can be challenging, to say the least. A new study shows that simply asking them what they wish for could be eye-opening.

The question: "If you could have three wishes, what would they be?" is included on a questionnaire designed to be given to adolescent patients before a doctor's visit. The survey, which is part of the American Medical Association's Guidelines for Adolescent Preventive Services program, also includes questions about medical history, health, school, safety and substance use.

The authors of a study to be presented Monday, May 2, at the Pediatric Academic Societies (PAS) annual meeting in Denver analyzed the themes of responses from 110 adolescent patients ages 11-18 years to the three wishes question. They also looked at how the themes were related to respondents' age, sex, income and racial/ethnic background.

Results showed that 85 percent of adolescents had wishes for themselves, 32 percent had wishes for others, and 10 percent had a wish for both themselves and others. Boys were more likely than girls to wish for things only for themselves (73 percent vs. 46 percent), while girls were more likely than boys to wish for something for their families (26 percent vs. 9 percent).

"While most of the wishes are predictable, the occasionally poignant wish like, 'I wish my mama felt better' reminds us of the value of asking these questions," said Eliana M. Perrin, MD, MPH, FAAP, senior author of the study.

The most common themes were to be wealthy (41 percent of wishes), followed by material items, e.g., a video game system or a car (31 percent). Twenty percent of adolescents had wishes for the world (i.e., world peace), and about 17 percent had wishes for their family or school or athletic success (e.g., to be an NBA player).

Boys also wished more for success, while girls wished more for happiness.

"Despite what we thought going into the study, only about 8 percent of adolescent wishes were about personal appearance, with only 4 percent wishing to be thinner," said Dr. Perrin, associate professor of pediatrics at the University of North Carolina at Chapel Hill and pediatrician at North Carolina Children's Hospital.

There were no differences in types of wishes by age or race/ethnicity, though teens with private insurance were more likely than those with public insurance to have wishes for the world.

"We so rarely get an insight into teenagers' wishes, and this study and the screening form in general give adolescents a voice," Dr. Perrin said. "Examining trends over time may help shape policy and education for adolescents."

"In my experience with this study, I've found that providing adolescents a chance to describe themselves and their future objectives has significant clinical value, particularly with the number of health issues they currently face," said lead author Josh P. Boyd, a medical student at American University of Antigua Medical School, St. John's, Antigua and Barbuda.

In fact, the researchers, who also include Asheley Skinner, PhD, Michael Steiner, MD, FAAP, and Tamera Coyne-Beasley, MD, MPH, plan to conduct additional studies to determine whether wishes are tied to health issues.