The role of formal operational thinking in adolescent decision-making about pregnancy and contraception is explored through an integration of the cognitive-developmental and pregnancy-contraception literatures. The ways in which cognitive-developmental change mechanisms initiate or hinder formal thinking on pregnancy-contraception are considered, and implications for counseling pregnant adolescents are discussed.

Four kinds of pretend-play inhibition, noted in children from 3-9 years of age, are described. These include: (a) nonresolution of negative affective experience through pretend activity, but maintenance of symbolic representation; (b) noncoordination and disorganization of play objects and activities; (c) perseveration of activity and repetition of single schemes, and (d) global inhibition of pretend play. Based on available literature, hypotheses are proposed regarding potential causes and developmental sequelae of pretend-play difficulties, in both cognitive and socioaffective realms. Implications of these observations for examining the relation between affectivity and the development of symbolic cognitive structures are disussed.

Therapy aimed at improving adolescents' affective and interpersonal functioning should be placed within a cognitive‐developmental context.

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