Exploring mother-daughter communication and social media influence on HPV vaccine refusal for daughters aged 9-17 years in a cross-sectional survey of 11,728 mothers in China

This study investigated the influences of mother-daughter communication and social media on mothers' HPV vaccine refusal for their daughters aged 9-17. A cross-sectional online survey among 11,728 mothers of girls aged 9-17 in Shenzhen, China was implemented between July and October 2023. Multi-level logistic regression models were fitted. Among 11,728 participants, 43.2% refused to have their daughters receive an HPV vaccination. In multivariate analysis, more openness in the mother-daughter communication (AOR: 0.99, 95%CI: 0.98, 0.99), perceived more positive outcomes of mother-daughter communication (AOR: 0.77, 95%CI: 0.75, 0.79), higher frequency of exposure to testimonials about daughters' HPV vaccination (AOR: 0.81, 95%CI: 0.78, 0.85) and information encouraging parents to vaccinate their daughters against HPV on social media (AOR: 0.76, 95%CI: 0.73, 0.79), and thoughtful consideration of the veracity of the information specific to HPV vaccines (AOR: 0.80, 95%CI: 0.77, 0.83) were associated with lower vaccine refusal. Mothers who were not the main decision-makers of daughters' HPV vaccination (AOR: 1.28 to 1.46), negative outcome expectancies of mother-daughter communication (AOR: 1.06, 95%CI: 1.04, 1.08), and mothers' HPV vaccine refusal (AOR: 2.81, 95%CI: 2.58, 3.06) were associated with higher vaccine refusal for their daughters. The level of mothers' HPV vaccine refusal for their daughters was high in China. Openness and outcome expectancies of mother-daughter communication and information exposure on social media were considered key determinants of HPV vaccine refusal for daughters. Future HPV vaccination programs should consider these interpersonal factors.

Cultural applicability and desirability of 'Broodles': The first serious game intervention for siblings of children with disabilities

Objective

Serious games can serve as easily accessible interventions to support siblings of children with disabilities, who are at risk of developing mental health problems. The Dutch serious game 'Broodles' was developed for siblings aged 6-9 years. The current study aims to assess the cultural applicability, desirability, feasibility, and acceptability of 'Broodles' in Norway.

Methods

Norwegian siblings (N = 16) aged 6-13 years and parents (N = 12) of children with intellectual disabilities assessed the game. Their feedback data from interviews and questionnaires were sorted using a model of engagement factors in serious games.

Results

At pre-use, participants showed interest in the game, and after initial use the participants were overall positive about the format, content and objectives, including validation of emotions and recognition. The participants had suggestions for improved engagement and feasibility.

Conclusion

The game was found to be culturally applicable, desirable and acceptable, although Norwegian translation is necessary for further evaluation. Recommendations to enhance engagement were provided, including suggestions to play the game with parents or in a group.

Innovation

This initial assessment of the serious game Broodles in a non-Dutch setting shows promise for an innovative way of supporting siblings of children with disabilities.

Mothers' and their children's emotional and behavioral symptom trajectories and subsequent maternal adjustment: Twenty-seven years of motherhood

BACKGROUND

This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems).

METHODS

The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4-5, 8-9, 16-17, and 26-27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4-5, 8-9, and 16-17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26-27 years after the birth of the first child. Complete follow-up data were available for 168 mothers.

RESULTS

We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child's internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning.

LIMITATIONS

Maternal and child measures were based on maternal reports only.

CONCLUSIONS

The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children.

"Be more positive and more kind to your own bodies": Adolescent and young adult preferences for how parents can support their children with weight-related pressures

Body dissatisfaction is a key factor contributing to the development of disordered eating, and body dissatisfaction is often influenced by media, peer, and parental pressures during adolescence. Little research has explored ways in which parents can help their children manage pressures from social media and their peers. The present study used the MyVoice National Poll of Youth, a large text-message cohort of young people (14-24 years old) in the United States, to collect and examine qualitative data about their experiences with parental weight-related communication and how they think parents can best support their children regarding messages they see/hear surrounding weight, body shape and size by their peers and media sources. 801 participants responsed to at least one question. Results from the present study suggest that young people want their parents to model healthy relationships with food and their body, teach body neutrality/acceptance, and normalize all body types. Findings suggest that there are many proactive, practical approaches parents can adopt to help support their children and offset weight-related pressures from other sources.

Applying the Family Stress Model to responsive feeding and early obesity prevention

Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.

Association of problems, coping styles, and preferred online activity with depression, anxiety, and other psychological disorders in Turkish adolescents diagnosed with chronic kidney disease

BACKGROUND

To assess depression, anxiety, and other psychological disorders in adolescents with chronic kidney disease (CKD) and determine the significant factors and the effect of digital media use on its scores among these patient groups.

METHODS

The study was conducted as a cross-sectional study and included 84 adolescents with CKD and 68 healthy controls. The participants completed the Revised Child Anxiety and Depression Scale (RCADS). We recorded their age, gender, the most problematic issue in their lives, coping methods with problems, and online applications they prefer in their leisure time.

RESULTS

Elevated rates (scores > 70) of separation anxiety, panic disorder, obsession, depression, total anxiety, and total depression scales were statistically higher in the CKD group. Separation anxiety, panic disorder, obsession, total anxiety, and total depression scales were higher in girls, and panic disorder, obsession, depression, total anxiety, and total depression scores were higher in younger ages in multivariate analysis. In the CKD group, family issues/problems increased panic disorder, obsession, depression, total anxiety, and total depression scales. Crying in tears/yelling response in children while facing a problem was associated with increased separation anxiety and social phobia rates. Also, preferring video applications was associated with separation anxiety and messaging applications with depression, total anxiety, and total depression.

CONCLUSIONS

Adolescents with CKD are at risk for depression, anxiety, obsession, and panic disorders. Also, crying in tears/yelling response may be at greater risk for anxiety among CKD adolescents. Early psychiatric evaluation and routine psychiatric follow-ups initiated early may improve the mental health of this vulnerable population.

Fear-related associations in children of parents with an anxiety disorder

BACKGROUND AND OBJECTIVES

Children of parents with an anxiety disorder are at elevated risk for developing an anxiety disorder themselves. According to cognitive theories, a possible risk factor is the development of schema-related associations. This study is the first to investigate whether children of anxious parents display fear-related associations and whether these associations relate to parental anxiety.

METHODS

44 children of parents with panic disorder, 27 children of parents with social anxiety disorder, and 84 children of parents without an anxiety disorder filled out the SCARED-71, and the children performed an Affective Priming Task.

RESULTS

We found partial evidence for disorder-specificity: When the primes were related to their parent's disorder and the targets were negative, the children of parents with panic disorder and children of parents with social anxiety disorder showed the lowest error rates related to their parents' disorder, but they did not have faster responses. We did not find any evidence for the expected specificity in the relationship between the parents' or the children's self-reported anxiety and the children's fear-related associations, as measured with the APT.

LIMITATIONS

Reliability of the Affective Priming Task was moderate, and power was low for finding small interaction effects.

CONCLUSIONS

Whereas clearly more research is needed, our results suggest that negative associations may qualify as a possible vulnerability factor for children of parents with an anxiety disorder.

Mother-infant feeding interactions in mothers with and without eating disorder history: Results of a structured observational study

BACKGROUND

A growing body of evidence suggests that children of mothers with eating disorders (EDs) have a greater risk of early feeding problems. Recognizing and reacting adequately to the infant's signals during feeding is crucial for the child's development of internal and external regulatory mechanisms of food intake. Parental EDs might affect this ability. Therefore, we investigated the quality of mother-infant interactions during feeding using video recording and a structured coding system.

METHODS

The data of this pilot study was collected in a prospective cohort study investigating the influence of maternal EDs on child outcomes. Twenty women with ED history and 31 control women were videotaped while feeding their infant during a main meal at ten months postpartum. The mother-infant interactions were evaluated by two raters using the Chatoor Feeding Scale. We assessed birth outcomes, the mother's ED and depression status, breastfeeding practices, infant feeding problems and infant temperament by maternal self-report.

RESULTS

Mothers with and without ED history scored very similar on the Feeding Scale, however mothers from the control group experienced more struggle for control with their infants during feeding (p = 0.046) and made more negative comments about the infant's food intake (p = 0.010). Mothers with ED history were more concerned about infant feeding at three months postpartum and reported significantly more problems with solid foods in their children. Birth outcomes were comparable between groups, except for lower weight-for-length birth percentiles in children of women with ED history.

CONCLUSION

Whilst examined mothers with ED history are more concerned about feeding their children, ED psychopathology does not affect the quality of mother-infant interaction during feeding at the transition to autonomous eating at ten months of age.

Integrating social media, body shame and psychological distress within the Elaborated Sociocultural Model

The Elaborated Sociocultural Model proposes exposure to sociocultural appearance pressures increases women's internalisation of the thin ideal, their engagement in social comparison and body surveillance, and subsequent body dissatisfaction and disturbances in eating (Fitzsimmons-Craft et al., 2011). Although this model has received some empirical support, it is limited in that it does not currently account for social media as a contemporary source of appearance pressure, nor include additional known outcomes of thin ideal internalisation (i.e., body shame, psychological distress). The current study tested the integration of these variables within the Elaborated Sociocultural Model. Using structural equation modelling with latent variables, the extended model provided acceptable to good fit to the data in a sample of 271 female participants. A latent variable representing sociocultural appearance pressures originating from social media, traditional media, family and peers was found to significantly predict thin ideal internalisation and body image concerns. Furthermore, both social comparison and body surveillance emerged as indirect mediators of the relationship between thin ideal internalisation and body image concerns, which in turn, increased report of restrained eating and psychological distress. Aligning with previous research, this extended model offers a useful and comprehensive framework for investigating women's body image.

Cross-lagged relationships between exposure to intimate partner violence, depressive symptoms and suicidal thoughts among adolescent and young married women

BACKGROUND

High rates of depression and suicidal ideation are found in women experiencing intimate partner violence (IPV), but their temporal relationship is unclear. This study explores the bidirectional causality between IPV victimization, depressive symptoms, and suicidal thoughts among adolescent and young married women in India.

METHODS

Data sourced from the UDAYA longitudinal survey in India, comprising 3,965 women aged 15-22. Employing Pearson's correlation coefficient, we analyzed the relationship between variables. Additionally, a two-wave cross-lagged autoregressive panel model explored the bidirectional link between IPV, depressive symptoms, and suicidal ideation.

RESULTS

Approximately 25 % and 45 % of the participants reported some form of partner violence at baseline and at follow-up after three years, respectively. Exposure to IPV at baseline was significantly associated with depressive symptoms at follow-up [β = 0.10, p < 0.001], and the association between depressive symptoms at baseline and IPV at follow-up was statistically not significant [β = -0.02, 95 % CI: -0.06-0.02]. Similarly, exposure to IPV at baseline was significantly associated with suicidal thoughts at follow-up [β = 0.24, p < 0.001], and the association between suicidal thoughts at baseline and IPV at follow-up was statistically not significant [β = 0.003, 95 % CI: -0.001-006].

CONCLUSIONS

The findings suggest that exposure to IPV is consistently and strongly associated with depressive symptoms and suicidal thoughts in adolescent and young married women. However, the reciprocal relationships did not hold true in this study, implying that reducing IPV during adolescence could potentially minimize the prevalence of depressive symptoms and suicidal thoughts during young adulthood.

The distinct affect regulation functions of body image flexibility and inflexibility: A prospective study in adolescents and emerging adults

Body image flexibility and inflexibility are alternative ways of responding to body image threats. Affect regulation offers a framework for understanding how these responses impact health outcomes; however, research in young people is limited. This prospective study tested two potential affect regulation functions in adolescents and emerging adults (N = 351, 66.7% female) via online surveys completed five months apart. Specifically, body image flexibility and inflexibility were tested as (a) direct predictors of adaptive (body appreciation, intuitive eating) and maladaptive (muscle-building strategies, disordered eating) outcomes, and (b) moderators of the indirect effect of a social comparison threat via body appreciation. Results from hierarchical linear and conditional process models showed that body image flexibility and inflexibility served distinct affect regulation functions. Whereas body image inflexibility directly predicted adaptive and maladaptive body- and eating-related outcomes, body image flexibility protected against the negative effects of social comparison on intuitive eating via body appreciation. Findings suggest that adolescents and emerging adults could benefit from learning body image flexibility skills and reducing inflexibility to promote positive body image and prevent body- and eating-related disturbances. Future research should investigate how body image flexibility and inflexibility relate to other established threats and outcomes in diverse demographic groups.

How do early affiliative memories explain body image shame? A 12-month longitudinal study in adolescent girls

OBJECTIVE

This study aimed to explain adolescent girls' body image shame across a 12- month longitudinal design, and its relationship with early parental memories of warmth and safeness and fear of receiving compassion from others.

DESIGN AND METHODS

Participants included 231 adolescent girls, who completed self-report measures at three different periods: baseline (W1), 6-month follow-up (W2), and 12-month follow-up (W3). Descriptive and correlational analyses were performed, and differences between participants at the different waves were explored through repeated measures ANOVA. A cross-lagged panel model tested the mediational effect of fears of receiving compassion on the association between early affiliative memories (W1) and body image shame (W3).

RESULTS

ANOVA results found significant differences throughout time in memories of warmth and safeness (tending to diminish) and in body image shame (tending to rise). Correlation analysis revealed that all variables were significantly associated in the expected directions, across the three waves. Finally, path analysis revealed that early affiliative parental memories (in W1) had a direct effect on body image shame (in W3), through the fear of receiving compassion from others (in W2), accounting for 85% of body image shame's variance (W3).

CONCLUSIONS

These findings indicate that the lack of early affiliative memories often leads to the development of defensive mechanisms such as fears of receiving compassion from others which in turn can foster isolation and distant relationships, enhancing feelings of inferiority and inadequacy, which in female adolescents can emerge centered on body image - body image shame. This study further highlights the importance of prevention and intervention strategies based on compassion to specifically target fears of receiving compassion from others, in adolescent girls dealing with feelings of inferiority and shame regarding their body.

The body positive… or the body neutral? A content analysis of body positivity and body neutrality hashtagged videos on TikTok

The goal of the present study was to examine how body positivity and body neutrality are presented on TikTok. Based on a grounded-theory analysis, body-positivity themes included Broadly Conceptualizing Beauty (i.e., diversity in appearance types is beautiful), Body Acceptance and Love (i.e., love for and comfort in one's body), and Critiquing Standards (i.e., rejecting strict appearance standards). Body-neutrality themes included Size Inclusivity (i.e., people's activities/preferences should be based on body size), Adaptive Self-Investment (i.e., self care focused on health), Body Appreciation (i.e., respect for what one's body can do), and No Judgment (i.e., a person's worth should not be based on appearance). Further, based on a content analysis of 394 TikTok vidoes that were hashtagged with body positivity and/or body neutrality terms, at least one body-positivity theme occurred in 35.3% (n = 141) of videos, and at least one body neutrality theme occurred in 45.0% (n = 180) of videos. Body Acceptance and Love was the most common body-positivity theme, and Size Inclusivity was the most common body-neutrality theme. Understanding how TikTok videos present body positivity and neutrality is essential to further theorizing about how they might affect social media users.

The Intensity of Formal Child-Care Attendance Decreases the Shared Environment Contribution to School Readiness: A Twin Study

The purpose of this study was to explore if child-care intensity (hours/weeks) and age of onset could moderate genetic and environmental contributions to school readiness. A sample of 648 (85% Whites; 50% Females) pairs of twins was used to compute a GxE, CxE and ExE interaction analyses. The moderation model showed that shared environment explains 48% of individual differences in school readiness for children not attending formal child-care, and decreased gradually to a mere 3% for children attending formal child-care full time, e.g., 40 h per week. Age of onset exerted no moderation effect. The results support the hypothesis that child-care acts as a normalizing environment, possibly buffering negative effects from low-quality home environments on school readiness.

Emerging adults' emotions toward their siblings with down syndrome

BACKGROUND

Typically-developing siblings of individuals with Down Syndrome often experience complex emotions towards their sibling. This study explored how social support, personal resources (optimism, sense of coherence [SOC]), and individual variables (sex, religious affiliation, siblings' functionality) may impact emerging adult siblings' emotions toward their sibling with Down Syndrome.

METHODS

Participants were 292 siblings of individuals with DS ranging in age from 18-27 (M=21.54, SD=2.50). Participants completed self-report questionnaires exploring optimism, SOC, support, and acceptance.

RESULTS

Higher levels of support and optimism were positively associated with positive emotions, and higher SOC with lower levels of negative emotions. Siblings' functionality and religious affiliation interacted with variables to predict emotions.

CONCLUSIONS

This study contributes to a greater understanding of how emotions may play a role in sibling relations during the emerging adulthood stage. It also provides unique insight into how religious affiliation may be associated with more positive outcomes for siblings.

Mental Health Needs, Barriers, and Receipt of Care Among Transgender and Nonbinary Adolescents

PURPOSE

Transgender and nonbinary youth disproportionately experience adverse mental health outcomes compared to cisgender youth. This study examined differences in their mental health needs and supports, barriers to care, and receipt of mental health care.

METHODS

This study examined cross-sectional data from 43,339 adolescents who completed the California Healthy Kids Survey, 4% (n = 1,876) of whom identified as transgender and/or nonbinary. Chi-square test and t-test were used to compare mental health needs and supports, resilience, and barriers to and receipt of care experienced by transgender and nonbinary youth compared to cisgender youth.

RESULTS

Transgender and nonbinary youth were significantly more likely to experience chronic sadness/hopelessness (74% vs. 35%) and consider suicide (53% vs. 14%) and less likely to report resilience factors (school connectedness: mean score 3.12 vs. 3.52). Transgender and nonbinary youth were significantly less likely to be willing to talk to teachers/adults from school (12% vs. 18%) or parents/family members (21% vs. 43%), but more willing to talk to counselors (25% vs. 19%) regarding mental health concerns. Transgender and nonbinary youth were significantly more likely to select being afraid (48% vs. 20%), not knowing how to get help (44% vs. 30%), or concern their parents would find out (61% vs. 36%) as barriers to seeking mental health care, yet reported slightly higher odds of receiving care when needed (odds ratio: 1.2).

DISCUSSION

Transgender and nonbinary youth are more likely to report mental health concerns and barriers to seeking care than cisgender youth. Increasing access to care is critical for this population.

Understanding Family Support for Transgender Youth: Impact of Support on Psychosocial Functioning

PURPOSE

This study investigated the association between positive and negative family support and psychosocial outcomes among transgender and gender diverse (TGD) youth.

METHODS

A retrospective analysis was performed using psychological data collected from 175 TGD youth (aged 13-18 years) at time of hormone readiness assessment within a multispecialty gender clinic between May 2021 and February 2023. As part of this assessment process, TGD youth provided responses to a variety of measures, including the Youth Self-Report and the Family Environment Scale.

RESULTS

Negative family support scales were more strongly associated with more outcomes than positive support scales. The exclusion and abuse, viewing gender expression as morally wrong, and trying to change gender scales were each associated with significantly higher Youth Self-Report T-scores for internalizing problems (βs = 6.86, 6.26, 5.56, all p < .01), externalizing problems (βs = 4.58, 4.42, 4.19, all p < .02), and total problems (βs = 6.70, 6.45, 5.34, all p < .02). The explicit care and support scale was associated with significantly lower T-scores for externalizing problems (β = -3.54 p = .02) and total problems (β = -3.35, p = .04). Overall support was also associated with higher T-scores in internalizing problems (b = -2.90, p = .02), externalizing problems (β = -2.40, p = .03), and total problems (β = -2.79, p = .03).

DISCUSSION

Family support plays a critical role in the psychosocial wellbeing of TGD youth. TGD youth reporting positive family support reported fewer mental health concerns, less experiences of nonaffirmation, and lower levels of internalized transphobia. TGD youth reporting negative family support were found to have an increased risk of suicidal ideation.

Towards implementation of cognitive bias modification in mental health care: State of the science, best practices, and ways forward

Cognitive bias modification (CBM) has evolved from an experimental method testing cognitive mechanisms of psychopathology to a promising tool for accessible digital mental health care. While we are still discovering the conditions under which clinically relevant effects occur, the dire need for accessible, effective, and low-cost mental health tools underscores the need for implementation where such tools are available. Providing our expert opinion as Association for Cognitive Bias Modification members, we first discuss the readiness of different CBM approaches for clinical implementation, then discuss key considerations with regard to implementation. Evidence is robust for approach bias modification as an adjunctive intervention for alcohol use disorders and interpretation bias modification as a stand-alone intervention for anxiety disorders. Theoretical predictions regarding the mechanisms by which bias and symptom change occur await further testing. We propose that CBM interventions with demonstrated efficacy should be provided to the targeted populations. To facilitate this, we set a research agenda based on implementation frameworks, which includes feasibility and acceptability testing, co-creation with end-users, and collaboration with industry partners.

Do classroom relationships moderate the association between peer defending in school bullying and social-emotional adjustment?

Peer defending has been shown to protect bullied peers from further victimization and social-emotional problems. However, research examining defending behavior has demonstrated positive and negative social-emotional adjustment effects for defending students themselves. To explain these mixed findings, researchers have suggested that associations between defending behavior and social-emotional adjustment may be buffered by protective factors (i.e., defender protection hypothesis) or exacerbated by vulnerability or risk factors (i.e., defender vulnerability hypothesis). Consistent with these hypotheses, the present study aimed to investigate whether relationships with teachers and peers would moderate the association between defending behavior and social-emotional adjustment. This three-wave longitudinal study examined the association between peer nominated defending behavior and later self-reported depressive symptoms and self-esteem in 848 Belgian students in Grades 4-6 (53% girls; Mage = 10.61 years, SD = 0.90 at Wave 1). Peer nominated positive and negative teacher-student relationships (i.e., closeness and conflict) and peer relationships (i.e., acceptance and rejection) were included as moderators. Clustered multiple linear regression analyses demonstrated that defending behavior did not predict later depressive symptoms (β = -0.04, p = .80) or self-esteem (β = -0.19, p = .42). The lack of these associations could be explained by the defender protection and vulnerability hypotheses. However, contrary to our expectations, teacher-student closeness and peer acceptance did not play a protective role in the association between defending behavior and social-emotional adjustment (β = -1.48-1.46, p = .24-0.96). In addition, teacher-student conflict and peer rejection did not put defending students at risk for social-emotional maladjustment (β = -1.96-1.57, p = .54-0.97). Thus, relationships with teachers and peers did not moderate the association between defending behavior and later depressive symptoms and self-esteem.

Engaging caregivers to prevent substance use by at-risk adolescents in pediatric primary care

PURPOSE OF REVIEW

Improving adolescent substance use prevention and treatment is an urgent public health priority in the United States. Current intervention models do not address how adolescents with a history of caregiver substance use are at particular risk for problematic substance use. We, therefore, reviewed the evidence on adolescent substance use prevention programs integrating caregiver-focused components and propose opportunities to incorporate adaptations of existing programs into pediatric primary care to improve outcomes for at-risk adolescents exposed to caregiver substance use.

RECENT FINDINGS

There are multiple evidence-based universal prevention programs that target adolescent substance use and incorporate caregivers; however, these programs do not address the specific concerns of caregivers with substance use. Caregiver-focused programs efficaciously address family and child risk factors for adolescent substance use but are not accessible to many families and have not been longitudinally studied to assess impact on adolescent substance use.

SUMMARY

Adaptation of existing prevention programs to pediatric primary care settings may open opportunities to improve engagement of families with caregiver substance use in targeted prevention strategies. Family Screening, Brief Intervention, and Referral to Treatment (F-SBIRT) is one model that can be incorporated into pediatric primary care to contextualize evidence-based practices to address substance use in a family-focused approach. To develop F-SBIRT, further research is needed to validate caregiver-focused screening tools, determine brief intervention (BI) best practices, and adapt existing evidence-based and caregiver-focused adolescent prevention programs for use with caregivers with substance use in pediatric primary care settings.

Early life adversities, psychopathologies and novel pharmacological strategies

Exposure to adversities during early life stages (early life adversities - ELA), ranging from pregnancy to adolescence, represents a major risk factor for the vulnerability to mental disorders. Hence, it is important to understand the molecular and functional underpinning of such relationship, in order to develop strategies aimed at reducing the psychopathologic burden associated with ELA, which may eventually lead to a significant improvement in clinical practice. In this review, we will initially recapitulate clinical and preclinical evidence supporting the link between ELA and psychopathology and we will primarily discuss the main biological mechanisms that have been described as potential mediators of the effects of ELA on the psychopathologic risk, including the role for genetic factors as well as sex differences. The knowledge emerging from these studies may be instrumental for the development of novel therapeutic strategies aimed not only at correcting the deficits that emerge from ELA exposure, but also in preventing the manifestation of a full-blown psychopathologic condition. With this respect, we will specifically focus on adolescence as a key time frame for disease onset as well as for early therapeutic intervention. We believe that incorporating clinical and preclinical research data in the context of early life adversities can be instrumental to elucidate the mechanisms contributing to the risk for psychopathology or that may promote resilience. This will ultimately allow the identification of 'at risk' individuals who may benefit from specific forms of interventions that, by interfering with disease trajectories, could result in more benign clinical outcomes.

Parenting Behaviors as Mediators of the Association Between Parental Internalizing Symptoms and Child Externalizing Symptoms

This study analyzes whether the association between parental internalizing symptoms (depression, anxiety, stress) and child symptoms of attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) is mediated by positive and negative parenting behaviors. Cross-sectional data of 420 parents of children (age 6-12 years) with elevated levels of externalizing symptoms were collected in a randomized controlled trial. Measures included parent ratings of their internalizing symptoms and parenting behaviors and of their child's externalizing symptoms. Two mediation models were examined, one including ADHD symptoms and one including ODD symptoms as the dependent variable. Parental internalizing symptoms were modeled as the independent variable and positive and negative parenting behaviors were modeled as parallel mediators. Regression analyses support negative parenting behavior as a mediator of the association between parental internalizing symptoms and child ODD symptoms. For the ADHD model, no significant mediator could be found. Future studies should use prospective designs and consider reciprocal associations.

A job analysis of mental health nursing in a school for students with intellectual and developmental disabilities

While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self-reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant-participator in a single-case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health.

Direct and Indirect Longitudinal Associations of Mother and Father Engagement in Middle Childhood on Adolescent Externalizing and Internalizing Behaviors

Parent engagement is an important aspect of parenting during childhood. However, little is known about the unique longitudinal associations of mother and father engagement with adolescents' externalizing and internalizing problem behaviors. This study uses Future of Families and Child Wellbeing Study data to examine the potential direct and indirect associations of parent engagement at age 9 on adolescent externalizing and internalizing behaviors at age 15. The analytic sample size is 1349, and at age 9, the mean age of children was 9.40 years (SD = 0.37). Forty-eight percent of children were female and 68% of them were from the married families. The results show that while controlling for mother engagement, higher father engagement at age 9 was directly associated with fewer adolescent internalizing behaviors, only among adolescent boys and in married families. In addition, among adolescent boys, father engagement had an indirect association with externalizing behaviors through father-child closeness. Mother engagement, however, is only found to have an indirect association with adolescents' externalizing and internalizing behaviors through maternal hostility (while controlling for father engagement). The results for mother engagement held for boys and in married families only. The findings indicate that both mother and father engagement during childhood is important and helpful to prevent adolescent problem behaviors directly or indirectly via parent-child relationship.

Marital concerns of long-term hospitalised patients with diagnosed schizophrenia: A descriptive phenomenological study

Marital concerns can trigger emotional stress, especially among long-term hospitalised individuals diagnosed with schizophrenia, significantly affecting their treatment and recovery. Unfortunately, rehabilitation programs tend to overlook the marital needs of individuals with diagnosed schizophrenia. This research aimed to investigate the content related to marital concerns of Chinese individuals diagnosed with schizophrenia who were undergoing extended hospitalisation. Fifteen participants diagnosed with schizophrenia were recruited through purposive sampling for face-to-face semi-structured interviews. The gathered data were analysed using Colaizzi's method, revealing three themes: (1) manifestations of marriage-related concerns, (2) effects of marriage on disease progression, and (3) the need for support from family and the hospital. This study offers new insights into marital concerns among long-term schizophrenia inpatients and underscores the significance of screening and intervention for such concerns. Healthcare professionals and family members should extend support to patients to foster confidence within their marital relationships.

Positive behavior support (PBS) with children with fetal alcohol spectrum disorders: Characterizing caregivers' use of PBS using follow-up clinical trial data

BACKGROUND

Fetal alcohol spectrum disorders (FASD) are associated with neurodevelopmental challenges leading to difficulties with everyday life tasks. The Families Moving Forward (FMF) Program teaches caregivers to use positive behavior support (PBS), integrated with other techniques. However, it is unknown how caregivers retain and use these PBS strategies after the intervention.

METHODS

About 4.5 months after completing the FMF Program, twenty-three caregivers of children with FASD aged 4-12 were interviewed about problem behaviors targeted during the FMF Program and their continued use of PBS strategies. Interviews were recorded and coded thematically by a five-coder team. Higher-level pattern codes were developed to facilitate themes across descriptive codes.

RESULTS

Caregivers commonly targeted task incompletion and rule breaking, and problem behaviors were often complex or combined. Caregivers identified environmental and interpersonal triggers for problem behavior. They used many accommodations to prevent problem behaviors, most often related to task or environment simplification. Caregivers also used consequence-based strategies.

CONCLUSIONS

This study is the first to characterize caregivers' use of PBS strategies for children with FASD using mixed methods. Problem behaviors such as rule breaking were more difficult to target. Caregivers found most success when using a combination of multiple different accommodations per problem behavior.

WHAT THIS PAPER ADDS

This is the first study to use mixed methods to characterize how caregivers of children with fetal alcohol spectrum disorders (FASD) use positive behavior support (PBS) strategies to target problem behavior after completion of the empirically validated Families Moving Forward (FMF) Program. Among other techniques involved in the FMF Program, PBS strategies are taught to caregivers and are used to target two distinct, caregiver-identified problem behaviors. This data provides essential information about behaviors responsive to PBS supports, for children with FASD, to inform clinical intervention and research. Notably, multiple problem behaviors often occurred together, emphasizing complexity of behavior challenges in this population and the resulting need for individualized supports. This study is the first to describe commonly observed triggers (antecedents) and commonly used supports (accommodations) from the perspective of caregivers of children with FASD. Importantly, results indicate that use of a wide variety of accommodations, or antecedent-based strategies, are effective in supporting behavior in children with FASD. However, success was most common when caregivers used multiple accommodations for any given concerning behavior. Findings represent 'real-world' strategies caregivers use to support adaptive behavior in their children several months after completion of the FMF Program, suggesting these strategies are applicable to clinical practice.

The role of emotional regulation on early child school adjustment outcomes

Emotional regulation involves managing attention, affect, and behavior, and is essential for long-term health and well-being, including positive school adjustment. The purpose of this secondary data analysis from the Durham Child Health and Development Study was to explore how parent and teacher reported emotional regulation behaviors related to school adjustment outcomes (social skills, academic performance, and academic achievement) during early childhood. Parent and teacher reports on emotional regulation behaviors showed mixed concordance, however they correlated with critical aspects of school adjustment. Clinical and practical implications are discussed, including the role of psychiatric nurses in promoting positive emotional regulation and school adjustment outcomes across settings.

Connected for life: How social connectedness can help prevent suicide in American Indian and Alaska Native communities

Enhancing social support and connectedness can reduce suicide risk, yet few studies have examined this effect in American Indian and Alaska Native (AI/AN) adults. We assessed suicidal ideation and behavior, thwarted belongingness, social support, enculturation, historical trauma, and traumatic life events in 709 AI/AN adults at high risk of suicide from five AI/AN communities. Suicidal ideation was associated with thwarted belongingness and protected against by social support and engaging in AI/AN ceremonies. Among those who made lifetime suicide attempts, traumatic life events, symptoms of depression/anxiety due to historical trauma, and thwarted belongingness were linked to more attempts. More engagement in cultural practices was associated with fewer suicide attempts. Higher levels of social support were associated with more suicide attempts, an observation potentially attributable to the cross-sectional nature of the study. Interventions should focus on protective factors and context-specific interventions emphasizing community history, values, and strengths.

Hyperscanning to explore social interaction among autistic minds

Hyperscanning - the monitoring of brain activity of two or more people simultaneously - has emerged to be a popular tool for assessing neural features of social interaction. This perspective article focuses on hyperscanning studies that use functional near-infrared spectroscopy (fNIRS), a technique that is very conducive to studies requiring naturalistic paradigms. In particular, we are interested in neural features that are related to social interaction deficits among individuals with autism spectrum disorders (ASD). This population has received relatively little attention in research using neuroimaging hyperscanning techniques, compared to neurotypical individuals. The study is outlined as follows. First, we summarize the findings about brain-behavior connections related to autism from previously published fNIRS hyperscanning studies. Then, we propose a preliminary theoretical framework of inter-brain coherence (IBC) with testable hypotheses concerning this population. Finally, we provide two examples of areas of inquiry in which studies could be particularly relevant for social-emotional/behavioral development for autistic children, focusing on intergenerational relationships in family units and learning in classroom settings in mainstream schools.

Suicide attempts of friends and family during adolescence and long-term suicidal ideation and attempts: Findings from the 25-year Add Health study

BACKGROUND

Suicide is a significant global public health concern. However, previous studies have predominantly focused on individual-level risk factors. Against this backdrop, microsystem suicide propinquity, which encompasses suicidal thoughts and behaviors (STB) within families and peer groups, is significant in elucidating the development and perpetuation of STB in adolescents.

METHODS

This study utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health, 1994-2018). Adolescents who reported instances of suicide attempts among their friends and family members during Wave 1 were selected (N = 4826). Generalized estimation equations (GEE) and structural equation models (SEM) were employed.

RESULTS

GEE analyses indicated that individuals with friends who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.57 [2.13, 3.11]) and suicide attempts (OR [95 % CI] = 2.47 [1.78, 3.42]). Also, individuals with family members who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.37 [1.62, 3.46]) and attempts (OR [95 % CI] = 2.27 [1.17, 4.41]). However, friends' and family members' suicide attempts failed to show significant interactive effect. Besides, SEM analyses indicated that friends' and family members' suicide attempts were associated with one's long-term suicidal ideation and attempts via depressive symptoms.

CONCLUSION

Suicide attempts of friends and family during adolescence were long-term risk factors for suicidal ideation and attempts from adolescence to young adulthood. Moreover, depressive symptoms served as long-term mechanisms in these associations.

The Provision of Psychosocial Support to Students in Jordan: Teachers' Knowledge, Attitudes, Skills, Practices, and Perceived Barriers

BACKGROUND

Psychosocial support provision in schools is a promising strategy for overcoming barriers to accessing mental health care. This study aimed to assess teachers' knowledge, attitudes, practices, skills, and perceived barriers in providing psychosocial support to students in Jordan.

METHODS

The sample included teachers working in public schools, private schools, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools, and Zaatari camp schools, as well as non-formal education centers. The study utilized a multi-stage stratified cluster sampling technique to select a nationally representative sample.

RESULTS

A total of 549 teachers were included, and only 25.2% have ever received mental health training. Most teachers reported a high level of good and acceptable knowledge of psychosocial support and had a positive attitude toward the provision of psychosocial support, however, about a quarter (25.5%) agreed on feeling nervous in discussing students' psychosocial problems with their parents or school administrators. The least enacted practice was the systematic engagement with parents, school administration, and other community resources in students' well-being (sometimes, 31.6%; rarely, 20.4%). Gaps in skills were mainly in communicating with external resources and parents. The main barriers included parents' misunderstanding of teachers' role in providing psychosocial support to students (56.8%), lack of integration of psychosocial support in the curriculum (55.6%), and challenges in identifying students with psychosocial problems due to large class sizes (54.3%).

CONCLUSION

The results show that gaps extend beyond the individual level of teachers to the community level. School-based psychosocial support interventions must consider the multiple factors that influence their implementation at multiple levels, including the individual, relational, community, and societal levels.

When virtual reality becomes psychoneuroendocrine reality: A stress(or) review

This review article was awarded the Dirk Hellhammer award from ISPNE in 2023. It explores the dynamic relationship between stressors and stress from a historical view as well as a vision towards the future of stress research via virtual reality (VR). We introduce the concept of a "syncytium," a permeable boundary that blurs the distinction between stress and stressor, in order to understand why the field of stress biology continues to inadequately measure stress alone as a proxy for the force of external stressors. Using Virtual Reality (VR) as an illustrative example to explicate the black box of stressors, we examine the distinction between 'immersion' and 'presence' as analogous terms for stressor and stress, respectively. We argue that the conventional psychological approaches to stress measurement and appraisal theory unfortunately fall short in quantifying the force of the stressor, leading to reverse causality fallacies. Further, the concept of affordances is introduced as an ecological or holistic tool to measure and design a stressor's force, bridging the gap between the external environment and an individual's physiological response to stress. Affordances also serve to ameliorate shortcomings in stress appraisal by integrating ecological interdependencies. By combining VR and psychobiological measures, this paper aims to unravel the complexity of the stressor-stress syncytium, highlighting the necessity of assessing both the internal and external facets to gain a holistic understanding of stress physiology and shift away from reverse causality reasoning. We find that the utility of VR extends beyond presence to include affordance-based measures of immersion, which can effectively model stressor force. Future research should prioritize the development of tools that can measure both immersion and presence, thereby providing a more comprehensive understanding of how external stressors interact with individual psychological states.

Parenting practices as a buffer in the relationship between exposure to community violence and bullying in Mexican adolescents

Multiple studies have shown that adolescents exposed to community violence are likely to engage in bullying behaviors. However, we still need to understand which variables can help reduce the influence of community violence exposure (CVE) on bullying. To investigate this question, a study was conducted with a sample of 568 Mexican adolescents, comprising 276 (48.6%) males and 292 (51.4%) females aged 12 to 16 years old (M age = 13.7 years, SD = 0.82). The study examined how parental support (PS) and parental induction to justice sensitivity (JS) can moderate the relationship between CVE and bullying. The study used structural equation modeling with latent variables. The results showed that CVE was positively associated with bullying, whereas PS and the induction to perpetrator JS were negatively associated. The moderation analysis suggests that the relationship between CVE and bullying was weaker among adolescents who received high PS. On the other hand, low and high parental induction to JS had the same moderating effect. Based on the findings, parental practices are critical when developing preventive programs to reduce the harmful effects of CVE on bullying behavior.

Impacts of early deprivation on behavioral and neural measures of executive function in early adolescence

Children reared in institutional settings experience early deprivation that has lasting implications for multiple aspects of neurocognitive functioning, including executive function (EF). Changes in brain development are thought to contribute to these persistent EF challenges, but little research has used fMRI to investigate EF-related brain activity in children with a history of early deprivation. This study examined behavioral and neural data from a response conflict task in 12-14-year-olds who spent varying lengths of time in institutional care prior to adoption (N = 84; age at adoption - mean: 15.85 months, median: 12 months, range: 4-60 months). In initial analyses, earlier- and later-adopted (EA, LA) youth were compared to a group of children raised in their biological families (non-adopted, NA). NA youth performed significantly more accurately than LA youth, with EA youth falling in between. Imaging data suggested that previously institutionalized (PI) youth activated additional frontoparietal regions, including dorsolateral prefrontal cortex, as compared to NA youth. In addition, EA youth uniquely activated medial prefrontal regions, and LA uniquely activated parietal regions during this task. A separate analysis in a larger group of PI youth examined whether behavioral or brain measures of EF varied with the duration of deprivation experienced. Duration of deprivation was negatively associated with activation of default mode network (DMN) regions. Overall, results suggest that there are lasting effects of deprivation on EF, but that those who are removed from institutional care earlier may be able to recruit additional neural resources as a compensatory mechanism.

Body dissatisfaction and dieting among Finnish adolescents: a 20-year population-based time-trend study

Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13-16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males.

Child temperament as a longitudinal predictor of mother-adolescent interaction quality: are effects independent of child and maternal mental health?

Adaptive parent-child interaction plays a major role in healthy child development. Caregiver mental health problems can negatively impact parent-child interaction. In turn, interactional quality is often studied as a predictor of child outcome. However, child characteristics supposedly shape parent-child interactions as well. Given associations between child and caregiver mental health and child temperament, this study aimed at differentiating their effects on dyadic interaction quality in adolescence. Child temperament and character at age 5 were investigated as longitudinal predictors of observed mother-adolescent interactional quality at age 14 in a community sample (N = 76). It was examined whether these effects were independent of maternal and child mental health and earlier dysfunctional interaction. Lower novelty seeking, higher reward dependence, and higher cooperativeness separately predicted higher dyadic interactional quality at age 14. Controlling regressions for dysfunctional interaction at age 5, which was a significant negative predictor of later interactional quality, cancelled out the effects of novelty seeking and cooperativeness. Past or concurrent maternal or child psychopathology did not explain variance in mother-adolescent interaction. Applying backward selection, a model including reward dependence and dysfunctional interaction at age 5 and concurrent maternal stress showed the best fit for explaining dyadic interaction quality. Results suggest that enduring rather than transient child features predict interactional quality in a community sample. Effects of temperament are not better explained by those of psychopathology, but a combination of child, maternal, and dyadic features predicted dyadic behaviour best. Selective prevention should target parenting in the context of challenging child characteristics specifically.

Longitudinal relationship between oppositional defiant disorder symptoms and attention-deficit/hyperactivity disorder symptoms in Chinese children: insights from cross-lagged panel network analyses

Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common childhood mental disorders, and they have substantial comorbidity. The developmental precursor model has long been widely used to explain the mechanisms of comorbidity between ODD and ADHD, however whether it is equally effective at the symptomatic level is unclear. Therefore, this study aimed to (a) examine the stability of the ODD and ADHD comorbidity network in a longitudinal sample of high-risk children in China; and (b) examine the longitudinal relationship between the ODD and ADHD symptom networks based on a developmental precursor model. Two hundred sixty-three Chinese children aged 6 to 13 years with ODD and/or ADHD were assessed for symptoms of ODD and ADHD in two surveys conducted 1 year apart. We used data from these two time points to construct two cross-sectional networks and a cross-lagged panel network (CLPN) to explore the symptom network for comorbidity of ODD and ADHD. The analysis shows that: (1) the two cross-sectional networks are highly similar in terms of structure, existence of edges, centrality estimates, and the invariance test shows that there is no significant difference between them. The symptoms "follow through", "interrupts/intrudes", "difficulty playing quietly" and "concentration" had the highest expected influence centrality at both time points. (2) Combined with the results of the cross-sectional and cross-lagged networks, we found that "annoy" and "blame" are potential bridge symptoms between the ODD and ADHD symptom networks. The symptom "annoy" forms a reciprocal predictive relationship with "interrupts/intrudes", while "blame" unidirectionally predicts "close attention". In addition, we found that "vindictive" predicted numerous ADHD symptoms, whereas "angry" was predicted by numerous ADHD symptoms. The findings emphasize the broad predictive relationship between ODD and ADHD symptoms with each other, and that ODD symptoms may lead to activation of the ADHD symptom network and vice versa. These findings suggest that the developmental precursor model at the symptom level may partially explain the comorbidity mechanisms of ODD and ADHD, and future studies should further investigate the underlying multiple mechanisms.

Parent Emotion Regulation, Mindful Parenting, and Youth Attachment: Direct and Indirect Associations with Internalizing and Externalizing Problems

The direct associations between two dimensions of parent emotion regulation within the parent-youth relationship (dysregulation; suppression), mindful parenting, and youth internalizing and externalizing problems were examined among 759 parents of youth with significant behavioural or emotional problems. The indirect associations of parent emotion regulation and mindful parenting with youth functioning through youth attachment anxiety and avoidance were also investigated. Parent dysregulation was associated with internalizing symptoms both directly and through attachment anxiety, and with externalizing symptoms directly and through attachment anxiety and avoidance. Parent suppression was associated with internalizing symptoms through attachment anxiety, and with externalizing symptoms through attachment anxiety and avoidance. Mindful parenting was associated with lower internalizing symptoms through attachment anxiety and with lower externalizing symptoms through attachment anxiety and avoidance. Emotion regulation within parent-child relationships and mindful parenting may be critical components of parenting programs aimed at promoting youth attachment security and mental health.

A Pilot Evaluation of the Respect You Curriculum

BACKGROUND

The objective of this study is to evaluate the Respect YOU program's impact on students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. A total of 444 (intervention cohort n = 348, control cohort n = 96) underclassmen enrolled in health or physical education courses from 7 high schools in the Midwest participated in the study.

METHODS

A repeated measure research design was utilized to assess students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. More specifically, paired t-tests were conducted to compare outcome measurements to evaluate the efficacy of the intervention.

RESULTS

Among the students who received the intervention (n = 348), there was a statistically significant change in scores for eating expectancies (Z = -14.403, p < .001), body image satisfaction levels (Z = -14.114, p < .001), social media self-efficacy (Z = 14.868, p < .001), and knowledge scales (Z = -16.100, p < .001) at post-intervention and compared to the control group.

CONCLUSIONS

Results indicate that the Respect YOU program was effective in improving body image scores, eating expectancies, self-esteem, and knowledge-related outcomes among students post-intervention. These results can be used to further develop educational programming to address body image concerns and disordered eating among adolescents.

Individualized approaches to pediatric chronic insomnia: Advancing precision medicine in sleep disorders

The manifestations of chronic insomnia undergo age-related changes. In younger infants and children, behavioral insomnia emerges as the most prevalent form and typically responds to behavioral interventions. However, distinct clusters of clinical presentations suggest the presence of various phenotypes, potentially implicating the primary involvement of specific neurotransmitters. These conceptualizations, coupled with genetic studies on pleiotropy and polygenicity, may aid in identifying individuals at risk of persistent insomnia into adulthood and shed light on novel treatment options. In school-age children, the predominant presentation is sleep-onset insomnia, often linked with nighttime fears, anxiety symptoms, poor sleep hygiene, limit-setting issues, and inadequate sleep duration. The manifestations of insomnia in adolescence correlate with the profound changes occurring in sleep architecture, circadian rhythms, and homeostatic processes. The primary symptoms during adolescence include delayed sleep onset, sleep misperception, persistent negative thoughts about sleep, and physiological hyperarousal-paralleling features observed in adult insomnia. An approach centered on distinct presentations may provide a framework for precision-based treatment options. Enhanced comprehension of insomnia's manifestations across diverse developmental stages can facilitate accurate assessment. Efforts to subtype insomnia in childhood align with this objective, potentially guiding the selection of appropriate treatments tailored to individual neurobiological, clinical, and familial features.

Long-term remission and relapse of anxiety and depression in older adults after Cognitive Behavioural Therapy (CBT): A 10-year follow-up of a randomised controlled trial

BACKGROUND

This study examined the long-term durability of cognitive behaviour therapy (CBT) for older adults with comorbid anxiety and depression 10 years after treatment, in comparison to an active control group.

METHOD

Participants from a randomised controlled trial for older adults with comorbid anxiety and depression (Wuthrich et al., 2016) were re-contacted. Participants had received either group CBT or an active control treatment (Discussion Group). The final sample (N = 54; Aged 70-84, Mage = 76.07, SD = 3.83; 59 % of the eligible original sample) completed a diagnostic interview, cognitive assessment and self-report measures of symptoms and quality of life.

RESULTS

CBT was associated with significantly improved long-term (10-year) efficacy for reducing anxiety and depression in older adults compared to the Discussion group. Effects included higher rates of remission (58 % remission of all diagnoses vs 27 %, 88 % of all depressive diagnoses vs 54 %, 63 % of all anxiety diagnoses vs 35 %, 67 % of primary diagnosis vs 42 %), lower rates of relapse (25-31 % vs 50-78 %) and lower rates of chronic treatment-resistance (8 % primary disorder vs 39 %, 21 % any disorder vs 58 %). Participants who showed an acute treatment response at post-treatment were 7-9 times more likely to be in remission after 10 years than those with residual symptoms.

LIMITATIONS

Results may not generalise to those who do not complete CBT, and the time trajectory of symptom change is unclear.

CONCLUSIONS

Long-term improvements in symptoms are specific to CBT. Results provide compelling evidence for CBT as an effective and durable treatment for late-life anxiety and depression.

Do Parents' Internal Processes and Feelings Contribute to the way they Report Their Children's Mental Difficulties on the Strength and Difficulties Questionnaire (SDQ)?

The way parents report their child's emotional and behavioral difficulties is important both for identifying the child's needs, diagnosis, and prevention. This study examined to what extent parents' internal processes predict the way in which parents report their child's emotional and behavioral difficulties on the SDQ, as mediated by parental feelings. Parents of children who were referred to a community mental health clinic completed a self-report questionnaire including the following scales: adulthood attachment style, self-regulation difficulty, personal well-being, self-compassion parental feelings, and their child's emotional-behavioral difficulties. Study findings indicated that parents' internal processes do not directly predict parents' report of their children's mental difficulties on the SDQ, only when mediated by parental feelings. These findings highlight the significance of parental feelings in reporting children's behavioral and emotional difficulties. It also contributes to the body of knowledge concerning the importance of caring for parents' needs and feelings and overall parenthood.

Family Functioning Profiles in Emerging Adults: Associations with Personal and Parental Psychological Problems

Although recent research has examined family profiles in younger children, emerging adults have not been examined as extensively despite evidence that families continue to be important to emerging adults. The current study examined family functioning profiles and associated psychological problems of both offspring and parents from the perspective of 585 college-attending emerging adults. Results supported six profiles where lower functioning groups generally had more psychological problems relative to higher functioning groups and with specific maternal and paternal differences. The current study advances family functioning research by demonstrating that family profiles can be identified and associated with psychological problems for both parents and emerging adults.

Reducing parenting stress in Chinese parents of children with learning disabilities with a mindful parenting program: A randomized controlled trial

BACKGROUND

Parents raising children with Learning Disabilities (LDs) often face multiple challenges and high levels of parenting stress, especially in societies with intense academic competitions. Mindful parenting (MP) is an emerging approach that brings mindful awareness to parent-child interactions and is found effective in reducing parenting stress in various parent populations.

AIMS

This study examined the effectivenesss of an 8-week online MP program on Chinese parents of children with LDs.

METHODS AND PROCEDURES

A MP program was adapted and implemented in an online format with 69 parents of children with LDs. A randomized controlled trial design was used to examine the efficacy of the mindful parenting group compared with a wait-list control group. Parenting stress, mindful parenting and self-compassion were assessed pre- and post-intervention.

OUTCOMES AND RESULTS

Compared with the wait-list control group, the MP group participants showed decreased parenting stress (d = 0.62, p < 0.05), improved mindful parenting (d = 0.63, p < 0.05), and increased self-compassion (d = 0.61, p < 0.05).

CONCLUSIONS AND IMPLICATIONS

These findings support the effectiveness of an online MP intervention in reducing parenting stress and increasing mindful parenting and self-compassion among Chinese parents of children with LDs. The behavioral and intrapersonal aspects of MP are more amenable to improvement, whereas the attitudinal and interpersonal aspects, particularly non-judgmental acceptance and compassion towards the child, are resistant to change. Future studies should explore strategies to enhance these attitudinal aspects and interpersonal processes of MP.

Females evaluated for autism: characteristics and co-occurring and differential DSM-5 diagnoses

Objective: While sex differences in autism spectrum disorder (ASD) have been identified in areas such as neurocognitive functioning, behavior patterns, and diagnostic criteria, less work has focused on differences within females referred for ASD evaluation, including those who did not go on to receive a diagnosis. This study examined psychological and behavioral characteristics and co-occurring and differential DSM-5 diagnoses between pediatric female participants who received an ASD diagnosis (ASD+) and those who did not (ASD-). Method: Data on cognitive functioning, adaptive functioning, internalizing symptoms, externalizing symptoms, and ADOS-2 scores were analyzed among 137 3- to 20-year-old patients. The sample was divided into two age groups (ages 3-8 and ages 9-20) for analyses of between-group differences (ASD+ vs. ASD-) and predictors of group membership. Results: Females in the ASD+ group were significantly younger, had lower cognitive scores, lower internalizing and externalizing symptoms, and had higher Autism Diagnostic Observation Schedule-2 (ADOS-2) scores than those in the ASD- group. ADOS-2 scores were also the only significant predictor of ASD group membership across age groups. The ASD+ group had a higher percentage of intellectual disability while the ASD- group had higher percentages of anxiety disorder, attention-deficit/hyperactivity disorder, and disruptive behavior disorders. Conclusions: Psychological and behavioral presentations among females referred for ASD evaluation varied with age and ASD diagnostic groups. These results highlight potential female differences in ASD referrals and identification of ASD and the need to improve care for females in consideration of demographic factors.

Cognitive and affective perspective taking amongst adolescent offenders with variants of callous-unemotional traits

Evidence suggests that associations between antisocial behaviour, callous-unemotional (CU) traits and cognitive empathy (e.g. perspective taking) vary depending on more fine-grained dimensions of these constructs. This study examined associations between adolescent antisocial behaviour and individual differences in cognitive and affective perspective taking ability. Based on current theory regarding distinct variants of CU traits, we further tested whether the correlates of CU traits differed amongst youth with high versus low levels of anxiety. Participants were 130 male adolescents (81 youth offenders; 49 non-offenders) aged 13-20 years, of predominantly Caucasian and Aboriginal Australian ethnicity. Perspective taking skills were indexed using performance-based testing, and self-report data was collected on CU traits and anxiety in a cross-sectional design. Offender status was associated with poorer cognitive and affective perspective taking. In addition, associations between CU traits and perspective taking skills were moderated by anxiety. Specifically, CU traits were associated with poorer skills for second-order cognitive perspective taking amongst high-anxiety youth, whereas CU traits were associated with better cognitive and affective perspective taking skills amongst low-anxiety youth. More fine-grained assessment of such factors stands to enhance understanding of, and effective intervention for, antisocial youth.

Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system

INTRODUCTION

Youth in the legal system are at high risk for opioid and other substance use problems and exhibit high rates of trauma exposure. Trauma-focused therapeutic approaches to prevent substance use show promise, but few evidence-based interventions are designed with justice-involved youth in mind. Consequently, implementing trauma-informed, evidence-based interventions within juvenile justice systems is challenging. The current paper describes the systematic adaptation of Trust-Based Relational Intervention (TBRI) as a family-centered substance use prevention program for youth transitioning from secure residential facilities.

METHODS

The study utilized the ADAPT-ITT methodological framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention designed to help caregivers support children and youth with histories of trauma. Phases of adaptation included (1) Assessment, (2) Decision, (3) Prototype Development, and (4) Testing and Integration. The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., youth in the legal system and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) with input from participants from the target population, key stakeholders, and content experts.

RESULTS

The systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum, TBRI Youth & Young Adult Curriculum, and TBRI Nurture Groups. The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum.

CONCLUSIONS

Utilizing a systematic methodological framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually appropriate interventions. Accounting for contextual factors and population needs can improve the fit of evidence-based interventions for youth in the legal system, facilitating uptake and ultimately improving outcomes for youth at risk for substance use problems.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04678960.

Selfie-Evaluation: A Meta-Analysis of the Relationship Between Selfie Behaviors and Self-Evaluations

The "selfie" phenomenon shaped the past two decades, yet there is inconsistent evidence concerning the relationship between selfie behaviors and self-evaluations. This meta-analysis investigates the relationship between selfie taking, editing, and posting behavior and general and appearance-specific self-evaluations. The results reveal that selfie taking and posting are related to positive appearance-specific self-evaluations. In contrast, selfie editing is related to negative self-evaluations both generally and specific to appearance. Gender and age did not moderate these relationships, but methodological factors did, suggesting these relationships depend on factors, such as how selfie behaviors are measured and study design. We interpret these findings through the lens of prominent social psychological theories and conclude with suggestions to guide future research.

Between- and within-child level associations between externalizing and internalizing behavior problems in a nationally representative sample of US elementary school children

BACKGROUND

Both transactional and common etiological models have been proposed as explanations of why externalizing behavior problems (EBP) and internalizing behavior problems (IBP) co-occur in children. Yet little research has empirically evaluated these competing theoretical explanations. We examined whether EBP and IBP are transactionally related at the within-child level while also identifying antecedents commonly associated with between-child differences in underlying stability of both EBP and IBP across elementary school.

METHODS

We analyzed a nationally representative and longitudinal sample of US schoolchildren (N = 7,326; 51% male) using random-intercept cross-lagged panel modeling (RI-CLPM). We used teacher ratings of EBP and IBP as annually assessed from the spring of kindergarten (Mage = 6.12 years) through the spring of 5th grade (Mage = 11.09 years). Early childhood antecedents included child internal (i.e. inhibitory control, cognitive flexibility, working memory, and language/literacy) and external factors (i.e. parental warmth, harsh parenting, parenting stress, and maternal depressive symptoms).

RESULTS

We found little evidence for within-child, transactional relations between EBP and IBP. Both types of behavior problems instead were substantially associated at the between-child level. Inhibitory control was the strongest common antecedent that explained this longitudinal overlap. Cognitive flexibility, working memory, language/literacy skills, and maternal depression contributed specifically to the stability of IBP. Measures of parenting were specific to the stability of EBP.

CONCLUSIONS

Common etiological factors rather than transactional relations better explain the co-occurrence of EBP and IBP during elementary school. Inhibitory control is a promising target of early intervention efforts for schoolchildren at risk of displaying both EBP and IBP.