Adolescent stress and symptoms of anxiety and depression: Resilience explains and differentiates the relationships

Resilience as a Mediator Between Interpersonal Risk Factors and Hopelessness in Depression

Several studies investigated the role of resilience as a mediating factor for psychopathological phenotypes. The aim of the current study is to explore the putative role of resilience as a mediator between different vulnerability factors and depressive symptoms. One hundred and fifty patients with a major depressive disorder diagnosis have been evaluated on the basis of humiliation (Humiliation Inventory), adverse past family experiences (Risky Family Questionnaire), hopelessness (Beck Hopelessness Scale), and resilience (Resilience Scale for Adult) scores. A multiple regression analysis and a bootstrapping method were carried out to assess the hypothesis that resilience could mediate the relationships between these risk factors as predictors and hopelessness as a dependent variable. Our results show that resilience has a mediating role in the relationship between several risk factors that are specifically involved in interpersonal functioning and hopelessness. The main limitations of the study are the cross-sectional nature of the study, the use of self-report instruments, the lack of personality assessment, and the consideration of the resilience as a unique construct. The understanding of the mechanisms through which resilience mediates the effects of different interpersonal risk factors is crucial in the study of depression. In fact, future prevention-oriented studies can also be carried out considering the mediating role of resilience between interpersonal risk factors and depressive symptoms.

Mediating role of resilience in relationship between negative life events and depression among Chinese adolescents

PURPOSE

To explore whether resilience acted as a protective factor between negative life events and depression among Chinese adolescents.

METHOD

Using convenient sampling, students (N = 278) in two junior and senior high schools in Wuhan, China were investigated, and structural equation model was used to examine the mediating effect of resilience in the relationship between negative life events and depression.

RESULTS

Resilience was negatively correlated with negative life events and depression, and negative life events were positively correlated with depression. Resilience partially mediated the effects of negative life events on depression in Chinese adolescents.

CONCLUSIONS

It is important for educators to improve adolescents' resilience to mitigate the effects of negative life events on depression.

Adolescent Mental Health Problems in Hong Kong: A Critical Review on Prevalence, Psychosocial Correlates, and Prevention

PURPOSE

Adolescent mental health problems are a public health issue in Hong Kong and a review of the situation can have implications for intervention and prevention. This paper aims to review the available prevalence rates of mental health problems among adolescents in Hong Kong and examines the correlates of these conditions through a positive youth development (PYD) framework.

METHODS

Local studies published in English between January 1995 and September 2017 were searched in ERIC, PsycArticles, PsycInfo, and PubMed. Data were selected and extracted by two reviewers. The primary outcome was the prevalence or the scores of mental health problems among adolescents. The secondary outcome was the correlates associated with the problems identified in the studies.

RESULTS

Twenty-three studies were identified. The prevalence of depression was between 0.55% and 2.2% (three studies), whereas the prevalence for anxiety (one study) and generalized anxiety disorder (two studies) were 6.9% and 2.6%, respectively. Comparatively higher levels of depressive symptoms and lower levels of general mental health among Hong Kong adolescents than adolescents in other regions. The protective factors examined in these studies were categorized into PYD constructs, namely: cognitive competence, behavioral competence, emotional competence, resilience, and bonding with family, which were associated with better mental health.

CONCLUSIONS

This review contends that future mental health research and intervention for adolescents should focus more on PYD constructs and family factors.

The relationship between perceived stress and problematic social networking site use among Chinese college students

BACKGROUND AND AIMS

Perceived stress has been regarded as a risk factor for problematic social networking site (SNS) use, yet little is known about the underlying processes whereby confounding variables may mediate or moderate this relationship. To answer this question, this study examined whether depression and anxiety mediated the relationship between perceived stress and problematic SNS use, and whether these mediating processes were moderated by psychological resilience and social support.

METHODS

Participants were 641 Chinese college students who completed anonymous questionnaires measuring perceived stress, depression/anxiety, psychological resilience, social support, and problematic SNS use.

RESULTS

The results showed that (a) depression/anxiety mediated the relationship between perceived stress and problematic SNS use; (b) the mediating effects of depression/anxiety on the association between perceived stress and problematic SNS use were moderated by psychological resilience. Specifically, the mediating effects of depression/anxiety were stronger for individuals with lower levels of psychological resilience, compared with those with higher levels of psychological resilience; and (c) the mediating effects of depression/anxiety were not moderated by social support, although social support was negatively related to depression/anxiety.

DISCUSSION AND CONCLUSION

This study can contribute to a better understanding of how and when perceived stress increases the risk of problematic SNS use, and implies the importance of enhancing psychological resilience in preventing problematic SNS use.

The mediating and moderating effects of resilience on the relationship between perceived stress and depression in heroin addicts

The purpose of this study was to examine the mediating and moderating roles of resilience on the relationship between perceived stress and depression among heroin addicts. A total of 138 heroin addicts completed the measures of perceived stress, resilience, and depression. Correlation analysis indicated that perceived stress was positively associated with depression. Resilience was negatively correlated with perceived stress and depression. Mediation analysis revealed that resilience partially mediated the relationship between perceived stress and depression. However, resilience did not moderate the influence of perceived stress on depression. These findings might provide a better understanding of the mental health among heroin addicts.

Executive Function and Resilience as Mediators of Adolescents' Perceived Stressful Life Events and School Adjustment

This study investigated psychological mechanisms underlying the relationship between stressful life events and school adjustment in Chinese adolescents. The Adolescent Self-rating Life Events Checklist, the Adolescent Executive Function Scale, the Chinese version of the Resilience Scale, and the School-adjustment Scale were administered to 1101 Chinese adolescents (465 males, 636 females), aged 11–19 years, from three secondary schools. Results from serial mediation analysis revealed that perceived stressful life events could affect school adjustment through the mediation of executive function and resilience. The mediation effect contained three paths, the separate mediation effect of executive function, the separate mediation effect of resilience, and the serial mediation effect of executive function and resilience. These findings provide valuable insights into the effect of perceived stressful life events on school adjustment of Chinese adolescents, and suggest that, the researchers and educators could enhance school adjustment in vulnerable groups by improving their executive function and resilience.

Depressive symptoms and diabetes management from late adolescence to emerging adulthood

OBJECTIVE

To examine changes in depressive symptoms as well as between- and within-person associations between depressive symptoms and Type 1 diabetes (T1D) management across the transition from late adolescence to emerging adulthood.

METHOD

Beginning in the senior year of high school, 197 late adolescents with T1D (M_age = 17.77) reported on their student status and living situation, and completed self-report measures of depressive symptoms and adherence to the diabetes regimen, annually at 3 time points. Glycemic control was gathered from hemoglobin A1c (HbA1c) assay kits at the same time points.

RESULTS

Results of multilevel models demonstrated high depressive symptoms at baseline, with significant increases in depressive symptoms across time when participants were not living in their parental home, but no change when living with parents. Participants with higher mean levels of depressive symptoms relative to peers (between-person association) had poorer adherence and glycemic control (i.e., higher HbA1c) on average. Within-person fluctuations in depressive symptoms were significantly associated with adherence: greater increases in depressive symptoms (relative to adolescents' own average) were associated with greater deteriorations in adherence. There was not a significant within-person effect of depressive symptoms on glycemic control.

CONCLUSIONS

The transition from late adolescence to emerging adulthood is particularly challenging for those with T1D. The findings that individuals with greater depressive symptoms have poorer adherence and glycemic control relative to those with lower depressive symptoms, and that increases in depressive symptoms are associated with declines in adherence, highlight the importance of screening and monitoring depressive symptoms during this life transition. (PsycINFO Database Record

Childhood maltreatment and perceived stress in young adults: The role of emotion regulation strategies, self-efficacy, and resilience

Childhood maltreatment has many deleterious outcomes; however, trait resilience as well as emotion regulation strategies, including suppression and reappraisal, may mediate between childhood maltreatment and later perceived stress. For this study, 267 college students (183 females and 84 males; M age = 19.77, SD = 2.29) completed self-report measures of parental psychological and physical maltreatment, parental emotion neglect, habitual use of suppression and reappraisal strategies, emotion regulation self-efficacy, trait resilience, and recent perceived stress. Analyses were conducted to investigate gender-specific associations. In females, both suppression and reappraisal mediated the relationship between maternal/paternal emotional neglect and perceived stress, and suppression also mediated the relationship between maternal psychological maltreatment and perceived stress. Trait resilience mediated the relationships of all three types of maternal maltreatment, paternal psychological maltreatment, and paternal emotional neglect with perceived stress in females. There were no significant mediation effects in males. Thus, interventions aiming at reducing perceived stress associated with maternal or paternal emotional neglect or maternal psychological maltreatment in women may benefit from targeting both suppression and reappraisal. Such interventions may also be enhanced by efforts to strengthen trait resilience.

Evaluation of the Factor Structure of the Adolescent Stress Questionnaire in Chinese Adolescents

This study evaluated the psychometric properties of the Chinese version of Adolescent Stress Questionnaire (ASQ-CN) in a sample of Chinese middle school students (N = 420; 52.14% boys and 47.86% girls). Iterated principal factor analysis and multiple-group principal components cluster analysis supported a six-factor model with 42 items out of 58 items in the ASQ-CN. The internal consistency was from .82 to .90. Girls reported lower stress levels in one subscale, Stress of romantic relationship, whereas no gender differences were found in the other five subscales. Compared with other studies of the ASQ in Westernized countries, the ASQ-CN showed a distinct factor structure that may be explained by cross-cultural differences. Scales constructed from factor analysis related negatively to measures of mindfulness and positively to a measure of behavioral problems, suggesting that they were valid for Chinese adolescent stress. The study did not support a higher order construct of the ASQ-CN. Altogether, our findings suggest that the ASQ-CN is adequate for assessing stressors in Chinese adolescents.

Specificity in mediated pathways by anxiety symptoms linking adolescent stress profiles to depressive symptoms: Results of a moderated mediation approach

BACKGROUND

We investigated the specificity in mediated pathways that separately link specific stress dimensions through anxiety to depressive symptoms and the protective utility of resilience. Thus, this study goes beyond lumping together potential mediating and moderating processes that can explain the relations between stress and (symptoms of) psychopathology and the buffering effect of resilience.

METHODS

Ghanaian adolescents between 13 and 17 years (female = 285; male = 244) completed the Adolescent Stress Questionnaire (ASQ), Spielberger State Anxiety Inventory (STAI), Short Mood Feeling Questionnaire (SMFQ) and the Resilience Scale for Adolescents (READ). Independent samples t-test, multivariate analysis of covariance with follow-up tests and moderated mediation analyses were performed.

RESULTS

Evidences were found for specificity in the associations between dimensions of adolescent stressors and depressive symptoms independent of transient anxiety. Transient anxiety partly accounted for the indirect effects of eight stress dimensions on depressive symptoms. Except stress of school attendance and school/leisure conflict, resilience moderated the indirect effects of specific stress dimensions on depressive symptoms. Results suggested differences in how Ghanaian adolescents view the various stress dimensions, and mediated pathways associated with anxiety and depressive symptoms.

LIMITATIONS

Use of cross-sectional data does not show causal process and temporal changes over time.

CONCLUSIONS

Findings support and clarify the specificity in the interrelations and mediated pathways among dimensions of adolescent stress, transient anxiety, and depressive symptoms. Conditional process analyses shows that resilience does not only buffer direct, but also indirect psychological adversities. Interventions for good mental health may focus on low resilience subgroups in specific stress dimensions while minimizing transient anxiety.

Anxiety symptoms mediate the relationship between exposure to stressful negative life events and depressive symptoms: A conditional process modelling of the protective effects of resilience

BACKGROUND

Resilience has provided a useful framework that elucidates the effects of protective factors to overcome psychological adversities but studies that address the potential contingencies of resilience to protect against direct and indirect negative effects are lacking. These obvious gaps have also resulted in oversimplification of complex processes that can be clarified by moderated mediation associations. This study examines a conditional process modelling of the protective effects of resilience against indirect effects.

METHOD

Two separate samples were recruited in a cross-sectional survey from Australia and Norway to complete the Patient Health Questionnaire -9, Generalized Anxiety Disorder, Stressful Negative Life Events Questionnaire and the Resilience Scale for Adults. The final sample sizes were 206 (females=114; males=91; other=1) and 210 (females=155; males=55) for Australia and Norway respectively. Moderated mediation analyses were conducted across the samples.

RESULTS

Anxiety symptoms mediated the relationship between exposure to stressful negative life events and depressive symptoms in both samples. Conditional indirect effects of exposure to stressful negative life events on depressive symptoms mediated by anxiety symptoms showed that high subgroup of resilience was associated with less effect of exposure to stressful negative life events through anxiety symptoms on depressive symptoms than the low subgroup of resilience.

LIMITATIONS

As a cross-sectional survey, the present study does not answer questions about causal processes despite the use of a conditional process modelling.

CONCLUSIONS

These findings support that, resilience protective resources can protect against both direct and indirect - through other channels - psychological adversities.

Childhood adversities and distress - The role of resilience in a representative sample

While adverse childhood experiences have been shown to contribute to adverse health outcomes in adulthood, specifically distress and somatic symptoms, few studies have examined their joint effects with resilient coping style on adult adjustment. Hence, we aim to determine the association between resilient coping and distress in participants with and without reported childhood adversities. A representative German community sample (N = 2508) between 14–92 years (1334 women; 1174 men) was examined by the short form of the Childhood Trauma Questionnaire, the Brief Resilience Coping Scale, standardized scales of distress and somatoform symptoms. Childhood adversity was associated with reduced adjustment, social support and resilience. It was also strongly associated with increased distress and somatoform complaints. Resilient coping was not only associated with lower distress, it also buffered the effects of childhood adversity on distress. Our study corroborates the buffering effect of resilience in a representative German sample. High trait resilient subjects show less distress and somatoform symptoms despite reported childhood adversities in comparison to those with low resilient coping abilities.