Causal links between stressful events, coping style, and adolescent symptomatology

Gender differences in the relationship between medical students' emotional intelligence and stress coping: a cross-sectional study

BACKGROUND

Given the increasing stress levels among medical students due to the impact of COVID-19, it is crucial to effectively reduce their stress levels for their future development. To better understand medical students' stress coping, this study investigated how their emotional intelligence is related to stress coping and whether this relationship is moderated by gender differences.

METHODS

A cross-sectional study was conducted. A random sample of 744 medical students from Hebei Province, China, was investigated via an emotional intelligence scale and stress coping questionnaire from March-May 2023. The response rate was 93%. SPSS and Mplus statistical software were used for the data analysis.

RESULTS

The self-emotional appraisal of medical students had a significant negative effect on avoidant coping (β = -0.173, CI 95% = [-0.243, -0.099], p < .001). However, the other dimensions of emotional intelligence (others' emotional appraisal, use of emotion, and regulation of emotion) had a significant positive impact on the active coping of female medical students (β = 0.146, CI 95% = [0.082,0.214], p < .001; β = 0.235, CI 95% = [0.167,0.304], p < .001; β = 0.165, CI 95% = [0.084,0.247], p < .001). In contrast to those of female medical students, other dimensions of emotional intelligence had a significant positive impact on the avoidant coping of male medical students (β = -0.161, CI 95% = [-0.284, -0.062]; p < 0.01; β = 0.126, CI 95% = [0.043,0.246], p < 0.001; β = 0.159, CI 95% = [0.054,0.277], p < 0.05; β = -0.221, CI 95% = [-0.363, -0.129], p < 0.001). Moreover, the use of emotion had a significant positive impact on the active coping of male medical students (β = 0.272, CI 95% = [0.182,0.382], p < .001). Furthermore, gender differences had a moderating effect on the relationship between emotional intelligence dimensions and stress coping (β = 0.178; CI 95% = [0.068,0.292]; p < 0.05). Others' emotional appraisal has a greater impact on female students' active coping. In addition, with increasing regulation of emotion ability, female medical students reduce avoidant coping (β = 0.169, CI 95% = [0.002,0.326]; p < 0.05).

CONCLUSIONS

The current study revealed that gender is a significant moderator of the relationship between medical students' emotional intelligence and stress coping. These findings may help medical colleges focus on gender differences when improving medical students' ability to cope with stress.

Young people's happiness in the context of negative life events and coping strategies: a latent profile and latent class analysis

Young people have to cope with many negative life events and stress factors to maintain their happiness. Although there are studies on how they benefit from different coping strategies and their results, there is no study that profiles/groups young people according to negative life events and coping styles. From this point of view, the study aims to determine different life events classes and stress coping profiles in young people, and to examine the differences in happiness among the new groups created according to the discovered classes and profiles. Participants consisted of 1093 young people (M = 21.08) from different state universities in Turkey. Latent profile analysis (LPA) was conducted, resulting in a 3 profile solution characterizing coping strategies: Positive-oriented (26.8%), slightly positive-oriented (50%), and negative-oriented (23.2%) coping strategy profiles. Latent class analysis (LCA) was conducted, resulting in a 2 class solution characterizing negative life events: More negative (40.1%) and less negative (59.9%) life events classes. For the purpose of the study, the profiles created with the latent profile analysis and the latent class analysis were considered together and the participants were divided into 6 groups. These groups differed significantly in terms of happiness. The group with the highest level of happiness is the group with positive-oriented coping strategies and less negative life conditions (μ = 4.35, p < .001), and the group with the lowest level of happiness is the group with negative-oriented coping strategies and more negative life conditions (μ = 3.48, p < .001). However, the findings indicated that a positive-oriented coping strategy profile (the profile that scored high on positive coping strategies and low on negative coping strategies) offers the most promising route to happiness whether experienced negative life events are less or more.

Childhood family environment predicting psychotic disorders over a 37-year follow-up - A general population cohort study

BACKGROUND

Childhood adverse effects and traumatic experiences increase the risk for several psychiatric disorders. We now investigated whether prospectively assessed childhood family environment per se contributes to increased risk for psychotic disorders in adulthood, and whether these family patterns are also relevant in the development of affective disorders.

METHODS

We used the Young Finns Data (n = 3502). Childhood family environment was assessed in 1980/1983 with previously constructed risk scores: (1) disadvantageous emotional family atmosphere (parenting practices, parents' life satisfaction, parents' mental disorder, parents' alcohol intoxication), (2) adverse socioeconomic environment (overcrowded apartment, home income, parent's employment, occupational status, educational level), and (3) stress-prone life events (home movement, school change, parental divorce, death, or hospitalization, and child's hospitalization). Psychiatric diagnoses (ICD-10 classification) over the lifespan were collected up to 2017 from the national registry of hospital care. Non-affective psychotic disorder and affective disorder groups were formed.

RESULTS

Frequent stress-prone life events predicted higher likelihood of non-affective psychotic disorders (OR = 2.401, p = 0.001). Adverse socioeconomic environment or emotional family atmosphere did not predict psychotic disorders. Only disadvantageous emotional family atmosphere predicted modestly higher likelihood of affective disorders (OR = 1.583, p = 0.013).

CONCLUSIONS

Our results suggest that childhood family environment and atmosphere patterns as such contribute to the risk for developing adulthood mental disorders with relative disorder specificity. The results emphasize the importance of both individual and public health preventive initiatives, including family support interventions.

Predicting Alcohol-Related Memory Problems in Older Adults: A Machine Learning Study with Multi-Domain Features

Memory problems are common among older adults with a history of alcohol use disorder (AUD). Employing a machine learning framework, the current study investigates the use of multi-domain features to classify individuals with and without alcohol-induced memory problems. A group of 94 individuals (ages 50-81 years) with alcohol-induced memory problems (the memory group) were compared with a matched control group who did not have memory problems. The random forests model identified specific features from each domain that contributed to the classification of the memory group vs. the control group (AUC = 88.29%). Specifically, individuals from the memory group manifested a predominant pattern of hyperconnectivity across the default mode network regions except for some connections involving the anterior cingulate cortex, which were predominantly hypoconnected. Other significant contributing features were: (i) polygenic risk scores for AUD, (ii) alcohol consumption and related health consequences during the past five years, such as health problems, past negative experiences, withdrawal symptoms, and the largest number of drinks in a day during the past twelve months, and (iii) elevated neuroticism and increased harm avoidance, and fewer positive "uplift" life events. At the neural systems level, hyperconnectivity across the default mode network regions, including the connections across the hippocampal hub regions, in individuals with memory problems may indicate dysregulation in neural information processing. Overall, the study outlines the importance of utilizing multidomain features, consisting of resting-state brain connectivity data collected ~18 years ago, together with personality, life experiences, polygenic risk, and alcohol consumption and related consequences, to predict the alcohol-related memory problems that arise in later life.

Non-suicidal self-injury and professional psychological help-seeking among Chinese left-behind children: prevalence and influencing factors

BACKGROUND

Non-suicidal self-injury (NSSI) is a risk factor for suicide. This study aimed to investigate the prevalence of NSSI and professional psychological help-seeking status and influencing factors among left-behind children (LBC) in China.

METHODS

We implemented a population-based cross-sectional study in participants aged 10-18 years. Sociodemographic characteristics, NSSI, help-seeking status and coping style were measured by self-reported questionnaires. A total of 16,866 valid questionnaires were collected, including 6096 LBC. Binary logistic regression models were used to analyze the factors influencing NSSI and professional psychological help-seeking.

RESULTS

The incidence of NSSI among LBC was 4.6%, significantly higher than that of non-left-behind children (NLBC). This incidence was higher among girls. Moreover, 53.9% of LBC with NSSI did not receive any treatment and only 22.0% sought professional psychological help. LBC often adopt emotion-oriented coping styles, specifically, those with NSSI. LBC with NSSI who seek professional help tend to adopt problem-oriented coping styles. Logistic regression analysis revealed that girls, learning stage, single-parent, remarried families, patience, and emotional venting were risk factors for NSSI in LBC, while problem-solving and social support seeking were protective factors. Moreover, problem-solving was also a predictor for seeking professional psychological help, patience will prevent it.

LIMITATIONS

This was an online survey.

CONCLUSIONS

The prevalence of NSSI in LBC is high. Gender, grade, family structure, and coping style affect the occurrence of NSSI among LBC. Only a few LBC with NSSI seek professional psychological help, while the coping style will affect the help-seeking behavior.

COVID-19 Stressors and Aggression among Chinese College Students: The Mediation Role of Coping Strategies

Although college students experienced excessive stressors (COVID-19 disease and negative COVID-19 news) during the COVID-19 pandemic, few studies have been aimed at coping strategies used by college students to deal with stress caused by the pandemic. Coping strategies are efforts to deal with anxiety in the face of a perceived threat or stress. Aggression is harmful social interaction with the intention of inflicting damage or harm upon another individual. In the present study, we aimed to examine the direct effect of stressors resulting from the pandemic on college students' aggression, as well as the indirect effect via their coping strategies. Through a cross-sectional survey of 601 Chinese college students (M-age = 20.28), we tested the proposed framework. We first found that information stressors of COVID-19 ranked highest among the four stressors of the pandemic. Results also indicated that college students' stressors of COVID-19 were directly and positively associated with their aggressive behavior. For the indirect effect, college students would adopt both adaptive coping strategies (self-help strategy) and maladaptive coping strategies (avoidance strategy and self-punishment strategy) with the stressors of COVID-19. Furthermore, adaptive coping strategy (approach strategy) was negatively related to their aggression, whereas maladaptive coping strategy (avoidance strategy and self-punishment strategy) was positively related to their aggressive behavior. The present research extends the general strain theory in the COVID-19 context. Practical implications are also discussed.

Perceived Information Overload and Intention to Discontinue Use of Short-Form Video: The Mediating Roles of Cognitive and Psychological Factors

The current study investigated the effects of Chinese young adult users' perceived information overload (i.e., the daily perception of exposure to excessive information) on their intention to stop using short-form video applications. Specifically, this study accomplished this by measuring the direct and indirect effects of social media fatigue, maladaptive coping, and life dissatisfaction in relation to users' intention to discontinue their use of short-form video applications. The data were collected using a web-based survey and validated questionnaire, with a sample of 340 young adult (18-26 years old) respondents. The results indicated that perceived information overload had a direct effect on the intention to discontinue the use of short-form video applications. Moreover, short-form video fatigue, maladaptive coping, and life dissatisfaction all played mediating roles in the relationship between perceived information overload and the intention to discontinue the use of short-form video applications among young adults in China.

Sleep Reactivity and Related Factors in Adolescence: An Increased Risk for Insomnia? A Longitudinal Assessment

Purpose

The individual vulnerability for stress-related sleep difficulties (eg, sleep reactivity) is known as a predisposing factor of insomnia in adults, yet relatively little is known about sleep reactivity in adolescence. The study goal is to determine factors related to sleep reactivity and to investigate whether sleep reactivity and related factors predict current and new incidents of insomnia in adolescents.

Patients and Methods

At baseline, 11-to-17-year-olds (N = 185, M_age = 14.3 years, SD = 1.8, 54% female) answered an age-appropriate version of the Ford Insomnia Response to Stress Test, questionnaires about sleep, stress, psychological symptoms, and resources, filled out a sleep diary and used actigraphy. Insomnia diagnoses according to ISCD-3 criteria were assessed at baseline, after 9 months and after one and a half years.

Results

Adolescents with high compared to low sleep reactivity had increased pre-sleep arousal, negative sleep-related cognitions, pre-sleep mobile phone use, stress experience, stress vulnerability, internalizing and externalizing symptoms, less social resources, and a later midpoint of bedtime. High sleep reactivity increased the likelihood for currently having insomnia, but not for the development of insomnia at subsequent assessments.

Conclusion

The findings suggest that high sleep reactivity is related to poor sleep health and mental health but cast doubt on sleep reactivity as a pivotal predisposing factor for the development of insomnia in adolescence.

One more step in the study of children's daily stress: The spillover effect as the transfer of tension in family and school environments

Introduction

The spillover effect is the psychological overflow due to daily stress in one context and the transfer of its consequences to another close environment. The aim is to explore the spillover effect in conflicts within the family, on the one hand, and school with peers on the other hand, as an inferred measure of daily stress according to the literature.

Method

The study consisted of a sample of 208 6-year-old students and their families. A methodology based on daily report records was used, by means of two ad hoc checklists with simultaneous measurements, for 2 consecutive weeks and 3 academic years, for both family and school contexts. A repeated measures design, together with a nonparametric statistical data analysis with Friedman's test and contrast measures, was used.

Results

Daily stress shows significant differences in the family setting throughout the week (χ ² = 32.44; p = 0.000) and at different times of the day (χ ² = 29.65; p = 0.000). In the school setting, differences were found across the different days of the week (χ ² = 36.96; p = 0.000). Spillover effect has been discovered between conflicts at home in the evening and conflicts at school. At the same time, conflicts at school are related to conflicts at home from Wednesday onward.

Discussion

The results suggest further research on daily stress through the interrelation of the different contexts, as well as the impact that moments of conflict may have on the psychological and emotional development of the child.

Coping-resilience profiles and experiences of stress in autistic adults

Emerging studies allude to high stress in autistic adults. Considering the detrimental impact of stress on health outcomes, examining individual resources which may influence the extent to which stress is experienced (e.g., coping and resilience) is vital. Using a person-focused approach, this study aimed to identify coping-resilience profiles, and examine their relations to general perceived stress and daily hassles in a sample of autistic adults (N = 86; aged 19-74 years). Cluster analysis identified four coping-resilience profiles (i.e., high cope/ low resilience, low cope/ high resilience, engage cope/ high resilience, and disengage cope/ low resilience). The high cope/ low resilience and disengage cope/ low resilience groups had significantly higher general perceived stress than the remaining groups. No significant group differences were noted in relation to daily hassles. Jointly addressing coping and resilience may be beneficial on the perceived stress experienced in autistic adults. The use of coping-resilience profiles may also allow for the personalization of stress management and support options in the autistic adult population.

Parenting in a Pandemic: Parental stress, anxiety and depression among parents during the government-initiated physical distancing measures following the first wave of COVID-19

Drawing on the tenets of family stress theory, the aim of this study is to examine parents' perceived stress, symptoms of anxiety, depression, and associated risk- and protective factors across demographic subgroups during in the first wave of the COVID-19 pandemic. Norwegian parents (N = 2868; 79.5% mothers) with >1 child under 18 years of age completed an online survey two weeks after the implementation of government-initiated distancing measures. The survey includes measures of COVID-related risk factors (parental stress, burnout, depression, anxiety, anger of parents towards children, difficulty working from home, and positive beliefs about worry) and protective factors (self-efficacy and social support). Mothers, parents living with more than one child, and parents with a psychiatric diagnosis reported greater levels of parental stress, more burnout, and more anger towards their children, as well as less social support. Almost 25% of the parents reported anxiety and depression that are clinically significant. Parents who followed distancing measures reported significantly higher distress. Anger of parents towards children explains 41% of the variation in parental stress. These findings indicate that parents have experienced symptoms of deteriorated mental health due to the COVID- 19 pandemic, including parental stress, anxiety, and depression. The study presents practical implications for meso- and macro-level policymaking and offers support to further the potential aims of public health and clinical interventions. Future studies to monitor long-term aversive mental health outcomes among parents are warranted.

Stress-related hippocampus activation mediates the association between polyvictimization and trait anxiety in adolescents

Early life stress exposures are associated with adverse health outcomes and heightened anxiety symptoms in adolescents. Stress-sensitive brain regions like the hippocampus and amygdala are particularly impacted by early life adversities and are also implicated in the development of anxiety disorders. However, to date, no studies have specifically examined the neural correlates of polyvictimization (exposure to multiple categories of victimization) or the contribution of stress-sensitive neural nodes to polyvictimization's impact on mental health. To elucidate these relationships, the current study analyzed associations between polyvictimization, hippocampal and amygdalar activation during an acute stress task and trait anxiety in a sample of 80 children and adolescents aged 9-16 years (33 female participants). Results showed that polyvictimization was associated with higher trait anxiety as well as greater stress-related right hippocampus activation, and this greater hippocampal activity predicted heightened trait anxiety. Robust mediation analyses revealed that stress-related right hippocampus activation partially mediated the relationship between polyvictimization and trait anxiety. Our results expand upon the existing polyvictimization literature by suggesting a possible neurobiological pathway through which polyvictimization is connected to the etiology of mental illness.

Secure Attachment Representation in Adolescence Buffers Heart-Rate Reactivity in Response to Attachment-Related Stressors

To date, we know very little about the effects of the differences in attachment classifications on the physiological correlates of stress regulation in adolescent age groups. The present study examined for the first time heart rate (HR) and heart rate variability (HRV) during an attachment interview in adolescents. HR and HRV data were collected during a baseline assessment as well as during the administration of the Adult Attachment Projective Picture System (AAP) in a community-based sample of 56 adolescents (26 females and 30 males, mean age = 16.05 years [SD = 1.10]). We additionally used the Adult Attachment Interview (AAI) in 50% of our sample to test the convergent validity. Adolescents with a secure attachment representation showed a higher HRV from baseline to the AAP interview compared to those with an insecure-dismissing (Ds) and the unresolved group. A comparison between the two insecure attachment groups showed no significant difference related to HR and HRV. Cohen’s Kappa (κ = 0.81) revealed an almost perfect agreement between the AAP and the AAI for the four-group classification. Our results indicate that adolescents with a secure attachment representation are more capable of dealing with attachment-related distress which is represented in higher HRV during an attachment interview.

Relationship between negative coping style and fear of COVID-19 among Wuhan college students during the post-pandemic period: A moderated chain mediation model

OBJECTIVES

After a long-term lockdown, particularly one in which human life is at risk, negative psychological consequences are expected. In this study, we aimed to explore the cause of stress and fear of coronavirus-19 (COVID-19) among Chinese college students in Wuhan during the latest strictest lockdown.

METHODS

During the COVID-19 outbreak, 1,070 college students from Wuhan, aged 18-29 years, took part in an online survey. We used correlations, bootstrap tests, and other statistical analysis methods to analyze the data.

RESULTS

Negative coping style significantly positively predicted fear of COVID-19, and stress had a significant mediating effect on the relationship between negative coping style and fear of COVID-19. In addition, rumination and stress had a chain-mediating effect on the relationship between negative coping style and fear of COVID-19. Perceived social support moderated the three paths of this serial mediation model.

CONCLUSION

Negative emotions, such as stress and fear of COVID-19, in college students are caused by both behavior (e.g., negative coping style) and cognition (e.g., rumination). Importantly, negative cognitive thinking (i.e., rumination) is often a malign consequence of a negative coping style. Thus, to improve students' mental health, students should be encouraged to engage in more positive behaviors and seek social support during periods of adherence to regular prevention and control measures.

The impact of stress and coping strategies on life satisfaction in a national sample of adolescents: A structural equation modelling approach

Although stress strongly predicts life satisfaction, the psychosocial mechanisms underlying this association remain unclear. To investigate the possible mediating role of coping, we conducted a cross-sectional study that assessed youths' life stress levels, propensity to engage in three different coping styles (i.e., active coping, internal coping, & withdrawal), ​and life satisfaction in a probabilistic, two-stage stratified cluster sample of 1830 high school seniors (986 females; age range: 17-22 years old) from 26 schools in or around the four largest cities in Croatia. We used correlational analyses and structural equation modelling to test the hypothesis that coping mediates the relation between stress and life satisfaction. The tested model was marginally acceptable: χ²  = 1613.85, df = 177, p < 0.001, goodness-of-fit-index = 0.92, Comparative Fit Index = 0.91, Tucker-Lewis Index = 0.89, root mean square error of approximation = 0.067 (90% CI = 0.064 to 0.070), standardized root mean squared residual = 0.056. As hypothesized, stress was related to life satisfaction directly (βc' = -0.22, p < 0.01) but also indirectly (βab = -0.05, p < 0.01) by affecting youths' likelihood of engaging in withdrawal behaviours, such as avoiding problems, distracting, or using anger, alcohol, or drugs. The proportion of the total effect mediated by withdrawal was 19.4%. In contrast, neither active nor internal coping were significant mediators. Based on these results, we conclude that preventive and educational programs for enhancing youth mental health may benefit from reducing adolescents' stress levels and stress-related withdrawal behaviour, and by encouraging youth to use active coping strategies instead.

Stressful Experiences, Connection, and Depressive Symptoms Among Taiwanese Han and Indigenous Youth

This study examined Taiwanese Han and indigenous (Tayal) youth’s experiences of stressful life events, the association between stressful experiences and depressive symptomology, and also the indirect and interactive effects of connection on the relationship between stressful experiences and depressive symptomology. Taiwanese Han (97%) is the majority group, whereas indigenous people make up 2.3% of Taiwan’s population. Taiwanese indigenous people have experienced disparities across socio-historical, educational, and economic aspects of their lives. This study included 291 eighth-grade participants (40% from the Tayal tribe, 48.8% female, and M_age = 13.44). The Han sample in this study all lived in cities, and the Tayal sample all lived in the tribal areas of the Northern Taiwan mountain regions. Person-centered (latent class analyses) and cumulative (sum of items) approaches were used to investigate family and school stressful events, respectively. Hierarchical regression analyses were conducted separately for the Han and Tayal participants to examine the role of family and school connection in relation to family and school stressors and depressive symptomology. Our results showed that stressful experiences are clearly linked to depressive symptomology and family connection was important to both Tayal and Han youth in supporting their coping with depressive symptoms. However, Tayal youth might be particularly vulnerable to family stressful events because family stressors disrupted their connection with their parents and thereby minimized the protective function of family relationships. To decrease the likely onset of depression during early adolescence, our results suggest that it is important for parents and other family members to monitor adolescents’ daily experiences of stress and provide support when needed. Furthermore, mental health interventions need to be tailored specifically for youth in specific racial, social, and economic contexts. Tayal youth mental health might benefit particularly from increasing school connection and decreasing stresses experienced in family contexts. Implications, limitations, and recommendations for future research are discussed.

Fear, Stress, Resilience and Coping Strategies during COVID-19 in Spanish University Students

COVID-19 (2019 coronavirus pandemic) and the resulting confinement has had an impact on mental health and the educational environment, affecting the stress, concerns, fear, and life quality of the university population. This study aimed to examine the correlation between fear of COVID-19, stress with COVID-19, and technological stress in university students, and their resilience, self-esteem, and coping strategies. The final sample comprised 180 Spanish university students, with an average age of 20.76 years (SD = 4.59). The above-mentioned effects were administered a series of self-report scales. We found statistically significant associations between fear of COVID-19 and stress with COVID-19, technological stress (total score), overload, and complexity (subdimensions of technological stress). Likewise, we found inverse relationships between the students’ fear of COVID-19 and the use of the coping strategy, cognitive restructuring. Ascertaining the factors that influence the coping strategies of undergraduate university students and their fears, psychological stress, and resilience provides valuable information for the development of educational interventions. This research has relevant implications for the diagnosis, orientation, and design of psycho-educational and clinical interventions that can improve students’ well-being and training for effective coping strategies for daily stress and this pandemic situation.

A Cross-National Validation of the Shortened Version of the Adolescent Stress Questionnaire (ASQ-S) Among Adolescents From Switzerland, Germany, and Greece

The experience of stress is receiving increasing attention in the context of adolescent mental health, which is why a valid and reliable stress assessment instrument is of great importance. For this purpose, an English-language adolescent stress questionnaire (ASQ) was developed, which assesses the subjective stress experience of adolescents in different areas of life (e.g., at home, at school, and during leisure time). However, the latest long version of the questionnaire with 56 items (ASQ-2) was found to be too extensive, so a more economical short version ASQ-S with 27 items was developed. The aim of this study was to validate a German and a Greek version of the ASQ-S. In order to investigate the psychometric properties of the German and Greek ASQ-S confirmatory factor analysis, analyses of variance and correlations were applied to sample data from Switzerland, Germany, and Greece (N = 1,071 seventh-grade students; M age = 12.53; SD = 0.76). The results yielded only poor to moderate internal reliability across all three countries and the suggested 9-dimensional factor structure could not be confirmed. Instead, a modified 6-factor structure was tested which showed acceptable model fits while demonstrating form invariance across the three countries. Furthermore, the ASQ-S scales correlated positively with depressive symptoms and anxiety and negatively with self-esteem and life satisfaction, all of which supported adequate concurrent validity. The results revealed that the utility of the ASQ-S appears to be limited when translated to other languages and should be used with caution when administered in international contexts.

Health-related quality of life among survivors in minority area 2 years after Jiuzhaigou earthquake: A cross-sectional study

To investigate the health-related quality of life (HRQoL) and related factors, the symptoms of posttraumatic stress disorder (PTSD) among earthquake survivors in minority area 2 years after Jiuzhaigou earthquake.Two years after the Jiuzhaigou earthquake, a cross-sectional survey was conducted by a multi-stage sampling approach. HRQoL was measured by the short form 12 (SF-12), PTSD was measured by the PTSD Check List-Civilian Version (PCL-C), and social support was measured by the Multidimensional Scale of Perceived Social Support. Descriptive statistics, t-tests, ANOVA and multiple linear regression analysis were used for data analysis.Of the 561 participants, the mean scores on the physical component summary (PCS) and mental component summary (MCS) were 46.36 ± 12.79 and 55.03 ± 8.73, and 5.73% reported the symptoms of PTSD. Lower PCS and MCS after an earthquake were associated with elderly age, physical illness, and low level of social support (P < .05). Meanwhile, PTSD was significantly associated with MCS.These findings showed that physical disease and psychological symptoms can adversely affect the HRQoL of survivors. Moreover, providing higher social support to survivors should be considered as a way to improve the HRQoL outcomes of survivors.

Resilience and mental health among juveniles: role of strategies for coping with stress

BACKGROUND

Mental health is an important aspect of the process of individual adaptation and development. The present study analysed the role played by resilience in mental health while taking into account both positive and negative indicators among juveniles. The aim of the first study (Study 1) is to analyse the relationship between resilience and the broadly understood mental health of juveniles admitted to youth education centres. Study 2 aimed to understand the direct and indirect role of resilience in shaping the mental health of juveniles. In the model we tested, we looked at the relationship among resilience, coping strategies, and mental well-being.

METHODS

The first study involved 201 juveniles, and the second involved 253 juveniles. Resilience was measured by the Resilience Scale-14. Coping strategies were measured with the Brief-COPE Questionnaire, and information on mental health was obtained using the Kutcher Adolescent Depression Scale, the Satisfaction with Life Scale and the Warwick-Edinburgh Mental Well-being Scale.

RESULTS

The results of both studies have shown that resilience is an important predictor of the mental health of juveniles, primarily with respect to its positive indicator. The stronger the severity of resilience, the greater the satisfaction with life and mental well-being of the juveniles surveyed. In addition, two coping strategies (seeking support from others and coping through emotions) mediated the relationship between resilience and mental well-being.

CONCLUSIONS

The results obtained indicate that work at the level of juvenile resilience leads to the strengthening of positive mental health indicators and buffering of negative indicators.

Gender differences in the experience of psychotic-like experiences and their associated factors: A study of adolescents from the general population

"Psychotic-Like Experiences" (PLEs) are common in the general population. While they are usually transient and resolve spontaneously, they can be distressing and signify increased risk for later psychosis or other psychopathology. It is important to investigate factors associated with PLEs which could be targeted to reduce their prevalence and impact. Males and females are known to experience PLEs differently, but any gender differences in the relationships between PLEs and other, potentially targetable, factors are currently unknown. 302 adolescents (175 females, mean age = 16.03, SD = 0.75; 127 males, mean age = 16.09, SD = 0.74) from secondary schools in the West Midlands region of the UK completed baseline self-report measures of positive PLEs, measured by the Community Assessment of Psychic Experiences (CAPE-P), and several potentially related factors including: cannabis use, perceived stress, anxiety, depression, and daily hassles. PLEs were common in this sample, with 67.5% of individuals experiencing at least one CAPE-P item 'often' or 'almost always'. Females reported significantly higher levels of PLEs, and associated distress, than males. Anxiety, depressive, and stress symptoms were similarly associated with PLEs in both genders. However, there was a significant interaction of gender and daily hassles in the association with PLEs. In summary, there were significant gender differences in the experience of PLEs in this sample. Although daily hassles were more common in females, they had a significantly stronger association with PLEs in males. Thus, addressing "daily life stress" in adolescents may require tailoring towards the more emotional perception of stress in females, and towards everyday life hassles in males.

Coping style predicts sense of security and mediates the relationship between autistic traits and social anxiety: Moderation by a polymorphism of the FKBP5 gene

The mechanism underlying the relationship between autistic traits and social anxiety still remains unknown. It is therefore necessary to investigate potential psychological and biological mechanisms. A total of 2695 college students were samples for this research during 2017-2018. The assessed variables included demographic characteristics and measures of autistic traits, sense of security, coping styles, and social anxiety. Blood samples were collected from which DNA was extracted. Regression analysis indicated that autistic traits and negative coping were positively associated with social anxiety; furthermore, positive coping, interpersonal security, and sense of control were negatively associated with social anxiety. Further analyses demonstrated that the relationship between autistic traits and social anxiety was mediated by coping styles (both positive coping and negative coping) and sense of security (both interpersonal security and sense of control), and coping style predicted the sense of security. The FK506 binding protein 5 (FKBP5) gene rs3800373 moderated the association between autistic traits and social anxiety. The present study is the first to demonstrate that both coping style and sense of security play an intermediate role between autistic traits and social anxiety in a sample of Chinese college students; moreover, the FKBP5 gene moderates this association between autistic traits and social anxiety.

Individual Differences in Adolescent Coping: Comparing a Community Sample and a Low-SES Sample to Understand Coping in Context

Coping that is adaptive in low-stress environments can be ineffective or detrimental in the context of poverty. Identifying coping profiles among adolescents facing varying levels of stress can increase understanding of when and for whom coping may be most adaptive. The present study applied latent profile analysis (LPA) to identify coping profiles in two distinct samples of adolescents: a community sample of youth aged 11–16 years (N = 374, M_age = 13.14, 53% girls), and a low-SES sample of youth aged 12–18 years (N = 304, M_age = 14.56, 55% girls). The ten coping subscales of the Responses to Stress Questionnaire were included as indicators in the LPAs (problem solving, emotion regulation, emotion expression, acceptance, positive thinking, cognitive restructuring, distraction, denial, wishful thinking, and avoidance). Five profiles were identified in the community sample: Inactive, Low Engagement, Cognitive, Engaged, and Active Copers. All but the Low Engagement Copers profile were also identified in the low-SES sample, suggesting that adolescents employ similar coping strategies across contexts, but fewer low-SES adolescents engage in lower levels of coping. Profiles differed by gender and symptoms of internalizing psychopathology. Inactive copers in both samples were more likely to be male. Engaged Copers reported the lowest symptom levels whereas Active Copers reported higher symptoms. Cognitive Copers reported higher levels of anxious and depressive symptoms in the low-SES sample only, suggesting that this pattern of coping may be protective only in less stressful contexts. Elucidating within-person coping patterns is a promising avenue for targeting interventions to those most likely to benefit.

The social withdrawal and social anxiety feedback loop and the role of peer victimization and acceptance in the pathways

Social withdrawal and social anxiety are believed to have a bidirectional influence on one another, but it is unknown if their relationship is bidirectional, especially within person, and if peer experiences influence this relationship. We investigated temporal sequencing and the strength of effects between social withdrawal and social anxiety, and the roles of peer victimization and acceptance in the pathways. Participants were 2,772 adolescents from the population-based and clinically referred cohorts of the Tracking Adolescents' Individual Lives Survey. Self- and parent-reported withdrawal, and self-reported social anxiety, peer victimization, and perceived peer acceptance were assessed at 11, 13, and 16 years. Random-intercept cross-lagged panel models were used to investigate within-person associations between these variables. There was no feedback loop between withdrawal and social anxiety. Social withdrawal did not predict social anxiety at any age. Social anxiety at 11 years predicted increased self-reported withdrawal at 13 years. Negative peer experiences predicted increased self- and parent-reported withdrawal at 13 years and increased parent-reported withdrawal at 16 years. In turn, self-reported withdrawal at 13 years predicted negative peer experiences at 16 years. In conclusion, adolescents became more withdrawn when they became more socially anxious or experienced greater peer problems, and increasing withdrawal predicted greater victimization and lower acceptance.

Negative Life Events as Predictors of Anxiety Outcomes: An Examination of Event Type

Long-term follow-up studies of anxiety treatment have found that greater exposure to negative life events (NLEs) predicts poorer anxiety outcomes, but none have examined whether specific types of NLEs are differentially associated with child outcomes. This study examined the frequency of NLEs and whether specific types of NLEs were associated with increased risk of having an anxiety disorder 6.5 years post randomization. Participants were 319 adolescents and adults, ages 11 to 26 (M = 17), enrolled in Child/Adolescent Anxiety Multimodal Extended Long-term Study. At their first follow-up visit, participants completed a diagnostic interview and a 40-item Life Events Scale that reflected whether specific events occurred since their last post treatment assessment. Life events were categorized into domains (i.e., family, academic, health, and social) via researcher consensus. Participants reported having experienced an average of four NLEs. Participants with an anxiety disorder at follow-up were significantly more likely to have failed a grade in school (OR = 5.9) and experienced a negative change in acceptance by peers (OR = 4.9; ps < 0.001). After controlling for gender, age, race, and SES, a greater number of NLEs in the academic domain increased the odds of having an anxiety disorder at follow-up (OR = 2.4, p < 0.001). No other domains were predictive of disorder status at follow-up. Findings highlight the value of examining specific NLEs in relation to the long-term child anxiety outcomes.

Neural mechanisms of acute stress and trait anxiety in adolescents

Adolescence is a critical period of heightened stress sensitivity and elevated vulnerability for developing mental illness, suggesting a possible association between stress exposure and the etiology of psychiatric disorders. In adults, aberrant neurobiological responses to acute stress relate to anxiety symptoms, yet less is known about the neural stress response in adolescents and how it relates to biological and psychological variables. Here we characterize the neurobiology of stress response in adolescents using multiple modalities, including neuroimaging, subjective stress ratings, heart rate, and cortisol data. We evaluated stress response in adolescents using the Montreal Imaging Stress Task (MIST), an acute psychosocial stressor commonly administered in adult functional magnetic resonance imaging (fMRI) studies but not previously utilized with this population. FMRI data were acquired from 101 adolescents (44 female; 9-16 years) exhibiting varied trait anxiety severity. The MIST elicited decreased high-frequency heart rate variability and increased heart rate, subjective stress and cortisol. Whole-brain analyses comparing fMRI activity during experimental versus control MIST conditions revealed stress-related activation in regions including the anterior insula, dorsal anterior cingulate cortex, and dorsolateral prefrontal cortex and deactivations in the hippocampus, ventral striatum, and putamen. Region of Interest analyses found that during acute stress (a) hippocampal deactivation corresponded to heightened cortisol release, (b) trait anxiety was associated with increased hippocampal and ventral striatum activation and decreased putamen activity, and (c) males exhibited greater putamen deactivation than females. These results provide novel evidence that the MIST is an effective stressor for adolescents. Associations between the neural acute stress response, other biological factors, and trait anxiety highlight the importance of these neurobiological mechanisms in understanding anxiety disorders.

A Dynamic Examination of the Associations between Shyness, Psychological Difficulties, and Stressful Life Events during Early Adolescence

Although numerous studies have established linkages between shyness and later psychological difficulties, most extant research did not examine variation in shyness over time in relation to variation in psychological difficulties over time or possible environmental factors of influence outside of the school context. The current study used multi-level modelling to simultaneously examine time-invariant and time-variant associations between shyness, the psychological difficulties of depressive symptoms and loneliness, and stressful life events at four waves across 1 year in a community sample of 271 young adolescents (51% boys; M_age = 11.83 years at W1). Results revealed significant time-variant and time-invariant effects when loneliness was examined as a predictor of shyness. In addition, a significant interaction effect indicated that shyness decreased over time for those young adolescents who experienced few stressful life events, highlighting an understudied moderator of risk. Overall, findings have important implications for understanding the psychological concomitants of shyness as well as etiological models of shyness.

Neurotizismus, Stressverarbeitung und Lebensqualität bei Jugendlichen

Zusammenfassung. Theoretischer Hintergrund: Persönlichkeitsmerkmale und Stressverarbeitungskompetenzen haben eine große Bedeutung in der psychosozialen Anpassung an belastende Situationen von Jugendlichen. Fragestellung: Diese Studie untersuchte den vermittelnden Effekt der Stressverarbeitung auf die Beziehung zwischen Neurotizismus und gesundheitsbezogener Lebensqualität unter Kontrolle des Geschlechts und Herkunftslandes. Methode: Es wurden vier einfache Mediationsanalysen mit den Kovariaten „Geschlecht“ und „Herkunftsland“ über N = 176 Siebtklässler aus Deutschland und Österreich durchgeführt. Ergebnisse: Die problembezogene Bewältigung vermittelte den ungünstigen Einfluss des Neurotizismus auf die eltern- und schulbezogene Lebensqualität. Die ungünstige Stressverarbeitung vermittelte lediglich zwischen Neurotizismus und schulbezogener, nicht aber elternbezogener Lebensqualität. Schlussfolgerung: Die Befunde unterstützen die Notwendigkeit zielgruppenspezifischer Gesundheitsförderprogramme zur Steigerung der Stressverarbeitungskompetenzen bereits im Grundschulalter. Hierbei deutete sich ein besonderer Bedarf bei Mädchen im Jugendalter an.

Internalizing and Externalizing Behaviors among Ukrainian Children: The Role of Family Communication and Maternal Coping

OBJECTIVES

This study aims to explore the relationship of mother's ways of coping with stress and family communication with the child internalizing and externalizing behaviors in Ukraine.

METHODS

In a cross-sectional sample of 294 mother-and-child (9-16 years of age) Ukrainian dyads, mothers answered questions from the revised Ways of Coping Checklist, FACES Family Communication scale, Child Behavior Checklist, and questions about their sociodemographic characteristics.

RESULTS

Robust regression results suggest increased internalizing behaviors were statistically associated with poor family communication (b = -.19, 95% CI [-.30, -.08], p<.01), maternal coping by accepting responsibility (b = 2.14, 95% CI [.44, 3.84], p<0.05), escape-avoidance (b = 3.79, 95% CI [1.00, 6.58], p<0.01), planful problem solving (b=2.80, 95% CI [.61, 4.99], p<0.05), child female gender (b = -2.53, 95% CI [-4.22, -.83], p<.01) and lower family income (b = -.003, 95% CI [-.006, -.0001], p<.01). Increased child externalizing behaviors were statistically associated with maternal seeking social support (b = 3.25, 95% CI [1.06, 5.43], p<.01), decreased positive reappraisal (b = -1.52, 95% CI [-2.91, -.12], p <.05), maternal unemployment (b = -2.80, 95% CI [-5.30, -.30], p<.05), poor family communication (b = .46, 95% CI [-.59, -.34], p<.001), and child male gender (b = 3.48, 95%CI [1.53, 5.44], p<.01). Poor family communication was linked with significantly higher increase in internalizing behaviors for girls compared to boys (b = .17, 95% CI [.03, .32], p<.05).

CONCLUSIONS

When examining child internalizing and externalizing behaviors it is important to consider the role of family communication and maternal coping.

Influence of coping, self-esteem and social support on undergraduate students’ emotional distress

Purpose

Emotional distress, which includes stress, anxiety and depression, is considered a substantial mental health problem among university students because of its effects on academic achievement and well-being. The purpose of this paper is to examine levels of emotional distress, self-esteem, social support and coping methods and predicted emotional distress in undergraduate students across year levels in two semesters.

Design/methodology/approach

A cross-sectional study was conducted in a regional university with 117 and 118 students, respectively, the majority of whom were from the Faculty of Science. Announcements posted on the university website in two semesters were used to recruit convenience samples of participants who completed a battery of four self-administered questionnaires online.

Findings

Findings showed significant differences across year levels for emotional distress total (F(2, 107)=3.90,p=0.02), and social support total (F(2, 107)=3.57,p=0.03), especially in semester 1. Almost all maladaptive coping approaches led to risk of heightened emotional distress in both semester cohorts, ranging from using self-distraction (adjusted OR=4.54) to denial (adjusted OR=32.05). Interestingly, the use of active coping and high self-esteem appeared as risk factors rather than protective factors for mental distress, adjusted ORs=11.27 and 8.46, respectively.

Originality/value

Although adaptive coping skills did not alleviate students’ mental distress, encouraging students to use adaptive coping and social support may help students face the challenges of university life.

Reasons for Living and Coping with Suicidal Ideation among Adolescents in Malaysia

Introduction

The rate of suicide ideation everywhere continues to increase, and adolescents are therefore at risk of displaying suicidal behaviour. This study examined the protective role of the reasons for living and coping strategies in reducing suicidal ideation among young adolescents in Malaysia.

Methods

A cross-sectional survey was conducted among 176 adolescents aged between 13 and 19 years of age with the majority being Malay and Muslim. The Brief Reasons for Living for Adolescents (BRFL-A), Jalowiec Coping Scale and Suicide Ideation Scale were employed.

Results

The results showed that the reasons for living and palliative coping strategy correlated negatively with suicide ideation; although, further analysis using multiple regression revealed that family alliance and optimistic and palliative coping strategies were found to be significant reasons for living that protect adolescents from suicidal thoughts. Also, those adolescents who used emotive and evasive coping strategies had higher suicidal ideation.

Conclusion

Cultural and social values continue to play an important role in protecting adolescents in Malaysia from suicidal behaviour.

Posttraumatic stress disorder and emotion dysregulation among Syrian refugee children and adolescents resettled in Lebanon and Jordan

BACKGROUND

Since the outbreak of the conflict in Syria, many people, including children and adolescents, have fled their homes into neighboring countries. Little research exists on the psychosocial adjustment of refugee children and adolescents resettled in Lebanon and Jordan.

OBJECTIVE

This study investigated the prevalence and predictors of PTSD and emotion dysregulation in Syrian refugee children and adolescents who resettled in Lebanon and Jordan. It was hypothesized that a combination of pre-trauma variables (age and gender), trauma-specific variables (traumatic events and time spent in host country, and host country), and post-trauma variables (coping strategies, family relationships, and school environment) would be associated with PTSD and emotion dysregulation.

PARTICIPANTS AND SETTING

Participants were 1000 Syrian refugee children and adolescents aged 7-18 years attending formal and non-formal schools representing various governorates in Lebanon and Jordan.

METHODS

The trauma exposure scale, DSM-IV criteria for the assessment of PTSD, the Difficulties in Emotion Regulation Scale Short Form, Kidcope, Family relationship scales, and school environment scale were administered in an interview format with children and adolescents at school by two trained psychologists. Multivariate binary logistic regression was used to predict PTSD whereas hierarchical multiple regression was used to predict emotion dysregulation.

RESULTS

Results indicated that 45.6% of the refugees have developed PTSD with excessive risk for comorbidity with emotion dysregulation. Emotion dysregulation was reported by older refugee children and adolescents. The prevalence of PTSD was higher in refugee children and adolescents who had resettled in Lebanon than for those who had resettled in Jordan. Refugee children and adolescents who were exposed to higher levels of war atrocities evidenced the greatest prevalence of PTSD and emotion dysregulation. PTSD symptomatology and emotion dysregulation in children and adolescents varied according to coping styles, family relationships, and school environment. Both decreased significantly with the passage of time spent in host country.

CONCLUSIONS

The results may be used to formulate cognitive-behavioral coping interventions that can lead to optimal developmental outcomes in the posttrauma environment.

Influencia del sexo, edad y cultura en las estrategias de afrontamiento de adolescentes paraguayos y mexicanos

La adolescencia es un periodo sensible al estrés, sin embargo, el afrontamiento puede contribuir a una adaptación positiva, el cual tiende a cambiar en función de algunas variables personales como el sexo, la edad y contextuales, como la cultura. El objetivo de este trabajo fue analizar la influencia del sexo, edad y cultura en las estrategias de afrontamiento con adolescentes paraguayos y mexicanos. Se realizó un estudio de campo transversal, expos-facto, de tipo comparativo de dos muestras independientes con un diseño 2 x 2 x 2. Participaron de manera intencional 2278 adolescentes escolares paraguayos (n = 1188) y mexicanos (n = 1090), de 13 a 18 años (M = 15.15; DE = 1.48). Se aplicó la Escala de Afrontamiento para Adolescentes (ACS) que evalúa tres estilos y 18 estrategias de afrontamiento, y una cédula sociodemográfica. Se encontraron diferencias y efectos principales por edad y país en los estilos de afrontamiento productivo, no productivo y con referencia a otros y en algunas de sus estrategias. Las mujeres usan más estrategias de afrontamiento, muchas relacionadas con la búsqueda de apoyo social. Los adolescentes tempranos paraguayos y mexicanos tienden a presentar menos estrategias productivas. Solo se observaron efectos de interacción del sexo y la cultura en los estilos de afrontamiento. Estos datos aportan evidencia que podría ser útil para las políticas públicas de prevención y promoción de salud en adolescentes.

Effects of self-esteem and stress on self-assessed health: a Swiss study from adolescence to early adulthood

PURPOSE

A large literature shows important effects of self-esteem and stress on mental and physical health in young adulthood. Negative life events are one type of stressor associated with poor health, but it is less clear whether more neutral stressors are also associated with poor health. This study contributes to the existing literature by investigating the association between different types of stressful life events, self-esteem, and health during the transition from adolescence to early adulthood in Switzerland.

METHODS

We draw on the "Transitions from Education to Employment" (TREE) panel study, a nationally representative longitudinal survey of a cohort of Swiss young adults, using logistic regression analysis. The study includes eight waves over a 10-year period, from 2001, average age 16, to 2010, average age 26. Our dependent variable is a dichotomized health self-assessment, and key independent variables include self-esteem and three measures of cumulative significant life events (SLEs): total cumulative SLEs, cumulative negative SLEs, and cumulative neutral SLEs.

RESULTS

Self-esteem had a significant positive impact on health, whereas cumulative SLEs had a significant negative impact. Negative SLEs had a larger negative impact than total SLEs, and neutral SLEs had a smaller impact. Considered individually, negative SLEs were more likely to have a significant negative impact on health.

CONCLUSIONS

In addition to their known influence on mental health, stress and self-esteem are important factors influencing individuals' general health, even in adolescence and young adulthood. While all types of stressors have a negative impact on health, the negative stressors seem to have more prominent effects than neutral stressors.

Desired Features of a Digital Technology Tool for Self-Management of Well-Being in a Nonclinical Sample of Young People: Qualitative Study

BACKGROUND

Adaptive coping behaviors can improve well-being for young people experiencing life stressors, while maladaptive coping can increase vulnerability to mental health problems in youth and into adulthood. Young people could potentially benefit from the use of digital technology tools to enhance their coping skills and overcome barriers in help-seeking behaviors. However, little is known about the desired digital technology use for self-management of well-being among young people in the general population.

OBJECTIVE

This is a small, qualitative study aimed at exploring what young people desire from digital technology tools for the self-management of their well-being.

METHODS

Young people aged 12-18 years were recruited from the general community to take part in semistructured interviews. Recorded data from the interviews were transcribed and analyzed using inductive thematic analysis.

RESULTS

In total, 14 participants were recruited and completed the study, with a mean age of 14.6 years (female n=3). None of the participants reported using any digital tools specifically designed to manage well-being. However, as indicated through the emerged themes, young people used digital technology to reduce their stress levels and manage their mood, mainly through games, music, and videos. Overall, identified themes showed that young people were keen on using such tools and desired certain facets and features of an ideal tool for self-management of well-being. Themes related to these facets indicated what young people felt a tool should do to improve well-being, including being immersed in a stress-free environment, being uplifting, and that such a tool would direct them to resources based on their needs. The feature-based themes suggested that young people wanted the tool to be flexible and enable engagement with others while also being sensitive to privacy.

CONCLUSIONS

The young people interviewed in this study did not report engaging with digital technology specialized to improving well-being but instead used media already accessed in their daily lives in order to self-manage their psychological states. As a result, the variety of coping strategies reported and digital tools used was limited to the resources that were already being used for recreational and social purposes. These findings contribute to the scarce research into young people's preferred use of digital technology tools for the self-management of their well-being. However, this was a small-scale study and the current participant sample is not representative of the general youth population. Therefore, the results are only tentative and warrant further investigation.

Emergency department text messaging for adolescent violence and depression prevention: A pilot randomized controlled trial

This study's purpose was to evaluate feasibility and acceptability, obtain preliminary efficacy data, and evaluate predictors of improvement with iDOVE, a technology-augmented violence and depression prevention intervention for high-risk adolescents seen in the emergency department (ED). We conducted a pilot randomized controlled trial (RCT) with 116 English-speaking adolescents (ages 13-17 years), presenting to the ED for any reason, who reported past-year physical peer violence and current depressive symptoms. The cognitive-behavioral therapy- and motivational interviewing-based intervention consisted of a brief in-ED intervention session and 8 weeks of automated text-message daily mood queries and tailored responses. The control was a brief in-ED presentation and twice-weekly text messages on healthy behaviors. Follow-up was conducted at 8 and 16 weeks. Descriptive statistics, bivariate comparisons, mixed-effects longitudinal regression models, and latent class models (LCMs) were calculated. iDOVE had high acceptability and feasibility, with 86% of eligible youth consenting (n = 116), 95% completing 8-week follow-up, and 91% completing 16-week follow-up. High quantitative and qualitative satisfaction were reported by intervention and control participants. Comparing intervention to control, improved depressive symptoms (p = .07) and physical peer violence (p = .01) were observed among the more symptomatic youth in the intervention group (but no difference in symptoms between full intervention and control groups). LCMs showed that intervention responsiveness correlated with lower mood (measured through daily text messages) at Day 7 of the intervention. This RCT of a technology-augmented intervention shows high feasibility and acceptability and a promising signal of reduced violence among the highest-risk participants. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A senior high school-based survey on the long-term impact of the Wenchuan earthquake on survivors' quality of life: PTSD as a mediator

Previous earthquake-related studies mostly focused on the prevalence and risk factors of post-traumatic stress disorder (PTSD), and there are only a few articles on the subsequent long-term outcomes of earthquakes. This study aimed to investigate the long-term impact of the Wenchuan earthquake on the quality of life (QOL) of surviving senior high school students 2-3 years post-disaster and to clarify whether PTSD was a mediator in the relationship of earthquake-related exposure and QOL. The study collected 1031 survivors' self-report questionnaires on socio-demographic data, earthquake-related experiences, PTSD symptoms (PCL-C), and QOL (WHOQOL-BREF). The results showed that earthquake-related exposure experiences were negatively associated with QOL scores, and the severity of PTSD symptoms was significantly and negatively related to QOL scores. Structural equation model (SEM) analysis showed that earthquake-related exposure was directly related to the severity of PTSD symptoms, while insignificantly directly related to QOL. Therefore, earthquake-related exposure was indirectly related to QOL (totally mediated by severity of PTSD symptoms). PTSD was a mediator in the relationship between earthquake-related exposure and QOL among adolescents: earthquake-related exposure affected the survivors' QOL mainly mediated by the PTSD symptoms that developed. Therefore, to improve the QOL of the survivors after an earthquake, more attention should be paid to survivors who have PTSD symptoms.

[Cluster-randomized, controlled evaluation of stress management training for high school students]

Cluster-randomized, controlled evaluation of stress management training for high school students Abstract.

OBJECTIVE

One fifth of German adolescents show elevated levels of mental health problems. The development of mental health problems is often closely related to experiences of stress. Hence, fostering competences in coping with stress offers an approach for counteracting the development of psychological problems. The aim of the present study is to test a stress management training of 3 x 90 minutes in a German high school, 11^th grade.

METHOD

A cluster-randomized, controlled design was used. The primary outcome was stress. Secondary outcome criteria were knowledge about stress, coping behaviour, emotional and behavioural problems as well as health-related quality of life. Students from twenty-one courses from four schools participated in the study.

RESULTS

The sample comprised 286 students (58.25 % girls; mean age 16.58 ± 0.65). Changes in stress levels from pre- to post-evaluation did not differ significantly between intervention and control group. With regard to secondary criteria, apart from a significant increase in knowledge no further effects were observed. An exploratory moderation analysis hints at a positive association between baseline levels of stress and effectiveness of the training.

CONCLUSIONS

The results question whether the universal application of a brief cognitive behavioural intervention is appropriate to prevent stress in this population. Future research should, inter alia, investigate the potential of indicated prevention regarding stress.

Emotional Health Among Youth Experiencing Family Homelessness

BACKGROUND AND OBJECTIVES

Youth who are homeless with adult family members comprise 37% of the US homeless population, yet mental health among this group has not yet been well described. We aimed to compare the risk of suicidality, and factors that may protect against it, between family-homeless and nonhomeless youth.

METHODS

We used cross-sectional data, representing 62 034 eighth- to 12th-graders, to estimate the adjusted odds ratio (aOR) of emotional distress, self-injury, suicidal ideation, and attempted suicide in the past 12 months for youth who experienced family homelessness in the past 12 months compared with housed youth, controlling for covariates. We then tested whether developmental assets moderated these outcomes.

RESULTS

Four percent (n = 4594) of youth (mean age 14.9 years) were homeless with an adult family member. Among these, 29.1% (n = 1317; aOR: 2.52, 95% confidence interval [CI] 2.34-2.69) reported self-injury, 21% (n = 940; aOR: 2.30, 95% CI: 2.14-2.48) reported suicidal ideation, and 9.3% (n = 416; aOR: 3.24, 95% CI: 2.91-3.60) reported suicide attempts. Developmental assets decreased the odds of these outcomes for all youth but were less protective for homeless youth.

CONCLUSIONS

Youth experiencing recent family homelessness are at higher risk of suicidality than their nonhomeless peers, suggesting homelessness itself as a marker of risk. Factors that protect emotional health are less impactful among youth experiencing recent family homelessness. Thus, interventions among homeless youth may need to address social determinants of health such as stable housing and adversity in addition to developmental assets.

Coping with stress in adolescents with self-harm and suicidal behavior

The paper presents the results of the study of coping specifics in adolescents at risk of self-injurious and suicidal behavior (N=174). We hypothesized that profiles of coping depended on the types of actual stress. We took into consideration the following types of stressful circumstances: parental divorce, death of relatives or loved ones, conflict with parents, serious somatic disease, academic failure and school problems, unrequited love, other, no actual stress. We discovered both common and stress-specific coping strategies. One of the common coping strategies is avoidance that is used more often in all stressful situations. Moreover, the sample was distinguished by increasing low-level strategies, rather than decreasing high-level strategies (such as planning or reappraisal). Applications to prevention measures are discussed.

Geschlechts- und situationsspezifische Stressverarbeitung und Lebensqualität bei Kindern und Jugendlichen

Zusammenfassung. In der vorliegenden Studie sollten insbesondere die wenigen Befunde zum alleinigen Einfluss der Art der Belastungssituation und dessen kombinierte Einflüsse mit dem Geschlecht auf die Stressverarbeitung erweitert werden. Hierfür bearbeiteten N = 1 087 Kinder und Jugendliche im Alter zwischen 7 und 16 Jahren den Stressverarbeitungsfragebogen für Kinder und Jugendliche (SVF-KJ). Darüber hinaus wurde die Vorhersagekraft der situationsspezifischen Stressverarbeitung auf die gesundheitsbezogene Lebensqualität an einer Teilstichprobe von N = 442 Kindern und Jugendlichen zwischen 9 und 16 Jahren untersucht. Die alleinigen Situationseinflüsse sprechen für erhöhte Ausprägungen in der Ablenkung, Situationskontrolle und Aggression für soziale Belastungssituationen. Mädchen verarbeiteten vor allem soziale Belastungssituationen ungünstig. Die Stressverarbeitung konnte die gesundheitsbezogene Lebensqualität unter Kontrolle des Alters, Geschlechts, chronischer Erkrankungen und der psychischen Stressreaktivität signifikant vorhersagen. Die Befunde unterstützen erneut, geschlechtssensible, altersangepasste Gesundheitsförderprogramme im Kindes- und Jugendalter zu implementieren, die insbesondere die Bagatellisierung, positiven Selbstinstruktionen, Vermeidung und Resignation modifizieren sollten.