Development and predictors of mental ill-health and wellbeing from childhood to adolescence

A review of information sources and analysis methods for data driven decision aids in child and adolescent mental health services

OBJECTIVE

Clinical data analysis relies on effective methods and appropriate data. Recognizing distinctive clinical services and service functions may lead to improved decision-making. Our first objective is to categorize analytical methods, data sources, and algorithms used in current research on information analysis and decision support in child and adolescent mental health services (CAMHS). Our secondary objective is to identify the potential for data analysis in different clinical services and functions in which data-driven decision aids can be useful.

MATERIALS AND METHODS

We searched related studies in Science Direct and PubMed from 2018 to 2023(Jun), and also in ACM (Association for Computing Machinery) Digital Library, DBLP (Database systems and Logic Programming), and Google Scholar from 2018 to 2021. We have reviewed 39 studies and extracted types of analytical methods, information content, and information sources for decision-making.

RESULTS

In order to compare studies, we developed a framework for characterizing health services, functions, and data features. Most data sets in reviewed studies were small, with a median of 1,176 patients and 46,503 record entries. Structured data was used for all studies except two that used textual clinical notes. Most studies used supervised classification and regression. Service and situation-specific data analysis dominated among the studies, only two studies used temporal, or process features from the patient data. This paper presents and summarizes the utility, but not quality, of the studies according to the care situations and care providers to identify service functions where data-driven decision aids may be relevant.

CONCLUSIONS

Frameworks identifying services, functions, and care processes are necessary for characterizing and comparing electronic health record (EHR) data analysis studies. The majority of studies use features related to diagnosis and assessment and correspondingly have utility for intervention planning and follow-up. Profiling the disease severity of referred patients is also an important application area.

Mediating mechanisms of the relationship between exposure to deprivation and threat during childhood and adolescent psychopathology: evidence from the Millennium Cohort Study

The key aim of our study was to examine pathways from exposure to childhood adversities (i.e., deprivation and threat) to adolescent psychopathology. The assessed mediating mechanisms included cognitive ability and emotion regulation, as proposed by the Dimensional Model of Adversity and Psychopathology (DMAP). The study comprised participants from the nationally representative Millennium Cohort Study. Latent scores for deprivation and threat were derived using confirmatory factor analysis from indicators collected when participants were at age of 9 months, 3 and 5 years. Cognitive ability was measured using the Verbal Similarities subscale of the British Ability Scales II at age 11, and emotion regulation was measured using emotion dysregulation subscale of the Child Social Behavioural Questionnaire at age 7. Psychopathology, defined as psychological distress, was assessed using the Kessler 6 scale at age 17. We conducted causal mediation analysis adjusting for multiple confounding factors. We did not find total effect of either exposure to deprivation or threat on psychological distress, but we did find significant indirect effects of exposure to deprivation on psychological distress via cognitive ability (- 0.11, 95% CI - 0.20 to - 0.05) and emotion regulation (0.03, 0.02 to 0.12), and exposure to threat on psychological distress via cognitive ability (- 0.04, - 0.07 to - 0.01) and emotion regulation (0.09, 0.03 to 0.15). The lack of associations between deprivation or threat and psychological distress may be due to reporting bias or developmental period of psychopathology. Results of mediation analysis partially support the DMAP but indicate limited benefits to reduce adolescent psychological distress by targeting cognitive ability or emotion regulation to those exposed to childhood adversities.

Experiences of Help-Seeking for Severe Mental Health Problems in Young Pakistani Women: A Preliminary Qualitative Study

Almost three quarters of mental illnesses start by the age of 25, yet youth (18-25-year-olds) are often underrepresented in U.K. services. This is particularly true for those of ethnic minorities. In this study, we aimed to understand how young Pakistani women and their parents make decisions to seek help for severe mental health problems, and the barriers and facilitators to accessing professional help. Young Pakistani women with experience of severe mental health problems and their parents were recruited from a community sample. Semi-structured interviews were conducted with six young people and two parents. Data were analyzed using reflexive thematic analysis. Pakistani culture and its interplay with British culture strongly influenced the decisions and ability of young Pakistani women and their parents to help-seek, largely through the role of stigma. Low mental health literacy, stigma, and a lack of culturally informed services were identified as the most common barriers to accessing care. These barriers fed into the internalized stigma these young women experienced which, through fear of damaged reputation and personal prejudices, posed further barriers to seeking help. Participants highlighted recommendations for both individual-level (e.g., increased education and awareness) and service-level (e.g., greater choice over care) change to facilitate accessibility of professional help. Young Pakistani women face multiple culturally related challenges to accessing care for severe mental health problems at both the individual- and service-level. Novel suggestions to address these challenges, such as including youth peer support workers in services, may facilitate more inclusive and accessible services.

Understanding Wellbeing Profiles According to White Matter Structural Connectivity Sub-types in Early Adolescents: The First Hundred Brains Cohort from the Longitudinal Adolescent Brain Study

Wellbeing is protective against the emergence of psychopathology. Neurobiological markers associated with mental wellbeing during adolescence are important to understand. Limited research has examined neural networks (white matter tracts) and mental wellbeing in early adolescence specifically. A cross-sectional diffusion tensor imaging analysis approach was conducted, from the Longitudinal Adolescent Brain study, First Hundred Brains cohort (N = 99; 46.5% female; Mage = 13.01, SD = 0.55). Participants completed self-report measures including wellbeing, quality-of-life, and psychological distress. Potential neurobiological profiles using fractional anisotropy, axial, and radial diffusivity were determined via a whole brain voxel-wise approach, and hierarchical cluster analysis of fractional anisotropy values, obtained from 21 major white matter tracts. Three cluster groups with significantly different neurobiological profiles were distinguished. No significant differences were found between the three cluster groups and measures of wellbeing, but two left lateralized significant associations between white matter tracts and wellbeing measures were found. These results provide preliminary evidence for potential neurobiological markers of mental health and wellbeing in early adolescence and should be tracked longitudinally to provide more detailed and robust findings.

Understanding How Youth Search for Mental Health Information Online: A Qualitative Descriptive Study

The objective of this study was to understand how youth search for mental health information online. Youth partners were engaged at the onset of the project and provided input throughout on the design, conduct and analysis. Individual, semi-structured interviews with Canadian youth with experience searching for mental health information online were conducted. Data collection and reflexive thematic analysis proceeded concurrently. Fourteen youth were interviewed. Four main themes related to how youth search online emerged: mind-set shapes the search process; external factors shape the search process; key attributes of helpful information; and cues affecting trustworthiness of online information. Findings can inform the development of youth-friendly online mental health information that is perceived as helpful and trustworthy by youth. Ensuring youth have access to quality online mental health information, accessible to how they search for it, is critical to the mental health and development of youth.

Mental Health and Well-being Measures for Mean Comparison and Screening in Adolescents: An Assessment of Unidimensionality and Sex and Age Measurement Invariance

Adolescence is a period of increased vulnerability for low well-being and mental health problems, particularly for girls and older adolescents. Accurate measurement via brief self-report is therefore vital to understanding prevalence, group trends, screening efforts, and response to intervention. We drew on data from the #BeeWell study (N = 37,149, aged 12-15) to consider whether sum-scoring, mean comparisons, and deployment for screening were likely to show bias for eight such measures. Evidence for unidimensionality, considering dynamic fit confirmatory factor models, exploratory graph analysis, and bifactor modeling, was found for five measures. Of these five, most showed a degree of non-invariance across sex and age likely incompatible with mean comparison. Effects on selection were minimal, except sensitivity was substantially lower in boys for the internalizing symptoms measure. Measure-specific insights are discussed, as are general issues highlighted by our analysis, such as item reversals and measurement invariance.

Bullying fosters interpersonal distrust and degrades adolescent mental health as predicted by Social Safety Theory

Social Safety Theory predicts that socially threatening experiences such as bullying degrade mental health partly by fostering the belief that others cannot be trusted. Here we tested this prediction by examining how peer bullying in childhood impacted adolescent mental health, and whether this effect was mediated by interpersonal distrust and several other commonly studied mediators-namely diet, sleep and physical activity-in 10,000 youth drawn from the UK's Millennium Cohort Study. Youth bullied in childhood developed more internalizing, externalizing and total mental health problems in late adolescence, and this effect was partially mediated by interpersonal distrust during middle adolescence. Indeed, adolescents who developed greater distrust were approximately 3.5 times more likely to subsequently experience clinically significant mental health problems than those who developed less distrust. Individual and school-based interventions aimed at reducing the negative impact of bullying on mental health may thus benefit from bolstering youths' sense of trust in others.

Gender, marginalised groups, and young people's mental health: a longitudinal analysis of trajectories

BACKGROUND

Individuals from marginalised groups experience higher levels of mental health difficulties and lower levels of wellbeing which may be due to the exposure to stress and adversity. This study explores trajectories of mental health over time for young women and girls and young people with other marginalised identities.

METHODS

We conducted a secondary analysis on N = 14,215 children and young people (7,501 or 52.8% female, 6,571 or 46.2% male, and 81 or 0.6% non-binary or questioning) who completed a survey at age 11 to 12 years and at least one other annual survey aged 12 to 13 years and/or aged 13 to 14 years. We used group-based trajectory models to examine mental health difficulties.

RESULTS

Except for behavioural difficulties, young women's and girls' trajectories showed that they consistently had higher levels of mental health difficulties compared to young men and boys. A similar pattern was shown for non-binary and questioning children and young people. Children and young people with economic disadvantage and/or special education needs, and/or for whom there were welfare concerns, were generally more likely to experience higher levels of mental health difficulties.

CONCLUSIONS

This information could inform public policy, guidance and interventions.

Current evidence and opportunities in child and adolescent public mental health: a research review

BACKGROUND

A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents.

METHODS

This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions.

RESULTS

In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements.

CONCLUSIONS

There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

Self-reported and parent-reported mental health in children from low-income families in Agder, Norway: results from baseline measurements of New Patterns project participants

BACKGROUND

Poverty may pose risks to child and adolescent mental health, but few studies have reported on this association among children and adolescents in low-income families in Norway.

METHODS

Based on a sample participating in an intervention for low-income families in Norway, we report data from the survey administered at the start of the intervention. Mental health problems were measured using the Strengths and Difficulties Questionnaire (SDQ; self-report (SR) n = 148; parent/proxy-report (PR) n = 153, mean age = 10.8). Demographic and family characteristics were obtained from parent reported data. Results are presented by gender and migration background. Regression analysis was used to investigate the relative contribution of background factors to mental health symptoms. The distribution of scores is compared to UK norms.

RESULTS

Participants reported relatively high scores on the Strengths and Difficulties Questionnaire (SDQ) Total Difficulties Scale (parent/proxy-report, PR mean=10.7; self-report, SR mean=10.1). Participants with non-immigrant backgrounds scored considerably higher on the Total Difficulties Scale (PR mean difference=2.9; SR 5.3) and on most other domains measured with the SDQ compared with their peers with immigration backgrounds. Participants generally scored higher than or equal to UK norms.

CONCLUSION

Participants in the current study had many symptoms of mental health problems, with large differences between those with and without a migrant background. Interventions for low-income families should be based on detailed knowledge about differences in family risks, resources and needs.

The association between adolescents' self-esteem and perceived mental well-being in Sweden in four years of follow-up

BACKGROUND

The situation concerning adolescent mental health is a global public health concern, and the concept includes the ability to cope with problems of everyday life. A person's approach and attitude towards themselves, i.e., their self-esteem, affects mental health. The study aimed to appraise and deepen the scientific understanding of adolescents' self-reported self-esteem at age 12-13 from a resource perspective and test its ability to predict subsequent perceived mental well-being at age 17.

METHODS

Data from the Longitudinal Research on Development in Adolescence (LoRDIA) prospective follow-up study of adolescents aged 12-13, and 17 (n = 654) were analysed using ANCOVA. The outcome variable, perceived mental well-being (MWB), covers the aspects of mental well-being inspired by the "Mental Health Continuum," representing positive mental health. Covariates were self-esteem (SE) and reported initially perceived MWB at age 12-13. Other independent explanatory variables were gender, the family's economy, and the mother's educational level.

RESULTS

Self-esteem appeared relatively stable from 12-13 to 17 years (M = 20.7 SD = 5.8 vs. M = 20.5 SD = 1.7). There was a significant but inverted U - shaped association between SE at age 12-13 and perceived MWB at age 17 [F (1, 646) = 19.02, β-0.057; CI -0.08--0.03, Eta = 0.03, p = .000]. Intermediate but not strong SE predicted significantly good MWB. When conducting the ANCOVA for boys and girls separately, only the mother's educational level was significantly positively associated with perceived MWB of girls.

CONCLUSIONS

Good self-esteem in early adolescence increases the likelihood of an unchanged favourable development of self-esteem and the probability of good perceived mental well-being. SE explained 18 per cent of the variation of MWB, and even more among girls. However, normal SE rather than high SE at 12 and 13 years is predictive of later mental well-being. Girls reported low self-esteem more often. Therefore, supporting self-esteem early in life can promote mental well-being in adolescence.

Gender and sexual identity-based inequalities in adolescent wellbeing: findings from the #BeeWell Study

BACKGROUND

Gender and sexual minority adolescents experience greater symptoms of psychological distress than their peers, but little is known about broader aspects of their wellbeing. This study examines wellbeing inequalities relating to gender and sexual identity among adolescents from Greater Manchester in the United Kingdom.

METHOD

37,978 adolescents (aged 12-15, attending 165 secondary schools) completed surveys of life satisfaction, positive and negative affect (hedonic framework); autonomy, self-esteem, optimism, and positive relationships (eudaimonic framework); and, symptoms of distress and mental wellbeing (complete state framework). Structural correlated factors models were used to assess gender and sexual identity wellbeing inequalities.

RESULTS

The magnitude of wellbeing inequalities pertaining to gender and sexual identity were routinely substantially greater than those concerning other characteristics (e.g., socio-economic disadvantage). Gender identity wellbeing inequalities followed a consistent pattern, with the largest disparities evident between gender diverse adolescents and boys. Sexual identity wellbeing inequalities also followed a consistent pattern, with the largest disparities evident between sexual minority youth (both gay/lesbian and bi/pansexual) and their heterosexual peers. Finally, variation was evident across wellbeing domains. For example, observed gender identity (boys vs. girls) and sexual identity (heterosexual vs. sexual minority) disparities were substantially greater for symptoms of distress than for mental wellbeing in the complete state model.

CONCLUSIONS

LGBTQ + adolescents experience lower wellbeing than their peers, and this is evident across a range of wellbeing domains. Accordingly, there is an urgent need for the prioritisation of improved prevention and intervention efforts that can better meet the needs of gender diverse and sexual minority youth, and future research should be conducted to improve understanding of the mechanisms underpinning the wellbeing inequalities observed.

Interpersonal Factors, Peer Relationship Stressors, and Gender Differences in Adolescent Depression

PURPOSE OF REVIEW

Compared to boys, girls value close relationships more. Thus, heightened affiliative proclivities may serve as a particularly salient psychosocial risk factor for depression in adolescent girls. The purpose of this review is to examine whether the preponderance of depression in girls is because of gender differences in interpersonal vulnerabilities and peer relationship stressors and/or in the associations between these factors and depression.

RECENT FINDINGS

Girls (vs. boys) exhibit higher levels of co-rumination and affective empathy, but not excessive reassurance-seeking. The prevalence of different forms of peer relationship stressors (e.g., peer victimization) varies by gender depending on the specific type. Evidence is mixed regarding gender differences in the association between peer victimization and depression. Gender differences in the association between peer victimization and depression not only depend on peer victimization subtype but also on the country. Most studies were conducted in non-clinical samples, highlighting the need for future research to assess major depressive disorder (not just depressive symptoms). Future research should also assess interpersonal factors (e.g., co-rumination) and peer relationship stressors together.

Mechanisms from Academic Stress to Subjective Well-Being of Chinese Adolescents: The Roles of Academic Burnout and Internet Addiction

Purpose

Academic stress is commonly known to affect adolescents' subjective well-being, but the influencing mechanisms are rarely investigated in the Chinese context. This study aims to investigate the psychological and behavioral factors operating as pathways between academic stress and adolescents' subjective well-being.

Samples and Methods

A multi-stage cluster random sampling is used to select 1043 adolescents from junior and senior high schools in Jinhu County, Jiangsu Province, China (mean age=14.98 years; 51.1% boys). Structural equation modeling is used to test the direct and indirect effects.

Results

Academic stress is significantly correlated with adolescents' subjective well-being after controlling for gender, grade, hukou, and socioeconomic status. In addition to partially mediating the link between academic stress and subjective well-being, academic burnout and Internet addiction can also operate as chain mediators in this mechanism. Adolescents' subjective well-being shows significant gender disparities, with boys having a greater degree of subjective well-being than girls. Father's income is found to have a significant positive association with adolescents' subjective well-being.

Conclusion

The results indicate that academic stress is a significant predictor of academic burnout, which in turn points to a positive association with Internet addiction, thereby explaining low levels of adolescents' subjective well-being. The present study develops current knowledge and expands our understanding of the underlying mechanisms by which academic stress influences adolescents' subjective well-being. This can also illuminate the practical ramifications for policymakers and social workers to mitigate academic-related stress and burnout, prevent Internet addiction, and ultimately promote the well-being of adolescent students.

A lifecourse approach in examining the association between accumulation of adversity and mental health in older adulthood

BACKGROUND

There is evidence for a cumulative effect of adversities on mental health, however, less is known on the accumulating duration of exposure to adversity across the lifecourse on mental health in older adults.

METHODS

Using data from the 1946 British birth cohort study (N = 2745), we examined associations between the accumulation of adversity (birth-63 years) and mental health (emotional symptom, life satisfaction, affective wellbeing) in older adults (63-69 years). Accumulation of adversity was assessed as the number of adversities and duration of exposure (number of lifecourse stages exposed to any, economic, psychosocial, or physical adversity). Linear regression tested their association with mental health, adjusted for sex, childhood cognition and emotional problems, and educational attainment.

RESULTS

Increased number of adversities was associated with increased emotional symptoms (β = 0.08 [0.06, 0.10]), decreased life satisfaction (β = -0.14 [-0.16, -0.12]) and decreased affective wellbeing (β = -0.08 [-0.10, -0.06]). Each additional duration of exposure was associated with a 0.38 [0.12, 0.65] standard deviation (SD) increase in emotional symptoms, and a - 0.68 [-0.96, -0.39] and -0.43 SD [-0.68, -0.18] decrease in life satisfaction and affective wellbeing, respectively. Life satisfaction showed stronger associations with economic and psychosocial compared to physical adversity.

LIMITATIONS

Some limitations include selective drop-out and lack of ethnic diversity.

CONCLUSIONS

Efforts to improve mental health in older adults should focus on reducing the number of adversities, as well as considering previous exposure across different lifecourse stages, to prevent adversities from becoming chronic. Future research should also consider the clustering and co-occurrence of different adversities across the lifecourse.

Mental health, gender, and higher education attainment

We compared the mental health of higher education students with that of nonstudents. Moreover, we examined whether the mental health of students predicts their probability of obtaining a higher education degree, and whether the extent to which mental health affects educational attainment varies by gender. Drawing on a risk and resilience framework, we considered five facets of mental health that may be implicated in distinct ways in the educational attainment process: positive attitude towards life, self-esteem, self-efficacy, negative affectivity, and perceived stress. We used data from a nationally representative panel study from Switzerland (Nstudents = 2070, 42.8% male; Nnonstudents = 3755, 45.9% male). The findings suggest that overall, the mental health of higher education students was relatively similar to that of nonstudents, although students exhibited slightly higher self-esteem, slightly weaker self-efficacy, greater negative affectivity, and higher levels of perceived stress. The effects of different facets of mental health on higher education degree attainment were mostly statistically and/or practically insignificant. However, positive attitudes towards life had a substantial positive effect on the probability of being awarded a higher education degree. Mental health was equally important for male and female students' educational attainment.

Supplementary Information

The online version of this article (10.1007/s11618-023-01187-3) contains supplementary material, which is available to authorized users.

A Mental Health Pandemic? Assessing the Impact of COVID-19 on Young People's Mental Health

BACKGROUND

Research indicates that young people have been a particularly vulnerable group when it comes to negative mental health outcomes following COVID-19, with some authors warning of a 'mental health pandemic'.

MATERIALS AND METHOD

Using a survey approach, this study explored the effects of lockdowns on the mental health of 1995 16-year-olds in Northern Ireland. Respondents completed the 12-item version of the General Health Questionnaire (GHQ-12) along with closed- and open-ended questions about COVID-19.

RESULTS

Results from regression analysis showed that being female, identifying as non-heterosexual and perceiving that mental health had worsened during lockdown were the best predictors of poor mental health. In the open responses, young people reported significant concerns about their mental health and their educational outcomes. They also felt that their needs were not given the same priority as those of adults during lockdown.

CONCLUSIONS

The results suggest that the COVID-19 lockdowns adversely affected the mental health of many young people in Northern Ireland with the effects most acute for females and those identifying as non-heterosexual. Future research should explore the longer-term impact of the pandemic on the mental health of these vulnerable young people and identify what support mechanisms need to be put in place to mitigate the negative effects of any future crises.

Smartphones, social Media and Adolescent mental well-being: the impact of school policies Restricting dayTime use-protocol for a natural experimental observational study using mixed methods at secondary schools in England (SMART Schools Study)

INTRODUCTION

Smartphone and social media use is prevalent during adolescence, with high levels of use associated with lower levels of mental well-being. Secondary schools in the UK have introduced policies that restrict daytime use of smartphones and social media, but there is no evaluation on the impact of these policies on adolescent mental well-being. The SMART Schools Study aims to determine the impact of daytime restrictions of smartphone and social media use on indicators of adolescent mental well-being, anxiety, depression, physical activity, sleep, classroom behaviour, attainment and addictive social media use.

METHODS AND ANALYSIS

This is a natural experimental observational study using mixed methods. Secondary schools within a 100 mile radius of the recruiting centre in the West Midlands (UK) have been categorised into two groups: Schools that restrict (intervention) and permit (comparator) daytime use of smartphones. We aim to recruit 30 schools (20 restrictive, 10 permissive) and 1170 pupils aged 12-13 and 14-15 years. We will collect data on mental well-being, anxiety and depressive symptoms, phone and social media use, sleep and physical activity from pupil surveys, and accelerometers. Policy implementation measures and data on individual pupil factors will be collected through school staff surveys, and website/policy analysis. Six case study schools will explore individual, school and family/home factors that influence relationships between school smartphone policies, smartphone/social media use, and mental well-being. Economic evaluation will be completed through a cost-consequence analysis from an education sector perspective.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of Birmingham's Research Ethics Committee (ERN_22-0723). Parents/carers of pupil participants can complete a form to opt their child out of the study. Pupil, school staff and parent/carer participants are asked to complete online/written consent (or assent). Findings will be disseminated through policy briefings, resources for schools, social media, reports, and open access publications.

TRIAL REGISTRATION NUMBER

ISRCTN77948572.

The influence of minority stress-related experiences on mental wellbeing for trans/gender-diverse and cisgender youth: a comparative longitudinal analysis

Trans and gender-diverse (TGD) adolescents are likely to experience poorer mental health and wellbeing than their cisgender peers. Minority stress theory has developed as a possible explanation for some of this disadvantage: factors such as increased bullying and discrimination lead to excess stress and reduced wellbeing. However, the evidence base remains limited. This study drew on secondary data analysis of the #BeeWell longitudinal cohort over 2 years (N = 26 042, aged 12-13 at time one, T1). We report two unregistered hypotheses relating to T1 (autumn 2021) data which was available at the time of stage-one submission: H1, mean differences in T1 wellbeing; H2, mean differences in T1 minority-related stressors. These are followed by two registered hypotheses relating to T2 (autumn 2022) data: H3, replication of T1 mean differences in T2 wellbeing; H4, predictions were made about the strength of the association between T1 minority-related stressors, controlling for sexuality and T2 wellbeing across T1 gender identity groups. At both time points cis-females, TGD and those who preferred not to say their gender had lower wellbeing than cis-males (CM), with the largest effect evident for the TGD group. TGD adolescents also showed the largest disadvantage (mean difference) compared with CM for minority stressors. Counter to H4 and minority stress theory, gender was not found to moderate the effect of minority stressors on later wellbeing. Our findings highlight the vulnerability of the TGD group in terms of wellbeing and minority stressors and are discussed with relevance for policy and future research.

Parent-adolescent informant discrepancy on the Strengths and Difficulties Questionnaire in the UK Millennium Cohort Study

BACKGROUND

Developmental researchers often use a multi-informant approach to measure adolescent behaviour and adjustment, but informant discrepancies are common. In general population samples, it is often found that parents report more positive and less negative outcomes than adolescents themselves. This study aimed to investigate factors associated with informant discrepancy, including adolescent sex, and parental level of psychological distress and education.

METHODS

Informant discrepancy on the Strengths and Difficulties Questionnaire was investigated using a Latent Difference Score (LDS) approach, which estimates the true difference between parent and adolescent reports in a structural equation model. The sample were parent-adolescent dyads from the seventh wave of the UK Millennium Cohort Study (N = 6947, 49.3% female, aged 17 years).

RESULTS

Parents reported lower levels of difficulties (emotion symptoms, peer problems, conduct problems), and higher levels of pro-social behaviour than adolescents themselves. Conditional effects were found, as discrepancy was greater amongst parent-daughter dyads for emotion and peer problems, and greater amongst parent-son dyads for conduct problems and pro-social behaviour. Parent-adolescent discrepancy was also greater generally if parents had a lower level of psychological distress or a higher level of education.

CONCLUSIONS

In a large general population sample from the UK, it was found that adolescents tended to report more negative and less positive outcomes than parents reported about them. Conditional effects were found at the parent and adolescent level suggesting that specific informant biases are likely to impact the measurement of adolescent behaviour and adjustment across reporters.

DBT-PAHSE Intervention for Reduce Emotion Dysregulation and Suicide Behavior in Mexican Early Adolescents: A Longitudinal Study

This study aimed to evaluate the effect of time on suicidal behavior, associated risk factors, and protective factors in early Mexican adolescents. Method: With a two-year longitudinal design, which included 18 of 34 adolescents who had previously participated in a DBT skills training program (DBT-PAHSE). The study evaluated ideation, suicide attempt, depression, emotional dysregulation, and psychological resources. Results: We observed differentiating significant differences over time in emotional dysregulation (F = 2.36 p = 0.04, η²= 0.12, β = 0.72), affective resources (F = 3.94, p = 0.01, η² = 0.18, β = 0.82), and suicidal ideation. (F = 2.55, p = 0.03, η²= 0.13, β = 0.77). In conclusion, the DBT-PAHSE program prevented deaths by suicide. It showed a reduction in emotional dysregulation up to two years after the end of treatment and maintained an increase in emotional and social resources. However, improvements are required to reduce depression over time and strengthen psychological resources.

The role of social capital in resilience among adolescents with adverse family environments

The Life Course Health Development (LCHD) framework underscores the profound impact of stressors during critical developmental phases on an individual's lifelong health, including their mental well-being. Among these developmental transitions, adolescence emerges as a pivotal life stage where an adolescent's mental health trajectory is significantly influenced by the various risk and promotive factors embedded within their social ecosystem. Adolescents from adverse family environments (AFEs) face heightened susceptibility to mental health challenges. Nevertheless, there are opportunities within the adolescent's environment to foster resilience. In this paper, we employ an interdisciplinary approach grounded in the LCHD framework to assess existing research pertaining to resilience, social capital, and health development. Furthermore, we aim to provide actionable recommendations tailored to healthcare providers, with a specific emphasis on strategies to augment mental health outcomes among adolescent populations, particularly those experiencing AFEs.

Debate: Don't mind the gap - why do we not care about the gender gap in common mental health difficulties?

There is a substantial gender gap in common mental health difficulties such as depression and anxiety, and evidence on drivers of this gap is sparse. Yet, the current tendency in the field is to treat it as inevitable, and its drivers are rarely examined as a worthwhile question to pursue. We discuss possible reasons for this oversight, while highlighting the need to reform research priorities and systems to ensure this issue receives the investment and interest necessary to inform better prevention and support. We emphasise the need to meaningfully engage with women on the gender mental health gap to better inform investigations into salient drivers and, in turn, efforts toward change. We challenge the research community to question such pervasive disinterest in this large inequality disproportionately affecting over half the population, to prevent and narrow this for future generations.

Parent- and teacher-reported associations from adolescent bifactor models of psychopathology: an outcome-wide association study of 26 outcomes in mid-life

BACKGROUND

Adolescent mental health problems have lasting impacts on health and social functioning later in life. Evidence to date mostly comes from studies of specific diagnostic categories/dimensions, but hierarchical models can elucidate associations with general as well as specific dimensions of psychopathology. We provide evidence on long-term outcomes of general and specific dimensions of adolescent psychopathology using both parent and teacher reports.

METHODS

Parents and teachers from the Isle of Wight study completed Rutter behaviour scales when participants were 14-15 years old (n = 2,275), assessing conduct, emotional and hyperactivity problems. Metric-invariant bifactor models for parents and teachers were used to test domain-specific and domain-general associations with 26 self-reported psychosocial outcomes at mid-life (age 44-45 years, n = 1,423). Analyses examined the individual and joint contributions of parent and teacher reports of adolescent psychopathology. All analyses were adjusted for covariates (gender, IQ and family social class) and weighted to adjust for the probability of nonresponse.

RESULTS

Parent- and teacher-reported general factors of psychopathology (GFP) were associated with 15 and 12 outcomes, respectively, across the socioeconomic, relationship, health and personality domains, along with an index of social exclusion. Nine outcomes were associated with both parent- and teacher-reported GFP, with no differences in the strength of the associations across reporters. Teacher-reported specific factors (conduct, emotional and hyperactivity) were associated with 21 outcomes, and parent-reported specific factors were associated with seven. Five outcomes were associated with the same specific factors from both reporters; only one showed reporter differences in the strength of the associations.

CONCLUSIONS

These findings confirm the relevance of the GFP and the utility of teacher as well as parent reports of adolescent mental health in predicting psychosocial outcomes later in the life course.

Infidelity in the Adolescence Stage: The Roles of Negative Affect, Hostility, and Psychological Well-Being

BACKGROUND

Infidelity is a relational process common in all types of romantic relationships and has been established as one of the main causes of relationship breakdown. However, little is known about this type of transgression in adolescent romantic relationships, although it manifests as a fairly frequent behavior involving different motivations. Even less is known about the emotional impact of infidelity on the offending person and its association with hostile behavior and psychological well-being.

METHODS

Through an experimental study (N = 301 Spanish adolescents (190 female and 111 male; M_age = 15.59, SD = 0.69; range from 15 to 17), we sought to analyze the effect of manipulating two types of motivations for infidelity (sexual vs. emotional dissatisfaction) on negative affect, hostility, and psychological well-being.

RESULTS

The main results revealed that committing infidelity motivated by hypothetical sexual (vs. emotional) dissatisfaction was indirectly related to lower psychological well-being through its effects on increased negative affect and hostility.

CONCLUSIONS

Last but not least, we discuss these findings, highlighting the possible implications of infidelity for the psychosocial and psychosexual development of adolescents.

Adolescent sleep, distress, and technology use: weekday versus weekend

BACKGROUND

In adolescents, technology use at bedtime is linked to disrupted sleep and psychological distress. Adolescents are known to sleep later on weekends compared to weekdays but whether this leads to greater technology use, and, hence, additional psychological distress is not known. At greater risk maybe adolescents with a late compared to early chronotype, that is a preference for late versus early sleep onset and offset times.

METHOD

Self-reported measures of sleep timing, chronotype (early, neither early nor late, late), technology medium (social media/texting, TV/streaming, and gaming), and psychological distress (DASS-21) were collected from 462 students attending one Australian high school.

RESULTS

Technology use at bedtime was greater on weekends and especially in adolescents with a late chronotype. Social media/texting on weekends was predictive of delayed sleep onset times (β = .120), and shorter sleep (β = -.172). Shorter sleep on weekdays but not on weekends was associated with greater psychological distress. Technology medium and chronotype were not predictive of psychological distress.

CONCLUSIONS

This study confirmed that technology use and its impact on sleep differed on weekdays compared to weekends and that a late chronotype was associated with greater technology use. However, neither technology medium nor chronotype was found to affect psychological distress. While greater autonomy may be granted to adolescents over the weekend regarding sleep behaviour, young people, parents, and clinicians should be mindful of the link between technology use and sleep.

Disruption to Education During COVID-19: School Nonacademic Factors Are Associated with Children's Mental Health

OBJECTIVE

Few studies have examined aspects of the school environment, beyond modality, as contributors to child and youth mental health during the coronavirus pandemic. We investigated associations between nonacademic school experiences and children's mental health.

METHODS

Parents of children ages 6 to 18 years completed online surveys about school experiences (November 2020) and mental health (February/March 2021). Parent-reported and child-reported school experiences (i.e., nonacademic factors) included school importance, adapting to public health measures, and school connectedness. Children's mental health symptoms of depression, anxiety, inattention, and hyperactivity were collected using standardized parent-reported measures.

RESULTS

Children's (N = 1052) self-reported and parent-reported nonacademic factors were associated with mental health outcomes, after adjusting for demographics and previous mental health. Lower importance, worse adapting to school changes, and less school connectedness were associated with greater depressive symptoms ( B = -4.68, CI [-6.04, -3.67] to - 8.73 CI [-11.47, 5.99]). Lower importance and worse adapting were associated with greater anxiety symptoms ( B = - 0.83 , CI [-1.62, -0.04] to -1.04 CI [-1.60, -0.48]). Lower importance was associated with greater inattention (B = -4.75, CI [-6.60, -2.90] to -6.37, CI [-11.08, -7.50]). Lower importance and worse adapting were associated with greater hyperactivity (B = -1.86, CI [-2.96, -0.77] to -4.71, CI [-5.95, -3.01]).

CONCLUSION

Schools offer learning opportunities that extend beyond curriculum content and are a primary environment where children and youth develop connections with others. These aspects of school, beyond academics, should be recognized as key correlates of child and youth mental health.

Critical life course interventions for children and adolescents to promote mental health

Childhood and adolescence are key developmental periods in the life course for addressing mental health, and there is ample evidence to support significant, increased investment in mental health promotion for this group. However, there are gaps in evidence to inform how best to implement mental health promotion interventions at scale. In this review, we examined psychosocial interventions implemented with children (aged 5–10 years) and adolescents (aged 10–19 years), drawing on evidence from WHO guidelines. Most psychosocial interventions promoting mental health have been implemented in school settings, with some in family and community settings, by a range of delivery personnel. Mental health promotion interventions for younger ages have prioritised key social and emotional skills development, including self-regulation and coping; for older ages, additional skills include problem-solving and interpersonal skills. Overall, fewer interventions have been implemented in low- and middle-income countries. We identify cross-cutting areas affecting child and adolescent mental health promotion: understanding the problem scope; understanding which components work; understanding how and for whom interventions work in practice; and ensuring supportive infrastructure and political will. Additional evidence, including from participatory approaches, is required to tailor mental health promotive interventions to diverse groups’ needs and support healthy life course trajectories for children and adolescents everywhere.

Patterns of students' well-being in early adolescence: A latent class and two-wave latent transition analysis

Adolescence is a developmental stage with high risks in terms of psychological challenges and adjustments related to subjective well-being. Thus far, the findings reported a general decrease in school-related well-being over time. We considered well-being a multidimensional and latent construct that included both feeling good and functioning well at the individual level, and focused on the interplay between hedonic and eudemonic factors. Data of N = 377 high school students in Switzerland were used by conducting an online longitudinal study with two waves. Baseline data was gathered in autumn 2019 and the subsequent time point occurred 1 year later (2020; grades seven and eight). By applying a person-oriented analytical approach via latent class and latent transition analyses, we were able to identify and compare longitudinally three distinct well-being patterns and the respective trajectories. Regarding the distribution of the well-being patterns for both waves, significant changes over time were identified: particularly from wave 1 to wave 2, where there was an increase for the low and high well-being patterns, yet a decrease for the middle pattern. Comparing the stability of the respective patterns over time, the high well-being level showed the highest stability of all identified patterns. Multinomial logistic regression of covariates to the identified latent status membership established for both waves showed low but significant effects of socio-demographic variables. At wave 1, having a migration background was associated with a significant increase of being in a low versus high well-being level pattern. At wave 2, being female was associated with a significant increase of being in a low versus high and in a middle versus high well-being pattern.

Adolescents' Well-being While Using a Mobile Artificial Intelligence-Powered Acceptance Commitment Therapy Tool: Evidence From a Longitudinal Study

BACKGROUND

Adolescence is a critical developmental period to prevent and treat the emergence of mental health problems. Smartphone-based conversational agents can deliver psychologically driven intervention and support, thus increasing psychological well-being over time.

OBJECTIVE

The objective of the study was to test the potential of an automated conversational agent named Kai.ai to deliver a self-help program based on Acceptance Commitment Therapy tools for adolescents, aimed to increase their well-being.

METHODS

Participants were 10,387 adolescents, aged 14-18 years, who used Kai.ai on one of the top messaging apps (eg, iMessage and WhatsApp). Users' well-being levels were assessed between 2 and 5 times using the 5-item World Health Organization Well-being Index questionnaire over their engagement with the service.

RESULTS

Users engaged with the conversational agent an average of 45.39 (SD 46.77) days. The average well-being score at time point 1 was 39.28 (SD 18.17), indicating that, on average, users experienced reduced well-being. Latent growth curve modeling indicated that participants' well-being significantly increased over time (β=2.49; P<.001) and reached a clinically acceptable well-being average score (above 50).

CONCLUSIONS

Mobile-based conversational agents have the potential to deliver engaging and effective Acceptance Commitment Therapy interventions.

The role of school connectedness in the prevention of youth depression and anxiety: a systematic review with youth consultation

Background

School connectedness reflects the quality of students’ engagement with peers, teachers, and learning in the school environment. It has attracted attention from both the health and education sectors as a potentially modifiable protective factor for common mental health problems. However, the extent to which school connectedness may prevent the onset of youth depression or anxiety or promote their remission is unclear. This systematic review examined evidence for prospective relationships between school connectedness and depression and anxiety, and the effect of interventions to improve school connectedness on depression and anxiety.

Methods

We searched MEDLINE, PsycINFO, PubMed, and ERIC electronic databases for peer-reviewed quantitative longitudinal, or intervention studies published from 2011–21 in English examining relationships between school connectedness and anxiety and/or depression. Participants were 14–24 years old when depression and anxiety outcomes were assessed in any education setting in any country. We partnered with five youth advisers (aged 16–21 years) with lived experience of mental health problems and/or the schooling system in Australia, Indonesia, and the Philippines to ensure that youth perspectives informed the review.

Results

Our search identified 3552 unique records from which 34 longitudinal and 2 intervention studies were ultimately included. Studies were primarily from the United States of America (69.4%). Depression and anxiety outcomes were first measured at 14 years old, on average. Most studies found a significant protective relationship between higher levels of school connectedness and depressive and/or anxiety symptoms; more measured depression than anxiety. A few studies found a non-significant relationship. Both intervention studies designed to increase school connectedness improved depression, one through improvements in self-esteem and one through improvements in relationships at school.

Conclusions

These findings suggest that school connectedness may be a novel target for the prevention of depression and anxiety. We were not able to determine whether improving school connectedness promotes remission in young people already experiencing depression and anxiety. More studies examining anxiety, diagnostic outcomes, and beyond North America are warranted, as well as intervention trials.

Trial registration

PROSPERO 2021 CRD42021270967.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14364-6.

Geographic, Socio-Demographic and School Type Variation in Adolescent Wellbeing and Mental Health and Links with Academic Competence in the United Arab Emirates

Interest in adolescents' wellbeing and mental health is growing worldwide, but little research in this area has been conducted in certain world regions and countries such as the United Arab Emirates (UAE). Geographic, socio-demographic and school type differences in adolescent wellbeing and mental health are commonly observed in the field, and the UAE is a diverse country where these types of differences have been found for other outcomes (notably, academic). Yet, no prior national study has explored these differences in terms of wellbeing and mental health in the nation. We address this gap by investigating differences across emirates, gender, socio-economic status, immigrant status, school sector and school curriculum for overall life satisfaction, positive affect, negative affect, meaning and purpose in life, and internalizing difficulties. We use linear regression to analyse cross-sectional data from the Programme for International Student Assessment (PISA) study from 2015 and 2018. We find substantial geographic, socio-demographic and school type differences in levels (2018) of wellbeing and mental health -which vary across distinct domains- and declines (2015-2018) of wellbeing. Better wellbeing and mental health are observed in the northern emirates and among boys. Better wellbeing and poorer mental health are observed among nationals (compared to expatriates) and in public schools (compared to private schools). Despite presenting the best academic outcomes, British schools present the worst wellbeing and mental health outcomes. However, results show the absence of a trade-off between academic competence and wellbeing and mental health, with evidence of a small positive association with wellbeing.

A Predictive Biomarker Model Using Quantitative Electroencephalography in Adolescent Major Depressive Disorder

Background: With evolving understanding of psychiatric diagnosis and treatment, demand for biomarkers for psychiatric disorders in children and adolescents has grown dramatically. This study utilized quantitative electroencephalography (qEEG) to develop a predictive model for adolescent major depressive disorder (MDD). We hypothesized that youth with MDD compared to healthy controls (HCs) could be differentiated using a singular logistic regression model that utilized qEEG data alone. Methods: qEEG data and psychometric measures were obtained in adolescents aged 14-17 years with MDD (n = 35) and age- and gender-matched HCs (n = 14). qEEG in four frequency bands (alpha, beta, theta, and delta) was collected and coherence, cross-correlation, and power data streams obtained. A two-stage analytical framework was then used to develop the final logistic regression model, which was then evaluated using a receiver-operating characteristic curve (ROC) analysis. Results: Within the initial analysis, six qEEG dyads (all coherence) had significant predictive values. Within the final biomarkers, just four predictors, including F3-C3 (R frontal) alpha coherence, P3-O1 (R parietal) theta coherence, CZ-PZ (central) beta coherence, and P8-O2 (L parietal occipital) theta power were used in the final model, which yielded an ROC area of 0.8226. Conclusions: We replicated our previous findings of qEEG differences between adolescents and HCs and successfully developed a single-value predictive model with a robust ROC area. Furthermore, the brain areas involved in behavioral disinhibition and resting state/default mode networks were again shown to be involved in the observed differences. Thus, qEEG appears to be a potential low-cost and effective intermediate biomarker for MDD in youth.

Life satisfaction and mental health from age 17 to 21 years in a general population sample

Adolescence is a period when both mental health (MH) and wellbeing start deteriorating, which raises the question of how the two phenomena are linked and whether deterioration in one might be used to flag problematic developments in the other. While research shows that wellbeing and MH are associated, the direction of the association is not clear and longitudinal analyses, that might help disentangle the cause and effect, are scarce. Moreover, few studies have investigated the directional relation between MH and wellbeing early in the life course. In emerging adulthood, evidence indicates reciprocal associations and no gender differences, whereas, in early and middle adolescence, results are mixed and differ across gender. Thus, we investigated the relationship between MH and wellbeing and the moderating effect of gender in the crucial developmental transition from middle adolescence to emerging adulthood. We undertake a cross-lagged longitudinal data analysis from a pooled sample of six pseudo-cohorts, including information from 661 young people who participated in the UK Household Longitudinal Study at ages 17, 19, and 21. Using a 7-points overall life satisfaction (LS) scale as an index of wellbeing and the 12-item General Health Questionnaire as a measure of MH, we found no associations between LS and MH in the 17-19 transition and bidirectional associations in the 19-21 transition. There were no substantial gender differences in either transition. We conclude that LS and MH predict each other in the transition from late adolescence (age 19) to emerging adulthood (age 21) for both males and females.

The Helpfulness of Web-Based Mental Health and Well-being Forums for Providing Peer Support for Young People: Cross-sectional Exploration

Background

Young people are increasingly seeking out web-based support for their mental health and well-being. Peer support forums are popular with this age group, with young individuals valuing the fact that the forums are available 24/7, providing a safe and anonymous space for exploration. Currently, little systematic evaluation of the helpfulness of such forums in providing support has been conducted.

Objective

This study examined the helpfulness of the support offered within web-based mental health and well-being peer support forums for young people. It specifically investigated the self-reported user ratings of helpfulness reported through the completion of a developing experience measure. The ratings will be used to consider further development of the measure and reflect upon the overall helpfulness of the forums as indicated by the reported scores.

Methods

The study used routinely collected practice-based outcome data from web-based mental health forums for young people. These forums are hosted by the UK-based web-based therapy and support service, Kooth. A cross-sectional design was used to explore—using a range of inferential statistical measures—the outcomes reported by those accessing the forums using a Peer Online Community Experience Measure (POCEM). To consider the helpfulness in general, 23,443 POCEMs completed in 2020 were used. A second data set of 17,137 completed POCEMs from the same year was used to consider whether various engagement indicators had an impact upon the helpfulness rating.

Results

Female users aged between 11 and 16 years predominantly completed the POCEM. This is in keeping with the majority of those using the service. In total, 74.6% (8240/11,045) of the scores on the POCEM indicated that the individuals found the posts helpful. An ANOVA indicated that male users were more likely to report obtaining intrapersonal support, whereas female users obtained interpersonal support. Furthermore, the POCEM scores reflected the internal consistency of the measure and provided an insight into the way that young people made use of the peer support resource; for instance, posts that were rated more helpful were correlated with spending longer time reading them, and the topics discussed varied throughout the day with more mental health issues being discussed later at night.

Conclusions

The results seem to demonstrate that, overall, the young people involved in this study found web-based peer support helpful. They indicate that peer support can provide an important strand of care within a supportive mental health ecosystem, particularly during time periods when in-person support is typically closed. However, limitations were noted, suggesting that caution is needed when interpreting the results of this study. Although such services are incredibly well used, they have received little research attention to date. As such, further investigation into what constitutes helpful and unhelpful peer support is needed.

Living with COVID-19: Subjective Well-Being in the Second Phase of the Pandemic

While there is ample evidence of the decline in mental health among youth during the onset of the COVID-19 pandemic, less is known about the determinants of recovery, which is the focus of this study. Drawing on a stress process framework, this study examines the associations of changes in direct, pandemic-related, and indirect, lockdown-related stressors with life satisfaction. A novel representative, longitudinal sample of British 16-25-year-olds is used, drawing on 6 data collections between February 2021 to May 2022 (N = 6000, 51% female, 24% ethnic minority, 46% in work, 35% with higher education). Using linear fixed-effects regression models, the findings suggest a substantial improvement in life satisfaction among youth. An increasing frequency of social contacts, receding worries about career prospects and job skills learning contributed significantly to increases in life satisfaction, whereas direct, health-related COVID-19 stressors did not affect life satisfaction. Sub-group analysis suggests that women's, adolescents', and students' life satisfaction responded more strongly to the stressors considered in this study. The findings highlight the positive effects of less stringent lockdown restrictions, economic recovery, and opportunities for job skills learning on youth's happiness.

Mental Health Literacy and Positive Mental Health in Adolescents: A Correlational Study

This study aimed to assess adolescents′ Mental Health Literacy (MHL) level, Positive Mental Health (PMH) level, the association between sociodemographic variables and the MHL and PMH levels, and the relationship between adolescent′s MHL and PMH levels. A quantitative, cross-sectional, correlational study was conducted with a convenience sample of 260 adolescents studying in the 5th to 12th years of school. The Mental Health Knowledge Questionnaire, the Mental Health-Promoting Knowledge, and the Positive Mental Health Questionnaire were used for data collection. Most of the adolescents were female (55.8%) with a mean age of 14.07 years. The participants showed good levels of MHL (MHKQ). The participants showed good levels of MHL (MHKQ 𝘹¯ = 60.03; MHPK-10 𝘹¯ = 4.49) and high levels of PMH (𝘹¯ = 128.25). The adolescents with higher levels of MHL were the oldest, in a higher year of school, female, those whose mothers are employed, those who have healthy eating habits, and those who have a better body image self-perception. Adolescents in a lower year of school, with adequate sleep habits, who spend fewer hours a day in front of a screen or online, and who have a better self-perception of mental and physical health and body image were the ones with higher PMH levels. These findings suggest the need to implement experimental or quasi-experimental studies to ascertain the effectiveness of interventions that promote adolescents′ positive mental health literacy.

Adolescent Mental Health Literacy Questionnaire: Investigating Psychometric Properties in Iranian Female Students

Objectives

Mental Health Literacy (MHL) is an important factor in promoting mental health. Assessing this structure is required for early recognition and intervention in mental health problems. To date, there was no tool to assess it among Iranian adolescents, so this study was aimed at examining the psychometric properties of the Persian version of the Adolescent Mental Health Literacy Questionnaire (AMHLQ) among Iranian female students.

Method

The study instrument was a Persian version of the AMHLQ prepared through a translation and back-translation process. In this cross-sectional study, 275 female students completed the AMHLQ, and the Adolescent Strengths, and Difficulties Questionnaire (SDQ).

Results

Findings of content, construct validity tests, Cronbach's alpha, and split-half coefficient demonstrated that the AMHLQ had satisfactory validity and suitable reliability. The exploratory factor analysis showed four dimensions of the AMHLQ: (1) knowledge of mental health problems (α = 0.89); (2) erroneous beliefs/stereotypes (α = 0.89); (3) help-seeking and first aid skills (α = 0.86); and (4) self-help strategies (α = 0.74).

Conclusion

The findings showed that the tool was confirmed by questions and subscales, and this questionnaire was a valid and reliable tool in assessing level differences of MHL and in determining the impact of programs designed to improve MHL in Iranian female adolescents.

The Mediating Role of School and Sibling Bullying in the Relationship between Subjective Well-Being and Mental Health Symptoms

Recently, empirical studies have indicated an association between well-being and mental health. The nature of this association remains unclear since some studies suggest it is weak, whilst others indicate it is strong. The present study seeks to contribute to this dialogue by modelling not only the relationship between well-being and internalising and externalising mental health symptoms but also by introducing a mediation model where school and sibling bullying, as risk factors, are acting as mediators. A national sample of 1244 youth (Mage = 12.47, SD = 1.69) from the Understanding Society household panel study in the UK was utilised to estimate the structural equation model. The findings showed that the direct effect of well-being on internalising symptoms was negative and strong, whereas it was negative and moderate on externalising symptoms. Furthermore, the pattern of indirect effects from subjective well-being to internalising and externalising mental health symptoms displayed some differences in the level of statistical significance and strength. Implications for policy and practice are discussed.

Mental Health Difficulties Related to Suicidal Behavior in Adolescents: The Moderating Role of Self-Esteem

OBJECTIVE

The objective was to analyze the moderating effect of self-esteem on the relationship between mental health difficulties and suicidal behavior in adolescence.

METHOD

The sample was composed of 1,790 Spanish adolescents (M = 15.70 years; SD = 1.26; 53.7% girls) through a stratified random sampling by cluster at classroom level. The participants completed questionnaires about emotional symptoms, behavioral problems, peer relationship difficulties, hyperactivity, suicidal behavior, and self-esteem.

RESULTS

The results evidenced gender differences, showing that girls tend to have more emotional symptoms (t = -15.27; p ≤ .001; d = -0.71), more difficulties in peer relationship (t=-2.49; p = .013; d = -0.12) and less self-esteem (t = 12.15; p ≤ .001; d = 0.57), as well as more suicidal behaviors (t = -5.36; p ≤ .001; d = -0.25) than boys. It is also noted that emotional and behavioral difficulties influence suicidal behavior (R² = 0.35; ΔF = 197.42; p ≤ .001). In addition, self-esteem appeared to act as a protective factor, buffering the relationship between emotional and behavioral problems and suicidal behavior (R² = 0.39; F = 376.92; p ≤ .001).

CONCLUSIONS

Adolescents who present mental health difficulties might commit suicidal behavior if they have an unfavorable attitude toward themselves. However, the risk of committing suicidal behavior decreases if their attitude toward themselves is favorable. Thus, the development of self-esteem may be included in intervention programs for the prevention of suicidal behavior.HIGHLIGHTSGirls present more suicidal behaviors and less self-esteem than boys.Mental health difficulties influence the appearance of suicidal behavior.Self-esteem moderates the relationship between emotional problems and suicidal behavior.

Prevalence of psychotic-like experiences and its predictors among early adolescents from rural areas in Indonesia

Background: Psychotic symptoms are present in a wide range of both clinical and non-clinical populations. Psychotic symptoms in adolescents often take the form of psychotic-like experiences (PLEs), which are considered a risk factor for numerous serious mental illnesses. Socioeconomic disadvantages are across rural areas, and poverty is known as the third most important risk factor of PLEs. However, there have been limited studies on PLEs which focus on populations in rural areas.Objective: The aim of this study was to assess the prevalence of PLEs and investigate their predictors among early adolescents living in rural areas.Method: Data from 629 early adolescents from two rural areas in Indonesia were analysed using descriptive statistics to determine the prevalence of PLEs. Multiple logistic regression analysis was used to assess the predictors of PLEs. This was a school-based cross-sectional study, and data were collected using a paper questionnaire.Results: The results showed that the prevalence of PLEs among early adolescents in rural areas is 24.5%. Four significant predictors of PLEs were identified after controlling for sex: emotional problems, age, the number of caregivers in daily life, and psychological well-being.

Perceived academic stress and depressive symptoms among Chinese adolescents: A moderated mediation analysis of overweight status

BACKGROUND

Previous research has indicated the association of perceived stress with mental health problems. In China, Confucian collectivism and an exam-centered culture encourage parents to have high educational expectations that impose great pressure on their children's learning. However, limited research has focused on adolescents' perceptions of the negative consequences of academic stress stemming from their parents' educational expectations. This study addressed this research gap by examining the direct effect of adolescents' perceptions of academic stress on their depressive symptoms and the indirect effects of both parent-child communication and interaction. We further explored the pathway differences between overweight and non-overweight adolescents.

METHODS

By using a sample (n = 6,566) from the first two waves of the China Education Panel Survey, moderated mediation analysis was performed to simultaneously analyze the mediating roles of parent-children communication and parent-children interaction and the moderating role of adolescent overweight status.

RESULTS

Adolescents' perceived academic stress (W1) was positively associated with their depressive symptoms (W2). This association was partially mediated by both parent-child communication (W1) and parent-child interaction (W1). Moreover, adolescent overweight status significantly moderated the paths between the adolescents' perceived academic stress and their depressive symptoms, between their perceived academic stress and parent-child interaction, and the indirect relationship via parent-child interaction.

LIMITATIONS

Some measurement biases including self-reported, unverified, and single-item measures, alongside not considering all variations in controlled variables should be noted.

CONCLUSION

The study's findings identify the significant roles of parent-child communication and parent-children interaction in contemporary China and indicate overweight adolescents' susceptibility to stress.

A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults

Cannabis and anxiety are both rising issues that impact young people. This review seeks to explore the association between anxiety and cannabis in adolescents and young adults (AYA). A database search was run retrospectively from July 2020 through calendar year 2013. Articles had to present outcomes examining cannabis use and symptoms of anxiety, be written in English, contain samples with ≥ 50% who are age 25 or younger, and be published in a peer-reviewed journal. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use. Twenty-three studies found a positive association that greater anxiety among AYA was associated with greater cannabis use. In contrast, seven studies found a negative association that greater anxiety was related to less cannabis use. And finally, 17 studies found no clear association between anxiety and cannabis use. Further research is needed to better understand the relationship between anxiety and cannabis use.

Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study

Mental health and well-being are of great interest in health policy and research. Longitudinal surveys are needed to provide solid population-based data. We describe the design and methods of an 11-year follow-up of the German BELLA study in children, adolescents and young adults, and we report on age- and gender-specific courses of general health and well-being, long-term health-related outcomes of mental health problems, and mental health care use. The BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Standardised measures were used at each of the five measurement points of the BELLA study. In the 11-year follow-up, young people aged 7-31 years participated (n = 3492). Individual growth modelling, linear regression and descriptive analyses were conducted. Self-reported general health and well-being were both better in younger (vs. older) and in male (vs. female) participants according to the data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) predicted impaired health outcomes at 6-year and 11-year follow-ups. Approximately one out of four children with a diagnosed mental disorder was not undergoing mental health treatment. With its 11-year follow-up, the prospective longitudinal BELLA study provides new and solid data on mental health and well-being from childhood to adulthood in Germany, and these data are important for health promotion and prevention practices. These results are consistent with previous findings. Promising future analyses are planned.

Self-regulation predicts companionship in children with autism

 Self-regulation is associated with many positive outcomes in children with and without autism, including increased mental health and academic achievement, and decreased problem behavior. Less is known regarding whether and how self-regulation and symptoms of mental health challenges (internalizing and externalizing problems) relate to social outcomes, such as friendship quality and loneliness. Parents and teachers of 106 children with autism aged 5-12 reported on children's self-regulation difficulties and externalizing and internalizing symptoms. Four-to-five months later, children reported on the quality of their friendship with their best friend (companionship, conflict, helpfulness, sense of relationship security, closeness), and their feelings of loneliness. Linear regression was used to examine the effects of self-regulation and symptoms of mental health challenges on friendship quality and loneliness. Less self-regulation difficulties predicted stronger companionship and girls had better quality friendships with their best friend than did boys, in terms of companionship, helpfulness, security and closeness, confirming that they have a protective advantage in friendship development. Autism symptoms, IQ, and age were not associated with friendship quality or loneliness. Results highlight the importance of self-regulation and mental health interventions for school-aged children with autism.