Family Functioning and Adolescent Psychological Maladjustment: The Mediating Role of Coping Strategies

Do Ethnic Identity, Familial, and Community Contexts Impact the Association Between Adverse Childhood Experiences and Psychopathology Among Latinx Adolescents?

OBJECTIVE

Few studies have explored the interplay of how individual identity, parental, familial, and contextual factors impact associations between Latinx adolescent adversities and psychopathology. This study aimed to examine whether these factors mediate the relationship between adversities and psychopathology in Latinx youth.

METHOD

Latinx youth (n = 2,411) data from the Adolescent Brain Cognitive Development (ABCD) Study were used to examine path models with adverse childhood experiences (ACEs) as the predictor and either youth- or caregiver-rated internalizing/externalizing scores over 4 timepoints as the outcome (ages 9-13 years). Models examined 3 potential mediators: (1) ethnic identity, (2) familial context (comprising parental monitoring, family conflict, and caregiver acceptance), and (3) community cohesion. Models were conducted separately for internalizing and externalizing symptoms.

RESULTS

Greater adversity was associated with greater youth- and caregiver-rated internalizing/externalizing psychopathology over time. Greater adversity was associated with lower family functioning and lower ethnic identity, and greater family functioning was associated with lower psychopathology. Family functioning mediated associations between adversity and psychopathology over time (youth-reported internalizing: 95% CI = 0.012-0.019; youth-reported externalizing: 95% CI = 0.020-0.028). In contrast, there was not strong evidence for ethnic identity and community cohesion mediating associations between adversities and psychopathology over time.

CONCLUSION

Unlike previous studies, ethnic identity did not influence the relationship between ACEs and psychopathology over time. Additional research is needed to identify whether possible tensions rise as Latinx youth acculturate into US culture and achieve optimal levels of ethnic identity formation. Providers need to assess specific Latinx parental and familial contexts that may interfere with youth identity formation.

Relationships Between Family Connectedness and Stress-Triggering Problems Among Adolescents: Potential Mediating Role of Coping Strategies

The aim of this study was to provide a better understanding of the mechanisms underlying the relationships between family connectedness, coping strategies, and stress-triggering problems in adolescents. To this end, it longitudinally examined the relationships between these three phenomena in a sample of New Zealand adolescents. Data were the three waves of the Youth Connectedness Project, in which 1,774 adolescents aged 10-17 completed a self-report survey three times at one-year intervals. Using random intercept longitudinal mediation path models, we tested whether and to what extent different coping strategies at T2 functioned as mediators between family connectedness at T1 and stress-triggering problems at T3. As predicted, statistical analyses indicated that family connectedness negatively predicted stress-triggering problems over time, and we found that maladaptive coping, but not adaptive coping, significantly mediated this relationship. This result suggests that family connectedness predicted a reduction in maladaptive coping one year later, and this lower level of maladaptation predicted a reduction in stress-triggering problems a subsequent year later. These and other related findings are important as they highlight several mechanisms shaping unfolding problematic situations experienced by adolescents. Contributions of the results to the existing body of knowledge about adolescents' stress and coping strategies are discussed, as well as their clinical implications for the prevention or reduction of stress experienced by adolescents.

Family function and emotional behavior problems in Chinese children and adolescents: A moderated mediation model

BACKGROUND

Studies have shown that family function is associated with emotional behavior problems. However, the underlying relationship mechanisms between family function and emotional behavior problems in children and adolescents is not fully understood. Therefore, the purpose of this study is to explore the mediating effect of resilience and the moderating effect of sleep quality using a moderated mediation model.

METHODS

6363 children and adolescents in grades four to nine were surveyed in some areas of Anhui Province, China. Family function, resilience, sleep quality, and emotional behavior problems were measured through a self-administered questionnaire. All data analysis was by performed by SPSS 23.0.

RESULTS

The results showed that family function was negatively associated with emotional behavior problems (r = -0.307, p < 0.01). Resilience partially mediated the relationship between family function and emotional behavior problems (indirect effect = -0.108, accounted for 38.4 %). Sleep quality moderated the relationship between family function and resilience (β = -0.039, P < 0.001).

CONCLUSION

Resilience and sleep quality respectively played a mediating and moderating effect in the relationship between family function and emotional behavior problems. These findings suggest that we should pay attention to the family function of children and adolescents in time, improve their resilience and sleep quality, so as to effectively reduce the occurrence of emotional behavior problems.

Family Functioning, Illness-Related Self-Regulation Processes, and Clinical Outcomes in Major Depression: A Prospective Study in Greece

Major depressive disorder (MDD) is a common, seriously impairing, and often recurrent mental disorder. Based on the predictions of the Circumplex Model of Marital and Family Systems and the Common-Sense Self-Regulation Model, the aim of the present prospective study is to examine the predictive value of clinical outcomes of a process model in which associations between perceived family functioning and patient's clinical outcomes (i.e., symptom severity and suicide risk) are mediated by illness representations and coping strategies. A total of 113 patients with a clinical diagnosis of MDD (16.8% males and 83.2% females) aged 47.25 ± 13.98 years and recruited from the outpatient department and the mobile mental health unit of the Psychiatric Clinic of the University Hospital of Heraklion in Crete, Greece, and from a Greek online depression peer-support group participated in the study. Family functioning was assessed in terms of cohesion and flexibility (Family Adaptability and Cohesion Evaluation Scales IV) at baseline. Illness representations (Illness Perception Questionnaire-Mental Health) and coping strategies (Brief Cope Orientation to Problems Experienced) were measured about five months later (5.04 ± 1.16 months). Symptom severity (Beck Depression Inventory) and suicidality (Risk Assessment Suicidality Scale) were measured about 10 months after the baseline assessment (9.56 ± 2.52 months). The results indicated that representations about MDD impact and symptom severity serially mediated the association between family cohesion and suicide risk in MDD. Furthermore, family cohesion was found to be linked with maladaptive coping through MDD impact representations. Family-based psychotherapeutic interventions specifically designed to target unhealthy family functioning, along with negative illness perceptions and dysfunctional coping, could be further developed and explored as adjunctive therapy to standard treatment in MDD.

Being a Young Carer in Portugal: The Impact of Caring on Adolescents' Life Satisfaction

Caring for an ill or disabled relative can present significant challenges that may exceed the personal resources of the caregiver. Young carers (YCs) often take on this role, providing support to family members or friends, which can have far-reaching effects on various aspects of their lives. This study involved 235 adolescents, 106 YCs, and 129 non-carers (NCs), who completed questionnaires assessing life satisfaction, satisfaction with social support, family functioning, academic functioning, and caregiving activities. Tests of group differences (MANOVA and MANCOVA controlling for age) showed YCs had more caregiving activities than NCs (as expected) and, critically, significantly lower life satisfaction. Hierarchical regressions with the YCS subsample showed academic functioning, social support, and the negative impact of caregiving were associated with life satisfaction, and that the negative influence of caregiving was linked to family functioning and the quantity of caregiving activities. For NCs, academic functioning, satisfaction with social support, and family functioning were associated with life satisfaction. In conclusion, caregiving in adolescents appears to be linked to lower life satisfaction, but this effect is determined by their social support, academic functioning, and negative impact of caring, which in turn depends on their family functioning and amount of caring activities.

Adolescents' Perspectives on Facilitators and Barriers to Social Health in the Family: A Qualitative Study

BACKGROUND

Family plays the most fundamental role in the adolescent's health. A deep understanding of family characteristics, beliefs, and function about the adolescent social health provides a framework, relying on which one can perceive how this dimension of health is developed and promoted in this setting. In this study, we aimed to understand the family context that facilitates or limits adolescent social health.

METHODS

Fifty-four adolescents and fifteen parents participated using a purposive sampling method. The findings were collected through semi-structured interviews and group discussions. The data was analyzed through conventional content analysis by the MAXQDA10 software.

RESULTS

Healthy and unhealthy family reactions are the two main categories that facilitate and limit the adolescents' social health. Sub-categories of healthy reactions included effective guidance, cultural safeguard, and accountable interactions. The unhealthy family reactions included sub-categories of poor intergenerational perception and passive parenting.

CONCLUSION

Our findings revealed that the family context of the adolescent's social health ranged from healthy to unhealthy responses. These results can contribute to improving and designing interventions for promoting the adolescent's social health. It is essential for policymakers and health experts to pay attention to the family empowerment approaches.

Funcionalidad Familiar de Adolescentes Asistentes a control prenatal. Cartagena 2021

Introducción: El embarazo en la adolescencia tiende a presentar repercusiones personales, sociales, educativas y psicológicas en la madre y en el hijo. Es por ello por lo que el apoyo de la familia y su funcionalidad resultan cruciales. Objetivo: Determinar el nivel de funcionalidad familiar existente en las familias de las adolescentes gestantes asistentes a controles prenatales en tres instituciones de salud de Cartagena-Colombia durante 2021. Materiales y Métodos: Estudio descriptivo, de corte transversal, y asociación. La población estuvo constituida por 780 adolescentes gestantes que asisten a controles prenatales en dos instituciones. Se determinó una muestra de 185 adolescentes gestantes, seleccionadas mediante muestreo probabilístico. Fue aplicado instrumento sociodemográfico y APGAR familiar. Resultados: Las gestantes participaron de la institución A (50,81%) y de la institución B (44,32%), se trató de adolescentes bachilleres (58,92%), que conviven en unión libre (51,35%), en familias nucleares de origen (32,97%) y sus familias devengan ingresos entre 1 – 2 salarios mínimos (48,11%). El embarazo actual no fue planeado, y a los controles prenatales asisten con la mamá (31,35%), la pareja (27,57%) o solas (22,16%). La funcionalidad normal fue la más frecuente (99,46%), y se presentó asociación (p ≤ 0,05) con las instituciones, con la tipología familiar de naturaleza monoparental conformada y con el acompañamiento a los controles prenatales. Conclusión: Se determinó un nivel de funcionalidad familiar normal en las familias de las adolescentes gestantes asistentes a controles prenatales en dos instituciones de salud de Cartagena.

Are you looking at me? A longitudinal vignette study of adolescent appearance rejection sensitivity and coping with peer evaluation

Appearance rejection sensitivity (ARS) refers to anxiously over-expecting rejection because of perceived appearance flaws. ARS has been associated with poorer mental health, which suggests coping with stress may be negatively affected by ARS. In this study, we investigated if ARS was related to adolescents' emotions and ways of coping with negative appearance evaluation two years later (T2). Other potential correlates of emotions and ways of coping were also tested, including peer appearance teasing, social anxiety, and gender, as well as reports of victimization, social status, and attractiveness gathered from peers. At Time 1 (T1), 329 adolescents (M = 13.9 years, 54% girls) self-reported their ARS, experience of appearance teasing, and social anxiety. T1 appearance victimization, popularity, and attractiveness were measured using peer nominations, and peer likeability was measured with peer ratings. At T2, participants' emotions and coping were measured using vignettes portraying appearance evaluation by peers. In regression models, T1 ARS, appearance teasing, social anxiety and female gender were associated with more T2 negative emotions, social withdrawal, rumination, and (except for social anxiety) thoughts about appearance change. ARS was not significantly associated with T2 positive thinking or support seeking. No peer-report measure was significantly associated with T2 outcomes.

Mental Health, Support System, and Perceived Usefulness of Support in University Students in Hong Kong Amidst COVID-19 Pandemic: A Mixed-Method Survey

BACKGROUND

This study explored the association of students' mental health with their support system, identified the preferred ways and sources of support, investigated the perceived usefulness of available university support, and recommended actionable strategies to enhance students' mental health.

METHOD

An online questionnaire survey and semi-structured focus group interviews were conducted in 2021.

RESULTS

Among 1121 university students, 39.4% reported anxiety symptoms, which were less common in Chinese students and those pursuing medical and health programmes. Overall, 32.6% reported depression symptoms, which were more common in undergraduates. Both anxiety and depression symptoms were less common in students with higher resilience and support system and more common in students with family distress. Students with higher resilience had a better support system and less family distress. Perceived support from universities was lower than from peers and families. Peer support and phone contacts were the most preferred sources and ways of support. The most useful available university support was updated university guidelines, and the least useful was the emotional hotline service from universities The qualitative findings corroborated the quantitative results.

CONCLUSION

We suggested that a holistic care approach and more proactive student-oriented university support would help students face adversity and enhance mental health.

Adolescent Mental Health and Family Economic Hardships: The Roles of Adverse Childhood Experiences and Family Conflict

Rising and economically disproportionate rates of adverse mental health outcomes among children and youth warrant research investigating the complex pathways stemming from socioeconomic status. While adverse childhood experiences (ACEs) have been considered a possible mechanism linking socioeconomic status (SES) and child and youth psychopathology in previous studies, less is understood about how family environments might condition these pathways. Using data from a longitudinal, multiple-wave study, the present study addresses this gap by examining the direct relationships between family economic status and youth internalizing and externalizing symptoms, if ACEs mediate these relationships, and if conflictual family environments moderate these direct and indirect relationships. The data were obtained from 5510 youth participants [mean age at baseline = 9.52 (SD = 0.50), 47.7% female, 2.1% Asian, 10.3% Black, 17.6% Hispanic, 9.8% Multiracial/Multiethnic, 60.2% White] and their caretakers from the baseline, 1-year, and 2-year follow up waves. Conditional process analysis assessed the direct, indirect, and moderated relationships in separate, equivalent models based on youth- versus caregiver-raters of ACEs and youth psychopathology to capture potential differences based on the rater. The results of both the youth- and caregiver-rated models indicated that lower family economic status directly predicted higher levels of externalizing symptoms, and ACEs indirectly accounted for higher levels of internalizing and externalizing symptoms. Additionally, family conflict moderated some, but not all, of these relationships. The study's findings highlight that lower family economic status and ACEs, directly and indirectly, contribute to early adolescent psychopathology, and conflictual family environments can further intensify these relationships. Implementing empirically supported policies and interventions that target ACEs and family environments may disrupt deleterious pathways between SES and youth psychopathology.

Emotional (dys)Regulation and Family Environment in (non)Clinical Adolescents’ Internalizing Problems: The Mediating Role of Well-Being

Adolescence is a period of several changes and a time when young people are confronted with some difficult tasks of dealing with a diversity of emotions and building their own identity. Therefore, it is a period of higher vulnerability for the development of internalizing problems. The present paper aims to study some constructs considered relevant to adolescents’ adjustment and/or internalizing disorders, emphasizing the role of well-being, emotional regulation and family environment. Therefore, this research aims to (1) test the mediating role of well-being in the relationship between emotional regulation difficulties, the family environment, and internalizing problems, and (2) understand the differences between adolescents with a higher and lower risk of presenting internalizing problems. In the study, 723 adolescents of both sexes (12–18 years old) from middle to high school completed self-report questionnaires. The results indicated that the mediating role of well-being was partially established between emotional regulation difficulties and internalizing problems, explaining 31% of the variance in these problems. Well-being was also considered a partial mediator between family environment (cohesion and support and conflict) and internalizing problems, explaining 19 and 26% of the variance, respectively. Furthermore, the group with a higher risk of developing internalizing problems (n = 130) revealed higher levels of emotional regulation difficulties and family conflict. In contrast, this group reported less family cohesion and support and lower levels of well-being. The main results of the present study provide relevant data in the context of clinical practice. Important implications are also discussed for the design of psychopathology prevention programs and the promotion of global well-being with adolescents. Considering the limitations of the present study, such as the nonrandom sampling process and the reduced number of participants included in the clinical group, these results need to be deepened in future research in this area.

An examination of the moderating role of growth mindset in the relation between social stress and externalizing behaviors among adolescents

INTRODUCTION

Experiencing elevated stress increases the risk of further difficulties in mental health, including externalizing behaviors in adolescents. There is a need for understanding the factors that help adolescents mitigate social stress to prevent problematic externalizing behaviors. Growth mindset has been found to be a promising protective factor in adolescent development including mental health. This study aimed to examine the potential buffering role of growth mindset of thoughts-emotion-and-behaviors in the context of two types of social stress (i.e., family and peer) to reduce externalizing behaviors among adolescents.

METHODS

The sample is composed of 399 adolescents (age range 14-18 years, M = 16.22, SD = 1.21; 56.4% female, 42.3% male, 1.3% gender-nonconforming or variant) from a large, urban, diverse high school in the United States. Adolescent self-reports were administered at one time.

RESULTS

Moderation analyses revealed that growth mindset of thoughts, emotion, and behaviors moderate the association between family stress and externalizing behaviors. The magnitude of this association weakened as the level of growth mindset increased, supporting the buffering effect of the moderator. Neither the moderation effect of growth mindset nor the main effects of peer stress and growth mindset were significant in predicting externalizing behaviors.

CONCLUSION

Taken together, the findings suggested that growth mindset has protective effects in reducing externalizing behaviors when adolescents experience family stress. Future directions and implications are discussed.

Leveraging the developmental science of psychosocial risk to strengthen youth psychotherapy

More than 50 years of randomized clinical trials for youth psychotherapies have resulted in moderate effect sizes for treatments targeting the most common mental health problems in children and adolescents (i.e., anxiety, depression, conduct problems, and attention disorders). Despite having psychotherapies that are effective for many children, there has been a dearth of progress in identifying the contextual factors that likely influence who will respond to a given psychotherapy, and under what conditions. The developmental psychopathology evidence base consistently demonstrates that psychosocial risk exposures (e.g., childhood adversities, interpersonal stressors, family dysfunction) significantly influence the onset and course of youth psychopathology. However, the developmental psychopathology framework remains to be well integrated into treatment development and psychotherapy research. We argue that advances in basic developmental psychopathology research carry promising implications for the design and content of youth psychotherapies. Research probing the effects of psychosocial risks on youth development can enrich efforts to identify contextual factors in psychotherapy effectiveness and to personalize treatment. In this article we review empirically supported and hypothesized influences of individual- and family-level risk factors on youth psychotherapy outcomes, and we propose a framework for leveraging developmental psychopathology to strengthen psychotherapies.

How Does Family Connectedness Contribute to Youths' Health? The Mediating Role of Coping Strategies

Family connectedness has important implications for adolescents' well-being, contributing to their physical, psychological, and social health. However, little is known about the mechanisms underlying these effects. The present longitudinal study examined the process by which family connectedness, as perceived by adolescents, predicted greater positive and fewer negative health behaviors in adolescents over time. In particular, we sought to determine whether adaptive and maladaptive coping strategies mediated the link between family connectedness and adolescents' self-reported health status. Data were obtained from 1,774 New Zealand adolescents aged 10-17 years, who completed a self-report survey three times at one-year intervals. With longitudinal mediation path models, we tested whether maladaptive and adaptive coping strategies at T2 functioned as mediators between family connectedness at T1 and overall health, vitality, sleep sufficiency, body satisfaction, substance use, and self-harm at T3. Findings revealed that family connectedness predicted greater levels of adaptive coping, which, in turn, predicted better health indicators but not decreases in ill-health indicators. Furthermore, family connectedness predicted lower maladaptive coping, which, in turn, predicted higher levels of positive health outcomes and fewer negative health outcomes. Results showed that the positive effect of family connectedness on adolescents' health occurred through increased use of adaptive coping strategies, decreased use of maladaptive coping strategies, or both. These results have important implications for practitioners working with adolescents and parents, as well as for health promotion program developers.

Latina/o Children Living With an Immigrant Mother With Depression: Developmental and Cultural Nuances in Recognition and Coping

The psychological experience of maternal depression and its impact on immigrant Latina/o families often goes unrecognized and unaddressed. Children may feel especially helpless and confused about the changes they observe in their mothers' mood and behavior, and about the deterioration of family relationships. Given the interdependence of family structures of immigrant Latina/o households, maternal depression can be detrimental to Latina/o youth attributions and coping strategies, and to their relationship with their mothers. The quantitative focus of most research on maternal depression in Latina/o samples limits our understanding of family processes in maternal depression. The current qualitative study explores the perceived impact of maternal depression on Latina/o youths' attributions and coping strategies. This inquiry involved focus groups with 12 participants aged 9-16 years to explore their perspectives on maternal depression. All youth had participated in a 12-week multifamily group intervention focused on building family and cultural strengths to address maternal depression on immigrant Latina/o families. Findings of the focus groups illuminated the essential experience of youth living with maternal depression, and indicated that there are developmental considerations for how youth recognize and make meaning of maternal depression, and cope with disrupted family life. Additionally, youth reported engaging in these culture-specific ways of coping: using close sibling relationships and family structure as support, having fathers and extended family members engage in additional and restorative parenting practices, and participating in religious practices to seek refuge from family stress. We propose considerations for intervention and further areas of research.

Emotion Socialization and Internalizing Problems in Late Adolescence and Emerging Adulthood: Coping Styles as Mediators

This study examined coping strategies as mediators of the relationship between parental emotion socialization and internalizing problems in late adolescence and emerging adulthood, and whether these relationships varied by gender or ethnicity. Participants were 1,087 individuals (Mage = 19.35 years; 50% male; 61% African American, 36% European American). Results from structural equation modeling indicated that parental supportive responses to sadness and fear were associated with less emotional distress, and this relationship was partly mediated by greater use of task-oriented coping and lower use of emotion-oriented coping. Parental unsupportive responses were related to greater emotional distress, and this relationship was fully mediated by greater use of emotion-oriented coping. Gender and ethnic differences emerged in the links between parental responses and several coping strategies. The findings suggest that parental emotion socialization may contribute to emotional functioning by fostering specific coping strategies, with some differences across gender and ethnicity.