Transactional relationships among cognitive vulnerabilities, stressors, and depressive symptoms in adolescence

B. W, Carlo G, Gonzales NA, Knight GP. U.S. Mexican-origin young adults' mental health relative to interpersonal stressor transitions from childhood to adolescence

OBJECTIVES

This study sought to describe latent transitions in developmentally and culturally salient interpersonal stressors from late childhood to late adolescence and examine whether different transition patterns predicted early adult mental health problems.

METHOD

Data from four waves (Grades 5, 7, 10, 12) of a study of 749 U.S. Mexican-origin youth were used for a latent transition analysis (LTA) of family, peer, and community stressors; distal outcomes of externalizing and internalizing problems were measured 5 years after Grade 12. Latent class analysis (LCA) and LTA were conducted for investigating underlying subgroups of interpersonal stress at each wave and transitions between subtypes over waves.

RESULTS

For the LCA, two latent classes emerged at all four waves, representing low and high interpersonal stress. The LTA model with two classes at all waves was conducted with good fit. Six prominent transition classes emerged and related to young adult internalizing and externalizing problems. Transition class related to young adult internalizing and externalizing problems, such that youth who consistently had exposure to interpersonal stress or who had transitions from low to high exposure had more internalizing and externalizing problems.

CONCLUSIONS

Findings are discussed relative to the developmental salience of these transitions and opportunities to intervene during adolescence to mitigate later mental health problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations between Sex, Rumination, and Depressive Symptoms in Late Adolescence: A Four-Year Longitudinal Investigation

OBJECTIVE

The literature on the association between sex, rumination, and depression indicates significant variability from childhood to adulthood. Although this variability indicates the need for a developmental lens, a surprising lack of research has been conducted on the association between these variables from middle to late adolescence.

METHOD

The present study seeks to bridge this gap using structured equation modeling (SEM) to evaluate the reciprocal associations between sex, brooding rumination, reflective rumination, and depressive symptoms in a sample of students measured at 8th grade, 9th grade, and 12th grade time points.

RESULTS

In line with findings across the lifespan, female participants indicated significantly higher average levels of both subtypes of rumination and depressive symptoms versus males. Novel results of this study include the findings that for male participants in this age range, brooding rumination predicted later depressive symptoms, while for female participants, early depressive symptoms predicted later brooding. For female participants, early reflective rumination predicted later depressive symptoms.

CONCLUSIONS

This is the first investigation of its kind to demonstrate deleterious longitudinal effects of self-reflective rumination. Findings are interpreted through an ecological framework and mark the transition to high school as a potential risk for interrupted problem-solving of circumstances related to adolescents' distress.

The Role of Men's Sexual Beliefs on Sexual Function/Dysfunction: A Systematic Review

Cognitive models of sexual dysfunction postulate that inflexible, unrealistic, and erroneous sexual beliefs work as a vulnerability factor for the development of sexual dysfunctions and existing studies give some support to this hypothesis. However, to date, there is no published systematic review of studies testing the association between men's sexual beliefs and sexual functioning. This systematic review was conducted from searches using EBSCO, PubMed, and Web of Science databases identifying peer-reviewed studies and gray literature sources from inception to November 2021. Twenty cross-sectional studies, assessing correlations between the degree of endorsement of sexual beliefs and sexual functioning and comparing endorsement of sexual beliefs in men with and without sexual problems were included. Despite the small effect sizes, results indicate that higher endorsement of inflexible/unrealistic/erroneous sexual beliefs is associated with poorer sexual functioning and that men presenting with sexual problems tend to report higher endorsement of these sexual beliefs. Further research with clinical samples as well as longitudinal studies are necessary to explore the ways these associations emerge and develop. The state of evidence on this research topic, including gaps and limitations, is discussed.

The influence of mental toughness and self-regulation on post-season perceptions in varsity athletes

OBJECTIVE

To investigate whether pre-season self-reported mental toughness and self-regulation strategies predicts post-season stress, mental health, group cohesion, and satisfaction in varsity athletes.

PARTICIPANTS

Sixty-seven varsity athletes from a U-Sport Canadian university.

METHODS

Athletes completed pre- and post-season measures of mental toughness, emotion regulation, self-control, group cohesion, and satisfaction. Multiple mediation models were employed during analyses.

RESULTS

Pre-season emotion regulation was a significant mediator for the relationships between mental toughness and post-season ratings of perceived stress, perceived mental health, and group cohesion. Self-control was not a significant mediator.

CONCLUSIONS

Emotion regulation plays a significant role in an athlete's experience of perceived stress, mental health issues, and their ratings of group cohesiveness. Research on student-athlete health may benefit from examining emotion regulation training techniques.

Co-occurring Stress Trajectories and the Longitudinal Coupling of Internalizing Symptoms in Parent-Adolescent Dyads

Stress is one candidate mechanism posited to contribute to the intergenerational risk of psychopathology. However, the ways in which parent and child stress are related across adolescence, and the role that co-occurring parent and child stress may exert regarding bidirectional risk for internalizing symptoms, are not well understood. Using repeated measures data spanning 3-years, this study investigated (1) the extent to which trajectories of parent and child stress are related during adolescence, and (2) whether co-occurring parent and child stress trajectories mediate prospective, bidirectional associations between parent depression symptoms and child internalizing symptoms (depression, physical and social anxiety). Participants included 618 parent-adolescent dyads (age 8-16; 57% girls; 89% mothers). Parent depressive symptoms and child symptoms of depression, social anxiety, and physical anxiety were assessed via self-report questionnaire at baseline and 36 months later. Parent and child stress were assessed via self-report questionnaire every three months between 3- and 33-months (11 total assessments). Latent growth curve model (LGCM) analysis found that parent and child stress trajectories were positively related across development. Prospective LGCM mediation analysis showed that higher youth stress at 3-months partially mediated prospective relations between parental depressive symptoms at baseline and youth depressive, as well as physical and social anxiety symptoms at 36-months. Parent and child stress reinforce each other across adolescence and may lead to increased risk for psychopathology. Increases in child stress represent an important factor conferring transdiagnostic risk for internalizing among children of depressed parents.

General Psychopathology, Cognition, and the Cerebral Cortex in 10-Year-Old Children: Insights From the Adolescent Brain Cognitive Development Study

General psychopathology and cognition are likely to have a bidirectional influence on each other. Yet, the relationship between brain structure, psychopathology, and cognition remains unclear. This brief report investigates the association between structural properties of the cerebral cortex [surface area, cortical thickness, intracortical myelination indexed by the T1w/T2w ratio, and neurite density assessed by restriction spectrum imaging (RSI)] with general psychopathology and cognition in a sample of children from the Adolescent Brain Cognitive Development (ABCD) study. Higher levels of psychopathology and lower levels of cognitive ability were associated with a smaller cortical surface area. Inter-regionally—across the cerebral cortex—the strength of association between an area and psychopathology is strongly correlated with the strength of association between an area and cognition. Taken together, structural deviations particularly observed in the cortical surface area influence both psychopathology and cognition.

Specific early maladaptive schemas differentially mediate the relations of emotional and sexual maltreatment to recent life events in youth with depression

The current study provided a novel investigation of relations among particular types of childhood maltreatment (emotional vs. physical vs. sexual maltreatment), specific cognitive schema themes and the generation of dependent versus independent life events. Participants included 227 adolescents and emerging adults (74% female; aged 12-29) in a current episode of a unipolar depressive disorder drawn from three archival cross-sectional studies. Childhood maltreatment and life events from the past 6 months were assessed using detailed contextual interviews with independent, standardized ratings. Emotional maltreatment was uniquely associated with schema themes of emotional deprivation and subjugation, and sexual maltreatment was uniquely associated with schema themes of abandonment, vulnerability and dependence/incompetence. Further, subjugation and abandonment cross-sectionally mediated the relations of emotional and sexual maltreatment, respectively, to greater dependent, but not independent, life events. Physical maltreatment was not associated with cognitive schemas or recent life events after accounting for its overlap with emotional and sexual maltreatment. Results suggest targets for cognitive intervention that may improve outcomes for youth with specific histories of emotional and sexual maltreatment.

The Conceptualization of the Positive Cognitive Triad and Associations with Depressive Symptoms in Adolescents

The positive cognitive triad (positive cognitions about the self, world, and future) has been considered a protective factor against depressive symptoms. This study examines three conceptualizations of the positive cognitive triad and their relation to depressive symptoms. Analyses were replicated in two samples in order to provide evidence for the validity of findings. Two samples (n₁ = 2982, M_age = 13.04, Range_age = 11-15 years; n₂ = 2540, M_age = 13.11, Range_age = 11-16 years) of Australian adolescents completed the Positive Cognitive Triad Inventory and Center for Epidemiological Studies Depression Scale. Findings supported the notion that the overall positive cognitive triad is a protective factor for depressive symptoms, and specifically, the role of positive cognitions about the self in this protection. After future studies examine the directionality of the relation between positive cognitions and depressive symptoms, mental health providers using cognitive behavioral approaches may consider examining positive cognitions with patients.

Stress Mediates the Within-Person Longitudinal Associations Between Depression and Different Anxiety Syndromes in Youth

Depressive symptoms predict within-person change in physical symptoms of anxiety and social anxiety symptoms; however, potential mediators of these within-person associations remain understudied. The current study examined whether overall stress, interpersonal stress, and achievement stress mediate the associations between depressive symptoms and physical, social, and separation anxiety symptoms for girls and boys in a sample of 680 community youth aged 8-18 (M = 11.8, SD = 2.4; 55% female) using a random intercept cross-lagged panel model (RI-CLPM). Participants completed measures of anxiety symptoms, depression symptoms, and stress (Adolescent Life Events Questionnaire) every 3 months for 3 years (13 total assessments). Overall and interpersonal stress partly mediated the longitudinal, within-person associations between depression symptoms and physical symptoms of anxiety and between depression symptoms and social anxiety symptoms. Stress did not mediate the longitudinal associations between depression and separation anxiety symptoms. Multigroup models indicated that total stress mediated the associations between depression and physical symptoms of anxiety, and between depression and social anxiety for girls but not for boys. Results support the role of stress as a mediator of the association between depression and anxiety symptoms and suggest that, as youth experience depression-related impairment, they may generate additional stressors, which increase their symptoms of physical and social anxiety.

Adolescent and Maternal Anxiety Symptoms Decreased but Depressive Symptoms Increased before to during COVID-19 Lockdown

Mothers (n = 155) and their adolescent children (n = 146; aged 12-13 at pre-COVID wave [Time 1, September 2019 to March 2020]) repeated measures of anxiety and depressive symptoms, and details about the impacts of the pandemic and social distancing at Time 2 (May-June 2020). Average slopes of mother and adolescent depression increased but anxiety symptoms decreased from Time 1 to Time 2. Adolescent decreases in anxiety symptoms were driven by males, whereas depression increase was driven by females. Adolescents' depression slopes were steeper for those who reported more negative changes. Implications are discussed relative to findings from other regions and later phases of the pandemic.

Examining the relationship between anhedonia symptoms and trait positive appraisal style in adolescents: A longitudinal survey study

INTRODUCTION

Anhedonia, defined as a loss of interest and pleasure in previously enjoyable activities, is a core symptom of depression that predicts a poor treatment response in adolescents. We know little about the cognitive vulnerability factors that contribute to the development of anhedonia in youth. This cross-sectional and longitudinal survey study investigated the link between anhedonia symptoms and cognitive appraisal of positive affect.

METHODS

Baseline data were collected from 392 secondary school students in the UK (aged 13-16, 54 % Female), 170 of whom went on to complete the three-month follow-up assessment (a 43 % response rate). Participants rated their anhedonia symptoms and appraisal styles which were measured in terms of use of amplifying appraisals, dampening appraisals, and fear of positive emotion.

RESULTS

At baseline, greater anhedonia was significantly associated with increased levels of dampening and reduced levels of amplifying but was not significantly related to fear of positive emotion. Prospectively, greater baseline levels of amplifying uniquely predicted lower anhedonia severity at three-month follow-up, and vice-versa. There was no evidence for reciprocal prospective associations between anhedonia and, appraisal styles of dampening and fear of positive emotion.

CONCLUSION

These results indicate that cognitive appraisal of positive affect is associated with concurrent and to some extent can predict future symptoms of anhedonia in youth.

Negative Inferential Style Mediates the Association between Racial Identity and Depressive Symptoms among African American Adolescents

Negative inferential style is a cognitive vulnerability for depression. Yet, few studies have explored how this risk factor intersects with culturally-specific protective factors, such as racial identity, in a unified cognitive risk-cultural asset model in youth of color. The current study addressed this gap by exploring the interplay between negative inferential style, racial identity, and depressive symptoms in an urban African-American adolescent community sample (N = 233; 51.9% female). Cross-lagged panel analyses estimated concurrent and prospective relationships between study variables. Racial identity dimensions of regard, but not centrality, were significant predictors of inferential style, and buffered against the development of depressive symptoms via the development of a less negative inferential style. Implications for the study of racial identity and cognition, and treatment of African-American adolescents are discussed.

Cyberbullying victimization and nonsuicidal self-injury in adolescents: The role of maladaptive schemas and dispositional mindfulness

BACKGROUND

Previous research has found associations between cyberbullying victimization and nonsuicidal self-injury (NSSI) in adolescents. Exploration of the possible mediating variables involved is necessary to support intervention with victims.

OBJECTIVE

This study examined whether depression and early maladaptive schemas (EMS) mediate the association between cyberbullying victimization and NSSI, along with the potential protective role of dispositional mindfulness.

PARTICIPANTS AND SETTING

A total of 742 Spanish adolescents (50.20% girls) between 12 and 17 years old (M = 14.58; SD = 1.00) participated in the final sample.

METHOD

Participants completed measures of cyberbullying victimization, NSSI, EMS, depression, and mindfulness facets. Mediational models moderated by facets of mindfulness were tested.

RESULTS

Cyberbullying victimization was associated with NSSI through increased depression and EMS. Acting with awareness buffered the association between cyberbullying victimization and NSSI, whereas non-judging increased the association between cyberbullying victimization and depression.

CONCLUSIONS

Cybervictimization is associated with NSSI. The mindfulness facet of acting with awareness plays a protector role. Interventions in NSSI and cyberbullying could benefit from these findings.

Cognitive Flexibility and Selective Attention's Associations with Internalizing Symptoms in Adolescents: Are they Reciprocal?

Although both executive functions and internalizing symptoms go through important changes during adolescence, the role of executive functions in internalizing symptoms is unclear. Based on developmental cascade models of psychopathology, this study aimed to fill this gap by studying the bidirectional predictive relationship between executive functions (cognitive flexibility and selective attention) and symptoms of depression and social anxiety. A sample of 698 adolescents (40.8% girls) between 12 and 17 years of age (M = 14.59, SD = 1.36) participated in three waves over 1 year. They completed measures of executive functions and internalizing symptoms. Depressive symptoms predicted deficits in executive functions. Conversely, social anxiety symptoms predicted an improvement in cognitive flexibility. These results suggest that executive function deficits are not a risk factor for the development of depressive symptoms but a consequence of them, and there are specific patterns of associations for depressive and social anxiety symptoms.

Psychological Mediators of the Association Between Childhood Emotional Abuse and Depression: A Systematic Review

Background: A number of existing meta-analyses and narrative reviews have already addressed the relation between childhood adversity and depression, yet none of them has examined the specific link between emotional abuse and depression highlighted by previous research. It is no longer appropriate to regard childhood maltreatment as a unitary concept when considering its effects on subsequent depression; instead, subtypes of childhood maltreatment need to be scrutinized separately. This review addresses this significant gap by critically evaluating empirical studies examining psychological mediators of the relationship between childhood emotional abuse and subsequent depression. Methods: A systematic search of nine electronic databases was conducted to identify eligible studies published in English between January 1980 and January 2020. Given the heterogeneous outcomes of eligible studies and the inconsistent reporting of indirect effects, a narrative synthesis, rather than a quantitative meta-analysis, was conducted. An appraisal of methodological quality was also included. Results: We identified 34 papers, comprising 18,529 adults and 3,434 adolescents, including 888 clinical participants. Our synthesis suggests that studies on mediators in the emotional abuse-depression link have focused on five clusters of intervening variables: early maladaptive schemas, cognitive-personality variables, emotion dysregulation, interpersonal styles, and stressful negative events. Only 11 studies identified the unique contribution of emotional abuse to depression by controlling for other forms of childhood maltreatment. Conclusions: Our findings support several routes with relative consistency (e.g., early maladaptive schemas, hopelessness, negative cognitive styles, brooding rumination, overall emotion dysregulation). Because psychological mediators function as a complex interrelated system, controlling for the interrelation between them is important. The evidence for the purported mediating role of the factors identified in this review should be considered with caution given the relative dearth of large-scale, adequately powered longitudinal studies. This review proposes a comprehensive multilevel theoretical framework as a basis for future research.

The Effect of an Intervention Teaching Adolescents that People can Change on Depressive Symptoms, Cognitive Schemas, and Hypothalamic-Pituitary-Adrenal Axis Hormones

Interest is increasing in developing universal interventions to prevent depression in adolescents that are brief enough to be scaled up. The aim of this study was to test the effects on depressive symptoms, cognitive schemas, and Hypothalamic-Pituitary-Adrenal Axis Hormones of an intervention focused on teaching an element of an incremental theory of personality, namely, the belief that people can change. We also examined whether grade level moderated the effects of the intervention. A double-blind, randomized, controlled trial was conducted with 867 Spanish adolescent participants (51.9% boys, Grades 8-10) randomly assigned to an incremental theory intervention (n = 456) or an educational control intervention (n = 411). The adolescents completed measures of depressive symptoms and negative cognitive schemas at pretest, at 6-month follow-up, and at 12-month follow-up. A subsample of 503 adolescents provided salivary samples for cortisol and DHEA-S testing. In 8th grade, adolescents who received the incremental theory intervention displayed a greater decrease in depressive symptoms and cognitive schemas and a lower increase in DHEA-S. Moreover, in adolescents who received the intervention, the rate of adolescents with high depression scores decreased by almost 18% whereas in the control group, the rate increased by 37%. Surprisingly, the effects of the intervention were in the opposite direction among adolescents in 9th grade. These data indicate that a brief universal intervention could prevent depressive symptoms under some conditions, but developmental characteristics can moderate the effectiveness of this approach.

Prevalence of depressive symptoms in primary school students in China: A systematic review and meta-analysis

BACKGROUNDS

Depression in children and adolescents is usually under-recognized. The findings of epidemiological studies on depressive symptoms in primary school students are inconsistent across studies. This study reports a systematic review and meta-analysis on the prevalence of depressive symptoms in primary school students in China.

METHODS

Literature search was performed in both international (PubMed, PsycINFO, EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and Chinese Biological Medical Literature) databases. The random-effects model was used to analyze data.

RESULTS

Twenty-seven studies involving 42,374 subjects were included. The pooled prevalence of depressive symptoms in Chinese primary school students was 17.2% (95% CI: 14.3%-20.5%). Subgroup analyses found that the prevalence significantly varied between geographic regions, with western China reporting the highest prevalence. Meta-regression analyses found that year of survey and study quality were significantly associated with the prevalence of depressive symptoms.

CONCLUSIONS

Given the high prevalence of depressive symptoms and its negative health outcomes, preventive measures, regular screening and effective treatments need to be implemented for this population.

Psychosocial risk factors associated with depressive symptoms among adolescents in secondary schools in mainland china: A systematic review and meta-analysis

BACKGROUND

The objective of the study is to systematically estimate the effect size of psychosocial risk factors for depressive symptoms among adolescents in secondary schools in mainland China.

METHOD

A literature search was conducted in both English and Chinese databases. This meta-analysis used a random-effects model to estimate the effect size.

RESULTS

Fifteen psychosocial risk factors were identified in a total of 164 articles. The results revealed the absolute value of effect size ranging from 0.16 to 0.43. Among them, poor parent-child communication (r = 0.43), negative life events (r = 0.40), academic pressure (r = 0.40), abuse (r = 0.33), poor family functioning (r = 0.33), bullying (r = 0.32), and poor family cohesion (r = 0.32) were associated with depression with a medium to large effect. Moderator analysis shows that grade, study quality, mean age, and gender were significant moderators of at least one factor for depression.

LIMITATIONS

Limitations included the heterogeneity which is largely unexplained, and the inability to investigate the interactions of different factors and to determine the direction of causal relationships between psychosocial factors and depression in the present meta-analysis.

CONCLUSIONS

This study suggests that family-related factors and school-related factors may be significantly associated with depressive symptoms in Chinese secondary school students. Further research is needed to develop effective strategies to modify these factors in depression prevention programmes.

Dispositional Mindfulness Profiles in Adolescents and their Associations with Psychological Functioning and Hypothalamic-Pituitary-Adrenal Axis Hormones

Adolescence is often accompanied by an increase in stress and depression. Although there is considerable consensus about the benefits of mindfulness-based interventions to reduce these problems, the results for the role of dispositional mindfulness facets have been mixed. Recent studies have contributed to clarifying this role by identifying subtypes of individuals according to their profiles in mindfulness facets and examining the functioning of these profiles in relation to several self-reported indicators of wellbeing and health. The current study extends previous research by exploring mindfulness profiles in adolescents and by providing several sources of indicators (self-reports, parent-reports, and hypothalamic-pituitary-adrenal axis hormones) to examine the adaptive role of these profiles. A sample of 571 adolescents (50.61% girls; 12-17 years old) completed measures of mindfulness, depression, maladaptive schemas, and temperament (neuroticism, extraversion, and effortful control), and provided salivary samples for cortisol and dehydroepiandrosterone sulfate. In addition, 331 adolescents' parents completed measures of their children' temperaments. The results of latent profile analyses supported a three-profile solution: (1) moderate mindfulness (65.5%), (2) judgmental observing (24.2%), and (3) nonjudgmentally aware (10.3%). The judgmental observing profile was associated with a worse adjustment, indicated by higher depressive symptoms, maladaptive schemas, perceived stress, stress-associated hormones, and neuroticism, as well as lower scores on extroversion and effortful control. This profile was more frequent among the oldest adolescents. In contrast, the nonjudgmentally aware group presented a better adjustment and was more frequent among the youngest adolescents. These findings have implications for preventive interventions. Analyzing the specific profile of each adolescent can help improve individual intervention, taking into account the strengths and weaknesses of each adolescent.

Effect of Parenting and Peer Stressors on Cognitive Vulnerability and Risk for Depression among Youth

Parenting behaviors influence clinical depression among youth, but little is known about the developmental processes that may account for this association. This study investigated whether parenting is associated with the onset of clinical depression and depressive symptoms through negative cognitive style, particularly under conditions of high exposure to stressors, in a community sample of children and adolescents (N = 275; 59% girls). Observational methods were used to assess positive and negative parenting during a laboratory social-evaluative stressor task. Depressive symptoms and clinical depressive episodes were repeatedly assessed over an 18-month prospective follow-up period. Results supported a conditional indirect effect in which low levels of observed positive parenting during a youth stressor task were indirectly associated with an increased likelihood of experiencing an episode of depression and worsening depressive symptoms over the course of the study through youth negative cognitive style, but only for youth who also experienced a high number of peer stressors. These findings elucidate mechanisms through which problematic parenting may contribute to risk for the development of clinical depression during the transition into and across adolescence. Implications for depression interventions are discussed.

Relation between cognitive and behavioral strategies and future change in common mental health problems across 18 years

Major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD), constitute common mental disorders that may have chronic and disabling courses. Cognitive and behavioral theories posit that lack of engagement in certain strategies (goal persistence, self-mastery, positive reappraisal) increases vulnerability toward these disorders. Further, scar effect theories assert that experiencing more of these disorders may diminish engagement in such strategies within individuals across time. However, dynamic longitudinal associations between cognitive-behavioral strategies (CBS) and disorder counts across adulthood are not well understood. Using bivariate latent difference score models, this study aimed to test the dynamic trajectories between disorder counts and each CBS across 18 years. Participants were 3,294 community-dwelling adults ages 45.62 years (SD = 11.41, range = 20-74; 54.61% female) who took part in 3 waves of measurement spaced 9 years apart. Self-mastery, disorder counts, and their change were not significantly related. However, higher within-subject increase in goal persistence (but not self-mastery or positive reappraisal) led to greater future decline in disorder counts, but not vice versa. Last, within individuals, greater prior levels of goal persistence and positive reappraisal predicted larger subsequent reduction in disorder counts, and vice versa. The reciprocal, bidirectional associations between specific CBS (goal persistence, positive reappraisal) and disorder counts support both vulnerability and scar models of depression and anxiety. Treatments for MDD, GAD, and PD should attempt to enhance perseverance and optimism. Theoretical and clinical implications are further discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Traumatic life event exposure and psychotic-like experiences: A multiple mediation model of cognitive-based mechanisms

Several cognitive mechanisms have been proposed to account for the relationship between exposure to traumatic life events (TLEs) and the entire psychosis spectrum. However, only few of these mechanisms have been empirically tested and those that have been tested have not considered multiple mechanisms simultaneously. The purpose of this study was to examine whether perceived stress, dissociation, negative self-schemas, negative other-schemas, and/or external locus of control mediated the association between TLEs and psychotic-like experiences (PLEs). An undergraduate sample of 945 individuals completed a battery of self-report questionnaires. We found significant indirect effects from TLE exposure to PLEs through perceived stress, dissociation, external locus of control, negative self-schemas, and negative other-schemas. When controlling for comorbid psychological symptoms, only the indirect effect from TLE exposure to PLEs through dissociation continued to be significant. Targeting stress sensitivity, maladaptive schemas, dissociative tendencies, and externalizing attributional styles may prove useful in the amelioration of risk for various psychopathologies (e.g., mood, psychosis) in the aftermath of TLE exposure. Findings underscore the importance of targeting trauma-related cognitions in the prevention or reduction of psychotic-like experiences or disorders.

Prevalence of depressive symptoms among adolescents in secondary school in mainland China: A systematic review and meta-analysis

BACKGROUND

The objective of the study reported here is to systematically estimate the prevalence of depressive symptoms among adolescents in secondary schools in mainland China.

METHOD

Literature searches were conducted in both English and Chinese databases from database inception to January 2018. This meta-analysis used a random-effects model to estimate the prevalence of depressive symptoms.

RESULTS

Fifty-one eligible studies (n = 144,060) using probability sampling were identified. The results revealed a pooled prevalence of depressive symptoms of 24.3% (95% CI, 21.3%-27.6%), with high between-studies heterogeneity (Q = 9909, I² = 99.5%, p < 0.001). The prevalence estimates reported by the individual studies ranged from 6.2% to 64.8%. There was an increased prevalence with increasing grades from year 1 in junior secondary school (24.5%; 95% CI, 17.8%-32.8%) to year 3 in senior secondary school (40.1%; 95% CI, 29.4%-51.9%) (Q = 7.1, p < 0.01). Potential sources of high heterogeneity of prevalence among studies can be accounted for by screening instruments with different cutoffs. Further analysis stratified by gender, grade, household registration (hukou) and number of children in the household were performed.

LIMITATIONS

Limitations include the high level of heterogeneity between studies (mainly from the heterogeneity of measurement tools) and stringent inclusion and exclusion criteria.

CONCLUSIONS

This study suggests that depressive symptoms are common among Chinese secondary school students. Further research is needed to identify the risk factors and effective strategies for preventing and treating depression among adolescents in secondary schools.

Bidirectional Relationships Between Stress, Depressive Symptoms, and Cognitive Vulnerabilities in Adolescents

Introduction: Depression is a highly prevalent problem in adolescence, with great clinical and social relevance. Recent models of psychopathology in childhood and adolescence underscore that the relationships between stress, cognitive vulnerabilities, and depressive symptoms are bidirectional. In addition, according to cognitive therapy models, cognitive vulnerabilities are organized hierarchically, with deep schemas guiding more superficial cognitive processes such as rumination. The present study examines the longitudinal predictive relationships between two levels of cognitions (early maladaptive schemas and rumination), stressors, and depression.

Method: A sample of 584 Spanish adolescents (262 girls; mean age = 15.99, SD = 1.10) completed measures of depression, stressors, rumination, and three early maladaptive schema domains (disconnection and rejection, impaired autonomy and other-directedness) over 4 intervals of 4 months. Path analysis was used to test the hypotheses of the study.

Results: Disconnection and rejection domain systematically predicted an increase in depression, new stressors, and rumination over time. In addition, depressive symptoms predicted an increase of disconnection/rejection scores at all time points. Finally, from Time 2 on, stressors predicted an increase in all schema domains.

Discussion: The outcomes suggest the importance of the disconnection and rejection schema domain. These results are important to understand the mechanisms underlying stress and depression in adolescents.

Development of a Shortened Version of the Adolescent Stress Questionnaire (ASQ-S): construct validity and sex invariance in a large sample of Swedish adolescents

Background

Stressor experience is an important topic of research concerning adolescent health and ill-health. For this, valid and reliable measures of adolescent stress are needed. The Adolescent Stress Questionnaire 2 was developed to tap into stressor domains specific for adolescence. Psychometric evaluations in Australian and European samples have indicated adequate psychometric properties. However, the ASQ-2 is quite extensive, which may render its use in large cohort studies, where several aspects of adolescent health are investigated, inconvenient and problematic.

Objective

To evaluate the psychometric properties of a short version of the ASQ-2 (ASQ-S) in terms of construct validity and factorial invariance across gender.

Method

The ASQ-2 was translated into Swedish and items were retained from nine of the ten scales based on factor loadings. One scale (stress of emerging adult responsibilities) was removed entirely due to low internal consistency and variance explained. The remaining 27 items were piloted and then included in an ongoing 5-year longitudinal study involving the participation of all students in the 7th and 8th grade in public schools from three Swedish municipalities (N = 2768, 47.5 % girls, mean age 13.64 years). For this study data from the first and second wave was used.

Results

A nine factor Confirmatory Factor Analysis (CFA) showed a good fit to the data and invariance across sexes was supported. The nine scales correlated positively with depressive symptoms, anxiety and worry and negatively with self-esteem. Girls reported higher stress levels than boys in eight of the nine scales. Stressors related to peer pressure predicted reported levels of anxiety and worry one year later, whereas stressors related to romantic relationships predicted depressive symptoms.

Conclusions

Overall this study suggests that the ASQ-S could be a valid measure of adolescent stressor experience and psychometrically equivalent to the full ASQ-2.

Maladaptive schemas as mediators of the relationship between previous victimizations in the family and dating violence victimization in adolescents

This study examined whether exposure to family violence, both in the form of direct victimization and witnessing violence, predicted dating violence victimization in adolescents through maladaptive schemas. A sample of 933 adolescents (445 boys and 488 girls), aged between 13 and 18 (M = 15.10), participated in a three-year longitudinal study. They completed measures of exposure to family violence, maladaptive schemas of disconnection/rejection, and dating violence victimization. The findings indicate that witnessing family violence predicts the increase of dating violence victimization over time, through the mediation of maladaptive schemas in girls, but not in boys. Direct victimization in the family predicts dating violence victimization directly, without the mediation of schemas. In addition, maladaptive schemas contribute to the perpetuation of dating violence victimization over time. These findings provide new opportunities for preventive interventions, as maladaptive schemas can be modified.

Cognitive reappraisal attenuates the association between depressive symptoms and emotional response to stress during adolescence

Depression is associated with increased emotional response to stress. This is especially the case during the developmental period of adolescence. Cognitive reappraisal is an effective emotion regulation strategy that has been shown to reduce the impact of emotional response on psychopathology. However, less is known about whether cognitive reappraisal impacts the relationship between depressive symptoms and emotional responses, and whether its effects are specific to emotional reactivity or emotional recovery. The current study examined whether cognitive reappraisal moderated the relationship between depressive symptoms and trait or state measures of emotional reactivity and recovery. A community sample of 127 adolescents (M-age = 15.28; 49% female, 47% Caucasian), at an age of risk for depression, completed self-report measures of trait emotional responding and depressive symptoms. In addition, they completed an in vivo social stress task and were assessed on state emotional reactivity and recovery from the stressor. Findings suggested that cognitive reappraisal was associated with an attenuated impact of depressive symptoms on trait and state emotional recovery. These results provide evidence that cognitive reappraisal may be an effective strategy for improving some aspects of emotional responding in relation to depressive symptoms among adolescents.

Associations between friend conflict and affective states in the daily lives of adolescents

This study examined the associations between friend conflict, defined as arguments with friends, and affective states using a daily diary design in a community sample of adolescents. Participants were 100 U.S. adolescents (13-17 years; 40% girls; 79% white). Adolescents completed an online survey on 14 consecutive evenings. Adolescents reported significantly higher anger/hostility, confusion, and tension/anxiety and less friendliness on days during which they experienced friend conflict relative to no-conflict days. However, no same-day associations for depressed affect, fatigue, or vigor were found. Adolescents experiencing friend conflict reported increased next-day anger/hostility, depressed affect, and tension/anxiety, but not other affective states. Higher levels of anger/hostility and depressed affect predicted an increased likelihood of next-day friend conflict. Conversely, higher levels of friendliness and vigor predicted a decreased likelihood of next-day friend conflict. These findings suggest that directional relationships between adolescents' friend conflicts and their affective states vary by affective domain.

Co-Rumination Exacerbates Stress Generation among Adolescents with Depressive Symptoms

Through stress generation, individuals' own thoughts and behaviors can actually lead to increases in their experience of stress. Unfortunately, stress generation is especially common among individuals who are already suffering from elevated depressive symptoms. However, despite the acknowledgement that some individuals with depressive symptoms generate greater stress than others, few studies have identified specific factors that could exacerbate stress generation among individuals with depressive symptoms. The present study examines co-rumination as a factor that might exacerbate stress generation among adolescents with depressive symptoms using a short-term longitudinal design. Considering these processes among adolescents was critical given that many youth experience increases in depressive symptoms at this developmental stage and that co-rumination also becomes more common at adolescence. Participants were 628 adolescents (326 girls; 302 boys) who reported on their depressive symptoms, experiences of stress, and co-rumination with a best friend. Interpersonal stressors (peer and family stress) and non-interpersonal stressors (school and sports stress) were assessed. Consistent with past research, adolescents with depressive symptoms experienced greater interpersonal and non-interpersonal stress over time. Importantly, co-rumination interacted with both depressive symptoms and gender in predicting increases in peer stress. Depressive symptoms predicted the generation of peer stress only for girls who reported high levels of co-rumination with friends. Implications for protecting youth with depressive symptoms against stress generation are discussed.

The Dusseldorf Illustrated Schema Questionnaire for Children (DISC)

Childhood experiences are considered to be of crucial importance in the formation of maladaptive schemas, according to Young’s concept. Although some schema questionnaires already exist for children, these instruments differ in their schema structures with between 8 and 12 identified factors. To obtain a deeper understanding of early maladaptive schemas in childhood an instrument based on Young’s 18-schema model was constructed (Dusseldorf Illustrated Schema Questionnaire for Children (DISC)).

Cartoons were designed which represented each schema, providing children with a visual impression of what was meant by the schema, and thus the questions that they had to answer. The items were phrased as self-report statements and children’s approval of the statements was assessed using a 4-point rating scale. The resulting preliminary questionnaire (18 cartoons, 90 items) was presented in classrooms across different school types (N = 569, between 8 and 13 years). A confirmatory factor analysis (CFA) was performed on this data to confirm the factorial structure of the questionnaire and to reduce the number of items to two items per schema. The DISC in its final version included 36 items and showed a sufficiently high test-retest reliability and convergent validity when assessed in comparison to another schema questionnaire for children. In addition, the present test is of predictive value since the DISC sum score correlated with ratings on the children’s behavioral problems. CFA showed a satisfactory goodness-of-fit based on the original 18-factor model, providing a compact instrument to assess schema representations and to evaluate the dynamics of maladaptation during child development.

Understanding comorbidity among internalizing problems: Integrating latent structural models of psychopathology and risk mechanisms

It is well known that comorbidity is the rule, not the exception, for categorically defined psychiatric disorders, and this is also the case for internalizing disorders of depression and anxiety. This theoretical review paper addresses the ubiquity of comorbidity among internalizing disorders. Our central thesis is that progress in understanding this co-occurrence can be made by employing latent dimensional structural models that organize psychopathology as well as vulnerabilities and risk mechanisms and by connecting the multiple levels of risk and psychopathology outcomes together. Different vulnerabilities and risk mechanisms are hypothesized to predict different levels of the structural model of psychopathology. We review the present state of knowledge based on concurrent and developmental sequential comorbidity patterns among common discrete psychiatric disorders in youth, and then we advocate for the use of more recent bifactor dimensional models of psychopathology (e.g., p factor; Caspi et al., 2014) that can help to explain the co-occurrence among internalizing symptoms. In support of this relatively novel conceptual perspective, we review six exemplar vulnerabilities and risk mechanisms, including executive function, information processing biases, cognitive vulnerabilities, positive and negative affectivity aspects of temperament, and autonomic dysregulation, along with the developmental occurrence of stressors in different domains, to show how these vulnerabilities can predict the general latent psychopathology factor, a unique latent internalizing dimension, as well as specific symptom syndrome manifestations.

The role of childhood trauma, early maladaptive schemas, emotional schemas and experimental avoidance on depression: A structural equation modeling

The present investigation was designed to examine disconnection and rejection (DR) schemas, negative emotional schemas (NESs) and experimental avoidance (EA) as mediating variables of the relationship between the childhood trauma (CT) and depression. Specifically we examined the mediating role of NESs and EA between DR schemas and depression. The study sample consist of 439 female college students (M_age=22.47; SD=6.0), of whom 88 met the criteria for current major depressive disorder (MDD) and 351 who had history of MDD in the last 12 months. Subjects were assessed by Structured Clinical Interview for DSM-IV (SCID) and completed the Childhood Trauma Questionnaire (CTQ), the Early Maladaptive Schemas Questionnaire (SQ-SF), the Leahy Emotional Schemas Scale (LESS), the Acceptance and Action Questionnaire (AAQ-II), and the Beck Depression Inventory-II (BDI-II). The findings showed that DR schemas were mediator of the relationship CT and depression but CT through the NESs and EA did not predict depression. NESs were mediator of the relationship between DR schemas and depression and EA was mediator of the relationship between DR schemas and depression. In general, results suggest that intervention of depressed women may need to target the changing of DR schemas, NESs and reduction of EA.

The effect of a depression prevention program on negative cognitive style trajectories in early adolescents

As restructuring a negative cognitive style is a central skill taught in many depression prevention programs, we tested whether a universal prevention program evoked a change in negative cognitive style in adolescents. In addition, we examined distinct developmental trajectories of negative cognitive styles and assessed whether research condition (intervention versus control) predicted these trajectories. Young adolescents (n = 1343; Mean age = 13.4 years; SD = 0.77; 52.3% girls) were randomly allocated to a cognitive behavioral therapy (CBT)-based depression prevention program or a care as usual control condition. A negative cognitive style was assessed at baseline, post-treatment and 6- and 12-months follow-up. Adolescents who received the intervention did not differ in their negative cognitive style from the control group at any time-point. We found four distinctive trajectories of negative cognitive style: normative, increasing, decreasing and stable high, which were not predicted by intervention condition and were not moderated by gender. Yet, the results revealed a trend, which indicated that adolescents who followed the program tended to show an increasing than a normative developmental pattern. We concluded that the CBT-based depression prevention program did not reduce or prevent an increase in negative cognitive style.

In Their Own Words: Rural Adolescent Stressors and Relationship to Depressive Symptoms

This study evaluated qualitative reports of stressful life events from young rural adolescents and examined the relationship between stressor themes and depressive symptoms. A phenomenological approach guided content analysis of qualitative data. Number of themes within each response was tabulated, and association with depressive symptoms was then examined. Stressors were categorized into four thematic domains: family, peers, academics, and intrapersonal. Individual themes within each domain varied, but the themes of conflict and loss were predominant in most domains. Higher number of themes were associated with elevated depressive symptoms ( p = .045). Study findings provide insight into the lived experience of adolescent stressors and provide additional empirical evidence regarding the association between stressors and depressive symptoms. The ubiquitous themes of conflict and loss, and the implications of these themes for adolescents' mental health provide insight for nurses as they advocate for quality mental and physical health care for adolescents and their families.