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

Adverse Childhood Experiences and Socio-Emotional Outcomes of Children Born Very Preterm

OBJECTIVE

To examine whether adverse childhood experiences (ACEs) confer risk for socio-emotional problems in children born very preterm (VPT) STUDY DESIGN: As part of a longitudinal study, 96 infants born VPT at 23-30 weeks of gestation were recruited from a level III neonatal intensive care unit and underwent follow-up at ages 2 and 5 years. Eighty-three full-term (FT, 37-41 weeks gestation) children were recruited from an adjoining obstetric service and the local community. ACEs were assessed with the Child Life Events Scale at age 2 and Preschool Age Psychiatric Assessment at age 5. At age 5, internalizing, externalizing, and Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms were assessed with the Child Behavior Checklist and Conner's Rating Scale-Revised, respectively. Covariates including socioeconomic disadvantage, maternal distress, and parent ADHD symptoms were assessed at the 2- and/or 5-year follow-up. Mediation and moderation analysis, accounting for family clustering, examined associations between birth group, ACEs, and socio-emotional outcomes.

RESULTS

After covariate adjustment, children born VPT experienced more ACEs (p<0.001), particularly medical ACEs (p<0.01), and had worse ADHD and internalizing outcomes (p<.05) than FT children. ACEs mediated the association between birth group and ADHD outcomes (95% CIs: 0.11 - 4.08). There was no evidence of mediation for internalizing outcomes. Higher parent ADHD symptoms (p<.001) and maternal distress (p<.05) were associated with poorer internalizing outcomes.

CONCLUSIONS

Screening for childhood ACEs should be embedded in the follow-up care of children born VPT and their families. Strategies to screen for and address parent psychosocial functioning may be important to support children's socio-emotional development.

Childhood mental health and educational attainment: Within-family associations in a late 20th Century U.S. birth cohort

Mental health problems during childhood are associated with lowered educational attainment in adulthood. However, it is not clear if these associations hold when controlling for unobserved features of the family environment and if they depend on the socioeconomic status (SES) of parents. We use the Panel Study of Income Dynamics (PSID) Child Development and Transition into Adulthood Supplements (CDS; TAS) to examine these questions. Using linear and logistic regression, we isolate within-family variability in mental health problems among full sibling pairs (n = 958 individuals in 479 pairs). Associations depend on the measure used. Parental reports of problem behaviors and diagnosed problems have the most consistent negative associations with educational attainment (for example, a hyperactivity diagnosis is associated with 0.74 fewer years of schooling). Retrospective self-reports of diagnoses other than depression or anxiety also have a negative association (0.96 fewer years of schooling). But self-reports of depressive symptoms and emotional or psychological well-being during late childhood and adolescence have no significant associations with educational attainment. In addition, there is no significant moderation of these associations by SES.

The Interaction Effect of Adverse Childhood Experiences and Socioeconomic Circumstances in Adolescent Depressive Symptomatology

PURPOSE

Limited research has examined the combined effects of psychosocial and material adversities experienced in childhood during adolescence, a sensitive period of rapid social, emotional, and cognitive development. We investigated the interaction effect of adverse childhood experiences (ACEs) and socioeconomic circumstances (SECs) during childhood on emerging self-reported depressive symptomatology among 13-year-old Portuguese adolescents.

METHODS

We utilized data from 4,280 participants in the Generation XXI birth cohort, collected during the baseline (2005-2006), third (2016-2017), and fourth waves (2018-2020). Adjusted odds ratios and 95% confidence intervals (CIs) were obtained from binary logistic regression analyses to estimate the likelihood of depressive symptoms based on exposure to ACEs and adverse family SECs. The interaction effect of ACEs and SECs was evaluated in terms of departure from additive and multiplicative models.

RESULTS

Adolescents who reported experiences of abuse, school-related problems, and household dysfunction, as well as those from less advantaged family SECs at age 10, were more likely to report moderate to severe depressive symptoms at age 13, compared to their more affluent counterparts. We observed a significant additive interaction between low household income and abuse in the development of moderate to severe depressive symptoms [relative excess risk due to interaction, 0.69, 95% CI: 0.11, 1.26]. This interaction remained statistically significant on a multiplicative scale [OR = 1.61, 95% CI: 0.99, 2.69].

DISCUSSION

ACEs and low family SECs during the first decade of life are associated with an elevated risk of moderate to severe depressive symptoms in adolescence.

Early Life Adversity Predicts Reduced Hippocampal Volume in the Adolescent Brain Cognitive Development Study

PURPOSE

Cross-sectional studies in adults have demonstrated associations between early life adversity (ELA) and reduced hippocampal volume, but the timing of these effects is not clear. The present study sought to examine whether ELA predicts changes in hippocampal volume over time in a large sample of early adolescents.

METHODS

The Adolescent Brain Cognitive Development Study provides a large dataset of tabulated neuroimaging, youth-reported adverse experiences, and parent-reported financial adversity from a sample of children around the United States. Linear mixed effects modeling was used to determine the relationship between ELA and hippocampal volume change within youth (n = 7036) from ages 9-10 to 11-12 years.

RESULTS

Results of the models indicated that the number of early adverse events predicted bilateral hippocampal volume change (β = -0.02, t = -2.02, p < .05). Higher adversity was associated with lower hippocampal volume at Baseline (t = 5.55, p < .01) and at Year 2 (t = 6.14, p < .001).

DISCUSSION

These findings suggest that ELA may affect hippocampal development during early adolescence. Prevention and early intervention are needed to alter the course of this trajectory. Future work should examine associations between ELA, hippocampal development, and educational and socioemotional outcomes.

Practitioner perspectives on the nature, causes and the impact of poor mental health and emotional wellbeing on children and young people in contact with children's social care: A qualitative study

BACKGROUND

Children and young people (CYP) who are in contact with social care are at higher risk of developing mental health difficulties compared to the general population. This has been attributed to their experience of significant childhood adversity. With an increased likelihood of experiencing poorer health outcomes which can persist into adulthood, it is crucial that key factors for their positive mental health development are identified.

OBJECTIVE

To identify factors associated with the poor mental health of CYP in contact with social care from the perspective of practitioners working in children's social care and mental health.

PARTICIPANTS AND SETTING

Social care and mental health practitioners; three Local Authorities across the North-East of England.

METHODS

Four focus groups were conducted with 23 practitioners between April and May 2022. A semi-structured topic guide exploring the nature and associated factors of mental health was used to focus discussion. Data were thematically analysed and informed by the four levels of the socio-ecological model.

RESULTS

Individual level risk factors were associated with the CYP's emotional health and included what practitioners described as the 'sense of shame'. Interpersonal level risk factors were most recurrent and included parental factors within the home environment. Community level risk factors consisted of characteristics of settings and institutions that increased the risk of the CYP developing mental health and wellbeing difficulties. Societal level risk factors included broader societal factors such as poverty. Practitioners maintained that certain protective factors possessed or developed by CYP including secure attachments, prevent the development of mental health difficulties.

CONCLUSIONS

Our current study provides strong evidence for the interlinkage between multiple levels of risk and their interacting impact on the CYP's mental health and emotional wellbeing. It is imperative that this, and the need to strengthen protective factors, whilst reducing risks are carefully considered for the development of effective support interventions for CYP in contact with social care.

Neuroendocrine mechanisms in the links between early life stress, affect, and youth substance use: A conceptual model for the study of sex and gender differences

Early life stress (ELS) is defined as an acute or chronic stressor that negatively impacts a child's development. ELS is associated with substance use and mental health problems. This narrative literature review focuses on sex and gender differences in the effects of ELS on 1) adolescent neuroendocrine development; 2) pubertal brain maturation; and 3) development of internalizing symptoms and subsequent substance use. We posit that ELS may generate larger hormonal dysregulation in females than males during puberty, increasing internalizing symptoms and substance use. Future research should consider sex and gender differences in neuroendocrine developmental processes when studying the link between ELS and negative health outcomes.

Distinct Constellations of Common Risk Factors Differentially Relate to Executive-Function Ability in Children

Executive functioning (EF) has been shown to relate to academic achievement and well-being. Independent bodies of work have aimed to understand what environmental or personal attributes influence EF ability. However, most research has not considered how constellations of risk factors create distinct patterns of influence on EF ability. The current study tested a sample of children aged 9 to 10 years from the United States (N = 10,323, 48.06% female, Mage = 9.9 years, age range = 8.9-11.08 years) using a latent profile analysis (LPA) to detect subgroups that varied in their combinations of various risk factors. Six distinct groups of risk factors for children emerged, which in turn related to different average EF abilities. We found that family socioeconomic measures related to a subgroup having above- or below-average EF ability, but we also found an effect on EF across different risk factors. These results inform our understanding of individual variations in EF ability and highlight the idea that EF interventions should consider risk holistically.

Social inequality in the association between life transitions into adulthood and depressed mood: a 27-year longitudinal study

Background

Few studies have considered the life-course development of depressive symptoms in relation to life transitions in early-adulthood and whether these might affect depressive trajectories differently depending on specific indicators of parental socioeconomic status (SES). In the present work, we explore these questions using the adolescent pathway model as a guiding framework to test socially differential exposure, tracking and vulnerability of the effects of life transitions on depressed mood across different socioeconomic backgrounds.

Methods

Latent growth modeling was used to estimate the associations between indicators of parental SES (parental education and household income) and depressed mood from age 13 to 40 with life transitions (leaving the parental home, leaving the educational system, beginning cohabitation, attaining employment) as pathways between the two. Our analyses were based on a 27-year longitudinal dataset (n = 1242) of a Norwegian cohort with 10 time points in total. To make socioeconomic comparisons, three groups (low, mid, and high) were made for parental education and income respectively.

Results

Depressed mood decreased from age 13 to 40. The low and high parental education groups showed a stable difference in depressed mood during early adolescence, which decreased in young adulthood and then increased slightly in mid-adulthood. The low household income group showed higher depressed mood across young adulthood compared to the medium and higher household income groups. For life transitions, leaving the parental home and beginning cohabitation was associated with an added downturn of the trajectory of depressed mood when adjusting for other transitions. However, adolescents with high parental education showed a relatively stronger decrease in depressed mood when leaving the parental home. Similarly, adolescents with a high household income showed a relatively stronger decrease in depressed mood when leaving the educational system.

Conclusions

Depressed mood decreased over time and developed differently depending on parental education and household income. Life transitions were generally associated with reductions in depressed mood across time, but lower SES youths were not found to be more socially vulnerable these effects.

The Role of Resilience in the Impact of Family Economic Adversity on Youth Emotional Distress over Time

Previous research has highlighted the enduring negative impact of family economic adversity on youth emotional well-being. However, the longitudinal mechanism underlying the link between economic adversity and emotional distress is less explored. The present study examined the longitudinal pathway of parent economic adversity, and parent and adolescent emotional distress at age 16, parental support at age 21, youth self-esteem and mastery at age 23, and adult emotional distress at age 27. Data came from the Family Transitions Project (N = 441, 57% female), a 30-year study of families from the rural Midwest. Structural equation models revealed that economic adversity exerted a long-term negative influence on adult emotional well-being through parent and adolescent emotional distress and youth self-esteem and mastery. Additionally, parental support was associated with adult emotional distress through youth self-esteem and mastery. The current study advances our understanding of youth emotional well-being by suggesting a longitudinal family process and resilience pathways from adolescence to early adulthood.

Prevalence and factors associated with suicidal ideation among students taking university entrance tests: revisited and a study based on Geographic Information System data

BACKGROUND

A previous study identified students taking Bangladeshi university entrance tests as a vulnerable group at a higher risk of suicidal behaviours before the COVID-19 pandemic. However, the impact of the pandemic on the magnitude of these behaviours among this population remains unexplored.

AIMS

This study aimed to investigate the prevalence of suicidal ideation and associated factors among Bangladeshi university entrance test takers following the pandemic. In addition, an approach based on Geographic Information System (GIS) data was used to visualise the distribution of suicidal ideation across the country.

METHODS

A cross-sectional approach was used to collect data among participants taking the entrance test at Jahangirnagar University in September 2022. Using SPSS, data were analysed with chi-squared tests and binary regression, and ArcGIS was used to map the results across the nation.

RESULTS

The study revealed a prevalence of 14.4% for past-year suicidal ideation, with 7.4% and 7.2% reporting suicide plans and attempts, respectively. Notably, repeat test-takers exhibited a higher prevalence of suicidal behaviours. Significant risk factors for suicidal ideation included urban residence, smoking, drug use, COVID-19 infection and deaths among close relations, depression, anxiety and burnout. The GIS-based distribution indicated significant variation in the prevalence of suicidal ideation across different districts, with higher rates observed in economically and infrastructurally deprived areas.

CONCLUSIONS

Urgent measures are needed to address the high prevalence of suicidal behaviours among students taking university entrance tests students in Bangladesh, particularly in light of the COVID-19 pandemic. Enhanced mental health support, targeted prevention efforts and improved resources in economically disadvantaged regions are crucial to safeguard the well-being of these students.

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.

Interpersonal and Environmental Protective Factors and Their Associations With Children's Weight Status

Both external structure (ie, participating in extracurricular activities) and family factors (ie, parental emotional support) have separately been linked with children's physical health and well-being, however, their combined effects are less well known. The current study examined the longitudinal associations between participating in structured out-of-school activities and parent reports of warmth/emotional support with children's weight status (ie, zBMI) over time. Utilizing longitudinal data from the United States-based Early Childhood Longitudinal Study, Kindergarten Class of 2010 to 2011 (ECLS-K:2011), we employed a confirmatory factor analysis (CFA) and a latent variable cross-lagged path analysis to examine if emotional supportiveness and participation in structured activities predicted lower zBMI over the course of 1 year. The final sample included 18 135 participants. Mean age of the participants was 8.12 years (±0.38 years), and 51% of children were male. Mean zBMI was 0.54 (±1.12). Structure at baseline predicted increased zBMI in year 2 (β = .03, P = .02) but did not predict parent emotional supportiveness at year 2 (β = -.05, P = .09). Parent emotional supportiveness at baseline predicted greater zBMI at year 2 (β = .02, P = <.01) but did not predict structure at year 2 (β = .02, P = .39). zBMI at baseline did not predict structure (β = .02, P = .25) or parent emotional supportiveness at year 2 (β = -.01, P = .55). Our findings were inconsistent with our hypothesis with regard to directionality. Continued refinement about the role of internal structure (ie, family, and parenting practices) may inform public health prevention strategies to support the well-being of children and families.

The Effect of Educational Expectations on Children's Cognition and Depression

Cognitive and psychological conditions in childhood will have an important impact on adult life. There is relatively little literature on the impact of educational expectations on children's cognition and psychological health from the perspective of urban and rural differences. Based on the cohort data of the CFPS from 2012 and 2016, this study screened a total of 994 children aged 10-15 to study the effects of parents' educational expectations and children's educational expectations on children's cognition and depression. The results show that both parents' educational expectations and children's educational expectations have a positive impact on children's cognition. Parents' educational expectations and children's educational expectations have negative effects on children's depression. When parents' educational expectations are greater than their children's educational expectations, educational expectations have a negative impact on children's cognition and a positive impact on children's depression. In both urban and rural samples, parents' educational expectations and children's educational expectations have a positive impact on children's cognition and a negative impact on children's depression. However, the impact of educational expectations on children's cognition and depression was greater in rural areas than in urban areas. When parents' educational expectations are greater than their children's educational expectations, educational expectations in urban areas have no effect on children's cognition.