Parental factors associated with depression and anxiety in young people: a systematic review and meta-analysis

The effectiveness of targeted preventive interventions for depression symptoms in children and adolescents: Systematic review and meta-analyses

BACKGROUND

Targeted interventions are needed to prevent depression in at-risk children and adolescents. Children and adolescents are commonly at risk of depression due to subsyndromal depressive symptoms or problems in their social environment.

METHODS

This review was conducted according to the Cochrane guidelines (2023) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was done in December 2023 using three electronic databases and a manual search. The methodological quality of all eligible studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias.

RESULTS

This review includes 77 intervention studies of which 13 are follow-ups. Of the 64 identified main studies (n = 11,808), 19 were selective interventions targeting the problems in a social environment. Of the participants 63.6 % were girls and the mean age ranged between 9 and 17. Most of the studies were conducted in a Western school setting using psychological interventions, with the majority being CBT (cognitive behavioral therapy) based programs. Targeted interventions reduced the symptoms of depression statistically significantly at postintervention (SMD 0.27, 95 % confidence interval 0.16-0.37) and 6-month follow-up (SMD 0.32, 0.18-0.45) compared to any comparator. Intervention effects were not statistically significant at the 12-month follow-up.

CONCLUSION

Indicated and selective interventions targeted to children and adolescents at risk of depression due to their social environment have a small effect on depressive symptoms. Interventions should be delivered by mental health experts.

Balanced parenting: Proposing a differentiation-based parenting approach informed by Bowen family systems theory

The purpose of this article is to introduce Balanced Parenting, a differentiation-based parenting approach informed by Bowen family systems theory. It is aimed at countering today's anxious, child-focused parenting culture and deconstructing attachment theory, which has been identified as contributing to this culture. The approach includes four main pillars: (a) deconstructing attachment theory, (b) the five principles of balanced parenting, (c) shifting the paradigm, and (d) steps toward change. Pillar one explains how attachment theory feeds anxious, child-focused parenting by ignoring parent autonomy and codependency between parent and child and underestimating children's ability to self-soothe. It also explains that attachment theory's claims are problematic due to lacking systemic thinking and not aligning with empirical research. Pillar two seeks to communicate Bowen theory's parenting perspective through five principles: mutual respect for autonomy, focus on self, child's self-reliance, improving couple relationships, and letting go of blame. Pillar three can help guide individuals shift their thinking from the attachment paradigm toward the Bowen theory paradigm. Pillar four communicates the steps reset, refocus, and redefine, which can help parents apply a Bowen theory perspective. This approach is expected to relieve parent guilt and burnout, foster children's well-being and healthy development, and promote genuine, lasting connection between parents and children.

Associations of Grandparenting Dimensions/Styles with Mental Health in Children and Adolescents: A Systematic Review and Meta-Analysis

In recent decades, grandparents' increased involvement in child-rearing around the world has accelerated research on grandparenting. However, findings have remained inconsistent, and no reviews have examined how grandparenting dimensions and styles affect child and adolescent mental health. In our systematic review and meta-analysis, we synthesized evidence on the relationship between dimensions and styles of grandparenting and children's and adolescents' mental health. In nine databases, we identified 3197 studies on the relationship between dimensions and styles of grandparenting and children's and adolescents' mental health, 20 of which we ultimately reviewed. To better integrate the results, we performed a meta-analysis of studies addressing the same mental health outcomes (i.e., depression, anxiety, and internalizing symptoms). Moreover, to synthesize evidence from the studies, we conducted both random- and common-effects meta-analyses. The reviewed studies involved 11,434 children overall. Among our findings, the associations between positive dimensions and styles of grandparenting and children's and adolescents' depression and anxiety were moderately significant (depression: r = -0.33; anxiety: r = -0.12), as were the correlations between negative dimensions and styles and all three mental health outcomes (depression: r = 0.15; anxiety: r = 0.15; internalizing symptoms: r = 0.25). In general, positive dimensions and styles of grandparenting are negatively associated with mental health conditions, whereas negative ones are positively associated. In this article, we discuss those and other findings and propose directions for future studies.

Racial-Ethnic Discrimination and Early Adolescents' Behavioral Problems: The Protective Role of Parental Warmth

OBJECTIVE

The purpose of the study was to investigate the association between discrimination by multiple sources (ie, teachers, students, and other adults) and early adolescents' behavioral problems (ie, internalizing, externalizing, and attention problems), also considering the protective role of parental warmth in the association.

METHOD

Cross-sectional analyses were conducted with 3,245 early adolescents of color obtained from the Adolescent Brain Cognitive Development Study (ABCD Study) at year 1 follow-up (Y1), a large and diverse sample of children (mean age = 9.48 years) in the United States. Racially-ethnically minoritized adolescents reported sources of discrimination, parental warmth, and symptoms of psychopathology. Regression with interaction terms was conducted to investigate the associations among sources of discrimination, parental warmth, and behavioral problems among racially-ethnically minority adolescents. Sensitivity analyses were conducted to examine (1) race/ethnicity and sex/gender variations; (2) whether the associations between different sources of discrimination and behavioral problems were reliably different; and (3) effects of discrimination, parental warmth, and their interplay at Y1 in predicting adolescents' behavioral problems at year 2 follow-up.

RESULTS

Early adolescents experiencing interpersonal racial-ethnic discrimination by multiple sources, including teachers, students, and other adults, reported higher levels of attention, internalizing, and externalizing problems. Parental warmth was protective for the association between interpersonal racial-ethnic discrimination and early adolescents' behavioral problems.

CONCLUSION

Experiencing interpersonal racial-ethnic discrimination from teachers, peers, and other adults is related to heightened attention, internalizing, and externalizing problems among racially-ethnically minoritized early adolescents. Parental warmth may reduce the risk of developing behavioral problems among early adolescents who experience interpersonal racial-ethnic discrimination from students, teachers, and other adults outside of school.

PLAIN LANGUAGE SUMMARY

In this cross sectional analysis of 3,245 early adolescents of color obtained from the Adolescent Brain Cognitive Development (ABCD) Study, the authors found that early adolescents experiencing interpersonal racial-ethnic discrimination from multiple sources, including teachers, students, and other adults, reported higher levels of behavioral problems (ie, internalizing, externalizing, and attention problems). Parental warmth was found to be protective for the association between interpersonal racial-ethnic discrimination and early adolescents' behavioral problems. These findings emphasize the importance of assessing experiences of interpersonal racial-ethnic discrimination among racially-ethnically minoritized early adolescents and contribute to the understanding of parental warmth as a protective factor for early adolescents to cope with such experiences.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Anxiety and depression in only children versus children with siblings: A cross-sectional study among Chinese medical students

OBJECTIVES

This study aimed to explore the characteristics, overall anxiety and depression status, and influencing factors of only-child and non-only-child students by examining a medical student population in the post-COVID-19 era.

STUDY DESIGN

This study was a cross-sectional design.

METHODS

An online questionnaire survey was administered among medical students. The psychological problems related to depression and anxiety were measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), respectively, which were scored via a Likert-4 scale. Statistical analysis was employed to explore the characteristics and overall differences between only-child and non-only-child students, along with the factors affecting their anxiety and depression.

RESULTS

A total of 1688 participants were enrolled. No significant differences were observed in the prevalence of anxiety (χ2 = 1.154, P = 0.283) and depression (χ2 = 0.313, P = 0.576) between only-child and non-only-child students. School level, single status, and desire for only child status are associated with anxiety and depression in the two groups. Region and loneliness are merely related to anxiety and depression among only-child students, while gender, willingness to apply for medical school, and equal treatment are associated with anxiety and depression among non-only-child students.

CONCLUSION

Our study found the factors that are associated with depression or anxiety inthe only-child and non-only-child medical students jointly and separately, which could provide a new theoretical basis for the psychological intervention of medical students, that is, to identify the high risk factors of depression and anxiety from the perspective of only child and non-only child.

The impact of perceived caregiver anxiety and stress during childhood on late-life depression: evidence from the China Health and Retirement Longitudinal Study

Introduction

This study investigates the long-term impact of perceived caregiver anxiety and stress during childhood on late-life depression. Adverse childhood experiences related to caregiver mental health may significantly influence emotional well-being, and this study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS) to explore these associations.

Methods

CHARLS data were analyzed for individuals who reported perceived caregiver anxiety and stress. Depression was measured using the CES-10 depression scale. Multivariate logistic regression models examined the relationship between caregiver anxiety and stress frequency and late-life depression, adjusting for confounders like socioeconomic status, health behaviors, and demographics.

Results

Childhood exposure to caregiver anxiety and stress significantly increased the risk of depression in later life (p < 0.05), with stronger effects observed among individuals with female caregivers. The risk escalated with the frequency of caregiver anxiety episodes. After adjusting for covariates, the association for male caregivers weakened, highlighting the potential role of other mediators.

Discussion

The results highlight the critical importance of parental mental health, especially maternal anxiety, in mitigating intergenerational mental health risks. Targeted interventions for caregiver mental health, particularly for female caregivers, are crucial. Longitudinal studies are needed to better establish causality and further investigate these mechanisms.

Perinatal cumulative risk scores for depression symptoms in young people from the Growing Up in New Zealand longitudinal study

BACKGROUND

Adolescent depression has increased markedly over the last decade and often persists into adulthood with a range of adverse outcomes. Identifying the perinatal risk factors contributing to adolescent depression is crucial to advise early interventions.

METHODS

The study included 4563 young people from the Growing Up in New Zealand (GUiNZ) longitudinal study who completed a questionnaire on depression symptoms at age 12 years (Centre for Epidemiological Studies Depression Scale for Children (CESD-10). Cumulative Risk (CR) scores were created by combining the perinatal risk factors significantly associated with depression symptoms. Then, these CR scores were grouped into three levels and their association with depression symptoms was investigated in univariable and multivariable analyses.

RESULTS

We found a statistically significant association between the CR scores (from one to six perinatal risk factors) and depression score at age 12, compared to the no-risk factor group, suggesting a dose-response relationship. In the adjusted analysis, young people exposed to the lower CR score (1-3 risk factors) had a 0.85 unit increase in depression score (p- < .001), and those exposed to the higher CR (4 ≥ risk factors) had a 1.70 unit increase (p < .001) compared to no perinatal risk factors.

LIMITATIONS

Our model was focused on the perinatal CR score without including the effects of childhood risk factors.

CONCLUSIONS

The perinatal CR score is a valuable approach to identifying the subgroup of young people who are most at risk for depression symptoms. As such, early interventions that simultaneously address multiple perinatal risk factors for depression are recommended.

The Indirect Effects of Fathers' Parenting Style and Parent Emotion Regulation on the Relationship Between Father Self-Efficacy and Children's Mental Health Difficulties

Improving parental self-efficacy has been linked with reductions in child mental health difficulties; however, underlying mechanisms remain unclear, especially for fathers. This study investigated whether father self-efficacy influences child mental health difficulties indirectly through parenting style and parent-facilitated regulation of children's negative emotions. A community sample of American fathers (N = 350, M = 39.45 years old) completed self-reports on father self-efficacy, parenting styles, parent-facilitated emotion regulation, and their children's mental health difficulties (aged 4-12). Path analysis was used to test a cross-sectional, parallel-sequential indirect effect model. Father self-efficacy had a significant indirect effect on child mental health difficulties via three significant pathways of permissive parenting, authoritative parenting-acceptance of child's negative emotions, and authoritarian parenting-avoidance of child's negative emotions. Our model explained a moderate amount of variance in child mental health difficulties. The findings support promoting father self-efficacy through parenting interventions and highlight parenting beliefs as important for clinicians providing child mental health care.

Relationship with Adults in Organized Sports and Non-Sports Activities and Links with Psychological Adjustment in Adolescence: A 6-Year Longitudinal Study

Relationships with adults in organized activities play a crucial role in the positive outcomes associated with these experiences, yet little is known about how these relationships evolve throughout adolescence or how they are differentially associated with mental health. Important distinctions could also be made regarding activity types. The sample consisted of 292 participants (58% female; M age = 12.5; SD = 0.48), primarily White, middle-class, French-Canadian adolescents. Participants reported annually on their relationships with adults from ages 14 to 17. They also provided information on their levels of depressive symptoms and self-esteem at ages 13, 17, and 18. Results showed that parental involvement and support from the activity leader significantly decreased over time during adolescence. Additionally, parental involvement appears to be higher over time in team sports than in non-sport activities, but no differences were found regarding support from the activity leader. Finally, parental involvement and leader support were both linked to lower depressive symptoms and higher self-esteem. These findings highlight the critical yet diminishing role of adults in organized activities as adolescents age, underscoring the need for sustained adult engagement to promote positive mental health outcomes in this developmental period.

Polygenic risk for epigenetic aging and adverse life experiences interact to predict growth in adolescent depression in a racially/ethnically diverse sample

Introduction

Research has yet to examine the interplay between indices of environmental risk and resilience processes and genetic predisposition for epigenetic aging in predicting early adolescent depressive symptoms. In the current study we examine whether adverse life events and parental acceptance moderate polygenic predisposition for GrimAge epigenetic aging in predicting trajectories of depressive symptoms across early adolescence.

Method

Using data from the Adolescent Brain Development Study (ABCD, N = 11,875), we created polygenic scores for GrimAge, and examined whether exposure to adverse life events and parental acceptance moderated the relation between genetic risk and depressive symptom trajectories from age 10/11 to 12/13 using growth mixture modelling. We examined models separately in European American (EA), African American (AA), and Latinx (LX) subgroups of ABCD.

Results

In the EA and AA subgroups, adverse life events moderated polygenic scores for GrimAge such that there was increased likelihood of membership in a higher vs. lower depression trajectory.

Discussion

We extend literature by identifying genetic contributions to epigenetic aging as a depression diathesis in adolescence. Findings also highlight the detrimental role of adverse life events in exacerbating genetic risk for the development of depression in adolescence.

Correlation between self-efficacy, parental parenting patterns, and severe depression in adolescents

BACKGROUND

Adolescence is a critical period marked by significant psychological changes. This study explores how self-efficacy and parental parenting styles may influence the risk of severe depression among teens. The hypothesis is that higher self-efficacy and authoritative parenting patterns will be negatively correlated with severe depression in adolescents.

AIM

To investigate the correlation between self-efficacy, parenting patterns and major depression in adolescents, and to provide guidance for mental intervention.

METHODS

Using a cross-sectional survey design, the data were collected through a questionnaire survey. Patients with major depression and healthy adolescents in the hospital control group were selected as the study objects. The General Self-Efficacy Scale, the Parenting Style Evaluation Scale, and the Beck Depression Inventory were used as research instruments. Data input and statistical analysis were performed, including descriptive statistics, correlation analysis, through SPSS software.

RESULTS

The study found that depressed patients had significantly lower self-efficacy than healthy controls, and parenting style was significantly associated with depressive symptoms in terms of emotional warmth and understanding, punishment severity, and denial. Specifically, parental emotional warmth and understanding were significantly negatively associated with depressive symptoms, while parental punishment severity and denial were significantly positively associated with depressive symptoms. Self-efficacy showed a significant negative correlation with depressive symptoms, indicating that higher self-efficacy had lower depressive symptoms.

CONCLUSION

Adolescent major depressive disorder patient was significantly associated with their parenting style and self-efficacy. Higher self-efficacy is associated with decreased depressive symptoms, so improving adolescent self-efficacy and improving parenting style are important.

The Association of Family Incivility with Adolescent Depression: A Moderated Mediation Model

Negative family interactions have an adverse impact on adolescent mental health. The present study focused on the influence of family incivility on adolescent depression. In order to examine the association of family incivility with depression, an integrated framework was constructed to explore the mediating role of self-compassion and the moderating role of sex differences. Two waves of data were collected from 999 Chinese senior high school students (43.6% males and 56.4% females), with a mean age of 16.58 ± 0.54 years. Time 1 family incivility was positively associated with depression at Time 2 (r = 0.40, p < 0.001). Sex differences moderated the link between family incivility and self-compassion, with their association being significant in females (B = -0.07, SE = 0.03, p = 0.013) but not in males (B = 0.03, SE = 0.03, p = 0.376). Regarding the effect of family incivility on depression, the direct effect was significant only in males (B = 0.13, SE = 0.03, p < 0.001), whereas the indirect effect via self-compassion was significant only in females (B = 0.01, SE = 0.01, 95% CI [0.0010, 0.0232]). The present findings revealed a positive association between family incivility and adolescent depression. Moreover, family incivility has a direct impact on depression in male adolescents and an indirect impact through self-compassion in female adolescents. These findings underscore the important role of adolescent sex differences in the impact of family incivility on adolescent depression and highlight the practical importance of developing interventions to reduce family incivility.

A case-control study to differentiate parents' personality traits on anorexia nervosa and affective disorders

Eating disorders (ED) and affective disorders (AD) in adolescent population and several investigations have pointed out that specific family dynamics play a major role in the onset, course, and maintenance of both disorders. The aim of this study was to extend the literature of this topic by exploring differences between parents' personality traits, coping strategies, and expressed emotion comparing groups of adolescents with different mental conditions (anorexia nervosa vs. affective disorder vs. control group) with a case-control study design. A total of 50 mothers and 50 fathers of 50 girls with anorexia nervosa (AN), 40 mothers and 40 fathers of 40 girls with affective disorder (AD), and 50 mothers and 50 fathers of 50 girls with no pathology that conformed the control group (CG) were measured with the Temperament and Character Inventory (TCI), the COPE Inventory, the Family Questionnaire (FQ), and psychopathology variables, anxiety, and depression. Both parents of girls with AN showed a significant difference in personality, coping strategies, and expressed emotion compared to both parents in the CG, while they presented more similarities to parents of girls in the AD group. Identifying personality traits, expressed emotion, coping strategies, and psychopathology of parents and their daughters will allow improvements in the interventions with the adolescents, parents, and families.

Environmental sensitivity moderates the longitudinal effect of fathers' positive parenting on mental disorders in Chinese adolescents

BACKGROUND

Exposure to fathers' positive parenting has been associated reducing mental disorder symptoms during adolescence, evidence on the mechanisms underlying this association is lacking. One potential mechanism linking fathers' positive parenting and mental disorders is environmental sensitivity (ES). Here we studied whether the increased positive behaviors of both parents (1) separately, (2) relatively, (3) and jointly predict reduced depression, attention deficit hyperactivity disorder (ADHD) symptoms, suicidal ideation (SI), and increased well-being in Chinese adolescents. Additionally we investigated (4) whether ES moderates these relationships.

METHODS

This study involving 7010 Chinese adolescents (55.6 % girls) aged 15 to 18 from six junior high schools in Shaanxi, China was conducted at four timepoints. ES was assessed using the Highly Sensitive Child (HSC) scale at ages 15 and 16, parental positive behaviors using the Parental Bonding Instrument (PBI) at ages 16 and 17, and psychopathology symptoms using the 9-item Patient Health Questionnaire (PHQ-9), Strengths and Difficulties Questionnaire (SDQ), and Positive and Negative Suicide Ideation (PANSI) Inventory at ages 17 and 18.

RESULTS

(1) Multilevel analyses revealed that increased positive parenting predicted reduced psychiatric disorder symptoms and improved well-being; (2) trend interaction indicated that the compensatory effect of fathers' positive parenting was stronger in alleviating mental problems in adolescents than that of mothers'; (3) Simple slope analyses suggested that both high levels of fathers' and mothers' positive parenting predicted fewer subsequent psychiatric disorder symptoms, particularly for sensitive adolescents.

LIMITATIONS

This study was limited to its generalizability to the Western Chinese adolescents.

CONCLUSIONS

Substantial differences in the effects of positive paternal and maternal parenting highlight the important role of fathers' positive parenting in mental development, especially for highly sensitive adolescents.

The impact of maternal emotional warmth on adolescents' internalizing problem behaviors: the roles of meaning in life and friendship conflict

Introduction

Numerous studies suggest that maternal emotional warmth is a critical protective factor against adolescents' internalizing problem behaviors. However, the underlying mechanisms linking these variables remain unclear. Grounded in ecological systems theory, this study explores the impact mechanisms of social support (maternal emotional warmth), individual resource (meaning in life), and environmental factor (friendship conflict) on adolescents' internalizing problem behaviors.

Methods

A questionnaire survey of 474 adolescents in vocational school aged 15-24 assessed maternal emotional warmth, meaning in life, friendship conflict, and internalizing problem behaviors.

Results

The results indicate that the meaning in life partially mediates the relationship between maternal emotional warmth and adolescents' internalizing problem behaviors, with friendship conflict moderating the latter half of this mediation pathway.

Discussion

The findings suggest that adolescents, during their social adaptation process, activate different protective factors depending on the environmental relational context. Specifically, high friendship conflict limits the direct protective role of maternal emotional warmth, whereas a meaning in life becomes a significant protective factor, exerting its effect through mediation. Conversely, when friendship conflict is low, maternal emotional warmth directly serves as a protective factor.

Puberty and NeuroDevelopment in adolescents (PANDA): a study protocol

BACKGROUND

Biopsychosocial changes during adolescence are thought to confer risk for emotion dysregulation, and in particular, anxiety disorders. However, there are substantial gaps in our knowledge about the biological mechanisms underlying anxiety during adolescence, and whether this contributes to the higher prevalence in females. The Puberty and NeuroDevelopment in Adolescents (PANDA) study aims to examine links between biological (sex hormones, cortisol) and social environmental factors and brain function during adolescence, with a focus on key processes (emotion regulation, fear learning) identified as relevant for the development of anxiety disorders.

METHODS

PANDA is a cross-sectional study with an observational design that aims to recruit a total of 175 adolescents aged 11-16 (majority female) and their parents/guardians, from the community. Brain function will be examined using magnetic resonance imaging (MRI), including functional MRI tasks of emotion regulation and fear learning. Hormones will be measured from hair (i.e., cortisol) and weekly saliva samples (i.e., oestradiol, progesterone, five across a month in females). Questionnaires and semi-structured interviews will be used to assess mental health and social environmental factors such as parenting and adverse childhood experiences. An online study of 113 adolescents was also incorporated during the COVID-19 pandemic as a questionnaire-only sub-study.

DISCUSSION

Strengths of this study include the collection of multiple saliva samples to assess variability in hormone levels, examination of the timing of adverse childhood experiences, inclusion of both maternal and paternal parental factors, exploration of mechanisms through the examination of brain structure and function, and multi-method, multi-informant collection of mental health symptoms. This study addresses important gaps in the literature and will enhance knowledge of the biological and environmental contributors to emotion dysregulation and anxiety in adolescents.

The Effect of Lifestyle Interventions on Anxiety, Depression and Stress: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

BACKGROUND/OBJECTIVES

Depression, anxiety, and stress are common mental health issues that affect individuals worldwide. This systematic review and meta-analysis examined the effectiveness of various lifestyle interventions including physical activity, dietary changes, and sleep hygiene in reducing the symptoms of depression, anxiety, and stress. Using stress as an outcome and conducting detailed subgroup analyses, this study provides novel insights into the differential effects of lifestyle interventions across diverse populations.

METHODS

Five databases were systematically searched: PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar, for gray literature searches. Keywords were used to search each database. The search period was from the conception of the databases until August 2023 and was conducted in English. For each analysis, Hedges' g was reported with a 95% confidence interval (CI) based on the random-effects method. Subgroups were analyzed and heterogeneity and publication bias were examined.

RESULTS

Ninety-six randomized clinical trial studies were included in this meta-analysis. Lifestyle interventions reduced depression (Hedges g -0.21, 95% confidence interval -0.26, -0.15; p < 0.001; I2 = 56.57), anxiety (Hedges g -0.24, 95% confidence interval -0.32, -0.15; p < 0.001; I2 = 59.25), and stress (-0.34, -0.11; p < 0.001; I2 = 61.40).

CONCLUSIONS

Lifestyle interventions offer a more accessible and cost-effective alternative to traditional treatments and provide targeted benefits for different psychological symptoms.

Prenatal representations link pregnancy intention to observed caregiving

AIMS/BACKGROUND

Children from unintended pregnancies are at an increased risk of experiencing less positive parenting practices as well as abuse and neglect. Thus, identifying factors that may explain the association between pregnancy intention and caregiving behaviours is critical, as well as identifying if these associations can be assessed during pregnancy.

DESIGN/METHODS

In a sample of 297 pregnant people (Mage = 31.17, SD = 4.89; gestational age range 9.71-35.14, M = 23.55, SD = 5.54) and, later, their 6-month-old infants, this prospective study examined the degree to which two facets (i.e. acceptance and richness of perceptions of the child and their role in being a parent for that child) of caregivers' prenatal mental representations of the child explained the association between pregnancy intention and the caregiver behaviour observed during caregiver - child interactions in infancy.

RESULTS

Results indicated that caregiver-child interactions following pregnancies that were intended, relative to those non-intended, were rated as higher in caregiving sensitivity and warmth. These relations were explained, in part, by a greater richness of perceptions, but not through acceptance.

CONCLUSION

Findings suggest richness of perceptions as a potential target for exploration in interventions to support pregnant people who were not intending to become pregnant as a means to promote positive caregiver - child relationships.

School connectedness as a protective factor between childhood adversity and adolescent mental health outcomes

School connectedness may offset mental health risks associated with childhood adversity. The present study examined the potential protective effects of school connectedness against childhood adversity when predicting adolescent mental health outcomes in 9,964 individuals (51% female, 81% white) from the Millennium Cohort Study. Structural equation models were fitted to examine the longitudinal relationships between childhood adversity, school connectedness, and adolescent mental health. Childhood adversity was a risk factor, predicting greater internalizing and externalizing problems and lower levels of positive mental health. School connectedness was a promotive factor as it predicted fewer mental health problems and greater positive mental health. Furthermore, school connectedness at age 11 was protective against childhood adversity when predicting internalizing and externalizing problems at age 14. That is, students with a history of adversity who felt more connected to school were less likely to exhibit internalizing and externalizing symptoms than those who felt less connected to school. Only school connectedness at age 11 was protective against childhood adversity, indicating that feeling connected to school at younger ages may disrupt processes linking childhood adversity to adolescent mental health. Schools should foster students' feelings of connectedness to protect vulnerable individuals and benefit all pupils' mental health.

Risk and resilience profiles and their transition pathways in the ABCD Study

The transition from childhood to adolescence presents elevated risks for the onset of psychopathology in youth. Given the multilayered nature of development, the present study leverages the longitudinal, population-based Adolescent Brain Cognitive Development Study to derive ecologically informed risk/resilience profiles based on multilevel influences (e.g., neighborhood and family socioeconomic resources, parenting, school characteristics) and their transition pathways and examine their associations with psychopathology. Latent profile analysis characterized risk/resilience profiles at each time point (i.e., baseline, Year-1, Year-2); latent transition analysis estimated the most likely transition pathway for each individual. Analysis of covariance was used to examine associations between profile membership at baseline (i.e., ages 9-11) and psychopathology, both concurrently and at Year-2 follow-up. Further, we examined the associations between profile transition pathways and Year-2 psychopathology. Four distinct profiles emerged across time - High-SES High-Protective, High-SES Low-Protective, Low-SES High-Family-Risk, and Low-SES High-Protective. Despite reasonably high stability, significant transition over time among profiles was detected. Profile membership at baseline significantly correlated with concurrent psychopathology and predicted psychopathology 2 years later. Additionally, profile transition pathways significantly predicted Year-2 psychopathology, exemplifying equifinality and multifinality. Characterizing and tracing shifts in ecologically informed risk/resilience influences, our findings have the potential to inform more precise intervention efforts in youth.

Promotive factors associated with reduced anxiety and depression across three years in a prospective clinical cohort of adolescents: Examining compensatory and protective models of resilience

The rates of anxiety and depression increase across adolescence, many experience recurrence after treatment, yet longitudinal studies examining promotive factors are scarce. We prospectively examined the role of the promotive factors structured style, personal and social competencies, family functioning, and social resources in homotypic and heterotypic continuity and discontinuity of anxiety and depression across three years in a clinical sample. Participants were adolescents with anxiety or depressive disorders aged 13-18 years at T1 (N = 717, 44% initial participation rate) and aged 16-21 years at T2 (N = 549, 80% follow-up participation rate). At T1, diagnoses were collected from medical records and participants responded to questionnaires. At T2, semi-structured diagnostic interviews were conducted. Higher levels of all promotive factors were associated with reduced probability of anxiety or depression three years later. The promotive factors were not associated with homotypic continuity of anxiety, whereas personal competence beliefs, social competence, and, less strongly, family functioning were associated with reduced homotypic continuity of depression and heterotypic continuity from depression to anxiety. Analyses with interaction terms did not indicate moderation by the promotive factors. Our findings suggest that bolstering promotive factors may be vital for increasing treatment success and preventing recurrence of anxiety and depression in the transition toward adulthood.

Patterns of resilient functioning in early life: Identifying distinct groups and associated factors

Resilience, the capacity to maintain or regain functionality in the face of adversity, is a dynamic process influenced by individual, familial, and community factors. Despite its variability, distinct resilience trajectories can be identified within populations, yet the predictors defining these distinct groups remains largely unclear. Here, using data from the Avon Longitudinal Study of Parents and Children (ages 0-18), we quantify resilience as the remaining variance in psychosocial functioning after taking into account the exposure to adversity. Growth mixture modeling identified seven distinct resilience trajectories, with over half of the study population maintaining resilience throughout early life. Factors increasing the likelihood of resilient trajectory membership included a less emotional temperament, high cognitive abilities, high self-esteem, low levels of autistic social traits, strong sibling relationships, high maternal care, and positive school experiences. Among the socioeconomic factors considered, maternal education - a significant indicator of socioeconomic status - and birth-order were associated with resilient trajectories. Our findings underscore the importance of fostering cognitive abilities, self-esteem, social relationships, positive school experiences, and extracurricular engagement to bolster resilience in adversity-exposed individuals and communities. This research informs resilience-focused interventions in mental health, education, and social policy sectors, and prompts further exploration of socioeconomic influences on resilience trajectories.

Parental warmth and young adult depression: A comparison of enduring effects and revisionist models

Guided by a novel analytic framework, this study investigates the developmental mechanism through which parental warmth is related to young adult depression. Data were from a large sample of participants followed from early adolescence to young adulthood (N = 1,988; 54% female). Using structural equation modeling, we estimated and compared competing developmental models - enduring effects vs. revisionist models - to assess whether parental warmth during adolescence had enduring or transient effects on depression in young adulthood. We also examined whether contemporaneous experiences of parental warmth in young adulthood were more salient than parental warmth in adolescence. Results supported the revisionist model: early intergenerational experiences in adolescence predicted psychopathology early in young adulthood, but their unique effects gradually diminished; whereas parental warmth in young adulthood continued to be protective of young adult depression. Effects of mother and father warmth on young adult depression were similar in pattern and magnitude. Results were held when accounting for covariates such as adolescent sex, family income status, and family structure. Young adult mental health interventions may consider targeting maintenance or improvement in parental warmth to help offset the long-term impact of adversity early in life.

Longitudinal examination of marijuana use and physical teen dating violence: Antisocial peers and impulsivity as mediators

BACKGROUND

Prior studies have shown that marijuana use is often associated with physical teen dating violence. However, few studies have examined the longitudinal mediating effects of associating with antisocial peers and impulsivity on this relationship. Also, few studies have estimated the cascading developmental impact of marijuana use and antisocial peer association, predicting the continued marijuana use and antisocial peer associations while considering the risk of impulsivity in physical teen dating violence. Thus, the current study utilized the problem behavior theory and an alternative path to physical dating violence to address these limitations.

OBJECTIVE

The current study tested the longitudinal effects of marijuana use on physical teen dating violence and the indirect effects of antisocial peer association and impulsivity on this relationship (M = 12.29); 52.1 % of males and 47.9 % of females participated.

METHODS

Adolescents completed questionnaires at baseline and were assessed six months later (n = 836). Generalized structural equation modeling (GSEM) and cross-lagged mediation models were used first to analyze the direct effect of lifetime marijuana use on physical dating violence and antisocial peer association and impulsivity as potential mediators of this relationship. Then, the cross-lagged mediation models were used to estimate the alternative path to physical teen dating violence using lifetime marijuana use and antisocial peer association as predictors at baseline and continued antisocial peer association, marijuana use, and impulsivity at the subsequent wave as mediators.

RESULTS

Results suggested that marijuana use at baseline was not positively associated with physical teen dating violence over time. The association with antisocial peers but not impulsivity mediated the relationship between marijuana use and physical dating violence. Cross-lagged mediation results suggested that marijuana use at baseline positively predicted antisocial peer association in the subsequent wave, which led to an increase in physical teen dating violence. Further, antisocial peer association at baseline is positively associated with continued antisocial peer association at the subsequent wave; thus, antisocial peer association is positively related to physical teen dating violence when controlling for depressive symptoms, family support, number of dates, and parental monitoring.

CONCLUSION

These results suggest though marijuana use alone is not statistically associated with physical teen dating violence, it does increase the risk of antisocial social peer associations that could increase adolescents' likelihood to engage in physical teen dating violence. Further, the onset of antisocial peer association could persist over time, thus serving as a risk factor for physical teen dating violence over time.

Identifying the risk of depression in a large sample of adolescents: An artificial neural network based on random forest

BACKGROUND

This study aims to develop an artificial neural network (ANN) prediction model incorporating random forest (RF) screening ability for predicting the risk of depression in adolescents and identifies key risk factors to provide a new approach for primary care screening of depression among adolescents.

METHODS

The data were from a large cross-sectional study conducted in China from July to September 2021, enrolling 8635 adolescents aged 10-17 with their parents. We used the Patient health questionnaire (PHQ-9) to rate adolescent depression symptoms, using scales and single-item questions to collect demographic information and other variables. Initial model variables screening used the RF importance assessment, followed by building prediction model using the screened variables through the ANN.

RESULTS

The rate of depression symptoms in adolescents was 24.6%, and the depression risk prediction model was built based on 70% of the training set and 30% of the test set. Ten variables were included in the final prediction model with a model accuracy of 85.03%, AUC of 0.892, specificity of 89.79%, and sensitivity of 70.81%. The top 10 significant factors of depression risk were adolescent rumination, adolescent self-esteem, adolescent mobile phone addiction, peer victimization, care in parenting styles, overprotection in parenting styles, academic pressure, conflict in parent-child relationship, parental rumination, and relationship between parents.

CONCLUSIONS

The ANN model based on the RF effectively identifies depression risk in adolescents and provides a methodological reference for large-scale primary screening. Cross-sectional studies and single-item scales limit further improvements in model accuracy.

Perceived parental rearing styles and depression in Chinese adolescents: the mediating role of self-compassion

Background

Adolescence is a period characterized by rapid biological and psychological change, and adolescents have a heightened risk of depression. Parental rearing is an important influencing factor for depression in adolescence. However, the mechanism of influence needs further exploration.

Methods

A total of 1839 adolescents were recruited from a junior and a senior high school in Zhongshan City, Guangdong Province, China. They were requested to completed the Parental Bonding Instrument (PBI), Self-Compassion Scale (SCS), and Depression Anxiety and Stress Scale-21(DASS-21).

Results

Adolescents recalled their mothers as being more caring and controlling than their fathers. Parental care (maternal care, paternal care) and parental encouragement of autonomy (maternal encouragement of autonomy, paternal encouragement of autonomy) were both negative predictors of depression, while parental control (maternal control, paternal control) was positive predictor of depression. Self-compassion mediated all relationships between parental rearing styles (parental care, parental encouragement of autonomy, and parental control) and depression but played different mediating roles (complete or incomplete mediating role) in different relationships.

Conclusion

Self-compassion plays a mediator role in all relationships between perceived parental rearing styles (parental care, parental encouragement of autonomy, and parental control) and depression. Adolescents who grown up with less parental care, less parental encouragement of autonomy, and high parental control deserve special attention. Educators and clinicians could help those adolescents reduce the occurrence of depression by increasing their level of self-compassion.

Parental Involvement in Adolescent Psychological Interventions: A Meta-analysis

Psychological interventions for adolescents have shown mixed efficacy, and including parents in interventions may be an important avenue to improve treatment outcomes. Evidence from meta-analyses examining the role of parents in interventions for youth is inconsistent and has typically combined findings for both children and adolescents together. No prior meta-analysis has examined the specific role of parents in adolescent interventions as compared with interventions focused solely on adolescents across several disorders. To address this gap, systematic literature reviews were conducted utilizing a combination of searches among keywords including (parent * OR family) AND (intervention OR therap * OR treatment OR prevent*) AND (adolescen*). Inclusion criteria were (1) a randomized controlled trial of an individual psychological intervention compared to the same intervention with a parental component, and (2) adolescents must have at least current symptoms or risk to be included. Literature searches identified 20 trials (N = 1251). Summary statistics suggested that interventions involving parents in treatment have a significantly greater impact on adolescent psychopathology when compared to interventions that targeted adolescents alone (g = - 0.18, p < .01, 95% CI [- 0.30, - 0.07]). Examination with symptom type (internalizing or externalizing) as a moderator found that the significant difference remained for externalizing (g = - 0.20, p = .01, 95% CI [- 0.35, - 0.05]) but not internalizing psychopathology (p = .11). Findings provide evidence of the importance of including parents in adolescent therapy, particularly for externalizing problems.

Parental Risk and Protective Factors Associated with Bullying Victimization in Children and Adolescents: A Systematic Review and Meta-analysis

The main objective of this meta-analysis was to investigate how modifiable parental factors are related to traditional and cyberbullying victimization in children and adolescents. A systematic literature search of modifiable parental factors associated with bullying victimization was conducted using PubMed, PsycINFO, Scopus, and Web of Science electronic databases. Meta-analyses were performed to assess the mean effect sizes of the associations between the broader categories of parental factors (risk and protective) and bullying victimization (traditional and cyber), as well as between specific parental factors and bullying victimization (traditional and cyber). The differential impact of maternal and paternal factors (risk and protective) was examined. Age and gender were tested as moderators. Out of the 13,171 records identified, 158 studies met the inclusion criteria. Larger evidence was found for the association between parental risk (i.e., authoritarian parenting, aversiveness, inter-parental conflict, over-involvement, permissive parenting, and withdrawal) and protective (i.e., authoritative parenting, autonomy granting, warmth, and monitoring) factors, respectively, and traditional bullying victimization, with parental warmth, aversiveness, and withdrawal being the only common related predictors for traditional and cyberbullying victimization. The effect sizes were generally small. Maternal and paternal factors showed similar patterns of association with both types of bullying victimization. Age had a moderating effect on the association between parental protective factors and cyberbullying victimization. Overall, the present findings suggest that parental factors are relevant in protecting or putting children at risk for bullying victimization, especially in the offline context.

Childhood maltreatment and its associations with trauma-related psychopathology: disentangling two classification approaches

Childhood maltreatment (CM) is associated with various mental health disorders, including PTSD, depression, and anxiety. This study explores how specific classifications - dichotomous (abuse versus neglect) and dimensional (physical, emotional, sexual) - relate to distinct psychopathologies. We recruited 642 individuals, screening them for CM history and symptoms. ANOVA, regression, and SEM analyses compared CM approaches and symptom associations. The dichotomous approach showed significant effects of abuse and neglect on all symptoms. In the dimensional approach, sexual and physical CM were primary features for PTSD, while sexual and emotional CM were primary for depression and anxiety. Overall, the dimensional approach outperformed the dichotomous approach in capturing symptoms, suggesting its importance in understanding psychopathologies and guiding therapeutic interventions. Our findings highlight the differential associations of CM experiences with PTSD, depression, and anxiety symptoms. The findings suggest the importance of a dimensional CM approach for understanding psychopathologies and possibly informing targeted therapeutic interventions.

The association between online learning, perceived parental relationship, anxiety, and depression symptoms among secondary school students: insight from symptom network and cross-lagged panel network approach

INTRODUCTION

Anxiety and depression often co-occur in adolescents, with factors from family and school playing a significant role in the comorbidity. However, network analysis has not examined and clarified the detailed bridge and central symptoms of this comorbidity caused by online learning and perceived parental relationships across different COVID-19 times.

METHODS

Over four months, 2,356 secondary school students completed the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7. Participants were divided into harmonious and disharmonious groups based on their answers to a question about parental conflicts.

RESULTS

The results indicated that adolescents perceiving more parental conflicts showed a denser comorbidity network after four months of online learning. Significant bridge symptoms decreased from three to two across two waves in the harmonious group, while in the disharmonious group, they increased from two to three. The number of central symptoms increased from one in wave 1 to three in wave 2 for the harmonious group, while four in wave 1 decreased to two in wave 2 for the disharmonious group. Furthermore, the CLPN analysis revealed that the strongest positive cross-lagged edge intensity between symptoms was anhedonia-energy in the harmonious group, with anhedonia being the most trigger symptom. In contrast, for the disharmonious group, guilt-suicide and trouble relaxing-excessive worry were the strongest cross-lagged edge, and trouble relaxing was the most trigger symptom.

CONCLUSION

These findings may have implications for interventions designed to promote adolescent mental health in the context of online learning and parental conflicts.

Influence of at-risk family interactions on the course of psychiatric care in adolescence

Dysparenting, referring to inappropriate parental attitudes, is a vulnerability factor for mental disorders during adolescence and a therapeutic leverage, yet clinicians lack reliable tools to assess it in daily clinical practice. Moreover, the effect of this dysparenting on the amount of psychiatric care remains unclear. The Family and Care study aims to develop the at-risk family interactions and levers (ARFIL) scale, a comprehensive 30-item clinical scale, and to assess in a cross-sectional design, the impact of these at-risk family interactions on the care of adolescents (n = 425) hospitalized in psychiatry and aged 13-19 years old. Factorial analysis shows that the ARFIL scale consists of three main dimensions associated with cohesion/conflicts, love/hostility, and autonomy/control with good psychometric properties. Multivariate regressions show that the ARFIL intensity score predicts the duration of hospital care, regardless of age, gender, medical severity on admission, assessed by the Global Assessment of Functioning scale, the presence of maltreatment and psychiatric diagnoses. Moreover, the ARFIL diversity score (number of items present regardless of their severity) predicts both the number and duration of hospitalizations. At-risk family interactions are a determining dimension of psychiatric adolescent care, and the ARFIL scale could constitute a valuable tool, not only for holistic evaluation and treatment, but also for prevention.

How do schools influence the emotional and behavioural health of their pupils? A multi-level analysis of 135 schools in the Born in Bradford inner city multi-ethnic birth cohort

PURPOSE

To estimate variation in emotional and behavioural problems between primary schools in Bradford, an ethnically diverse and relatively deprived city in the UK.

METHODS

We did a cross-sectional analysis of data collected from 2017 to 2021 as part of the 'Born In Bradford' birth cohort study. We used multilevel linear regression in which the dependent variable was the Strengths and Difficulties Questionnaire (SDQ) total score, with a random intercept for schools. We adjusted for pupil-level characteristics including age, ethnicity, socioeconomic status, and parental mental health.

RESULTS

The study included 5,036 participants from 135 schools. Participants were aged 7-11 years and 56% were of Pakistani heritage. The mean SDQ score was 8.84 out of a maximum 40. We estimated that the standard deviation in school-level scores was 1.41 (95% CI 1.11-1.74) and 5.49% (95% CI 3.19-9.37%) of variation was explained at school level. After adjusting for pupil characteristics, the standard deviation of school-level scores was 1.04 (95% CI 0.76-1.32) and 3.51% (95% CI 1.75-6.18%) of variation was explained at school level. Simulation suggested that a primary school with 396 pupils at the middle of the distribution has 63 pupils (95% CI 49-78) with a 'raised' SDQ score of 15 + /40; and shifting a school from the lower to the upper quartile would prevent 26 cases (95% CI 5-46).

CONCLUSION

The prevalence of emotional and behavioural problems varies between schools. This is partially explained by pupil characteristics; though residual variation in adjusted scores may suggest that schools have a differential impact on mental wellbeing.

Testing the temporal precedence of family functioning and child psychopathology in the LONGSCAN sample

Family functioning may serve as protective or risk factors in the development of youth psychopathology. However, few studies have examined the potentially reciprocal relation between child psychopathology and family functioning. To fill this gap in the literature, this study tested for time-ordered associations between measures of family functioning (e.g., cohesion, conflict, and emotional expressiveness) and child psychopathology (e.g., total behavior problems, externalizing, and internalizing problems) using data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN; N = 1143, 52.3% female, Nwaves = 5). We used a random-intercept cross-lagged panel model to identify whether child psychopathology preceded and predicted family functioning, the reverse, or both processes occurred simultaneously. At the between-person level, families who tended to have more cohesion, who lacked conflict, and who expressed their emotions had lower levels of child psychopathology. At the within-person level in childhood, we found minimal evidence for time-ordered associations. In adolescence, however, a clear pattern whereby early psychopathology consistently predicted subsequent family functioning emerged, and the reverse direction was rarely found. Results indicate a complex dynamic relation between the family unit and child that have important implications for developmental models that contextualize risk and resilience within the family unit.

Prevalence and correlates of depression, anxiety, and stress among adolescents in urban and rural areas of Mysuru, South India

Background

Adolescence, a volatile period of growth between the ages of 10 and 19, is associated with increased vulnerability to mental health problems. Factors such as academic pressure can contribute to these challenges.

Objectives

The current study aimed to evaluate the factors and prevalence of depression, anxiety, and stress among adolescents in the urban and rural areas of Mysuru district.

Materials and Methods

A cross-sectional study was conducted in private high schools in both urban and rural regions. Prior permission and informed consent were obtained from participants and their legal guardians aged 18 years and older.

Results

The gender distribution in urban areas was 60.2% female and 39.8% male, while in rural areas, it was 51% male and 49% female. The prevalence of depression was higher in rural (39.3%) than in urban areas (24.2%), while anxiety was more prevalent in urban (50.6%) than in rural areas (49%). Stress was also more common in rural (16.6%) than urban adolescents (14.6%). Factors significantly associated with mental health outcomes included monthly family income, parenting practices, academic pressures, and self-esteem. Key needs identified were mobile mental health applications, online counseling services, and access to school counselors.

Conclusion

This study provides insights into the prevalence and correlates of common mental health issues among adolescents in this region of South India. The findings emphasize the necessity of providing mobile applications and offline counseling services to effectively support and meet the needs of adolescents in these settings.

Longitudinal associations between family functioning and generalized anxiety among adolescents: the mediating role of self-identity and cognitive flexibility

BACKGROUND

Generalized anxiety (GA) is showing a high prevalence among adolescents nowadays; investigations on influencing factors and potential mechanisms are important to inform intervention development. The present two-wave study investigated the ways in which family functioning predicted GA six months later among adolescents, by considering the mediating role of self-identity and cognitive flexibility.

METHODS

Adolescents were recruited from 27 randomly selected classes in two secondary schools in Chongqing and Fujian Province, China. Survey questionnaires assessing family functioning, self-identity, cognitive flexibility and GA were obtained from 1223 adolescents (Mage = 13.14, SD = 1.35) at two time points of the 6-month interval.

RESULTS

The association between family functioning (T1) and GA (T2) was significant (r= -0.152, p < 0.01). Self-identity and cognitive flexibility sequentially mediated the relationship between family functioning (T1) and GA (T2) (with the indirect effect = -0.005, 95% CI = -0.007~ -0.002) after controlling for age, gender, and GA at baseline. Cognitive flexibility also showed a significant and direct mediating effect (with the indirect effect = -0.008, 95% CI = -0.012 ~ -0.005).

CONCLUSION

Findings indicated that family functioning can be a protective factor of GA, and self-identity and cognitive flexibility act as a crucial role in the association between family functioning and GA. Future studies should adopt more time points and long-term follow-up assessments using more robust approaches to improve the reliability of the study findings. Findings may offer some implications that building a harmonious, open and warm family and guiding adolescents to develop self-identity as well as more flexible cognitive style could be helpful to prevent and cope with anxious emotion.

Humor in parenting: Does it have a role?

BACKGROUND

Despite the widespread use of humor in social interactions and the considerable literature on humor in multiple fields of study, the use of humor in parenting has received very little formal study. The purpose of this pilot study was to gather preliminary data on the use of humor in the raising of children.

MATERIALS AND METHODS

We developed and administered a 10-item survey to measure people's experiences being raised with humor and their views regarding humor as a parenting tool. Responses were aggregated into Disagree, Indeterminate, and Agree, and analyzed using standard statistical methods.

RESULTS

Respondents (n = 312) predominantly identified as male (63.6%) and white (76.6%) and were (by selection) between the ages of 18-45 years old. The majority of participants reported that they: were raised by people who used humor in their parenting (55.2%); believe humor can be an effective parenting tool (71.8%) and in that capacity has more potential benefit than harm (63.3%); either use (or plan to use) humor in parenting their own children (61.8%); and would value a course on how to utilize humor in parenting (69.7%). Significant correlations were found between the use of humor and both i) the quality of respondents' relationships with their parents and ii) assessments of how good a job their parents had done.

CONCLUSIONS

In this pilot study, respondents of childbearing/rearing age reported positive views about humor as a parenting tool.

Self-stigma mediates the relationships between childhood maltreatment and symptom levels of PTSD, depression, and anxiety

Background: Childhood maltreatment is a risk factor for developing multiple forms of psychopathology, including depression, posttraumatic stress disorder (PTSD), and anxiety. Yet, the mechanisms linking childhood maltreatment and these psychopathologies remain less clear.Objective: Here we examined whether self-stigma, the internalization of negative stereotypes about one's experiences, mediates the relationship between childhood maltreatment and symptom severity of depression, PTSD, and anxiety.Methods: Childhood trauma survivors (N = 685, Mage = 36.8) were assessed for childhood maltreatment, self-stigma, and symptoms of depression, PTSD, and anxiety. We used mediation analyses with childhood maltreatment as the independent variable. We then repeated these mediation models separately for childhood abuse and neglect, as well as the different subtypes of childhood maltreatment.Results: Self-stigma significantly mediated the relationship between childhood maltreatment and depression, PTSD, and anxiety symptoms. For sexual abuse - but not physical or emotional abuse - a significant mediation effect of self-stigma emerged on all symptom types. For childhood neglect, self-stigma significantly mediated the relationship between both emotional and physical neglect and all symptom types.Conclusion: Our cross-sectional study suggests that different types of childhood maltreatment experiences may relate to distinct mental health problems, potentially linked to increased self-stigma. Self-stigma may serve as an important treatment target for survivors of childhood abuse and neglect.

Parent-child relationship, parenting behaviors, and adolescents' depressive symptoms after an earthquake: unraveling within-adolescent associations from between-adolescent differences

This study assessed temporal associations between parent-child relationship, parenting behaviors (i.e., warmth, rejection, and overprotection), and adolescents' depressive symptoms after trauma, using random-intercept cross-lagged panel models to distinguish between- and within-adolescent differences. We surveyed Chinese adolescents 12 (Aug 2018; T1), 21 (May 2019; T2), 27 (Nov 2019; T3) months after the Jiuzhaigou earthquake that occurred in August 2017. Of the 585 adolescents who participated in at least two waves of the study, mean age at T1 was 15.50 years old (SD = 1.58 years) and 57.8% were girls. Controlling adolescents' gender, age, ethnicity, trauma exposure at T1, and parents' marital status, between-adolescent results showed that parent-child relationship and parenting behaviors, parent-child relationship and depressive symptoms were correlated across models of parental warmth, rejection, and overprotection, whereas depressive symptoms were only correlated with parental rejection and overprotection. Within-adolescent results indicated that parent-child relationship and adolescents' depressive symptoms had bidirectional associations via the mediation of parental warmth from T1 to T3. Over the longer term following the earthquake, we found that parental rejection was bidirectionally associated with adolescents' depressive symptoms, whereas parental overprotection was unidirectionally influenced by adolescents' depressive symptoms from T2 to T3. In addition, more depressive symptoms in adolescents were associated with worsening parent-child relationship from T2 to T3. In conclusion, shortly after trauma, interventions should focus on improving parent-child relationship and relieving adolescents' depressive symptoms. Over the longer term after trauma, relieving adolescents' depressive symptoms should be prioritized to avoid its eroding effects on parent-child relationship and parenting behaviors, and to break the "vicious cycle".

Knowledge, attitudes, and practices of adolescent depression among parents of children diagnosed with depression in Ningbo City, eastern China

Objective

To investigate parental knowledge, attitudes, and practices (KAP) toward adolescent depression.

Methods

A cross-sectional survey was conducted between October 2022 and October 2023 at The First Affiliated Hospital of Ningbo University among parents of adolescents diagnosed with depression. A self-administered questionnaire was used to collect the parents' demographic characteristics and KAP toward adolescent depression.

Results

A total of 522 questionnaires were collected from parents of depressed adolescents. Among the participants, 383 (73.37%) were female. In addition, 426 participants (81.61%) had children aged 14-18. The mean knowledge, attitude, and practice scores were 9.09 ± 2.37 (possible range: 0-12), 37.04 ± 4.11 (possible range: 11-55), and 31.53 ± 3.84 (possible range: 8-40), respectively. There were significant positive correlations between knowledge and attitude (r = 0.225, p < 0.001), knowledge and practice (r = 0.240, p < 0.001), and attitude and practice (r = 0.381, p < 0.001). The path analysis showed significant direct effects of knowledge on attitude (β = 0.422, p < 0.001) and practice (β = 0.283, p < 0.001). There was an indirect effect of knowledge on practice through attitude (β = 0.131, p = 0.004). Attitude directly impacted practice (β = 0.311, p < 0.001).

Conclusion

Parents of adolescents diagnosed with depression exhibited moderate KAP regarding adolescent depression. The study underscored the importance of targeted interventions to improve parental KAP in supporting adolescents with depression. Moreover, future research should explore additional factors influencing parental attitudes and behaviors toward adolescent depression to develop more effective interventions.

Neural and affective responses to prolonged eye contact with parents in depressed and nondepressed adolescents

Eye contact improves mood, facilitates connectedness, and is assumed to strengthen the parent-child bond. Adolescent depression is linked to difficulties in social interactions, the parent-child bond included. Our goal was to elucidate adolescents' affective and neural responses to prolonged eye contact with one's parent in nondepressed adolescents (HC) and how these responses are affected in depressed adolescents. While in the scanner, 59 nondepressed and 19 depressed adolescents were asked to make eye contact with their parent, an unfamiliar peer, an unfamiliar adult, and themselves by using videos of prolonged direct and averted gaze, as an approximation of eye contact. After each trial, adolescents reported on their mood and feelings of connectedness, and eye movements and BOLD-responses were assessed. In HCs, eye contact boosted mood and feelings of connectedness and increased activity in inferior frontal gyrus (IFG), temporal pole, and superior frontal gyrus. Unlike HCs, eye contact did not boost the mood of depressed adolescents. While HCs reported increased mood and feelings of connectedness to the sight of their parent versus others, depressed adolescents did not. Depressed adolescents exhibited blunted overall IFG activity. These findings show that adolescents are particularly sensitive to eye contact and respond strongly to the sight of their parents. This sensitivity seems to be blunted in depressed adolescents. For clinical purposes, it is important to gain a better understanding of how the responsivity to eye contact in general and with their parents in particular, can be restored in adolescents with depression.

Within-family associations of parent-adolescent relationship quality and adolescent affective well-being

BACKGROUND

Parent-adolescent relationship quality is theorized to be an important correlate of adolescent affective well-being. Little is known about the within-family processes underlying parent-adolescent relationship quality and affective well-being over a period of months. This three-wave, preregistered study examined within- and between-family associations between parent-adolescent relationship quality (support and conflict) and adolescent well-being (negative and positive affect). In addition, we examined whether the associations differed between mothers and fathers, and for adolescents' affective well-being in different social contexts (at home, at school, with peers).

METHODS

The sample consisted of 244 Dutch adolescents (61.5% girls; age range: 12-17 years; mean age = 13.8 years). Random-intercept cross-lagged panel models were used.

RESULTS

At the between-family level, higher levels of support and lower levels of conflict were associated with higher levels of positive affect and lower levels of negative affect. At the within-family level, increases in support and decreases in conflict were concurrently associated with increases in positive affect and decreases in negative affect. More parent-adolescent conflict than typical also predicted increases in negative affect, 3 months later, and more negative affect and less positive affect than typical predicted increased conflict, 3 months later. These within-family effects were largely similar for fathers and mothers. Associations for conflict occurred through bidirectional processes: Parent-adolescent conflict shaped and was shaped by adolescents' emotions at home, at school, and with peers.

CONCLUSION

Results suggest that parent-adolescent relationship quality (especially conflict) and adolescent affective well-being cofluctuate and predict each other over time within families.

Modifiable parental factors associated with the mental health of youth from immigrant families in high-income countries: A systematic review and meta-analysis

Parental factors play a major role in youth mental health and many youth in high-income countries have at least one overseas-born parent. It is, hence, important to understand how immigrant parenting is associated with youth mental health in high-income countries. Following PRISMA guidelines, this review sought to identify modifiable parental factors to inform parenting interventions to prevent mental health problems in youth aged 0-18 years whose parents migrated voluntarily for economic reasons from low and middle-income countries to high-income countries. Sixteen parental factors were identified from 56 studies that were associated with five outcomes - youth self-esteem (k = 17), general stress (k = 4), acculturative stress (k = 4), anxiety symptoms (k = 9), and depressive symptoms (k = 41). A sound evidence base was found for one or more of these outcomes associated with protective factors - caring and supportive parenting and parental monitoring; and risk factors - parent-youth acculturative and general conflict, parental withdrawal, interparental conflict, and parent mental health problems. This systematic review and meta-analysis identified immigrant parental factors that have robust associations with youth mental health outcomes. These findings can be used to inform parenting interventions and support immigrant parents in preventing youth mental health problems.

The effect of systematic couple group therapy on families with depressed juveniles: a pilot trial

Background

Depression is a primary cause of illness and disability among teenagers, and the incidence of depression and the number of untreated young people have increased in recent years. Effective intervention for those youths could decrease the disease burden and suicide or self-harm risk during preadolescence and adolescence.

Objective

To verify the short efficacy of the systemic couple group therapy (SCGT) on youths' depression changes and families with depressed adolescents.

Methods

The study was a self-control trial; only within-group changes were evaluated. Participants were couples with a depressed child who was resistant to psychotherapy; they were recruited non-randomly through convenient sampling. The paired-sample t-test and Wilcoxon signed-rank test were used to compare differences before and after interventions. The effect sizes were also estimated using Cohen's d. Spearman's correlation analysis was used to examine associations between changes.

Results

A downward trend was seen in depressive symptoms after treatment, and Cohen's d was 0.33 (p = 0.258). The adolescents perceived fewer interparental conflicts, and the effect sizes were medium for perceived conflict frequency (0.66, p = 0.043), conflict intensity (0.73, p = 0.028), conflict solutions (0.75, p = 0.025), coping efficacy (0.68, p = 0.038), and perceived threat (0.57, p = 0.072). For parents, global communication quality, constructive communication patterns, and subjective marital satisfaction significantly improved after interventions, with large effect sizes (1.11, 0.85, and 1.03, respectively; all p < 0.001). Other destructive communication patterns such as demand/withdraw (p = 0.003) and mutual avoidance (p = 0.018) and communication strategies like verbal aggression (p = 0.012), stonewalling (p = 0.002), avoidance-capitulation (p = 0.036), and child involvement (p = 0.001) also reduced, with medium effect sizes (0.69, 0.52, 0.55, 0.71, 0.46, and 0.79, respectively). Meanwhile, the associations between depression changes and changes in interparental conflicts (p < 0.001) and marital satisfaction (p = 0.001) were significant.

Conclusions and clinical relevance

The SCGT offers the possibility for the treatment of families with depressed children who are unwilling to seek treatment. Helping parents improve communication and marital quality may have benefits on children's depressive symptoms.

Interpersonal Sensitivity as a Mediator of the Effect of Childhood Parenting Quality on Depressive Symptoms

ABSTRACT

The aim of this study was to analyze whether interpersonal sensitivity mediates the effect of qualitative parenting characteristics experienced during childhood on the appraisal of life experiences and depression severity during adulthood in adult community volunteers. A total of 404 Japanese adult volunteers answered the following four self-report questionnaires: Parental Bonding Instrument, Interpersonal Sensitivity Measure, Life Experiences Survey, and Patient Health Questionnaire-9. Structural equation modeling was performed to analyze whether childhood parenting quality increases depressive symptom severity through interpersonal sensitivity, which then affects the appraisal of recent life events. In the two structural equation models, inadequate care and excessive overprotection received during childhood were associated with the negative evaluation of life experiences and depression severity in adulthood through high interpersonal sensitivity. Our findings indicate interpersonal sensitivity as a mediator of the effect of inadequate care and excessive overprotection experienced in childhood on the negative evaluation of life experiences and depression severity in adulthood.

Individual- and family-level associations between child psychopathology and parenting

Parenting can protect against the development of, or increase risk for, child psychopathology; however, it is unclear if parenting is related to psychopathology symptoms in a specific domain, or to broad liability for psychopathology. Parenting differs between and within families, and both overall family-level parenting and the child-specific parenting a child receives may be important in estimating transdiagnostic associations with psychopathology. Data come from a cross-sectional epidemiological sample (N = 10,605 children ages 4-17, 6434 households). Parents rated child internalizing and externalizing symptoms and their parenting toward each child. General and specific (internalizing, externalizing) psychopathology factors, derived with bifactor modeling, were regressed on parenting using multilevel modeling. Less warmth and more aversive/inconsistent parenting in the family, and toward an individual child relative to family average, were associated with higher general psychopathology and specific externalizing problems. Unexpectedly, more warmth in the family, and toward an individual child relative to family average, was associated with higher specific internalizing problems in 4-11 (not 12-17) year-olds. Less warmth and more aversive/inconsistent parenting are broad correlates of child psychopathology. Aversive/inconsistent parenting, is also related to specific externalizing problems. Parents may behave more warmly when their younger children have specific internalizing problems, net of overall psychopathology.

Parenting and Emotional and Behavioral Difficulties in a General Population Sample of Adolescents: The Mediating Role of Emotional Dysregulation

Research has shown that both parenting and emotional dysregulation are associated with mental health outcomes in youth. This cross-sectional research was developed to replicate these noted findings and explore the mediating role of emotional dysregulation to explain the relationship between parenting and emotional and behavioral difficulties (internalizing and externalizing problems) in adolescents. A total of 104 adolescents (61.5% females; M = 15.62 yrs., SD = 1.38) participated in the study. Participants completed the Parental Bonding Instrument (measuring care, promotion of autonomy, and overprotection) referring to both the mother and father, the Difficulties in Emotion Regulation Scale, and the Youth Self-Report. The results showed that difficulties in emotion regulation fully mediated the relationship between overprotection (in both parents) and low maternal care with internalizing problems, on the one hand, and the relationship between maternal overprotection and low care (in both parents) with externalizing problems, on the other hand. Furthermore, emotional dysregulation partially mediated the effect of paternal care on internalizing problems. These findings help to clarify one of the mechanisms through which parenting can affect mental health in youth. Theoretical and clinical implications are discussed.

How Coparenting Is Linked to Depression among Chinese Young Girls and Boys: Evidence from a Network Analysis

This study aimed to explore the relationship between parental coparenting and depression among Chinese young adolescents and potential gender differences via network analysis. Thus, 793 fourth-grade students (girls: 281 (35.40%), Mage = 9.99 years, SD = 0.59 years) were recruited from three primary schools in Northern China. The young adolescents rated their depression and perceived paternal and maternal coparenting. Network analysis was used to detect the central nodes and bridge mechanisms among coparenting and depressive components. The results indicated that paternal and maternal consistency as well as maternal conflict were the most central components in the coparenting-depression network. Paternal consistency, maternal conflict and paternal disparagement in coparenting, as well as somatic complaints and positive affect in adolescents' depression, exhibited high bridge strengths, suggesting those constructs served as vital bridges to connect the two subnetworks. Moreover, paternal consistency showed a higher bridge strength in the boys' network than the girls' one, whereas the edge linking adolescents' positive affect to paternal disparagement and integrity was stronger in the girls' network. This study contributes to the understanding of associations between parental coparenting and young adolescents' depression and offered insights into targeted interventions for early adolescent depression by enhancing parental coparenting.

[Anxiety and depression in adolescents]

Anxiety and depression among young people had already increased in the years before the COVID-19 pandemic and then experienced a significant increase again during the pandemic. In this article the different clinical forms of expression of these emotional syndromes are presented in detail and the developmental paths of a combination of both disorders are also explained. Even subclinical forms of anxiety and depression already have clear clinical implications and impair the developmental tasks of adolescence. The "avolitional depression" (depression with severe drive disorders) is mentioned as a special form. Pathogenetic building blocks-from genetic vulnerability to psychosocial stressors-come up for discussion in light of the fact that anxiety and depression are about twice as common in adolescent females as in males. The embedding of the disorders in current events shows the special importance of the self-reflective emotion of shame in the adolescent development process. The scarcity and dysfunctionality of emotional dialogue between significant caregivers and children must be cautioned against. Its role in adolescents' self-regulation and affect regulation should not be underestimated. Finally, an overview of the most important therapeutic measures for anxiety and depression in adolescence is presented.

The effects of emotion-focused skills training on parental mental health, emotion regulation and self-efficacy: Mediating processes between parents and children

Objective: Emotion-Focused Skills Training (EFST) is a short-term parental intervention based on humanistic principles. While studies have demonstrated the efficacy of EFST in alleviating child mental health symptoms, the mechanisms by which this happens is less clear. The present study investigated whether program participation led to improvements in the parents' own mental health, emotion regulation, and self-efficacy, and compared two versions of EFST: one experiential involving evocative techniques, and one psychoeducational involving didactic teaching of skills. Further, this study investigated whether improvements in parent outcomes mediated the effects on children's mental health. All parents received 2-days group training and 6 h of individual supervision. Methods: 313 parents (Mage = 40.5, 75.1% mothers) of 236 children (ages 6-13, 60.6% boys) with mental health difficulties within the clinical range and their teachers (N = 113, 82% female) were included. Participants were assessed at baseline, post-intervention, and 4-, 8- and 12-months follow-up. Results: Multilevel analysis showed significant improvements over time on all parental outcomes with large effects (drange0.6-1.1, ps < .001), with fathers benefitting more in terms of emotion regulation and self-efficacy (ps < .05). Significant differences were found between conditions on parental mental health and self-efficacy (all p's > .05). Cross-lagged panel models showed indirect effects of child symptoms at post-intervention on all parental outcomes at 12-months follow-up (βrange0.30-0.59, ps < .05). Bidirectional associations were observed between children's mental health symptoms and parental self-efficacy (βrange0.13-0.30, ps < .05). Conclusion: This study provides support for the effect of EFST on parent outcomes and the reciprocal relationship between the mental health of children's and their parents.Trial registration: ClinicalTrials.gov identifier: NCT03807336.

Exploring the Impact of Maternal and Paternal Acceptance on Adolescent Girls' Emotion Regulation

Maternal acceptance is associated with youth emotion regulation (a correlate of depression among adolescent girls); however, less is known about the impact of fathers. In this prospective study, we examined effects of maternal and paternal acceptance on youth sadness inhibition (a facet of emotion dysregulation) among adolescent girls (n = 82; Mage = 13.28; 43% from minoritized racial/ethnic groups) over 1 year. Youth varied on depression risk, which was assessed via clinical diagnostic interviews. Bivariate results showed that maternal acceptance was associated with lower youth sadness inhibition at baseline and 1-year follow-up, while paternal acceptance was only associated with lower youth sadness inhibition at 1-year follow-up. Step-wise regressions showed that paternal acceptance was inversely associated with youth sadness inhibition over time, above and beyond effects of youth age, baseline sadness inhibition, depression risk, and maternal acceptance. Findings highlight the importance of examining both mothers' and fathers' impact on adolescent girls' development of emotion regulation.