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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Progression of Comorbid Depression and Substance Use among Racially Diverse Adults

Comorbidity of depression and substance abuse is common and a major public health burden. Studies of this form of comorbidity in racial and ethnic minoritized (REM) populations are minimal and have mixed findings. The present study examined the effect of general risk factors (family bonding, supervision, involvement, peer delinquency), depression risk factors (caregiver depression), and substance use risk factors (adult family members, sibling, and peer substance use) in early adolescence (~ ages 13-14) on comorbid depression and substance use in later adolescence (~ ages 15-17) and adulthood (~ ages 29-31) and continuity in comorbidity from adolescence to adulthood. Longitudinal data on 1000 Black (n = 680) Hispanic (n = 170) and White (n = 150) individuals came from the Rochester Youth Development Study. Participants were interviewed 14 times over 17 years beginning in 1988. General risk factors predicted comorbidity across racial/ethnic groups. Substance specific risk predicted comorbidity among Black and Hispanic individuals whereas depression specific risk was predictive among White individuals. Adolescent comorbidity predicted comorbidity in adulthood across race. These findings highlight the importance of substance use intervention for racial and ethnic minoritized individuals and mental health risk factors in Whites. The continuity of comorbidity from adolescence to adulthood highlights the importance of targeting adolescents for intervention to prevent long-term manifestation of this form of comorbidity and its associated consequences.

Neighborhood disadvantage and parenting predict longitudinal clustering of uncinate fasciculus microstructural integrity and clinical symptomatology in adolescents

Parenting behaviors and neighborhood environment influence the development of adolescents' brains and behaviors. Simultaneous trajectories of brain and behavior, however, are understudied, especially in these environmental contexts. In this four-wave study spanning 9-18 years of age (N=224 at baseline, N=138 at final assessment) we used longitudinal k-means clustering to identify clusters of participants with distinct trajectories of uncinate fasciculus (UF) fractional anisotropy (FA) and anxiety symptoms; we examined behavioral outcomes and identified environmental factors that predicted cluster membership. We identified three clusters of participants: 1) high UF FA and low symptoms ("low-risk"); 2) low UF FA and high symptoms ("high-risk"); and 3) low UF FA and low symptoms ("resilient"). Adolescents in disadvantaged neighborhoods were more likely to be in the resilient than high-risk cluster if they also experienced maternal warmth. Thus, neighborhood disadvantage may confer neural risk for psychopathology that can be buffered by maternal warmth, highlighting the importance of considering multiple environmental influences in understanding emotional and neural development in youth.

Investigating Associations Between Maternal Behavior and the Development of Functional Connectivity During the Transition From Late Childhood to Early Adolescence

BACKGROUND

Parenting behavior is thought to affect child brain development, with implications for mental health. However, longitudinal studies that use whole-brain approaches are lacking. In this study, we investigated associations between parenting behavior, age-related changes in whole-brain functional connectivity, and psychopathology symptoms in children and adolescents.

METHODS

Two hundred forty (126 female) children underwent resting-state functional magnetic resonance imaging at up to two time points, providing a total of 398 scans covering the age range 8 to 13 years. Parenting behavior was self-reported at baseline. Parenting factors (positive parenting, inattentive parenting, and harsh and inconsistent discipline) were identified based on a factor analysis of self-report parenting questionnaires. Longitudinal measures of child internalizing and externalizing symptoms were collected. Network-based R-statistics was used to identify associations between parenting and age-related changes in functional connectivity.

RESULTS

Higher maternal inattentive behavior was associated with lower decreases in connectivity over time, particularly between regions of the ventral attention and default mode networks and frontoparietal and default mode networks. However, this association was not significant after strict correction for multiple comparisons.

CONCLUSIONS

While results should be considered preliminary, they suggest that inattentive parenting may be associated with a reduction in the normative pattern of increased network specialization that occurs with age. This may reflect a delayed development of functional connectivity.

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.

Network analysis of maternal parenting practices and adolescent mental health problems: a longitudinal study

BACKGROUND

An extensive literature has shown a strong connection between maternal parenting practices and adolescent mental health problems. However, it has been difficult for previous research to map a dynamic concurrent and prospective relationships within and between types of parenting practices and adolescent mental health problems. The present study addressed these issues using a network analysis approach and a longitudinal design.

METHODS

This study involved 591 Chinese adolescents (249 males; mean age at T1 = 13.53) and their mothers (mean age at T1 = 39.71) at two time points (T1 and T2) with eighteen months apart. Mothers reported their parenting practices including warmth, monitoring, inductive reasoning, hostility, and harshness, while adolescents reported their mental health problems including anxiety, depression, aggression, and conduct problems. Network analysis was conducted for contemporaneous networks at T1 and T2 and temporal networks from T1 to T2.

RESULTS

The contemporaneous networks revealed the negative association between monitoring and conduct problems served as the main pathway through which parenting practices and adolescent mental health mutually influenced each other, and further, warmth was the most influential parenting practice on adolescent mental health. The temporal network revealed that maternal hostility exerted the most influence on adolescent mental health problems, whereas adolescents' depression was most influenced by maternal parenting practices. Moreover, maternal hostility was most predicted by maternal harshness.

CONCLUSIONS

This study presents a novel perspective to gain a better understanding of the dynamics between and within maternal parenting practices and adolescent mental health problems. Findings highlight maternal harshness and warmth as potential prevention and intervention targets for adolescent mental health problems.

Adapting a coach-assisted web-based intervention for parents of adolescents who refuse school: qualitative study with users of the Partners in Parenting Plus programme

BACKGROUND

School refusal is a heterogenous problem which typically emerges in adolescence and co-occurs with internalising disorders. A substantial proportion of adolescents do not respond to existing treatment modalities; thus, novel, effective intervention options are needed. Partners in Parenting Plus (PiP+) is a coach-assisted, web-based intervention designed to empower parents to respond to adolescent internalising disorders.

AIMS

To conduct a process evaluation of PiP+ and identify programme adaptations required to meet the needs of parents of adolescents who refuse school.

METHOD

Semi-structured interviews were conducted with 14 Australian mothers who had: (a) received the PiP+ programme (not tailored for school refusal) during a prior research trial; and (b) reported that their adolescent was refusing school during their participation in PiP+. Inductive thematic analysis was used to analyse interview transcripts.

RESULTS

Participants were 41-53 years old (M = 47.8) and parenting adolescent children aged 14-17 years (M = 14.9). Three themes illustrated how PiP+ features met or could better meet the needs of parents of adolescents who were refusing school: (a) feeling heard, supported and respected; (b) relevance to me and my context; and (c) seeing positive changes. Participants had favourable views of PiP+, especially coached components. Participants requested programme enhancements to better meet the needs of parents of neurodiverse adolescents and discussed the impact of cumulative help-seeking 'failures' on self-efficacy and locus of control.

CONCLUSIONS

PiP+ was highly acceptable to the majority of parents navigating the issue of school refusal. This has implications for the enhancement of coach-assisted parenting interventions and the context-specific adaptation of PiP+ for school refusal.

Impact of Moral Elevation on College Students' Sense of Meaning of Life: The Mediating Roles of Gratitude and Perceived Social Support

Purpose

The current study examined the association between moral elevation and college students' sense of meaning of life, along with the potential mediating effects of gratitude and perceived social support on this relationship.

Methods

Using the convenience sampling method, the Moral Elevation Scale, the Sense of Meaning of Life Questionnaire, the Gratitude Questionnaire, and the Multidimensional Scale of Perceived Social Support were used to conduct questionnaire surveys on 1088 college students (Mage=19.59 years, SD=1.46). SPSS25.0 data statistics software was used to analyze the data, and the PROCESS macro for SPSS was used to conduct the mediation effect test.

Results

(1) Moral elevation was significantly and positively associated with college students' sense of meaning of life (β = 0.43,p < 0.001). (2) Both gratitude and perceived social support partially mediated the relation between moral elevation and sense of meaning of life. The indirect effect of moral elevation on sense of meaning of life via gratitude was 0.11 (95% CI = [0.0709, 0.1453]), and the mediating effect accounted for 52.71%. The indirect effect of moral elevation on sense of meaning of life via perceived social support was 0.06 (95% CI = [0.0385, 0.0863]), and the mediating effect accounted for 29.41%. (3) Gratitude and perceived social support sequentially mediated the association between moral elevation and sense of meaning of life, the indirect effect through gratitude and perceived social support was 0.04 (95% CI = [0.0237, 0.0512]) and accounted for 17.88%.

Conclusion

This study revealed the chain mediating roles of gratitude and perceived social support in the relation between moral elevation and sense of meaning of life for Chinese college students, which is of great theoretical and practical significance for the formation of a positive sense of meaning of life and the cultivation of moral elevation among college students.

Anxiety and Teacher-Student Relationships in Secondary School: A Systematic Literature Review

Anxiety disorders are the most prevalent mental disorders experienced by adolescents. As students spend a significant amount of time within a school environment, it is not surprising that factors in the school environment have been linked to student mental health. Positive teacher-student relationships (TSRs) in children have been found to improve student mental health outcomes, with supportive TSRs associated with reduced student anxiety, and in turn, student anxiety has also been associated with reduced poorer TSR quality. The findings in adolescents are less clear. This review aimed to systematically evaluate the impact of TSRs on anxiety in secondary school students, and vice-versa using PRISMA guidelines. Searches were conducted in five databases and studies screened against inclusion and exclusion criteria, and rated for study quality by two independent researchers. Twenty-six studies across 12 countries were included. Most studies reported higher quality TSRs (e.g., those that are perceived as more supportive, caring, and warm) was associated with decreased anxiety. Conversely, TSRs that were characterised by dependence, motivational support, conflict, or harassment, were associated with increased anxiety. Most studies used a cross-sectional design and as such conclusions regarding causality as well as the direction of the effects cannot be made. However, early evidence from a limited number of longitudinal studies indicated that positive TSRs reduced anxiety over time. Future research is warranted to investigate whether anxiety affects TSRs, as well as exploring specific strategies and approaches teachers can use to establish positive relationships with their students.

Parental Symptoms of Anhedonia, Parenting, and Youth Outcomes: A Multi-Method, Multi-Informant Investigation

Parental depression is a well-established risk factor for youth psychopathology; however, depression is highly heterogeneous, and different parental symptom profiles may be differentially associated with risk mechanisms and youth psychopathology outcomes. Thus, this study examined associations between parental anhedonic symptoms of depression, specifically, and (1) parenting and (2) youth outcomes using a multi-method, multi-informant approach. Participants included 595 parents (89% mothers) and youth (ages 8-16; M[SD] = 12.07[2.39]). Regression analyses indicated that parental self-reported anhedonic symptoms at baseline demonstrated relatively specific prospective associations with chronic parent-child stress assessed using contextual stress interview methods, as well as youth self-reported depressive symptoms at 18-month follow-up. Findings also indicated concurrent associations between parental anhedonic symptoms and observed parental criticism, conflict, and responsiveness in the context of a 5-min discussion task, as well as parent self-reported monitoring/supervision, although results were no longer significant after controlling for parental co-occurring non-anhedonic depressive symptoms. Findings suggest that parental anhedonic symptoms may contribute to relatively unique reductions in the quality of the parent-child relationship and may be a particularly salient risk factor for youth depression.

Research Review: Child emotion regulation mediates the association between family factors and internalizing symptoms in children and adolescents - a meta-analysis

BACKGROUND

Parental influence on children's internalizing symptoms has been well established; however, little is known about the underlying mechanisms. One possible mechanism is child emotion regulation given evidence (a) of its associations with internalizing symptoms and (b) that the development of emotion regulation during childhood and adolescence is influenced by aspects of the family environment. This meta-analysis aimed to systematically investigate the mediating role of child emotion regulation in the relationship between various family factors and internalizing symptoms in children and adolescents.

METHODS

We searched Medline, Embase, PsychInfo, and Web of Science for English articles up until November 2022. We included studies that examined child emotion regulation as a mediator between a family factor and child/adolescent internalizing symptoms. Random-effects models were used to calculate pooled indirect effects and total effects for nine family factors. Heterogeneity and mediation ratio were also calculated.

RESULTS

Of 49 studies with 24,524 participants in this meta-analysis, family factors for which emotion regulation mediated the association with child/adolescent internalizing symptoms included: unsupportive emotion socialization, psychological control, secure attachment, aversiveness, family conflict, parent emotion regulation and parent psychopathology, but not supportive emotion socialization and behavioral control.

CONCLUSIONS

Various family factors impact children's emotion regulation development, and in turn, contribute to the risk of internalizing symptoms in young people. Findings from this study highlight the need for interventions targeting modifiable parenting behaviors to promote healthy emotion regulation and better mental health in children and adolescents.

Parental education level and adolescent depression: A multi-country meta-analysis

Adolescent depression, as a common problem, has always been the focus of attention and research. However, no consistent conclusion has been drawn on its relationship with parental education level. Therefore, this study used meta-analysis and dose-response analysis techniques to explore the overall relationship between the two, and further explore the moderating factors affecting the relationship between the two through subgroup analysis and meta-regression analysis. After a literature search and screening, a total of 22 literatures were included, including 634,821 adolescents aged 9-25, distributed in 10 countries. The results showed that: (1) Overall parental education level was negatively correlated with adolescent depressive symptoms (RR = 0.88. p < 0.001), and there was a dose-response relationship between the two. (2) Geographical location (p = 0.002 < 0.05) and national economic development (p = 0.03 < 0.05) significantly moderated and affected the association between parental education level and adolescent depression, thus presenting a global inconsistency. The results of this study provide a more accurate conclusion on the relationship between parental education and adolescent depression to some extent, highlight the importance and necessity of considering family, economic and cultural factors when studying and solving adolescent depression problems, and guide us to pay more attention to the cross-regional and cross-cultural differences in adolescent depression problems.

Parent-adolescent discrepancies in positive parenting and adolescent problem behaviors in Chinese families

Based on the discrepancy-maladaptive hypothesis and general strain theory, in this study, we examined two key aspects: first, the mediating role of self-control in the relationship between parent-adolescent discrepancies in positive parenting and adolescent internalizing and externalizing problems, and second, variations in problem behavior among subgroups with different parent-adolescent dyads reporting patterns. The participants were 349 intact Chinese families, with parents as the primary caregivers and teenagers aged 15-18 years who are attending secondary vocational schools. The results revealed that adolescents generally perceived lower levels of caring and behavioral control than parents. Compared to behavioral control, discrepancies in perceived levels of caring had more significant predicting levels of internalizing and externalizing problems, and the relationship between discrepancies of caring and internalizing and externalizing problems was mediated by self-control. Latent profile analysis revealed three parent-adolescent responding patterns (subgroups); compared to the other subgroups, only the subgroup characterized by adolescents perceiving lower caring and behavioral control than parents exhibited higher levels of internalizing and externalizing problems. The findings of this study provide insights on how parent-adolescent discrepancies may lead to adolescent problem behaviors and highlight the importance of self-control as a mediating mechanism.

Sticky criticism? Affective and neural responses to parental criticism and praise in adolescents with depression

BACKGROUND

Parent-adolescent interactions, particularly parental criticism and praise, have previously been identified as factors relevant to self-concept development and, when negative, to adolescent depression. Yet, whether adolescents with depression show aberrant emotional and neural reactivity to parental criticism and praise is understudied.

METHODS

Adolescents with depression (n = 20) and healthy controls (n = 59) received feedback supposedly provided by their mother or father in the form of negative ('untrustworthy'), neutral ('chaotic'), and positive ('respectful') personality evaluations while in an MRI-scanner. After each feedback word, adolescents reported their mood. Beforehand, adolescents had rated whether these personality evaluations matched their self-views.

RESULTS

In both groups, mood decreased after criticism and increased after praise. Adolescents with depression reported blunted mood responses after praise, whereas there were no mood differences after criticism. Neuroimaging analyses revealed that adolescents with depression (v. healthy controls) exhibited increased activity in response to criticism in the subgenual anterior cingulate cortex, temporal pole, hippocampus, and parahippocampal gyrus. Praise consistent with adolescents' self-views improved mood independent of depression status, while criticism matching self-views resulted in smaller mood increases in adolescents with depression (v. healthy controls). Exploratory analyses indicated that adolescents with depression recalled criticism (v. praise) more.

CONCLUSIONS

Adolescents with depression might be especially attentive to parental criticism, as indexed by increased sgACC and hippocampus activity, and memorize this criticism more. Together with lower positive impact of praise, these findings suggest that cognitive biases in adolescent depression may affect how parental feedback is processed, and may be fed into their self-views.

Systematic Review and Meta-Analysis: Early Irritability as a Transdiagnostic Neurodevelopmental Vulnerability to Later Mental Health Problems

OBJECTIVE

Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0 to 5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalization.

METHOD

Relevant studies published in peer-reviewed, English-language journals between the years 2000 and 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first 5 years of life and reported associations with later internalizing and/or externalizing problems. Methodological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist.

RESULTS

Of 29,818 identified studies, 98 met inclusion criteria, with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months) and later internalizing (r = 0.14, 95% CI = 0.09, 0.20) and externalizing symptoms (r = 0.16, 95% CI = 0.11, 0.21) symptoms. For toddler/preschool irritability (13-60 months), small-to-moderate pooled associations were observed for internalizing (r = 0.21, 95% CI = 0.14, 0.28) and externalizing (r = 0.24, 95% CI = 0.18, 0.29) symptoms. These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization.

CONCLUSION

Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterize irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems.

DIVERSITY & INCLUSION STATEMENT

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 living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.

STUDY PREREGISTRATION INFORMATION

Early irritability as a transdiagnostic neurodevelopmental vulnerability to early onset mental health problems: A systematic review; https://www.crd.york.ac.uk/prospero/; CRD42020214658.

Longitudinal Associations Between Relationship Quality and Depression Among Youth with Intellectual Disabilities: A Latent Change Perspective

This study investigates associations between initial levels and change in the quality of the relationships youth with intellectual disabilities (ID) share with their parents and teachers, and changes in their levels of depression over time. A sample of 395 youth with mild (48.3%) and moderate (51.7%) ID, aged between 11 and 22 (M = 15.69), were recruited in Canada (n = 142) and Australia (n = 253). Youth completed self-report measures of relationship quality and depression twice over a one-year period. Initial levels of warmth (β = - .109) and conflict (β = - .302) predicted decreases in depression. Increases in warmth predicted decreases in depression (β = - .179), while increases in conflict predicted increases in depression (β = .268). Discrepancies between youth relationships with their parents and teachers predicted decreases in depression (βwarmth = - .732; βconflict = - .608).