Impact of socio-emotional context, brain development, and pubertal maturation on adolescent risk-taking

Measuring the Complexity of Self-Regulated Learning and Academic Challenges for Adolescents in Canada

Research that uses self-report measures to examine the complexity of self-regulated learning (SRL) and academic challenges for adolescents is limited. This study examined the psychometric property of the Self-Regulated Learning Profile and Self-Diagnostic (SRL-PSD) instrument and addressed the multi-components of SRL and academic challenges for adolescents. Participants were 358 adolescents from a Canadian middle school. The subscales of SRL-PSD were administered to students through LimeSurvey during a 25-min instructional session over two days. Results demonstrated the SRL-PSD was a reliable and valid self-report instrument to measure adolescents' SRL practices and academic challenges. Also, all types of SRL practices and academic challenges were significantly intercorrelated. Additionally, all types of SRL practices were positively associated with school engagement, whereas all types of academic challenges were negatively associated with school engagement. Overall, this study provides a validated self-report measure for educators and researchers to examine adolescents' SRL practices and academic challenges.

Validation of the Sexual Discounting Task for Use in Adolescents

The Sexual Discounting Task (SDT) was developed to evaluate the effects of delay on decision making as it relates to sexual risk-taking behaviors. Though previously validated with other populations, including urban emerging adults, the current study sought to validate the SDT with adolescents. A sample of adolescents (N = 155; 61% female) between ages 14 and 21 (Mage = 19.5 years) was recruited to complete the SDT (involving choices between immediate unprotected sex and delayed sex with a condom with hypothetical sexual partners) and the Delay Discounting Task (a delay discounting task for money outcomes). Additionally, they completed several self-report measures assessing demographics, sexual behavior, and sexual history. If the condom was readily available, respondents were more likely to use a condom for partners who were judged "most likely to have an STI" and for those that participants were "least likely to have sex with." Moreover, when a condom was not immediately available, greater self-reported sexual risk-taking was related to greater sexual discounting (i.e., greater effects of delay on decreasing condom use). Furthermore, sexual discounting was greater among partners deemed more desirable and those judged "least likely to have an STI." Differences in sexual discounting were significant after controlling for immediately available condom use. Findings from the current study suggest that the SDT is clinically meaningful for adolescents and is sensitive to factors that influence real-world decisions to use condoms. Future treatment and prevention should consider delay discounting as an important variable affecting sexual risk behavior.

Microbiome depletion prior to repeat mild TBI differentially alters social deficits and prefrontal cortex plasticity in adolescent and adult rats

Although aging, repeat mild traumatic brain injury (RmTBI), and microbiome modifications independently change social behavior, there has been no investigation into their cumulative effects on social behavior and neuroplasticity within the prefrontal cortex. Therefore, we examined how microbiome depletion prior to RmTBI affected social behavior and neuroplasticity in adolescent and adult rats. Play, temperament analysis, elevated plus maze, and the hot/cold plate assessed socio-emotional function. Analyses of perineuronal nets (PNNs) and parvalbumin (PV) interneurons was completed. Social-emotional deficits were more pronounced in adults, with microbiome depletion attenuating social behavior deficits associated with RmTBI in both age groups. Microbiome depletion increased branch length and PNN arborization within the PFC but decreased the overall number of PNNs. Adults and males were more vulnerable to RmTBI. Interestingly, microbiome depletion may have attenuated the changes to neuroplasticity and subsequent social deficits, suggesting that the microbiome is a viable, but age-specific, target for RmTBI therapeutics.

Association between sedentary behavior and Brain-Derived Neurotrophic Factor (BDNF) in children and adolescents: A protocol for systematic review and meta-analysis

BACKGROUND

There is evidence in the literature suggesting that high time spent in sedentary behavior (SB) can reduce the Brain-Derived Neurotrophic Factor (BDNF) levels, an important neurotrophin that plays a role in modulating cognition, learning and memory. Children and adolescents usually spend many hours a day on SB, either sitting for a long time and/or using screen equipment.

OBJECTIVE

The aim of this study is to describe a systematic review and meta-analysis protocol on the associations between SB and BDNF levels in children and adolescents.

METHODS

This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and was published in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42023392246). The databases that will be searched are EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, CINAHL, and PubMed. Cross-sectional and cohort studies conducted with children and adolescents (5 to 19 yr) that analyzed the association between SB and BDNF will be included in the systematic review. The characteristics of the studies, methodological aspects, and main results will be described. Then, the risk of bias (assessed by STROBE and Newcastle-Ottawa scales) and the level of evidence (assessed by the GRADE tool) from included studies will be evaluated. Sub-group analysis will also be performed. Two experienced reviewers will perform the studies selection, data extraction, and methodological quality assessment.

CONCLUSION

This systematic review and meta-analysis will analyze the association between SB and BDNF in children and adolescents. The results will provide subsidies to better understand this relationship and will strengthen evidence-based practice for both health professionals and future researches.

Beyond the Situation: Hanging Out with Peers now is Associated with Short-Term Mindsets Later

It is well-established that unstructured unsupervised socializing with peers (UUS) motivates deviance while in that specific context. In this article, we extend this situational view by arguing that repeated UUS may also gradually shape adolescents' norms and decision making beyond the situation. Specifically, we argue that UUS promotes short-term mindsets, i.e., an increased focus on present rewards at the expense of considering future consequences. We test this hypothesis with fixed-effects models, using longitudinal data from a representative sample of 1,675 adolescents from Zurich, Switzerland. Consistent with our preregistered predictions, more frequent UUS is associated with increased short-term mindsets. Thus, our finding suggests that the effects of UUS on later deviance might be driven by becoming more present-oriented. This link offers new insights into the developmental pathways toward adolescent delinquency and offers a potential target for intervention.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40865-024-00249-2.

Youth-friendly services was the magic: Experiences of adolescent girls and young women in the community PrEP study, South Africa

Adherence to daily oral pre-exposure prophylaxis (PrEP) for HIV prevention has been challenging for adolescent girls and young women (AGYW). As part of The Community PrEP Study (CPS), AGYW were randomised to HIV-prevention empowerment counselling (intervention) or basic medication pick-up (control). In this qualitative sub-study, we interviewed AGYW participants (n = 39) to explore PrEP use and study experiences by study arm, and study staff (n = 7) to explore study implementation, site environment, and participant engagement. Data were thematically analysed using a constant comparison approach. Comparative matrices assessed similarities and differences in study experiences and PrEP support preferences. Friendly, non-judgmental, non-stigmatizing study staff were described as central to participant's positive experiences. Participants highly valued CPS staff's holistic health support (e.g. physical and psycho-social). Intervention participants described empowerment counselling as helpful in supporting PrEP disclosure. However, control participants also described disclosing PrEP use to trusted individuals. Participants and staff recommended public-sector PrEP services provide holistic, confidential, and integrated sexual and reproductive health services, and community sensitisation. An adolescent and youth-friendly environment was the primary factor motivating AGYW's study engagement. While HIV-prevention empowerment counselling was well received, welcoming, respectful and non-judgmental staff may be the 'secret sauce' for implementing effective PrEP services to AGYW.

The age-varying effects of adolescent stress on impulsivity and sensation seeking

Adolescence is defined in part by heightened exposure and sensitivity to stressors. In a longitudinal cohort of youth at risk for substance use problems, we examined the age-varying relationship between stress exposure and traits that are central to the dual systems model. The positive associations between stress exposure, impulsivity, sensation seeking varied as function of age. Specifically, the influence of stress exposure on impulsivity strengthened during early adolescence and remained stable into early adulthood, while the influence of stress exposure on sensation seeking strengthened from early- to mid-adolescence and weakened thereafter. These findings suggest that the maturational imbalance between the capacity to regulate impulsive tendencies and sensation seeking may be exaggerated for youth who are exposed to a high number of stressors.

Impulsiveness among Undergraduates from the United Arab Emirates and Jordan: Role of Socio-demographic Variables

BACKGROUND

Some undergraduate students may appear impulsive in their behavior without taking enough time to think, and impulsiveness may vary according to gender, academic specialization, and academic level.

OBJECTIVE

This study investigated the differences in impulsiveness between undergraduates of different gender, academic specializations, and academic years at three private universities in the United Arab Emirates and Jordan.

METHOD

The research design of the study was a survey in nature. The researchers collected data online using a translated Arabic version of the Barratt Impulsiveness Scale (BIS-11) as described in Patton et al..1 A sample of 334 undergraduates was selected using the convenient non-probability sample technique.

RESULTS

To analyze data, the researchers deployed descriptive and inferential statistics and found no significant differences between the students in the subscales of motor impulsiveness, non-planning, attentional impulsiveness, and the total scale score according to gender, academic specializations, and academic years variables.

CONCLUSION

The researchers concluded that undergraduates have a moderate level of impulsiveness; except for attentional impulsiveness, the results indicated that the average student's score on the subscale was low. Motor impulsiveness, non-planning impulsiveness, and attentional impulsiveness were not significantly different between males and females, academic specialization, academic year variables, and their interaction. The limitations and implications of these findings are discussed.

Early Childhood Behavioral and Academic Antecedents of Lifetime Opioid Misuse among Urban Youth

OBJECTIVE

Opioid misuse has become an epidemic in the United States. In the present study, we examine potential malleable early childhood predictors of opioid misuse including whether childhood achievement, aggressive behavior, attention problems, and peer social preference/likability in first grade predicted opioid misuse and whether these relationships differed depending on participant sex.

METHOD

Data are drawn from three cohorts of participants (N = 1,585; 46.7% male) recruited in first grade as part of a series of elementary school-based, universal preventive interventions conducted in a Mid-Atlantic region of the US. In first grade, participants completed standardized achievement tests, teachers reported on attention problems, and peers nominated their classmates with respect to their aggressive behavior and social preference/likability. At approximately age 20, participants reported on their misuse of opioids defined as lifetime use of heroin or misuse of prescription opioids.

RESULTS

Higher levels of peer nominations for aggressive behavior in first grade predicted a greater likelihood of opioid misuse. An interaction between participant sex and attention problems was observed such that females higher in attention problems were more likely to misuse opioids, particularly prescription opioids, than females lower in attention problems. An interaction was also found between participant sex and peer likability such that males lower in peer-nominated likability were more likely to misuse opioids relative to males higher in likability.

CONCLUSION

Given the malleable nature of attention problems, aggression, and social skills in early childhood, prevention programs that target these behaviors during this developmental period may attenuate risk for opioid misuse.

Intrinsic connectivity within the affective salience network moderates adolescent susceptibility to negative and positive peer norms

Not all adolescents are equally susceptible to peer influence, and for some, peer influence exerts positive rather than negative effects. Using resting-state functional magnetic resonance imaging, the current study examined how intrinsic functional connectivity networks associated with processing social cognitive and affective stimuli predict adolescents' (n = 87, ages 11-14 years) prosocial tendencies and risky behaviors in the context of positive and negative peer norms. We tested the moderating role of four candidate intrinsic brain networks-associated with mentalizing, cognitive control, motivational relevance, and affective salience-in peer influence susceptibility. Only intrinsic connectivity within the affective salience network significantly moderated the association between peer norms and adolescent behavior above and beyond the other networks. Adolescents with high intrinsic connectivity within the affective salience network reported greater prosocial tendencies in contexts with more positive peer norms but greater risk-taking behavior in contexts with more negative peer norms. In contrast, peer norms were not associated with adolescent behavior for individuals with low affective salience within-network intrinsic connectivity. The mentalizing network, cognitive control network, and motivational relevance network were not associated with individual differences in peer influence susceptibility. This study identifies key neural mechanisms underlying differential susceptibility to positive and negative peer influence in early adolescence, with a particular emphasis on the role of affective salience over traditional mentalizing, regulatory, and motivational processes.

Is paternal oxytocin an oxymoron? Oxytocin, vasopressin, testosterone, oestradiol and cortisol in emerging fatherhood

How do hormonal levels in men change from pregnancy to after the birth of their firstborn child, and what is the role of oxytocin, alone or in interplay with other hormones, in explaining variance in their parenting quality? We explored in 73 first-time fathers the development of five hormones that have been suggested to play a role in parenting: oxytocin (OT), vasopressin (AVP), testosterone (T), oestradiol (E2) and cortisol (Cort). In an extended group of fathers (N = 152) we examined associations with fathers’ behaviour with their 2-month-old infants. OT and E2 showed stability from the prenatal to the postnatal assessments, whereas AVP and T decreased significantly, and Cort decreased marginally. OT on its own or in interplay with other hormones was not related to paternal sensitivity. Using an exploratory approach, the interaction between T and E2 emerged as relevant for fathers’ sensitive parenting. Among fathers with high E2, high T was associated with lower sensitivity. Although we did not find evidence for the importance of OT as stand-alone hormone or in interplay with other hormones in this important phase in men's lives, the interaction between T and E2 in explaining variation in paternal behaviour is a promising hypothesis for further research.

This article is part of the theme issue ‘Interplays between oxytocin and other neuromodulators in shaping complex social behaviours’.

Delinquency, Substance Use, and Risky Sexual Behaviors among Youth who are involved in the Justice System and Predominantly Reside in Rural Communities: Patterns and Associated Risk Factors

There is a significant gap in research examining the prevalence of problem behaviors among youth involved in the juvenile justice system in rural areas. The current study sought to address this gap by exploring the behavioral patterns of 210 youth who were on juvenile probation in predominantly rural counties and who were identified as having a substance use disorder. First, we examined the correlation among 7 problem behaviors representing different forms of substance use, delinquency, and sexual risk-taking and 8 risk factors related to recent service utilization, internalizing and externalizing difficulties, and social support networks. Then, we used latent class analysis (LCA) to identify distinct behavioral profiles based on the observed problem behaviors. LCA identified a 3-class model representing distinct groups labeled Experimenting (70%), Polysubstance Use + Delinquent Behaviors (24%), and Diverse Delinquent Behaviors (6%). Finally, we assessed differences (i.e., ANOVA, χ2) in each risk factor across the behavioral profiles. Important similarities and differences in the association among the problem behaviors, behavioral profiles, and the risk factors were revealed. These findings underscore the need for an interconnected behavioral health model within rural juvenile justice systems that is able to address youths' multidimensional needs including criminogenic, behavioral, and physical health needs.

Individual-, peer-, and parent-level substance use-related factors among 9- and 10-year-olds from the ABCD Study: Prevalence rates and sociodemographic differences

Background

Although a relatively large body of research has identified multiple factors associated with adolescent substance use, less is known about earlier substance-related factors during preadolescence, including curiosity to use substances. The present study examined individual-, peer-, and parent-level domains pertaining to substance use and how these domains vary by sociodemographic subgroups and substance type.

Methods

Participants were 11,864 9- and 10-year-olds from the baseline sample of the Adolescent Brain Cognitive Development (ABCD) Study. Youth-reported measures were curiosity to use substances and perceived peer substance use. Parent-reported measures were availability of and rules about substances. Generalized logistic mixed models (GLMM) were used to compare these measures across alcohol, nicotine, and marijuana and across sociodemographic subgroupings (sex, race/ethnicity, household income, and family history of alcohol problems). GLMM was then used to examine predictors of curiosity to use by substance type.

Results

The most striking descriptive differences were found between race/ethnicity and income categories (e.g., positive associations between greater income and greater availability of alcohol). In multivariable analyses, greater curiosity to use alcohol was associated with being male, higher household income, perceived peer alcohol use, and easy alcohol availability; greater curiosity to use nicotine was associated with being male, perceived peer cigarette use, easy availability of cigarettes, and no parental rules about cigarette use.

Conclusions

This study identified substance use-related individual-, peer-, and parent-level factors among a diverse, national sample. Findings highlight the importance of considering sociodemographic and substance-specific variability and may help identify risk and protective factors preceding adolescent substance use.

Politics of Plasticity: Implications of the New Science of the "Teen Brain" for Education

In recent years, claims that developmental brain science should inform pedagogical approaches have begun to influence educational policies. This article investigates the promise, pitfalls, processes, and implications of these claims. We explore how research on neuroplasticity has led to enormous interest in harnessing mechanistic models of development for applications in the classroom. Synthesizing analysis from the scientific literature on "neuroeducation" and interviews with key actors in the field, we analyze how neural and cognitive processes are mapped onto pedagogical constructs, and how psychological and social-structural factors are (or are not) integrated into explanations. First, we describe the historical trajectory of educational neuroscience and identify how tensions between antagonist groups struggling for authority over brain-based educational claims shaped the field. Second, we focus on the pervasive use of the concept of "neuroplasticity" in the literature. We argue that it is used as a rhetorical device to create hope and empower children, teachers, and parents through educational exercises that promote neurobiological reflexivity. Third, we turn to the notion of "self-regulation" in the neuroeducational programs. We argue that the rationale of these programs emphasizes the young person's responsibility in navigating their social worlds through the imperative to enhance their executive functions while failing to adequately account for the role of the social environment in the development of self-regulation.

Family environmental antecedents of pubertal timing in girls and boys: A review and open questions

Across nonhuman species, pubertal timing is affected by the social environment, with consequences for reproductive success and behavior. In human beings, variations in pubertal timing have not been systematically examined in relation to social environmental antecedents, although their psychological consequences are well documented. This paper focuses on links in human beings between pubertal timing and the childhood social environment, with several sections: A review of studies relating pubertal timing to the family context, a key aspect of the social environment; challenges in studying the issue; and opportunities for future work that takes advantage of and creates links with evidence in other species. The review shows that pubertal timing in girls is accelerated by adversity in aspects of the early family social context, with effects small in size; data in boys are not sufficient to enable conclusions. Inferences from existing studies are limited by variations in conceptualizations and measurement of relevant aspects of puberty and of the family social environment, and by methodological issues (e.g., reliance on existing data, use of retrospective reports, nonrandom missing data). Open questions remain about the nature, mechanisms, and specificity of the links between early family social environment and pubertal timing (e.g., form of associations, consideration of absence of positive experiences, role of timing of exposure). Animal studies provide a useful guide for addressing these questions, by delineating potential hormonal mechanisms that underlie links among social context, pubertal timing, and behavior, and encouraging attention to aspects of the social environment outside the family, especially peers.

Associations Between Psychosocial Well-Being, Stressful Life Events and Emotion-Driven Impulsiveness in European Adolescents

Knowing the extent to which mental well-being and stressful life events during adolescence contribute to personality characteristics related to risk-taking behaviors, such as emotion-driven impulsiveness, is highly relevant for the development of health promotion measures. This study examined whether psychosocial well-being and different stressful life events are associated with emotion-driven impulsiveness. In total, 3,031 adolescents (52% girls; M_age = 13.6 years) were included from the I. Family Study, a cross-sectional examination on lifestyle-related behaviors conducted across eight European countries in 2013/14. Linear mixed-effects regression models showed that higher psychosocial well-being was associated with lower emotion-driven impulsiveness independent of socio-demographic, health-related, and parental variables. A higher number of stressful life events was associated with higher emotion-driven impulsiveness. Psychosocial well-being and stressful life events need to be further considered in the development and tailoring of health promotion strategies that aim to reduce emotion-driven impulsiveness.

Community Violence Exposure and Youth Aggression: The Moderating Role of Working Memory

Community violence exposure (CVE) is associated with aggression among youth, particularly those who reside in low-income, urban neighborhoods. However, not all youth who experience CVE exhibit aggression. Working memory (WM) difficulties may interfere with attributions or retrieval of nonaggressive responses, suggesting that individual differences in WM may contribute to proactive and/or reactive aggression among youth who experience CVE. Participants were 104 low-income, urban youth (M = 9.92 ± 1.22 years old; 50.5% male; 95% African American). Youth reported on frequency of direct victimization and witnessing of violence in the community and completed two WM tasks. Teachers reported on youth proactive and reactive aggression. WM moderated the relation between direct victimization and proactive and reactive aggression, and between witnessing violence and reactive aggression. Among youth reporting less frequent victimization and witnessing, lower WM was associated with higher levels of proactive and reactive aggression. Among youth reporting more frequent direct victimization, lower WM was associated with higher levels of proactive aggression. Proactive and reactive aggression levels were similar among youth reporting more frequent witnessing regardless of WM levels. WM represents a potential target for early identification and intervention efforts to reduce reactive and proactive aggression among low-income, urban youth who are at elevated risk for CVE.

How does social evaluation influence Hot and Cool inhibitory control in adolescence?

The aim of the present study is to examine whether in Hot, i.e., affectively charged contexts, or cool, i.e., affectively neutral contexts, inhibitory control capacity increases or decreases under social evaluation in adolescents and adults. In two experiments, adolescents and young adults completed two Stroop-like tasks under either a social evaluation condition or an alone condition. The social evaluation condition comprised the presence of a peer (Experiment 1) or an expert (Experiment 2) playing the role of an evaluator, while under the alone condition, the task was performed alone. In the Cool Stroop task, participants had to refrain from reading color names to identify the ink color in which the words were printed. In the Hot Stroop task, participants had to determine the emotional expression conveyed by faces from the NimStim database while ignoring the emotion word displayed beneath. The results were similar in both experiments. In adolescents, social evaluation by a peer (Experiment 1) or by an expert (Experience 2) facilitated Hot but not cool inhibitory control. In adults, social evaluation had no effect on Hot or cool inhibitory control. The present findings expand our understanding of the favorable influence of socioemotional context on Hot inhibitory control during adolescence in healthy individuals.

Capitalizing on Neuroplasticity Across Development to Redirect Pathways from Juvenile Justice Involvement

Adolescence is an exquisitely sensitive period of development during which pathways branch toward success in school and prosocial pursuits or, conversely, toward behavior problems and involvement in high-risk activities and systems, such as juvenile justice (JJ). Adverse childhood experiences (ACEs) such as poverty, family dysfunction, and child maltreatment, have been strongly and repeatedly associated with JJ involvement. A significant body of research from neuroscience has established that ACEs can alter facets of neurodevelopment that undergird self-regulation throughout childhood and adolescence, thereby increasing susceptibility to behaviors that attract attention of the JJ system. Because the ability to intervene prior to system-entrenchment is crucial to disrupting an adverse developmental pathway, we look toward neuroscience to offer insights into how to do so more effectively. In this chapter, evidence is summarized that informs an understanding of how neurodevelopmental pathways may lead to JJ involvement. Because neurodevelopment is malleable in response to both detrimental and positive experiences, there is potential for well-targeted interventions to normalize brain and cognitive development, especially during sensitive periods of maturation. This discussion is followed by a proposed research agenda to determine how to exploit these critical windows of opportunity to divert youth from persistent antisocial behavior and JJ involvement. Lastly, a review of neuroscience findings regarding the ability of intervention to strengthen brain systems that modulate self-regulation is presented. This research has direct practical significance with potential to be translated into meaningful policy change.

Associations of developmental imbalance between sensation seeking and premeditation in adolescence and heavy episodic drinking in emerging adulthood

BACKGROUND

Dual systems theories suggest that greater imbalance between higher reward sensitivity and lower cognitive control across adolescence conveys risk for behaviors such as heavy episodic drinking (HED). Prior research demonstrated that psychological analogues of these systems, sensation seeking and premeditation, change from childhood through emerging adulthood, and each has been independently linked with HED. However, few studies have assessed whether change over time in these developing analogues is prospectively associated with HED. Moreover, we know of no research that has shown whether within-person differences between higher sensation seeking and relatively lower premeditation across the adolescent period predict HED in emerging adulthood.

METHODS

Prospective data from the National Consortium on Alcohol and NeuroDevelopment in Adolescence study (n = 715) were used to examine the association of sensation seeking and premeditation with HED among adolescents ages 16 to 20 years. We used novel applications of latent difference score modeling and growth curve analysis to test whether increasing sensation seeking, premeditation, and their imbalance over time are associated with HED across the study period, and whether these associations differed by sex.

RESULTS

Whereas premeditation increased linearly from adolescence through emerging adulthood across sexes, males reported growth and females reported decline in sensation seeking. Sensation seeking in adolescence (and not premeditation) was associated with higher levels of HED by emerging adulthood. Importantly, greater imbalance between sensation seeking and premeditation was associated with higher levels of HED by emerging adulthood though we note that variability capturing this imbalance correlated highly (r = 0.86) with baseline levels of sensation seeking.

CONCLUSIONS

Developmental imbalance between higher sensation seeking and lower premeditation in late adolescence may be a risk factor for greater HED in emerging adulthood.

Incentives conditioned on tenofovir levels to support PrEP adherence among young South African women: a randomized trial

Introduction

HIV incidence remains high among African adolescent girls and young women (AGYW), who would benefit from pre‐exposure prophylaxis (PrEP). Strategies to increase PrEP adherence and persistence need to be evaluated in African AGY, including incentives conditional on high adherence.

Methods

The 3Ps for Prevention Study was a 12‐month prospective cohort of 200 women ages 16 to 25 initiating PrEP in South Africa from 2017 to 2018. Participants received retrospective feedback about drug levels at Months 1, 2 and 3; half was randomized to receive a 200 Rand shopping voucher ($13 US) at Months 2, 3 and 4, conditioned on high intracellular tenofovir diphosphate (TFV‐DP) levels in dried blood spots (≥500 fmol/punch at Month 1, ≥700 fmol/punch at Months 2 and 3). The primary analysis was intention‐to‐treat, comparing the proportion with high PrEP adherence (≥700 fmol/punch) at Month 3 by randomized group, based on 100% efficacy among men who have sex with men.

Results

Median age of the 200 women was 19 years (interquartile range [IQR] 17, 21); 86% had a primary sexual partner. At Month 3, the mean TFV‐DP level was 822 fmol/punch (SD 522) in the incentive group and 689 fmol/punch (SD 546) in the control group (p = 0.11). Forty‐five (56%) of 85 women in the incentive group and 35 (41%) of 85 women in the control group had TFV‐DP levels ≥700 fmol/punch (RR 1.35; 95% CI 0.98, 1.86; p = 0.067), which declined to 8% and 5% in the incentive and control groups at Month 12 (no significant difference by arm). 44% refilled PrEP without gaps, 14% had a gap of ≥3 weeks in coverage subsequently restarted PrEP and 54% accepted at the final dispensing visit at Month 9. No new HIV infections were observed after PrEP initiation.

Conclusions

Among South African AGYW initiating PrEP, drug levels indicated high PrEP adherence in almost half of women at Month 3, with a non‐statistically significant higher proportion with high adherence among those in the incentive group. Over half persisted with the 12‐month PrEP programme although high adherence declined after Month 3. Strategies to support PrEP adherence and persistence and longer‐acting PrEP formulations are needed.

Sociodevelopmental Challenges Faced by Young People with Chronic Pain: A Scoping Review

OBJECTIVE

Map the current literature investigating autonomy development, identity development, and peer relationships in young people aged 10-24 years with chronic pain.

METHODS

A scoping review method was used to systematically search four databases (APA PsycNET, PubMed, Web of Science, and Cinahl) for peer-reviewed articles. Search results were screened against inclusion and exclusion criteria to ensure they met the objective. Eligible papers were assessed for quality, their data relating to the objective were extracted, and results are synthesized.

RESULTS

Searches returned 3,815 papers after the removal of duplicates, with 42 papers included in the full review. The majority of papers investigated peer relationships (86%). Fewer papers investigated autonomy (43%) and identity (21%) development. Included papers were mostly quantitative (64%), with fewer qualitative (34%) and mixed-methods papers (2%). Overall, we found bidirectional relationships between chronic pain in young people, their social development, and a range of functional outcomes. However, the mechanisms underlying these relationships remain relatively unexplored.

CONCLUSIONS

Review results are mapped onto the model proposed by Palermo et al. (2014). Guided by this model, clinical treatment for young people with chronic pain should consider social development. The model also sets out a future research agenda focused on exploring: (a) identity development, (b) the mechanisms underlying the relationships between social-developmental domains, pain, and outcomes, (c) a variety of participants and populations, and (d) a variety of methods, including longitudinal study designs.

Brain and motor synchrony in children and adolescents with ASD-a fNIRS hyperscanning study

Brain-to-brain synchrony has been proposed as an important mechanism underlying social interaction. While first findings indicate that it may be modulated in children with autism spectrum disorder (ASD), no study to date has investigated the influence of different interaction partners and task characteristics. Using functional near-infrared spectroscopy hyperscanning, we assessed brain-to-brain synchrony in 41 male typically developing (TD) children (8-18 years; control sample), as well as 18 children with ASD and age-matched TD children (matched sample), while performing cooperative and competitive tasks with their parents and an adult stranger. Dyads were instructed either to respond jointly in response to a target (cooperation) or to respond faster than the other player (competition). Wavelet coherence was calculated for oxy- and deoxyhemoglobin brain signals. In the control sample, a widespread enhanced coherence was observed for parent-child competition, and a more localized coherence for parent-child cooperation in the frontopolar cortex. While behaviorally, children with ASD showed a lower motor synchrony than children in the TD group, no significant group differences were observed on the neural level. In order to identify biomarkers for typical and atypical social interactions in the long run, more research is needed to investigate the neurobiological underpinnings of reduced synchrony in ASD.

Perceived Parental Monitoring: A Systematic Review of Monitoring Instruments

BACKGROUND AND PURPOSE

The purpose of this systematic review was to evaluate parental monitoring instruments and the theoretical perspectives informing their development.

METHODS

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, seven databases were searched for original studies using a monitoring instrument. The psychometric properties of each identified instrument were assessed using the "COnsensus-based Standards for the selection of health status Measurement INstruments" (COSMIN) methodology.

RESULTS

Of 2,245 articles identified, 72 studies representing six parental monitoring instruments met inclusion criteria. Quality of reporting on psychometric properties varied widely across instruments with only three including content validation studies.

CONCLUSIONS

Findings of this review reveal inattention to the psychometric quality of child self-reported monitoring instruments. Future research must focus on the psychometric quality of instruments used to measure the parent-child relationship.

Risk Preferences of Children and Adolescents in Relation to Gender, Cognitive Skills, Soft Skills, and Executive Functions

We conduct experiments eliciting risk preferences with over 1,400 children and adolescents aged 3-15 years old. We complement our data with an assessment of cognitive and executive function skills. First, we find that adolescent girls display significantly greater risk aversion than adolescent boys. This pattern is not observed among young children, suggesting that the gender gap in risk preferences emerges in early adolescence. Second, we find that at all ages in our study, cognitive skills (specifically math ability) are positively associated with risk taking. Executive functions among children, and soft skills among adolescents, are negatively associated with risk taking. Third, we find that greater risk-tolerance is associated with higher likelihood of disciplinary referrals, which provides evidence that our task is equipped to measure a relevant behavioral outcome. For academics, our research provides a deeper understanding of the developmental origins of risk preferences and highlights the important role of cognitive and executive function skills to better understand the association between risk preferences and cognitive abilities over the studied age range.

Onset of Puberty: Mother Knows Best

STUDY OBJECTIVE

Several strategies have been proposed to determine onset of puberty without examination by a trained professional. This study sought to evaluate a novel approach to determine onset of puberty in girls.

DESIGN, SETTING, AND PARTICIPANTS

This study used the Cincinnati cohort of the Breast Cancer and the Environment Research Program. Girls were recruited at 6-7 years of age and followed every 6 months in the initial 6 years, and annually thereafter. Breast maturation and foot length were performed at each visit by health professionals certified in those methods. Mothers were asked to provide the age at which they believed that their daughter's shoe size had increased more rapidly.

RESULTS

These analyses include 252 participants. Age at increase in shoe size was correlated to age at onset of puberty (r = 0.21) and increase in foot length (r = 0.24). The difference of reported age of increased shoe size was 0.46 years before breast development.

CONCLUSION

Reported increase in shoe size occurred somewhat earlier and was significantly correlated to age of breast development. These preliminary results suggest that mother's report of increase in shoe size appear to be as accurate as reports of other indirect methods of determining onset of puberty, such as self- or maternal estimates of breast development.

Recent trends in sexually transmitted infections among adolescents, Catalonia, Spain, 2012-2017

Monitoring sexually transmitted infections (STIs) in adolescents is essential to inform STI prevention strategies at primary and secondary levels in this key population. We aim to describe recent trends in STIs among adolescents and to analyse their socio-demographic and behavioural characteristics in Catalonia, Spain between 2012 and 2017. Data on Chlamydia trachomatis (CT) infection, gonorrhoea and syphilis cases aged from 13 to 19 years reported to the Catalan Mandatory Notifiable System from 2012 to 2017 were analysed. Diagnosis rates were calculated and a descriptive analysis was performed. Between 2012 and 2017, CT infection, gonorrhoea and syphilis cases reported among adolescents aged 13-19 years accounted for more than one-eleventh of all reported cases in Catalonia. The rate of the three nationally-notifiable STIs increased dramatically among adolescents. CT infection rates rose from 13 to 144.1 per 100,000 adolescents between 2012 and 2017, an increase of 1007%; gonorrhoea cases increased by 246% (from 13.4 to 45.4/100,000) and syphilis cases increased by 247% (from 1.7 to 5.9/100,000). Gonorrhoea and syphilis cases affected mainly males while CT infection cases were mostly in females (84%). Adolescents are being increasingly affected by CT infection, gonorrhoea and syphilis. A broader array of intervention strategies aimed at adolescents should be reinforced through strong prevention campaigns, improved sexual health information, as well as encouragement of regular offers of STI screening by healthcare providers.

Profiles and sociodemographic correlates of Internet addiction in early adolescents in southern China

Adolescent Internet addiction is currently one of the most common and serious publicly social problems. Understanding Internet addiction in early adolescents has become particularly important for early detection and intervention. This study examines profiles of Internet addiction among Chinese early adolescents and explores both the personal and familial correlates of Internet addiction based on a large random sample. A total of 2059 Chinese seventh-grade students were invited to complete the questionnaire, which included sociodemographic factors, family functions, and Internet addiction. The results reveal that 15.3% of the participating Chinese early adolescents were defined by Young (1998) criteria as expressing Internet addiction, in which boys were more likely to express Internet addiction than girls. Students with poor academic achievements were also more likely to fall into this addiction. Adolescents who did not live with their parents and who experienced more family conflicts and less family communication were more likely to report Internet addiction. These findings suggest that focusing on boys and academic under-performers as well as improving family environments can help early adolescents reduce their propensity to become addicted to the Internet.

Safe schools for teens: preventing sexual abuse of urban poor teens, proof-of-concept study - Improving teachers' and students' knowledge, skills and attitudes

Child sexual abuse (CSA) is a difficult form of abuse to detect, with the peak age of reports from 13 to 15 years old. The recent revision of the Philippine school curriculum provided an opportunity to incorporate an educational intervention for prevention of CSA. This study aimed to improve the teachers' and students' knowledge, skills and attitudes on disclosure, identification, and reporting of CSA. This research is a two-phase proof-of-concept cross-sectional study of 237 teachers and 1,458 Grade 7 students from 2 public high schools in metro Manila over a two-year period. Phase 1 involved in-service training curriculum for all teachers on the recognizing, recording, reporting, and referral (4R's) of child abuse and establishment of a referral and support system. Outcome measures included pre- and post-tests and number of CSA reports. Phase 2 involved implementation of eight student modules through the Health and Values Education subjects of the curriculum. Outcome measures were pre- and post-intervention measurement of abuse and module content. Training of teachers resulted in an increase in confidence for identifying CSA from 25% to 57%, and a decrease in apprehension of reporting CSA from 40% to 33%. The Safe Schools for Teens intervention significantly improved self-reported knowledge on abuse, dating violence, and how to help friends as well as on adolescent's impulse control and emotional clarity. There was a significant decline from pre- to post-intervention in self-reported experiences of dating violence which includes physical, sexual and emotional violence, t(793) = 3.363, p = 001 as well as a significant decline in self-reported experiences of emotional abuse from a dating partner, t(837) = 2.693, p = 0.008. The Safe Schools for Teens intervention increases awareness and reporting of child sexual abuse. The intervention also reduces dating violence highlighting that the mindfulness focused approach in connection with systems strengthening is useful for addressing adolescent violence.

Differential Correlates of Positive and Negative Risk Taking in Adolescence

Positive risks benefit adolescent development without posing the same public safety concerns as negative risks, but little is understood about the psychological characteristics of positive risk taking. This study explored the shared and unique correlates of positive and negative risk taking in 223 adolescents (48% female) ages 16-20 years (M = 18.1; SD = 0.81). Positive and negative risk taking were both associated with higher sensation seeking. Unlike negative risk taking, positive risk taking was not associated with impulsivity or risk taking on experimental tasks. Further, positive risk taking was associated with lower reward sensitivity, higher punishment sensitivity, and greater school engagement than negative risk taking. The findings offer new insights for prevailing models of adolescent risk behavior and suggest positive risk taking may be particularly beneficial in the school context.

Individual intelligence and brain neural correlates associated with outcome expectancies for risk behaviors in adults

Although adults have matured developments of general intelligence, brain structure and brain function, many people continue to be risk takers, despite the harm that can result. The neural basis underlying risk-taking behaviors has been studied extensively in adolescents, but less so in adults. Outcome expectancies are important factors influencing individuals' risk behaviors, which comprise the expected risks (ER) and expected benefits (EB) associated with risk behaviors. In the current study, we systematically investigated inter-individual differences in adults' outcome expectancies for risk behaviors, considering the general intelligence, brain function, and brain structure. At the intelligence level, individuals with higher intelligence scores showed lower ER but higher EB associated with risk behaviors. At the brain function level, resting-state functional connectivity (FC) between regions within the default mode network is negatively correlated with ER but positively correlated with EB associated with risk behaviors, while FC between the insula and motor cortex is negatively correlated with EB associated with the risk behaviors. At the brain structure level, gray matter volume in posterior cingulate cortex (PCC) and bilateral parahippocampus were negatively correlated with the ER associated with risk behaviors. Furthermore, the relationship between the outcome expectancy associated with risk behaviors and the FC between anterior cingulate cortex and PCC is partially mediated by the general intelligence. The current study provides new insight that furthers our understanding of how individual differences in adults' risk attitudes and behaviors are modulated by general intelligence and reflected in resting-state FC and brain structures related to self-reference and inhibitory control processing.

Internalizing symptoms in intractable pediatric epilepsy: Structural and functional brain correlates

Internalizing disorders (i.e., depression and anxiety) are common comorbidities in people with epilepsy. In adults with epilepsy, comorbid depression or anxiety is associated with worse seizure control and reduced quality of life, and may be linked to specific neural biomarkers. Less is known about brain correlates of internalizing symptoms in pediatric populations. In the current study, we performed a retrospective analysis of 45 youth between the ages of 6 and 18 years old with intractable epilepsy. Individuals were evaluated for internalizing symptoms on the Child Behavior Checklist (CBCL) and underwent magnetic resonance (MR) and fluorodeoxyglucose (FDG)-positron emission tomography (PET) imaging as part of the clinical evaluation for surgical treatment of epilepsy. Forty-two percent of patients experienced clinically significant internalizing symptoms based on parent report. Compared with individuals who scored in the normal range, youth with clinical levels of internalizing problems showed overall reductions in cortex volume, as well as widespread reductions in cortical thickness and functional activation in the bilateral occipital/parietal lobe, left temporal regions, and left inferior frontal cortex on MR and PET scans. There were no group differences in amygdala or hippocampus volumes, nor other patient- or illness-related variables such as age, sex, or the type, lateralization, or duration of epilepsy. Results suggest that high rates of internalizing disorders are present in youth with refractory epilepsy. Multifocal reductions in cortical thickness and function may be nonspecific risk factors for clinically meaningful internalizing symptoms in youth with chronic epilepsy. As such, the presence of broad cortical thinning and reduced glucose uptake upon radiological examination may warrant more focused clinical evaluation of psychological symptoms.

Relevance of students' demographic characteristics, sources of information and personal attitudes towards HIV testing for HIV knowledge: evidence from a post-conflict setting

Although studies on HIV knowledge have previously been conducted in central Serbia and southern Kosovo, none has included the Serbian population residing in the northern part of the Kosovo province. The aim of this study was to assess HIV-related knowledge and to estimate factors contributing to a higher HIV-related knowledge level among Serbian university students in the Kosovo province. A cross-sectional study including 1017 first- and fourth-year students enrolled at the University of Pristina temporarily seated in Kosovska Mitrovica was carried out during the academic year 2013-2014. The students completed a 31-item questionnaire comprising demographic data, HIV transmission knowledge and attitude towards HIV testing. Data were statistically analysed. Students demonstrated good knowledge of HIV (average 32.8 ± 3.3 out of a maximum 42). Only 5% of the students reported having been tested for HIV. Factors associated with being more knowledgeable about HIV were studying health-related disciplines (β = -0.09; 95% confidence interval [CI] -0.13, 0.00), using the internet as a source of information about HIV (β = -1.09; 95% CI -1.65, -0.52), having a positive attitude towards HIV testing (β = -0.43; 95% CI -0.59, -0.26), having a low self-perceived risk for HIV infection (β = 0.41; 95% CI 0.23, 0.56) and the position that one would keep the same level of contact with an HIV-positive person after learning their HIV status (β = 0.38; 95% CI 0.21, 0.55). Setting up specialized classes on this topic at high schools and universities could help to increase the awareness of HIV infection and promote HIV testing and a positive attitude towards HIV-positive persons.

Longitudinal link between trait motivation and risk-taking behaviors via neural risk processing

Prior research has emphasized the importance of the motivational system in risky decision-making, yet the mechanisms through which individual differences in motivation may influence adolescents' risk-taking behaviors remain to be determined. Based on developmental neuroscience literature illustrating the importance of risk processing in explaining individual differences in value-based decision making, we examined risk processing as a potential mediator of the association between trait motivations and adolescents' risk-taking behaviors. The sample consisted of 167 adolescents (47% females) annually assessed for three years (13-14 years of age at Time 1). Approach and avoidance motivations were measured using adolescent self-report. Risk preference was estimated based on adolescents' decisions during a modified economic lottery choice task with neural risk processing being measured by blood-oxygen-level-dependent responses in the bilateral insular cortex for chosen options. Adolescents' risk-taking behaviors were assessed by laboratory-based risky decision making using the Stoplight task. Longitudinal mediation analyses revealed a significant indirect effect of approach motivation, such that higher motivation was correlated with increases in risk-taking behaviors via decreases in neural activation in the bilateral insular cortex during risk processing. The findings illustrate a neural pathway through which approach motivation is translated into the vulnerability to risk taking development.

Sexual risk-taking and subcortical brain volume in adolescence

Background

The developmental period of adolescence marks the initiation of new socioemotional and physical behaviors, including sexual intercourse. However, little is known about neurodevelopmental influences on adolescent sexual decision-making.

Purpose

We sought to determine how subcortical brain volume correlated with condom use, and whether those associations differed by gender and pubertal development.

Methods

We used FreeSurfer to extract subcortical volume among N = 169 sexually experienced youth (mean age 16.07 years; 31.95% female). We conducted multiple linear regressions to examine the relationship between frequency of condom use and subcortical volume, and whether these associations would be moderated by gender and pubertal development.

Results

We found that the relationship between brain volume and condom use was better accounted for by pubertal development than by gender, and moderated the association between limbic brain volume and condom use. No significant relationships were observed in reward areas (e.g., nucleus accumbens) or prefrontal cortical control areas.

Conclusions

These data highlight the potential relevance of subcortical socioemotional processing structures in adolescents' sexual decision-making.

Girls-Boys: An Investigation of Gender Differences in the Behavioral and Neural Mechanisms of Trust and Reciprocity in Adolescence

BACKGROUND

Trust and reciprocity toward others have often been found to increase from childhood to adulthood. Gender differences in these social behaviors have been reported in adults. While adolescence is a key-period of change in social behavior, gender differences in trust and reciprocity during this developmental stage have rarely been investigated.

METHODS

Here we investigate age-related gender differences in trust and reciprocity (n = 100, 51 female) and associated neural mechanisms (n = 44, 20 female) in adolescents between 13 and 19 years of age. Participants played two multi-round trust games with a pre-programmed cooperative and an unfair partner. Forty-four of 100 participants completed the trust game while undergoing functional brain imaging.

RESULTS

Participants' investments were greater toward a cooperative than unfair game partner (p < 0.01), showing sensitivity to the degree of trustworthiness. There were no gender or age or related differences in baseline trust. In repeated cooperative interactions no gender differences were found, but younger adolescents showed slightly steeper increase of investments than older adolescents. In unfair interactions, younger males reacted with stronger decrease of investments than older males. Region of interest analysis of brain areas associated with in mentalizing, reward learning, conflict processing, and cognitive control revealed gender-by-age interactions on trusting behavior in the temporo-parietal junction (TPJ) and the caudate, showing stronger influence of age in males than in females during cooperation, and the reverse in unfair interactions. Additionally, main effects of gender were found in the TPJ, with higher activation in males, and in the caudate, with females showing greater activation.

CONCLUSION

In first interactions and during repeated cooperative interactions, adolescent males and females showed similar trusting behavior. Younger males showed stronger responses to unfairness by others. Gender-by-age interactions in specific ROIs suggest differential development in mentalizing and reward related cognitive processes. In conjunction with previous research, our findings suggest the presence of subtle gender and age-related changes in trust and cooperation that are only detectable using larger age windows.

Future considerations for pediatric cancer survivorship: Translational perspectives from developmental neuroscience

Breakthroughs in modern medicine have increased pediatric cancer survival rates throughout the last several decades. Despite enhanced cure rates, a subset of pediatric cancer survivors exhibit life-long psychological side effects. A large body of work has addressed potential mechanisms for secondary symptoms of anxiety, post-traumatic stress, impaired emotion regulation and cognitive deficits in adults. Yet, absent from many studies are the ways in which cancer treatment can impact the developing brain. Additionally, it remains less known whether typical neurobiological changes during adolescence and early adulthood may potentially buffer or exacerbate some of the known negative cancer survivorship outcomes. This review highlights genetic, animal, and human neuroimaging research across development. We focus on the neural circuitry associated with aversive learning, which matures throughout childhood, adolescence and early adulthood. We argue that along with other individual differences, the precise timing of oncological treatment insults on such neural circuitry may expose particular vulnerabilities for pediatric cancer patients. We also explore other moderators of treatment outcomes, including genetic polymorphisms and neural mechanisms underlying memory and cognitive control. We discuss how neural maturation extending into young adulthood may also provide a sensitive period for intervention to improve psychological and cognitive outcomes in pediatric cancer survivors.

Mind the gap: A review and recommendations for statistically evaluating Dual Systems models of adolescent risk behavior

According to Dual Systems models (Casey et al., 2008; Luna and Wright, 2016; Steinberg, 2008), a rapidly-developing socioemotional system and gradually-developing cognitive control system characterize adolescent brain development. The imbalance hypothesis forwarded by Dual Systems models posits that the magnitude of the imbalance between these two developing systems should predict the propensity for engaging in a variety of risk behaviors. The current integrative review argues that the excitement generated by the imbalance hypothesis and its implications for explaining adolescent risk behaviors has not been meet with equal efforts to rigorously test this hypothesis. The goal of the current review is to help guide the field to consider appropriate and rigorous methods of testing the imbalance hypothesis. First, we review the analytic approaches that have been used to test the imbalance hypothesis and outline statistical and conceptual limitations of these approaches. Next, we discuss the utility of two longitudinal analytic approaches (Latent Difference Scores and Growth Mixture Modeling) for testing the imbalance hypothesis. We utilize data from a large community adolescent sample to illustrate each approach and argue that Latent Difference Scores and Growth Mixture Modeling approaches enhance the specificity and precision with which the imbalance hypothesis is evaluated.

Are Mid-Adolescents Prone to Risky Decisions? The Influence of Task Setting and Individual Differences in Temperament

Recent developmental models assume a higher tendency to take risks in mid-adolescence, while the empirical evidence for this assumption is rather mixed. Most of the studies applied quite different tasks to measure risk-taking behavior and used a narrow age range. The main goal of the present study was to examine risk-taking behavior in four task settings, the Treasure Hunting Task (THT) in a gain and a loss domain, the Balloon Analogue Risk Task (BART), and the STOPLIGHT task. These task settings differ in affective task moderators, like descriptive vs. experienced outcomes, anticipation of gains vs. losses, static vs. dynamic risk presentation, and time pressure vs. no time pressure and were applied in a sample of 187 participants from age 9-18. Beneath age trends, we were interested in their association with individual differences in approach behavior, venturesomeness, impulsivity, and empathy above age, gender, and fluid intelligence. Our findings revealed that risk-taking behavior is only low to moderately correlated between the four task contexts, suggesting that they capture different aspects of risk-taking behavior. Accordingly, a mid-adolescent peak in risk propensity was only found under time pressure in the STOPLIGHT that was associated with higher impulsivity and empathy. In contrast, risky decisions decreased with increasing age in task settings, in which losses were anticipated (THT Loss), and this was associated with higher cognitive abilities. We found no age differences when gains were anticipated, neither in a static (THT Gain) nor in a dynamic task setting (BART). These findings clearly suggest the need to consider affective task moderators, as well as individual differences in temperament and cognitive abilities, in actual models about adolescent development.

HIV pre-exposure prophylaxis for adolescent girls and young women in Africa: from efficacy trials to delivery

INTRODUCTION

Adolescent girls and young women (AGYW) in Africa have high HIV incidence despite scale-up of HIV testing and HIV treatment. Placebo-controlled trials of tenofovir-based pre-exposure prophylaxi (PrEP) in diverse populations demonstrated that PrEP works with close to 100% effectiveness if taken with high, but not perfect, adherence. Divergent efficacy estimates among African AGYW led to demonstration and implementation projects to better understand motivations for HIV prevention, uptake, adherence and persistence to PrEP. To inform PrEP programmes, the design and initial findings from PrEP demonstration projects for AGYW are reviewed.

DISCUSSION

Early lessons from PrEP implementation projects among young African women include: (1) awareness and demand creation with positive messaging about the benefits of PrEP are critical to motivate AGYW to consider this novel prevention technology and to foster awareness among peers, partners, parents and guardians to support AGYW's effective PrEP use; (2) PrEP initiation is high in projects that are integrating PrEP into youth-friendly clinics, family planning clinics and mobile clinics; (3) young African women at risk are initiating PrEP, based on behavioural characteristics, history of intimate partner violence, depression and 30% prevalence of chlamydia and/or gonorrhoea; (4) provision of youth-friendly PrEP delivery programmes that integrate reproductive health services, including contraception and the diagnosis and treatment of sexually transmitted infections, increase health impact; (5) messages that emphasize the necessity for high adherence while at potential risk of HIV exposure and support strategies that addresses AGYW's adherence challenges are essential; and, (6) a substantial proportion of AGYW do not persist with PrEP, and strategies are needed to help AGYW assess their ongoing need, motivation and challenges with persisting with PrEP.

CONCLUSIONS

PrEP is feasible to implement in integrated reproductive health service delivery models to reach African AGYW. While PrEP demonstration projects indicate that women with behavioural risks and high rates of sexually transmitted diseases are initiating PrEP; effective strategies to support AGYW's adherence and persistence with PrEP are needed. Lessons learned from oral PrEP delivery, a novel first generation HIV prevention product, are relevant to longer-acting and less adherence-dependent strategies which are currently in clinical trials.

Psychosocial Maturation, Race, and Desistance from Crime

Research on maturation and its relation to antisocial behavior has progressed appreciably in recent years. Psychosocial maturation is a relatively recent concept of development that scholarship has linked to risky behavior. Psychosocial maturation appears to be a promising explanation of the process of exiting criminal behavior, known as desistance from crime. However, to date, research has not examined whether psychosocial maturation is related to desistance in similar ways across race/ethnicity. Using the Pathways to Desistance Study which followed a mixed-race/ethnicity group of serious adolescent offenders for 7 years, this research tested growth in psychosocial maturation across race/ethnic groups. The sample (14.46% female, average age 15.97 at baseline) was composed of white (n = 250), black (n = 463), and Hispanic (n = 414) individuals. The results showed variation in trajectories of psychosocial maturation with blacks having higher initial levels but slower growth in maturation over time compared to whites. Psychosocial maturation was negatively related to crime across all racial/ethnic groups. Across all racial/ethnic groups, differences in the magnitude of the association between psychosocial maturation and desistance were small. Rather than needing distinct theories for specific groups, psychosocial maturation appears to be a general theoretical perspective for understanding desistance from crime across races/ethnicities. Policy formulation based on psychosocial maturation would, therefore, be applicable across racial/ethnic groups.

Relationships Between Mental Health, Skill Sets, and Violence Perpetration Among Adolescent Girls

This study examines relationships between emotional health, stress management skills, fight-avoidance skills, and two forms of violence perpetration among adolescent girls at high risk for violence involvement. Participants ( n = 253) were 13- to 17-year-old girls enrolled in a randomized controlled trial. The current study was completed with baseline data collected prior to the start of the intervention. Analyses examined self-report outcome measures of physical violence perpetration in the past 6 months (five-item scale, α = .79) and relational aggression perpetration in the past 30 days (six-item scale, α = .77). Independent variables included baseline measures of self-esteem (four-item scale, α = .89), emotional distress (six-item scale, α = .89), stress management skills (eight-item scale, α = .86), and fight avoidance skills (five-item scale, α = .70). Multivariate regression models predicted each form of violence perpetration controlling for age, race/ethnicity, violence victimization, and clustering of participants within clinics. Initial bivariate results showed that stress management skills and fight avoidance skills were inversely and significantly related to perpetration of both relational and physical violence. Emotional distress was related to significantly higher levels of both violence outcomes. In contrast, self-esteem was not significantly related to either violence outcome. Multivariate analyses revealed that stress management skills and fight avoidance skills were significantly protective against perpetration of both relational aggression and physical violence. In conclusion, findings suggest that clinicians providing services to adolescent girls involved in high risk behaviors assess and foster girls' development of stress management and fight avoidance skills to help reduce their risk of involvement in relational violence and physical fighting.

Differentiation of functional networks during long-term memory retrieval in children and adolescents

The processes that characterize the neural development of long-term memory (LTM) are largely unknown. In young adults, the degree of activation of a single large-scale memory network corresponds to the level of contextual detail involved; thus, differentiating between autobiographical, episodic, and semantic retrieval. In contrast to young adults, children and adolescents retrieve fewer contextual details, suggesting that they might not yet engage the entire memory circuitry and that this brain recruitment might lack the characteristic contextual differentiation found in adults. Twenty-one children (10-12 years of age), 20 adolescents (14-16 years of age), and 22 young adults (20-35 years of age) were assessed on a previously validated LTM retrieval task, while their brain activity was measured with functional magnetic resonance imaging. The results demonstrate that children, adolescents, and adults recruit a left-lateralized subset of the large-scale memory network, comprising semantic and language processing regions, with neither developmental group showing evidence of contextual differentiation within this network. Additionally, children and adolescents recruited occipital and parietal regions during all memory recall conditions, in contrast to adults who engaged the entire large-scale memory network, as described previously. Finally, a significant covariance between age and brain activation indicates that the reliance on occipital and parietal regions during memory retrieval decreases with age. These results suggest that both children and adolescents rely on semantic processing to retrieve long-term memories, which, we argue, may restrict the integration of contextual detail required for complex episodic and autobiographical memory retrieval.

Longitudinal trajectories of hippocampal and prefrontal contributions to episodic retrieval: Effects of age and puberty

The current study investigated longitudinal change in hippocampal and prefrontal contribution to episodic retrieval. Functional neuroimaging data were collected during an item-context association memory task for children between the ages of 8 and 14 with individuals scanned 1-3 times over the course of 0.75-3.7 years (Timepoint 1 N = 90; Timepoint 2 N = 83, Timepoint 3 N = 75). We investigated developmental changes in functional activation associated with episodic retrieval (correct item-context > incorrect item-context contrast) and asked whether pubertal changes contributed to developmental changes in pattern of activation. Non-linear developmental trajectories were observed. In the hippocampus, activation decreased with age during childhood and then increased into early adolescence. In the dorsolateral prefrontal cortex, activation was largely absent initially, but quickly accelerated over time. Independent of age, changes in pubertal status additionally predicted increases in item-context activation in initially older children, and decreases in initially younger children across both regions and two indicators of puberty: the Pubertal Development Scale and salivary testosterone. These findings suggest that changes in both age and pubertal status uniquely contribute to memory-related activation, and the timing of pubertal onset may play an important role in the neural mechanisms supporting memory retrieval.

Peers influence adolescent reward processing, but not response inhibition

Most adolescent risk taking occurs in the presence of peers. Prior research suggests that peers alter adolescents' decision making by increasing reward sensitivity and the engagement of regions involved in the processing of rewards, primarily the striatum. However, the potential influence of peers on the capacity for impulse control, and the associated recruitment of the brain's control circuitry, has not yet been adequately examined. In the current study, adolescents underwent functional neuroimaging while they completed interleaved rounds of risk-taking and response-inhibition tasks. Social context was manipulated such that the participants believed they were either playing alone and unobserved, or watched by an anonymous peer. Compared to those who completed the tasks alone, adolescents in the peer condition took more risks during the risk-taking task and exhibited relatively heightened activation of the striatum. Activity within this striatal region also predicted individual differences in overall risk taking. In contrast, the presence of peers had no effect on behavioral response inhibition and had minimal impact on the engagement of typical cognitive control regions. In a subregion of the anterior insula engaged mutually by both tasks, activity was again found to be sensitive to social context during the risk-taking task, but not during the response-inhibition task. These findings extend the evidence that the presence of peers biases adolescents towards risk taking by increasing reward sensitivity rather than disrupting cognitive control.