Interpersonal Competence: A Mediator Between ODD Problems and Parent-Child Relationship Discord

A central requirement of Oppositional Defiant Disorder (ODD) consists of difficulties with interpersonal relationships. As emerging adults' transition into adulthood and seek more autonomy from parents, it is important to examine how ODD problems and parent-child discord are indirectly associated through interpersonal competencies. The current study examined the indirect effects between ODD problems in emerging adults and parent-child discord through multiple interpersonal competencies as well as the additional differences among parent-child gender dyads. Emerging adults (N = 599 individuals aged 18 to 25 years; M = 19.60, SD = 1.40; 68% females) were recruited via an online research platform and completed online survey measures of ODD problems, parent-child relationship discord, and interpersonal competence. Indirect effects were significant for the mother-daughter dyad only. Additional results, limitations, and implications are discussed.

Predictors of Youth Accessibility for a Mobile Phone-Based Life Skills Training Program for Addiction Prevention

BACKGROUND

Digital interventions are an emerging and promising avenue for addiction prevention and mental health promotion, but their reach and use are often limited, and little is known about the factors associated with youth accessibility. SmartCoach is a life skills training program for addiction prevention where adolescents are proactively invited for program participation in secondary school classes. The mobile phone-based program provides individualized coaching for a period of 4 months and addresses self-management skills, social skills, and substance use resistance skills. This study examined sociodemographic and other predictors of program participation and program use.

METHODS

A total of 476 adolescents in 28 secondary and upper secondary school classes in the German-speaking part of Switzerland were proactively invited for participation in the SmartCoach program. Using generalized linear mixed models (GLMMs), we examined predictors of both program participation and program use at the individual and school class levels.

RESULTS

In total, 315 (66.2%) of the present 476 adolescents gave their active consent and provided the necessary information to be included in the program. None of the individual sociodemographic characteristics significantly predicted program participation, however, the participation rate was significantly higher in upper secondary school classes (84%) than secondary school classes (59%). The mean number of interactions with the program was 15.9, i.e., participants took part in almost half of the 34 possible interactions with the SmartCoach program. None of the baseline characteristics on the level of the school class significantly predicted program use. On the level of the individual, the univariate models showed that, compared to the reference category of 14-year-old students, program use was significantly lower for students who were 16 or older. Furthermore, participants with a migration background or an origin from a non-German-speaking country showed significantly lower program use. Finally, students with a medium level of perceived stress showed higher program use compared to those with a low level of stress. Within the final multivariate model for program use, only the variable "origin from a non-German-speaking country" remained significant.

CONCLUSIONS

SmartCoach is an attractive offer for young people, in which two out of three young people who are invited in the classroom to participate do so. Among the program participants, the use of the program is acceptable, with an average of almost half of the content being worked on. There is potential for improvement in terms of recruitment, especially in school classes with a lower level of education. The most important starting point for improving program use lies in taking greater account of needs and wishes of students with non-German-speaking countries of origin.

Psychometric Properties of the Chinese Version of the Brief Interpersonal Competence Questionnaire for Adolescents

This study aimed to evaluate the psychometric properties of the Brief Interpersonal Competence Questionnaire (ICQ-15) administered to Chinese adolescents. A sample of 1705 adolescents (Mean age = 14.08, SD = 3.22, 46.5% male) completed a questionnaire including the Chinese version of the ICQ-15, as well as measurements of well-being, psychological resilience, and depression. To examine the psychometric properties of the ICQ-15, item analyses (item-total correlation and normality test), confirmatory factor analysis, concurrent validity analyses, multi-group analyses, and internal consistency analyses were performed. The results of the item analyses suggested a good item-total correlation, and the item scores were distributed approximately normally. The confirmatory factor analysis showed that the five-factor model had acceptable fit indices. The concurrent validity analyses indicated that the Chinese version of the ICQ-15 had a satisfactory concurrent validity. The multi-group analyses proved the measurement invariance across females and males, as well as participants in early, middle, and late adolescence. The ICQ-15 demonstrated satisfactory internal consistency reliability among Chinese adolescents. The ICQ-15 presents good psychometric properties and can be used to assess interpersonal competence in Chinese adolescents.

Longer-Term Efficacy of a Digital Life-Skills Training for Substance Use Prevention

INTRODUCTION

The main objective of this study was to test the longer-term and differential efficacy of a mobile phone‒based life-skills training program designed to prevent substance use among adolescents.

STUDY DESIGN

A 2-arm, parallel-group, cluster RCT with assessments at baseline and follow-up after 6 and 18 months was conducted. The efficacy of the intervention was compared with that of an assessment-only control condition.

SETTING/PARTICIPANTS

A total of 1,473 students with a mean age of 15.4 years were recruited in 2019/2020 within 89 Swiss secondary and upper secondary school classes.

INTERVENTION

The automated intervention program included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management, social, and substance use resistance skills.

MAIN OUTCOME MEASURES

Primary outcomes included 30-day prevalence rates for problem drinking and tobacco use.

RESULTS

The 18-month follow-up assessments were completed by 1,232 study (83.6%) participants. Those in the intervention group reported lower tobacco-smoking prevalence than the controls (OR=0.67; 95% CI=0.47, 0.96), but no significant difference in problem drinking (OR=0.84; 95% CI=0.61, 1.17) was observed. Among secondary outcomes, the intervention was effective at reducing cannabis-smoking prevalence (OR=0.55; 95% CI=0.39, 0.76) and cannabis use days (Cohen's d= -0.19; 95% CI= -0.29, -0.09), whereas no effects were observed for quantity of alcohol use, quantity of cigarettes smoked, well-being, or social skills. No significant moderators of the primary outcomes were observed.

CONCLUSIONS

An automated mobile phone‒based life-skills training program produced longer-term effectiveness in preventing tobacco smoking and cannabis use, whereas no effects were observed for problem drinking. These results suggest that digitally delivered life-skills training programs are similarly effective and are an easy-to-implement alternative to training conducted within a school curriculum.

TRIAL REGISTRATION

This study is registered at ISRCTN41347061 (registration date: 21/07/2018).

How social rejection expectations and depressive symptoms bi-directionally predict each other - A cross-lagged panel analysis

BACKGROUND

Although research suggests that social rejection expectations play a crucial role in the development and maintenance of depressive symptoms, it is not clear whether such expectations are a risk factor for depression or rather a consequence thereof. The present study addressed this issue by investigating the time-lagged bi-directional effects of social rejection expectations and depressive symptoms.

METHODS

In an online survey, participants (N = 347) completed measures of social rejection expectations, depressive symptoms, interpersonal competencies, and perceived social support at baseline and 2 months later. The relationships between the variables were examined using path models and cross-lagged path analyses.

RESULTS

Cross-lagged path analyses provided evidence for a substantial positive effect of social rejection expectations at baseline on depressive symptoms at follow-up in addition to the reverse effect. A mediator analysis indicated that neither interpersonal competencies nor perceived social support mediated these bi-directional effects.

CONCLUSION

The current results demonstrate that social rejection expectations and depressive symptoms bi-directionally predict each other. Thus, social rejection expectations appears to be both a risk factor for - and a symptom of - depression. In order to prevent a vicious circle of social rejection expectations and depressive symptoms, we recommend the early detection and treatment of social rejection expectations. Moreover, social rejection expectations should be specifically addressed in cognitive-behavioural treatment of depression.

Engagement With a Mobile Phone-Based Life Skills Intervention for Adolescents and Its Association With Participant Characteristics and Outcomes: Tree-Based Analysis

Background

Mobile phone–delivered life skills programs are an emerging and promising way to promote mental health and prevent substance use among adolescents, but little is known about how adolescents actually use them.

Objective

The aim of this study is to determine engagement with a mobile phone–based life skills program and its different components, as well as the associations of engagement with adolescent characteristics and intended substance use and mental health outcomes.

Methods

We performed secondary data analysis on data from the intervention group (n=750) from a study that compared a mobile phone–based life skills intervention for adolescents recruited in secondary and upper secondary school classes with an assessment-only control group. Throughout the 6-month intervention, participants received 1 SMS text message prompt per week that introduced a life skills topic or encouraged participation in a quiz or individual life skills training or stimulated sharing messages with other program participants through a friendly contest. Decision trees were used to identify predictors of engagement (use and subjective experience). The stability of these decision trees was assessed using a resampling method and by graphical representation. Finally, associations between engagement and intended substance use and mental health outcomes were examined using logistic and linear regression analyses.

Results

The adolescents took part in half of the 50 interactions (mean 23.6, SD 15.9) prompted by the program, with SMS text messages being the most used and contests being the least used components. Adolescents who did not drink in a problematic manner and attended an upper secondary school were the ones to use the program the most. Regarding associations between engagement and intended outcomes, adolescents who used the contests more frequently were more likely to be nonsmokers at follow-up than those who did not (odds ratio 0.86, 95% CI 0.76-0.98; P=.02). In addition, adolescents who read the SMS text messages more attentively were less likely to drink in a problematic manner at follow-up (odds ratio 0.43, 95% CI 1.29-3.41; P=.003). Finally, participants who used the program the most and least were more likely to increase their well-being from baseline to 6-month follow-up compared with those with average engagement (βs=.39; t₅₈₆=2.66; P=.008; R²=0.24).

Conclusions

Most of the adolescents participating in a digital life skills program that aimed to prevent substance use and promote mental health engaged with the intervention. However, measures to increase engagement in problem drinkers should be considered. Furthermore, efforts must be made to ensure that interventions are engaging and powerful across different educational levels. First results indicate that higher engagement with digital life skills programs could be associated with intended outcomes. Future studies should apply further measures to improve the reach of lower-engaged participants at follow-up to establish such associations with certainty.

A Mobile Phone-Based Life-Skills Training Program for Substance Use Prevention Among Adolescents: Cluster-Randomized Controlled Trial

Background

Life skills are abilities for adaptive and positive behavior that enable individuals to deal effectively with the demands and challenges of everyday life. Life-skills training programs conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones may provide a more economic and scalable approach.

Objective

The goal of this study was to test the appropriateness (ie, acceptance, use, and evaluation) and short-term efficacy of a mobile phone–based life-skills training program to prevent substance use among adolescents within a controlled trial.

Methods

The study design was a two-arm, parallel-group, cluster-randomized controlled trial with assessments at baseline and follow-up assessments after 6 and 18 months. This report includes outcomes measured up to the 6-month follow-up. The efficacy of the intervention was tested in comparison to an assessment-only control group. The automated intervention program SmartCoach included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management skills, social skills, and substance use resistance skills. Linear mixed models and generalized linear mixed models, as well as logistic or linear regressions, were used to investigate changes between baseline and 6-month follow-up in the following outcomes: 30-day prevalence rates of problem drinking, tobacco use, and cannabis use as well as quantity of alcohol use, quantity of cigarettes smoked, cannabis use days, perceived stress, well-being, and social skills.

Results

A total of 1759 students from 89 Swiss secondary and upper secondary school classes were invited to participate in the study. Of these, 1473 (83.7%) students participated in the study; the mean age was 15.4 years (SD 1.0) and 55.2% (813/1473) were female. Follow-up assessments at 6 months were completed by 1233 (83.7%) study participants. On average, program participants responded to half (23.6 out of 50) of the prompted activities. Program evaluations underlined its appropriateness for the target group of secondary school students, with the majority rating the program as helpful and individually tailored. The results concerning the initial effectiveness of this program based on 6-month follow-up data are promising, with three of nine outcomes of the intention-to-treat analyses showing beneficial developments of statistical significance (ie, quantity of alcohol use, quantity of tobacco use, and perceived stress; P<.05) and another three outcomes (ie, problem drinking prevalence, cannabis use days, and social skills) showing beneficial developments of borderline significance (P<.10).

Conclusions

The results showed good acceptance of this intervention program that could be easily and economically implemented in school classes. Initial results on program efficacy indicate that it might be effective in both preventing or reducing substance use and fostering life skills; however, data from the final 18-month follow-up assessments will be more conclusive.

Trial Registration

ISRCTN Registry ISRCTN41347061; https://doi.org/10.1186/ISRCTN41347061

Development and Validation of the Multicontextual Interpersonal Relations Scale (MIRS)

Abstract. Interpersonal relationships provide insight into a wide range of adult psychological health behaviors and well-being. Modern advancements in relational contexts (e.g., social media and phone use) have caused debate about the implications of technology use on overall interpersonal relationships and psychological health. Thus, the Multicontextual Interpersonal Relations Scale (MIRS) was developed to measure three unique processes of interpersonal relations and four unique contexts in which these activities take place. In total, N = 962 adult participants (aged 18–78 years) were recruited from the United States through Amazon Mechanical Turk, an online recruitment tool. Confirmatory factor analyses (CFAs) were conducted to examine the hypothesized factor structure, and bivariate correlations were computed to assess concurrent validity. CFA results supported a model with three process and three context (specific) factors, where face-to-face relations served as the reference context factor. Bivariate correlations revealed that the interpersonal relations factors correlated with the related constructs in the hypothesized ways. Overall, strong standardized factor loadings, item-level reliability, concurrent validity, and internal consistency support the structure and use of the MIRS. Findings suggest that participation in interpersonal relations is a multicontextual construct, requiring measurement of all unique processes and relational contexts.

Efficacy of a mobile phone-based life-skills training program for substance use prevention among adolescents: study protocol of a cluster-randomised controlled trial

Background

Life-skills trainings conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones might represent a more economic and scalable approach. The main objective of the planned study is to test the efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents within a controlled trial.

Methods/design

The efficacy of a mobile phone-based life-skills training to prevent substance use among adolescents will be tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with two follow-up assessments after 6 and 18 months. The fully automated program is based on social cognitive theory and addresses self-management skills, social skills, and substance use resistance skills. Participants of the intervention group will receive up to 4 weekly text messages over 6 months in order to stimulate (1) positive outcome expectations, e.g., on using self-management skills to cope with stress, (2) self-efficacy, e.g., to resist social pressure, (3) observational learning, e.g. of interpersonal competences, (4) facilitation, e.g., of strategies to cope with negative emotions, and (5) self-regulation, e.g., by self-monitoring of stress and emotions. Active program engagement will be stimulated by interactive features such as quiz questions, message- and picture-contests, and integration of a friendly competition with prizes in which program users collect credits with each interaction. Study participants will be 1312 students between the ages of 14 and 16 years from approximately 100 secondary school classes. Primary outcome criteria will be problem drinking according to the short form of the Alcohol Use Disorders Identification Test and cigarette smoking within the last 30 days preceding the follow-up assessment at month 18.

Discussion

This is the first study testing the efficacy of a mobile phone-based life-skills training for substance use prevention among adolescents within a controlled trial. Given that this intervention approach proves to be effective, it could be easily implemented in various settings and would reach large numbers of young people in a cost-effective way.

Trial registration

ISRCTN41347061 (registration date: 21/07/2018).

An internet-based intervention for people with psychosis (EviBaS): study protocol for a randomized controlled trial

BACKGROUND

Evidence shows that internet-based self-help interventions are effective in reducing symptoms for a wide range of mental disorders. To date, online interventions treating psychotic disorders have been scarce, even though psychosis is among the most burdensome disorders worldwide. Furthermore, the implementation of cognitive-behavioral therapy (CBT) for psychosis in routine health care is challenging. Internet-based interventions could narrow this treatment gap. Thus, a comprehensive CBT-based online self-help intervention for people with psychosis has been developed. The aim of this study is the evaluation of the feasibility and efficacy of the intervention compared with a waiting list control group.

METHODS

The intervention includes modules on delusion, voice hearing, social competence, mindfulness, and seven other domains. Participants are guided through the program by a personal moderator. Usage can be amended by an optional smartphone app. In this randomized controlled trial, participants are allocated to a waiting list or an intervention of eight weeks. Change in positive psychotic symptoms of both groups will be compared (primary outcome) and predictors of treatment effects will be assessed.

DISCUSSION

To our knowledge, this project is one of the first large-scale investigations of an internet-based intervention for people with psychosis. It may thus be a further step to broaden treatment options for people suffering from this disorder.

TRIAL REGISTRATION

NCT02974400 (clinicaltrials.gov), date of registration: November 28th 2016.