Age, gender, race, socioeconomic status, and birth cohort differences on the children's depression inventory: a meta-analysis

The trajectory of depression and anxiety among children and adolescents over two years of the COVID-19 pandemic

Longitudinal research examining children's mental health (MH) over the course of the COVID-19 pandemic is scarce. We examined trajectories of depression and anxiety over two pandemic years among children with and without MH disorders. Parents and children 2-18 years completed surveys at seven timepoints (April 2020 to June 2022). Parents completed validated measures of depression and anxiety for children 8-18 years, and validated measures of emotional/behavioural symptoms for children 2-7 years old; children ≥10 years completed validated measures of depression and anxiety. Latent growth curve analysis determined depression and anxiety trajectories, accounting for demographics, child and parent MH. Data were available on 1315 unique children (1259 parent-reports; 550 child-reports). Trajectories were stable across the study period, however individual variation in trajectories was statistically significant. Of included covariates, only initial symptom level predicted symptom trajectories. Among participants with pre-COVID data, a significant increase in depression symptoms relative to pre-pandemic levels was observed; children and adolescents experienced elevated and sustained levels of depression and anxiety during the two-year period. Findings have direct policy implications in the prioritization and of maintenance of educational, recreational, and social activities with added MH supports in the face of future events.

Exploring Multiple Perspectives on Psychological Health of Adolescents in Relation to Gender and School Grade - Jiangsu Province, China, 2022

What is already known about this topic?

Mental health issues in Chinese children and adolescents have emerged as a substantial public health concern, causing distress and strain among families and society.

What is added by this report?

This study examines the effects of gender and school grade on mental health symptoms and risky behaviors among Chinese children and adolescents, with a particular focus on the role of family and school environments.

What are the implications for public health practice?

Caregivers and educators should enhance their awareness and skills in supporting the mental health of children. These findings offer critical insights for the early detection and intervention of mental health issues in Chinese children and adolescents.

Change Score and Subscore Precision and Reliability of the Children's Depression Inventory

The Child Depression Inventory (CDI) is often used to assess change in depression over time, but no studies estimate the reliability of CDI change scores nor its five subscores. Our study investigated the reliability of change scores for both the total score on the CDI as well as its five subscores. We examined CDI responses from 186 maltreated children and estimated change score reliability for relative (e.g., comparison) and absolute (e.g., diagnosis) purposes. We also conducted subscore utility analysis, which determines if subscores have adequate reliability and provide information beyond the total score. We found that the total change score had acceptable reliability of .70 for our sample for both relative and absolute interpretations. In addition, the total score was a better predictor of true subscore values than the observed subscores-suggesting subscores did not add value over the total score, and that the reliability of changes in subscores was too low to be useful for any purpose. In summary, we found that the total CDI change scores were useful for assessing change in studies that examine relative or absolute change, and we advise caution when interpreting CDI subscores based on our analysis.

The effects of two types of neighborhood factors on trajectory of internalizing and externalizing symptoms from early childhood to adolescence

Although a robust body of previous empirical studies investigated the long-term trend of child behavior problems, limited research discussed the influences of various types of neighborhood factors on such trajectory (e.g., neighborhood structural characteristics and collective efficacy). Using a nationally representative longitudinal dataset the Fragile Families and Child Wellbeing Study (FFCWS), with six waves from 1998 to 2017, this study captures the longitudinal effects of two types of early childhood neighborhood factors on the co-development of internalizing and externalizing symptoms. Data was collected at the focal child's age 3, age 5, age 9, age 15 (N = 2,385), and the parallel-process growth curve models were applied. Results suggest that the trajectories of both internalization and externalizing symptoms showed U-shape and bidirectional relationships among internalizing and externalizing problems. The long-term effects of neighborhood social cohesion and economic disadvantages were significantly associated with children's internalizing and externalizing symptoms. The implication of this study was further discussed.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

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

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

The relation between family socioeconomic status and depressive symptoms among children and adolescents in mainland China: a meta-analysis

Family socioeconomic status (SES) is widely believed to be associated with depressive symptoms in children and adolescents. The correlation between SES and depressive symptoms changes based on social culture and the economic development level. In China, which includes many children and adolescents, the magnitude of the relationship between SES and depressive symptoms and its potential moderators remains unclear. The current meta-analysis was conducted to determine the overall association between SES and depressive symptoms in children and adolescents in mainland China. We included 197 estimates in mainland China from 2000-2023. Among 147,613 children and adolescents aged 7-18 years, the results showed a weak but significant overall negative association between SES and depression (r = -0.076). Moderator testing showed that the composite SES indicator (r = -0.104) had a stronger association with depression than parental educational level (r = -0.065) and occupational status (r = -0.025) but not family income (r = -0.088). Additionally, the negative association between SES and depression became weaker over the past 20 years in China (β = 0.010). Furthermore, the magnitude of the relationship between SES and depression was stronger in West China (r = -0.094) than in Middle China (r = -0.065), but not East China (r = -0.075). These findings indicate that the relationship between SES and depression among children and adolescents in mainland China may vary based on social contexts. It is necessary to further explore the effect of these social factors and the underlying mechanisms.

Joint developmental trajectories of internalizing and externalizing problems from mid-childhood to late adolescence and childhood risk factors: Findings from a prospective pre-birth cohort

There is limited evidence on heterogenous co-developmental trajectories of internalizing (INT) and externalizing (EXT) problems from childhood to adolescence and predictors of these joint trajectories. We utilized longitudinal data from Raine Study participants (n = 2393) to identify these joint trajectories from 5 to 17 years using parallel-process latent class growth analysis and analyze childhood individual and family risk factors predicting these joint trajectories using multinomial logistic regression. Five trajectory classes were identified: Low-problems (Low-INT/Low-EXT, 29%), Moderate Externalizing (Moderate-EXT/Low-INT, 26.5%), Primary Internalizing (Moderate High-INT/Low-EXT, 17.5%), Co-occurring (High-INT/High-EXT, 17%), High Co-occurring (Very High-EXT/High-INT, 10%). Children classified in Co-occurring and High Co-occurring trajectories (27% of the sample) exhibited clinically meaningful co-occurring problem behaviors and experienced more adverse childhood risk-factors than other three trajectories. Compared with Low-problems: parental marital problems, low family income, and absent father predicted Co-occurring and High Co-occurring trajectories; maternal mental health problems commonly predicted Primary Internalizing, Co-occurring, and High Co-occurring trajectories; male sex and parental tobacco-smoking uniquely predicted High Co-occurring membership; other substance smoking uniquely predicted Co-occurring membership; speech difficulty uniquely predicted Primary Internalizing membership; child's temper-tantrums predicted all four trajectories, with increased odds ratios for High Co-occurring (OR = 8.95) and Co-occurring (OR = 6.07). Finding two co-occurring trajectories emphasizes the importance of early childhood interventions addressing comorbidity.

The Epidemic of Internalizing Problems Among Latinx Adolescents Before and During the Coronavirus 2019 Pandemic

OBJECTIVE

Latinx youth exhibit disproportionately higher internalizing symptoms than their peers from other racial/ethnic groups. This study compares depression and anxiety symptoms between referred students of Latinx and non-Latinx backgrounds before and during the COVID-19 pandemic and examines key determinants within the Latinx sample.

METHOD

Data are analyzed from four academic years - two before and two during the pandemic - from 1220 5th through 8th grade students (Mage = 12.1; 59.6% female; 59.9% Latinx or mixed-Latinx) referred for services across 59 Chicago Public School District (CPS) elementary schools. Using the Children's Depression Inventory (CDI) and the Revised Child Anxiety and Depression Scale (RCADS), mean scores and risk levels for depression, social anxiety, and generalized anxiety are examined.

RESULTS

Higher internalizing risk and comorbidity rates were found in the second year of the pandemic, compared to pre-pandemic levels. Latinx students reported higher depression, social anxiety, and generalized anxiety symptoms than non-Latinx students. During the pandemic, more Latinx students were classified as having comorbid depression and anxiety, and scored in the clinical range for depression, generalized anxiety, and social anxiety than non-Latinx students. Within the Latinx sample, girls and gender non-conforming students reported the highest maladjustment.

CONCLUSIONS

Results highlight the pressing need to examine the long-term impact of COVID-19 on the mental health of Latinx children and adolescents, and to address their internalizing problems.

[Gender characteristics of depressive disorders: clinical, psychological, neurobiological and translational aspects]

Various studies have indicated that the prevalence of depression is almost twice as high among women as among men. A major factor associated with the development of depression and other affective disorders are adverse and psychologically traumatic life events that contribute to changes in the neuroendocrine system, altering the capacity to adapt to stress. These changes are involved in the pathogenesis of mental disorders, along with genetic and other factors, and are to a significant degree regulated by gender dependent mechanisms. While women have a high prevalence of depressive disorders, men show a higher rate of alcohol and substance abuse. These differences in the epidemiology are most likely explained by different predisposition to mental disorders in men and women and a diversity of biological consequences to adverse life events. Taking this into account, there is a need for a critical review of currently used approaches to modeling depressive disorders in preclinical studies, including the use of animals of both sexes. Adaptation of experimental models and protocols taking into account gender characteristics of neuroendocrine changes in response to stress, as well as structural-morphological, electrophysiological, molecular, genetic and epigenetic features, will significantly increase the translational validity of experimental work.

Resilience in the Time of COVID-19: Familial Processes, Coping, and Mental Health in Latinx Adolescents

OBJECTIVE

This study investigated COVID-19 stressors and silver linings, familism values, familial resilience, and coping, and their relation to internalizing symptoms among Latinx youth.

METHOD

A community sample of 135 Latinx adolescents completed online surveys 6-months apart (M age = 16, 59.3% female; majority U.S-born).

RESULTS

COVID-19 stress was associated with more depressive (β = .18, p = .027) and anxiety (β = .21, p = .010) symptoms. However, COVID-19 stress was related to higher levels of depressive and anxiety symptoms only for youth who engaged in low (β = .38, p < .001; β = .38, p = .001) and medium (β = .19, p = .004; β = .22, p = .011) levels of problem-focused engagement coping. Higher levels of family resilience were associated with lower cross-sectional depressive symptoms (β = -.28, p = .004). For longitudinal models, a significant relation between COVID-19 stress and problem-focused engagement predicted Time 2 depressive symptoms (β = -.20, p < .041).

CONCLUSION

Latinx youth who experienced high levels of COVID-19 stress who enacted problem-focused coping fared better across the pandemic. Familial resilience did not carry the same longitudinal benefit but did bolster mental health concurrently. Clinicians should endeavor to buttress familial resilience processes in addition to problem-engaged coping for Latinx youth in treatment.

Associations Between Structural Stigma and Psychopathology Among Early Adolescents

OBJECTIVE

Ample evidence demonstrates that structural stigma - defined as societal-level conditions, cultural norms, and institutional policies and practices that constrain opportunities, resources, and well-being of stigmatized populations - is associated with psychopathology in adults from marginalized groups. Yet there is limited research on whether structural stigma is similarly associated with internalizing and externalizing symptoms among youth.

METHOD

Structural stigma related to sex, sexual orientation, race, and Latinx ethnicity was measured using indicators of state-level policy and aggregated attitudes. Using data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,414; M age = 12 years, SD = 0.66; 48% female, 6.8% lesbian, gay, and bisexual (LGB), 13.4% Black, 20% Latinx), we examined associations of structural stigma with internalizing and externalizing symptoms among female, LGB, Black, and Latinx youth.

RESULTS

LGB youth living in higher (vs. lower) structural stigma states had elevated levels of internalizing and externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between LGB and heterosexual youth. Similarly, Latinx youth and females living in higher (vs. lower) structural stigma states had elevated levels of externalizing symptoms. In lower structural stigma states, there were no differences in externalizing symptoms between Latinx youth and non-Latinx White youth. Structural stigma related to race was unrelated to internalizing or externalizing symptoms for Black youth.

CONCLUSIONS

This study provides novel evidence that macro-level social environments, in the form of structural stigma, contribute to adverse mental health outcomes for marginalized youth and partly explain disparities in externalizing symptoms.

Prevalence of depression symptoms among female adolescents in Saudi Arabia

OBJECTIVE

Epidemiological studies on the prevalence of elevated depression symptoms among female adolescents in Saudi Arabia report a wide variation, ranging from 13.9% to 80.2%. However, different methods of assessment and sampling have been used. The aim of the current study is to estimate the prevalence of elevated depression symptoms amongst female adolescents in Saudi Arabia using a gold-standard self-report measure, the Mood and Feelings Questionnaire (MFQ).

DESIGN AND MEASURES

A cross-sectional study was conducted with 515 female students aged 13-18 years, recruited from public schools. Participants completed the Arabic versions of the MFQ, Rosenberg Self-Esteem Scale and Multidimensional Scale of Perceived Social Support.

RESULTS

Mean MFQ score for this sample was 26.35 and almost half of participants (48.2%) had scores above the cut-off. Severity of depression varied with age, with those aged 13 showing reduced symptoms, and was negatively correlated with self-esteem and perceived social support. There were no associations with other demographic factors.

CONCLUSION

Elevated levels of depression symptoms were common in this sample. This highlights the need to improve public mental health in this community and to improve methods of identifying and treating depression in female adolescents.

Negative Life Events on Depression of Vocational Undergraduates in the Partial Least Squares Structural Equation Modeling Approach Perspective: A Mediated Moderation Model

BACKGROUND

Following China's strategy of developing applied and compound social talents, vocational undergraduates are surging rapidly, and it is essential to understand the causes of their depression to effectively prevent and intervene in schools.

OBJECTIVE

We aimed to investigate the relationship between negative life events (NLEs) and depression among vocational undergraduates in China, along with the mediating role of loneliness and the moderating role of socioeconomic status (SES).

METHODS

A convenience sample survey was conducted at a vocational education university (N = 1487), and analyzed using partial least squares structural equation modeling.

RESULTS

Findings showed that NLEs directly predicted depression (β = 0.399, 95% CI [0.339, 0.452], p < 0.001) among vocational undergraduates. Furthermore, this relationship was partially mediated by loneliness (β = 0.182, 95% CI [0.145, 221], p < 0.001); SES moderated the link between NLEs and depression (β = 0.051, 95% CI [0.004, 092], p < 0.05), but not between NLEs and loneliness (p > 0.05).

CONCLUSIONS

The current study highlights the impact of NLEs on depression among vocational undergraduates, indicating the importance of addressing NLEs and consequent feelings of loneliness to promote mental health. In addition, the moderating role of SES underscores the necessity of targeted interventions to mitigate the impact of NLEs on depression. The present study contributes to our understanding of the unique characteristics of depression in vocational undergraduates and has practical implications for psychological support services. Moreover, it probably has broader implications for addressing mental health challenges in global education settings for vocational undergraduates.

Does depression affect the association between prosocial behavior and anxiety? A cross-sectional study of students in China

Background

A growing number of studies have suggested that adolescents' prosocial behavior can protect against depression and anxiety. It is known that anxiety and depression are often comorbid. However, it remains unclear if when depression is present, prosocial behavior remains protective against anxiety, and if when anxiety is present, prosocial behavior remains protective against depression. The purpose of this study was to determine the association of anxiety and depressive with prosocial behavior.

Methods

A large representative sample of middle-school students was recruited for a cross-sectional study and completed standardized instruments (the Children's Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders-Child version (SCARED-C), and Strengths and Difficulties Questionnaire (SDQ)). We used structural equation modeling (SEM) to examine the protective effect of prosocial behavior against anxiety when depression was present.

Results

A survey of 3,510 students was conducted, and the final analysis included 3,169 students, comprising 1,616 boys (51.0%) and 1,553 girls (49.0%), with a mean age of 13.09 years (SD = 1.31, range 11-16).The prevalence rates of anxiety and depression in early adolescents were 31.6 and 16.7%, respectively. More than two-thirds of depressed adolescents had comorbid anxiety, while more than one-third of anxious adolescents had comorbid depression. Regression models showed that compared with depressed adolescents, adolescents without depressive symptoms exhibited a significant negative correlation between prosocial behaviors and anxiety and depression (β = -0.01, p > 0.01, β = -0.06, p > 0.01; β = -0.11, p < 0.01, and β = -0.17, p < 0.01). There was no difference in the relationship between prosocial behavior and depression between anxious and non-anxious adolescents (p > 0.05).

Conclusion

Anxiety and depression are common in adolescence and are often comorbid disorders. However, the comorbidity is not symmetrical. Specifically, the protective effect of prosocial behavior against anxiety is weaker in depressed adolescents. Findings are discussed in light of related research and theory, and insights for intervention programs and future research are presented.

Sleep time and quality associated with depression and social anxiety among children and adolescents aged 6-18 years, stratified by body composition

BACKGROUND

Sleep has been suggested as risk factors for depression and social anxiety in children and adolescents, but little is known about the role of individual body composition on these association.

METHOD

We conducted a cross-sectional survey of children and adolescents aged 6-18 years in Beijing, China, in 2020, and assessed body composition by using iDXA dual-energy X-ray bone densitometer. Generalized liner model (GLM) and restricted cubic spline (RCS) were employed to analyze the associations between sleep and depression and social anxiety with different body composition. The attributable fraction (AFs) to assess the benefits of improvements of sleep in reducing depression and social anxiety odds.

RESULTS

Depression and social anxiety accounted for 13.1 % and 30.3 % of the study population. Sleep time was significantly associated with depression (HR = 2.35[1.58, 3.50]), and social anxiety (HR = 1.65[1.24, 2.20]); and sleep quality was significantly associated with depression (HR = 7.27[4.87, 10.84]), and social anxiety (HR = 2.54 [1.99, 3.25]) among children and adolescents. The exposure to both insufficient sleep time and poor sleep quality were associated with a higher odd of depression and social anxiety, but lower BF%, higher muscle rate and FFM/FM alleviated the adverse effects of sleep quality on depression and social anxiety.

LIMITATIONS

Conclusions about causality remain speculative because of the cross-sectional design.

CONCLUSION

Insufficient sleep time, poor sleep quality, high BF%, low muscle rate and FFM/FM can jointly associate with anxiety and depression. This study provides new evidence support for accurate prevention and control of mental diseases in children and adolescents with different body types.

The trade-offs of co-ruminating with friends: A profile analysis

Adolescents' co-ruminating with friends has been tied to trade-offs: having higher quality friendships but experiencing more depressive symptoms. To determine if individual youth experience these trade-offs, we applied a person-centered approach to Swedish adolescents' self-reports of co-rumination with friends, depressive symptoms, and friend support (n = 2767, aged 12-16, 52% girls; 88% Swedish). We found four latent profiles: Two high in co-rumination and two low. One high co-rumination profile exhibited the proposed trade-offs; the other reported high friendship support and fewer depressive symptoms. Comparisons indicated that the trade-offs profile were primarily girls and exhibited comparatively more difficulties with stress regulation, conceptions of their parents and themselves, and relations with peers. Focusing on the complexity of co-rumination could reveal further nuances.

More prevalent and more severe: gender differences of depressive symptoms in Chinese adolescents

Background

Adolescent depression has become a leading problem around the world, especially as the COVID-19 pandemic has remained prevalent and heavily influenced people's mental health. While gender difference has always been a topic in the field of psychiatry, there are cultural differences across the world that must be taken into account. The current study is examining gender differences in symptoms of Chinese adolescents with depression.

Methods

The sample was obtained from a total of 574 adolescent patients (172 males and 402 females) diagnosed with depression following the DSM-IV/ICD-10 diagnostic criteria; patients who also had other severe mental or physical illnesses were excluded. The ages of participants ranged from 10 to 19 years. Additionally, independent t-test and one-way ANOVA were used to examine differences in symptoms between different gender and age groups. The LPA was used to examine whether females and males were having different patterns of symptoms.

Results

Our analysis showed that compared to males, females exhibited higher rates of depression and more severe depressive symptoms across age groups. Likewise, the analysis also revealed an earlier onset of depression among Chinese adolescents compared to that in Western countries in previous studies. Finally, the LPA showed that mild to moderate depression was predominant in male patients, while severe depression was predominant in female patients.

Conclusion

This study highlights the gender differences in the prevalence and severity of depressive symptoms in Chinese adolescents. The current study highlighted the importance of gender equality and developing gender-friendly interventions in maintaining the overall mental health of adolescents in China.

Validating the Children's Depression Inventory-2: Results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study

Childhood-onset depression has adverse consequences that are sustained into adulthood, which increases the significance of detection in early childhood. The Children's Depression Inventory (CDI) is used globally in evaluating depressive symptom severity in adolescents, and its second version, the CDI-2, was developed by taking into account advances in childhood depression research. Prior research has reported inconsistencies in its factor structure across populations. In addition, the CDI-2 has not yet been empirically validated with Southeast Asian populations. This study sought to empirically validate the CDI-2's psychometric properties and evaluate its factorial structure with a Singaporean community sample of non-clinical respondents. A total sample of 730 Singaporean children aged between 8.5 and 10.5 years was used. Psychometric properties of the CDI-2, including internal consistency as well as convergent and discriminant validity, were assessed. Factor analyses were conducted to assess the developers' original two-factor structure for a Southeast Asian population. This two-factor structure was not supported in our sample. Instead, the data provided the best fit for a hierarchical two-factor structure with factors namely, socio-emotional problems and cognitive-behavioural problems. This finding suggests that socio-cultural and demographic elements influence interpretation of depressive symptoms and therefore the emerging factor structure of the construct under scrutiny. This study highlights the need to further examine the CDI-2 and ensure that its interpretation is culture-specific. More qualitative work could also bring to light the idiosyncratic understanding of depressive symptomatology, which would then guide culture-specific validation of the CDI-2.

Depression and anxiety among college students: Understanding the impact on grade average and differences in gender and ethnicity

Objective: Psychiatric disorders, such as depression and anxiety, can hinder academic performance among college-age individuals. Participants: Mental health among college students is a growing public health concern, with some scholars describing collegiate mental health as a crisis (Chen et al., Psychiatr Serv. 2019;70(6):442-449). Methods: This study analyzes data from four annual administrations of the American College Health Association (ACHA)'S NCHA (n = 117,430). Results: Overall, anxiety and depression were the most common conditions, at 9.2% and 8.7%, respectively. Of students reporting the focal symptom, 17.87% were treated for depression and 12.91% were treated for anxiety. Compared to not-treated students, diagnosed only students, had significantly lower grade averages, with effect sizes of -0.30 and -0.20 for depression and anxiety, respectively. Conclusions: Given the prevalence of depression and anxiety among college-aged students, continued research into help seeking behaviors and their effects on outcomes like grade average is an essential part of understanding the toll these disorders take.

Functional connectivity analysis of childhood depressive symptoms

BACKGROUND

Childhood depression is a highly distinct and prevalent condition with an unknown neurobiological basis. We wish to explore the resting state fMRI data in children for potential associations between neural connectivity and childhood depressive symptoms.

METHODS

A longitudinal birth cohort study with neuroimaging data obtained at 4.5, 6.0 and 7.5 years of age and the Children Depression Inventory 2 (CDI) administered between 8.5 and 10.5 years was used. The CDI score was used as the dependent variable and tested for correlation, both simple Pearson and network based statistic, with the functional connectivity values obtained from the resting state fMRI. Cross-validated permutation testing with a general linear model was used to validate that the identified functional connections were indeed implicated in childhood depression.

RESULTS

Ten functional connections and four brain regions (Somatomotor Area B, Temporoparietal Junction, Orbitofrontal Cortex and Insula) were identified as significantly associated with childhood depressive symptoms for girls at 6.0 and 7.5 years. No significant functional connections were found in girls at 4.5 years or for boys at any timepoint. Network based statistic and permutation testing confirmed these findings.

CONCLUSIONS

This study revealed significant sex-dependent associations of neural connectivity and childhood depressive symptoms. The regions identified are implicated in speech/language, social cognition and information integration and suggest unique pathways to childhood depressive symptoms.

Investigating the Link Between Depression, Cognition, and Motivation in Late Childhood

Research has revealed broad cognitive deficits (e.g., memory, learning) in depression, and that motivation may account for this link. We tested the state (i.e., only present during depression), trait (i.e., underlying vulnerability) and scar (i.e., lasting corollary) hypotheses of cognitive dysfunction in depression. We additionally tested subjective motivation as a mediator of the concurrent depression-cognition link. In a longitudinal sample of 11,878 children ages 9-11, we found no evidence of a concurrent state or longitudinal trait or scar relationship between depression and cognition. The pattern of depression-cognition relationships-which precluded a mediator analysis-in our childhood sample is a departure from previous studies. Our findings indicate that cognitive deficits are not strongly associated with depression in childhood, in contrast with the impairment commonly seen in older individuals with depression.

Best Friend's Popularity: Associations with Psychological Well-Being and School Adjustment in China During Early Adolescence

Popularity has been empirically linked to psychological and several indices of school adjustment outcomes during childhood and early adolescence. Yet, best friend popularity in relation to the adjustment outcomes remains unclear, especially in more interdependent-oriented cultures. To address this gap, this study applied the Actor-Partner Interdependence Model (APIM) to simultaneously considering whether, and how, the popularity of youth (actor effects) and their best friends (partner effects) contribute uniquely to psychological well-being and school adjustment outcomes, after controlling for social preference. Age and gender differences were also examined. Participants were 162 same-gender best friend dyads (81 boys, M_age = 11.24 years, SD = 1.18) from Shanghai, P.R. China. Among the results, both youth's own and their best friends' popularity were positively related to self-esteem and school attitudes, and negatively related to depressive symptoms. In addition, results from multi-group analyses revealed both actor and partner effects did not vary across gender. Finally, exploratory analyses showed that only actor effects varied across age for the associations between popularity and self-esteem and school attitudes. These findings highlight the important role of the best friend's popularity in promoting Chinese youth's experiences of psychological and school adjustment.

The Role of Emotional Skills (Competence) and Coping Strategies in Adolescent Depression

Depression is a state of low mood that can lead to several negative outcomes on thoughts, emotions, behaviors, and even physical state. With that in mind, it is important to detect individuals at risk of developing depressive symptoms early and identify protective factors. During the COVID-19 pandemic, adolescents emerged as one of the most vulnerable groups, with deteriorated anxiety and depression due to imposed social isolation, reduced social activities, and concerns over household status, health, and peer support. Distance learning through public service broadcasts and online tools lasted for several months, posing the need for adjustment. This study aimed to assess emotional competence and coping styles as predictors of depression in a sample of adolescents. The study was conducted in-person on a sample of 142 high school students. A high percentage of participants reported above-average levels of depression (21.1% severely depressed). On average, girls reported higher levels of depression than boys (t = 3.86, p < 0.01). Gender differences were also found in emotion-focused coping and avoidance, with girls scoring higher on both (p < 0.05). However, there were no gender differences in problem-focused coping or emotional competence. Hierarchical regression analysis concluded that perceiving and understanding emotions, expressing and naming emotions, regulating emotions, and avoidance were significant predictors of depression. This regression model explained 53% of depression variance, with the regulation of emotions being the most powerful predictor (p < 0.01). No mediating effect of coping styles on the relationship between emotional competence and depression was found in this study.

Mothers' and Children's Mental Health During the COVID-19 Pandemic Lockdown: The Mediating Role of Parenting Stress

The present study, carried out during the first peak of the COVID-19 outbreak in Italy, aimed at investigating the mental health of mothers and children during the nationwide lockdown. More specifically, the study investigated children's depression and mothers' individual distress and parenting stress, in comparison with normative samples. The mediating effect of mothers' parenting stress on the relationship between mothers' individual distress and children's depression was also explored. Finally, the study analyzed whether children's biological sex and age moderated the structural paths of the proposed model. A sample of 206 Italian mothers and their children completed an online survey. Mothers were administered self-report questionnaires investigating individual distress and parenting stress; children completed a standardized measure of depression. Mothers' individual distress and parenting stress and children's depression were higher than those recorded for the normative samples. Mothers' parenting stress was found to mediate the association between mothers' individual distress and children's depression. With respect to children, neither biological sex nor age emerged as significant moderators of this association, highlighting that the proposed model was robust and invariant. During the current and future pandemics, public health services should support parents-and particularly mothers-in reducing individual distress and parenting stress, as these are associated with children's depression.

The longitudinal predictive effect of self-reported frequency of premenstrual syndrome on depression: Findings from the Australian Longitudinal Study on Women's Health

Background

Previous studies have revealed a high comorbidity between premenstrual syndrome (PMS) and depression; however, whether PMS can longitudinally predict depression has not been examined in large sample studies.

Methods

This study surveyed 8,133 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Participants completed seven repeated measurements at 3-year intervals starting in 2000 (aged 22-27 years). Binary logistic and multivariate ordered logistic regression models were used to examine the predictive role of self-reported frequency of PMS symptoms in 2000 on self-reported diagnosis of depression and frequency of depressive symptoms, respectively, for each follow-up survey.

Results

Self-reported frequency of PMS symptoms in the year 2000 predicted self-reported diagnosis of depression in most follow-up surveys. Specifically, compared to women who reported "never" had PMS symptoms in 2000, those who reported "often" had them were more likely to report a diagnosis of depression in 2006 (OR = 1.72), 2012 (OR = 1.88), 2015 (OR = 1.49), and 2018 (OR = 1.90); and those who reported "sometimes" had PMS symptoms in 2000 were more likely to report a diagnosis of depression in 2012 (OR =1.37) and 2018 (OR = 1.59). Furthermore, self-reported frequency of PMS symptoms in 2000 predicted self-reported frequency of depressive symptoms in each follow-up survey. Compared to women who reported "never" had PMS symptoms in 2000, those who reported "sometimes", or "often", had PMS symptoms reported depressive symptoms more frequently.

Conclusion

Self-reported frequency of PMS can predict the self-reported frequency of depressive symptoms and the subsequent diagnosis of depression.

The dark triad and depressive symptoms among chinese adolescents: moderated mediation models of age and emotion regulation strategies

Dark Triad has been found to relate with depressive symptoms, but the underlying mechanism was rarely investigated. In the present study, we examined the mediating effect of two emotion regulation strategies (cognitive reappraisal and expressive suppression) and the moderating effect of gender and age. 709 Chinese adolescents aged 12-18 years (M = 14.54, SD = 1.70;55.3% girls) filled out the Dirty Dozen, Emotion Regulation Questionnaire and the 10-item of Center for Epidemiological Studies Depression Scale. As expected, Dark Triad was related with increased levels of depression and emotion regulation strategies acted as mediators in these associations. Suppression mediated the relationship between Machiavellianism and depression. Reappraisal and suppression mediated the link between psychopathy and depression. Reappraisal mediated the association between narcissism and depression. Besides, age moderated the effect of Machiavellianism on reappraisal, suggesting Machiavellianism had a negative impact on reappraisal for younger adolescents, but not for older adolescents. Age also moderated the effect of reappraisal on depression, indicating the negative effect of reappraisal on depression was stronger for younger adolescents than for older adolescents. These results address how Dark Triad traits affect depression via emotion regulation strategies and indicate the effectiveness of Dark Triad and emotion regulation strategies may change across age groups.

An application of the Biobehavioral Family Model: Examining the impact of maternal depression on child asthma mediated by insecure attachment and child depression

OBJECTIVE

Child asthma disparities are prevalent in socio-economically stressed single-parent families. Stress impacts childhood asthma mediated by immune and autonomic pathways, but specific family stress pathways are not well established. This study tests the hypothesis, derived from a version of the Biobehavioral Family Model, that single parent maternal depression impacts child asthma mediated by insecure attachment and child depression.

METHODS

In a cross-sectional study, children with asthma (age 7-17 years old) from a socio-economically disadvantaged population and their single parent mothers (N = 202) were assessed for depression and attachment security. Child asthma disease activity was assessed by symptom report and lung function tests. Structural equation modeling (SEM) was used to test a model in which caregiver depression impacts child asthma disease activity mediated by insecure attachment and child depression.

RESULTS

SEM results indicated that maternal depression statistically predicted child depression (β = 0.21, p < 0.01) and insecure mother-child attachment (β = 0.17, p < 0.05). In addition, insecure attachment statistically predicted child depression (β = 0.50, p < 0.001). Child depression mediated the adverse effects of maternal depression and insecure attachment on child asthma disease activity (β = 0.43, p < 0.01). There was no direct effect of insecure attachment on child asthma.

CONCLUSION

In single-parent families, maternal depression may impact child asthma disease activity, mediated serially by insecure attachment and child depression. Longitudinal and/or intervention studies are needed to establish a causal effect. These findings suggest that caregiver depression and parent-child relationships may be important targets for family intervention. These interventions may help improve child asthma outcomes and reduce health disparities.

Testosterone Replacement Therapy in the Treatment of Depression

BACKGROUND

Depression is a common disorder that affects millions globally and is linked to reduced quality of life and mortality. Its pathophysiology is complex and there are several forms of treatment proposed in the literature with differing side effect profiles. Many patients do not respond to treatment which warrants augmentation with other treatments and the investigation of novel treatments. One of these treatments includes testosterone therapy which evidence suggests might improve depressed mood in older patients with low levels of testosterone and helps restore physical impairments caused by age-related hormonal changes.

OBJECTIVE

The objective of this review is to synthesize information regarding clinical depression, its treatment options, and the efficacy and safety of testosterone treatment for the treatment of depression.

METHODS

This review utilized comprehensive secondary and tertiary data analysis across many academic databases and published work pertaining to the topic of interest.

RESULTS

Within some subpopulations such as men with dysthymic disorder, treatment resistant depression, or low testosterone levels, testosterone administration yielded positive results in the treatment of depression. Additionally, rodent models have shown that administering testosterone to gonadectomized male animals reduces symptoms of depression. Conversely, some studies have found no difference in depressive symptoms after treatment with testosterone when compared with placebo. It was also noted that over administration of testosterone is associated with multiple adverse effects and complications.

CONCLUSION

The current evidence provides mixed conclusions on the effectiveness of testosterone therapy for treating depression. More research is needed in adult men to see if declining testosterone levels directly influence the development of depression.

Adolescence as a peak period of borderline personality features? A meta-analytic approach

This meta-analysis of cross-sectional data aimed to shed light on the often assumed peak in mean-level of borderline personality features during middle to late adolescence (i.e. age 17–22). Borderline personality features were operationalized through the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Search terms were entered into PsycINFO and Scopus. A total of 168 samples were included in the analyses, comprising 25,053 participants. Mean age ranged from 14.35 to 51.47 years ( M = 29.01, SD = 8.52) and mean number of borderline personality features from 0 to 8.10 ( M = 4.59, SD = 2.34). The hypothesized peak between age 17 and 22 was not substantiated by the confirmatory ANOVA analysis. However, subsequent exploratory GAM analysis provided evidence for a peak at 29.4 years. Caution is needed in interpreting these findings given that different trends appeared when GAM models were constructed separately for community, patient and borderline personality disorder (BPD) samples. Age differences in community samples indicated a significant linear decline in mean-level of borderline personality features over time. A linear rising trend was found in BPD samples. As a between-person mean-level approach was used in the current study, future longitudinal studies are needed to substantiate if between-person age difference generalize to within-person changes.

Trajectories of positive and negative affect across adolescence: Maternal history of depression and adolescent sex as predictors

BACKGROUND

Trajectories of affect vary across development, with normative increases in positive affect occurring during childhood and declines in positive affect appearing across adolescence. Little is known, however, about predictors of the trajectories of affect across adolescence. The present study examined associations between changes in adolescent affect across adolescence and maternal history of depression and child sex.

METHODS

Participants were 240 adolescents and their mothers; 185 mothers had a history of depression (i.e., high risk) and 55 mothers did not (i.e., low risk). Youth were assessed annually from 6th grade (meanage = 11.86 years, SD = 0.57, 54.2 % female, 82 % White) through 12th grade. Latent growth models tested the relation of maternal depression history and adolescent sex with trajectories of adolescent affect.

RESULTS

High-risk adolescents exhibited lower levels of PA as compared to low-risk youth (coefficient = -3.51, p = .008, 95 % CI [-6.11, -0.91]). Girls experienced earlier increases in negative affect (NA) as compared to boys, with more positive linear (coefficient = 2.07, p = .002, 95 % CI [0.774, 3.368]) and quadratic (coefficient = -0.29, p = .025, 95 % CI [-0.55, -0.04]) slopes.

LIMITATIONS

Use of self-report measures and limited generalizability.

CONCLUSION

Maternal depression significantly predicted decreases in offspring PA and distinct trajectories of NA in girls and boys. Interventions aimed at reducing risk in adolescent offspring of depressed parents may benefit from targeting PA and supporting girls in early adolescence.

Rumination as a Mediator of the Association Between Racial Discrimination and Depression Among Black Youth

BACKGROUND

Racial discrimination constitutes a significant risk factor for depressive symptoms among Black youth. Rumination, a maladaptive self-regulatory stress response, is a notable pathway by which racial discrimination contributes to depressive symptoms among racial/ethnic minority adults. Yet, examinations of the mechanistic nature of rumination in the context of racial discrimination among racial/ethnic minority youth remain limited. The present study investigated rumination as a mediator of the association between racial discrimination and depressive symptoms among Black youth.

METHODS

Data for the current study were drawn from baseline questionnaire responses of community recruited Black pre-and-early adolescents (N = 158, 53% female, Mage = 11.50) in the southeast USA participating in an ongoing longitudinal study examining the effects of interpersonal stressors on youth mental health outcomes.

RESULTS

After adjusting for age and gender, mediation analyses revealed a significant indirect effect of racial discrimination on depressive symptoms through rumination, estimate = 0.29, 95% confidence interval [0.12, 0.47]. Racial discrimination was positively associated with rumination (b = .74, SE = .23, p = .001), and rumination, in turn, was positively associated with depressive symptoms (b = .40, SE = .06, p < .001).

CONCLUSION

Consistent with previous research, we found racial discrimination to be directly and indirectly associated with depressive symptoms among Black youth. Findings provide evidence of the cognitive burden of discriminatory experiences and suggest that rumination represents a potential pathway that can be targeted at early developmental stages to reduce the deleterious impact of racism-related stressors.

Socioeconomic status and depressive symptoms: An individual-participant data meta-analysis on range restriction and measurement in the United States

INTRODUCTION

The association between socioeconomic status (SES) and depressive symptoms is well documented, yet less attention has been paid to the methodological factors contributing to between-study variability. We examined the moderating role of range restriction and the depressive-symptom measurement instrument used in estimating the correlation between components of SES and depressive symptoms.

METHODS

We conducted an individual participant data meta-analysis of nationally-representative, public-access datasets in the United States. We identified 123 individual datasets with a total of 1,655,991 participants (56.8 % female, mean age = 40.33).

RESULTS

The presence of range restriction was associated with larger correlations between income and depressive symptoms and with smaller correlations between years of education and depressive symptoms. The measurement instrument of depressive symptoms moderated the association for income, years of education, and occupational status/prestige. The Center for Epidemiological Studies-Depression scale consistently produced larger correlations. Higher measurement reliability was also associated with larger correlations.

LIMITATIONS

This study was not a comprehensive review of all measurement instruments of depressive symptoms, focused on datasets from the United States, and did not examine the moderating role of sample characteristics.

DISCUSSION

Methodological characteristics, including range restriction of SES and instrument of depressive symptoms, meaningfully influence the observed magnitude of association between SES and depressive symptoms. Clinicians and researchers designing future studies should consider which instrument of depressive symptoms is suitable for their purpose and population.

Patterns of internalizing symptoms and disability functioning in children and adolescents

Despite findings from previous studies, there is still little consistent knowledge regarding the co-occurrence patterns of somatic, depressive and anxiety symptoms in childhood and adolescence. Moreover, functional disability due to somatic symptoms at different concomitant levels of depression and anxiety is understudied. The present study examined the co-occurrence patterns of somatic symptoms and symptoms of depression and anxiety, in children and adolescents using two-step cluster analysis. Differences in functional disability due to somatic symptoms were tested with ANCOVA controlling for gender and age. The sample comprised 1127 Italian children and adolescents (48.7% males, n = 549) aged 8-16 years (M_age = 11.7, SD = 2.37). Data were collected using the Children Somatization Inventory-24, the Children Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, and the Functional Disability Inventory. A four-cluster solution based on the co-occurrence of internalizing symptoms best fit the data. The four clusters were labelled as follows: cluster 1: "High somatic symptoms and average depression/anxiety"; cluster 2: "High somatic symptoms and high depression/anxiety"; cluster 3: "Average somatic symptoms and above average depression/anxiety"; and cluster 4: "Low somatic symptoms and low depression/anxiety". Significant differences between the four groups according to gender and age were shown. Participants with high levels of somatic, depressive, and anxiety symptoms reported greater functional disability due to somatic symptoms than the other three groups. Our findings indicate that children and adolescents who demonstrate high symptoms of depression and anxiety also reported higher levels of disability in daily life due to somatic symptoms.

Screening for depressive symptoms in adolescence: A Rasch analysis of the short-form childhood depression inventory-2 (CDI 2:SR[S])

BACKGROUND

Screening for depressive symptoms during adolescence is of high clinical significance. The shorter 12-item version of the Children's Depression Inventory (CDI 2:SR[S]) was specifically developed for this purpose. Evaluations of the CDI 2:SR[S] psychometrics are limited, however. The purpose of this study was to validate the CDI 2: SR[S] for use as a screening measure using Rasch analysis.

METHODS

The CDI 2: SR[S] was administered online to 1513 10-17 year old Western Australian adolescents (635 males, 878 females) from 11 schools. Overall fit, individual item fit, local response dependence, dimensionality, operation of response categories, and differential item functioning (DIF) were examined.

RESULTS

The Rasch analysis demonstrated the CDI 2: SR[S] has good reliability. Thresholds for all items were ordered, showing its three response categories functioned as intended. One item (I have to push myself to do schoolwork) showed misfit. No items were locally dependent. Two items (I am sad) and (I have to push myself to do schoolwork) showed DIF for gender. At the same level of depression, females reported being sad more than males, while males pushed themselves more to do schoolwork than did females. Adolescents (14-17 years) reported significantly higher mean depressive symptom scores than early adolescents (10-13 years).

LIMITATIONS

Sole reliance on adolescent's self-report and limited data about cultural backgrounds are limitations.

CONCLUSIONS

The results support the interval scale measurement properties of the CDI 2: SR[S] and provides educators, clinicians and researchers with a screening measure to assess depressive symptoms in adolescents.

Associations between screen time and internalizing disorder diagnoses among 9- to 10-year-olds

BACKGROUND

Children and adolescents spend an increasing amount of time with screen media. Identifying correlates of youth mental disorders has become more urgent with rates of depression, self-harm, suicide attempts, and suicide deaths rising sharply among U.S. children and adolescents after 2012. This study examined the relationship between screen time and internalizing disorders in preadolescent children between the ages of 9 and 10.

METHODS

Participants were 9- and 10-year-old youth (n = 11,780) in the baseline of the multi-site Adolescent Brain and Cognitive Development Study (ABCD). Youth reported the number of hours a day they spent watching TV shows or movies, watching videos online, playing video games, texting, using social media, and video chatting. Youth responded to an abbreviated version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-5), a semi-structured clinical interview measuring current and past symptoms of internalizing disorders using DSM-5 criteria.

RESULTS

Youth spending 2 or more hours (vs. less than 2) a day with screen media were more likely to fit criteria for depressive disorders, self-harm, and suicidal ideation or attempts, even after adjustment for demographic covariates. For anxiety disorders, associations with digital media use (social media, texting, gaming, and online videos) were stronger than with screen time generally.

LIMITATIONS

This is a cross-sectional study utilizing retrospective screen time reports, which limits our ability to determine causality and the accuracy of the reports.

CONCLUSIONS

Preadolescents who spend more time using screens, especially digital media, are more likely to fit DSM-5 criteria for internalizing disorders.

Predicting South Korea adolescents vulnerable to depressive disorder using Bayesian nomogram: A community-based cross-sectional study

BACKGROUND

Although South Korea has developed and carried out evidence-based interventions and prevention programs to prevent depressive disorder in adolescents, the number of adolescents with depressive disorder has increased every year for the past 10 years.

AIM

To develop a nomogram based on a naïve Bayesian algorithm by using epidemiological data on adolescents in South Korea and present baseline data for screening depressive disorder in adolescents.

METHODS

Epidemiological data from 2438 subjects who completed a brief symptom inventory questionnaire were used to develop a model based on a Bayesian nomogram for predicting depressive disorder in adolescents.

RESULTS

Physical symptoms, aggression, social withdrawal, attention, satisfaction with school life, mean sleeping hours, and conversation time with parents were influential factors on depressive disorder in adolescents. Among them, physical symptoms were the most influential.

CONCLUSION

Active intervention by periodically checking the emotional state of adolescents and offering individual counseling and in-depth psychological examinations when necessary are required to mitigate depressive disorder in adolescents.

Refugee Children and Interventions for Depression: A Review of Current Interventions and Implications of the Ecological Context

As of 2018, over 25.4 million people worldwide meet the criteria to be considered refugees, the highest number on record. Over half of these individuals are under 18 years old, leaving approximately 12 million children to cope with the trauma and stress typically encountered by refugees. Increased rates of depression in this population are well-documented in the literature. This article reviews the ecological determinants of depression for displaced children and current empirical methods for alleviating depression across contexts. PubMed and PsycINFO databases were reviewed for articles that met the following criteria for inclusion: published between January 1, 2000, and April 16, 2020; peer-reviewed empirical article; in English; reviewed an intervention targeting depression; and included a sample of refugees 18 years of age or younger. Sixteen interventions met inclusion criteria and were assessed using an ecological framework. The programs were analyzed for several methodological and outcome factors including intervention type, retention rate, participant demographics, participant country of origin and host country, ecological framework, and effectiveness. Major findings suggest that interventions including caregivers, involving the child's community, addressing multiple contexts, and that are culturally informed may improve outcomes. This article presents research surrounding risk and protective factors for depression within each context to inform existing interventions and presents additional avenues for services to meet the needs of refugee youth across contexts.

Sugar-Sweetened Beverages and Depressive and Social Anxiety Symptoms Among Children and Adolescents Aged 7–17 Years, Stratified by Body Composition

Background

Rare studies investigated the associations between sugar-sweetened beverage (SSB) consumption with depressive and social anxiety symptoms among children and adolescents, particularly in different stratification of body composition, which was our purpose.

Methods

A cross-sectional survey of children and adolescents aged 7–17 years was conducted in Beijing, China, in 2020, with an average age of 12.07 (SD: 3.09) years. Children's Depression Inventory (CDI) questionnaires and social anxiety scale for children (SASC) were completed in the baseline questionnaires. SSB consumption and body composition were assessed using child-reported questionnaires and a GE Healthcare Lunar iDXA dual-energy X-ray bone densitometer. Multivariate logistic regression was used to assess the associations between SSB consumption with depressive and social anxiety symptoms. Confounders were evaluated by child-reported and parental questionnaires, including age, sex, parental educational attainment, maternal smoking status, single-child status, BMI, incomes, fruit consumption, physical activity, screen time, and the frequency of fried food consumption. Stratified analyses were performed to explore whether the associations were influenced by body composition.

Results

A total of 1,311 children and adolescents, including 658 boys and 653 girls, were included in the final analysis. There were 13.96 and 29.75% of the study population with depressive and social anxiety symptoms, respectively. Overall, about 63.77% of the children and adolescents consumed SSB, and the average SSB intake was 0.35 servings per day. In the fully adjusted model, compared to participants who did not consume SSB each day, SSB consumption of ≥1 servings/day was positively associated with depressive symptoms [odds ratio (OR) = 2.28, 95% CI = 1.30–4.01] and social anxiety (OR = 1.10, 95% CI = 0.69–1.77), though the latter did not reach statistical significance. When individuals had higher body fat or lower fat-free mass (FFM) or muscle, the ORs of depressive symptoms were more evident among children and adolescents who drank SSB for ≥1 servings/day (P < 0.05).

Conclusion

Higher consumption of SSB could be associated with increased OR of depressive symptoms in children and adolescents. The association remained robust, especially in groups with higher body fat or lower fat-free mass or muscle.

Age-Related Differences in Psychological Distress during the COVID-19 Pandemic

While the negative impact of COVID-19 total lockdown on mental health in youth has been extensively studied, findings collected during subsequent waves of the pandemic, in which restrictive rules were more eased, are very sparse. Here, we explore perceived psychological distress during the partial lockdown of the third wave in Southern Italy in a large sample of students, focusing on age and gender differences. Also, we assessed whether attending the type of education could have a protective role on students' psychological well-being. An online survey was completed by 1064 southern Italian students (age range: 8-19 years; males = 368) from March to July 2021. The survey consists of a set of questions regarding general sociodemographic information as well as several aspects of students' psychological well-being. Psychological distress was higher in high school students compared to both elementary and middle ones. In addition, we found gender differences, but only in high school students, with females reporting higher psychological distress than males. Finally, our mediation analysis showed a mediated role of face-to-face schooling in the relationship between age and psychological distress. In conclusion, this study highlights age-related differences in psychological distress during the pandemic and the protective role of school in presence for mental health in Italian students.

Gender differences in the association of depression trajectories with executive and memory functions: Evidence from the longitudinal study of the Survey of Health, Ageing and Retirement in Europe (2004-2017)

Gender differences in depression trajectories and their effects on cognitive function are poorly understood. This article aims to identify depression trajectories in both genders and further explore the association of depression trajectories with executive and memory functions by gender. A total 3990 participants aged 50 years or older with repeated measurements from waves 1 to 7 (wave 3 excluded) of the Study of the Survey of Health, Ageing and Retirement in Europe (SHARE) were included. Group-based trajectory modeling (GBTM) was conducted to identify the optimal number of depression trajectories. Generalized estimating equation (GEE) models were used to examine the relation of depression trajectories to cognitive function after stratification by gender. Three distinct depression trajectories were identified in both genders, but the patterns of trajectories among genders were nonidentical. The trajectories of depression in males were characterized by non-low, moderate, persistent-depressive symptoms but with an unstable trend, while in females, they were characterized by non-low, moderate, persistent-depressive symptoms and with a worsening trend. The prevalence of persistent high depression in women (20.08%) was higher than that in men (3.13%). Moderate and persistent high depression trajectories were negatively associated with episodic memory (β = -0.53 and -0.72, respectively, p < 0.001) and verbal fluency in females (β = -0.96 and -1.47, p=0.01 and < 0.001, respectively). Older women had a greater frequency of developing depression than older men. Gender differences in depression trajectories existed. Moderate and persistent high depression trajectories exerted a negative effect on some domains of cognitive impairment only in females.

Adolescents Who Have Been Sexually Abused: Trauma Symptoms and Self-Blame while Waiting for Treatment

OBJECTIVE

Adolescents who have been sexually abused commonly experience trauma symptoms, and many are referred for trauma-based treatment. However, they sometimes spend considerable time on waitlists before beginning treatment. This study examines the course of trauma symptoms among adolescents who have been sexually abused and are waiting for treatment, and the extent to which self-blame for the abuse predicts trauma symptoms at the beginning of treatment.

METHOD

Participants were 127 adolescents (89.0% female, Mage = 13.61 years; 53.2% identified as Hispanic) at a Children's Advocacy Center in the southern United States. All had reported being sexually abused. Participants reported on their trauma symptoms and self-blame appraisals at a screening assessment (T1), and trauma symptoms were re-assessed at the beginning of treatment (T2).

RESULTS

The mean level of trauma symptoms declined over time for the total sample. Regression analyses indicated that greater self-blame for the abuse at T1 was associated with higher levels of trauma symptoms at T2, even when controlling for T1 trauma symptoms and other correlates of T2 trauma symptoms. Higher levels of trauma symptoms at T1 and adolescent sex (female) were also associated with higher levels of trauma symptoms at T2.

CONCLUSIONS

Findings suggest that assessing for self-blame for sexual abuse may be important in triage and treatment planning for youth with trauma symptoms after experiencing sexual abuse.

Metacognitions and brooding predict depressive symptoms in a community adolescent sample

Depressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16-20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.

Cognitive Triad and Depressive Symptoms in Adolescence: Specificity and Overlap

Adolescence is a critical period for the development of depressive symptoms and the understanding of vulnerability factors that facilitate their onset is pivotal. In this study, we focused on Beck's cognitive triad, namely its three-fold structure, comprising views of the self, world, and future. Despite its crucial role in the cognitive theory of depression, the relationship between the cognitive triad and depressive symptoms in adolescence is still unclear. In our study, we adopted a meta-analytic commonality analysis approach, in order to clarify whether the three components of the triad overlap in accounting for depressive symptoms, or they show distinct profiles of association. By relying on six independent samples of early adolescents (age range = 13-14: n = 174, 66% female, n = 347, 41% female), mid adolescents (age range = 15-17: n = 304, 61% female; n = 92, 34% female), and late adolescents (age range = 18-21: n = 217, 84% female, n = 101, 56% female), we showed that the views of the self, world, and future substantially overlap in accounting for depressive symptoms, although specific areas of distinctiveness could be detected. Moreover, the association between the cognitive triad and depressive symptoms appeared to be a function of both the developmental phase and gender. Furthermore, the cognitive triad emerged as specifically related to symptoms related to negative mood, absence of positive mood, and negative appraisal of the past. These findings advance our understanding of cognitive vulnerability for depressive symptoms in adolescence.

Non-Suicidal Self-Injury Among Adolescents: A Structural Model with Socioecological Connectedness, Bullying Victimization, and Depression

The objective was to examine the associations of socioecological connectedness with bullying victimization and depressive symptoms in early adolescence and with non-suicidal self-injury (NSSI) in mid-adolescence, and how these might differ between genders. Diverse adolescents (N = 4115; 49.1% girls) in the 7th grade reported on connections with parents/family, peers, school, and neighborhood, as well as bullying victimization and depressive symptoms, and NSSI in 10th grade (M^e = 16.1 years). Structural equation modeling with WSLMV indicated that the lower likelihood of NSSI in 10th grade was associated with higher perceptions of connections between adolescents and their families, both directly as well as indirectly through reduced bully victimization and depressive symptoms three years earlier. Higher school connectedness was indirectly associated with the lower likelihood of NSSI through bullying victimization and depressive symptoms. Paths to NSSI varied for girls and boys. Results advance the understanding of developmental pathways leading to NSSI in adolescent girls and boys.

Development of internalizing symptoms during adolescence in three countries: the role of temperament and parenting behaviors

This longitudinal study examined the unique and joint effects of early adolescent temperament and parenting in predicting the development of adolescent internalizing symptoms in a cross-cultural sample. Participants were 544 early adolescents (T1: M_age = 12.58; 49.5% female) and their mothers (n = 530) from Medellín, Colombia (n = 88), Naples, Italy (n = 90), Rome, Italy (n = 100) and Durham, North Carolina, United States (African Americans n = 92, European Americans n = 97, and Latinx n = 77). Early adolescent negative emotionality (i.e., anger and sadness experience), self-regulation (i.e., effortful control), and parent monitoring and psychological control were measured at T1. Adolescent internalizing symptoms were measured at three time points. Latent Growth Curve Modeling (LGCM) without covariates or predictors indicated a slight linear increase in internalizing symptoms from ages 13-16 years across nearly all cultural groups. Multi-group LGCMs demonstrated several paths were consistently invariant across groups when examining how well temperament and parenting predicted intercept and slope factors. Higher initial levels of internalizing symptoms were significantly predicted by higher adolescent negative emotionality and parental psychological control as well as lower adolescent effortful control and parental monitoring measured one year earlier. Overall, adolescent effortful control appeared to protect against the emergence of internalizing symptoms in all cultures, but this effect faded over time. This study advances knowledge of the normative development of internalizing symptoms during adolescence across cultures while highlighting the predictive value of early adolescent temperament and parenting.

Reliability and Validity of the Korean Version of Children's Depression Inventory 2 Short Version as a Screening Tool: A Comparison With the Standard 28-Item Version

OBJECTIVE

To investigate the reliability and validity of the Korean version of Children's Depression Inventory 2 Short Version (CDI 2:S) in comparison with its full-length version (CDI 2) as a screening tool for depressive youth.

METHODS

A total of 714 children from the community and 62 psychiatric patients were enrolled in this study. The Korean version of the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL-K) served as the reference standard for computing receiver operating characteristic (ROC) curves. To evaluate the ability of the CDI 2 and CDI 2:S to discriminate major depressive disorders, areas under the curves (AUCs) were compared. To investigate psychometric properties of the CDI 2:S, internal consistency was calculated and confirmatory factor analysis was conducted.

RESULTS

For the CDI 2, the cutoff at 20 yielded the best balance between sensitivity (83%) and specificity (91%). For the CDI 2:S, the cutoff point of 10 resulted in high sensitivity (82%) and high specificity (93%). The short form was proven to be as sensitive and specific as the CDI 2. Further analyses confirmed that the CDI 2:S also had good reliability and validity.

CONCLUSION

The CDI 2:S, a sensitive and brief form of the CDI 2, may serve as a better option in time-constrained psychiatric settings.