The role of parental and peer attachment relationships and school connectedness in predicting adolescent mental health outcomes

Commentary: What young people want from psychotherapy

In recent times there has been increasing acknowledgement of the importance of attending to the agenda of people with lived experience in psychotherapy research. In particular, young people's voices have been recognised as central to the design and development of psychotherapies that work for them. It is important to recognise the limits of professional agendas and make sure that young people's own priorities are represented in the indicators against which we measure change in research evaluations of psychotherapy. This requires an extension of evaluation research indicators from psychiatric symptomatology, to include aspects of wellbeing that matter to young people themselves. This article joins others in calling for a shift from the focus on symptom change in the evaluation of psychotherapy with youth, to acknowledge subjective indicators identified through research conducted with young people. New indicators might, for example, be centred on the degree to which young people experience increased capacity for acceptance of their emotions, a comfortable sense of identity, improved relational trust, and a stronger sense of their own agency. If psychotherapy is to be meaningful to young people, it is vital that we tailor it to young people's own needs and priorities and evaluate it against the aspects of change that matter to them.

Exploration of Variables Predicting Sense of School Belonging Using the Machine Learning Method-Group Mnet

The purpose of this study was to explore variables related to school belonging from a holistic perspective, including a large number of variables in one model, different to the traditional analytical method. Using 2015 data from the Program for International Student Assessment (PISA), we sought to identify variables related to school belonging by searching for hundreds of predictors in one model using the group Mnet machine learning technique. The study repeated 100 rounds of model building after random data splitting. After exploring 504 variables (384 student and 99 parent), 32 variables were finally selected after selection counts. Variables predicting a sense of school belonging were categorized as individual/parent variables (e.g. motivation to achieve, tendency to cooperative learning, parental support) and school-related variables (e.g. school satisfaction, peer/teacher relationship, learning/physical activities). The significance and implications of the study as well as future research topics were discussed.

The relationship between perceived family support and subclinical positive symptoms of psychosis among Black college students

AIM

Black individuals in the Unites States endure compounded and unique experiences of discrimination and structural racism that may not be as overtly evident in other countries. These distinctive forms of discrimination and racism can impact the mental health of Black individuals in the Unites States, in this case, their risk for psychosis. Adolescence and early adulthood are vulnerable periods in life where mental illness typically begins to manifest. Understanding the factors contributing to an increased likelihood of specific mental illnesses, such as psychosis, among youth in these vulnerable periods can inform intervention development. This is particularly important for those from minoritized backgrounds Unites States; this group is especially important to study given that Black American youth tend to experience higher psychosis rates and different symptom presentations than non-Black groups.

METHODS

This study examined the associations between perceived family support, a critical environmental factor known to be associated with full-psychosis, and attenuated positive symptoms and distress levels in a sample of 155 Black students from a Historically Black College and University (HBCU). Participants completed the Prodromal Questionnaire-Brief that assessed psychosis risk and the Family Environment Scale that assessed three dimensions of family support (family cohesion, expressiveness, and conflict).

RESULTS AND CONCLUSION

Positive symptom intensity (r = .30, p < .001) and distress (r = .34, p < .001) were significantly associated with higher family conflict for Black individuals in the Unites States. The findings inform novel intervention targets for psychoeducation and family therapy that have potential to reduce psychosis risk.

Exploring attachment security in a sample of Lebanese adolescents: The validation of the Arabic IPPA-R

Despite growing evidence supporting the importance of the quality of attachment during adolescence, no studies have been conducted to date in the Arab world due to an absence of valid and reliable tools to measure this construct in Arabic. The Inventory of Parent and Peer Attachment-Revised (IPPA-R) was devised as a self-report questionnaire in English to assess the quality of adolescent attachment to mother, father, and peers, each scale consisting of 25 items. The current study sets out to determine the psychometric properties of the Arabic IPPA-R and to explore attachment styles in Lebanon in a sample of 765 Lebanese adolescents. Results suggested a modified three-factor structure to reach satisfactory reliability of the Arabic IPPA-R, resulting in a modified questionnaire consisting of 19 items for each of mother (α = .82) and father (α = .85), and 21 items for peers (α = .89). Strict measurement invariance across gender was achieved for the IPPA-R parental forms, while only scalar invariance was achieved for the IPPA-R peers form. Overall, there were significant differences in attachment scores to mother and father, with adolescents scoring higher on attachment to mother, with both scores being significantly lower than attachment to peers. Gender differences were found on the peer scale with girls scoring significantly higher than boys. Results are interpreted from a cultural lens, emphasizing the importance of accounting for cultural, religious, and socio-economic factors in understanding adolescent attachment. This study is the first conducted in the Arab region and provides a road map to understanding gender-roles, parental expectations and adolescent perceived parenting, and their impact on adolescent attachment scores.

Direct and indirect effects of father-child attachment on academic burnout in college students

The study aims to investigate the multiple mediating roles of core self-evaluation and sense of school belonging in the relationship between father-child attachment and academic burnout in college students. A sample of 418 college students completed the father-child attachment scale, the scale of sense of school belonging, core self-evaluation scale, and academic burnout scale. After controlling for variables such as mother-child attachment, gender, age, and grade, the results showed: (1) father-child attachment was significantly and negatively correlated with academic burnout, and positively correlated with core self-evaluation and sense of school belonging; both core self-evaluation and sense of school belonging were significantly and negatively correlated with academic burnout. (2) The multiple mediating model of father-child attachment influencing academic burnout in college students was established. Both core self-evaluation and sense of school belonging played a partial mediating role between father-child attachment and academic burnout. The direct effect of father-child attachment on academic burnout accounts for 33.3% of the total effect. The indirect effects of core self-evaluation and sense of school belonging between father-child attachment and academic burnout account for 50.0 and 16.7% of the total effect, respectively. These findings identify the internal mechanisms through which father-child attachment affects academic burnout in college students from personal traits and interpersonal perspectives.

Connectedness to the young adult cancer community and post-traumatic growth: A young adults with cancer in their prime study

OBJECTIVE

For young adults (YAs) with cancer, connecting with peer cancer survivors can provide a unique sense of community and may enhance post-traumatic growth (PTG). This study examined the relationship between connectedness to the YA cancer community and PTG among YAs, independent of overall social support.

METHODS

Data were obtained from the young adults with cancer in their prime study, a cross-Canada survey of YA cancer survivors. Participants were stratified by level of social support into two groups (low/high). Multivariable logistic regression was used to examine the association between PTG and connectedness to the YA community adjusting for respondent characteristics, and the interaction between support and connectedness.

RESULTS

Of 444 respondents, mean age was 34.2 (SD = 6.0), time-since-diagnosis was 4.8 years (SD = 5.4), and 87% were female. Over two-thirds of respondents (71%) reported feeling connected to the YA community. Level of connectedness to the YA community did not differ by social support group, and interaction between social support and connectedness to the YA community was not significant. In the adjusted regression, connectedness to the YA community (aOR = 2.29, 95% CI: 1.10-4.91), high social support (aOR = 2.98, 95% CI: 1.36-6.74), greater time-since-diagnosis (aOR = 1.09, 95% CI: 1.04-1.15) and female sex (aOR = 2.21, 95% CI: 1.23-4.04) were associated with greater odds of moderate-to-high PTG.

CONCLUSIONS

Feeling connected to a community of YA cancer peers was associated with moderate-to-high PTG among YAs, independent of overall perceived social support. Future efforts should increase access to YA cancer communities and foster a sense of connectedness among YAs with cancer.

Trial protocol for the Building Resilience through Socio-Emotional Training (ReSET) programme: a cluster randomised controlled trial of a new transdiagnostic preventative intervention for adolescents

BACKGROUND

Adolescence is a period of heightened vulnerability to developing mental health problems, and rates of mental health disorder in this age group have increased in the last decade. Preventing mental health problems developing before they become entrenched, particularly in adolescents who are at high risk, is an important research and clinical target. Here, we report the protocol for the trial of the 'Building Resilience through Socioemotional Training' (ReSET) intervention. ReSET is a new, preventative intervention that incorporates individual-based emotional training techniques and group-based social and communication skills training. We take a transdiagnostic approach, focusing on emotion processing and social mechanisms implicated in the onset and maintenance of various forms of psychopathology.

METHODS

A cluster randomised allocation design is adopted with randomisation at the school year level. Five-hundred and forty adolescents (aged 12-14) will be randomised to either receive the intervention or not (passive control). The intervention is comprised of weekly sessions over an 8-week period, supplemented by two individual sessions. The primary outcomes, psychopathology symptoms and mental wellbeing, will be assessed pre- and post-intervention, and at a 1-year follow-up. Secondary outcomes are task-based assessments of emotion processing, social network data based on peer nominations, and subjective ratings of social relationships. These measures will be taken at baseline, post-intervention and 1-year follow-up. A subgroup of participants and stakeholders will be invited to take part in focus groups to assess the acceptability of the intervention.

DISCUSSION

This project adopts a theory-based approach to the development of a new intervention designed to target the close connections between young people's emotions and their interpersonal relationships. By embedding the intervention within a school setting and using a cluster-randomised design, we aim to develop and test a feasible, scalable intervention to prevent the onset of psychopathology in adolescence.

TRIAL REGISTRATION

ISRCTN88585916. Trial registration date: 20/04/2023.

Gendered Parenting: Maternal Son Preference and Depressive Symptoms in Chinese Early Adolescents

This study focused on the nuanced phenomenon of gendered parenting by exploring how maternal son preference is associated with depressive symptoms among Chinese early adolescents. Focusing on 1093 junior high school students from a relatively affluent city in Western China, this study examined the mediating roles of mother-child attachment and father-child attachment as well as the moderating role of school connectedness in the relationship between maternal son preference and depressive symptoms. The results revealed a noteworthy positive correlation between maternal son preference and depressive symptoms among female adolescents, with no significant association observed in males. In addition, mother-child attachment and father-child attachment mediated the relationship between maternal son preference and girls' depressive symptoms, supporting the "spillover effect" and "crossover effect". Moreover, a moderation effect analysis indicated that a higher level of school connectedness can buffer the effect of maternal son preference on girls' depressive symptoms, while a lower level of school connectedness can enhance the effect of maternal son preference on girls' depressive symptoms. In addition, maternal son preference was negatively correlated with boys' depressive symptoms in relation to high school connectedness. These insights help enhance people's understanding of gendered parenting, emphasizing the enduring necessity of addressing son preference within the broader context of promoting gender equality.

Connections matter: Adolescent social connectedness profiles and mental well-being over time

INTRODUCTION

This study examined profiles of social connectedness among early adolescents in grade 7 before the COVID-19 pandemic was declared (Winter 2020), and in grade 8 during the second Wave of the pandemic (Winter 2021).

METHOD

Linked data from 1753 early adolescents (49% female) from British Columbia, Canada who completed the Middle Years Development Instrument survey in grades 7 and 8 were used. Participants reported on life satisfaction, depressive symptoms, and connectedness with peers and adults at home, school and in the community. We used Latent Profile Analysis to identify connectedness profiles at both time points, and Latent Transition Analysis to examine transitions in connectedness profiles over time. Multiple regression analyses examined the associations between profile membership in grade 7 and mental well-being in grade 8, and the associations between transitions in profile membership (i.e., increase vs. decrease in connectedness over time) and mental well-being.

RESULTS

Connectedness in multiple domains in grade 7 was related to significantly higher levels of mental well-being in grade 8, controlling for demographics, well-being in grade 7, and COVID-related mental health worries. Well-being was highest when students felt highly connected in all domains and lowest when they felt lower levels of connection. Increases in connectedness were associated with improvements in mental well-being and decreases with a decline in well-being over time.

CONCLUSIONS

Experiencing connectedness with peers and adults is critical for the mental well-being in early adolescence. Providing opportunities to connect is important in the context of major societal challenges such as the COVID-19 pandemic.

Sex-related differences in parental rearing patterns in young adults with bipolar disorder

The aim of this study was to examine the parenting characteristics of young patients with bipolar disorder (BD) and explore the sex differences. The parental rearing pattern of young patients with BD was measured and compared with the healthy control of young adults. The EMBU scale was used to assess parental rearing patterns. Patients with BD reported significantly higher scores in the punishment and severity index, as well as of the rejection and denial index, but lower scores in the warmth & affectionate index in the paternal rearing pattern, compared with healthy controls. In addition, patients scored higher on the punishment and severity index and rejection and patterns index in maternal rearing patterns. More importantly, we found significant sex differences in maternal rearing patterns (pBonferroni < 0.05). Specifically, in the maternal rearing patterns, male patients had higher scores on the favoring index than male controls, whereas female patients had lower scores on the warmth & affectionate index than female controls. This study shows significant differences in parental rearing patterns between patients and control subjects. Male patients were overprotective by their mothers and female patients were overlooked by their mothers during upbringing.

Influence of Childhood Psychological Maltreatment on Peer Attachment Among Chinese Adolescents: The Mediation Effects of Emotion Regulation Strategies

The formation of peer attachment is vitally important for the mental health of adolescents. Additionally, converging evidences show that childhood emotional trauma leads to poor peer attachment during adolescence. However, little is known about the underlying mechanism accounting for the link between early emotional trauma and adolescent peer attachment. Therefore, the present study is intended to examine the relationship between childhood psychological maltreatment (CPM) and peer attachment among Chinese adolescents and reveal its underlying mechanism. In total, we collected data from 670 adolescents (36.5% males and 63.5% females, Mage = 16.44 years, SD = 0.78) attending two Chinese high schools. These participants completed measurement scales for CPM (emotional abuse and neglect), peer attachment, and emotion regulation strategies, including cognitive reappraisal (CR) and expressive suppression (ES). The multiple mediation models showed that emotional neglect negatively predicted adolescent peer attachment but that emotional abuse did not. Furthermore, the two emotion regulation strategies, CR and ES, completely mediated the relationship between emotional abuse and peer attachment and partially mediated the relationship between emotional neglect and peer attachment. These findings extend the existing studies on adolescent peer attachment and elucidate how childhood emotional trauma negatively influences adolescent peer attachment. In addition, the present results provide implications for improving the peer attachment of adolescents. On one hand, appropriate family intervention should be implemented to reduce CPM. On the other hand, schools can focus on improving the peer attachment of adolescents by enhancing their emotion regulation. Specifically, adolescents should be taught how to use adaptive strategies, such as CR, to regulate negative emotions.

Investigating associations between emotional and behavioral problems, self-esteem, and parental attachment among adolescents: A cross-sectional study in Indonesia

Background

Emotional and Behavioral Problems (EBPs) are prevalent among adolescents, and adolescents' capacity for adaptation can be influenced by their interactions with their parents, environment, and self-esteem. This link has not been systematically examined among adolescents in West Sumatra, Indonesia. This study aimed to assess the association of parental attachment and self-esteem with EBPs in adolescents.

Methods

A cross-sectional study was conducted from July to November 2022 in Padang West Sumatra, Indonesia. In total, 854 students from public senior high school 4 Padang were involved in this study and completed questionnaires on demographics, EBPs, parental attachment, and self-esteem. There was a total of five subscales for EBPs, which included emotional problems, conduct problems, hyperactivity, peer problems and prosocial. Additionally, there were three subscales for parental attachment, which included the mother's attachment, father's attachment, and peer attachment. Spearman's correlation, independent-sample t-tests, ANOVA and multiple linear regression analysis were employed to examine factors associated with EBPs.

Results

This study showed that father's attachment (r = -0.191, p < 0.001), mother's attachment (r = -0.241, p < 0.001), and self-esteem (r = -0.437, p < 0.001) were negatively correlated with EBPs. The linear regression analysis showed EBPs was associated with father's education, father's communication, father's alienation, mother's alienation, and self-esteem. All predictors of overall EBPs among adolescents were able to explain 31 % of the variance in EBPs.

Conclusion

High self-esteem and a strong parental attachment have positive outcomes in terms of mental health in adolescents. Thus, increasing adolescent self-esteem and establishing a warm parent attachment can be the main target in providing interventions for Indonesian adolescents with EBPs.

The association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents

The purpose of this study is to investigate the association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents. This cross-sectional study was conducted by investigating the 2018 Bolivia global school-based student health survey (GSHS). The total number of students who participated in this survey was 7931, and the final sample was 7377. The mean age of the participants was 15.3 years (SD = 1.4). Psychological distress was assessed with a 2-item screener (loneliness and worry induced sleep disturbance). In all 22.3% of participants reported experiencing psychological distress, with 18.1% among adolescent males and 26.2% among adolescent females. In adjusted logistic regression analysis (AOR, 95% CI), there are two significant directions of association. One is the negative association, such as parental involvement as a protective factor. School adolescents who had more parental involvement were less likely to experience psychological distress. Parents understand problems or worries (0.64, 0.54-0.75, p < .001) and parents disregard privacy (0.69, 0.58-0.82, p < .001). On the other hand, many psycho-social factors are significantly positively associated with psychological distress. School adolescents who experience more psychosocial factors are more likely to experience psychological distress. Physical assault in the previous year (1.83, 1.59-2.11, p < .001), being bullied at school (1.27, 1.07-1.52, p < .01), being bullied outside of school (1.36, 1.15-1.61, p < .001), and being cyberbullied (1.60, 1.37-1.88, p < .001), were all significantly associated with psychological distress. Healthy relationships in a family, and interventions to reduce violence and bullying, should be encouraged and promoted.

Mental health and loneliness in Scottish schools: A multilevel analysis of data from the health behaviour in school-aged children study

BACKGROUND

Adolescent loneliness and poor mental health represent dual public health concerns. Yet, associations between loneliness and mental health, and critically, how these associations vary in school settings are less understood.

AIMS

Framed by social-ecological theory, we aimed to identify key predictors of adolescent mental health and examine school-level variation in the relationship between loneliness and mental health.

SAMPLE

Cross-sectional data on adolescents from the 2018 wave of the Health Behaviour in School-aged Children study (HBSC) in Scotland were used (N = 5286).

METHODS

Mental health was measured as a composite variable containing items assessing nervousness, irritability, sleep difficulties and feeling low. Loneliness was measured via a single item assessing how often adolescents felt 'left out'. Multilevel models were used to identify social-ecological predictors of mental health, associations with loneliness and between-school variation.

RESULTS

Loneliness, as well as demographic, social and school factors, was found to be associated with mental health. Mental health varied across schools, with the between-school difference greater among adolescents with high levels of loneliness. Additionally, the negative effect of loneliness on mental health was stronger in schools with lower average mental health scores.

CONCLUSIONS

The findings suggest that schools can play an important role in shaping adolescent mental health. Our study uniquely identifies that school-based interventions targeting mental health may be especially necessary among lonely adolescents, and programmes aimed at tackling loneliness may be more beneficial in schools with poorer mental health.

Barriers to School-Based Mental Health Resource Utilization Among Black Adolescent Males

Black adolescent males use available mental health services at a disproportionately lower rate compared to males of other racial groups. This study examines barriers to school-based mental health resource (SBMHR) use among Black adolescent males, as a means of addressing reduced usage of available mental health resources and to improve these resources to better support their mental health needs. Secondary data for 165 Black adolescent males were used from a mental health needs assessment of two high schools in southeast Michigan. Logistic regression was employed to examine the predictive power of psychosocial (self-reliance, stigma, trust, and negative previous experience) and access barriers (no transportation, lack of time, lack of insurance, and parental restrictions) on SBMHR use, as well as the relationship between depression and SBMHR use. No access barriers were found to be significantly associated with SBMHR use. However, self-reliance and stigma were statistically significant predictors of SBMHR use. Participants who identified self-reliance in addressing their mental health symptoms were 77% less likely to use available mental health resources in their school. However, participants who reported stigma as a barrier to using SBMHR were nearly four times more likely to use available mental health resources; this suggests potential protective factors in schools that can be built into mental health resources to support Black adolescent males' use of SBMHRs. This study serves as an early step in exploring how SBMHRs can better serve the needs of Black adolescent males. It also speaks to potential protective factors that schools provide for Black adolescent males who have stigmatized views of mental health and mental health services. Future studies would benefit from a nationally representative sample allowing for more generalizable results regarding barriers and facilitators to Black adolescent males' use of school-based mental health resources.

Effective coping with cyberbullying in boys and girls: the mediating role of self-awareness, responsible decision-making, and social support

There is sufficient evidence on the negative consequences of cyberbullying victimisation depending on the coping styles. Social support seeking is among the most effective strategies for coping with cybervictimisation, but it is scarcely used. The robust Maximum Likelihood (ML) method was used to test the potential mediating role of individual (self-awareness, and responsible decision-making) and contextual variables (self-perceived parental and peer support) in the relationship between cybervictimisation and social support seeking in boys and girls. This cross-sectional study collected data from 1,276 Spanish secondary school students (51.2% boys, 48.8% girls) aged 11–18 (M = 13.88, SD = 1.42). Structural equation modelling (SEM) results pointed out responsible decision-making and self-perceived parental support as relevant mediating factors for girls. By contrast, the model was not significant for boys. These findings highlight the importance of both individual and contextual variables in helping adolescents cope with cyberaggressions, considering gender differences.

Mother-child cohesion, friendship quality, and depressive symptoms in children: Direct and indirect associations between developmental trajectories

BACKGROUND

Mother-child cohesion and friendship quality have been shown to be protective factors against the development of children's depressive symptoms. However, the possible direct and indirect pathways from these two important interpersonal relationships to children's depressive symptoms need to be further elucidated. Moreover, these associations have not been examined from a developmental perspective. Therefore, this study examined the direct and indirect relations among developmental trajectories of mother-child cohesion, friendship quality, and depressive symptoms in children.

METHODS

A total of 4078 Chinese children (45.2 % girls, M_age = 9.90 years, SD = 0.73) participated in assessments at five time points across 2.5 years, employing six-month intervals. Latent growth curve modeling was conducted to examine the direct and indirect relations among the developmental trajectories of mother-child cohesion, friendship quality, and depressive symptoms.

RESULTS

The developmental trajectories of both mother-child cohesion and friendship quality were negatively and directly associated with the developmental trajectory of children's depressive symptoms. The developmental trajectory of friendship quality was indirectly associated with the developmental trajectory of depressive symptoms through the mediating role of mother-child cohesion.

LIMITATIONS

This study did not investigate father-child cohesion and other important psychological mechanisms linking interpersonal relationships to depressive symptoms.

CONCLUSIONS

The findings documented the direct and indirect relations among mother-child cohesion, friendship quality, and depressive symptoms from a developmental perspective, which suggested that prevention and intervention efforts target improving mother-child cohesion and friendship quality to reduce children's depressive symptoms.

Parental Attachment and Adolescent Moral Reaction Modes: The Serial Mediating Model of the Teacher-Student Relationship and Deviant Peer Affiliation

Purpose

Moral decision outcomes and emotional experiences after moral decisions are combined to create four moral reaction modes: happy victimizer (HV), unhappy victimizer (UHV), happy moralist (HM), and unhappy moralist (UHM). This study aimed to explore the relationships between parental attachment (PA) and adolescent moral reaction modes, and further examine the mechanism of the serial mediating effects of the teacher-student relationship (TS) and deviant peer affiliation (DP).

Sample and Method

A cross-sectional study was conducted in 2022 among 3053 students (including 1496 females) from four middle schools, four high schools, and three colleges in China using a voluntary and anonymous questionnaire.

Results

Our study reveals that PA was positively associated with HM modes and negatively associated with UHM, UHV, and HV modes. Both TS and DP serially or partly mediated the relationship between PA and adolescents' four moral reaction modes.

Conclusion

This study uncovered significant social relationship pathways for moral reaction modes. TS and DP are two important mediators between PA and moral reaction modes. Secure parental attachment can develop positive teacher-student and peer relationships. This can then encourage adolescents to behave in more positive HM modes and fewer UHM/HV/UHV modes.

Siblings of young people with chronic illness: Caring responsibilities and psychosocial functioning

Siblings of young people with chronic illness commonly undertake caring responsibilities for their affected brother/sister, which may encourage maturation, yet may also be perceived as a burden. Our study determined (1) siblings' caring responsibilities, (2) siblings' current emotional distress and psychosocial functioning, and (3) how siblings' caring responsibilities and psychosocial functioning related to familial relationships and coping strategies. Siblings completed questionnaires which contained Sibling Inventory of Behavior, Sibling Inventory of Differential Experiences, PedsQL, emotion thermometers, Brief COPE, and a checklist of caregiving responsibilities. We analyzed the data with t-tests and multi-level models. Forty-five siblings (mean age = 15.40 years, SD = 3.31 years; 60.0% female) participated. Siblings who had caring responsibilities (n = 26, 57.8%) reported lower anxiety symptoms, lower need for help, greater use of problem-focused coping, and more companionship and teaching/directiveness with their affected brother/sister than siblings without caring responsibilities. Siblings reported lower psychosocial and physical functioning when they perceived their parents provided them with less affection than their affected brother/sister. Family-based psychosocial interventions may aim to improve the sibling-parent relationship (including expressing affection) and the sibling-sibling relationship. Future interventions may also focus on increasing siblings' use of problem-focused coping strategies.

Adolescent connectedness: cornerstone for health and wellbeing

Approaches to youth development that enhance connectedness and opportunities for young people are key to adolescent health and wellbeing argue Robert Blum and colleagues

Maternal positive coparenting and adolescent peer attachment: Chain intermediary role of parental involvement and parent–child attachment

This study investigated the relationship between maternal positive coparenting and adolescent peer attachment, and the intermediary role of parental involvement and parent–child attachment in 1,807 families using the maternal positive coparenting scale, the parental involvement scale, and the parent and peer attachment scale. The results showed that maternal positive coparenting behaviour, parental involvement, parent–child attachment, and peer attachment had significant positive relationships, and maternal positive coparenting had a positive correlation with adolescent peer attachment. Moreover, parental involvement and parent–child attachment played a significant mediating role between maternal positive coparenting behavior, including unity and consistent behavior, and adolescent peer attachment, respectively, which consisted of a sole intermediary role of parental involvement; a single intermediary role of parent–children attachment; and a chain intermediary role of parental involvement and parent–children attachment. Hence, maternal positive coparenting was positively associated with adolescent peer attachment, in which parental involvement and parent-child attachment served as a crucial bridge.

Living with parents, lifestyle pattern and common mental disorders in adolescents: a school-based study in Brazil

Background

Mental health conditions represent 16% of the global burden of disease and injury in adolescents. Promotion, protection, and restoring the mental health must be considered indispensable, especially in adolescence. This study aims to verify the association of lifestyle pattern, living with parents and the presence of Common Mental Disorders (CMD) in Brazilian adolescents.

Methods

Cross-sectional study that analyzed data from 71,553 adolescents aged 12–17 years, from the Study on Cardiovascular Risks in Adolescents (ERICA), between 2013 and 2014. Principal Component Analysis (PCA) was performed to identify lifestyle pattern, and Logistic Regression Models were performed to identify the associations between lifestyle pattern, living with parents, and presence of CMD.

Results

To construct the Common Mental Disorders (CMD) variable, the Goldberg General Health Questionnaire was used. The Pattern of Healthy Lifestyle Practices found was characterized by higher water consumption, lower consumption of ultra-processed foods, the habit of eating breakfast, less exposure time to screens, habit of physical activity, and longer mean sleep time in hours. Adolescents belonging to the second (OR: 0.73; 95% CI 0.65–0.82) and third (OR: 0.44; 95% CI 0.39–0.50) terciles of the pattern, that is, those who had higher belonging to the pattern had lower chances of having CMD. Adolescents who lived with neither parent (OR: 1.44; 95% CI 1.16–1.78) were associated with a higher chance to present CMD.

Conclusion

Living with parents can contribute to better mental health among adolescents. In addition, the adoption of a healthy lifestyle, encouraged by parents and the community, can reduce the chances of CMD in Brazilian adolescents.

Nicotine vaping for relaxation and coping: Race/ethnicity differences and social connectedness mechanisms

The current study examined race- and ethnicity-based differences in the reasons that youth report for vaping, with an emphasis on understanding the relationship between race/ethnicity and vaping for relaxation and stress/anxiety coping. This work also sought to go beyond examining race-based differences as a cause of tobacco-use disparities by assessing social connectedness factors that mediate relationships between race/ethnicity and vaping for relaxation and coping. Research questions were tested using data from the 2019-2020 California Student Tobacco Survey, a representative school-based survey of 10th and 12th grade public school students throughout schools in California. Overall, 7.78% of the sample reported using nicotine vapes in the past 30 days. The final sample included 11,112 high school student current vape users. The most important reason that youth vaped was for relaxation and stress/anxiety coping, with racial and ethnic minorities most likely to report this vaping motivation. Analyses of the structural mechanisms underlying the relationship between race/ethnicity and vaping reasons showed that minority youth reported lower school, peer, and family connectedness when compared to White youth. Lower school and family connectedness were in turn correlated with being motivated to vape to relax or relieve stress and anxiety, and lower overall mental health. Findings imply that future intervention efforts might profitably focus on reducing stressors associated with relaxation and stress/anxiety coping motivations and highlight the importance of connectedness for indirectly decreasing vape use risk by improving negative mood and mental health.

Impact of College Students’ Learning Adaptation on Learning Conformity Behavior in Hengyang: Moderating Role of Peer Attachment

This study explored the relationships among learning adaptation, peer attachment, and learning conformity behavior among college students in Hengyang, Hunan Province, China. A total of 704 questionnaires were collected from three universities in Hengyang through purposive sampling, and 650 valid questionnaires were obtained. Structural equation models were used to test the direct and moderating effects among the variables. The research indicated that good learning adaptation in Hengyang college students had a positive impact on learning conformity behavior and that college students’ peer attachments had a positive effect on their learning conformity behavior. Compared with students with low peer attachment, students with high peer attachment were better at learning and adapting; they engaged in learning conformity behavior more frequently. College students’ peer attachment positively moderated the relationship between learning adaptation and learning conformity behavior.

Attachment anxiety and smartphone addiction among university students during confinement: Teacher–student relationships, student–student relationships and school connectedness as mediators

Learning at home during the COVID-19 confinement might affect students' relationships with their peers, teachers, and schools and increase the possibility of smartphone addiction. We hypothesized that attachment anxiety directly and indirectly affects smartphone addiction, with teacher–student relationships, student–student relationships, and school connectedness as mediators. The participants were 999 university students from different regions of China. The results showed that six of the paths were significant except the one between student–student relationships and smartphone addiction. Also, the association between attachment anxiety and smartphone addiction was mediated by teacher–student relationships and school connectedness not but student–student relationships. The current study highlights the mediating effect of school connectedness and teacher–student relationships in the multiple mediation model, and suggests that universities can alleviate the risk of smartphone addiction in distance teaching by cultivating good teacher–student relationships and strengthening students' sense of belonging to their schools.

Changes in Attachment to Parents and Peers and Relations With Mental Health During the COVID-19 Pandemic

Using a longitudinal design, we examined changes in parent and peer attachment among college students, and their predictive and protective roles in relation to mental health problems during the COVID-19 pandemic. College students (N = 106) rated their parent and peer attachment, and self-reported anxiety, loneliness, and depressive symptoms 1 year before and during the pandemic. Participants also rated the impact of COVID-19 related stressors (CRS). Results demonstrate significant increases in loneliness and depression and a decrease in peer attachment security during the pandemic. Increases in peer attachment security were negatively correlated with loneliness during the pandemic. Parent attachment buffered the relationship between the impact of CRS and mental health problems during the pandemic. Guided by the integrated framework from attachment theory and life course theory, the current study discussed findings and practices regarding the important role of attachment for college students and their adjustment to the pandemic.

Parental support, marital conflict, and stress as predictors of depressive symptoms among African American adolescents

Given the increase of depressive symptoms among adolescents, it is essential to investigate familial and temperamental correlates of depressive symptoms such as parental support, marital conflict, and stress. Thus, using a cross-sectional design, the current study examined whether parental support, marital conflict, and stress predicted depressive symptoms. Then, using structural equation modeling, this study tested whether stress mediated the relationships among parental support, marital conflict, and depressive symptoms among African American adolescents while controlling for sex (N = 883). Results suggest that maternal support negatively related to depressive symptoms in contrast to stress and marital conflict. However, paternal support and sex were not statistically associated with depressive symptoms. Mediation results suggest that stress explained the relationships among parental support, marital conflict, and depressive symptoms. Family therapy and depression reduction implications are discussed.

Peer Power! Secure Peer Attachment Mediates the Effect of Parental Attachment on Depressive Withdrawal of Teenagers

Adolescents’ depressive social withdrawal is a relevant concern for mental health professionals, and it is widespread among community teenagers in form of subclinical symptoms. Different studies suggest that insecure attachment representations increase the adolescents’ likelihood to show symptoms of withdrawal (e.g., loneliness). This study explored the effect of the general attachment internal working model (IWM) and the independent and cumulative effects of the specific attachment representations of parents—in terms of secure base/safe haven—and peers on adolescents’ withdrawal. Additionally, the mediation of peer attachment on the effect of parental attachment on symptoms was explored. All analyses were conducted controlling for the difference between teenagers living with parents together or divorced/separated, as children of divorcees are considered more exposed to stressors. Ninety-one adolescents aged 12–17 years old were assessed online during the COVID pandemic period, employing the Youth Self-Report to assess withdrawal and the Friends and Family Interview to assess attachment-general IWM and attachment-specific representations. Results show no influence of parents together/separated or of the general IWM on withdrawal, but higher parent secure base/safe haven and peer attachment cumulatively predicted 10–21% less withdrawal. Moreover, more positive peer attachment mediated 61% of the effect of the parental secure attachment on withdrawal, revealing an indirect effect of parental attachment on withdrawal through peer attachment. In conclusion, both parents and peers are influential on adolescent mental health, and fostering positive peer relationships can buffer the effect of dysfunctional family relationships on teenagers’ withdrawal.

Affective Representation of Early Relationships with Parents and Current Anxiety and Depression

Research on the role of early relationships with parents on youth's anxiety and depression, especially in collectivist societies such as China, is limited. To fill this gap, we investigated the unique role of early relationship with mothers and fathers, respectively, in Chinese youth's anxiety and depression outcomes. The participants were 347 Chinese college students from 20 provinces. They first separately rated the frequency of experiencing 13 emotions (e.g., anger) from recalling early relationships with their mothers and fathers, then completed the Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale. Logistic regression was performed to determine the unique contribution of early relationships with mothers and fathers, respectively, to the participants' clinical-level anxiety and depression. Based on the final model of our logistical regression, we found that an increase in negative affective representation of early relationship with the mother was associated with a higher likelihood of clinical level anxiety (OR = 3.58; 95% CI = 1.32-9.70), while an increase in positive affective representation of early relationship with the mother was associated with a lower likelihood of clinical-level depression (OR = 0.47; 95% CI = 0.25-0.87). Furthermore, an increase in negative affective representation of early relationship with the father was associated with a higher likelihood of clinical-level anxiety (OR = 3.36; 95% CI = 1.37-8.26) and depression (OR = 3.68; 95% CI = 1.59-8.52), above and beyond their affective representation of early relationship with the mother.

Effectiveness of the Strengthening Families Programme in the UK at preventing substance misuse in 10-14 year-olds: a pragmatic randomised controlled trial

OBJECTIVES

The Strengthening Families Programme 10-14 (SFP10-14) is a USA-developed universal group-based intervention aiming to prevent substance misuse by strengthening protective factors within the family. This study evaluated a proportionate universal implementation of the adapted UK version (SFP10-14UK) which brought together families identified as likely/not likely to experience/present challenges within a group setting.

DESIGN

Pragmatic cluster-randomised controlled effectiveness trial, with families as the unit of randomisation and embedded process and economic evaluations.

SETTING

The study took place in seven counties of Wales, UK.

PARTICIPANTS

715 families (919 parents/carers, 931 young people) were randomised.

INTERVENTIONS

Families randomised to the intervention arm received the SFP10-14 comprising seven weekly sessions. Families in intervention and control arms received existing services as normal.

OUTCOME MEASURES

Primary outcomes were the number of occasions young people reported drinking alcohol in the last 30 days; and drunkenness during the same period, dichotomised as 'never' and '1-2 times or more'. Secondary outcomes examined alcohol/tobacco/substance behaviours including: cannabis use; weekly smoking (validated by salivary cotinine measures); age of alcohol initiation; frequency of drinking >5 drinks in a row; frequency of different types of alcoholic drinks; alcohol-related problems. Retention: primary analysis included 746 young people (80.1%) (alcohol consumption) and 732 young people (78.6%) (drunkenness).

RESULTS

There was no evidence of statistically significant between-group differences 2 years after randomisation for primary outcomes (young people's alcohol consumption in the last 30 days adjusted OR=1.11, 95% CI 0.72 to 1.71, p=0.646; drunkenness in the last 30 days adjusted OR=1.46, 95% CI 0.83 to 2.55, p=0.185). There were no statistically significant between-group differences for other substance use outcomes, or those relating to well-being/stress, and emotional/behavioural problems.

CONCLUSIONS

Previous evidence of effectiveness was not replicated. Findings highlight the importance of evaluating interventions when they are adapted for new settings.

TRIAL REGISTRATION NUMBER

ISRCTN63550893.Cite Now.

The Contributing Role of Family, School, and Peer Supportive Relationships in Protecting the Mental Wellbeing of Children and Adolescents

Globally, mental disorders are the leading cause of disability in children and adolescents. Previous research has demonstrated that supportive relationships are a key protective factor against poor mental health in children, particularly amongst those who have experienced adversity. However, fewer studies have examined the relative impact of different types of supportive relationships. The current study examined the association between level of family adult support, school adult support, and school peer support and mental wellbeing in a sample of children (age 8–15 years, N = 2,074) from schools in the UK. All three sources of support were independently associated with mental wellbeing. Analyses demonstrated a graded relationship between the number of sources of support and the odds of low mental wellbeing (LMWB), reflecting a cumulative protective effect. While all three sources of support were best, it was not vital, and analyses demonstrated a protective effect of school sources of support on LMWB amongst children with low family support. Peer support was found to be particularly important, with prevalence of LMWB similar amongst children who had high peer support (but low family and school adult support), and those who had high family and school adult support, (but low peer support), indicating that high peer support has an equivalent impact of two other protective factors. Findings from the study highlight the crucial context schools provide in fostering positive peer relationships and supportive teacher–student relationships to promote mental health and resilience for all children, including both those with and without supportive home environments.

Adolescent Attachment Profiles Are Associated With Mental Health and Risk-Taking Behavior

This person-oriented study aimed to identify adolescents' hierarchical attachment profiles with parents and peers, and to analyze associations between the profiles and adolescent psychosocial adjustment. Participants were 449 Finnish 17-19-year-olds reporting their attachments to mother, father, best friend, and romantic partner and details on mental health (internalizing symptoms, inattention/hyperactivity, and anger control problems) and risk-taking behavior (substance use and sexual risk-taking). Attachment was measured with Experiences in Close Relationships - Relationship Structures (ECR-RS); internalizing, inattention/hyperactivity, and anger control problems with Self-Report of Personality - Adolescent (SRP-A) of the Behavior Assessment System for Children, third edition (BASC-3); substance use with the Consumption scale of the Alcohol Use Disorders Identification Test (AUDIT-C) and items from the Finnish School Health Promotion Study; and sexual risk-taking behavior with the Cognitive Appraisal of Risky Events (CARE). Latent profile analysis identified five attachment profiles: "All secure" (39%), "All insecure" (11%), "Parents insecure - Peers secure" (21%), "Parents secure - Friend insecure" (10%), and "Parents secure - Partner insecure" (19%). "All insecure" adolescents showed the highest and "All secure" adolescents the lowest levels of mental health problems and substance use. Further, parental attachment security seemed to specifically prevent substance use and anger control problems, while peer attachment security prevented internalizing problems. Our findings help both understand the organization of attachment hierarchies in adolescence and refine the role of specific attachment relationships in psychosocial adjustment, which can be important for clinical interventions in adolescence.

Parent-Child Attachment and Social Adaptation Behavior in Chinese College Students: The Mediating Role of School Bonding

Family and school are two main places for adolescents to develop socialization, which can be contributed by good parent-child attachment and school bonding. Earlier studies suggested that parent-child attachment played an important role in promoting the formation of high-level school bonding, which is also likely to influence social adaptation. This study aimed to explore the relationship between parent-child attachment and social adaptation, and the mediating role of school bonding. Using stratified cluster sampling, 1,440 college students were first randomly selected from four universities and then stratified by specialty with a balance between genders and grades. Participants voluntarily participated in this study and completed questionnaires including the Parent-Child Attachment Scale, School Bonding Scale, and Social Adaptation Scale. Finally, a total of 1,320 college students were included in the analysis (59.5% female; aged 18-24years, Mage=20.39±1.52years). Data analysis and structural equation modeling were conducted using SPSS 22.0 and AMOS 23.0. The results indicated that the overall level of parent-child attachment in females (M=75.72, SD=12.36) was significantly higher than that of males (M=73.71, SD=12.68; F=8.22, p<0.01). Difference was also found between sibling status (F=13.90, p<0.001), and the only-child (M=76.16, SD=12.72) scored significantly higher than their counterparts (non-only children, M=73.60, SD=12.19). Parent-child attachment was positively correlated with social adaptation (p<0.01) and school bonding (p<0.01), while school bonding was also positively correlated with social adaptation score (p<0.01). School bonding played a partial intermediate role in the relationship between parent-child attachment and social adaptation (β=0.15). Our research identified a direct influence of parent-child attachment and an indirect influence via school bonding on social adaptation among college students.

Distress Among Adolescents: An Exploration of Mattering, Social Media Addiction, and School Connectedness

This study aimed to explore the effects of mattering, social media addiction, online activity, school connectedness, age, and gender on anxiety/depressive symptomatology among U.S. adolescents. A nationally representative Qualtrics panel sample consisting of 441 adolescents ( Mage = 17.3; SDage = 1.67) participated in this study. The results of a three-step hierarchical multiple regression analysis indicated that gender, social media usage, and mattering were most strongly associated with adolescent distress (i.e., anxiety/depressive symptom reporting). For the full predictive model with all six predictors added, mattering was found to significantly improve the prediction of adolescents’ anxiety/depressive symptomatology, contributing an additional 12.8% of explained variance. For this sample, adolescent girls participants reported experiencing more anxiety/depressive symptoms. Furthermore, higher levels of social media usage, indicative of an addictive stage, and lower levels of mattering were related to more significant anxiety/depressive symptomatology. Overall, mattering was found to significantly correlate with adolescent distress, online activity, problematic social media usage, and school connectedness, evidencing its importance in addressing adolescent mental health.

Social mobility, adolescents' psycho-social dispositions, and parenting

Psycho-social dispositions and parental influence are central in early status attainment models. We apply the Social Structure and Personality framework to investigate the contributions of adolescents' psycho-social dispositions to social mobility, and then the contributions of parents' socioeconomic status (SES) and parenting to adolescents' psycho-social dispositions. The Kaplan Longitudinal and Multigenerational Study includes data on two generations of respondents: the first-generation of respondents was observed from seventh grade in 1971 until midlife, and the second-generation, their children, was observed from adolescence to young adulthood. We find that upward social mobility is inhibited by poor psycho-social dispositions, particularly by negative self-feelings. SES, in turn, also affects psycho-social dispositions. Family income is more relevant (i.e., variance explained) than parental education for adolescents' locus of control, while parental education is more relevant for adolescents' negative self-feelings. Finally, our findings indicate that parenting can disrupt the cycle of social reproduction, with lower SES adolescents exhibiting lower levels of negative self-feelings if their parents are more attached or less authoritarian.

The effects of group art therapy on adolescents' self-concept and peer relationship: A mixed-method study

This study examined the effects of group art therapy on self-concept and peer relationships among adolescents using a mixed-method approach. Twelve recruited adolescents from a high school in Northern Taiwan attended weekly 2-h group art therapy sessions for 8 weeks. Through a discovery-oriented approach incorporating focus group interviews and individual interviews, qualitative results revealed that the participants started getting to know themselves better and were able to explore their inner selves while noticing their own emotions. Their self-concept also became more positive along with reduced negative self-concept, increased positive self-concept, and clearer visions towards future goals. Furthermore, the therapy modified adolescents' negative peer relationships by reducing their social anxiety and adjusting their complicated experiences. Participants were found to experience trustable, allied, and compassionate positive peer relationships while having reduced loneliness and improved social skills at the same time. Besides, the participants answered self-concept and peer relationship scales at pre- and post-interventions as well as a 12-month follow-up thereafter. Friedman test on the longitudinal data showed participants reporting consistently higher self-concept and peer relationship at post-intervention and 12-month follow-up than at the pre-intervention stage. Taken together, the findings duly support art therapy in boosting adolescents' self-concept and peer relationships.

The Relationship between Peer Attachment and Aggressive Behavior among Chinese Adolescents: The Mediating Effect of Regulatory Emotional Self-Efficacy

This study aimed to test the association between peer attachment and aggressive behavior, as well as the mediating effect of regulatory emotional self-efficacy on this relationship. A total of 1171 (582 male, 589 female) Chinese adolescents completed self-reported questionnaires that assessed peer attachment, regulatory emotional self-efficacy, and aggressive behavior. Path analysis showed that the negative association between peer attachment and adolescent aggressive behavior was mediated by self-efficacy in managing negative emotions. However, the mediating effect of self-efficacy in expressing positive emotions was nonsignificant. Moreover, there was no significant difference in the indirect paths mentioned above between male and female respondents. These findings highlight self-efficacy in managing negative emotions as a potential mechanism linking peer attachment to adolescent aggressive behavior.

Teen resilience: the role of school and family connectedness

The sense of connectedness with family and school is an element associated with the psychosocial development in adolescents, being a factor that can influence the way they respond against adversity and adjust to change. This study aimed to establish the predictive value of intrafamilial relationships and connectedness with school, teachers, and between students on resilience in Mexican high school adolescents. The sample consisted of 645 students (50.7% female), with an age range of 12 to 16 years old (M = 13.35, SD = 0.99), from a public high school of México. Participants answered the Intrafamilial Relations Assessment Scale, the subscales of social connectedness with school and students of the MDS3 School Climate Survey, and the revised Resilience Questionnaire for Children and Adolescents. The results indicated moderate positive associations between the study variables and resilience. The higher coefficients were found between intrafamilial relationships and resilience. In the predictive analysis, intrafamilial relationship, connectedness with school and between students, conserved its significance for predicting resilience, with family relationships maintaining the highest coefficient. Results suggest that the family environment is the main factor that shapes how adolescents cope with adversity. Limitations and practical implications are discussed. We conclude it is important to generate strategies that promote a higher adolescent connectedness with key environments for the development of protective factors such as resilience.

Harnessing Home-School Partnerships and School Consultation to Support Youth With Anxiety

Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time- and staff-intensive programs. Such programs often leave teachers and caregivers feeling ill-equipped to support the student with anxiety throughout the natural course of the school day. Given the heavy demands placed on teachers and documented burnout among school professionals, providing effective school supports requires collaborative partnerships among outpatient therapists/specialists, school personnel, and caregivers. Drawing from literature on collaborative models for externalizing problems, we offer recommendations for outpatient therapists and specialists working to implement evidence-based supports in school settings and promote home-school partnerships to benefit youth with anxiety in the school setting. Our recommendations touch upon several components of such school consultation, including (a) identification of key parties involved, (b) conducting a needs assessment, (c) collaborative goal setting and development of a fear hierarchy, (d) plan development and implementation (e.g., facilitating a school-based exposure mindset, promoting home-school communication, enhancing school relationships), and (e) progress monitoring and ongoing support. We conclude with a case example to bring these recommendations to life.