Parent-Adolescent Relationship Qualities, Internal Working Models, and Styles as Predictors of Adolescents' Observed Interactions with Friends

The implications of the COVID-19 pandemic on eating disorder features and comorbid psychopathology among adolescents with anorexia nervosa and matched controls: a comparative cohort design study

PURPOSE

To examine implications of the COVID-19 pandemic on eating disorder (ED) features and psychopathology in female adolescents with anorexia nervosa (AN).

METHOD

In total 79 females with first-onset AN (aged 12-22 years) were included and were followed up across a period of 1 year. We assessed AN participants recruited pre-pandemic (n = 49) to those recruited peri-pandemic (n = 30). Pre- (n = 37) and peri-pandemic (n = 38) age-, and education-matched typically developing (TD) girls (n = 75) were used as a reference cohort. ED features and psychopathology were assessed at baseline. After 1 year of follow-up the association between pandemic timing and clinical course was assessed. Analyses of covariance were used to examine differences in ED features and psychopathology.

RESULTS

Peri-pandemic AN participants experienced less ED symptoms at baseline compared to pre-pandemic AN participants. In particular, they were less dissatisfied with their body shape, and experienced less interpersonal insecurity. In addition, the peri-pandemic AN group met fewer DSM-IV criteria for comorbid disorders, especially anxiety disorders. In contrast, peri-pandemic AN participants had a smaller BMI increase over time. In TD girls, there were no differences at baseline in ED features and psychopathology between the pre- and peri-pandemic group.

CONCLUSION

Overall, peri-pandemic AN participants were less severely ill, compared to pre-pandemic AN participants, which may be explained by less social pressure and peer contact, and a more protective parenting style during the pandemic. Conversely, peri-pandemic AN participants had a less favorable clinical course, which may be explained by reduced access to health care facilities during the pandemic.

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Parental Psychological Control, the Parent-Adolescent Relationship, and Non-suicidal Self-Injury Among Chinese Adolescents: The Moderating Effect of the Oxytocin Receptor Gene rs53576 Polymorphism

Parental psychological control (PPC) is associated with adolescent non-suicidal self-injury (NSSI); however, its underlying mechanisms have not been extensively investigated. Considering that genetic and environmental factors interactively influence adolescent development, this study examined whether the parent-adolescent relationship mediated the link between PPC and adolescent NSSI, and whether this mediating process was moderated by the oxytocin receptor gene rs53576 polymorphism (OXTR rs53576). Participants comprised 673 adolescents (Meanage = 12.81 years, SD =  0.48 years) who completed questionnaires regarding PPC, the parent-adolescent relationship, and NSSI. DNA was extracted from each participant's saliva samples. The results indicated that the positive association between PPC and adolescent NSSI was mediated by the parent-adolescent relationship. Moreover, this indirect link was stronger for adolescents with AA homozygotes of OXTR rs53576 than for those with the GG or AG genotype. These findings extend our understanding of the association between PPC and adolescent NSSI and suggest that a simultaneous focus on PPC, the parent-adolescent relationship, and OXTR rs53576 may favor NSSI interventions.

Observations of parent-adolescent interactions relate to food parenting practices and adolescent disordered eating in adolescents at risk for adult obesity

Adolescent disordered eating and obesity are interrelated and adversely relate to mental and metabolic health. Parental feeding practices have been associated with adolescent disordered eating and obesity. Yet, observable interactions related to food parenting have not been well characterized. To address this gap, N = 30 adolescents (M ± SD 14 ± 2 year) at risk for adult obesity due to above-average body mass index (BMI ≥70th percentile) or parental obesity (BMI ≥30 kg/m2 ) participated in a video-recorded parent-adolescent task to discuss a food/eating-related disagreement. Interactions were coded for individual/dyadic affect/content using the Interactional Dimensions Coding System. We examined associations of interaction qualities with parent-reported food practices, adolescent disordered eating behaviors/attitudes, and insulin resistance. Reported parenting practices were correlated with multiple interaction qualities (p-values <0.05), with the most consistent correspondence between parent-reported pressure to eat (e.g., pressure to eat more healthy foods) and negative aspects of parent-adolescent interactions. Also, after accounting for adolescent age, sex, and BMI-standard score, parent-adolescent interaction qualities were associated with adolescents' disordered eating and insulin resistance. Specifically, greater adolescent problem-solving related to less adolescent global disordered eating, shape, and weight concern (p-values <0.05); adolescent autonomy related to less weight concern (p = 0.03). Better parent communication skills were associated with less adolescent eating concern (p = 0.04), and observed dyadic mutuality related to adolescents' lower insulin resistance (p = 0.03). Parent-adolescent interaction qualities during food/eating-related disagreements show associations with parent-reported food practices and adolescent disordered eating. This method may offer a tool for measuring the qualities of parent-adolescent food/eating-related interactions. A nuanced understanding of conversations about food/eating may inform family-based intervention in youth at-risk for adult obesity.

Examining the Effects of Adverse Childhood Experiences and Gender on Trauma-Informed Intervention Outcomes

Purpose

The prevalence of Adverse Childhood Experiences (ACEs) and their link to negative behavioral and health outcomes is well documented, but very few studies have empirically examined the effect of ACEs on intervention outcomes. There is also emerging evidence of gender differences in vulnerability to developing traumatic symptoms, which relates to intervention outcomes. The current study examined the effects of ACEs and gender on trauma-informed intervention outcomes in a community-based clinical setting.

Methods

The study includes data from children who were treated with trauma-informed intervention services grounded in the Attachment, Self-Regulation, and Competency (ARC) framework from 2017 to 2019. ACE scores are measured as a total across 10 items and different types, maltreatment versus family dysfunction, at intake. Children's trauma-related symptoms are assessed at intake and every 90 days under the ARC framework. In order to examine the changes of traumatic symptoms over time, a total of 362 children with three time points are included for the current analyses using Multilevel modeling with SAS PROC MIXED.

Results

The study found that a trauma-informed intervention based on the ARC framework was effective in reducing children's trauma related symptoms until they experienced 6 or more ACEs. The intervention effect, however, did not hold when children's ACEs were cumulated to 7 or more. The study also revealed gender differences in intervention outcomes.

Conclusions

The finding has significant implications for early detection and preventative intervention efforts with children's ACEs before their ACEs further cumulate to a higher number. Gender difference should be considered in intervention planning and monitored during the intervention process.

The longitudinal associations between perceived maternal parenting practices, mother-adolescent relationship quality, and friendship quality

INTRODUCTION

As adolescents begin to expand their social networks beyond their family, they turn increasingly to their peers for support. Parenting practices present in the parent-child dyad are likely to extend to peer dyads. However, when considering the process involved in the transmission from parenting practices to friendships, the mediating role of parent-child relationships remains unclear. The current study explored the mediating effect of mother-adolescent relationship quality in the association between perceived maternal parenting practices (i.e., autonomy support and psychological control) and friendship quality using a three-wave longitudinal design, and also examined whether adolescents' gender moderates these associations.

METHODS

A sample of 344 Chinese adolescents (12.01 to 15-year-old at Wave 1, M = 13.08, SD = 0.39; 153 boys and 191 girls) filled out questionnaires on perceived maternal parenting practices, mother-adolescent relationship quality, and friendship quality, separately in three waves.

RESULTS

Perceived maternal autonomy support was associated with positive friendship quality through positive mother-adolescent relationship quality. However, perceived maternal psychological control was not associated with negative friendship quality. Moreover, marginal gender differences were only found in the associations between autonomy support and positive mother-adolescent relationship quality.

CONCLUSIONS

These findings demonstrate the spillover effects existed only between autonomy support and positive friendship quality, and highlight the importance of positive mother-adolescent relationship quality when promoting positive friendship quality.

Negative parenting styles and social adjustment of university students: a moderated chain mediation model

This study aimed to explore the relationship between parenting styles and the social adjustment of university students as well as the mediating effects of attachment avoidance and friendship quality. We further examined the moderating role of gender. This study used convenience sampling to recruit 501 Chinese university students to complete the Chinese version of the Negative Parenting subscale of EMBU, Attachment Avoidance Scale, Friendship Quality Questionnaire, and Social Adjustment Scale. SPSS 24.0 and the Process 3.5 macro program were used to carry out descriptive statistical and correlation analyses and mediating effect and moderated chain-mediating effect tests on the data. The analyses revealed that negative parenting styles significantly negatively predicted social adjustment in university students. Attachment avoidance mediated the relationship between negative parenting styles and social adjustment in university students, and friendship quality mediated the relationship between negative parenting styles and social adjustment in university students. Attachment avoidance and friendship quality played a chain-mediating role in the relationship between negative parenting styles and university students' social adjustment. Gender moderated the effect of negative parenting style on friendship quality among university students. These results show how negative parenting styles affect college students' social adjustment and its underlying mechanisms in the context of China's collectivist culture and high power distance and further reveal the gender differences involved, providing insights to better understand the factors influencing college students' social adjustment.

Parent-adolescent relationships, peer relationships, and adolescent mobile phone addiction: The mediating role of psychological needs satisfaction

INTRODUCTION

Prior studies have shown that parent-adolescent relationships and peer relationships may be important factors associated with adolescent mobile phone addiction (MPA). The present study aims to further explore the direct effects of parent-adolescent and peer relationships on adolescent MPA as well as the indirect effects through the mediating roles of autonomy, competence, and relatedness needs satisfaction.

METHODS

Our sample consisted of 1766 Chinese adolescents (53.10% male; M_age = 13.33, SD = 1.94, range from 10 to 18 years) who completed questionnaires regarding parent-adolescent relationships, peer relationships, psychological needs satisfaction, and MPA. SPSS 24.0 was used to analyze correlations among variables and Mplus 7.4 was used to test the structural equation model in this study.

RESULTS

(1) positive parent-adolescent relationships were negatively associated with adolescent MPA, while peer relationships did not show a significant association with MPA; (2) autonomy and competence needs satisfaction significantly mediated the effects of parent-adolescent and peer relationships on MPA, while the mediating role of relatedness need satisfaction between parent-adolescent and peer relationships and MPA was not significant; (3) the mediating effect of competence need satisfaction between peer relationships and MPA was significantly stronger than that between parent-adolescent relationships and MPA.

CONCLUSIONS

This study explored the different mechanisms by which parent-adolescent and peer relationships influence adolescent MPA. These discoveries may contribute to intervention and prevention programs for adolescent MPA.

Parental Attachment and Peer Relationships in Adolescence: A Systematic Review

According to attachment theory, children's early experiences with their primary caregivers, in terms of protection and security, are the basis for socioemotional development and for the establishment of close relationships throughout their lives. During adolescence, friends and peers become a primary developmental environment, and thereby establishing quality bonds with peers will foster good psychological adjustment. The aim of the present study was to review the evidence on the relation of parental attachment to the quality of peer relationships during adolescence. A systematic review was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was performed in the PsycInfo, Scopus, and Web of Science (WOS) databases. Inclusion criteria were studies published since 2001, in English, that are academic publications in scientific journals, that explore adolescence, and that analyze the relationship between attachment styles and adolescent peer interactions. The search resulted in 1438 studies, of which 19 studies met the criteria and were included in the review. The results highlighted that secure attachment predicts and promotes the creation of affective relationships with peers and friends based on communication, support, intimacy, trust, and quality. In addition, some variables, such as gender differences or family characteristics, were found to be involved in attachment and provide a better understanding.

Too Much Too Soon?: Borderline Personality Disorder Symptoms and Romantic Relationships in Adolescent Girls

Despite the centrality of adult romantic relationships to the conceptualization of borderline personality disorder (BPD), little is known about the earlier development of this interdependency during adolescence. Thus, we examined the co-development of romantic relationships and BPD symptoms from ages 15 to 19 in a large urban sample of girls (N = 2310) in the Pittsburgh Girls Study. We had two major aims. First, we sought to examine associations between BPD symptoms and romantic relationship involvement (number of partners, importance of relationship) and relational insecurity (concerns about infidelity and tactics to maintain relationship) during adolescence. Second, we investigated mutual influences and temporal precedence of BPD symptoms and four specific romantic relationship characteristics (perceived support and antagonism, verbal and physical aggression) during adolescence using latent growth curve models (LGCMs). Results indicated that BPD symptoms were associated with increased involvement in romantic relationships and heightened relational insecurity across adolescence. Furthermore, higher BPD symptoms at age 15 predicted increases in antagonism, verbal aggression, and physical aggression across ages 15 to 19. Conversely, perceptions of higher levels of relationship support at age 15 predicted steeper increases in BPD symptoms across ages 15 to 19, suggesting a potential negative influence of early involvement in close romantic relationships. These findings demonstrate the reciprocal nature of romantic relationship functioning and BPD symptoms during adolescence and suggest novel prevention targets for youth at risk for BPD.

The Role of Reproductive Autonomy in Adolescent Contraceptive Choice and Acceptance of Long-acting Reversible Contraception

STUDY OBJECTIVE

To examine the association between reproductive autonomy and adolescent receptivity toward long-acting reversible contraceptive (LARC) methods.

DESIGN

A survey to assess sexual history and contraceptive practices/knowledge/attitudes was administered. Reproductive autonomy was measured with an adapted validated scale.

SETTING

Adolescent medicine clinic in an urban academic medical center in the Midwestern United States.

PARTICIPANTS

Girls ages 14-21 years who presented for well or contraceptive visits.

INTERVENTIONS AND MAIN OUTCOME MEASURES

Primary outcome was a favorable rating toward the question "How much do you like the idea of LARC for yourself?" The primary independent variable was the reproductive autonomy decision-making subscale score (higher score indicating increased autonomy).

RESULTS

Eighty-nine participants with a mean age of 16 years completed surveys. Almost all (92%) identified as African American. At study enrollment 56.2% were using Depo-Provera (Pfizer), 15.7% oral contraceptives, 3.4% implants, and 24.7% no method. Only 13.5% of participants liked the idea of LARC for themselves. The mean score on the decision-making subscale was 9 (range, 4-12). In bivariable analysis, age was associated with decision-making subscale score, but was not retained as a confounder in multivariable analysis. The odds of liking LARC decreased by 30% with each unit increase in the autonomy decision-making subscale score (odds ratio, 0.70; 95% confidence interval, 0.52-0.94; P = .02).

CONCLUSION

Our findings suggest that adolescents with higher reproductive autonomy, measured according to their score on the decision-making subscale, were less likely to favor LARC. Further research should explore participants' perceptions of autonomy and the relational dynamics between adolescents and their parents/partners in contraceptive choice.

Autonomy and relatedness in early adolescent friendships as predictors of short- and long-term academic success

This study examined early adolescent autonomy and relatedness during disagreements with friends as key social competencies likely to predict academic achievement during the transition to high school and academic attainment into early adulthood. A sample of 184 adolescents was followed through age 29 to assess predictions to academic success from observed autonomy and relatedness during a disagreement task with a close friend. Observed autonomy and relatedness at age 13 predicted relative increases in grade point average (GPA) from 13 to 15, and greater academic attainment by age 29, after accounting for baseline GPA. Findings remained after accounting for peer acceptance, social competence, scholastic competence, externalizing and depressive symptoms, suggesting a key role for autonomy and relatedness during disagreements in helping adolescents navigate challenges in the transition to high school and beyond.

Reciprocal Relations between Emerging Adults' Representations of Relationships with Mothers, Fathers, and Romantic Partners

This study employed a fully cross-lagged, longitudinal model to examine reciprocal relations between representations of relationships with parents and romantic partners at ages 20 and 22. Representations were assessed with continuous measures of dismissing/avoidant and preoccupied relationship styles across the attachment and affiliation systems for parents, and across the attachment, affiliation, and caregiving systems for romantic partners. Earlier relationships with both mothers and fathers independently predicted changes in later views of romantic relationships, and earlier romantic relationships predicted changes in later views of relationships with both mothers and fathers. This evidence of a developmental system of interconnected representations across relationships has theoretical implications about the nature of working models, and practical implications alerting parents to the onset of dating as a potentially fertile context for changes in their relationships with children.

Interdependence of attachment styles and relationship quality in parent-adolescent dyads

The current study examined how attachment styles of parents and adolescents may jointly influence the quality of their relationship. Parent-adolescent (N_dyads = 77) pairs were recruited from a Midwestern town in the United States. The mean of adolescents' age was 16.25. Both members reported their attachment styles, relationship closeness, and relationship discord. The Actor-Partner Interdependence Model (APIM) showed that both members' attachment avoidance was associated with self-report lower levels of closeness. Parents' attachment anxiety was related to relationship discord. Parents with higher avoidant attachment reported lower closeness when adolescents were higher in avoidant attachment. Higher parents' anxious attachment was related to higher relationship closeness when adolescents were higher on anxious attachment. Such an association was negative when adolescents had lower anxious attachment. Higher parents' anxious attachment was related to greater discord when adolescents were lower on anxiety attachment. This study reveals the complex dyadic dynamics of relationship quality in parent-adolescent pairs.

Adolescent-Parent Attachment and Externalizing Behavior: The Mediating Role of Individual and Social Factors

The aim of this study was to test whether the associations between adolescent-parent attachment and externalizing problem behavior of adolescents were mediated by adolescent cognitive distortions, self-esteem, parental monitoring and association with deviant peers. A total of 102 adolescents (71 % male; aged 12-19 years) at risk for developing delinquent behaviors reported on attachment, parental monitoring, aggressive and delinquent behavior and peers. Mediation effects were tested by using structural equation modeling. Different pathways were found depending on the type of externalizing behavior. The association between attachment and direct and indirect aggressive behavior was mediated by cognitive distortions. The relation between attachment and delinquency was mediated by deviant peers and parental monitoring. We argue that clinical practice should focus on the attachment relationship between adolescent and parents in order to positively affect risk and protective factors for adolescents' aggressive and delinquent behavior.

Girls' and boys' problem talk: Implications for emotional closeness in friendships

This research highlights the critical role of gender in the context of problem talk and social support in adolescents' friendships. Early- and middle-adolescents' (N = 314 friend dyads; Ms = 13.01 and 16.03 years) conversations about problems were studied using observation and a short-term longitudinal design. Mean-level gender differences emerged in that girls participated in problem talk more than boys and responded in a more positive and engaged manner to friends' statements about problems (e.g., by saying something supportive, asking a question) than did boys. Interestingly, boys used humor during problem talk more than girls. Despite mean-level differences, there were not gender differences in the functional significance of participating in problem talk and positive engaged responses in that these behaviors predicted increased friendship closeness for both boys and girls. In contrast, humor during problem talk predicted increased closeness only for boys, highlighting an understudied pathway to closeness in boys' friendships.

Positive Interactions and Avoidant and Anxious Representations in Relationships with Parents, Friends, and Romantic Partners

We examined associations between positive interactions and avoidant and anxious representations in relationships with parents, friends, and romantic partners. Two hundred adolescents completed questionnaires, observations, and attachment interviews. From a between-person perspective, those adolescents with more positive interactions overall had less avoidant representations. Within persons, more positive interactions were relative to one's own average level in relationships, the less avoidant representations were for that type of relationship. Adolescents were less anxious about a particular type of relationship if they have positive interactions in their other types of relationships. Finally, representations were primarily predicted by interactions in the same type of relationship; interactions in other relationships contributed little. The findings underscore the importance of examining representations of particular types of relationships.

Predictors of disordered eating in adolescence and young adulthood

We investigated longitudinal predictors for disordered eating from early adolescence to young adulthood (12–34 years) across gender and different developmental phases among Norwegian young people. Survey data from a population-based sample were collected at four time points (T) over a 13-year time span. A population-based sample of 5,679 females and males at T1 and T2, 2,745 at T3 and 2,718 at T4 were included in analyses, and linear regression and random intercept models were applied. In adolescence, initial disordered eating and parental overprotectiveness were more strongly related to disordered eating among females, whereas loneliness was a stronger predictor for adolescent males. Initial disordered eating during early adolescence predicted later disordered eating more strongly in late- than mid-adolescence. In young adulthood, no significant gender-specific risk factors were found. The findings provide support for both shared and specific risk factors for the developmental psychopathology of disordered eating.

Associations of Mothers' Friendship Quality with Adolescents' Friendship Quality and Emotional Adjustment

Little research has examined the association of parents' friendships with adolescent's well-being, perhaps because the association was considered too distal. However, developmental theories suggest that contexts in which parents, but not their children, are situated may be related to child development (Bronfenbrenner, 1979; 1986). The current work examined associations between the quality of mothers' own friendships and their adolescent children's friendship quality and emotional adjustment. Fifth-, eighth-, and eleventh-graders (N = 172) whose mothers' friendships were characterized by conflict and antagonism reported having friendships that were high in negative friendship qualities as well as elevated internalizing symptoms. These associations held after controlling for mother-child relationship quality, suggesting that mothers' friendships may have a unique association with adolescents' adjustment.

Attachment, the tripartite influence model, and the development of body dissatisfaction

The tripartite model of influence proposes that three primary core sources of influence-parents, peers and media-contribute to the development of body dissatisfaction and disordered eating. In the current study, this model was examined in a sample of 205 undergraduate women. This study added to previous research by investigating mother and father criticism separately and by examining the potential moderating effects of parental attachment in the pathway to body dissatisfaction. Results indicated partial support for the tripartite model of influence. Sociocultural influences (media) were found to be a significant predictor of body dissatisfaction, but not parental or peer criticism. Anxious attachment was found to be a significant moderator on the effects of sociocultural attitudes in body dissatisfaction. Limitations and future research implications are discussed.

What I like about you: the association between adolescent attachment security and emotional behavior in a relationship promoting context

Because the ability to flexibly experience and appropriately express emotions across a range of developmentally relevant contexts is crucial to adaptive functioning, we examined how adolescent attachment security may be related to more functional emotional behavior during a relationship promoting interaction task. Data were collected from 74 early adolescent girls (Mean age 13.45 years; SD = 0.68; 89% Caucasian) and their primary caregiver. Results indicated that, regardless of the parent's interaction behavior and the level of stress in the parent-adolescent relationship, greater adolescent security was associated with more positive and less negative behavioral displays, including greater positivity, greater coherence of verbal content and affect, less embarrassment, and less emotional dysregulation in response to a situational demand for establishing intimacy with the parent. Implications for encouraging and fostering adolescents' capacity to respond to interpersonal contexts in ways that promote the relationship are discussed.