Adolescent brain development: a period of vulnerabilities and opportunities. Keynote address

Trust under development: The Italian validation of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ) for adolescents

INTRODUCTION

In recent years, the concept of epistemic trust has emerged as a critical factor in understanding psychopathology, particularly within the context of personality disorders. A self-report instrument, the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ), has demonstrated its validity among English and Italian adult populations. However, extending its applicability to adolescents is essential for comprehending the role of epistemic trust in the development of mental disorders. The aim of this study was to validate the ETMCQ within the Italian adolescent demographic.

METHODS

Data were gathered from a wide selection of middle and high schools across Italy. The data collection started on 01/03/2022 and ended on 30/06/2022. Besides the ETMCQ (Study 1 = 662 participants, 12-18 years old, M = 15.56, SD = 2.20; 324 females, 338 males), we also administered other self-report instruments measuring mentalization, emotional dysregulation, general levels of psychopathology, and interpersonal trust in a smaller groups (Study 2 = 417 participants, aged from 12-19 years old, M = 15.64; SD = 2.08; 249 females, 168 males).

RESULTS

Our findings provide empirical validation for the theoretical framework concerning the role of epistemic trust in psychological functioning and substantiate the validity of ETMCQ as a measure to assess it among teenagers.

CONCLUSIONS

The ETMCQ is a valid and promising instrument for adolescent populations; its ease and brevity of administration could make it a valuable tool both in clinical and research contexts, shedding light on the role of epistemic trust in mental health.

Examining Self-Regulation and Problematic Smartphone Use in Canadian Adolescents: A Parallel Latent Growth Modeling Approach

Despite extensive research on the prevalence and mental health implications of problematic smartphone use in adolescents, the cognitive mechanisms underpinning its development, such as self-regulation, remain underexplored. This study aims to fill this research gap by investigating the developmental trajectories of self-regulation and problematic smartphone use among Canadian adolescents. Participants (N = 1303; 614 girls; Mage = 14.60 years, SD = 1.16 years) attended one of five public high schools in Southern British Columbia. Adolescents self-reported their self-regulation skills, as well as problematic smartphone use annually for three years. In line with developmental expectations, results indicated that both self-regulation and problematic smartphone use increased across the three years. Parallel latent growth models revealed significant intercept and positive slope differences for self-regulation and problematic smartphone use, showing that higher initial self-regulation predicted lower initial problematic smartphone use, and vice versa. Girls exhibited higher initial levels of problematic smartphone use, but gender differences in developmental trajectories were not observed. These findings emphasize the importance of early self-regulation skills in preventing the escalation of problematic smartphone use in adolescents, providing evidence-based insights for developing targeted interventions.

Mixing energy drinks and alcohol during adolescence impairs brain function: A study of rat hippocampal plasticity

In the last decades, the consumption of energy drinks has risen dramatically, especially among young people, adolescents and athletes, driven by the constant search for ergogenic effects, such as the increase in physical and cognitive performance. In parallel, mixed consumption of energy drinks and ethanol, under a binge drinking modality, under a binge drinking modality, has similarly grown among adolescents. However, little is known whether the combined consumption of these drinks, during adolescence, may have long-term effects on central function, raising the question of the risks of this habit on brain maturation. Our study was designed to evaluate, by behavioral, electrophysiological and molecular approaches, the long-term effects on hippocampal plasticity of ethanol (EtOH), energy drinks (EDs), or alcohol mixed with energy drinks (AMED) in a rat model of binge-like drinking adolescent administration. The results show that AMED binge-like administration produces adaptive hippocampal changes at the molecular level, associated with electrophysiological and behavioral alterations, which develop during the adolescence and are still detectable in adult animals. Overall, the study indicates that binge-like drinking AMED adolescent exposure represents a habit that may affect permanently hippocampal plasticity.

Eating disorder risks and psychopathological distress in Italian high school adolescents

BACKGROUND

Psychopathological disorders are often comorbid diagnosis in eating disorders (EDs). We aimed to assess the presence of psychopathological traits and symptoms associated with EDs in an Italian high school adolescent population.

METHODS

A sample of high school adolescents was enrolled, and demographic and clinical data were collected. Two self-report questionnaires, the Eating Disorder Inventory-3 (EDI-3) and the Questionnaire for the Assessment of Psychopathology in Adolescence (Q-PAD), were administered.

RESULTS

548 adolescents (333 F/215 M; 16.89 ± 0.85 years) were included. Symptoms associated with EDs of clinical or high clinical concern were prevalent in a range of individuals, with percentages varying from 26.82% for body dissatisfaction to 51.83% for Interoceptive Deficits. The findings from the Q-PAD assessment indicated the presence of psychological distress, leading to discomfort or challenging situations requiring potential intervention in a percentage of adolescents ranging from 2.93% for psychosocial risks to 23.77% for anxiety. These percentages showed differences between genders (F > M, p < 0.001). Our study also highlighted an association between symptoms of EDs and lifestyle factors within families. We observed correlations between Q-PAD measures and EDI-3 scores, including a positive correlation between Q-PAD and EDI-3 body dissatisfaction (r = 0.7), Q-PAD interpersonal conflicts and EDI-3 interpersonal problems (r = 0.6) and a negative correlation between Q-PAD self-esteem and well-being and EDI-3 ineffectiveness Composite (r=-0.7).

CONCLUSIONS

a substantial prevalence of ED symptoms and psychological distress among high school adolescents were recorded. These conditions are interrelated, suggesting the importance of addressing them comprehensively. Early detection is essential to improve treatment outcomes and to implement preventive strategies.

The burden and its determinants of mental health distress among adolescents dwelling in Africa: a systematic review and meta-analysis

BACKGROUND

Adolescent mental health issues are emerging as a significant public health concern across many low- and middle-income countries, particularly in Africa. This study aims to evaluate the aggregated prevalence and contributing risk factors of mental health distress among adolescents in Africa.

METHODOLOGY

A comprehensive search of PubMed, PsycINFO, Web of Science, Google Scholar, and HINARI databases was conducted to identify relevant articles on the prevalence and risk factors associated with mental health distress among African adolescents, published up to December 2023. The quality of the selected studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Heterogeneity among the studies was evaluated using the I² statistical test. Potential publication bias was assessed through a funnel plot and Egger's statistical test. This systematic review was registered with PROSPERO under reference number CRD42023494665.

RESULTS

Eighteen studies encompassing data from 37,016 adolescents were included in the analysis. The overall prevalence of mental health distress among adolescents in Africa was found to be 27.34% (95% CI: 23.18-31.50). The occurrence of mental health distress is observed in older adolescents at a prevalence of 29.44% (95% CI: 23.26-35.66) and in younger adolescents at 24.73% (95% CI: 11.96-37.51). Significant risk factors identified included bullying victimization, with an odds ratio (POR) of 1.30 (95% CI: 1.16, 1.46), and experiencing hunger, with an odds ratio (POR) of 2.10 (95% CI: 1.13, 3.91).

CONCLUSION

The findings indicate a high prevalence of mental health distress among adolescents in Africa, highlighting the widespread impact on this demographic. These results underscore the urgent need for targeted interventions to prevent and address mental health distress among adolescents. Further research on a global scale is essential to develop effective prevention and treatment strategies tailored to this age group.

Transitioning from paediatric to adult care in epilepsy: A qualitative study of adolescent experiences

OBJECTIVE

Transition into adulthood and adult medical care is an important step in the life of young people with epilepsy. We aimed to gain a better insight into the lived experience of the transition to adulthood and adult medical care in epilepsy in Sweden, to improve future transitional care.

METHODS

A cross-sectional observational study with digital focus-group meetings and interviews with young people with epilepsy (16-22 years, n = 37) prior to, or after the transfer to adult care, or their primary caregivers if they had intellectual disability. We used reflexive thematic analysis to analyse the experiences and expectations on the transition to adulthood and adult medical care.

RESULTS

The results of the thematic analysis included four key areas during transition to adulthood and adult care for young persons with epilepsy: (I) worries on coming changes and future, (II) transfers are not smooth and adult care is less integrated, (III) epilepsy is part of a bigger picture, and (IV) parental roles change. In those with intellectual disability, parents experienced a stressful process and had to increase their efforts to coordinate all care contacts in adult care. Here, epilepsy was often experienced as a minor part of a more complex disease picture, where neurodevelopmental issues were often the primary concern.

SIGNIFICANCE

Transition in epilepsy is often complex due to the large burden of co-occurring disease, specifically intellectual disability and neuropsychiatric diagnoses. Transfer to adult care is experienced as unplanned and participants experience uncertainty, indicating a need for an improved transition process. As effective interventions are known in other chronic diseases, future studies should focus on the evaluation of how these approaches can be feasible and effective in young people with epilepsy.

"We did more than survive": lessons learned from studies of risk and resilience of young people growing up with HIV and mental health needs

Despite advances in HIV-treatment, adolescents and young adults (AYA) with HIV (AYAHIV) face myriad challenges. They are less likely than children and older adults to be virally suppressed and are at higher risk for mental health conditions compared to their peers who do not have HIV. AYA are also developing in the context of numerous biomedical, neurocognitive, and psychosocial developmental changes. Normative challenges during this time can be exacerbated by HIV and can result in significant physical and mental health problems. Yet, many AYAHIV have shown resilience with positive assets and resources and few health or mental health problems. Historically research has had a risk-focused approach to understanding AYAHIV needs. This paper discusses the rationale for a shift from a risk-focused only approach to one that examines AYAHIV needs from both a risk and resilience perspective. This paper presents: (1) epidemiological data on AYAHIV; (2) conceptual models for understanding both risk (e.g., poverty, stress, trauma, limited resources) and resilience/protective factors (e.g., family and peer support, future orientation, problem-solving skills); (3) global data examining risk and protective factors for physical and mental health challenges; and (4) promising interventions that incorporate elements of resilience to improve overall outcomes among AYAHIV.

Victims of drug facilitated sexual assault aged 13-24: a cross sectional study on the pool of users of a sexual violence relief centre in Northern Italy

This cross-sectional study aimed to assess the association between drugs and alcohol intake and sexual abuse in adolescents, otherwise defined as Drug Facilitated Sexual Assault (DFSA). We considered the survivors who accessed care at the Centre "Soccorso Violenza Sessuale" (SVS - Sexual Violence Relief Centre) in Turin (Italy), between May 2003 and May 2022. We found that 973 patients aged 13-24 among which 228 were victims of DFSA. Epidemiological and anamnestic aspects of the episode of sexual violence were examined, with a specific focus on investigating the alcohol and/or drug intake as reported by the victim, along with the results of the toxicological analysis. the study further accounts for the variations caused by the COVID-19 pandemic on DFSA-related accesses. Our findings show that 23% of adolescents accessing care at SVS were subjected to DFSA. Six out ten adolescents knew their aggressor, at times a partner (10%) oran acquaintance (43%). In 12% of cases violence was perpetrated by a group of people (12%). Almost 90% of young victims described alcohol consumption, while 37% reported drug use at the time of the assault. Alcohol taken alone or in combination with other substances was the most detected drug in our sample throughout the period considered. Given the large use of psychoactive substances among adolescents, it is imperative to implement harm reduction strategies alongside educational activities aimed at fostering awareness about consent. Health personnel should be trained to manage the needs of victims of DFSA clinically and forensically.

Social epidemiology of the Mediterranean-dietary approaches to stop hypertension intervention for neurodegenerative delay (MIND) diet among early adolescents: the Adolescent Brain Cognitive Development Study

BACKGROUND

The purpose of our study was to understand the relationship between sociodemographic factors and adherence to the MIND (Mediterranean-DASH [Dietary Approaches to Stop Hypertension] Intervention for Neurodegenerative Delay) diet in a demographically diverse national population-based sample of 9-12-year-olds in the US.

METHODS

We analyzed data from the Adolescent Brain and Cognitive Development (ABCD) Study (Year 1, N = 8333). Multivariable linear regression analysis was used to identify associations between MIND diet score and sociodemographic factors, including race/ethnicity, household income, parent education level, age, sex, and sexual minority status.

RESULTS

Compared to White adolescents, Latino adolescents showed the greatest adherence to the MIND diet. Boys had lower adherence to the MIND diet than girls. Lower household income was associated with lower adherence to the MIND diet. Older age was associated with lower adherence to the MIND diet. Sexual minorities had a lower adherence to the MIND diet when compared to their heterosexual counterparts.

DISCUSSION

Female sex, Latino ethnicity, Asian and Black race, high household income, heterosexual sexual orientation, and younger age were associated with higher adherence to the MIND diet. These sociodemographic differences can inform targeted screening and counseling for clinicians and public health organizations among diverse adolescent populations.

IMPACT STATEMENT

Sociodemographic disparities in diet quality have been documented, but none have explored adherence to the MIND (Mediterranean-DASH [Dietary Approaches to Stop Hypertension] Intervention for Neurodegenerative Delay) diet in early adolescence. In this demographically diverse sample of 9-12-year-old early adolescents in the U.S., we found notable and nuanced sociodemographic disparities in adherence to the MIND diet. Sociodemographic factors associated with higher adherence to the MIND diet included female sex, Latino ethnicity, high household income, heterosexual sexual orientation, and younger age.

Predicting longitudinal changes in patterns of tobacco and nicotine product use among adolescents: A Latent Transition Analysis based on the X:IT study

INTRODUCTION

Understanding factors influencing the transition from non-use to tobacco and nicotine product initiation among adolescents is crucial for designing and implementing effective preventive strategies. This study explores transition patterns among 13-15-year-old adolescents in lower secondary school, focusing on the transition from non-use to tobacco and nicotine product initiation and the influence of individual, social, risk behavioral, and mental health factors on this transition.

METHODS

Based on data from a Danish smoking prevention trial between 2017 and 2019, this study employed questionnaire surveys at three time points: baseline (start of seventh grade, n = 1,990, response rate = 86.3%), eight-month follow-up (end of seventh grade, n = 1,666, response rate = 74,8%), and 20-month follow-up (end of eighth grade, n = 1,149, response rate = 70,6%). Tobacco and nicotine use indicators included current and lifetime use of cigarettes and lifetime use of e-cigarettes, smokeless tobacco, and hookah. A latent transition analysis was applied to identify longitudinal transition patterns across waves and to explore predictors of these patterns.

RESULTS

Three user classes emerged across all waves: none-use, lifetime e-cigarette and cigarette use, and poly-tobacco use. While the most prevalent class was the non-user class (71%-86%), the proportion of the lifetime e-cigarette and cigarette class increased over time (from 12% to 17%). Similarly, the poly-tobacco user class increased from 2% to 12%. The probability of transitioning from non-use to lifetime e-cigarette and cigarette use increased from 0.5% at baseline to 12% by the second follow-up, while the probability of transitioning from lifetime e-cigarette and cigarette use remained stable over time (12%-15%). Across all waves, elevated risk behavior predicted this transition. For instance, binge-drinking (OR = 3.76, 95% CI: 1.51-9.34), susceptibility to smoking (OR = 7.63, 95% CI: 3.68-16.83), and truancy (OR = 7.00, 95% CI: 1.98-24.59) influenced the transition from non-use at baseline to lifetime e-cigarette and cigarette use at first follow-up. Additionally, boys, adolescents with low socioeconomic status, low life satisfaction, and those with smoking friends or parents were more likely to transition from non-use to lifetime e-cigarette and cigarette use.

CONCLUSION

This study demonstrates that sociodemographic, social risk, behavioral, and mental health factors impact the transition from non-use to lifetime e-cigarette and cigarette use. The findings provide valuable insights for developing targeted preventive strategies focusing on these influencing factors.

Adolescents' experience with sports-related pain and injury: A systematic review of qualitative research

OBJECTIVE

The aim of this review is to synthesise qualitative studies examining adolescents' experience with pain and injury arising from sports participation.

METHODS

This review was registered on Open Science Framework prior to data extraction. A systematic search of PubMed, Embase, and SPORTDiscus was conducted. Studies were appraised using the CASP (critical appraisal skills programme) checklist. Data was synthesised using a meta aggregation.

STUDY SELECTION CRITERIA

Inclusion criteria included studies related to adolescents aged 14-19yrs with sports related pain/injury, employed a qualitative design, full text publications in English.

RESULTS

Sixteen studies of 216 participants were included. Studies investigated severe knee injuries, concussion, or other musculoskeletal injuries. Synthesised findings show that, regardless of injury type, adolescents experience a mix of positive (motivation to rehab and return to sport, optimism) and negative emotions (fear of re-injury, isolation, depressive responses) throughout recovery. Common coping strategies were to ignore symptoms, modify activity levels, or seek support.

CONCLUSION

Sports-related pain and injury has a multifaceted effect on the adolescent athlete. There is a pervasive fear of re-injury and social isolation, but the desire to return to sports is facilitated through motivation and support. Peer motivation effects the willingness of the adolescent to persist with rehabilitation.

Coastal cultural ecosystem services and adolescents' subjective well-being

Despite growing recognition of nature's impact on mental health, its specific effects on adolescents remain unclear. This gap hinders effective strategies for youth well-being in a world facing increasing environmental pressures. This study directly investigates the connections between coastal environments and subjective well-being in adolescents. We explore how interactions with coastal landscapes and associated cultural ecosystem services contribute to both personal and social dimensions of well-being in a sample of 202 adolescents (16 and 17 years old) from Sardinia, Italy. Our findings reveal a beneficial impact of coastal experiences, promoting positive affect, social integration, and physiological well-being. However, human pressures on these environments can lead to negative affect, while fostering a sense of social contribution. This research highlights the complex interplay between coastal environments, human impacts, and teenagers' well-being. Understanding these links empowers planners to craft coastal management strategies that balance adolescents' well-being with the long-term sustainability of coastal regions.

Body image, eating distress and emotional-behavioral difficulties among adolescents in Mbarara, Southwestern Uganda

BACKGROUND

Adolescents frequently have emotional and behavioral difficulties as they struggle with the challenges of transition from childhood to adulthood. Many struggle with issues of body image and eating distress as they deal with the difficult and frequently perplexing changes that occur with puberty. Yet there is surprisingly little research on the emotional and behavioral challenges, as well as body image and eating distress among this sizable population in Uganda. This study sought to assess attitudes and behaviors related to body image and eating distress, as well as emotional and behavioral difficulties among adolescents in Mbarara, Southwestern Uganda.

METHODS

This was a cross-sectional study among 788 adolescents aged 13 to 19 years in secondary schools in Mbarara city and Mbarara district in south-western Uganda. The study employed the Body Image and Eating Distress scale to assess attitudes and behaviors about dieting and body shape and the extended version of the Strengths and Difficulties Questionnaire (SDQ) to assess for perceived emotional and behavioral difficulties. Logistic regression was used to identify the association between body image and eating distress and perceived difficulties.

RESULTS

The prevalence of high body image and eating distress was 10.8% while that of perceived emotional and behavioral difficulties was 45.8%. Some of the adolescents (16.1%) were dissatisfied with their body shape, 24.6% exercised a lot to avoid gaining weight, 15.0% were terrified to gain even a little weight, and 12.1% could not control their eating. More males reported eating large amounts of food at one time (p =  < 0.001). Having emotional and behavioral difficulties (aOR: 1.89; 95% CI: 1.18 - 3.02; p = 0.019) and coming from a two-parent household (aOR: 1.79; 95% CI: 1.10 - 2.92; p = 0.019) increased the odds of high body image and eating distress.

CONCLUSION

High levels of body image and eating distress are linked to behavioral and emotional problems and adolescent's family structure. Clinicians who treat adolescents should use a holistic care strategy and be aware of the high prevalence and close association between emotional and behavioral difficulties, concerns about weight, and dieting. It is important to encourage parental involvement and support in providing information about mental health issues among adolescents.

Neural and affective responses to prolonged eye contact with parents in depressed and nondepressed adolescents

Eye contact improves mood, facilitates connectedness, and is assumed to strengthen the parent-child bond. Adolescent depression is linked to difficulties in social interactions, the parent-child bond included. Our goal was to elucidate adolescents' affective and neural responses to prolonged eye contact with one's parent in nondepressed adolescents (HC) and how these responses are affected in depressed adolescents. While in the scanner, 59 nondepressed and 19 depressed adolescents were asked to make eye contact with their parent, an unfamiliar peer, an unfamiliar adult, and themselves by using videos of prolonged direct and averted gaze, as an approximation of eye contact. After each trial, adolescents reported on their mood and feelings of connectedness, and eye movements and BOLD-responses were assessed. In HCs, eye contact boosted mood and feelings of connectedness and increased activity in inferior frontal gyrus (IFG), temporal pole, and superior frontal gyrus. Unlike HCs, eye contact did not boost the mood of depressed adolescents. While HCs reported increased mood and feelings of connectedness to the sight of their parent versus others, depressed adolescents did not. Depressed adolescents exhibited blunted overall IFG activity. These findings show that adolescents are particularly sensitive to eye contact and respond strongly to the sight of their parents. This sensitivity seems to be blunted in depressed adolescents. For clinical purposes, it is important to gain a better understanding of how the responsivity to eye contact in general and with their parents in particular, can be restored in adolescents with depression.

Androgen regulation of behavioral stress responses and the hypothalamic-pituitary-adrenal axis

Testosterone is a powerful steroid hormone that can impact the brain and behavior in various ways, including regulating behavioral and neuroendocrine (hypothalamic-pituitary-adrenal (HPA) axis) stress responses. Early in life androgens can act to alter development of brain regions associated with stress regulation, which ultimately impacts the display of stress responses later in life. Adult circulating androgens can also influence the expression of distinct genes and proteins that regulate stress responses. These changes in the brain are hypothesized to underlie the potent effects of androgens in regulating behaviors related to stress and stress-induced activation of the HPA axis. Androgens can induce alterations in these functions through direct binding to the androgen receptor (AR) or following conversion to estrogens and subsequent binding to estrogen receptors including estrogen receptor alpha (ERα), beta (ERβ), and G protein-coupled estrogen receptor 1 (GPER1). In this review, we focus on the role of androgens in regulating behavioral and neuroendocrine stress responses at different stages of the lifespan and the sex hormone receptors involved in regulating these effects. We also review the specific brain regions and cell phenotypes upon which androgens are proposed to act to regulate stress responses with an emphasis on hypothalamic and extended amygdala subregions. This knowledge of androgen effects on these neural systems is critical for understanding how sex hormones regulate stress responses.

Adherence to physical activity recommendations and associations with self-efficacy among Norwegian adolescents: trends from 2017 to 2021

Background

The crucial role of physical activity (PA) in promoting well-being and overall health of adolescents is widely acknowledged. Previous global studies have consistently revealed low adherence to PA recommendations among adolescents, emphasizing potential links between PA engagement and self-efficacy in school-based populations. However, there is a need for further exploration of this relationship, in particularly gender differences and taking into account the potential influences of the COVID-19 pandemic. The objective of this study is to provide a comprehensive description of adherence to PA recommendations and its associations with self-efficacy in Norwegian school-based adolescents over the period from 2017 to 2021.

Methods

Cross-sectional data on physical activity (PA) levels and self-efficacy among 13-19-year-old Norwegian adolescents were collected from the Norwegian Ungdata Survey during the period 2017 to 2021. The survey, conducted in Norwegian lower- and upper-secondary schools, was administered electronically during school hours. All data collected is anonymous and has received approval from the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were performed using SPSS software.

Results

Girls consistently exhibited lower adherence to PA recommendations (17.6-19.8%) compared to boys (27.7-31.1%) each year from 2017 to 2021 (all p < 0.01). Similarly, girls reported lower self-efficacy (14.1 to 14.8 out of 20) than boys (15.5 to 15.9) during the same period (all p < 0.01). Regression analyses highlighted robust positive associations between PA and self-efficacy in those adhering to PA recommendations (i.e., physically active at least 5 times a week) and strong inverse associations for those reporting inactivity (never active) in both girls and boys from 2017 to 2021.

Conclusion

Adolescents in Norway report PA adherence ranging from 15 to 30%, with girls consistently exhibiting lower adherence to PA recommendations and reporting lower self-efficacy than boys. Notably, there are substantial associations between self-efficacy and both adherence to PA recommendations and inactivity over time. These findings underscore the significance of promoting adherence to PA recommendations during adolescence, especially among girls. Policymakers in Norway should focus on initiatives to increase PA levels among adolescents in both lower and upper secondary schools.

Disentangling associations between pubertal development, healthy activity behaviors, and sex in adolescent social networks

With the onset of puberty, youth begin to choose their social environments and develop health-promoting habits, making it a vital period to study social and biological factors contextually. An important question is how pubertal development and behaviors such as physical activity and sleep may be differentially linked with youths' friendships. Cross-sectional statistical network models that account for interpersonal dependence were used to estimate associations between three measures of pubertal development and youth friendships at two large US schools drawn from the National Longitudinal Study of Adolescent to Adult Health. Whole-network models suggest that friendships are more likely between youth with similar levels of pubertal development, physical activity, and sleep. Sex-stratified models suggest that girls' friendships are more likely given a similar age at menarche. Attention to similar pubertal timing within friendship groups may offer inclusive opportunities for tailored developmental puberty education in ways that reduce stigma and improve health behaviors.

Nonsuicidal Self-Injury and Suicidal Beliefs in Adolescent Inpatient

Background and Objectives: Although nonsuicidal self-injury (NSSI), by definition, excludes suicidal intent, numerous studies show associations between NSSI and suicidal phenomena in clinical and outpatient adolescent samples. Given the growing interest in the relationship between NSSI and suicidal phenomena, the present study aimed to investigate the relationship between NSSI and suicidal beliefs in adolescent psychiatric inpatients. Materials and Methods: The study sample included 50 adolescent inpatients at a specialized facility, with a mean age of 15.44 ± 1.39, who fulfilled DSM-5 criteria for NSSI. For study purposes, we use the Ottawa Self-Injury Inventory (OSI) and Brief Suicide Cognitions Scale (B-SCS). Statistical data processing was performed in the R software 4.3.0 (R Core Team, Vienna, Austria). Results: Of all NSSI functions, the Internal ER function score was the highest (18.72 ± 7.08), followed by External ER (8.10 ± 3.11), Social Influence (5.88 ± 5.37), and Sensation Seeking (3.44 ± 2.98). The mean Craving (C) score was 14.06 ± 7.51. The mean value of the B-SCS score was 19.54 ± 5.24. It was found that the B-SCS score is significantly related to Internal ER (r = 0.441, p < 0.001) and Craving (r = 0.297, p = 0.036). The multivariable model shows that internal ER function and participants' age are significantly related to the B-SCS score. Conclusion: Despite the limitations of the study, it is emphasized that cognitions occurring across the fluid suicidal belief system alone do not fully capture the complexity of suicide, but assessing the suicidal belief system in NSSI inpatient adolescents could nevertheless provide helpful information for identifying individuals who may have an elevated vulnerability to experiencing suicidal ideas and behaviors over time.

Impact of the COVID-19 Pandemic on Swedish Adolescents' Mental Health, Psychosocial Functioning, Risk Behaviours, and Victimisation: Gender Differences and Implications

The COVID-19 pandemic has shown varying effects on adolescents' mental health, psychosocial functioning, risk behaviours, and victimisation. This study aims to examine the changes reported by a sample of Swedish adolescents (N = 1607) at the end of the first year of the pandemic in relation to these factors. Data were collected with an electronic survey between September 2020 and February 2021, targeting upper-secondary high school students (aged 15-19 years). The results indicate a relatively low overall impact of the pandemic on Swedish upper-secondary school students, with notable gender differences. Compared to adolescent women, a higher percentage of adolescent men reported experiencing elevated levels of anxiety, depression, sleep disturbances, anger, and increased illicit drug use as consequences of the pandemic. In contrast, women demonstrated an increase in several salutogenic behaviours. Victimisation rates generally decreased during this period. These findings underscore the importance of heightened awareness among professionals within schools, social services, and healthcare settings regarding the distinct challenges encountered by a larger portion of adolescent men during the COVID-19 pandemic in Sweden.

A daily diary study of discrimination and distress in Mexican-origin adolescents: Testing mediating mechanisms

The present 21-day daily diary study (conducted 2021-2022) tested anger and racism-related vigilance as potential transdiagnostic mediators linking exposure to racial and ethnic discrimination (RED) to distress (negative affect and stress, respectively). The data analytic sample included N = 317 Mexican-origin adolescents (Mage = 13.5 years; 50.8% male, 46.7% female; 2.5% non-binary) from the Midwestern United States. Results from longitudinal mediation models revealed significant mediation effects through anger and racism-related vigilance, respectively, in the association between daily RED and daily distress, both within and across adolescents. Implications for theory, research, and practice are discussed so that future work can leverage these novel findings toward promoting the well-being of Mexican-origin adolescents, especially those who live in contexts of ethnoracial adversity.

Puberty Suppression for Pediatric Gender Dysphoria and the Child's Right to an Open Future

In this essay, we consider the clinical and ethical implications of puberty blockers for pediatric gender dysphoria through the lens of "the child's right to an open future," which refers to rights that children do not have the capacity to exercise as minors, but that must be protected, so they can exercise them in the future as autonomous adults. We contrast the open future principle with the beliefs underpinning the gender affirming care model and discuss implications for consent. We evaluate claims that puberty blockers are reversible, discuss the scientific uncertainty about long-term benefits and harms, summarize international developments, and examine how suicide has been used to frame puberty suppression as a medically necessary, lifesaving treatment. In discussing these issues, we include relevant empirical evidence and raise questions for clinicians and researchers. We conclude that treatment pathways that delay decisions about medical transition until the child has had the chance to grow and mature into an autonomous adulthood would be most consistent with the open future principle.

Understanding the paradox: anhedonia and the unexpected divergence from reward seeking during adolescence - A commentary on Gupta et al. (2024)

Anhedonia is a symptom encompassing reduced or absence of motivation and pleasure that often emerges in adolescence and conveys risk for different mental illnesses and other difficulties. In their review, Gupta, Eckstrand, and Forbes (Journal of Child Psychology and Psychiatry, 2024) present an empirically-based conceptual neurodevelopmental model of anhedonia whereby brain development and pubertal maturation create openness to vulnerability to anhedonia that is influenced by early life adversity and chronic inflammation. This commentary considers anhedonia as a paradox of adolescence given its juxtaposition to the expected developmental milestones of adolescence. It highlights the need to consider anhedonia in terms of both variability and universality of children's experiences and biological development, missed opportunities for social relationships and experiences, and forms and functions of rewards and anhedonia.

The Assessment of Nutritional Status of Adolescents Aged 15-18 Years Using BMI Cutoffs and BMI Z Scores: A Secondary Analysis of National Family Health Survey-5 (2019-21) Data

BACKGROUND

Appropriate assessment of nutritional status of adolescents as a population group is an important area of focus, considering the age of culminating growth, the size of the age group, the changing nutrition patterns, and as a window of opportunity for corrections before adulthood sets in. Nutritional status is now recognized to be a prime indicator of the health of individuals. The World Health Organization (WHO) emphasizes the importance of employing age- and sex-specific reference values (body mass index-for-age Z scores {BAZ} scores) for nutritional assessment in this age group. However, the National Family Health Survey (NFHS), the major source of data in India for the policymakers, reports the nutritional status of adolescents based on adult body mass index (BMI) cutoffs, which might not be as appropriate as compared to body mass index-for-age Z scores (BAZ) scores. Misclassification of nutrition status has impacts on public health policies, intervention programs, and long-term health outcomes for adolescents.

METHODS

This secondary analysis of NFHS-5 data was performed with the objective of estimating the degree of agreement between BMI and BAZ cutoffs in classifying the nutritional status among Indian adolescents. The NFHS-5 data were collected from over 636,000 households across the country. Height and weight were measured for adolescents using standardized instruments. BMI and BAZ scores were derived to assess nutritional status. World Health Organization's classifications were used to categorize nutritional status based on BMI and BAZ scores. The final analysis included data from 109,340 adolescents (13,040 males and 96,300 females) after excluding subjects having BAZ outliers and those whose age was 179 months or less.

RESULTS

Substantial discrepancies emerged between the two methods. BMI classifications underestimated nutritional status in almost 30% of adolescents compared to BAZ. Over one-third of normal-weight individuals by BAZ are classified as thin by BMI. Conversely, nearly 78% of obese adolescents by BMI are classified as overweight by BAZ. The agreements between the classifications improved with age and were better among males.

CONCLUSION

This analysis highlights the limitations of BMI for assessing adolescent nutritional status and suggests that BAZ offers a more accurate and age-appropriate alternative.

Disengagement coping and sleep problems among trauma-exposed adolescents

BACKGROUND

The formation of healthy sleep patterns is a critical component of positive adolescent development. Dysregulated sleep habits can put youth at risk for the development of a multitude of inimical outcomes, particularly among those who are exposed to a traumatic event.

DESIGN AND METHODS

The present study investigated the links between voluntary disengagement coping (e.g., avoidance, denial, wishful thinking) and sleep outcomes among 86 trauma-exposed and non-exposed adolescents between the ages of 12-17 (Mage = 15.44, SD = 1.51; 41.9% female).

RESULTS

The relationship between voluntary disengagement coping and sleep outcomes was significant only among trauma-exposed adolescents, such that greater use of voluntary disengagement strategies was associated with greater sleep disturbances and greater daytime dysfunction.

CONCLUSIONS

Targeting disengagement coping may be an important strategy to improve sleep health among trauma-exposed adolescents. Continued efforts in improving the efficacy of trauma-exposed adolescent intervention strategies are needed.

Momentary effects of life stressors on mindfulness and emotion regulation difficulties among adolescents exposed to chronic stressors

Adolescents faced with chronic stressors (e.g., financial instability, interpersonal violence) are at heightened risk for developing mental health problems, likely due in part to stressors that interfere with effective emotion regulation. Although mindfulness may help to act as a buffer against the deleterious effects of life stressors, a relatively untested assumption is that adolescents can maintain mindfulness during periods of stress. This paper explores this assumption by investigating the real-time, dynamic relationships among life stressors, mindfulness, and emotion regulation difficulties among adolescents exposed to chronic stressors. Eighty-one participants who were 10-18 years old (M = 14.33; SD = 2.20; 56% male; 57% Non-Hispanic White) completed ecological momentary assessments (EMA) three times a day for 7 days and contributed a total of 1186 EMA reports. Multilevel structural equation modelling revealed that the presence (vs. absence) of stressors was associated with lower momentary mindfulness and greater momentary emotion regulation difficulties concurrently and prospectively. Stressors with greater severity were also concurrently, but not prospectively, associated with lower momentary mindfulness and greater momentary emotion regulation difficulties. Findings highlight that exposure to life stressors may degrade momentary mindfulness and emotion regulation. Given that mindfulness and emotion regulation are closely associated with mental health, these results also demonstrate one way that stressors may contribute to health disparities at the micro-level. Going forward, it will be important to investigate methods of helping adolescents learn to maintain mindfulness and adaptive emotion regulation in the face of stressful events. This study was preregistered (NCT04927286).

Prenatal Fluoxetine Exposure Influences Glucocorticoid Receptor-Mediated Activity in the Prefrontal Cortex of Adolescent Rats Exposed to Acute Stress

Any deviation from the programmed processes of brain development may modify its formation and functions, thereby precipitating pathological conditions, which often become manifest in adulthood. Exposure to a challenge during crucial periods of vulnerability, such as adolescence, may reveal molecular changes preceding behavioral outcomes. Based on a previous study showing that prenatal fluoxetine (FLX) leads to the development of an anhedonic-like behavior in adult rats, we aimed to assess whether the same treatment regimen (i.e., fluoxetine during gestation; 15 mg/kg/day) influences the ability to respond to acute restraint stress (ARS) during adolescence. We subjected the rats to a battery of behavioral tests evaluating the development of various phenotypes (cognitive deficit, anhedonia, and anxiety). Furthermore, we carried out molecular analyses in the plasma and prefrontal cortex, a brain region involved in stress response, and whose functions are commonly altered in neuropsychiatric conditions. Our findings confirm that prenatal manipulation did not affect behavior in adolescent rats but impaired the capability to respond properly to ARS. Indeed, we observed changes in several molecular key players of the hypothalamic pituitary adrenal axis, particularly influencing genomic effects mediated by the glucocorticoid receptor. This study highlights that prenatal FLX exposure influences the ability of adolescent male rats to respond to an acute challenge, thereby altering the functionality of the hypothalamic-pituitary-adrenal axis, and indicates that the prenatal manipulation may prime the response to challenging events during this critical period of life.

Annual Research Review: Puberty and the development of anhedonia - considering childhood adversity and inflammation

Anhedonia, or diminished pleasure and motivation, is a symptom of severe mental illness (e.g., depressive disorder, bipolar disorder, schizophrenia) that emerges during adolescence. Anhedonia is a pernicious symptom that is related to social impairments, treatment resistance, and suicide. As the mechanisms of anhedonia are postulated to include the frontostriatal circuitry and the dopamine neuromodulatory system, the development and plasticity of these systems during the vulnerable period of adolescence, as well as their sensitivity to pubertal hormones, suggest that pubertal maturation could play a role in the development of anhedonia. This review takes a developmental perspective, considering the possibility that anhedonia emerges in the context of pubertal maturation and adolescent development, with childhood adversity and chronic inflammation influencing neural reward systems to accelerate anhedonia's progression. Here, we review the relevant extant literature on the components of this model and suggest directions for future research.

Pubertal timing in adolescents with ADHD: extension and replication in an all-female sample

Pubertal timing predicts a miscellany of negative mental and physical health outcomes. Prior work examining pubertal timing in youth with attention-deficit hyperactivity disorder (ADHD) has failed to investigate potential sex specificity of results. Therefore, we aim to extend past findings in a sample of female adolescents with ADHD. We compare pubertal timing (1) between females with and without carefully diagnosed ADHD and (2) between females with ADHD who do vs. do not have a history of stimulant medication use during childhood. We examine 127 adolescent females with childhood-diagnosed ADHD and 82 matched neurotypical peers (Mage: 14.2 years, range: 11.3-18.2) from the Berkeley Girls with ADHD Longitudinal Study (Wave 2). We measured pubertal timing using self-reported Tanner staging and age at menarche. Three strategies compared pubertal timing across groups: (1)χ 2 tests of Tanner Stages, (2) t tests of residuals of pubertal status regressed on age, and (3) t tests of age at menarche. Pubertal timing of girls with and without ADHD did not differ significantly across methods and measures. Yet females with ADHD who had received stimulant medication during childhood menstruated later than those without a stimulant history, potentially related to differences in BMI across groups. On the other hand, no significant differences between medicated vs. non-medicated participants emerged for the two Tanner staging indicators. Our findings extend prior work, suggesting that females with ADHD are developing physically at a similar time as their peers, which parallels findings from previous mixed-sex samples that did not examine effects separately by sex.

Unveiling the silent crisis: global burden of suicide-related deaths among children aged 10-14 years

BACKGROUND

The rise in suicides among children aged 10-14 years demands urgent attention globally. This study aims to assess the global burden of suicide-related deaths in this age group from 1990 to 2019, considering factors such as sex, geography, and sociodemographics, to inform prevention strategies and interventions.

METHODS

The data from Global Burden of Disease 2019, encompassing 204 countries and territories, were analyzed to investigate deaths and years of life lost (YLLs) due to suicide among children aged 10-14 years. Statistical analyses, including mortality rates, YLLs, and the sociodemographic index (SDI), were conducted using standardized tools.

RESULTS

In 2019, a total of 8327 [95% uncertainty interval (UI) = 7073-9685] children aged 10-14 years died globally due to suicide, with a mortality rate of 1.30 (95% UI = 1.10-1.51) per 100,000. The rates varied across countries/territories ranging between 0.05 (95% UI = 0.02-0.10) in South Africa and 7.49 (95% UI = 5.13-10.57) in Greenland. The contribution of suicide-related deaths to all-cause mortality ranged from 0.07% (95% UI = 0.04%-0.15%) in South Africa to 33.02% (95% UI = 24.36%-41.53%) in Greenland. Worldwide, there were approximately 636,196 (95% UI = 540,383-740,009) YLLs due to suicide, with a rate of 99.07 (95% UI = 84.15-115.23) per 100,000. The association between SDI and suicide-related deaths was evident, with higher contributions observed in countries with higher SDI.

CONCLUSIONS

This study reveals a concerning global burden of suicide-related deaths among children aged 10-14 years. Despite progress in reducing mortality rates, suicide remains a significant issue. While overall rates have declined, the percentage of deaths caused by suicide in this age group is increasing.

Age-dependent effects of acute stress on the behavior, blood parameters, immunity, and enteric nerves of mice

The impact of stress on mental and digestive health has been extensively studied, with chronic stress being associated with various disorders. However, age-related differences in the response to acute stress, both behaviorally and physiologically, remain poorly understood. Therefore, this study aimed to develop a model to detect transient stress in mice of different ages. The stressor employed in our experiments was a restraint stress procedure, where mice were subjected to brief periods of immobilization to induce an acute stress response. Male C3H/HeN mice aged 3, 6, 12, and 30 weeks were subjected to acute restrain stress (ARS) by being placed in a 50 ml conical centrifuge tube for 15 min. Subsequently, their behavior, organ tissues, hematological parameters, cortisol concentration, and immune responses were assessed. Following ARS, the increased in time and entries into the center by the 12-week-old mice following stress. In comparison to mice of other ages, those aged 6 weeks demonstrated notable elevations in erythrocytes, platelets, hemoglobin, and hematocrit, all of which were influenced by the time-dependent changes and the recovery process of ARS. Blood corticosterone levels were substantially elevated in all age groups after ARS. Furthermore, ARS induced a notable increase in leukocytes, basophils, residential macrophages, and CD4+ T cells in all age groups except for 3-week-old mice. However, the number of monocyte-derived macrophages and CD8+ T cells did not change significantly. Additionally, mice aged 3 and 6 weeks demonstrated an increase in GFAP+ cells following ARS, whereas NeuN+ cells decreased across all ages. These results suggest that ARS has varying effects on the behavior, cortisol concentration, and quantity of blood cells as well as hepatic immune cells in mice of different ages. These age-dependent responses shed light on the complex interplay between stress and physiological systems and contribute to the broader understanding of stress-related diseases.

Anxiety symptoms and coping strategies among high school students in Vietnam after COVID-19 pandemic: a mixed-method evaluation

Introduction

The objective of the current study was to examine the rate of high school students at risk of anxiety disorder during the COVID-19 pandemic in Vietnam, as well as the coping strategies utilized within this demographic.

Methods

An evaluation was conducted through the utilization of mixed methods, consisting of a combination of a cross-sectional study and in-depth interviews. In this study, a sample of 3,910 students from 13 high schools in Hanoi, Vietnam were selected for participation. The measurement of symptoms of anxiety disorder was conducted through the application of the seven-item General Anxiety Disorder (GAD-7) scale. To comprehend the underlying causes of anxiety and the various coping mechanisms employed, in-depth interviews were conducted.

Results

The findings indicate a prevalence rate of anxiety disorder symptoms among students at 40.6% The prevalence rates of mild, moderate, and severe anxiety symptoms were found to be 23.9%, 10.9%, and 5.8%, respectively. In-depth interviews uncovered multiple sources of anxiety experienced by high school students, namely their academic performance, social interactions, prejudicial attitudes from their social circle, and familial expectations. Numerous coping strategies were then documented.

Discussion

The current investigation ascertained that there exists a moderate level of anxiety amongst high school students in Hanoi, Vietnam during the COVID-19 outbreak. Furthermore, this study configured potential indicators to identify vulnerable individuals and further suggests the development of targeted interventions.

Central role of the habenulo-interpeduncular system in the neurodevelopmental basis of susceptibility and resilience to anxiety in mice

Having experienced stress during sensitive periods of brain development strongly influences how individuals cope with later stress. Some are prone to develop anxiety or depression, while others appear resilient. The as-yet-unknown mechanisms underlying these differences may lie in how genes and environmental stress interact to shape the circuits that control emotions. Here, we investigated the role of the habenulo-interpeduncular system (HIPS), a critical node in reward circuits, in early stress-induced anxiety in mice. We found that habenular and IPN components characterized by the expression of Otx2 are synaptically connected and particularly sensitive to chronic stress (CS) during the peripubertal period. Stress-induced peripubertal activation of this HIPS subcircuit elicits both HIPS hypersensitivity to later stress and susceptibility to develop anxiety. We also show that HIPS silencing through conditional Otx2 knockout counteracts these effects of stress. Together, these results demonstrate that a genetic factor, Otx2, and stress interact during the peripubertal period to shape the stress sensitivity of the HIPS, which is shown to be a key modulator of susceptibility or resilience to develop anxiety.

Nurturing positive mental health and wellbeing in educational settings - the PRICES model

This article presents a comprehensive framework for the implementation of social and emotional learning (SEL) programs as a means of health promotion in educational settings, to positively impact student, school, and adult mental health and wellbeing across education. It emphasizes the profound impact of education on life trajectories and success definitions. Drawing inspiration from the Greek myth of Icarus and Maya Angelou's poem "Still I Rise," it explores contrasting notions of success and their consequences. Schools play a pivotal role in shaping students' wellbeing across multiple dimensions and developmental stages. Because of this, holistic mental health and wellbeing promotion that takes a whole-school approach is critical. The paper introduces the PRICES framework (Preparation and Access, Restoration, Integration, Connection and Community, Educator Support, Strengths-Based Cultivation and Student Voice) as a comprehensive method for implementing SEL programs in educational systems. Each component of the PRICES framework is discussed in detail, emphasizing its role in fostering positive health promotion within schools. Examples of implementation plans that operationalize this model through a co-development process focusing on the Social, Emotional, and Ethical (SEE) Learning program are also presented. The PRICES model encourages a shift towards a more holistic approach to education, nurturing social and emotional development alongside academic achievement. By prioritizing wellbeing, fostering a sense of community, and integrating evidence based SEL interventions, schools can positively impact the mental health and overall flourishing of students and educators, contributing to thriving communities.

Early developmental risks for tobacco addiction: A probabilistic epigenesis framework

Considerable progress has been made in elucidating the relationships between early life psychobiological and environmental risk factors and the development of tobacco addiction. However, a comprehensive understanding of the heterogeneity in tobacco addiction phenotypes requires integrating research findings. The probabilistic epigenesis meta-theory offers a valuable framework for this integration, considering systemic, multilevel, developmental, and evolutionary perspectives. In this paper, we critically review relevant research on early developmental risks associated with tobacco addiction and highlight the integrative heuristic value of the probabilistic epigenesis framework for this research. For this, we propose a four-level systems approach as an initial step towards integration, analyzing complex interactions among different levels of influence. Additionally, we explore a coaction approach to examine key interactions between early risk factors. Moreover, we introduce developmental pathways to understand interindividual differences in tobacco addiction risk during development. This integrative approach holds promise for advancing our understanding of tobacco addiction etiology and informing potentially effective intervention strategies.

Using Virtual Reality Interventions to Promote Social and Emotional Learning for Children and Adolescents: A Systematic Review and Meta-Analysis

This study provides a comprehensive review of the application of virtual reality (VR) in social and emotional learning (SEL) for children and adolescents over the past decade (January 2013-May 2023), with a specific interest in the relations between their technological and instructional design features. A search in Web of Science resulted in 32 relevant articles that were then manually screened. Coding analysis was conducted from four perspectives: participant characteristics, research design, technological features, and instructional design. The analysis provides insights into the VR literature regarding publication trends, target populations, technological features, instructional scenarios, and tasks. To test the effectiveness of VR interventions for promoting SEL, a meta-analysis was also conducted, which revealed an overall medium effect size and significant moderating effects of SEL disorder type and instructional task. Finally, based on the research results, the practical implications of and future research directions for applying VR in SEL were discussed.

A preliminary investigation into cortical structural alterations in adolescents with nonsuicidal self-injury

The structural neural correlates underlying youth nonsuicidal self-injury (NSSI) warrant further exploration. Few studies have explored the association between NSSI and brain structure in adolescence, and no studies have investigated differences in the relation between age and brain structure in youth with NSSI. This preliminary investigation examined associations between NSSI history, age, and cortical structure using magnetic resonance imaging in adolescent girls (N=100, Mage=13.4 years) at increased risk for psychopathology. We conducted whole-brain analyses to investigate the associations between age and cortical structure, NSSI history and cortical structure, and NSSI history as a moderator of the association between age and cortical structure. Results suggested that age was associated with less cortical thickness and surface area in the left and right prefrontal, temporal, and parietal cortex. NSSI history was associated with less left insula and left inferior parietal cortex cortical surface area. Among adolescents with NSSI history, older age predicted greater left inferior parietal cortex surface area and was not associated with left precentral cortex surface area. Among adolescents without NSSI history, older age predicted smaller surface areas as expected with the typical trajectory of neurodevelopment. Overall, our results suggest differences in cortical surface area development in adolescents with NSSI history.

Rural sixth-grade teachers' and students' perceptions of a mindfulness-based mental health curriculum

Introduction

Mindfulness-based interventions (MBIs) have the potential to improve students' mood, behavior and cognitive functioning; yet, little is known about the feasibility and acceptability of adapting such programs for rural middle schools.

Methods

An exploratory qualitative evaluation was conducted to examine the feasibility and acceptability of an initial trial delivery of AttuneEd®, a trauma-informed, mindfulness-based mental health curriculum. In this single-group design study, 10 weekly lessons were taught in a middle school located in a rural town in the pacific northwest during 6th grade students' P.E. classes. Three P.E. teachers, 26 6th grade teachers, and one school counselor attended trainings before and mid-curriculum implementation, where they provided qualitative feedback. A total of 160 students completed acceptability surveys before and after curriculum delivery.

Results

Three themes were identified from qualitative data: cultural considerations, teacher self-efficacy, and barriers and facilitators to student acceptability. Student acceptability ratings were high. Students reported, on average, that the classes helped them better understand themselves and others.

Conclusion

Some identified needs for future MBIs include (1) the need for culturally sensitive, trauma-informed delivery strategies; (2) teachers' desire for more support in content delivery; and (3) students' desire to have their own teachers deliver the curriculum. Findings elucidate the nuances associated with implementing an MBI in a rural middle school and have notable implications for development, scalability, and sustainability.

HIV-Related Shame, Stigma and the Mental Health Functioning of Adolescents Living with HIV: Findings from a Pilot Study in Uganda

This study examined the relationship between HIV-related shame, stigma and the mental health of adolescents (10-14 years) living with HIV in Uganda. Cross sectional data from a 2-year pilot study for adolescents living with HIV (N = 89) were analyzed. Multiple linear regression analyses were conducted to determine the relation between HIV-related shame, as measured by the Shame Questionnaire, stigma, and adolescents' mental health functioning, including depressive symptoms, hopelessness, PTSD symptoms, loneliness and self-concept. The average age was 12.2 years, and 56% of participants were female. HIV-related shame was associated with higher levels of depressive symptoms (p < 0.05), hopelessness (p < 0.001), PTSD symptoms (p < 0.001), loneliness (p < 0.01), and low levels of self-concept (p < 0.01). HIV stigma was not associated with any of the outcomes. Findings support the need for the development of strategies to help adolescents overcome the shame of living with HIV and mitigate the effects of shame on adolescents' mental health and treatment outcomes.

The Emotionally Sensitive Child-Adverse Parenting Experiences-Allostatic (Over)Load (ESCAPE-AL) Model for the Development of Secondary Psychopathic Traits

Understanding and treatment of antisocial behavior have improved through efforts to subtype individuals based on similar risk factors and outcomes. In particular, the presence of psychopathic traits is associated with distinct etiological factors and antisocial behavior that begins early in life, is aggressive, persistent, and less likely to normalize with traditional treatments, relative to individuals low on psychopathy or its childhood precursor, callous-unemotional (CU) traits. However, important distinctions can be made within individuals with CU/psychopathic traits according to the presence of elevated anxiety symptoms and/or adverse childhood experiences, known as secondary psychopathy/CU traits. This paper provides a broad and brief overview of theory and empirical literature supporting the existence of secondary psychopathy/CU variants as a distinct subtype of childhood antisocial behavior. It outlines the Emotionally Sensitive Child-Adverse Parenting Experiences-Allostatic (Over)Load (ESCAPE-AL) model for the developmental psychopathology of secondary psychopathic/CU traits and discusses research and theory supporting this perspective. Future research directions for testing this conceptual model and its implications for assessing and treating high-risk individuals with secondary CU/psychopathic traits are discussed.

Identifying who adolescents prefer as source of information within their social network

Adolescents are highly influenced by their peers within their social networks. This social influence can stem from both unsolicited peer pressure and the active search for guidance. While extensive research examined the mechanisms of peer pressure, little is known about who adolescents prefer as a source of information. To address this gap, we conducted two independent studies using a novel social search paradigm that allows participants to choose which social sources they wish to observe. In both studies, adolescents demonstrated a preference for their friends over non-friends, as well as for peers who were perceived as trustworthy. Across both studies, we found mixed evidence for the role of perceived popularity as a selection criterion. Notable, study 2 revealed the significance of "cool", "admirable" and "acting mean" as additional characteristics of preferred peers, traits that are often associated with elevated peer status. It also revealed an interest for peers perceived as being smart. These findings highlight the active role adolescents have in choosing social sources and emphasize the importance of multiple peer characteristics. Future research should investigate whether adolescents' interest in these types of peers is contingent upon specific social contexts, age groups, and peer cultures.

Striatal correlates of Bayesian beliefs in self-efficacy in adolescents and their relation to mood and autonomy: a pilot study

Major depressive disorder often originates in adolescence and is associated with long-term functional impairment. Mechanistically characterizing this heterogeneous illness could provide important leads for optimizing treatment. Importantly, reward learning is known to be disrupted in depression. In this pilot fMRI study of 21 adolescents (16-20 years), we assessed how reward network disruption impacts specifically on Bayesian belief representations of self-efficacy (SE-B) and their associated uncertainty (SE-U), using a modified instrumental learning task probing activation induced by the opportunity to choose, and an optimal Hierarchical Gaussian Filter computational model. SE-U engaged caudate, nucleus accumbens (NAcc), precuneus, posterior parietal and dorsolateral prefrontal cortex (PFWE < 0.005). Sparse partial least squares analysis identified SE-U striatal activation as associating with one's sense of perceived choice and depressive symptoms, particularly anhedonia and negative feelings about oneself. As Bayesian uncertainty modulates belief flexibility and their capacity to steer future actions, this suggests that these striatal signals may be informative developmentally, longitudinally and in assessing response to treatment.

Corticostriatal connectivity mediates the reciprocal relationship between parent-reported sleep duration and impulsivity in early adolescents

BACKGROUND

Adolescence, a developmental period characterized by significant changes in sleep, is associated with normative increases in impulsivity. While short sleep duration has been linked to elevated impulsivity, the neural mechanism underlying the relationship between short sleep duration and elevated impulsivity remains poorly understood.

METHODS

We analyzed a dataset of 7,884 drug-naive 9-10 year-olds from the Adolescent Brain Cognitive Development (ABCD) study. Among them, 5,166 have two-year follow-up neuroimaging data. Linear mixed-effects models, mediation analyses, and longitudinal mediation analyses were used to investigate the relationship between parent-reported sleep duration, impulsivity, and functional and structural connectivity between the cortex and the striatum.

RESULTS

We found that less sleep duration is significantly associated with higher positive and negative urgency, which are two affect-related components of impulsivity. In addition, we observed a link between short sleep duration and reduced corticostriatal connectivity. Neural pathways associated with short sleep duration-functional connectivity between the cingulo-opercular network and the left caudate, and between the cingulo-parietal network and the right pallidum-mediated the association between sleep duration and positive urgency both at baseline and two-year follow-up. Longitudinal mediation analyses further revealed that short sleep duration and elevated positive urgency exacerbated each other through these two corticostriatal connectivities.

CONCLUSIONS

These findings highlight the key role of corticostriatal connectivities in the reciprocal relationship between short sleep duration and elevated impulsivity. Given the increasing prevalence of short sleep duration in adolescents, the link between sleep duration, impulsivity, and corticostriatal connectivities has important implications for timely interventions to address impulsive problems in early adolescents.

Identifying the midline thalamus in humans in vivo

The midline thalamus is critical for flexible cognition, memory, and stress regulation in humans and its dysfunction is associated with several neurological and psychiatric disorders, including Alzheimer's disease, schizophrenia, and depression. Despite the pervasive role of the midline thalamus in cognition and disease, there is a limited understanding of its function in humans, likely due to the absence of a rigorous noninvasive neuroimaging methodology to identify its location. Here, we introduce a new method for identifying the midline thalamus in vivo using probabilistic tractography and k-means clustering with diffusion weighted imaging data. This approach clusters thalamic voxels based on data-driven cortical and subcortical connectivity profiles and then segments the midline thalamus according to anatomical connectivity tracer studies in rodents and macaques. Results from two different diffusion weighted imaging sets, including adult data (22-35 years) from the Human Connectome Project (n = 127) and adolescent data (9-14 years) collected at Florida International University (n = 34) showed that this approach reliably classifies midline thalamic clusters. As expected, these clusters were most evident along the dorsal/ventral extent of the third ventricle and were primarily connected to the agranular medial prefrontal cortex (e.g., anterior cingulate cortex), nucleus accumbens, and medial temporal lobe regions. The midline thalamus was then bisected based on a human brain atlas into a dorsal midline thalamic cluster (paraventricular and paratenial nuclei) and a ventral midline thalamic cluster (rhomboid and reuniens nuclei). This anatomical connectivity-based identification of the midline thalamus offers the opportunity for necessary investigation of this region in vivo in the human brain and how it relates to cognitive functions in humans, and to psychiatric and neurological disorders.

Sexual differentiation of neural mechanisms of stress sensitivity during puberty

Anxiety disorders are a major public health concern and current treatments are inadequate for many individuals. Anxiety is more common in women than men and this difference arises during puberty. Sex differences in physiological stress responses may contribute to this variability. During puberty, gonadal hormones shape brain structure and function, but the extent to which these changes affect stress sensitivity is unknown. We examined how pubertal androgens shape behavioral and neural responses to social stress in California mice (Peromyscus californicus), a model species for studying sex differences in stress responses. In adults, social defeat reduces social approach and increases social vigilance in females but not males. We show this sex difference is absent in juveniles, and that prepubertal castration sensitizes adult males to social defeat. Adult gonadectomy does not alter behavioral responses to defeat, indicating that gonadal hormones act during puberty to program behavioral responses to stress in adulthood. Calcium imaging in the medioventral bed nucleus of the stria terminalis (BNST) showed that social threats increased neural activity and that prepubertal castration generalized these responses to less threatening social contexts. These results support recent hypotheses that the BNST responds to immediate threats. Prepubertal treatment with the nonaromatizable androgen dihydrotestosterone acts in males and females to reduce the effects of defeat on social approach and vigilance in adults. These data indicate that activation of androgen receptors during puberty is critical for programming behavioral responses to stress in adulthood.

The role of sex and drug use during adolescence in determining the risk for adverse consequences of amphetamines

Use of amphetamines during adolescence, a critical period of brain development and reorganization, may lead to particularly adverse outcomes that are long-lasting. Similarly, female users may be uniquely vulnerable to certain aspects of drug use. A recognition of the role of use during adolescence and sex on outcomes of amphetamine and methamphetamine exposure are of critical importance in understanding and treating substance use disorders. This chapter highlights what human research, which has been largely epidemiological, suggests about sex and age differences in drug use patterns and outcomes. We also discuss work in laboratory animals that has typically utilized rats or mice exposed to drugs in a non-contingent manner (i.e., involuntarily) or through volitional self-administration. Lastly, we draw attention to the fact that advancing our understanding of the effects of amphetamine and methamphetamine use, the development of problematic drug taking, and the mechanisms that contribute to relapse will require an emphasis on inclusion of age and sex as moderating factors in future studies.

Associations between parental depression and anxiety symptom severity and their Offspring's cortical thickness and subcortical volume

Depression and anxiety are associated with grey matter changes in subcortical regions in adults and adolescents. Parent psychopathology is associated with offspring brain structure, but it's unclear whether altered brain structure in children is associated with severity of parental depression and anxiety symptoms. We examined 123 youth (Mean age = 13.64; 62% female) with no clinically significant history of depression or anxiety and one parent diagnosed with current or past depressive or anxiety disorders. Parents completed the Mini International Neuropsychiatric Interview to assess diagnostic status and the Beck Depression Inventory-II, and the Generalized Anxiety Disorder-7 to assess current symptom severity. Youth underwent T1 weighted structural Magnetic Resonance Imaging scans. Bivariate analyses revealed higher parental depressive severity was not significantly associated with offspring grey matter. Parental anxiety severity was significantly associated with less left global surface area. When controlling for offspring age, sex and intracranial volume (ICV), offspring right surface area was negatively associated with parental depressive severity at a trend level. In previously depressed parents, greater parental depressive severity was significantly associated with offspring decreased left and right surface area. There were no significant associations between parental anxiety severity in previously depressed parents and offspring subcortical or cortical brain regions. These results highlight associations between parental depressive symptom severity and offspring brain structure and suggest that even within an already high-risk group of adolescents, there may be altered cortical surface area depending on parent symptom severity. This may help identify youth most at risk for developing a mood disorder and could help further early intervention and identification efforts.

Risk-related brain activation is linked to longitudinal changes in adolescent health risk behaviors

Middle adolescence is the period of development during which youth begin to engage in health risk behaviors such as delinquent behavior and substance use. A promising mechanism for guiding adolescents away from risky choices is the extent to which adolescents are sensitive to the likelihood of receiving valued outcomes. Few studies have examined longitudinal change in adolescent risky decision making and its neural correlates. To this end, the present longitudinal three-wave study (Nw1 = 157, Mw1= 13.50 years; Nw2 = 148, Mw2= 14.52 years; Nw3 = 143, Mw3= 15.55 years) investigated the ontogeny of mid-adolescent behavioral and neural risk sensitivity, and their baseline relations to longitudinal self-reported health risk behaviors. Results showed that adolescents became more sensitive to risk both in behavior and the brain during middle adolescence. Across three years, we observed lower risk-taking and greater risk-related activation in the bilateral insular cortex. When examining how baseline levels of risk sensitivity were related to longitudinal changes in real-life health risk behaviors, we found that Wave 1 insular activity was related to increases in self-reported health risk behaviors over the three years. This research highlights the normative maturation of risk-related processes at the behavioral and neural levels during mid-adolescence.

Efficiency of Heterogenous Functional Connectomes Explains Variance in Callous-Unemotional Traits After Computational Lesioning of Cortical Midline and Salience Regions

Introduction: Callous-unemotional (CU) traits are a youth antisocial phenotype hypothesized to be a result of differences in the integration of multiple brain systems. However, mechanistic insights into these brain systems are a continued challenge. Where prior work describes activation and connectivity, new mechanistic insights into the brain's functional connectome can be derived by removing nodes and quantifying changes in network properties (hereafter referred to as computational lesioning) to characterize connectome resilience and vulnerability. Methods: Here, we study the resilience of connectome integration in CU traits by estimating changes in efficiency after computationally lesioning individual-level connectomes. From resting-state data of 86 participants (48% female, age 14.52 ± 1.31) drawn from the Nathan Kline institute's Rockland study, individual-level connectomes were estimated using graphical lasso. Computational lesioning was conducted both sequentially and by targeting global and local hubs. Elastic net regression was applied to determine how these changes explained variance in CU traits. Follow-up analyses characterized modeled node hubs, examined moderation, determined impact of targeting, and decoded the brain mask by comparing regions to meta-analytic maps. Results: Elastic net regression revealed that computational lesioning of 23 nodes, network modularity, and Tanner stage explained variance in CU traits. Hub assignment of selected hubs differed at higher CU traits. No evidence for moderation between simulated lesioning and CU traits was found. Targeting global hubs increased efficiency and targeting local hubs had no effect at higher CU traits. Identified brain mask meta-analytically associated with more emotion and cognitive terms. Although reliable patterns were found across participants, adolescent brains were heterogeneous even for those with a similar CU traits score. Conclusion: Adolescent brain response to simulated lesioning revealed a pattern of connectome resiliency and vulnerability that explains variance in CU traits, which can aid prediction of youth at greater risk for higher CU traits.